Update from the Kidney Community Emergency Response Coalition (KCERC): Response to Earthquake in Haiti

Through its Acute Kidney Injury (AKI) and Dialysis Advisory Groups, the American Society
of Nephrology (ASN) is monitoring the situation in Haiti. ASN has also established contact with other kidney-related organizations, including the International Society of Nephrology, the Kidney Community Emergency Response (KCER) Coalition and the Florida ESRD Network, the National Kidney Foundation, the Sociedad Latino-Americana de Nefrologiae Hipertension, dialysis providers, and industry as well as the U.S. Departments of State and Health and Human Services.

United Nations Office for the Coordination of Humanitarian Affairs (OCHA) Situation Report (1-17-10)

On 12 January, a powerful earthquake of 7.0 magnitude (USGS) on the Richter Scale affected Haiti , at16.53hrs local time (GMT 21.53hrs). The earthquake happened 17km southwest of Port-au-Prince, the capital of Haiti. Aftershocks measured 5.9 and 5.5 respectively in the first hours after the quake and continue to occur. The capital of Haiti, Port-au-Prince, has been severely affected including critical city infrastructure components such as, electricity, water and phone services. Tens of thousands of people affected by the earthquake are now living on the streets and in makeshift camps in open public spaces throughout Port-au-Prince. The death toll is unknown but is expected to be high.

Priorities

Priorities for assistance continue to be search and rescue, medical services, shelter, food and water. IOM estimates that 200,000 families(up to one million people) are in need of immediate shelter and non-food assistance. Major health concerns include untreated trauma wounds and infection of wounds. The Government has said that its priorities are currently to evacuate survivors out of Port-au-Prince, create a more complete overview of incoming humanitarian assistance and address the fuel situation through re-establishing the port. It also plans on increasing the number of distribution sites.

Sea Port

The port remains unusable; incoming vessels are being re-directed to Cap-Haitien.

Airport

The Port-au-Prince airport is heavily congested. All information about incoming flights should be sent to haiti.cargo@logscluster.org or haiti@logscluster.org. For the coming 48 hours, there are no available storage facilities at the airport. The Logistics Cluster recommends that Santo Domingo is used as the primary entry point for humanitarian relief destined for Haiti, while Port-au-Prince airport is operating at diminished capacity.

Logistics / Commodity Distribution

Distribution of aid is taking place but access to shelter, sanitation, water, food and medical
care remains extremely limited. Thousands of people remain in makeshift camps where the sanitation situation is precarious. The availability of food in markets is limited and extremely expensive. Medical facilities in Port-au-Prince still lack staff and medicine. Four distribution sites will be established at Petionville Club, two soccer fields in Delmas, and on Place Dessaline on Champ de Mars. Tents and shelter material will be required for temporary shelter sites in the coming week. At least 20,000 tents will be needed with only 3-4,000 tents already in country.

Fuel

The fuel situation countrywide is becoming more and more critical. Fuel restrictions are now in place. The price for fuel has increased to the equivalent of $10 per gallon. The Logistics Cluster reports that 10,000 gallons would be brought in from Santo Domingo by truck on January 17. The national telecommunications system has been partly restored but without access to fuel, the mobile network will be cut off within days, which will have serious implications for the humanitarian operation.

Transport between Dominican Republic and Haiti

The road from Santo Domingo to Port-au-Prince is congested with transit time running up to 18 hours. UN officials confirmed that convoys are now being sent from Jimani to Port-au-Prince, coordinated and escorted by Dominican Civil Defense and MINUSTAH. The Logistics Cluster has made a request to the Government of the Dominican Republic for approval to establish a major humanitarian hub in Barahona as an alternate for channeling humanitarian relief cargo from Santo Domingo to Haiti. The United Nations Humanitarian Air Service (UNHAS) started passenger flights plus small cargo (subject to available space) today from Santo Domingo to Port-au-Prince and back, to support the humanitarian community (UN agencies, international organizations, donor community and NGOs). UNHAS will begin booking passengers on flights from Santo Domingo to Port-au-Prince starting on January 20. Flights for January 17 and 18 will cover passengers on the existing waiting list. For booking flights from Port-au-Prince to Santo Domingo, partners should contact the WFP focal point in Haiti, Mr. Andrew Stanhope tanho.stanhope@wfp.org, mobile +503 78615152. Two UNHAS Mi*171 helicopters are being positioned and are expected to be operational from January25.

Hospitals / Field Hospitals

According to the Office of the Resident Coordinator in the Dominican Republic, hospitals in the border region are overwhelmed and have begun to refer patients to hospitals in other cities. The Dominican Red Cross and the Universidad Autónoma de Santo Domingo are setting up a field hospital in Jimani. There is a shortage of specialized medical supplies, equipment, and physicians at these hospitals, and no clear inventory of what is needed. An effective waste management system is required for the border region in order to avoid disease and contamination of rivers.

