Patients overwhelm medical teams at Haiti clinics

By Mary Beth Sheridan, Debbi Wilgoren and Carol D. Leonnig
Washington Post Staff Writers
Sunday, January 17, 2010; 5:28 PM

PORT-AU-PRINCE, HAITI -- Medical teams struggled to cope with an overwhelming crush of injured patients in this earthquake-ravaged city Sunday, while an international armada of would-be helpers vied in frustration for access to the disaster zone.

The French-based group Doctors Without Borders issued a public call that its planes "be allowed to land" at the Port-au-Prince international airport, "in order to treat thousands of wounded waiting for vital surgical operations." In North Carolina, troops with the 82nd Airborne who have been ready to deploy since Friday were told it would be at least 9 p.m. before they leave, because the tarmac is clogged with too many planes.

"We're ready to go," said Lieutenant Col. Peter Im. "It is a matter of having the capacity to receive it. There's very limited infrastructure, so getting equipment and personnel in is like you're going through a funnel."

Top State Department and military officials on the ground in Haiti said their ability to quickly get vital food and water in Haitians' hands has been hampered by their reliance on Port-au-Prince's tiny airport. Because of damaged roads and a devastated port, an airfield that typically serves three flights a day and lacks electricity and a functioning tower is having to handle up to 60 civilian flights a day.

The airport has been swarmed by incoming flights carrying emergency relief items from many nations, and some officials and organizations have been angered that the U.S. military took over prioritizing which flights it considered the most important to gain entry.

After the complaint from Doctors Without Borders, its hospital plane was given clearance to land around 3 p.m. Sunday. An Air Force official said the military had 67 civilian flights trying to arrive Saturday, and turned away only three.

"When you're dealing with life and death, everybody feels quite strongly . . . understandably," Denis McDonough, the chief of staff of President Obama's National Security Council, said of complaints about delays at the airport. "It's absolutely understandable that tempers would flare. But one thing that I'm sure none of us will apologize for is that we're all trying to relieve the pain of the Haitian people in this time of disaster."

At a field hospital run by the University of Miami in a United Nation's compound outside the Port-au-Prince airport, workers set up cots on an outdoor patio to accommodate waves of sick and wounded who could not fit into the already overflowing surgical and medical tents.

Since Wednesday night, the staff at the field hospital has grown from three doctors to 87 personnel. On Sunday, they were treating 280 patients crammed into a large tent on side-by-side cots. Next door was the surgery tent. On the patio, patients hooked up to intravenous lines filled the rows of new cots as soon as they were in place.

"The need is just overwhelming. We're just scratching the surface," said Dr. Eduardo de Marchena, a cardiologist taking a break from operating on patients. "We may have to turn people away, we're overspilling."

Seven field hospitals had been set up in Port-au-Prince by international organizations as of Saturday, and three more were supposed to open Sunday, said Nicholas Reader, a spokesman for the U.N. Office for the Coordination of Humanitarian Affairs.

While some Haitian hospitals were still functioning, they were facing a new challenge -- patients and their families who refused to leave once they were treated because they had no other shelter available.

"They have nowhere to go. Their homes have been destroyed. So they are staying," Reader said. "So the hospitals are literally overflowing with people."

Among the 30 search-and-rescue teams from around the globe who were scouring the fetid rubble, some successes were reported. Nadine Cardoso Ridela, 60, the owner of the destroyed Hotel Montana, was found alive in the rubble shortly before dawn Sunday, and was being treated for nonlife-threatening injuries, medical officials said.

But officials acknowledged that the effort here is soon going to move from a search-and-rescue operation to a recovery effort

"The further we get from the event, the more difficult, the more challenging it becomes to find people alive," said Tim Callaghan, USAID's senior regional adviser on the Caribbean. "We're getting close to that painful time."

The Red Cross said access to food, water, shelter, sanitation and medical care remain extremely limited throughout the capital, as tens of thousands of survivors spent a fifth night camped out in squalid tent cities and makeshift shelters. Some people sought refuge in smashed and dust-covered cars, Red Cross officials said. Residents were seen picking through a dumpster in search of something to eat. Where medical help is available, those in need vastly outnumber those able to help. Long lines of sick and wounded form outside the gates of makeshift clinics, and the doctors and nurses who have mobilized search for desperately needed medicine and equipment.

At a clinic in the Montrissant neighborhood, pieced together out of two metal containers and a canvas-covered courtyard, "one of the doctors told me they cannot cope and lost over 50 patients in the past two days," said International Committee of the Red Cross spokesman Simon Schorno, who has toured most parts of Port-au-Prince. Fifty foreign doctors were expect to arrive at the clinic "soon," the Red Cross said.

The nearly collapsed Haitian government is at least nominally in charge of the relief effort, even though it has ceded air traffic control at the airport to the U.S. military.

With their offices heavily damaged, the president and his cabinet are now working out of a cramped, low-slung Haitian judicial police headquarters near the airport. International aid workers consider the building so fragile -- it has small cracks from the earthquake -- that they hold meetings with the officials on plastic chairs on the patio outside.

Secretary of State Hillary Rodham Clinton flew in for a visit Saturday with Haitian President Rene Preval, telling him: "We will be here today, tomorrow and for the time ahead."

Adding to the confusion, the top two leaders of the U.N. mission in Haiti, who normally would coordinate an aid response, are presumed dead. They disappeared after the quake destroyed the building in which they were meeting.

Clinton said the Haitian government has given the United States and others some leeway to meet emergency needs. The Haitian "government says the highest priority is to save lives," she said.

Haiti's government had reportedly recovered 20,000 bodies from the rubble by Saturday. Estimates are that the death toll could reach 50,000 to 100,000.

A few signs of national survival flickered, even as some Haitians began an exodus out of the devastated capital and into the countryside. But there was rising frustration -- and scattered looting -- among the desperate Haitian population. On Friday, the World Food Program had to suspend distribution of high-energy biscuits near the destroyed national palace when a crowd revolted, complaining that they were not getting better food.

"We're hungry. We're hungry," a group of boys on the side of the road implored a passing journalist on Saturday.

Much of the population of the city continues to sleep outside, with parks, streets, car lots and other sites turned into open-air dormitories. But other groups of people were seen trekking out of what one resident described as the "hell" of Port-au-Prince to friends, relatives and security in the countryside.

In Washington, meanwhile, former presidents Bill Clinton and George W. Bush pledged to lead a long-term fundraising effort on behalf of Haitian relief as they stood with President Obama in the White House Rose Garden Saturday morning.

The two former presidents continued their public appeal Sunday morning, with a joint appearance on CNN's "State of the Union." Bush, who until now has kept out of public view since leaving the White House, dismissed as "defeatist" critics who say Haiti will never recover from the devastation.

"Success is helping save lives in the short term," Bush said. "And then we can worry about the long-term after the situation has been stabilized."

Wilgoren and Leonnig reported from Washington. Staff writers Michael E. Ruane, Glenn Kessler and Michael D. Shear in Washington and Dana A. Hedgpeth in Fort Bragg, NC, contributed to this report.

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