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Lessons Emerge from Quake Relief Effort in Haiti

January 19, 2010 at 12:00 AM EST
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One week after the devastating earthquake that rocked Haiti, Gwen Ifill speaks with Jon Andrus of the Pan American Health Organization about which aspects of the international response have worked and which have failed.
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GWEN IFILL: Now, a week into the disaster, we take a closer look at what’s working and what’s not. The Pan American Health Organization, which is part of the World Health Organization, is providing assistance on the ground. And its deputy director, Dr. Jon Andrus, joins me now.

Welcome, Dr. Andrus. Thank you for joining us.

DR. JON ANDRUS, Deputy Director, Pan American Health Organization: Thank you.

GWEN IFILL: One week later, what can you tell us about the level of coordination on the ground? We saw a lot of confusion in those pieces.

DR. JON ANDRUS: We sure did.

And the level of coordination is something that started with — immediately after the disaster, the world came crashing down on Haiti, a country that had very fragile infrastructure, and, so, really no capacity to respond.

We have gone from that picture to a picture today where there’s better coordination. We’re far from achieving the levels of effective coordination where we need to be. But there is some progress. And that’s the situation. There’s incredible challenges, when roads were completely blocked, bodies and debris blocking roads, no communication on the ground.

I have a dear friend and colleague working for our office whose husband works for a nongovernmental organization. And he happened to be in Haiti the evening of the quake. She didn’t hear from him for two days, until he was finally discovered and found to be alive.

That’s just an example even in our own organization. We have had a number of deaths among the volunteers there. You know, there’s — I think the security has made it very, very difficult.

GWEN IFILL: For sovereignty reasons, it makes sense that the U.S. would cede control to the Haitian government. But a government that is impacted the way that the Haitian government has been as a result of this quake, in much the way that your workers have been, can they effectively manage this?

DR. JON ANDRUS: I think that, in the case of the port and entry of supplies and medical teams, the U.S. needed to step to the plate and take charge there.

In the case of the response, the United Nations has divided the work among several what are called clusters. The health cluster is what WHO, the Pan American Health Organization is currently in charge of. There are other clusters for water and sanitation, logistics, which handles the security, nutrition, a number of others.

And each of those clusters must begin and have begun to work very hard on bringing in the key partners that are involved in those areas of work.

GWEN IFILL: Well, one of those key partners, Doctors Without Borders, we have had them on this program. They’re saying today that they have had medical planes again, for the fifth time, turned away from the airport that were carrying need supplies. Who do they speak to? How does that happen?

DR. JON ANDRUS: Well, they have to — I would think, in that situation, that they — we need to take that information and then feed it to our contacts.

We have daily meetings with our partners and agencies within the U.S. government. So, that’s happening. We have global meetings with all our partners beyond that involve other countries. We have hourly meetings with our staff on the ground and so on. So, that information needs to be made available.

The logjam that existed at the beginning is gradually being freed up. We know of teams arriving to certain hospitals, as was reported. We know of some services and supplies getting out at — with these enormous challenges in place.

The ministry of health, the government needs to be involved. To that end, I’m pleased that, two days ago, they met. They formed a national health commission. And, with that commission, they’re beginning to prioritize activities that we all can then support.

GWEN IFILL: Well, you take the words right out of my mouth, prioritizing. How and who gets to prioritize? You’ve got medical concerns. You have got security concerns. You have got distribution concerns. How do you decide what comes first?

DR. JON ANDRUS: Well, the — in the area of health, the priorities are water and sanitation and then providing immediate medical emergency care to those that were injured, and, then, during — and after this initial response, building a primary health care system that can deal with problems that already existed in Haiti, tuberculosis, the highest incidence in the region, level of HIV infection, infectious disease that was a real problem, with little infrastructure, so the bridging from this immediate response to handling those other issues that will be sustainable, making sure government is involved, to the extent possible.

GWEN IFILL: So, what health concerns have — has this earthquake exacerbated that existed before and new ones as a result of the triage which you have to do immediately, but which sets up consequences for what happens next?

DR. JON ANDRUS: Well, immediately with the injured patients, we’re worried about secondary infections. That needs to be taken care of. The water issue can lead to outbreaks of contaminated water, becomes a vehicle of a spread of bacteria and viruses to others.

I think the conditions that existed before need to be addressed as the long-range plan gets implemented, so we — leptospirosis, that doesn’t exist in most countries, is highly prevalent in Haiti. Malaria is a concern. During this immediate period, though, we’re focused on the response to injury and trauma.

GWEN IFILL: Are you satisfied during this immediate period that you’re getting the kind of coordination and support that you need, not only from the U.S. government, but also other governments, the United Nations, others who are all on the ground, and perhaps not all quite yet talking to each other?

DR. JON ANDRUS: We’re never satisfied. There’s always room for improvement. I think there’s been some progress. But we’re far from being where we want to be.

And, so, we need to challenge ourselves. We need to, each agency, each one that has a role in this, challenge ourselves how we can do better. And we need to be thinking about the government and the future of this country. Many times, agencies come in prioritizing their own interests, rather than the interests of the whole.

And, so, we have to come back to the table and say, this is about Haiti. This is about the future. And to the extent that you represent a certain NGO, agency or so on, we — that has to be secondary. This is about stepping to the plate to the long run.

GWEN IFILL: Dr. Jon Andrus of the Pan American Health Organization, thank you so much.

DR. JON ANDRUS: Thank you.