Oh . . . No

Jerry is taking me to affected areas no one has been to.

I wish I could tell you how death feels and I hope I can get rid of it.

I thought I knew death. I don’t.

Spirit

Some of the relief teams are already having to cycle people back out of country.

It’s very hard here. It’s hard for me too, sometimes, but the Haitian folks I am staying with are amazing and help me more than you could imagine.

Thank you again, Steve, Jerry, and Carla. Your courage and forbearance humbles me every minute.

OMIGOD! ACTUAL UN FOOD!

Was just in Christ Roi and saw the first UN food delivery in the six days I've been in country.

Saturday Morning

An army helicopter dropped supplies into a neighborhood called Croix-des-Bouquets, about eight miles northeast of PAP. No one to distribute them, just a naked supply drop. This area of about 450,000 people was not as badly damaged as central Haiti so the Haitian government is planning to locate tent cities here. Ironically, Croix-des-Bouquets used to be a beachtown community, but it was relocated inland after the 1770 quake.

Right now we are sitting in UN - created traffic jams, trying to get to Bistou. There seem to be random caravans of military from all nations (not just the U.S.) moving jeeps and MPs from the airport.

Creature Comforts

Also Friday night, in the restaurant there was this little brown dog, who had been somewhat cared for but was very thin. I have been avoiding dogs because of the rabies problem here, but she was clearly no threat, and had a collar with tags. Somewhere, some family had loved her.

She laid at my feet and I surrendered and petted her head. Then she slowly got up and just stood and looked at me with her head bowed a bit. I petted her some more and she jumped up on the ledge where I was sitting. She put her head in my lap. We sat for a while this way and then she eased her way into my lap and fell asleep. She had been well loved before the quake.

Then Steve came out of the restaurant and was yelling at me, very animated, that I was crazy, that this was a dirty street dog and I should get up right away. The dog and I both looked at him, probably with the same puzzled expressions on each of our faces. Steve realized we were happy right where we were and walked away, mildly frustrated, but amused.

Leaving her was not easy.

News of the "I'm Going to Be Sick Now"

Word is just reaching the relief folks that cruise ships are docking at a private beach that is fenced off and protected from the sick, starving Haitians by armed guards.

Apparently sipping mojitos and working on your tan just blocks away from where bodies are piled in the streets is America's way of saying "we care". I am so ashamed.

News of the Weird II

We have volunteer Scientology Ministers here.

No shit.

See badly lit photo of dude in green shirt.

I feel so much better now.

News of the Weird

Stef: Some unnamed “official” is being quoted on CNN as saying concerns may be overblown. Sanjay Gupta is blasting them right now. Gupta just had a fucking fit on camera about it.

Fuck the asswipe who said this.

Mark: May I blog this?

Stef: Don’t post yet, till we know who it is, because the descriptive might change.

Supplies: As in Where the FUCK Are They??

The wait for basic supplies seems endless you know. By the time they get there we will have lost so many lives due to the incompetent coordination.

Do not believe that there is some threat by the Haitians to riot – or any other excuse. The delay is due to the utter absence of clear, defined leadership.

Many groups have slowed down influx because new arrivals cannot be accommodated, and because of their needs for housing, security, etc.

We have four huge warehouses with 24 hour security available. Or the UN could provide security. The UN base here is just enormous. But then again, I’m just a nurse. Nobody asked for my two cents and when I offer suggestions I realize they don’t really want them.

There are no supplies to count on now. I guess this is a little like how the Haitians have felt for decades. I understand the long term issues but there are going to be so many fucking unnecessary deaths in the meantime.

Kasra Mofarah, Director of Operations for Bambou Generation, the French relief team informs me that for every $15,000 of supplies that are distributed, the US Army spends $30,000 distributing them.

Everyone is talking about the water trucks here. Two companies, Frechelocal and Mag are SELLING the water.

Local Heroes

We have stopped so Carla, Jerry’s wife, can feed me. I’ve lost nine pounds and she said I had to eat. So long as I can keep working.

Jerry is Steve’s friend who took me to Bistou the first time. He owns a gas station and he arranged the fuel, labor, and storage facility for supplies (if they ever get here.) He just makes things happen! (He also has arranged security if we need it.)

Jerry and Carla precious people – strong and committed to their nation. They had been working in New York . but Jerry’s parents persuaded them to come back to invest in their country.

And a better picture of Carla .....

Later Friday Afternoon -- After Surviving the Air Conditioned UN Lady

Leaving Clusterfuck Building 60f I checked in with some of the other relief groups. There is a Florida group from Dade County Hospital and the University of Florida that has a field hospital near the airport and I will be able to work there.

I also met an incredible French team from Bambou Generation that does low-tech housing and structural design with bamboo. They have plans for a medical clinic (contingent on guess what -- supplies) as well as emergency housing, public buildings, and sanitation. Wonderful, high energy people in spite of it all.

