RedR-trained medical worker saves lives in Haiti

Valerie Rzepka is Chair for grass-roots medical response and relief organisation, Canadian Medical Assistance Teams (CMAT). Valerie has recently returned from Haiti where she was providing medical care following the devastating earthquake, and she is now coordinating the organisation’s operations in Haiti from Canada. She attended RedR’s Needs Assessment in Emergencies course in 2008 and has previously attended RedR’s Managing People in Emergencies and Managing Projects in Emergencies courses. Valerie found all the training and networking opportunities invaluable in her work in Haiti.

Following a disaster such as the Haiti earthquake, it is vital to have people with the right skills and knowledge in place. CMAT has a database of professionals, including doctors, nurses and paramedics which they call on in times of disaster. 72 hours after the earthquake occurred, Valerie and her team of health professionals were in Port-au-Prince. They soon realized that despite the devastation in the capital, an even greater need for their medical services existed in the city of Leogane, about 35 km southwest of Port-au-Prince.

42 hours after they had conducted an initial assessment, Valerie had mobilised their inflatable field hospital and medical team. Their first patient that evening was a baby boy - born healthy before they had even opened their doors! They saw a huge array of horrific injuries during the first few days - treating 200 to 300 patients each day, and performing orthopaedic surgeries, amputating infected limbs, repairing broken bones, and attempting to mend broken lives. Now the immediate traumatic injuries are treated, there are pressing primary care concerns, as Valerie points out; “Infectious disease can spread through camps like wildfire. Our teams have seen outbreaks of measles, tetanus, TB, and chicken pox. Also rampant was acute watery diarrhea, likely due to a contaminated water source.”

Valerie was pleased to be able to collaborate and work with other NGOs in the field, for example one day the CMAT surgeon was unwell, which meant the anaesthesologist couldn't work, so he was redeployed to another NGO which needed anaesthesia. As she states; ”It is all about cooperation for the greater good, not about competition“.

A challenging working environment

There were a number of challenges that the CMAT team had to overcome - logistics was very difficult as Valerie states; “Roads are covered in rubble, cracked and at times unusable. Trucks, at least those which weren't crushed by rubble, are in high demand, and need gasoline to run. Gasoline is very difficult to find, and expensive.“ In addition to the difficulties due to lack of infrastructure, safety and security was also a concern. In one instance, an NGO was handing out food tickets near to the CMAT camp and there was a scuffle at the distribution point. The local police fired shots in the air, and the shrapnel fell on their tents, and even struck one of their volunteers in the shoulder (he was not injured). As well as collaborating with other NGOs, the CMAT team benefited from a strong working relationships with the military; “ CMAT developed an extremely strong and unprecedented relationship with the Canadian Forces, who not only provided us with Force protection from the Royal 22e Regiment “Van Doos”, around the clock, but also provided us with manpower, in the form of sailors from the HMCS Athabaskan, who helped to move patients on stretchers, provided translation during patient assessments, and other critical skills.”

Other challenges were personal - both physical and emotional. Not everyone realizes how difficult being in such an environment can be. It is important to have aid workers responding who know what they are doing as well as being self-sustaining, in order to effectively help the people affected by the disaster, otherwise they can in fact harm the aid process. As Valerie clarifies; “I can't even count how many times we came across well-meaning individuals, who become a burden on the already suffering population, because they require food, water and shelter. Organizations and individuals need to come prepared with ready to eat meals, and bottled water or purification systems, so that they don’t divert desperately needed food aid, shelter and potable water from the victims in order to sustain themselves. This is by far the most important thing we learned in the field.”

In addition to physical issues such as the heat, posing problems for the team, the working environment was stressful and emotions were heightened. CMAT therefore made a point of having daily debriefing sessions. These sessions enabled everyone to share lessons - what worked well, what needs improvement, what were the highlights of the day, what were the things they had difficulty with. The team also shared stories with one another over supper. This helped keep them grounded, and made them realize that they were all experiencing a very emotional event.

Using RedR’s training

Valerie found knowledge gained on RedR’s Needs Assessment in Emergencies course invaluable. “The course was critical in bettering my understanding of the disaster process… Mapping and GIS were very handy to have and a lot of what I used from the needs assessment course has become second nature to me in responding to such a situation”. The course also provided Valerie with solid knowledge of the different relief sectors such as water, sanitation and hygiene and nutrition which helped her to deliver the health services more efficiently and effectively.

The course gave Valerie and the other participants a fantastic opportunity to network and meet other aid workers, two of whom she has met up with while in Haiti; “Networking was a phenomenal opportunity during this course, and I am so grateful to have met Ben and Jude!”.

From the Managing People in Emergencies and Managing Projects in Emergencies courses Valerie found some of the financial frameworks and accountability strategy useful. Learning how to build and support teams, utilise communications skills and manage conflict was also vital, as she observes; “A heightened emotional environment led to some interpersonal conflicts and role realignment, so dealing with these human resource issues was critical from the perspective of team leader/ chairperson”.

The future

The medical response has seen a shift from traumatic injuries to primary care – the next CMAT team to depart will include more general practitioners and nurse practitioners and fewer surgeons. There will also be an increase in the spread of infectious disease, as people live in close quarters, and more diseases become apparent. Valerie expects to work together with the Health Cluster and OCHA to report and manage these cases of infection.

CMAT will continue to monitor the situation in Leogane. Currently (and this could change at a moment's notice), CMAT will be sending primary care teams into Haiti until mid-march. Following that, they plan to send in rehabilitation teams of physiotherapists, occupational therapists, and psychologists. They are looking into sending alternative therapy providers as well, such as art therapists for the children. Whatever happens in the coming weeks, having people with the right skills and training in place like Valerie and her team has made a real difference to people affected by this disaster.

Photo credits: CMAT
 

More Personal Stories