Providing Expert Consultation in Haiti

Hope Staff Participate in Ministry of Health Ambulance Transport Network Meetings

As the cholera epidemic’s death toll continues to rise throughout Haiti, the Haitian Ministry of Health (MSPP), in coordination with the Interim Haitian Reconstruction Committee (IHRC), convened key stakeholders last week to continue coordinating efforts to meet the difficult challenges of providing rapid emergency transportation for cholera victims.

Project HOPE was invited by MSPP to offer expert analysis and recommendations for alternative emergency transport systems to the working group, which was attended by representatives from over twenty international aid organizations.

Haiti faces an extremely difficult situation. Years before the January 2010 earthquake, Port-au-Prince’s infrastructure had been crippled by a steep, rapid increase in population size that had outgrown the capital’s functional capacity. Poor roads and a drastic influx of automobiles resulted in daily gridlock through most of the city, severely impacting emergency response and transportation systems. In the rural areas, a lack of resources and development has also led to significant challenges with the infrastructure.

Since the earthquake, the situation has deteriorated even more as many roads and bridges are still in a state of disrepair caused by the violent tremors, while many others remain impassable due to rubble which has not yet been removed.

Since October, the situation took another hit with the introduction of cholera into the country. Cholera is a fatal disease that spreads primarily through contaminated water – a situation that is all too common in the highly unsanitary conditions that are common in most of the tent cities around the capital, as well as in the isolated rural communities who lack basic health care facilities and clean drinking water.

While cholera is a disease that is relatively easy to treat at the outset of symptoms, it can also become fatal in severe cases in as few as four hours when health care is not easily accessible. Despite the best efforts of the Haitian government and innumerable humanitarian aid workers, the widespread gridlock and bottlenecks in Port-au-Prince, and the poor access to remote rural communities, has created a situation in which cholera victims regularly die simply because of a lack of rapid transportation to the hospital.

Facing these many challenges, Project HOPE was asked to present alternative solutions for emergency response and transportation to the working group, in both urban and rural settings. Because the traffic and road conditions in Haiti are so poor that even regular transportation vehicles have difficulty operating, the prospect of importing North American and European ambulances into Haiti can often cause more problems than they are meant to solve. To deal with these issues, Project HOPE presented several alternatives that would enable improved access to emergency transport by relying on local transportation vehicles like motorcycles and Tap Taps, the primary mode of public transportation in Haiti.

Similarly, alternative transportation networks were also presented to maximize the use of existing emergency transport vehicles, including ambulances. Some of these networks included a “rendezvous system” where ambulances are posted at highly visible locations along major avenues and roadways. Using this model, the community will be aware of where ambulances are readily available so that patients can be brought directly to them from tent cities and other inner city neighborhoods, as well as from rural communities, and then can be more easily transported directly to hospitals. This system model would make transportation more accessible to the public, while avoiding the potential for mechanical failures that regularly occur when sending ambulances into areas where they cannot operate effectively.

Additionally, Project HOPE was also able to offer community-based training programs for layperson responders to equip community members with simple, life-saving medical skills for cholera patients, as well as trauma victims and obstetrical emergencies.

Finally, the recommendations offered by Project HOPE included basic telecommunication capabilities to improve the existing emergency call center in Port-au-Prince, as well as ways to incorporate simple mobile phone technologies to improve direct communications between patients and emergency responders.

Project HOPE was very grateful for the opportunity to offer these alternative solutions to the Haitian Ministry of Health and other aid organizations, and is currently working with these groups to effectively implement their recommendations.