Hispaniola Island shared by Haiti is quite seismically active having a history of earthquakes being the poorest country. Haiti is struck by natural disasters, especially earthquakes and economically unstable. On 12th January, 2010 at 4:53 p.m. 7.0 Mw magnitude earthquakes struck approximately 25 km at a depth of 13 km from Port-au-Prince. There was tremendous loss of lives, property and shortage of medical care and supplies at the capital. Everyone pleaded for donations, aids, testimonials and images were circulated after earthquake and social media in response to global engagement. Therefore, the following discussion involves the early responses to Haiti earthquake, barriers to receiving health care services and role of nurses related to global event.
Local and national responses
After the earthquake, there were unclear roles of the states; however immediate responses of local people, volunteers and aids were provided to affected population in the form of health, shelter and food. Moreover, medical care and service relocations were provided to Haitian earthquake victims. Haitian government gave immediate responses in rescuing survivors by conducting search operations. The communication was properly set for the better functioning and coordination response efforts.
The first response was provided by Doctors Without Borders/ Médecins Sans Frontières (MSF) immediately early hours of 13th January morning. The team members took quick and effective responsive decisions about supplies and delivering extra staffs and healthcare professionals to the causalities. Surgical team was prepared maintaining surgery and shelter materials rigging new facilities in the damaged hospitals (Kirsch, Sauer & Sapir, 2012).
After 48 hours, human suffering increased where first aid was provided by international community assisted and provided quick response to the earthquake. The Dominian Republic was the first country who provided aid to Haiti, lifted heavy machinery, sent water and food to the victims. Along with surgeons and 36 doctors, Dominican Republic sent eight mobile medical units to Haiti. However, due to damage caused to key government buildings and members being missing or trapped, the immediate relief efforts lacked leadership. Boston provided emergency coordination meetings where they discussed about airlifting victims and sending health supplies (food), local health workers and volunteers to Haiti. It was an international emergency situation that has impacted local population being responsive to behavioral health and needs of the casualties. Real Medical Foundation provided medical staffing, strategic coordination and medical supplies to the health crisis in Haiti (Goggins, Mascaro & Mascaro, 2012).
Haiti is a fragile country and social unrest increased after the 2010 earthquake further weakening the institutions in the country. Social factors like gender inequalities rendering to the demographics of Haiti population experiencing severe human suffering form. The high levels of poverty and weak governance were some of the contributing factors for the mass infrastructure destruction and wide-scale destruction (Van de Walle & Dugdale, 2012). These conditions impacted the impeding responses and reconstruction efforts after the earthquake in Haiti. The victims were represented as evil, backward and poor in need for an intermediary help portraying Haiti as a failed state in the Western Hemisphere. The framing illustrated Haiti government as inept being politically unstable, corrupted, violent having multitude of chaotic problems. Media projected earthquake victims as ‘objects of pity’ that influenced the hegemonic response discourse put forth for earthquake response. This portrayal has shown to have unprecedented assistance from the international community having keen interest from investors to provide immediate response after earthquake (Raviola et al., 2013). The disaster response was effective, fast and well-funded; however long-term responses were few and failed to provide opportunity for better future. The social factors affected in a way that there was ineffective and weak leadership by Haitian authorities as maximum government buildings were damaged and officials trapped or missing.
Gender inequalities also followed post Haiti depicting wider context of gender crisis. There were gender exclusion patterns witnessed and obstacles seen after earthquake including gender-specific obstacles like class, exploitation, violence and stigmatization or racism. There was lack of support and recognition of women’s capacities by organizations providing relief responses. There was also lack of gender equality framework empowering women and ineffective responses towards their needs post earthquake (Horton, 2012). Moreover, the different expertise level, high staff turnover, inadequate language skills of volunteers and healthcare professionals affected the efficiency, effectiveness and quality of response.
A clear picture of vulnerability to disasters and colonial oppression, there was no sustained response and improvement of Haitians post earthquake. Although, huge amount of international efforts and humanitarian aids responded to earthquake, however there were systemic problems associated with these responses. About 900 non-governmental organizations (NGOs) and every organization had their own work style, suppliers and priorities. This created clashes and utter chaos between the organizations resulting in inability to deliver and little progress made in coordination to work towards response (Allen et al., 2016). There was ineffective delivery of response to local authorities and civilians as there was reduction of coordination by military bases. A study conducted by Sonshine et al., (2012) illustrated that training and organizational barriers obstructed the immediate care delivery after Haiti earthquake. Disaster training was much needed for healthcare professionals and volunteers as there was lack of medical support and impaired coordination. There was unorganized response that hampered relief efforts and professionals lacked disaster response in terms of immunizations, safety, cultural sensitivity and logistics. In addition, there was impairment in access to mental healthcare services due to lack of cultural and lingual sensitivity and multi-faceted approach required to improve awareness and access to services (Raviola et al., 2012). During an emergency, to develop an ethically responsible and culturally relevant workforce is not possible and therefore, protection needs and safety issues were not addressed by aids. Continuing disruptions and massive infrastructure devastation in every facet of Haitian society acted as barriers for rescue team and relief efforts. Logistics support including housing, communication and transportation due to massive property destruction acted barriers to allocation of resources to locations also influenced the relief efforts.