These people are remarkable.

Friday Afternoon

I spent part of the day trying to secure supplies for a children’s clinic in Peterville neighborhood of Port-Au-Prince. There are many children with diarrhea from drinking contaminated water. And babies with diarrhea from being breastfed by mothers who are drinking contaminated water. The babies are the scariest, because they have so little body fat and extra fluid to give up.

I spent hours trying to find find pediatric catheters to no avail.

People are drinking contaminated water now because there is nothing else. The ones who don’t want to get sick are starting to show signs of moderate dehydration.

The healthy can make it on a glass a day (for a little while) but the young, the elderly, and the ill will advance to severe dehydration in another two or three days.

Then they will start to die.

It’s almost like everyone has prepared themselves, relief workers and Haitians alike. It is like a movie where everything that can go wrong did . . and you are waiting for the hero to come save the day, only to realize in those last minutes of the movie that there is no hero. You know that really awful feeling when you realize it and you can’t stop watching and you can’t take back that you watched it.

You can forget it if it's a movie.. but tragically, this time we wrote the script. And now we have to live with the ending.

And it will never go away.

Thursday and Friday (out of order -- Blame Kleiman!)

Steve has not been able to speak with our Partners in Health

I don’t know where I will end up, but it won’t be very good. A seven day wait for supplies is not acceptable, but I'm not ready to leave until I've tried every avenue.

Right now this is the worst possible scenario So may people are going to die needlessly. More sad to have to leave them than anything. What a failure to the Haitian people . We have failed them – AGAIN.

None, Ma'am

Friday began with me afraid I would be leaving because there was no way to get supplies. My own had not come and would not for another week because we were not privileged enough to get a landing slot. So I went to the airport to see if I could find anyone to let me work with them and hiked about four miles with full gear. Striking out, I hiked another mile to the UN command area to give report on my findings.

I reported to the shelter cluster (Bldg 60f) responsible for assessment management and coordination of displaced persons. After writing my report, the nice lady in the air conditioned building (who has probably not been out of the compound) said to me, “we need to know more specific details about where you were in each area. You know each area is really big.”

I had given her the neighborhood names – Delmas, Nazon, Peggyville, Peterville, and Bistou, with the approx. numbers of casualties, infections, and people displaced who needed assistance.

Then she asked if I could identify the areas which had received relief aid. Of course, standing there like a deer in the headlights, I politely and sadly replied, “none, ma’am.”

The nice lady in the air conditioned room thanked me and I’m sure my report was filed in a latrine somewhere.

Amanuensis' Note

As Stef's breakneck pace becomes even more breakneck (and because I am sometimes out of touch) some of her reports from the front become less clear.

I am compiling them and posting shortly in mostly chronological order, with clarifications where I can get them, and without if I cannot. She is fine and very dug in.

Mark

URGENT!! -- re AREAS VISITED

I am posting this out of order because of the urgency of the information I just received from Stef.

If any of you have contacts on the ground let them know immed.

Areas visited this A.M. and status:

Delmas 75 "We need help" signs

Delmas 56 "We need help" signs

Delmas 60 "Help us please need food and water"

Delmas 91 SOS

Freres 18 "Desperate pleas for help"

Each of these areas have massive numbers of displaced families. We spoke with many people in each area who said there has been NO UN contact or relief in these areas.

WTF ??

An anonymous United States official told CNN today "There are great people on the ground who are working very, very hard to try and get as much in as they can and try and keep everybody impressed that we are there to support them. But there are some people who are not going to be happy because we just can't get it all."

This comment is clearly from someone who is not here. It implies that supplies have already gotten out. We are not unhappy because they "can't get it all". We are mad as hell because they haven't got "it" anywhere. So little is in the neighborhoods, and so much is stacked on pallets.

HAITI'S ELITE SPARED MUCH OF THE DEVASTATION

http://www.washingtonpost.com/wp-dyn/content/article/2010/01/17/AR2010011702941.html

By William Booth

Washington Post Foreign Service

Monday, January 18, 2010; A08

PETIONVILLE, HAITI -- Through decades of coups, hurricanes, embargoes and economic collapse, members of the wily and powerful business elite of Haiti have learned the art of survival in one of the most chaotic countries on Earth -- and they might come out on top again.

Although Tuesday's 7.0-magnitude earthquake destroyed many buildings in Port-au-Prince, it mostly spared homes and businesses up the mountain in the cool, green suburb of Petionville, home to former presidents and senators.

A palace built atop a mountain by the man who runs one of Haiti's biggest lottery games is still standing. New-car dealers, the big importers, the families that control the port -- they all drove through town with their drivers and security men this past weekend. Only a few homes here were destroyed.

