Dr. Paul Farmer, PIH co-Founder and United Nations Deputy Special Envoy for Haiti, recently testified at the “Haiti: From Rescue to Reconstruction” hearing of the U.S. Senate Foreign Relations Committee.

"I am at my core optimistic about the possibilities before us and the potential of our support to help rescue and transform our poorest neighbor," stated Paul in his submitted testimony. "The response from citizens of the United States to the recent events in Haiti has been overwhelming and encouraging. There is the promise of solidarity by our leadership to make long-term commitments to the kinds of investments needed in Haiti—and to fulfilling them."

"For two centuries, the Haitian people have struggled for basic human and economic rights, the right to health care, the right to education, the right to work, the right to dignity and independence,"he continued. "These goals, which Haitians share with people all over the world, should direct our policies of aid and rebuilding."

Read and watch the complete testimony at the link below:

Links:

• Read and watch Dr. Paul Farmer's testimony

Sent on January 17, 2010, 3:34AM, General Hospital in Port-au-Prince (HUEH) by Dr. Evan Lyon of Partners In Health:

can't get through much now but beyond the horror, one very striking reality is that things are totally peaceful. we circulated in PAP in the middle of everything until just now. everywhere. no UN. no police. no US marines and no violence or chaos or anything. just people helping each other. drove past the main central park in PAP where at least 50K people must be sleeping and it was almost silent.

people cooking, talking, some singing and crying. people are kind, calm, generous to us and others. even with hundreds lying on the ground, open fractures, massive injuries of all kinds.

there are few dead bodies on the street. stench is everywhere. the city is changed forever.

we had a late day opportunity to evacuate 4 patients to the US. these may be the first haitian nationals allowed to leave for the US. but martinique has taken over 200. the DR has taken many many more. so we circulated in PAP looking for urgent cases. found hundreds but picked up the 4 to get out, hopefully to philadelphia. open fractures, gangrene, one 4 year old boy with a leg broken in 3 places, a minor head wound, and now 4 days of sleeping outside with IV fluid and maybe some pain meds. probably none.

at the airport, we drove onto the tarmac to meet the air ambulance. surrounded by marines and UN, massive weapons. a humvee with a gunner turret at the top drove by. the noise from the large transport planes was deafening. us citizens and haitian american citizens leaving by the hundreds on US planes. and our small team of haitian and american docs evacuating a drop in the bucket. my ears are still ringing from the noise of it all.

in contrast, port au prince is silent. no current. no car traffic. people sleeping in the streets but little else. beside the impossible weight and tragedy of this city completely devastated, one lasting impression was the stillness of the city. in shock, tragically sad, but quiet. so good to get away from the airport.

sleeping tonight in the house of a dear PIH friend and doctor. attending to neighbors here and able to rest. safety and the work is with our sisters and brothers in this beautiful, proud, and strong nation.

the safest and best way to be here and help is with our colleagues and friends. wonderful to be in the city, away from the airplanes, and working shoulder to shoulder with people we know and love and will continue work with to mourn, assist, and rebuild this special country.

in the photo you see the first time operating of any kind possible at the main general and academic center.

for press / outreach strategy, we might highlight the generosity and getting it done kindness of the air ambulance team. they also left us all the supplies they had on board - water, meds, IV material, blankets, food.

goodnight everyone. love. evan.

Pictures:

• An operating room in the General Hospital (HUEH), Port-au-Prince (JPG)

1/18/2010

• From Dr. Evan Lyon, 7:00pm, from the General Hospital (HUEH) in Port-au-Prince: “Incredible progress in our capacity here. 7 ORs running. 10-12 by tomorrow night. We have electricity and will be operating overnight tonight for the first time.”

• Surgical services are ramping up rapidly at the central hospital in Port-au-Prince, where PIH has been assigned by the World Health Organization to coordinate the response of seven other non-governmental organizations from around the world. Five operating rooms are now staffed and performing surgeries around the clock. But they have a desperate need for all the resources required to run a hospital: surgical equipment—anesthesia machines, sterilizers, autoclaves; surgical consumables—alcohol, suture; surgical instruments—scalpels, saws; and the essentials of life—water, food, and fuel. PIH has managed to deliver some essential supplies. With more than 1,000 patients awaiting surgery, large-scale shipments from larger governmental and charitable organizations are urgently needed.

