Haiti: Update from Doctors Without Borders team in Port-au-Prince


Stefano Zannini, the head of mission for Doctors Without Borders (Medecins Sans Fronteres / MSF) in Haiti, spoke to reporters this morning about the organization's operations in response to the catastrophic earthquake. Following are my notes from this call, and from related emails with MSF staff. Here's a link for online donations to MSF.

• All 3 MSF medical facilities in Port-au-Prince, the capital city, were damaged in the quake: a health center in Martissant slum, the Trinity trauma centre (60 beds), and the Solidarité maternity hospital (a 75 bed emergency obstetric facility). Two new operating facilities will be set up in the next 48 hours, including an emergency inflatable hospital due to arrive in Haiti on Saturday (like the one in the photo above — Maggie blogged about this earlier on Boing Boing).

• MSF staff have scavenged equipment from damaged hospitals and medical centers to augment resources at the Choscal hospital in the Cité Soleil district where operations are centered. Materials and surgical equipment have also been salvaged from a free maternity hospital normally operated by MSF. They are continuing to deliver babies, also. The two other obstetric hospitals in the area were destroyed in the earthquake.

• MSF staff in Haiti have been working shifts of up to 24 hours straight since the quake hit 3 days ago. They are exhausted. The first MSF planes with supplies are now arriving in Port-au-Prince, bringing goods and reinforcement staff. Some 40 tons of surgical equipment and sanitation treatment supplies to ensure clean drinking water are on the way.

• Many thousands of survivors are now homeless, or afraid to return to quake-damaged homes. Everyone is seeking shelter. People are sleeping in the streets, protecting themselves with blankets, or if they do not have blankets, covering themselves with plastic bags.

Stefano-Zaninnimsf.jpg • The immediate focus for MSF teams is on expanding the ability to perform surgery for trauma victims, and responding to the incoming flood of victims who need immediate first aid for wounds. MSF priorities in days to come: stabilizing wounded, referring more complicated cases to specialists, reinforcing staff teams, restarting obstetric care, and addressing mental health needs of survivors. Also monitoring the need for food, clean water, and shelter.

MSF: "It is a race against time because infected wounds need rapid interventions. Inflatable operating theatres, with more surgical specialists are en route. But there are major issues of access and transport, with the staff delayed in the air and on the roads. "

• Survivors are trying to rescue their personal effects from their houses. During the daytime, streets are crowded with people looking for help and trying to find their families. Zannini: "I can see thousands of them walking in the streets, asking for help, asking for everything. Trying to stop every car they see in order to get something to go on."

• People are transporting patients on doors which are being used like stretchers. Also transporting patients by car, truck and moped. A few hospitals were not completely destroyed by the earthquake.

• Zannini: "In our hospitals, there are thousands of people waiting for surgery."

• Lots of survivors with open fractures needing surgery. First surgery last night was a complicated delivery of a baby. Zannini: "I am very proud to share with you that we were able to save the life both of the baby and the mother."

• Three things survivors need most right now: medical attention (including surgery), food, safe drinking water.

• Zannini: there were hundreds of dead bodies at MSF facilities. "Trucks from the Haitian government have come to retrieve them. We have protocols about treating the bodies with disinfectants to limit the risk of infection spreading. We do whatever we have to do... our primary role is looking after the [living] wounded."

• Currently MSF's teams are operating out of medical facilities that survived the earthquake. The inflatable hospital structures should be arriving today, and will be set up as fast as possible. These structures will include a surgery operating theater.

• Government trucks are going around the capital collecting dead bodies. A reporter on the conference call asks about dead bodies and the spread of disease. Zannini replies that MSF is focused primarily on surgical care: "Thousands of people need immediate surgical intervention."

• How concerned is MSF team about the spread of disease from corpses? Avril Benoit, director of communications for MSF Canada: "We get qustions like that all the time after a disaster. In our experience as a medical organization, we have rarely seen disease spread. We are always concerned about it, keeping an eye on it. After the hurricane in Gonaives [Haiti], the major priority was clean drinking water... water and sanitation experts are on the way to Haiti now and will be working on that from MSF side and from other organizations... there is no question that clean drinking water is a priority right now, but risks of disease spreading are seldom seen."

• Dr Mego Terzian, from an MSF emergency cell: "Triage, stabilisation of the wounded and referrals for surgical needs are the medical priorities. The dead bodies represent a medical issue in the sense that it's a factor of stress for the survivors. But in this context, as the cause of the death is not an infectious factor, there is no risk of epidemics linked to bodies."

