Expansion of MSF post-op care in Haiti

03 Mar 10

Seven weeks after the earthquake of 12th January, which left up to 300,000 people injured, medical needs continue to grow.

Some health providers that responded to the initial emergency phase of the crisis are beginning to leave the country and discharge patients, even though thousands of injured people require long term medical care.

MSF is currently expanding its capacity to care for wounded people requiring extensive postoperative care, including secondary surgery, follow-up, physiotherapy and mental healthcare, for at least the next several months. In the past few days, public hospitals and medical teams leaving the country have referred more than 200 patients to MSF medical centres.

The immediate emergency phase may be over, but the long-term work is just beginning and it’s no less an emergency,” said MSF Haiti Head of Mission Karline Kleijer.

© Kadir van Lohuizen A physiotheray session in Léogâne hospital
Every day, patients require bandage and dressing changes, cast removals, wound cleaning, removal of dead tissue, external fixator adjustments, x-ray monitoring of fractures, skin graft monitoring and reconstructive and other specialised surgery.

Emergency surgery is one thing, but lack of or inefficient post-operative care will result in long-term hospitalisation or even in lifelong physical disabilities” adds Dr Nico Heijenberg.

After weeks of immobilisation due to traction, casts, external fixators and amputation, patients are just beginning to regain mobility through physiotherapy. People who had limbs amputated may also require additional procedures to ensure the good fitting of artificial limbs.

Returning patients home in their current medical - and living - condition is simply not an option for us,” said Dr. Michel Janssens, director of the MSF inflatable hospital in the St. Louis neighbourhood of Port-au-Prince. The hospital, located on a former soccer field, will remain on site for at least a year.

Another critical element of postoperative care is the psychological monitoring and counseling of patients. For people who suffered horrible injuries, counseling and psychological support is as vital as physiotherapy and learning how to use crutches.

Survivors of the earthquake are often very anxious about their future. "I was an electrician, but who's going to hire a disabled person?” asked Ricardo, a 33-year-old father who suffered severe burns to his hands in the earthquake. “How will I find work to support my family?

Mental health services are being provided by MSF throughout the city.