"All the nation is feeling this earthquake -- the poor, the middle class and the richest ones," said Erwin Berthold, owner of the Big Star Market in Petionville. "But we did okay here. We have everything cleaned up inside. We are ready to open. We just need some security. So send in the Marines, okay?"

As Berthold stood outside his two-story market, stocked with fine wines and imported food from Miami and Paris, his customers cruised by and asked when he would reopen. "Maybe Monday!" he shouted, then held up his hand to his ear, for customers to call his cellphone.

So little aid has been distributed that there is not much difference between what the rich have received and what the poor have received. The poor started with little and now have less; the rich simply have supplies to last.

But search-and-rescue operations have been intensely focused on buildings with international aid workers, such as the crushed U.N. headquarters, and on large hotels with international clientele. Some international rescue workers said they are being sent to find foreign nationals first.

There is an extreme, almost feudal divide between rich and poor in Haiti.

The gated and privately guarded neighborhoods resemble a Haitian version of Beverly Hills, but with razor wire.

Elias Abraham opened the door of his pretty walled compound, a semiautomatic pistol on his right hip and his family's passports in his back pocket.

His extended family's four-wheel-drive sport-utility vehicles are filled with gas. He has a generator big enough to power a small hotel. And even if his kids are sleeping in the courtyard because they are afraid of the continuing aftershocks, his maids are dressed in crisp, blue uniforms and his hospitable wife is able to welcome visitors with fresh-brewed coffee.

Abraham has not been unaffected by the quake. His Twins Market grocery store collapsed Tuesday and fell prey to looters Wednesday.

"They took everything," said Abraham, the Haitian-born son of a Syrian Christian merchant family. "I don't care. God bless them. If they need the food, take it. Just don't take it and sell it for a hundred times what it is worth.

"This is not the time to think about making money," he added. "We need security. We need calm."

Up in the mountains, there are flower vendors selling day-old roses across the street from refugees in tents. There are beauty salons, fitness gyms and French restaurants. All of them are shuttered but mostly undamaged.

Few buildings collapsed in Petionville and the surrounding area, but a drive through the hillsides found only three or four spilling into ravines.

"Thank God for the mountain," said Wesley Belizaire, who escaped to the hills above Petionville with 15 friends and family members to camp out in a sprawling stucco. "It is so safe, safe, safe." The house belongs to his boss, the owner of a travel agency, who was visiting the Bahamas when the quake struck.

The police are operating out of a well-supplied station in Petionville, where the parking lot was filled with idle police trucks. There have been few reports of looting here, even though the town has banks on every corner.

Hervé Delorme, executive marketing director of Sogebank, stood outside a branch and said the building was safe and sound. "Only because of the electricity and communications we do not have the technology available to open," he said.

Across the street, one of the few pharmacies in the area was open. It was guarded by three Haitian police officers with rifles who let one customer in at a time. Down at the General Hospital, families wandered through the courtyard filled with patients with amputated limbs and open wounds, begging foreigners for medicine.

For better or worse, it will likely be the residents of Petionville who through their government connections, trading companies and interconnected family businesses will receive a large portion of U.S. and international aid and reconstruction money.

After a service at St. Louis Catholic Church in Port-au-Prince early Sunday, Yva Souriac was warning fellow parishioners what would come next with international assistance. "They only give the aid money to the same big families, over and over. So I ask, what is the point? They have given money to these families to help Haiti for 50 years, and look at Haiti. I say the Americans need to make up a new list."

I'm Not the Only One . . .

http://www.independent.co.uk/opinion/commentators/paul-mcmaster-equipment-needed-to-save-lives-was-here-ndash-then-sent-away-1874216.html

The hacksaw my colleagues have been using for amputations in the absence of any surgical equipment is broken. One of their most urgent tasks yesterday was to track down a replacement at the market. There were 12 people depending on the success of this mission, 12 people who will die if we cannot remove their gangrenous limbs.

Many of the patients Médecins Sans Frontières is treating have been pulled from the rubble of the collapsed buildings. There is not only the risk of septicaemia, but also "crush syndrome", which is where damaged muscles release toxins into the blood, potentially causing kidney failure. We desperately need dialysis machines to keep these patients alive.

It is unspeakably frustrating to think there were two of them on the cargo plane, which has been turned back from Port-au-Prince airstrip three times in as many days, most recently on Tuesday night. Five patients in another MSF health centre have already died because we don't have the medical supplies that we need.

I've never seen the kind of devastation I'm seeing in Haiti, despite having flown in to many emergencies. We're seeing the kind of daily casualty numbers you expect to see in a war. In some areas the city is absolutely destroyed. And it's always the most vulnerable who suffer most. Whenever I leave our makeshift clinic, I see so many people begging for surgery, for even the most basic medical help.

