Haiti: Before and After the Earthquake  Vincent DeGennaro, MD, MPH
Goals <ul><li>History of Haiti </li></ul><ul><li>Health and economic indicators </li></ul><ul><li>My personal experiences ...
A Brief History of Haiti <ul><li>Christopher Columbus landed on Ayiti in 1492 </li></ul><ul><li>Haiti became known as the ...
Viva la Revolution! <ul><li>1791 The slave revolt begins in Northern Haiti </li></ul><ul><li>1799 Fighting the British, Fr...
A New Nation is Born <ul><li>France, England, and USA enacted embargo and forced Haiti to pay 90 million gold francs which...
Modern Haiti <ul><li>“ Papa Doc” ruled from 1957 to 1971 </li></ul><ul><ul><li>His government killed 30,000 people and dro...
 
Health Demographics Haiti USA Maternal Mortality Rate 680 deaths/ 100,000 live births 11 deaths/ 100,000 live births Birth...
Economic Indicators <ul><li>GDP per capita: $1,300 (203 rd ) </li></ul><ul><li>80% live below poverty line </li></ul><ul><...
 
 
My prior experiences in Haiti
The “Pearl of the Antilles”
Life in Rural Haiti
 
Port au Prince 2006
Port au Prince 2006
Transit in  Port au Prince
 
 
Project Medishare/UM Hospital
Early “OR’s”
Medical Record Keeping
Tour of Port au Prince
US Embassy
L’Hopital Communitaire Haitien
 
Skull Laceration
Draining a breast abscess
Closed Dislocated First and Second Digit
Baby with facial nerve palsy
Ortho injuries
Pediatrics
OB/GYN
Pharmacy
After the “aftershock”
Before………….and after
Partnerships Portuguese Bombeiros Korean EMT French Mountain Rescue EMT/MD’s Hungarian EMTs Swiss Nurses/EMTs Australian N...
What now? <ul><li>Short term: Weeks </li></ul><ul><ul><li>Address immediate medical needs </li></ul></ul><ul><ul><li>Food ...
Long term: Years <ul><li>Rebuild schools, hospitals, government buildings </li></ul><ul><li>Peaceful transition of governm...
How will the US respond? <ul><li>When to leave? </li></ul><ul><li>How to transition control of government? </li></ul><ul><...
<ul><li>&quot;I am at my core optimistic about the possibilities before us and the potential of our support to help rescue...
Please give: Partners in Health www.pih.org Project Medishare for Haiti www.projectmedishare.org
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Haiti Before And After Vince De Gennaro 2010

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Haiti Before And After Vince De Gennaro 2010

