Report from Haiti

PARISIEN, Haiti — Nearly a month after a massive earthquake devastated
Haiti, paramedic Anthony Croese looked into the crowd outside a
destroyed orphanage near Port-au-Prince and spotted an emaciated baby
cradled in his father’s arms.

The baby looked far too tiny for his eight months of life, and a
short conversation explained why. His mother died in the Jan. 12 quake,
and his father, Emilio Eliassaint, in the weeks since had been feeding
him sugar water, devoid of the nutrients in mother’s milk.

Croese, who feared the baby wouldn’t survive long on such a diet,
bundled him into a car and sent him to a field hospital that has sprung
up amid the thorny trees and dried grass at Fond Parisien, near the
border with the Dominican Republic.

There, the baby began a diet of formula, eating ravenously, to the relief of workers.

Sandwiched between mountains and a large lake, the site has become
an oasis of medical care and hope in this still-reeling nation, where
many thousands died and many more have been injured. The field hospital
was willed into existence by two Harvard faculty members and researchers from the Harvard Humanitarian Initiative (HHI),
an interfaculty program designed to harness expertise across Harvard’s
Schools to understand and improve the response to disasters, both
natural and man-made.

The hospital was started less than a week after the earthquake by Hilarie Cranmer and Stephanie Rosborough, both HHI researchers, emergency medicine doctors at Harvard-affiliated Brigham and Women’s Hospital, and faculty members at Harvard Medical School (HMS).

When the two first arrived, 25 patients already were huddled under
sparse trees. The patients, some of whom still had open wounds and
exposed bones, had gathered at the site, which contains an orphanage,
church, and school run by the nonprofit group Love A Child Inc. Despite
the exhortations of the group’s founder, the patients refused to go
into a nearby church, where they had been resting the night before when
a large aftershock struck.

Rosborough and Cranmer, who is also an assistant professor at the Harvard School of Public Health
(HSPH), immediately set to work. Drawing on training and extensive
field experience in disaster settings, they secured tents, generators,
toilets, food, medical supplies, and volunteers. Power and plumbing
arrived in the form of the Rescue Task Force, which showed up one day
and offered assistance that Cranmer gratefully accepted.

Drawing on an extensive network of Harvard affiliates, former
students, and colleagues in the disaster relief field, HHI marshaled an
array of volunteers, including doctors, nurses, pharmacists, and
Haitian staff.

The result is an HHI-led field hospital that has about 200 patients
and also runs outreach operations that provide vaccinations and other
care for smaller area clinics. It collaborates with other
organizations, including Love A Child (whose compound and permanent
buildings provide the facility’s structural backbone), the University
of Chicago, and the governments of the Dominican Republic and Haiti.
Though those groups have the major organizing role, the volunteers
providing care hail from institutions around the world. In addition to
the field hospital, there is a nearby displaced-persons camp run by the
American Refugee Committee, where some patients go after finishing
treatment.

The hospital focuses on rehabilitation, taking in patients from
other hospitals, including the giant U.S. naval hospital ship Comfort moored
off Port-au-Prince, the devastated Haitian capital. These patients’
broken bones, crushed limbs, and other injuries have received initial
care but require additional treatment, whether it’s for handling
follow-up care or complications such as new infections.

With physical therapists as part of the volunteer corps, the
hospital not only continues the bodily repair begun after the quake,
but also begins the long, slow recovery process.

HHI Director Michael VanRooyen
applauded the efforts of all involved, particularly the guiding hands
of Cranmer and Rosborough. To get the hospital up and running so
quickly required putting into practice many of the principles taught by
HHI, which not only conducts research, but which also runs courses in
disaster relief, including a weekend-long simulated disaster workshop
in New England’s forests.

VanRooyen, who is also an emergency medicine specialist at BHW and an associate professor at both HMS
and HSPH, has begun the process of
formalizing arrangements and collaborations that, of necessity, have
been ad hoc until now. Last weekend VanRooyen was in Haiti for
whirlwind meetings with officials from the Haitian and Dominican
governments, the U.S. Agency for International Development, Love A
Child, and representatives of the relief and nonprofit agencies that
are lending a hand. He hopes to establish a sturdy administrative
structure and secure support that will allow the field hospital to
complete care of its patients and slowly transition them back to local
health providers, a process that could take six months to a year.

Key needs, VanRooyen said, include gaining enough funds to keep the
operation running, and partnering with other nongovernment
organizations. The work so far has been financed by a combination of
in-kind contributions from volunteers and relief organizations, HHI
funds, and even personal funds from those involved. Gaining permanent
funding may well determine the ultimate success of the effort,
VanRooyen said.