Remember When?

In the midst of all the problems going on in the world today, does anyone remember a significant event that occurred 10 years ago? On January 12, 2010, a massive, devastating earthquake occurred in Haiti, killing as many as 160 000 people and damaging as many as 250 000 homes and 30 000 commercial buildings. From the standpoint of the wound care community, the call for help was answered by Dr. John Macdonald and the Project Medishare (sponsored by University of Miami); Dr. Macdonald and others went to Haiti 2 days after the disaster and established the Haitian Relief Tent Hospital in Port-au-Prince to help care for the thousands of people who had developed wounds from the earthquake. About 6 months later, as the situation seemed to be stabilizing and more of the health care was being provided by the local physicians, nurses, physical therapists, and other health care professionals, I became involved. It became apparent that the local health care providers were in need of additional training if they were going to be able to manage the huge number of patients with wounds. The Minister of Health in Haiti and the Medical Association of Haiti contacted the World Association of Wound and Lymphedema Care to provide the training. In July 2010, I and 3 others were selected to help provide that training with an educational program. We were very pleased when more than 45 local health care providers attended the program.  

At the conclusion of the program, the attendees were excited to return to their facilities and begin providing good wound care to their patients. As with any teaching endeavor, we wondered if the enthusiasm would be sustained and if we had really made any difference at all. We realized that there were still major needs in their health care system and hoped we could provide assistance for some of them. After returning home, educational programs were continued as surgical residents from the university hospital in Port-au-Prince began wound care preceptorships at our wound center in Alabama. With time, a wound center was established at the Mevs Hospital in Port-au-Prince, Haiti, under the direction of Dr. John Macdonald, Project Medishare, the University of Miami, and a Haitian surgeon, Dr. Adler Francius. Their wound center has grown and has been seeing more than 60 patients with a variety of wounds daily. A second wound center at the university hospital is slowly growing. We have been able to make return trips to Haiti to continue providing educational programs in Port-au-Prince and surrounding towns and hospitals.  

Now, 10 years later, has any of this made an impact in the care of patients with wounds in Haiti? The situation in general has made few advances. Of the hundreds of millions of dollars pledged to Haiti for the recovery, less that 2% has actually been sent to Haiti. In 2015, $500 million donated to the Red Cross for earthquake victims “disappeared.” A detailed explanation about the disappearance of the money has never been provided.¹ As of 2017, the United Nations reported that over 2.5 million Haitians still needed humanitarian aid.²  What about health care? As of 2020, the hospitals have not been repaired or replaced. Civil unrest is still rampant, thus keeping people from seeking medical care across all of Haiti, especially in this time of COVID-19 infections. Many in Haiti are fearful of leaving their homes because of the possibility of being kidnapped, killed, or worse.³ Hospitals are closed due to COVID-19 but are slowly beginning to reopen as are the wound centers.  

Were we successful with our educational programs and investment of time and money in the care of patients with wounds in Haiti? Obviously, we did not change the entire country, but I do not think we expected to do that. We have been able to educate a number of health care providers who are silently working on their own with little support from the government or the medical establishment to improve the lives of their patients, especially those with wounds. It can be hoped that with our prayers and support from afar they will be able to continue making a difference in the lives of their people. Perhaps that is all we could have realistically expected after 10 years.