Role of health/altruistic organizations
On request of Haiti’s ambassador, notable countries like UK, U.S. Dominican Republic, Brazil, Canada, Cuba and Italy sent contingents of medical staff, disaster relief, security personnel and reconstruction technicians and Cuba sent around 930 healthcare professionals to Haiti. MSF sent 269 professionals and provided much better funded and extensive medical facilities with WHO, PAHO and UNICEF sending thousand disaster relief and military personnel being single largest contributor to relief efforts. Dominican Republic being the first country mobilized resources and provided aid to rescue Haitians (Holguín-Veras, Jaller & Wachtendorf, 2012).
Volunteers were deployed that met the partner and hospital needs working in coordination with local health clinics and facilities in supplying food, filed clinics set-up, physical therapy support and coordinated mobile outreaches to relief camps. Altruistic organizations in response to earthquake were American Red Cross (ARC) and Giving Children Hope provided supplies and medicines to the casualties, provided emergency care and humanitarian aids to Haiti. The Humanitarian Coalition reached to victims through donor program supporting recovery and reconstruction efforts with large influx of remarkable primary care (Altay & Labonte, 2014).
Role of nursing professionals
Nurses assisted in Haitian earthquake responded generously to emergency assistance and calls. Not every nurse was willing to respond, however many nurses worked beyond their scope of practice. Nurses provided care to earthquake victims in relief camps and focused on orthopaedic injuries like dislocations and fractures and infected wounds. This nursing role was drastically different from their traditional roles where they worked lots of casts and wound debridement. However, there was inability to patient follow-up due to huge number of casualties became of source of frustration for team where it was ‘hit-and-run medicine’. There was proper wound management by nurses performing wound cleaning and fracture immobilization on victims (Sapat & Esnard, 2012). California-based nationwide nurses’ union performed pin care, wound care and percutaneous endoscopic gastrostomy feedings and also personal care tasks. Paediatric nurse practitioner treated diarrheal illnesses as they were secondary infections due to earthquake injuries (Sloand et al., 2012). Concisely, working outside scope of nursing practice for global threat is challenging, however with world community support and internal resources, Haitians recovered and nurses built a nation better than before.
Conclusion
Earthquake in Haiti was unfortunate caused massive destruction of life and property. Immediate response was provided by both local and international organizations as relief efforts to victims. Haitian government gave immediate responses within few hours of earthquake strike and appealed for help from neighbouring countries. Dominican Republic, Cuba and other countries worked in collaboration with local communities in providing immediate relief. However, issues like communication, transport disruption and medical facilities are some of the barriers that impacted delivery of care. International organizations and disaster-relief volunteers extended their selfless help to Haitian population for effective care delivery and recovery.
References
Allen, J. D., Leyva, B., Hilaire, D. M., Reich, A. J., & Martinez, L. S. (2016). Priorities, concerns and unmet needs among Haitians in Boston after the 2010 earthquake. Health & social care in the community, 24(6), 687-698.
Altay, N., & Labonte, M. (2014). Challenges in humanitarian information management and exchange: evidence from Haiti. Disasters, 38(s1).
Goggins, S., Mascaro, C., & Mascaro, S. (2012, February). Relief work after the 2010 Haiti earthquake: leadership in an online resource coordination network. In Proceedings of the ACM 2012 conference on Computer Supported Cooperative Work (pp. 57-66). ACM.
Holguín-Veras, J., Jaller, M., & Wachtendorf, T. (2012). Comparative performance of alternative humanitarian logistic structures after the Port-au-Prince earthquake: ACEs, PIEs, and CANs. Transportation research part A: policy and practice, 46(10), 1623-1640.
Horton, L. (2012). After the earthquake: gender inequality and transformation in post-disaster Haiti. Gender & Development, 20(2), 295-308.
Kirsch, T., Sauer, L., & Sapir, D. G. (2012). Analysis of the international and US response to the Haiti earthquake: recommendations for change. Disaster medicine and public health preparedness, 6(3), 200-208.
Raviola, G., Eustache, E., Oswald, C., & Belkin, G. S. (2012). Mental health response in Haiti in the aftermath of the 2010 earthquake: a case study for building long-term solutions. Harvard Review of Psychiatry, 20(1), 68-77.
Raviola, G., Severe, J., Therosme, T., Oswald, C., Belkin, G., & Eustache, F. E. (2013). The 2010 Haiti earthquake response. Psychiatric Clinics, 36(3), 431-450.
Sapat, A., & Esnard, A. M. (2012). Displacement and Disaster Recovery: Transnational Governance and Socio?legal Issues Following the 2010 Haiti Earthquake. Risk, Hazards & Crisis in Public Policy, 3(1), 1-24.
Sloand, E., Ho, G., Klimmek, R., Pho, A., & Kub, J. (2012). Nursing children after a disaster: A qualitative study of nurse volunteers and children after the Haiti earthquake. Journal for Specialists in Pediatric Nursing, 17(3), 242-253.
Sonshine, D. B., Caldwell, A., Gosselin, R. A., Born, C. T., & Coughlin, R. R. (2012). Critically assessing the Haiti earthquake response and the barriers to quality orthopaedic care. Clinical Orthopaedics and Related Research®, 470(10), 2895-2904.
Van de Walle, B., & Dugdale, J. (2012). Information management and humanitarian relief coordination: findings from the Haiti earthquake response. International Journal of Business Continuity and Risk Management, 3(4), 278-305.
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