Health

*The lead agencies for health are designated as WHO and PAHO.* The Government announced that efforts will focus on the following interventions across the affected area: increasing basic medical assistance to affected populations on-site; strengthening capacity of the remaining primary care facilities which are still able to function through provision of equipment, supplies and medical staff; and strengthening capacity of the hospital and surgical facilities. Safety assessment by structural engineers of all medical facilities in affected areas is planned for the coming days. The Health Cluster (21 organizations lead by WHO) report that seven field hospitals have arrived and three are fully operational. An additional 11 medical teams are expected to arrive. The cluster is planning on undertaking a structural assessment
of hospitals to evaluate operational capacity. Handling of dead bodies remains an issue. Refrigerated containers have been requested by the cluster. A shipment of around 40 tons of ICRC medical supplies, sent from Geneva, is expected to arrive in Port-au-Prince on January 17 evening. It will arrive by truck from the Dominican Republic. The ICRC, with the support of the Haitian Red Cross, has supplied medical kits to treat 2,000 patients for a month to two Port-au-Prince referral hospitals. Hundreds of blankets and plastic sheets have also been distributed. The first of three basic health care emergency response units (ERUs) arrived on January 16. The ERU is designed to provide basic and immediate health care to 30,000 people.

Pan American Health Organization (PAHO) Situation Report #5 (1-17-10)

Five days after the event a comprehensive assessment of the damages is underway but not yet completed. Inter-Agency health assessment teams have started to systematically visit existing hospitals and report to the Health Cluster meetings held daily. PAHO/WHO is coordinating the health sector response from operation bases in Port-au-Prince and Santo Domingo, Dominican Republic. An operations center is also being setup in Jimaní along the Haiti Dominican Republic border.

Hospitals

Due to widespread population displacement of from the capital to outlying areas, hospitals in towns such as Gonaive and San Marc as well as Jimaní are overwhelmed. An engineer from UNOPS is currently assessing the HUEH University Hospital in Haiti. The maternity, medical ward and dermatology are intact, but the surgical ward is damaged and cannot be used.

Emergency medical care continues to be provided outdoors at the Hospital San Francois de Sales. Haitian medical teams are being assisted by teams from Dominican Republic.

There is concern about the influx of injured and other displaced persons to the Dominican Republic and the north of Haiti, mainly Saint Marc. Injured persons are seeking health services in health centers on the border towns of the Dominican Republic. In recent days, the 20 bed hospital in Jimaní saw 2000 people, and conducted 200major surgeries. Patients that cannot be treated are being sent/airlifted to Santo Domingo.

The Hospital General Melenciano in Jimaní has received 18 patients. The Hospital Buen Samaritano has received 200 patients and set up four surgical rooms. Medical staff from Puerto Rico are assisting these efforts.

Field Hospitals

Israel has set up a mobile field hospital that is now serving 60 patients. This facility has been requested to serve as a referral hospital for severely injured patients. It is fully operational.

A Russian hospital is operational and new field hospitals will be arriving from Turkey, France, MSF, Indonesia and the USA. Additionally, the Navy hospital ship USNS Comfort is scheduled to arrive on the January 22.

Due to the overwhelming number of offers of field hospitals, the Health Cluster has set up a separate field hospital sub-group to deal with this issue under the coordination of Friends of Haiti.

Many open spaces that had been previously identified yesterday for setting up field hospitals were found to be occupied by those who had set up distribution sites for food or water, or were identified as helicopter landing sites, or are being used by those who have set up temporary shelter.

Media Reports and Updates

U.S. Kidney Dialysis Community Responds to Haiti's Emergency Plea for Life-Saving Dialysis Care

http://www.prnewswire.com/news-releases/us-kidney-dialysis-community-responds-to-haitis-emergency-plea-for-life-saving-dialysis-care-81933737.html

In the wake of an earthquake that has devastated this Caribbean country, the U.S. kidney community has mobilized rapidly with the collection of millions of dollars as well as dialysis equipment, medications, supplies and clinical staff to assist in providing life-saving care to Haitian survivors living with kidney failure and in need of emergency treatment.

UN concerned: Massive humanitarian disaster unfolding in Haiti

http://www.cocorioko.net

As the window closes on the timetable for emergency rescue for victims of the earthquake
in Haiti, the greater humanitarian disaster surrounding the destruction is becoming clearer. United Nations Secretary General Ban Ki-moon emphasized the importance of the first 72 hours following the disaster. But already much of that crucial time has been spent attempting to
assess the situation. The UN Stabilization Mission in Haiti (MINUSTAH) suffered the collapse of its headquarters. Approximately 150 peacekeepers are still missing and 36 staff members are confirmed dead. Much of the focus of the United Nations had been on this internal tragedy and the logistical difficulties of losing track of the majority of the UN presence. Meanwhile the fate of millions of Haitian civilians affected by the earthquake remained "sketchy" according to Ban.

Navy's Comfort on its way to Haiti

http://www.baltimoresun.com/news/maryland/bal-md.comfort17jan17,0,7122923.story

The U.S. Navy's East Coast hospital ship sailed away from its Baltimore home Saturday, steaming toward a desperate and uncertain mission in Haiti that could last months. The Comfort is expected to arrive in the harbor of Port-au-Prince, Haiti's capital, next week.

1/18/10