The almost incomprehensible scale of the destruction makes it all the more unacceptable that medical supplies are not getting through. MSF teams were treating patients within half an hour of the quake last Tuesday. We have managed to get some electricity working, and water, and we have treated more than 3,000 people in the Haitian capital and performed more than 400 surgeries. But we need more supplies if we are to continue saving lives here, and bringing them in has been incredibly difficult.

Since last Thursday, MSF has had five planes diverted from Port-au-Prince to the Dominican Republic. The planes carried a total of 85 tonnes of indispensable medical and relief supplies. Now those supplies are being moved by truck. Some trucks have arrived, others are still making their way along the only viable route. It's causing huge delays and we're in a race against time.

MSF has successfully landed another five planes with a total of 135 tonnes of supplies at Port-au-Prince. But that is only a drop in the ocean. To give you some idea, we estimate we need at least another 195 tonnes if we want to continue to scale up our medical relief here. Deprived of these urgent medical supplies, doctors are having to be ever more resourceful in saving Haitian lives. We ran out of histamine drugs for anaesthetics at the weekend, twice we have run out of plaster of Paris to fix fractures. And at the moment, we don't even have a simple thing like crêpe bandages. Our logistics team are working very, very hard, but it's just a nightmare.

The writer is a British surgeon working for Médecins Sans Frontières in Port-au-Prince

My Lame Plea to President Obama

Dear Mr. President:

A failure that is beyond belief is about to occur.

The United States is not leading any part of the relief mission here. We are participating in many ways, but we are not leading.

There is no leadership or organization anywhere in the country. There is chaos among the agencies rendering aid which results in little aid actually getting to the Haitian people. The death toll will rise significantly because we missed the opportunity to treat minor infections which have now turned into gangrene.

I am a registered nurse from California.   A local Haitian family took me in and they have been driving me to the injured and ill. In a few days it may not matter because many of these people will die from dehydration. There is little medical teams can do without supplies and drugs. There is nothing they can do if the supplies are left stacked at the airport. And none of this will matter without water.

Please consider this plea as though it were made for my own family – or for yours. We are running out of time here.

Sincerely,

Stefanie Fletcher, R.N.

Dry

We are out of sterile water. The local doc and nurse are staying to do what they can. Everyone figures the White lady will have better luck getting water and supplies.

I am really scared for people here.

Adrift in the Boneyard

I have a medical "tent" in Bistou, outside of Port-Au-Prince. I am working with a local Haitian M.D. and R.N. who have traveled here with me. A French aid group was here and left me with antibiotics, bandages, etc. This is good because United will not be delivering our supplies for another eight days and I will have to beg OCHA and scrounge from other groups when I return to town.

Well, the "tent" is actually a bunch of tarps held together with rope, with a piece of wood supported by other trash as a table.

There are 125,000 people here, and this is the only medical presence. We immediately began treating patients with pretty severe wounds. Infections are rampant and we don't have nearly enough. WHERE IS THE AID FOR THESE PEOPLE?? How could we possibly be the only ones here?

Spoke w. ABC news and some reporter is trying to get "clearance" to come out here. I'm not sure I understand the "clearance" part. We certainly didn't need any.

If A Nuclear War Could Have Survivors, They Would be Haitian

I’m at a restaurant somehow still running, owned by a friend of Steve’s– having the best soup I’ve ever had, and cherry juice. The day was a complete mix of horror, hymns to quiet courage, and the absurd.

Dead bodies are on the sidewalks and there are SOS signs everywhere – with NO visible relief effort in 90% of the city’s ruins. I spent the day driving around to random places to help people with survivable injuries. There will be another unnecessary mass death within five days due to untreated infections.

I do not understand why all of the foreign relief agencies behave as though there is no local capacity or ability among these beautiful, resilient people. The Haitians have offered to find me trucks, arrange labor, and “coordinate” supplies. If the truck pans out, we have located emergency food, water, and antibiotics – and we’re off to Leogane, the still neglected epicenter. If we can’t get the truck, a local police officer and his wife will help me set up a local tent clinic and I will treat the children with what I have and what I can scrounge.

If a nuclear war could have survivors, they would be Haitian. Say prayers for them.

After my prayers I had to listen to someone killing a dog, not too far away, and not very quickly. Nothing could drown it out, and nothing will take it away. None of this will go away. Ever.

The Bottleneck Continues -- Fatally

From the Doctors without Borders website . . .

http://www.msf.org/msfinternational/invoke.cfm?objectid=48616897-15C5-F00A-257556B8AC216486&component=toolkit.pressrelease&method=full_html

MSF plane with lifesaving medical supplies diverted from landing in Haiti Patients in dire need of emergency care dying from delays in arrival of medical supplies

Port-au-Prince - A Médecins Sans Frontières (MSF) cargo plane carrying 12 tons of medical equipment, including drugs, surgical supplies and two dialysis machines, was turned away three times from Port-au-Prince, Haiti, airport since Sunday night, despite repeated assurances of its ability to land there.

