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Monday, 8 February 2010

Christopher - Day 7 Port-au-Prince through the looking glass

We drive through Port-au-Prince each day on the way to and from the hospital. So, we get snap-shots of what is happening in the city as each day goes by.  In the first days there was just a mad rushing about as everyone simply tried to survive and find out who else was still alive.

But today, a different movement is visible. Everyone is busy doing something, and there is a sense of purpose in everyone’s actions. Sure, there are still people pushing the remains of their belongings along in wheelbarrows, but now they are going somewhere. Others are carrying beams of wood, or sheets of corrugated iron.

But everyone you see has now got a plan, and they are starting to make it happen. The resilience of the human race is something to behold, and I suppose bodes well whatever ghastly Armageddon we finally visit on ourselves, whether it be global warming or an exchange of nuclear warfare.

The local mobile phone distributor has a gigantic digger in their forecourt clearing the site. Clearly they are going to be one of the first to have a brand new building standing in the ruins of this city. I am sure that their Board of Directors have justified this expense as symbolising their dynamism and their ‘futuristic’ culture. It seems a pity that they have not decided to invest in their customers by building some housing, but there we go. Hooray for capitalism!

Port-au-Prince the capital and its comparisons with the UK

Port-au-Prince is a tiny city in our western consciousness. I think I had heard of it before this earthquake, but I don’t think that I could have told you that it was the capital of Haiti. I certainly could not have told you that the population of Port-au-Prince is over 3 million, the same as Birmingham, one of Britain’s principle cities.

The authorities still have no idea how many people have died here but we do know that the atom bomb dropped on Hiroshima killed forty thousand. This earthquake has killed somewhere between five and ten times as many. I find the numbers involved in this disaster hard to grasp.

Wounds, dressings and maggots

Today we accepted from the emergency service a sweet lady in her forties. She was as light as a feather and I wonder if she has eaten since the earthquake three weeks ago? It seems likely from what we can gather that she has lost every single member of her family - children, husband, parents, brothers and sisters. Her foot had been crushed and the wound had been dressed some weeks ago, and this is why she came to us.  My heart went out to this patient.

What kind of misery had this poor lady been through for the past three weeks with no close family and with a crushed foot which was being slowly eaten by maggots?  Actually, the larvae only eat dead tissue so they had probably done good rather than harm over this time, but I just cannot envisage the mental and physical torture that she must have been through.

Turf wars and the British ‘stiff upper lip’

Last night as darkness fell, gunfire started as it does most evenings in Port-au-Prince. However, last night it was in the wood immediately behind the house. I was delighted to see that no-one flinched at all.  All of us have worked in war zones. The shooting then got louder and a bit more frantic and those of us on the veranda decided to move inside. I explained to my French colleagues the concept of the ‘stiff upper lip’. They responded by opening another bottle of wine!

It appears that drug dealing is big, in the way it is everywhere in this part of the world, and that this was probably part of a turf war.  An hour later the Police arrived armed with Martini rifles. I kid you not! Each weapon was a veritable collectors piece and no match for whatever the dealers were using this year. They were clearly deeply embarrassed by the incident and very unwilling to go any closer to the scene of the dispute with their ancient weapons.

Plans afoot to create a Rehabilitation Centre

In the hospital there is a plan to create a rehabilitation centre for all those who have been injured in this disaster.  It is depressingly rare that NGOs agree to work together but in this case Doctors of the World (M├ędecins du Monde) and Handicap International have agreed to collaborate to try to create a huge integrated service providing both physical and psychological support for the thousands left damaged by this earthquake. There are actually great synergies between the two organisations and if this works it should be a quite wonderful initiative, which should make a real difference for thousands of people.

My son who is studying Aid to the Third World has just introduced me to a new phrase ‘Pink collar workers’ which I had never encountered before. If I have understood this concept correctly, pink collar workers are people in Third World countries trained to provide an international service such as Call Centres etc. You and I may sneer at them, but it is work like this which may provide some kind of future to those who have been disabled by this earthquake and so lost any other chance of earning a living.

Keeping pace with a heavy workload & the patients who need help

In the hospital itself there is still no sign that we are really keeping pace with the workload. Each morning there is a queue of several hundred waiting for the Emergency Department to open, and each evening the queue is just as long.

The waiting time along the side of the main road in the hot sun must be around 8 hours before you even get logged into the system, and these patients are really very ill indeed. It makes our efforts to see, treat and discharge patients within 4 hours at the John Radcliffe 2 Hospital in Oxford very creditable indeed.  I just wonder whether after all that waiting, we are providing what they really want.

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