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Haiti: MSF expands post-operative care

Published 03 March 2010

 

Seven weeks after the earthquake of January 12 left up to 300,000 people injured in Haiti, medical needs remain immense. “The immediate emergency phase may be over, but the long-term work is just beginning, and it’s no less an emergency,” said Médecins Sans Frontières head of mission in Haiti, Karline Kleijer.

Thousands of injured people remain in need of long-term care but some of the health providers that responded to the initial emergency phase of the crisis are starting to discharge their patients and leave the country. In recent days, public hospitals and medical teams preparing to depart have referred more than 200 patients to MSF medical facilities.

In response to this and the overall medical dynamic in the country, MSF is expanding its capacity to deliver extensive post-operative services — including secondary surgeries, medical follow-up, physical therapy, and mental healthcare — for at least the next several months. MSF will soon open additional post-operative facilities in Port-au-Prince, Carrefour, Léogâne, and Jacmel. These facilities will have a total of approximately 1,000 beds and will operate for at least one year.

 Every day, post-operative patients need a range of services: bandage and dressing changes, cast removals, wound cleaning, removal of dead tissue, external fixator adjustments, x-ray monitoring of fractures, skin graft monitoring, and reconstructive and other specialized surgery. “Emergency surgery is one thing, but lack of or inefficient post-operative care will result in long-term hospitalization or even in life-long physical disabilities,” declared Dr. Nico Heijenberg.

In many cases, patients who endured weeks of immobilization as a result of traction, casts, external fixators, and amputation, are just beginning to regain mobility through physiotherapy. People who had limbs amputated may require additional procedures to ensure that they can eventually accept artificial limbs. “Returning patients home in their current medical and living conditions is simply not an option for us,” said Dr. Michel Janssens, director of the MSF hospital in the St. Louis neighborhood of Port-au-Prince. The hospital, which was established on what was a soccer field, will remain on-site and operable for at least one year.

Survivors of the earthquake are often very anxious about their future. "I was an electrician, and who's going to hire a disabled person?” asked Ricardo, a 33-year-old father who suffered severe burns to his hands in the earthquake. “How will I find work to support my family?” Because so many Haitians endured such a  profound trauma and are now dealing with great uncertainty, MSF is also offering mental health services throughout the capital and in other locations as well. Psychological monitoring and counselling are critical elements of postoperative care, as vital to the recovery and rehabilitation process as physiotherapy and learning how to use crutches.

 

MSF has worked in Haiti since 1991. In the aftermath of the catastrophic earthquake that ravaged the country on Jan 12 2010, MSF teams were highly active in supplying immediate medical aid, including emergency surgery.  Seven weeks later, the situation continues to evolve: post-operative care, mental health support, and the improvement of living conditions are now a priority.

 

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