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Haiti: Emerging trends in patient care

Published 04 February 2010

One of the emerging trends in Médecins Sans Frontières’ (MSF) medical work in Haiti is the return to care for common illnesses and conditions amongst people coming to the hospitals and clinics. The gaps in the country's healthcare provision before the earthquake meant that MSF's emergency facilities were always busy. The disruption of so much of the most basic medical care means that alongside the continuing care for injuries from the quake there is also an influx of every kind of patient.

© William Daniels - Port-au-Prince, Haiti - January 28, 2010 - MSF Chancerelle hospital maternity in PAP. Seventeen-year-old Dodeline Luis gave birth to Wolf at Isaie Jeanty, one of the hospitals supported by MSF in Port-au-Prince.

In Port-au-Prince's Martissant hospital there are more and more children coming with illnesses like diarrhea or respiratory tract infections. In Léogâne, the increasing reach of MSF's mobile clinics now touches 350 patients a day, many of them now for those more ‘normal’ consultations. In Chancerelle hospital, back in the capital, there has been a big increase in the number of maternity and obstetrics cases. The team there transformed a small stock room into an additional maternity room, increasing the number of beds from 18 to 40. An average of 12 children each day are born there. Part of the explanation for the increase seems to be that more people in the city are becoming aware that this is a functioning specialist centre.  

Earthquake-related psychological trauma continues to appear in MSF consultations. In mobile clinics in Léogâne and Port-au-Prince, around 20 percent of the patients looking for help are suffering from mental health problems. The classic symptoms are anxiety, despair, sleep disruption and even anger. Depending on the culture of the people involved, there may be physical symptoms which derive from repression of these emotions. In Haiti, there is relatively little stigma associated with these feelings and so MSF's psychologists and psychiatrists there report that physical signs are limited to headaches and lack of appetite.

  The earliest mental health work was with amputees and the more general provision of care for post-operative cases is still very much a priority in Haiti because of an overall shortage of beds for this longer-term care. MSF moved the first 20 patients from the St. Louis inflatable hospital to the post-operative ‘tent village’ at nearby Delmas 30. While the Bicentenaire hospital now has 60 beds ready. A special treatment room for tetanus patients is also being created there to provide the intensive care necessary for this dangerous illness.

  Living conditions for people who lost their homes and are now in camps under makeshift shelter are particularly difficult. The need for water and sanitation is one of their most pressing needs. The latest MSF contributions here are a plan to supply the 7,000 people living in the camps near the St. Louis Hospital. While another team has identified between 20 and 30 sites in the city where they will provide water trucking and latrines. In total, MSF is improving access to water and sanitation for around 40,000 displaced people in the Port-au-Prince and Léôgane areas. Distribution of household necessities, like blankets and jerrycans, has been done or is planned for around 7,000 families. 

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