This 12-ton cargo was part of the contents of an earlier plane carrying a total of 40 tons of supplies that was blocked from landing on Sunday morning. Since January 14, MSF has had five planes diverted from the original destination of Port-au-Prince to the Dominican Republic. These planes carried a total of 85 tons of medical and relief supplies.

“We have had five patients in Martissant health center die for lack of the medical supplies that this plane was carrying,” said Loris de Filippi, emergency coordinator for the MSF’s Choscal Hospital in Cite Soleil. “I have never seen anything like this.

“Any time I leave the operating theater, I see lots of people desperately asking to be taken for surgery. Today, there are 12 people who need lifesaving amputations at Choscal Hospital. We were forced to buy a saw in the market to continue amputations. We are running against time here.”

More than 500 patients in need of surgery have been transferred from MSF health center in the Martissant neighborhood to Choscal Hospital with more than 230 operated on since Thursday. MSF teams have been working since the first hours after the earthquake and these cargo shipments are vital to continue their ability to provide essential medical care to victims of the disaster. In five different locations in the city, MSF has given primary care to an estimated 3,000 people in the capital and performed more than 400 surgeries.

“It is like working in a war situation,” said Rosa Crestani, MSF medical coordinator for Choscal Hospital. “We don’t have any more morphine to manage pain for our patients. We cannot accept that planes carrying lifesaving medical supplies and equipment continue to be turned away while our patients die. Priority must be given to medical supplies entering the country.”

Many of the patients have been pulled from the rubble of collapsed buildings are at grave risk of death from septicemia and the consequences of “crush syndrome,” a condition where damaged muscle tissue releases toxins into the bloodstream and can lead to death from kidney failure. Dialysis machines are vital to keeping patients alive with this condition.

Another two planes carrying a total of 26 MSF aid workers were diverted to Dominican Republic. MSF has successfully landed five planes with a total of 135 tons of supplies into Port-au-Prince. Another 195 tons of supplies will need to be granted permission to land in the airport in the coming days in order to continue MSF’s scale up of its medical relief operation in Haiti.

More than 700 MSF staff are working to provide emergency medical care to earthquake survivors in and around Port-au-Prince. MSF teams are currently working in Choscal Hospital, Martissant Health Center, Trinite Hospital, Carrefour hospital, Jacmel Hospital, and are establishing a 100-bed inflatable hospital in the Delmas area. They are running exploratory assessment missions to other locations outside the capital as well.

Cuban Hospital an Oasis of Well Organized Care

"CNN's Steve Kastenbaum reports on a hospital which provides quality care
for Haiti's earthquake victims."

"There are so few places where ordinary Haitians can turn to when they are in need of urgent medical care in the center of the city. We came across one: La Paz hospital. It is now being administered by Cuban medical personnel here in Haiti alongside crews from Spain and Latin America. And it is amazing to see. They are giving medical attention-quality medial care-to severely injured people, six to seven hundred patients a day, several dozen surgeries a day. They have three theaters going around the clock, 24-7, and it is one of the only places deep in the city where Haitians can go and be treated and have a reasonable expectation of surviving.

We saw so many traumatic injuries there. I can't even say how many amputations we saw, compound fractures, traumatic flesh wounds. Yet, these overwhelmed medical teams were finding ways to take care of all of them,
despite being very low on critical supplies-sutures, oxygen, anesthetics, water-they need all these things. Their supply lines stretch all the way back to Spain, and it's being sent in. And it is being done in a remarkably orderly fashion."

Steve Kastenbaum, CNN, Haiti"

http://edition.cnn.com/video/#/video/world/2010/01/17/kastenbaum.haiti.la.paz.hosp.cnn?iref=allsearch

Nightpeace

It is very quiet right now, which is very unusual. I can hear dogs barking and children crying, and an airplane every now and again.

The most comforting sound right now is lying here while Steve and his cousin and his nephew, Jean, listened to this wonderful mixture of jazz and salsa, and now a French language radio program. I cannot follow the details, but for just a bit, things quietly feel almost normal. This tiny patch of comfort and normalcy is very sobering, knowing that just a few streets away, an entire family lies buried under the concrete of a home so like this one, with imagined lives so like those of our hosts.

I am so moved by Steve and his family opening their home to us. Steve's nephew, fifteen year-old Jean has kindly consented to help me pick up a bit of essential French. Younger than my own sons, but maturing so quickly, Jean is endlessly patient with my Tennessee-accented attempts at French, and ready with a kind and enchanting smile despite what surrounds us.

In the midst of all of this, I am free to sleep, humbly thankful for this kind and gentle welcome.

I Have No Mouth But I Must Scream

Tonight we drove past a home that had been leveled. The entire family was still inside . . . dead. There are no words in our language to describe this.

I have to sleep now.

