This document summarizes a hazard vulnerability analysis conducted at six orphanages in Haiti managed by Child in Hand. The analysis identified numerous physical hazards that could easily lead to injury or death, as well as a severe lack of basic needs like food, water, sanitation, and healthcare. Recommendations include prioritizing mitigation activities to build resiliency, conducting annual HVAs to document improvements and determine the effectiveness of interventions, and developing a sustainable improvement plan. The goal is to improve living conditions and futures for children in Haiti despite the complex challenges facing the country.

1. Child in Hand - A Hazard Identification, Vulnerability, and Disaster
Preparedness Analysis of Orphanages and Schools in Haiti
Srihari Cattamanchi1
, Meg Femino2
, Bryan Sears2
, John Mangino2
, Majed Aljohani1
,
Abdulrahman Saad Alqahtani1
, Amalia Voskanyan1
, Gregory Ciottone1
OBJECTIVES
1.Harvard Affiliated Disaster Medicine / Emergency Management Fellowship, Dept. of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA
2.Department of Emergency Management, Beth Israel Deaconess Medical Centre, Boston, MA
METHODS
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Boston Red Sox
CONCLUSION
RESULTSINTRODUCTION
• Children are most vulnerable to any disaster, particularly in poor
and developing countries.
• Historically, Haiti has been impacted by many disasters,
including natural, man-made, technological, hazardous &
infectious outbreak.
• Hazard vulnerability analysis (HVA) provides for a systematic
approach to risk-stratifying potential hazards orphanages,
schools may face.
• Risks associated with each hazard are prioritized to optimize
planning, mitigation, response & recovery.
• To identify and risk-stratify hazards specific to each orphanage.
• To make recommendations on prioritization of mitigation
activities to build resiliency to these hazards.
• The HVA’s revealed a severe deprivation of basic human
needs, including food, safe drinking water, sanitation facilities,
healthcare, shelter, education and information, not all inclusive
at each site.
• In some centers this results not only from lack of resources but
also access to services.
• In our observational and relative risk assessment at each
facility, some keep children healthier with simple changes of
practice.
• At each site we noted observed numerous physical hazards
which could be easily lead to injury or death and easily
mitigated with limited resources.
• It is recommended to implement periodic evaluations to
document improvement and determine effectiveness of
interventions.
• An HVA should be conducted annually and the vulnerabilities
should change and re-prioritize as improvements are affected.
• The HVA can assist non-governmental organizations like CiH
in developing a prioritized and sustainable improvement plan
for Haitian orphanages.
• Over time, we hope environment, daily life & future for
children of Haiti improves despite complex issues facing the
country as a whole.
• A cross sectional, qualitative study, conducted in Haiti by Beth
Israel Deaconess Medical Center Emergency Management
Team along with Harvard Affiliated Disaster Medicine
Fellowship in April 2012.
• Six orphanages under Child in Hand program (CiH) were
identified and an HVA was done individually for each of these
orphanages.
• Data was collated using a modified version of the Kaiser
Permanente HVA tool.
• The on-site emergency managers, taking into consideration the
lack of formal data collected or available, modified this tool.
• We did not complete the hazardous events portion but instead
added medical events, which may impact the population at
each site and be directly related to a hazard exposure.
• Analysis was completed using a systematic approach.
• First, historical data was researched to determine probability.
• Second, leaders were interviewed at each orphanage regarding
frequency of specific events, human impact, and operational
impact, and response, resources available.
METHODS
• Third, site surveys were completed to observe processes such as
water treatment, sanitation, site condition, and other physical
hazards.
• It is noted in each individual site report whether the interviewer
considered the interviewee credible or not.
• This is an opinion based on observations, discrepancies witnessed
and conflicting information from other caretakers at the same
location.
RESULTS
• The HVA’s demonstrated that at all CiH sites there is an extreme
lack of resources, with most children living at absolute poverty
level.
Society For Academic Emergency Medicine 2013 Conference, Atlanta, GA.