The document summarizes Canada's response to the 2010 Haiti earthquake, known as Operation Hestia. Over 2,000 Canadian Forces personnel were deployed, including a Disaster Assistance Response Team (DART) of 200 members and a 1 Canadian Field Hospital of over 180 health services personnel. The field hospital treated nearly 5,000 patients during its 40-day deployment in Léogâne, Haiti, conducting hundreds of surgical procedures. Lessons learned centered around the need for rapid deployment after disasters and tailoring healthcare to local needs.

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Canadian Forces Response
to Earthquake in Haiti
Operation HESTIA
Presentation to:
AMMA 2010
Commodore HW Jung
Surgeon General/Commander
Canadian Forces Health Services

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OVERVIEW
• History of CF DART deployments
• Haiti
– earthquake overview
– Country profile
• Canada’s response to the disaster
• CF response – Op Hestia
– Op Hestia Organizational Structure
• Op Hestia Health Services
– What we did
– What we learned

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CF HUMANITARIAN OPERATIONS
• Recent CF DART deployments:
– 1998 - Honduras – Hurricane Mitch
– 1999 - Turkey earthquake
– 2005 - Pakistan earthquake
– 2004/2005 - Sri Lanka earthquake-generated tsunamis
– 2010 - Haiti earthquake

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SITUATION
• Earthquake on 12 January at 1653L
– 7.0 magnitude;
– Approximately 13 km deep.
• Deaths: estimated at 150,000 by GoH
– Later revised at 230,000 (GoH)
– International estimate 92,000
• Injured: 300,000
• Affected by the event: 3,000,000
• Homeless estimated at 1,500,000

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Jacmel
Dest: 50-60%
Pop: 40k
Léogâne
Dest: 80-90%
Pop: 134k
Port-au-Prince
Pop: 2M
Relocation ext: 469k
Epicentre
Mag: 7.3
16h53 12/01/ 10
Situation on 12 January 2010
Estimation of Devastation
Dead: 220k
Wounded: 300k
homeless: 1,2M
relocated: 272k
Needing food: 2M
standard.jpg (21
Ko)

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• Canadian Forces (CF) participation in a whole-of-
government humanitarian response to the earthquake
• Under command of Brigadier-General Guy Laroche
• Over 2,000 CF personnel deployed
OPERATION HESTIA

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OPERATION HESTIA CAPABILITIES
• Search and rescue
• Health Services Support services
• Disaster Victim Identification
• Food and water
• Engineering expertise
• Mobility by sea, land and air
• Defence and security support

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HAITI DEPLOYMENT TIMELINE
0
500
1000
1500
2000
2500
12-Jan
14-Jan
16-Jan
18-Jan
20-Jan
22-Jan
24-Jan
26-Jan
28-Jan
30-Jan
01-Feb
03-Feb
05-Feb
Séisme
OPS start – 1Cdn
Fd Hosp
R2
Leogane
Ops Start
Arrival
HMCS HAL & ATH
Arrival
DART
Medical Recce
Quake
12-Jan 14-Jan 16-Jan 18-Jan 20-Jan 22-Jan 24-Jan 26-Jan 28-Jan 30-Jan 01-Feb 03-Feb
AO confirmed Last troops arrive
Arrival Comd HS
R1 Embassy R1 Leogane
USNS Comfort-R3
Total pers
Op Hestia

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Detailed Timeline of Health Services Deployment
Earthquake
12 Jan 29 Jan
15 Jan
16 - 22 Jan
22-27 Jan19 Jan
Move to Trenton
Fd Hosp
IOCMND Announces
the deployment
of 1 Cdn Fd
Hosp
DART Med Pl
IOC
Warning Order
10 Mar
6-19 Mar
Closing of R2
Redeployment
Deployment
21 Jan

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Land Component
DART
3 R22eR Battalion Group
1 Canadian Field Hospital
Maritime Component
HMCS ATHABASKAN
HMCS HALIFAX
(C2 and CH-124 Helo)
Naval construction troop
Ships' medical teams
Air Component
Airfield Operations
6 Griffons (Utility)
CC130 (Tactical Lift)
CC177 (Strategic Lift)
CC150 (Passenger lift)
CC144 (Passenger lift)
Aeromedevac teams
Search & Rescue
technicians teams
Op HESTIA – Force structure
Joint Task Force (JTF)
Support Element
Transport, shipping & receiving,
contract administration etc.
Joint Task Force Haiti (JTF-H)
Command Element - BGen Guy Laroche
(Command & control, Co-ordination with Cdn
and international partners)

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NAVY
• Over 500 naval personnel
• HMCS ATHABASKAN - destroyer
• HMCS HALIFAX - frigate
• Sea King helicopter air detachment
• Naval Construction Troop

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ARMY
• 500 soldiers in total
• Two infantry companies from 3 R22R
• Engineer company from 5 Combat
Engineer Regiment
• Support company

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AIR FORCE
• Over 250 personnel
• Medical Evacuations
• Transport of humanitarian aid supplies,
equipment, vehicles and passengers
(including evacuees)
• Jacmel airstrip: air traffic and ground
control

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CF HEALTH SERVICES - PERSONNEL
Over 180 CFHS members representing more than 18
different Health Services and Support professions/trades
* GD/Flt Surg Medical Offrs (13) * Gen/Orthopedic Surgeons (4)
* Anesthesiologists (2) * Radiologists (1)
* Intensivist (1) * Health Services Ops Officers
* Nursing : ICU, GD,OR, Flt * Pharmacists
* Social Worker (1) * Health Care Admin
* Advanced General Dentist (1) * Dental Techs
* Preventative Med Techs * Operating Room Techs
* Laboratory Technicians * Biomed Engineering Techs
* X Ray Technicians * Physician Assistants