Leogane's Post-Apocalyptic Landscape

http://online.wsj.com/article/SB10001424052748703569004575009493976627772.html#

In Léogane, Miles From the Capital and Waiting for Aid By JOSé DE CóRDOBA And CHARLES FORELLE

LÉOGANE, Haiti – Hilda Alcindor, dean of the nursing school here, has seen 5,000 patients since Tuesday's quake. She and her brigade of nurses and students have sutured countless wounds, delivered six babies and amputated a little girl's arm.

Sunday, a little relief finally arrived in the form of two volunteer doctors who set up operations inside the nursing college. A town of 50,000 just 20 miles west of the capital, Léogane has been left practically to its own resources since Tuesday's earthquake. "Everybody is talking about Port-au-Prince. What about Léogane?" asks Ms. Alcindor who returned to Haiti in 2005 after 30 years of working in Miami hospitals. "Léogane is all broken." If getting aid from Port-au-Prince's airport out to its shattered neighborhoods is difficult, bringing help to devastated outlaying areas has proven to be a monumental challenge.

Léogane's police chief, Alain Auguste, says that almost 80% of the town has been destroyed, and that there are at least 10,000 dead. Authorities say they have buried about 1,300 -- about 800 in mass graves. Mr. Auguste says Léogane has no heavy equipment like bulldozers or cranes to lift rubble and get to the bodies. "The city is completely destroyed. We have nothing. We work with our hands," he said. Léogane has practically no communication with national authorities in Port-au-Prince, where most of the aid is arriving.

To plead the city's case, the mayor drove to the capital Saturday.

The campus of the nursing college has been turned into a tent city where hundreds of survivors who have lost their houses, or are afraid to sleep in them because of recurring aftershocks, strung sheets between shaved branches of trees under a sweltering sun. "I need antibiotics, I need pain medicine, I need anti-tetanus shots," says Ms. Alcindor. She fears an outbreak of infection from the filthy conditions. "Those legs we treated Tuesday, they are falling apart," she says, standing in the middle of the refugee camp.

Scores of injured people ringed the building, clustered in patches of shade.

Joachin Esau, 22 years old, lay on his back with a gash in his shoulder and a badly swollen right leg. He had been at home when the quake hit and his foot was caught by a falling wall. "I spent the entire night under the rubble," says Mr. Esau. Neighbors found him the next morning.

Salomon Roosevelt, the principal of a now flattened elementary school, had come to the nursing school to help. "We need orthopedists and radiologists,"

said Mr. Roosevelt, wearing a smock and a surgical mask. "Nothing has been done. Nothing." Sunday afternoon a little bit of help trickled into Léogane.

In front of a United Nations compound, a dozen Argentine doctors and medics were setting up a tent for a field hospital. Three Canadian rescue workers were heading out to survey the damage and preparing for the arrival of another eight of their colleagues. "Aid is now beginning to flow into Port-au-Prince, but we are trying to get out to areas that are potentially underserved," said Chris Kaley, a Vancouver paramedic.

Write to Charles Forelle at charles.forelle@wsj.com

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved

Leogane, Haiti's Third Largest City, is 90% Destroyed

I met with OCHA (the United Nations Office for the Coordination of Humanitarian Affairs) and learned of the desperate emergency in Leogane, just ten miles west of Port-Au-Prince. There are many survivors with major and moderate, survivable injuries -- but there is

• No hospital
• No supplies
• No nurses and
• One doctor

The devastation is worse than Port-Au-Prince, if that can be imagined. Leogane has a population of about 140,000. There is no government or infrastructure left at all.

I have hooked up with Partners in Health so we can coordinate our efforts to provide emergency food, water, and shelter.

The road from Port-Au-Prince to Leogane is passable with minor blockages, but cars and fuel are major problems. Those gas stations undamaged by the quake are closed.

But we will do this.

LANDFALL!

Stef and a medical team have landed in Port-Au-Prince. A Haitian businessman from Boston, Mr. Steve Texas, is kindly hosting us at his house (still standing!) for the team's use. It is centrally located so they won't be stuck in a militarized compound, and will also accommodate much of the first shipment of medical equipment.

We are all grateful for this generosity which makes the work so much easier.

Photos to follow

Santo Domingo

Stef just landed in Santo Domingo on a corporate jet Honeywell donated to get a medical team in. We are checking on transport to PAP.

Cruise ship docks at private beach in Haiti for barbeque and water sports

FROM http://boingboing.net

The Royal Caribbean Cruise Lines' ship Independence of the Seas went ahead with its scheduled stop at a fenced-in private Haitian beach surrounded by armed guards, leaving its passengers to "cut loose" on the beach, just a few kilometers from one of the worst humanitarian disasters in the region's history. The ship's owners justified it as a humanitarian call, because the ship also delivered 40 palettes of relief supplies while its passengers frolicked on zip-lines and ate barbeque within the 12-foot-high fence's perimeter:

The Florida cruise company leases a picturesque wooded peninsula and its five pristine beaches from the government for passengers to "cut loose" with watersports, barbecues, and shopping for trinkets at a craft market before returning on board before dusk. Safety is guaranteed by armed guards at the gate.

