FIU public health researcher co-authors new study for World Health Organization
A new World Health Organization report on the public health response to the Haiti earthquake says the international community repeated and amplified mistakes of past disasters and those failures cost lives during a critical lifesaving period.
The study, co-authored by FIU physician and disaster expert Dr. Juan Pablo Sarmiento, examined the first three months immediately following the Jan. 12, 2010 quake. The picture that emerges is a chaotic devastation zone crowded with hundreds of organizations — some of them incompetent and unprepared for the disaster — working in isolation, with little or no coordination of health care services, or accountability for their actions.
“The chaotic situation in Haiti extended for two weeks and a half,” said Sarmiento, who directs FIU’s Paul C. Bell Disaster Risk Management Program and co-directs the USAID-funded program, Disaster Risk Reduction in the Americas in the School of International and Public Affairs. “At this point there is no information on how many people died in this chaotic situation.”
Among the most startling questions raised by their analysis is whether the reported numbers of dead, 220,000, was exaggerated. The government of Haiti “unexpectedly raised further the official figure to over 300,000 when commemorating the first anniversary of the earthquake,” the report says. The authors point to a “lower but statistically more credible” estimate of 150,000.
“In many catastrophes, the management of death figures, a difficult technical task under any circumstances, is handled politically,” the report says. “What’s new in the case of Haiti is the significant and rising discrepancy between the official figures and the scientific estimates.”
Governments are inclined to report the highest numbers dead possible because that figure is tied to how much international relief money the country receives. That formula, the report says, needs to change.
The report was commissioned by the World Health Organization’s regional office, the Pan-American Health Organization, to analyze what the international community can learn from the response to Haiti. Sarmiento’s co-authors include Claude de Ville de Goyet, retired director of emergency preparedness and disaster relief coordination for the Pan American Health Organization (PAHO) and Francois Grunewald, an engineering professor at Paris XII University.
PAHO Director Maria Roses Periago notes in the preface of the report that an earthquake could not have occurred in a more vulnerable capital than Haiti’s. “If the impact was unprecedented, the organization of the response was not. It followed the same chaotic pattern as in past disasters. The humanitarian community failed to put in practice the lessons learned.”
One stark example cited in the report is that of “crush syndrome,” the name given to the fatal renal failure people suffer once they have been pulled from rubble. Most health workers are unfamiliar with the pathology of crush syndrome — rarely seen except in disasters -– and would not be aware that survivors pulled from rubble need specific treatment to prevent acute kidney failure.
“We don’t know how many crush syndromes there were in Haiti but what we do know is there was a specialized facility available to receive patients and they could not get enough patients,” Sarmiento said.
The facility, set up by the International Society of Nephrology, could have accommodated 200 patients a day but ran at 20 percent capacity. “Among the many important announcements of available services…no mention was made of crush syndrome and the existing resources for diagnosis and treatment.”
The report also documents the partial success of international search and rescue efforts. More than 60 search and rescue teams with 1,800 rescuers from 30 nations rescued only 132 people alive, mostly foreigners. There were few references to the immense work of the local population who rescued thousands of people “in spite of the limited skills and lack of equipment.”
FIU disaster expert Richard Olson, who was not involved with producing the report, said it points to the need for a fully resourced United Nations operation capable of not only coordinating, but leading international response to disasters. That’s not a popular idea, he said.
“There are too many governments and NGOs that don’t want strong leadership role for the United Nations,” said Olson, a professor in the School of International and Public Affairs who co-directs Disaster Risk Reduction in the Americas. “A coordinating, pass-through role is what they prefer and that is what the UN has. There is leadership vacuum with weak governments that leads to the brink of chaos.”
To view the report online and download it, click here.