Haiti’s Homeless Are Short Hundreds of Thousands of Tents, Aid Groups Say/In Haiti, Many Amputees Have No Place to Go

Haiti’s Homeless Are Short Hundreds of Thousands of Tents, Aid Groups Say
By GINGER THOMPSON
Copyright by The New York Times
Published: January 24, 2010
http://www.nytimes.com/2010/01/25/world/americas/25haiti.html?hpw


PORT-AU-PRINCE, Haiti — As officials focused Sunday on the Herculean task of this nation’s physical recovery — clearing the wreckage and setting up housing for the hundreds of thousands left homeless by an earthquake — desperate relatives of those still missing pleaded with the authorities not to give up the search.

With so many of this city’s buildings left in ruins and a public health crisis brewing from a failed sanitation system and a shortage of clean water, search and rescue efforts were winding down.

Across this devastated capital, demolition crews were razing buildings teetering dangerously close to collapse, and teams of American surveyors were expected to begin examining the stability of those structures left intact so that people whose homes were spared can move off the streets and businesses can go back to work.

International aid organizations said they had identified three sites to temporarily resettle the homeless. Brazilian teams have begun clearing a field in the Croix des Bouquets neighborhood for a tent city for some 10,000 people, according to Niurka Piñeiro, a spokeswoman for the International Organization for Migration, but it estimates the need at 100,000 tents for families of five, to assist 500,000 people.

Another temporary settlement will be established on Rue de Tabarre for the estimated 4,000 people now camped in squalid conditions on the grounds of the prime minister’s home. A third settlement will be built in the city of Léogâne. And French authorities have said that they will begin efforts to provide water and sanitation to several thousand people crowded in the Champ de Mars plaza downtown.

“Tents, tents, tents,” Ms. Piñeiro said. “That’s the word we want to get out. We need tents.”

The call for aid organizations to focus on shelter came 12 days after the quake, when an estimated 250,000 people were still living under pieces of scavenged tarpaulins, tin and bedsheets. With so many people lacking access to clean water and sanitation, illnesses are running rampant.

“We’re getting a lot of kids with diarrhea,” said Yveline Auguste, who is working at a Haitian hospital on behalf of Catholic Relief Services. So far the cases are generally mild enough to be treated with medicine at home, she said.

But Rick Bauer, a shelter expert for the international aid agency Oxfam, said that the temporary camps would work only if they were secure, their residents were working and the government offered a clear exit strategy.

“The camps must not become warehouses of people waiting for permanent homes that never materialize,” he said.

The Inter-American Development Bank has committed to building 10,000 houses in Léogâne, Ms. Piñeiro said, and further plans for permanent housing will be the focus of a United Nations donors’ conference in Montreal on Monday.

Still, the pivot from rescue to recovery met resistance from relatives of the missing, whose pleas not to give up hope were heard at funerals, demolition sites and displacement camps across the city.

Bulldozers were halted at the Collège du Canapé-Vert when one of the teachers reported getting a telephone message from someone believed trapped in the school’s ruins.

Capt. Christian Morel, leader of a French search team, said that four other teams had searched the school and found no signs of life. He said search teams had received frequent reports of texts or messages from those believed to be dead. But he speculated that either the messages were just now being transmitted as cellphone towers came back on line, or that they were the work of wishful thinking.

Nonetheless, he unleashed search dogs to go over the ruins of the school again. And again he came up with nothing.

That was not enough, however, to convince Madeline Dorville, whose husband, Oriol Randiche, was attending a teacher training program at the school when it collapsed. Tears wetting her cheeks, she said she would be tempted to throw herself in front of the waiting orange bulldozer if it resumed demolition work.

“How can we trust these kinds of decisions to a dog?” she said. “Dogs are not detectives or magicians.”

For others, the thought of starting a new chapter was all the more excruciating because they had not been able to properly close the last one.

“Can you imagine trying to say goodbye to your brother with his body still in the concrete?” asked Lindsay Soliman, 24, a law student who was conducting a funeral service with her family for her brother, Mikenley Soliman, 21. His body lay somewhere under the rubble of a home in the Carrefour district.

Ms. Soliman’s family decided that it was time for his funeral, which they held Sunday at a badly damaged house owned by the Roman Catholic Church, using a photo of him instead of his body.

Mikenley, a computer science student, “dreamed of America like no one,” his sister said. He was a Los Angeles Lakers fan and an aspiring computer programmer who planned to move to Maryland this year after attaining a United States residence visa.

He was watching a soccer game with three friends when the earth shook and the walls of the house fell in. None of the men made it out.

Steeve Hilaire, 27, a police officer and a cousin of Mr. Soliman’s, said he could not understand why the government was in such a hurry to begin clearing away the debris before recovering all who were lost.

“The bulldozers would be roaring if a government minister’s body or his relatives were under there,” he said. “But when it’s just a regular person, no one cares.”

Reporting was contributed by Simon Romero, Deborah Sontag, Damien Cave, Marc Lacey and Ray Rivera.