The decision to go ahead with the visit has divided passengers. The ships carry some food aid, and the cruise line has pledged to donate all proceeds from the visit to help stricken Haitians. But many passengers will stay aboard when they dock; one said he was "sickened".

"I just can't see myself sunning on the beach, playing in the water, eating a barbecue, and enjoying a cocktail while [in Port-au-Prince] there are tens of thousands of dead people being piled up on the streets, with the survivors stunned and looking for food and water," one passenger wrote on the Cruise Critic internet forum.

"It was hard enough to sit and eat a picnic lunch at Labadee before the quake, knowing how many Haitians were starving," said another. "I can't imagine having to choke down a burger there now.

Step by Step

Stef is getting closer. Tonight United is flying her to Newark. Kudos to to an amazing United employee, Nicole Lee Klein who worked through the day with her one and three year old kids in the office to make this happen for Stef and for other health care workers. Nicole may never get to Haiti herself, but has struggled like a champion to make this happen for the folks with the training to make a difference.

Tomorrow Stef and a medical team fly out at the crack of dawn, hopefully for Port-Au-Prince, but if need be, Santo Domingo.

Meanwhile, another heart-breaker from one of the few medical teams on the ground:

January 17, 2010

Makeshift Haiti hospital

Posted: 11:17 AM ET

By John Bonifield
CNN Medical Producer

For a while they were throwing limbs of the dead in the trash. A human foot and arm mixed amongst the garbage. If there was ever any semblance of dignity here at this makeshift hospital on the United Nations compound near the airport in Port-au-Prince, it is quickly vanishing.

Dr. Jennifer Furin

I just watched aid workers remove a dead body from a warehouse tent that is being used to triage survivors from the earthquake. This was the forth person to die since midnight, and right now it’s only 9am.

“I have no morgue. I have no place to put dead bodies,” says Dr. Jennifer Furin, a physician from Harvard Medical School who is coordinating care in one of two hospital tents here.

“This is becoming the killing field,” she says.

The injuries I am seeing here could be managed in the United States. But here in Haiti they’re starting to kill. Some people are dying from overwhelming infection. Others from a chemical reaction in their bodies called rhabdomyolysis. When a wall or chunk of concrete falls on a person, their muscles are crushed and the body releases an enzyme that poisons the kidneys. If the injured limb is not amputated or surgically cleaned out they die.

Doctors here have been using IV fluids to protect patients from kidney failure, but they haven’t had any anesthesia to perform surgeries until today.

“This is the beginning,” says Dr. Furin. “We missed our window. Maybe not for all of them, but for many of them.”

Dr. Furin refuses to let her hospital tent become any more undignified than the situation here is making it. She’s ordered all of the doctors working in it not to dispose of any more dead limbs in the trash. Instead, she’s found a plastic bin that she's placed next to her, where the remains will go until they can be properly buried.

The Cubans Have Treated Over A Thousand Patients

Henry Reeve Cuban Medical Brigade Serving in Haiti

Despite repeated aftershocks following the 7.2 earthquake that shook Haiti on Tuesday, a 60-member relief team of Cuban healthcare professionals is already providing medical assistance in that country

By:

Email:

2010-01-15 | 15:32:13 EST

Despite repeated aftershocks following the 7.2 earthquake that shook Haiti on Tuesday, a 60-member relief team of Cuban healthcare professionals is already providing medical assistance in that country.

The team is part of the Henry Reeve emergency medical brigade, a contingent of Cuban doctors specializing in disaster situations and epidemics created by Fidel Castro to bring professional assistance to peoples in need in any corner of the world.

In a catastrophe report published by the Cubadebate website, Cuban radio correspondent Isidro Fardales reports that this group of specialists brings the total number of Cuban doctors working in Haiti to 300, many of whom were sent to Puerto Principe in the aftermath of the earthquake.

Upon arriving in Haiti, Fardales reports the following, “We arrived at a field hospital located in the central courtyard of a place Haitians call the El Anexo, a facility within the Military Hospital facilities.

“There, under a big tent, Cuban surgeons tirelessly treat every patient that comes in, injured or mutilated; although the line of people waiting for assistance seems to stretch on forever.

“As I write this, our medical staff has already treated more than a thousand patients in little more than 24 hours, and dozens of them have undergone emergency life-saving surgery.

“Another field hospital has been set up in the Renacimiento Ophthalmology Center, the hospital that used to house the Milagros mission [Cuban-Venezuelan Free Eye-Surgery Program] in Haiti.”