• Asked how operational the Haitian government is, Zannini replies: "We speak with other actors, we meet with them, but our priority now is on the patients." Asked about coordinating with the UN or other NGOS, Zannini replies, "We are focused around our teams."

• 40 tons of supplies are on the way. On Thursday, MSF team in Haiti received medical supplies including medicines/drugs via airplane. The biggest needs at first were antibiotics, blankets, medical equipment. "At the moment we have enough supplies." More supplies coming in. "Most common problem is open fractures."

• What materials are needed most in the field? "Equipment, drugs to stabilize patients." Avril Benoit: "We have also been able to recover some of the material from our damaged hospitals. One cargo plane is due to arrive from Bordeaux, France, and another from MSF base in Panamá."

• MSF has been operating 24 hours a day. Staff have been working up to 24 hour shifts at a time in the immediate days following quake, but goal is to rotate staff in 12-hour shifts. Staff has drinking water and food, they are exhausted but coping as best they can. MSF: "25 new staff are expected to have joined the teams in Port au Prince by the end of today."

• Psychologists are arriving soon to help with mental health needs of Haitian victims, and with the mental health needs of MSF staff. But surgical activities are top priority right now.

• Zannini still expects more survivors to be rescued alive from damaged structures. "It is impossible for me at the moment to know" how many more survivors may be recovered in coming days.

• Asked "When will it get better?" Zannini replies, "It became better when we started surgical activity... we are full of patients... but as far as we are able to treat and stabilize and operate, things will [continue to] improve."

(Special thanks to Pete Masters from MSF. Photo: Inflatable medical village Doctors Without Borders set up in Mansehra, Pakistan. Credit: Remi Vallet, via Discovery News. )


  1. At a time like this it makes me happy to see that the whole world co-operates, either with money, in writing or other way, to help those poor people in Haiti. They are in my prairs…

  2. Observe that we are coming up on the 72 hour mark, and disaster recovery efforts are coming up to speed. What’s magical about the 72 hour number? There are multiple organizations like MSF and the Red Cross, and governments like ours, that keep disaster recovery specialists and their equipment on standby, but sheer transportation logistics means that no matter where the disaster is, it takes 48 to 72 hours for relief to arrive. When a disaster happens where you live, you and your fellow survivors will be on your own for 48 to 72 hours. Everybody on earth should have that fact drummed into their heads repeatedly, and they need to prepare and plan accordingly.

    On a more bitter and angry note, observe that when MSF goes into wrecked facilities and takes what they need, this is “scavenging.” When disaster survivors go into wrecked grocery stores whose owners are nowhere to be seen, and distribute the food that is sitting there rotting on the shelves, they are (as the AP just put it yet again) “looting.” It’s not even a racial thing; this disparity in language between labeling what local ad hoc survivor networks do and when outside volunteer organizations or local or foreign governments do the same thing is a constant across all disasters.

    Third thing: please, please buy and read Rebecca Solnit’s book on disaster response, both by survivors and by outside agencies, “A Paradise Built in Hell.” Ignore the episodic rants about the wonders of anarcho-communism, but enjoy, absorb, and memorize all of the rest of this wonderful, wonderful book about what life is really like in the immediate aftermath of an earthquake, hurricane, terrorist attack, industrial accident, or other disaster.

  3. As #1 stated, these people are my heroes. Their donation page was my first stop after the size of the disaster became clear.

  4. I’m going to echo too-Thanks to Boing Boing for this update.

    It’s amazing how the Web has flooded our eyes/ears with the plight in Haiti. Here’s some insight from Curtis BRAINARD on how new media did it:


    I’m still counting current tweets/RTs on Twitter that allow people to donate easily via text messages/or through links. I too, found out about Doctors Without Border’s through a Facebook update.

  5. MSF are worth a donation.

    I am also very proud of my own country (Iceland) in this matter as we sent our volunteer specialist urban rescue teams extremely fast, and my fellow Icelanders who are digging deep into their almost empty pockets to help out.

    When disasters like this strike it’s time to set aside stupid politics and work together.
    We will judge ourselves, as well as our countries, by how we take care of those who need our help.

  6. I too made my donation to Doctors Without Borders.

    Yes, they are heroes. They are doing great work under some of the most shocking conditions imaginable.

    Thank you for putting this update on, and everyone who can, please contribute something.