• Hundreds of thousands of earthquake victims need food, water, and shelter NOW. While scattered incidents of violence have made the headlines, they are no excuse for delaying delivery of humanitarian assistance. Our team on the ground, which has been criss-crossing Port-au-Prince at all hours, reports that the city is remarkably calm and quiet amidst the devastation. While security must be a concern wherever and whenever people are desperate to provide for themselves and their families, the most effective response is not military intervention but massive, well-organized, and equitable humanitarian assistance.

• Paul Farmer, PIH co-founder, is in Port-au-Prince today meeting with government officials and international relief organizations to assist in the coordination of the relief efforts.

1/17/2010

• Yesterday, a PIH team of 25 medical professionals (surgical teams, anesthesiologists, emergency room physicians and nurses) arrived in Haiti and were operating and caring for patients within hours after they touched down. Many of the patient they are seeing are very serious cases (mostly amputations). There remains a great need for additional medicines (anesthesia and narcotics), medical equipment (anesthesia machines and x-rays), medical supplies (IV’s, tubing, irrigating saline), and water. PIH will be sending additional planes with medical teams and supplies into Haiti in the course of the next 48 hours.

• Yesterday, PIH succeeded in transporting four very critical patients and one guardian out of Haiti on a MedEvac plane to Philadelphia, where they landed in the early morning hours today. All four patients desperately needed surgical and post-op care not possible under current conditions in Haiti. To the best of our knowledge these are among the first patients evacuated to the US since the earthquake. All four patients survived the trip to Philadelphia and are already receiving the urgent care they need.

Partners In Health: Sat. 1/16 Report from Haiti

Partners In Health (PIH) has been providing vital health care services in Haiti for more than 20 years and has over 100 doctors, 600 nurses and 4,000 employees on the ground in Haiti working from 10 existing PIH hospitals to provide relief services to those affected by Tuesday’s earthquake.

PIH surgical teams are currently located in: Port-au-Prince, St Marc, Cange, Hinche, and Belladere and medical teams located elsewhere.

“We find that years of patient investment in building a strong local partner organization mean that we are again in the position of responding effectively to a natural disaster. We are very proud of our team.” – Paul Farmer on Partners In Health and Zanmi Lasante

Here are the latest on-the-ground developments as reported by the PIH team in Haiti:

• The PIH team in Port-au-Prince has been designated by the World Health Organization to serve as coordinators at University Hospital (HUEH). In that role, PIH is supporting the administration and staff in restoring services at the city's central hospital, which will also serve as the base of operations for our emergency triage and surgical teams in Port-au-Prince and for referring patients who need more advanced care for transport to our facilities in the Central Plateau and Lower Artibonite.

• Today, PIH is sending 25 medical professionals (surgical teams, anesthesiologists, emergency room physicians and nurses) to support ongoing efforts. The doctors and nurses are from Partners Health Care and Dartmouth Hitchcock Medical Center and many speak Haitian Creole. PIH has also sent engineers to assess structural damage and safety at HUEH and PIH facilities. Additionally, PIH is sending over 300,000 bottles of potable water and well as approximately 1,500 lbs of critically needed medicines, medical supplies and equipment. The medical teams and supplies are being transported via four separate planes and set to arrive on the ground in Haiti by later this afternoon/evening.

• PIH teams located in the Central Plateau are reporting a wave of massive reverse urban migration among more able bodied Haitians fleeing the devastated and chaotic capital looking for safety, shelter and medical care. PIH experts believe these migration trends will have long-lasting impacts on the settlement patterns across Haiti with profound impact on the public health system and social services. PIH was built in partnership with the Ministry in Health for more than 20 years.

• PIH co-founder Paul Farmer flew into Haiti on Friday (1/15). He witnessed the devastation, met with Haitian government officials and reviewed the situation at the University Hospital, confirming the importance of restoring its capacity to serve as the hub of the medical response in the capital. In his capacity as the UN’s Deputy Special Envoy for Haiti, he also met with staff from the UN mission that lost its headquarters and over 100 colleagues in the earthquake to offer his solace and support.