A Frightening Reminder of Katrina

http://www.npr.org/templates/story/story.php?storyId=122674038

85 Elderly Quake Survivors Await Death In Haiti

by The Associated Press

PORT-AU-PRINCE, Haiti January 17, 2010, 01:09 pm ET

The old lady crawls in the dirt, wailing for her pills. The elderly man lies motionless as rats pick at his overflowing diaper. There is no food, water or medicine for the 85 surviving residents of the Port-au-Prince Municipal Nursing Home, just a mile (1 1/2 kilometers) from the airport where a massive international aid effort is taking shape.

"Help us, help us," 69-year-old Mari-Ange Levee begged Sunday, lying on the ground with a broken leg and ribs. A cluster of flies swarmed the open fracture in her skull.

One man has already died, and administrator Jean Emmanuel said more would follow soon unless water and food arrive immediately.

"I appeal to anybody to bring us anything, or others won't live until tonight," he said, motioning toward five men and women who were having trouble breathing, a sign that the end was near.

The dead man was Joseph Julien, a 70-year-old diabetic who was pulled from the partially collapsed building and passed away Thursday for lack of food.

His rotting body lies on a mattress, nearly indistinguishable from the living around him.

With six residents killed in the quake, the institution now has 25 men and 60 women camped outside their former home. Some have a mattress in the dirt to lie on. Others don't.

Madeleine Dautriche, 75, said some of the residents had pooled their money to buy three packets of pasta, which the dozens of pensioners shared on Thursday, their last meal. Since there was no drinking water, some didn't touch the noodles because they were cooked in gutter water.

Dautriche noted that many residents wore diapers that hadn't been changed since the quake.

"The problem is, rats are coming to it," she said.

Old men and women lay camped outside their quake damaged nursing home in Port-au-Prince, Sunday, Jan. 17, 2010. More than 100 elders are living outside the home with no food or care other than an occasional bath from two orderlies who remained to help.

Associated Press

An elderly woman begs for food from people passing by as she lays with other senior citizens outside their nursing home in Port-au-Prince, Sunday, Jan. 17, 2010i. More than 100 old men and women were living outside the home, that was damaged during Tuesday's earthquake, with no food or care other than an occasional bath from two orderlies who remained to help.

Associated Press

An old man lays on a bed outside his nursing home in Port-au-Prince, Sunday, Jan. 17, 2010. More than 100 old men and women were living outside the home, that was damaged during Tuesday's earthquake, with no food or care other than an occasional bath from two orderlies who remained to help.

Associated Press

An old man is fed a few nuts from his nephew while lying outside his quake damaged nursing home in Port-au-Prince, Sunday, Jan. 17, 2010. More than 100 old men and women were living outside the home, that was damaged during Tuesday's earthquake, with no food or care other than an occasional bath from two medical orderlies who remained to help.

Associated Press

An medical orderly waves flies off an old man asleep on the ground outside his nursing home in Port-au-Prince, Sunday, Jan. 17, 2010. More than 100 old men and women were living outside the home, that was damaged during Tuesday's earthquake, with no food or care other than an occasional bath from two orderlies who remained to help.

A

On the Razor's Edge Between Life and Death

From: stefanie fletcher <STEFLETCHER@earthlink.net>

Date: January 17, 2010 1:24:37 PM CST

To: xxxxxxx@united.com

Cc: xxxxxxx@united.com, "xxxxxxx@united.com>

Subject: Re: medical personnel into Port au Prince,

Hi Xxxxxx,

I touched base with Rosemary last night and wanted to touch base with you and Alissa too. I am a nurse traveling relief supplied and I wanted to make sure that you knew, although it would be ideal to travel with our supplies, it is not necessary. I have enough supplies, personal and medical (medicine, bandages, etc for 500 people) to be self sufficient for 5 days --- in two checked bags, which weigh about 150 pounds total.

I was not very clear about the delay in getting the medical personnel into the country -- even if the supplies are on another flight. I am sitting in a hotel in Chicago with supplies, medicine and life saving skills, while I watch people injured and dying wait for doctors and nurses. I understand there are doctors and nurses from South Africa here somewhere too. I apologize for not understanding the delay until Tuesday and could you please explain it to me? Are there other medical teams that you are transporting today or has there been government instructions that will not approve a flight plan?

Please forgive my ignorance of the situation and it isn't meant to be disrespectful. My request is heartfelt because I just received the latest U.N. video of the 11 year old girl, pulled from a building yesterday who died this morning because once they pulled her out, there was no place to take her and no medical personnel available immediately to treat her injuries. Her story is but one of too many -- people are being saved and then left without medical attention.

Again, thank you for your time and the efforts of United Airlines to work on this lifesaving and humanitarian mission.

With deep gratitude and humility,
Stefanie Fletcher Nieber, R.N.