  7. Which of these organizations is providing food, if any?

    I’ve donated to MSF, Partners in Health and Oxfam, and I know a lot of people would probably add Red Cross to that list. Those organizations probably make up 80-90% of all donations. Are any of them providing food?

    I think MSF, PIH and Red Cross will almost certainly be focusing on medical supplies, and Oxfam says it’s sending water and sanitation supplies.

    I’m just wondering whether organizations like the MSF will be able to spend any of their budget on food, or if we should start donating to food-specific organizations (like CARE, for instance.)

    1. You’re probably only hearing about water, sanitation, and medicine right now because those are the most urgent needs in any catastrophe. Lack of food takes a lot longer to cause serious harm.

  8. Made my donation, will probably donate again soon to MSF or to American Red Cross.

    Does anyone know anything about the Cuban response?

  9. Asked about coordinating with the UN or other NGOS, Zannini replies, “We are focused around our teams.”

    I was glad to read this. My stomach turned yesterday when I heard an official from USAID on CNN yesterday going on about making sure the correct people from the Haitian government and UN were consulted with before any action was taken.

    Wish more organizations were acting first and asking for forgiveness later if any bureaucrat was offended.

  10. Oh well. The only honest reaction would have been not to care about Haiti – the way the US and the rest of the world always did. Who cares about another 100.000 uselessly dead bodies? The country has seen far more than that.

    This may be cynical, but it is *much* closer to the real state of affairs than the sudden discovery of sympathy for Haitians. The country is a disaster area and has been for decades. The change really isn’t as big as it seems to be. A country as wrecked as Haiti can’t get much more wrecked. So why bother now?

    The reason is probably, that now politicians can get cheap PR out of it. And as a bonus, nobody will ask any questions about the money spend.

    Except for emergency help, what Haiti *really* needs is unilateral free trade agreement with the US. None of that exists of course, since the US is afraid that Haitians could take away their precious jobs and perhaps get a few pounds of cocain into the country – always good enough reasons to condemn a millions of people to abject poverty.

    The hypocrisy is stunning and yet, nobody is going to listen to me.

    Because this “not the right time to argue about politics” and once the crisis is gone from peoples minds, everybody will go back to state of ignorance they were in before and their reaction will be limited to “Oh, Haiti? Where was that again? Wasn’t there a tsunami a couple of years back?”

    Oh well. So if you feel like telling me that this is not the right thing to say, or this is not the right time, or that I suffer from a lack of common sense to put blame on people worrying for their jobs:

    Get over it, I know.

    The crisis here is not the earthquake. The problem is that the country that was condemned to poverty long ago, by the French colonial power for demanding compensation for lost slave-owner property (that Haiti had to pay back until the 1980ies), the US for destroying what government there was and placing the country under crippling embargos and withholding foreign aid to push through “Democracy” in complete disregard to the fact that pushing through democracy by putting an *embargo* on a country is mass murder by starvation and has nothing to do with any of the ideals of human rights that we are supposedly so proud of.

    People can overcome a dictatorship, but they can not overcome hunger when they are completely at the mercy of the whims of foreign powers granting and withholding “aid”. No economy can work without a minimum amount of trust and stability, and by withholding aid and blocking imports into a country, that minimum can under no circumstances be satisfied.

    What Haiti needs is a *real* commitment to aid. It is stability. And if you feel like they have the wrong government, then talk to the government and don’t starve the people. You must also give the country *full* access American and European markets in order to help the people develop their country. And don’t you dare not to let them sell their products at the prices they can afford to offer, because they are a country of abject poverty and their wages are dirt cheap.

    Yes, this will mean that they will compete against American jobs. (Mostly Chinese jobs though.) But, so what? Are you a nation of wimps who think they don’t stand a chance in the world unless you keep countries like Haiti in the gutter?

    1. So…your approach would be to let the wounded bleed out and others starve while you create the perfect stable Haitian government model first? And a free trade agreement to follow in close second place?

      I find a thin, yet very bright line that proceeds from any stated position valuing ideology over people to the actions of those such as Mao or Pol Pot.

      Get over yourself. People are injured, maimed, and dying. Help them first, then worry your precious head about such things as you describe. Those problems will still exist for you to fulminate about (and not solve in the least) but more pressing issues are at hand right now.

      1. Read what I wrote, not what you want to read. I wrote that this would be the honest thing to do, not a good thing nor the right thing.