  1. 1. Haiti: Before and After the Earthquake Vincent DeGennaro, MD, MPH
  2. 2. Goals <ul><li>History of Haiti </li></ul><ul><li>Health and economic indicators </li></ul><ul><li>My personal experiences in Haiti </li></ul><ul><li>Short term and long term goals </li></ul><ul><li>Donate to Project Medishare or Partners in Health </li></ul>
  3. 3. A Brief History of Haiti <ul><li>Christopher Columbus landed on Ayiti in 1492 </li></ul><ul><li>Haiti became known as the &quot;Pearl of the Antilles” </li></ul><ul><ul><li>By the 1780s, Haiti produced about 40 % of all the sugar and 60 % of all the coffee consumed in Europe </li></ul></ul><ul><li>Children of whites and their concubines were free people and could own property, including slaves </li></ul>
  4. 4. Viva la Revolution! <ul><li>1791 The slave revolt begins in Northern Haiti </li></ul><ul><li>1799 Fighting the British, French, and mulatto land owners, rebel slaves capture all of Haiti and all Hispaniola by 1801 </li></ul><ul><li>1802 Napoleon invades and recaptures Haiti </li></ul><ul><li>1804 United by France’s brutality, all indigenous oust French army </li></ul><ul><ul><ul><li>All whites evacuate and remaining 4,000 are slaughtered as retribution </li></ul></ul></ul>
  5. 5. A New Nation is Born <ul><li>France, England, and USA enacted embargo and forced Haiti to pay 90 million gold francs which took until 1947 </li></ul><ul><li>Haiti occupied the DR from 1822 to 1844 </li></ul><ul><li>Ruled by series of dictators until 1915 when US occupied Haiti until 1934 </li></ul><ul><ul><li>Rewrote the constitution to allow foreign ownership of land </li></ul></ul><ul><ul><li>Owned Haitian national bank until 1947 </li></ul></ul>
  6. 6. Modern Haiti <ul><li>“ Papa Doc” ruled from 1957 to 1971 </li></ul><ul><ul><li>His government killed 30,000 people and drove away Haiti’s intellectuals </li></ul></ul><ul><li>19 year old “Baby Doc” lived as a playboy and drove Haiti into debt </li></ul><ul><li>Jean-Bertrand Aristide elected and overthrown in 1991 and over 40,000 Haitians fled by boat </li></ul><ul><li>US Marines reinstate Aristide in 1994 </li></ul><ul><li>In 1996, Haiti had its first peaceful transition between two democratically elected leaders </li></ul><ul><li>Aristide was overthrown and “evacuated” by US in 2005 </li></ul><ul><li>UN peacekeepers arrive and oversee election of Rene Preval </li></ul>
  7. 8. Health Demographics Haiti USA Maternal Mortality Rate 680 deaths/ 100,000 live births 11 deaths/ 100,000 live births Birth Rate 29.1 births/1,000 population 13.82 births/1,000 population Infant Mortality Rate 57 deaths/ 1,000 live births (37 th ) 11.6 deaths/1,000 live births Under Five Mortality Rate 72 deaths/ 1,000 live births (48 th ) 7.6 deaths/ 1,000 live births Life Expectancy 55 years 78.11 years
  8. 9. Economic Indicators <ul><li>GDP per capita: $1,300 (203 rd ) </li></ul><ul><li>80% live below poverty line </li></ul><ul><li>Half the population earns $60 or less per year. </li></ul><ul><li>The total expenditure on health per person is $54 per year </li></ul><ul><li>Sources: CIA Factbook 2009, WHO Country Fact Sheet, UNICEF State of the World’s Children </li></ul>
  9. 12. My prior experiences in Haiti
  10. 13. The “Pearl of the Antilles”
  11. 14. Life in Rural Haiti
  12. 16. Port au Prince 2006
  13. 17. Port au Prince 2006
  14. 18. Transit in Port au Prince
  15. 21. Project Medishare/UM Hospital
  16. 22. Early “OR’s”
  17. 23. Medical Record Keeping
  18. 24. Tour of Port au Prince
  19. 25. US Embassy
  20. 26. L’Hopital Communitaire Haitien
  21. 28. Skull Laceration
  22. 29. Draining a breast abscess
  23. 30. Closed Dislocated First and Second Digit
  24. 31. Baby with facial nerve palsy
  25. 32. Ortho injuries
  26. 33. Pediatrics
  27. 34. OB/GYN
  28. 35. Pharmacy
  29. 36. After the “aftershock”
  30. 37. Before………….and after
  31. 38. Partnerships Portuguese Bombeiros Korean EMT French Mountain Rescue EMT/MD’s Hungarian EMTs Swiss Nurses/EMTs Australian Nurses/EMTs Israeli MDs/Nurses Cuban MDs USA Jamaican Army UN Peacekeepers from Bolivia, Chile, Argentina, Nepal Haitian MDs Nurses EMTs Administrators Translators
  32. 39. What now? <ul><li>Short term: Weeks </li></ul><ul><ul><li>Address immediate medical needs </li></ul></ul><ul><ul><li>Food and water distribution </li></ul></ul><ul><ul><li>Sanitation and hygiene </li></ul></ul><ul><ul><li>Restore government to power </li></ul></ul><ul><ul><li>Demolition of buildings </li></ul></ul><ul><li>Medium term: Months </li></ul><ul><ul><li>Permanent shelter for rainy/hurricane season </li></ul></ul><ul><ul><li>Rebuild governmental capacity </li></ul></ul><ul><ul><li>Rebuild public health infrastructure for basic health needs </li></ul></ul><ul><ul><li>Long term access to food, water, sanitation </li></ul></ul>
  33. 40. Long term: Years <ul><li>Rebuild schools, hospitals, government buildings </li></ul><ul><li>Peaceful transition of government </li></ul><ul><li>Developing industry, agriculture, transportation sectors </li></ul><ul><li>Education </li></ul><ul><li>Training and retaining of national intellectual capacity </li></ul><ul><li>Elimination of extreme poverty </li></ul>
  34. 41. How will the US respond? <ul><li>When to leave? </li></ul><ul><li>How to transition control of government? </li></ul><ul><li>Healing </li></ul><ul><ul><li>Micro or macro? </li></ul></ul><ul><li>Rebuilding infrastructure </li></ul><ul><ul><li>How to design buildings? Where to build? </li></ul></ul>
  35. 42. <ul><li>&quot;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. The response from citizens of the US 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. These goals, which Haitians share with people all over the world, should direct our policies of aid and rebuilding.“ </li></ul><ul><ul><li>Paul Farmer, 1/29/10 in testimony to US Senate Foreign Relations Committee </li></ul></ul>
  36. 43. Please give: Partners in Health www.pih.org Project Medishare for Haiti www.projectmedishare.org

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