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Roles:
– Primary medical care
– Clean-up and construction
– Safe drinking water
– Security
DISASTER ASSISTANCE RESPONSE TEAM
(DART)
• Rapid-response capability
Total of 200 CF members:
• engineers,
• Defence & security platoon &
• Medical Pl: 47 pers:
• General Duty Medical
Officers
• Nursing
• Pharmacy
• Preventive Medicine
• Medical Technicians

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DART Med Platoon
Roles:Roles:
• Work with/augment local/international health staff to support their objectives; and
• Work with other military and non-government organizations to do the same.
• To provide Primary Medical Care in order to
– Stabilize the primary effects;
– Limit/mitigate secondary effects; and
– Address humanitarian needs while domestic or international mobilizes to facilitate long-term recovery
Limitations:
No trauma capability as standard DART
No surgical capability as standard DART
Enhancements (pull):
Laboratory
Mental health
Forensics
X-Ray
Extra Holding
*Acute Medical Surgical Capability

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Map of DART Medical Assistance Ops
DART AOR

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Traum
a cases (com
partm
ent,
burns, fractures, etc)
Dehydration
(headaches, stom
ach
aches) Dressing changes
Skin
infections (scabies),
dehydration
(headaches,
stom
ach
pain)
Vaginosis,
parasites,
headache, chroni
DART Medical Ops

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Critical Relief 1.5 wk
Stabilisation and FU 1.5 wk
Follow-Up Care 0.5 wk
Beyond disaster care
DART Medical Ops

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Disaster Victim Identification
• CF Dental Services Forensic Odontologist deploy upon request from
– Dept of Foreign Affairs
– RCMP / Provincial Police / Municipal Police
– Coroners / Medical Examiners
• Haitian community saw little value in disturbing buried victims for
identification purposes.
– Birth and death certificates are not the norm for Haiti
– Local customs favoured not disturbing the dead
– Most decedents would not have ante-mortem records suitable for
identification purposes
• Canada sent three teams of 6 investigators, each for a two week
rotation

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CF HEALTH SERVICES IN LÉOGÂNE
• Role 2 - 1 Canadian Field Hospital (1 Cdn Fd Hosp)
– 2 operating rooms,
– 4 resuscitation bays,
– 103 beds: 5 critical care, 10 intermediate care, 88 minimal-
care,
– pharmacy, laboratory, diagnostic imaging, and dental svcs.
• Role 1 - 3 R22eR Battalion Group
– Physician, Physician Assistant (PA) and Med Techs
• Village Medical Outreach clinics in isolated communities;
• 1 Cdn Fd Hosp augmentees
• Primary Care- HMCS ATHABASKAN
– Physician, PA and Med Techs embedded with other teams

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130’
120’
320’
Dental
Triage
OR 2
OR 1
CSS
MIR
WARD B
WARD C
WARD D
Support/Engr
Generators
TOC/CS8
RESUS
HQ
CCW
Lab
Diag Imag
Pharmacy
FMED
Reefer
WARD A
Entrance
1 Cdn Fd
Hosp

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1 Canadian Field Hospital STATISTICS
• 4922 patients seen in 40 days
– 711 children
• 178 surgical procedures
– 123 General Surg
– 55 Ortho Surg
• 364 dental patients
– 421 extractions
– 258 surgical procedures
• 243 admissions
– 18 ICU admissions

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1 Dental
Unit
1 Dental
Unit

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CF HUMANITARIAN HEALTHCARE SUMMARY
# of patients
Patients / consultations 22 447
Surgery 198
Medical Outreach in rural regions 5 558
Strategic Aeromedical Evacuation to Canada of Canadian Entitled
Persons
62
Canadian Entitled Persons seen at Embassy 438
Total Canadian Entitled Persons evacuated 3291

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CC-177 Globemaster III strategic airlifters
LESSONS LEARNED

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LESSONS LEARNED: Health Services Support to
Future Humanitarian Operations / Disaster Response
Lesson # 1: Arrive rapidly in location within 7-10 days of the
event
Need to balance capability with mobility
Lift Requirements need to be minimized
Task Force Movement Tables / Sequencing essential

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LESSONS LEARNED: Health Services Support to
Future Humanitarian Operations / Disaster Response
Lesson # 2: Health care delivery must be tailored to the
population at risk:
Standards of Care
Medical / Dental Rules of Eligibility
“Filling the Right Niche”

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LESSONS LEARNED: WAY AHEAD
• Refining of the DART primary care high readiness module
• Public Health module
• Fwd AE/ Ground evacuation module
• Disaster Victim Identification module
• High Readiness Acute Medical Surgical module

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Scalable Acute Med/Surg Module (48 hrs NTM)
Basic Functional Module:
Bed Count (30):
2 OR beds
4 CCW/Resus/PACU
10 ICW
16 minimum care beds
Total Personnel Required: 92
Lift Required: 3 CC-177 Chalks
Sustain: 14 DOS
• This module could be added onto
the DART Med Pl module which
contains an existing 50 pers and 30
minimum care beds
Follow On module if required:
Additional Beds (50):
6 CCW/Resus/PACU
12 ICW
32 minimum care
Additional Personnel Required: 26
Additional Lift: 1.5 CC-177 chalks
TOTAL: 80 beds
118 personnel
4.5 C-177 chalks to move

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QUESTIONS