        The point I was making is that it is hypocritical to provide 100 million dollars to rescue a few 10,000 people in a country where 9 million people are practically incarcerated with no chance to escape the poverty.

        There are several ways do deal with such problems. One is to develop the economy to the point where poverty is a thing of the past. The other is to let people move out of the country if they want to. The US is a large, underpopulated country. Even if 8 of the 9 million people in Haiti wanted to move into the US, you’d hardly feel it.

        Practically though, the policy of the USA is to turn a blind eye to hundreds of Mexicans starving in the desert and boat people drowning, because there is no legal way for them to enter the USA and have a stab at the American dream that you so jealously guard.

        Moral is *not* a collection of do’s and don’ts.

        It is the consideration whether you would like it if you had to live with the consequences of your own actions.

        Trust me – Americans wouldn’t.

        1. Practically though, the policy of the USA is to turn a blind eye to hundreds of Mexicans starving in the desert and boat people drowning, because there is no legal way for them to enter the USA and have a stab at the American dream that you so jealously guard.

          Over 175000 immigrants from Mexico come into the US every year. Tens of millions of immigrants live here. There are plenty of legal ways to get in. Over 20 million first generation immigrants live here. We naturalized over a million new citizens in 2008 alone. We bring in far more refugees than any other country (double the rest of the top ten).

          It’s pretty insulting to say we don’t allow anyone in because we don’t allow EVERYONE in. No other developed nation lets much of anyone in, maybe that should be the target of your ire. I work with people born on 5 different continents every day, and I work in a pretty small company.

          1. You couldn’t tell from the fence on the border to Mexico. Nor from the camera drones patrolling the border. Nor citizen vigilantes “securing” the border. Nor from the fact that people have to sneak into the country.

            And yes, I do complain about the EU not letting Africans in and basically making them drown by the hundreds each year in the Mediterranean sea, while at the same time pointing at how cruel the communist government of the GDR was, where some 54 people were shot on the border in the course of 30 years.


            As I said, I didn’t suggest ignoring them, I only said that it is hypocritical.

            As for the free trade agreement – this is a purely unilateral matter. The USA only needs to make a statement (and carry it out in practice) that all Haitian citizens and businesses will be allowed to export goods to the USA with no restrictions (other than legal – that is, no drugs, no weapons, rare animals etc.) and tariffs.

          2. I would LOVE to import from Haiti. Right now I get everything from Pakistan. The problem is the same as with Mexico though. The businesses are not on the internet and not run by people who understand exporting or manufacturing. I haven’t checked but I think the Haiti duties to the US are probably pretty low already but they should be zero to help countries like these. Currently, the only way to do business with these countries is to go there are start an export business, but local laws keep you out! Mexico… are you LISTENING? Get on the internet and SELL ME SOMETHING.

  11. My heart and prayers are with all of you dedicated men and women who are working so hard to save lives in Haiti. Please stay strong, we are all sending our thanks and love your way.

  12. tp1024 @17, how would ignoring the victims of the Haitian earthquake make the free-trade agreement you propose any more likely?

  13. I wonder if it would make sense for groups like MSF or the Red Cross to build secure caches in disaster-prone areas (especially where they already have an established presence) that would include some of these inflatable hospitals, medical tools and equipment, and food/water/drugs (that are okay with sitting in storage for long periods). Put them somewhere that they could be accessed no matter what (i.e., not in a building’s basement). Lock them up really well so they’re not looted. Change out what you need to every few years. I know it would be expensive, but in a disaster like this, you could have an emergency hospital up and running in hours, rather than days.

  14. #4, yes, the difference between “looting” and “scavenging” does make me twitch a bit. Short of taking something directly away from other living people who also needs it to live, I don’t think anyone there should be worried about property right now.

  15. I keep thinking about the line from an Eliza Gilkyson song: People ’round here don’t know what it means to suffer at the hands of the American dream … Thank you for the updates, Boing Boing.

  16. while at the same time pointing at how cruel the communist government of the GDR was, where some 54 people were shot on the border in the course of 30 years.

    Speaking as American who favors much more open borders than we have now, I can still point out that there is a salient difference between controlling whether or not people are allowed to enter your country and controlling whether or not people are allowed to leave your country.

  17. I have noticed that whenever people show signs of goodness, there is always some ass ready to take them to task for not being perfect.

  18. I am an ER physician I want to help out for a few days I will be in the DR in the latter part of February. Where could I stay at night?

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