Pictures:

• Treating a patient in the Ministry of Health/ZL Hinche Hospital (JPG)
• Red Cross workers bringing a patient to Hinche Hospital (JPG)
• Complicated, compound fractures being examined (JPG)

The catastrophe in Haiti spared the country’s largest – and, I believe, most effective – rural health care provider, Partners In Health. The organization’s principal founder, Dr. Paul Farmer, is on his way to Haiti now with a surgical team. The staff already in Haiti will welcome his arrival, but they have been at work for days now. Indeed, they were some of the first medical personnel to respond to the crisis. This is a large, highly skilled group of about 2000 community health workers, 500 nurses, and 120 doctors. All but a few of them are Haitian. They are spread out now. Thousands of injured people have been traveling from the capital to the hospitals that PIH operates, along with the Ministry of Health, in the Central Plateau – 10 hospitals, all well-equipped and fully functional. Others of the PIH-Haiti team are in the capital Port-au-Prince, where they have set up mobile clinics and where they are now establishing a central base of operations. The plan is to provide emergency care to all comers and to stabilize patients who need higher levels of care and arrange to get them to the PIH hospitals.

Personally, I take hope from the example that PIH has set and is setting again. I think it is one excellent model for the reconstruction of Haiti to come: an endeavor that employs and trains Haitians every step of the way, that builds infrastructure while attending to the basic needs of the poor, that does all it can to strengthen the public sector.

Many people have been writing to ask what they can do. Paul reports, “I just talked to some of my Haitian coworkers who are in Port-au-Prince in the general hospital, and they’ve reported to work. [But] they don't have electricity yet. They don't have the supplies that they need. But there's a lot of Haitian health professionals, doctors, nurses, aides who would like to [do their job], but to do that you need the supplies. You have to have the basics. Gauze, plaster, or other casts. You have to have the equipment that you need. Anesthesia, pain medications, antibiotics. And that's what some of my medical colleagues are asking us for, supplies."

PIH is purchasing and procuring donated supplies around the clock. To aid in these efforts, please consider making a donation to their efforts today.

- Tracy Kidder

Links:

• The transcript from Paul Farmer's interview with Campbell Brown
• Tracy Kidder's interview on the Rachel Maddow Show

Tremors from Tuesday’s massive earthquake were still being felt in Port-au-Prince this morning. “Little earthquake passed this morning, it’s not done yet,” wrote Dr. Fernet Leandre, a physician at PIH’s sister organization Zanmi Lasante. “[People are] crying, yelling… some are still alive under houses’ debris or ruins.”

Like our facilities in Hinche and Cange, the St. Marc Hospital where Fernet sent his message from, is handling many cases from Port-au-Prince. "The crowd of injured continues to arrive at St. Marc, and there's no surgeon," he said. He and Zanmi Lasante staff are working to bring in a surgeon to handle the many orthopedic cases facing the facility.

Trip to Port-au-Prince reveals more of the tragedy:

A report from Cate Oswald, one of our staff in Haiti, reveals a tragedy more dire than we could have ever expected. Yesterday, she traveled through the Central Plateau to Port-au-Prince and back with our two trucks of meds and supplies. She described the scene:

"We started seeing destruction from Mt. Cabrit (where big rocks lie in the middle of the road) through Croix de Bouquets where it doesn't seem as bad but lots of walls down. Then the scene gets much, much worse. Tonight, everywhere throughout the city, as we drove by the national plaza, there are thousands of people sleeping outside. While I was in Port-au-Prince, there were still aftershocks being felt. I didn't venture into other parts of the city, but as you all know, koze sa pa jwet menm [Haitian saying literally translated as 'this is not a game']."

The trucks met up with PIH staff, including Dr. Louise Ivers in Port-au-Prince, at the UN’s Log Base in Port-au-Prince. Louise was one of two doctors attending at the time, and they had nothing but aspirin until our trucks showed up. The conditions are horrific and people are dying, but in Cate’s report she was hopeful that the supplies will help those at Log Base for the time being. Tomorrow, we plan to move PIH/Zanmi Lasante’s base of operations to the public hospital in the capital city. Some of our colleagues are at the public hospital today assessing the needs and are organizing the next steps of getting supplies, equipment, and additional staff there.

Importantly, given the patients already flowing out of Port-au-Prince to St. Marc and our other facilities outside the city, we cannot leave our hospitals understaffed. So we are recruiting surgeons, anesthetists, nurses, and other medical professionals to go down in the next couple of days to help with staffing, particularly as many of our staff have lost family members and friends.

There are still a handful of our colleagues unaccounted for – we continue to have every hope that it is due to lack of ability to communicate via telephone and the lack of electricity for computers, but we do not know.

Our staff has more or less been working around the clock in Boston and Haiti. We will be paying close attention to our team in Haiti and hope that the volunteer medical groups will help give some of them time to rest, particularly those who have just experience the trauma of being in Port au Prince for the worst of the earthquake’s wreckage.