In Haiti, Many Amputees Have No Place to Go
By RAY RIVERA
Copyright by The New York Times
Published: January 24, 2010
http://www.nytimes.com/2010/01/25/world/americas/25amputee.html?scp=1&sq=haiti's%20amputees&st=cse


PORT-AU-PRINCE, Haiti — In a tent serving as an acute-care ward on the grounds of this city’s biggest hospital, Jocelin François was sitting up in bed when a nurse went by, barking at him in French. Mr. François, whose left leg was amputated nearly to his knee after the earthquake on Jan. 12, threw out his arms and fell back on the mattress.

“She said I have to go home,” Mr. François, 26, said. “I don’t want to leave until I can walk. I am weak. I have no place to go.”

A doctor, sensing some confusion, intervened. “We’re not telling him he has to go home,” the doctor, Rose Antoine, 33, a native of Haiti who now lives in Pennsylvania, explained. “We’re only telling him that this is an acute ward and we need the bed. We’re trying to find a step-down unit where he can go to.”

Nearly two weeks after the 7.0-magnitude earthquake that devastated Port-au-Prince, the immediate health crisis, which involved treating the injuries of people who were crushed by collapsing buildings and amputating damaged limbs, has begun to settle into a new phase.

This one is perhaps even more daunting: caring for thousands of post-operation trauma patients who are ready to leave the hospitals, but lack homes or families to go to. Many will require prosthetic limbs, frequent wound cleanings, bandage changes and months of rehabilitation.

As officials warn of possible outbreaks of infectious diseases from unsanitary conditions in hundreds of makeshift camps of people made homeless by the earthquake, they are also wondering where to send patients who have been treated for their injuries but require follow-up care.

“It’s very hard to send people home when they don’t have a house,” said Dr. Surena Claude, who is coordinating a commission appointed by President René Préval to respond to the health emergency. “This situation is causing so many problems, because the hospitals are full, and if this continues we will have no room.”

Early reports that there might be as many as 200,000 people who required amputations appear to have been exaggerated. At the University Hospital, Port-au-Prince’s largest hospital, which received the brunt of the casualties after the quake, surgeons have performed about 225 amputations, mostly in the first few days. Doctors Without Borders estimated that its doctors had performed 125 amputations in 12 centers across the country. Hundreds more have been done in other clinics and hospitals elsewhere; the total is more likely to have been a few thousand.

Still, this is a country that, even before the earthquake created so much devastation, could barely cope with the healthy. There will be thousands more who will need rehabilitation for a range of injuries, from broken hips and femurs to neurological disorders from head injuries.

Health officials are still in the earliest stages of determining how to deal with post-operative patients, even as new patients are coming to the hospitals with secondary infections as well as the usual array of emergencies.

Dr. Mirta Roses, director of the World Health Organization’s Pan-American region, said Sunday that all of the country’s remaining 48 hospitals were at full capacity, including 11 in Port-au-Prince. That does not include the many clinics that aid groups have created.

Health officials are dealing with another problem. With aftershocks still rattling the city, including another on Sunday, many people are afraid to be inside the hospitals but are also unwilling to leave the grounds, where they can get food and water and have access to care.

“Even their relatives want to be with them in the hospitals,” Dr. Roses said. She added that a solution would involve creating centers for ambulatory and post-operative care and persuading patients and their families to move there.

Even in the best of circumstances, it can take four to six months for a person who has had a traumatic amputation to function again, Dr. Steven R. Flanagan, medical director of the Rusk Institute of Rehabilitation Medicine at N.Y.U. Langone Medical Center, said in a telephone interview. The Rusk Institute has a team in Haiti.

“What they really need to worry about in Haiti is infectious complication, so if you have an amputation of a leg or arm, that wound is subject to infection,” Dr. Flanagan said. “And clearly they don’t have all the medicines they need down there.”

Dr. Claude, of the presidential commission, said the government was well aware of the situation.

“Unfortunately, a solution is not yet found,” he said. Even when one is found, he said, logistics in this rubble-choked country will continue to be a problem.

The hope is that access to medicines and care will be eased greatly when the government carries out plans to build giant tent cities across Port-au-Prince and the vicinity, but that could take weeks.

At University Hospital, which is next to a nursing school that collapsed, killing about 50 students, Mr. François was relieved to learn that he did not have to leave immediately. He said he did not know if his relatives died in the earthquake, and that they did not know that he survived.

Outside the tent, a giant post-operative ward has been created in a grove of mango and oak trees, with low-slung tarps strung over patients’ beds. The ward, known as “the forest,” is filled with many patients who did not want to be inside the hospital. The doctors do not know how many patients are there, because they have been too busy to count.

In the United States, many of these patients would already be home, receiving outpatient care, said Dr. Michael Marin, chairman of surgery at Mount Sinai Hospital in New York, who is volunteering here with the International Medical Corps, the group coordinating relief efforts at the hospital.

Here, many of the patients cannot return home. “The only place they have to go is the forest,” Dr. Marin said.