Haiti's recovery won't be easy, but a local doctor says: 'If we have the support, we can do it'
Dr. Jean William Pape is co-ordinating with medical officials near the epicentre of the deadly earthquake
A Haitian doctor says it will be a long road to recovery for his country, but there's still hope.
Bodies are still being pulled from the rubble, and injured people are still trickling into overwhelmed hospitals five days after a massive earthquake struck the Caribbean country's southwestern region. At least 1,941 have been killed and 9,900 injured, Haiti's Civil Protection Agency estimated on Wednesday.
Dr. Jean William Pape is the executive director of GHESKIO, a Haitian community-based medical, research and training centre. He has been co-ordinating with medical officials on the ground at the Immaculée Conception hospital in Les Cayes, near the epicentre of the quake.
He spoke to As It Happens guest host Helen Mann from the capital city of Port-au-Prince. Here is part of their conversation.
What are [your colleagues in Les Cayes] telling you about the cases that they're seeing and how they're able to cope with them?
During the first two days … they were totally overwhelmed. But since then, surgical and medical staff with national and international [agencies] have arrived and the situation is much better.
What kind of injuries are people arriving with?
They have multiple fractures. They have broken bones. They have abdominal injuries. So those are the people that are seen in the hospital. They've seen over 600 patients. A dozen have been transferred to Port- au-Prince because these were complicated cases.
What about the medical infrastructure itself? How much is still standing and functioning?
At lot have been destroyed ... including in locations in Saint-Louis-du-Sud [and] Cavaillon.
Now we are setting up a 100-bed mobile hospital. That could be really a part of the solution, and could be moved to the most needed areas.
What you need to understand is that there are a lot of rural areas that have not been completely reached, and it's possible that we have people there who are badly wounded. And in some cases, they are still able to get people out of the rubble.
The major problem we have now are the aftershocks. Just about two hours ago, we had one. But there have been over 500 aftershocks after the quake. So this has created many, many problems, because people are in and out of buildings.
Many of those buildings are damaged, if not destroyed. But the [storm] that we had, that fortunately just passed, brought flooding, but also a lot of rain. So many of those people had to go inside dangerous homes because of the rain. But, fortunately, now they are outside. So most of the people being treated at the hospital are outside.
The hospital has released 40 per cent of those people. The problem is that many of them do not have a home to stay [in]. We lived through this in Port-Au-Prince during the 2010 earthquake, and that is a problem that's going to be constant before we hit the more chronic problems.
So as you release people from hospital, they don't necessarily have anywhere to go. Can you tell us about the relief effort on the ground in these places, though, in terms of trying to establish temporary facilities?
They are trying to put up temporary shelters with tents, providing food. Food for the poor has been very, very helpful. Potable water. Those are the three most important things that you need early on.
You also need to establish in the camps — because you're going to have miserable camps, as we've lived through that in 2010 — some kind of order.
You need to establish a group that's going to lead the camp, and you need to make sure that you have women among them, because that will protect women from rape. And you need also to put solar poles so that there is electricity at all times. You need to give women the whistles so that if [someone is] attacking them, they can alert other people to that.
So we know what to do to prevent this kind of setting. What we need now is the support to do that.
What is it like for your fellow doctors and for nurses and other health-care workers working in those conditions and seeing all of this?
It is tough. Morale is low, and many people will need psychological support. But the best support that any medical person can have is to see their patients getting better, and their patients getting better care, and getting what we call global health ... [which means] that those people are eating properly, that they are able to receive decent potable water, that they are secure, and that they don't have a reason for epidemics.
We understand that after the 2010 quake around Port-Au-Prince, a lot of procedures were improved in terms of building structure, in terms of medical facilities, to respond to crises like this. But as you point out, more remote areas like Les Cayes are still dealing with pretty basic conditions. What will the roadmap to recovery look like for these areas?
It's going to be long and complex. You know, we went through multiple disasters. We had the 2010 earthquake. We had the cholera epidemic the first year. Now, the good news most people don't talk about is the fact that cholera is almost eradicated in Haiti. We've not had one single case in two years. The dangerous part for us is that it could start again. And that's a concern. We also had Hurricane Matthew in 2016 that … devastated … the same region. And now we have this major quake.
It is the political situation that is complicated. The economic situation is a disaster. We have a security situation with the gangs. And then we need to provide health care and avoid epidemics.
There's a long road to rehabilitation of patients. So you can see that it's going to take some time. But at least we have the know-how. If we have the support, we can do it.
What do you still need in the coming days, weeks and months from international donors and aid groups to get you through this?
We need to … properly [take care] of the various fractures, but we need orthopaedic support to do that. That's no. 1. No. 2, infection is a major concern, both pre-surgery and post-surgery. So particularly for people who have been under the rubble, they are likely to lose a limb because it's infected.
Those are the acute situations. We also need rehabilitation for the people who were amputated, for the people who had other serious surgeries.
But the most serious problem, and where we could lose more people, is to make sure that we do not have epidemics. Whenever you have a large number of people gathering together, you need to make sure that the COVID epidemic doesn't expand, the cholera doesn't get started, that you don't have an epidemic of typhoid fever or tuberculosis [or] AIDS. Those are all major concerns, but we know how to prevent them. Obviously, you need to provide shelter for those people, as well as food and water, electricity, and eventually to put them in homes that are secure.
This is a long process. It took a long time after the 2010 earthquake. We're still not recovered. Downtown, where I'm talking to you from, has not been rebuilt.
Written by Sheena Goodyear with files from The Associated Press. Interview produced by Niza Lyapa Nondo. Q&A has been edited for length and clarity.