Médecins Sans Frontières (MSF) wards and operating theatres in and around Port-au-Prince are still working through very heavy caseloads and the medical staff there are increasingly concerned about supply problems that are beginning to threaten the welfare of patients. Drugs for surgical care and equipment like dialysis machines are urgently needed but access problems for cargo shipments are causing delays in delivery.

Loris De Filippi, the coordinator for MSF's work in Choscal hospital in Cité Soleil says the situation there and at other locations is a problem. "It's the most difficult part of our job. Every time we go out of the operating theatre we see faces imploring us for treatment. And they are begging us there in front of the hospital. It's a very unacceptable situation. What we are trying to do is to expand our capacity to answer these calls. But we need supplies to get to the airport – and we don't know why the planes are being re-directed."

In Carrefour Hospital, where again the medical staff are facing very difficult conditions, Paul McMaster, a surgeon, says the needs are all too obvious. "We've not been able to get the equipment we need in the hospital because of these delivery problems. We're running out. On Saturday we didn't have one of our anesthetics. We've run out of plaster of paris for fractures and we've no crepe bandages at the moment. So it's just a nightmare to get these basic materials."

In another of MSF's hospitals, Martissant, where more than 1,500 patients have received treatment since the earthquake, there are 120 people in the hospital itself, 20 of them burns cases. And MSF now has six other locations where it is dealing with a similar variety of quake injuries. One of the most recently established facilities is in the dialysis ward of the large General Hospital in the city, where MSF is working with a machine that survived the quake. MSF's nephrology team carried out its first treatment yesterday and will be expanding their work when new dialysis machines arrive by road from Dominican Republic.

One of the hardest hit towns outside the main city, Léogâne, is also a new centre for MSF's work. A team is supporting a nursing school there where the staff were providing basic care. In the same town, another team is preparing four surgical wards in what was a missionary hospital to create a reference centre for the region. In Jacmel, another heavily hit town, an MSF team has started performing surgery in the hospital's operating theatre. At the same time, work has begun assembling MSF's inflatable hospital, which provides two operating theatres, in Port-au-Prince itself. The material and staff were severely delayed when a cargo flight was diverted to Dominican Republic.

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