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When the doctors and nurses arrived at the camps that held displaced Haitians, scabies was among the first things they noticed.
“The thing that jumped right in our face was skin issues, because they had poor water quality,” said Dr. Jean Edouard Mathon, who is coordinating response efforts for GHESKIO, a research and treatment institution in Haiti.
Lack of clean water was, indeed, causing widespread problems in the camp, from infectious skin diseases to dehydration to water-borne diseases that cause diarrhea. “They had scabies already…kids with fever [that] we thought was infection. It was not infection, it was lack of water,” said GHESKIO deputy director Dr. Marie-Marcelles Deschamps. “Scabies is a very contagious disease; it affected many kids. And the kids cannot sleep, it’s so itchy.”
In addition, Deschamps said, hip and leg fractures and other infections were widespread. People with HIV/AIDS and chronic diseases had been separated from their vital medications. Others were rummaging through the rubble to find soda bottles to drink.
The organization’s teams identified two camps to the south and west of the hard-hit city of Les Cayes, holding about 100 families overall, that particularly needed water and medical attention.
Then, they swung into action, arranging for tanks of clean water to be brought into each of the camps, and doing medical and psychosocial evaluations of the people living there. If patients needed urgent or extensive medical attention, they were sent to a nearby hospital in Les Cayes.
“We decided to stay there and we are still there, caring for the victims, caring for their infections, caring for their water-borne diseases,” Deschamps said.
A History of Response
Scott Morgan is the executive director of the Haitian Global Health Alliance, which exists to support GHESKIO. He explained that providers screen patients carefully, looking for chronic disease, trauma, HIV/AIDS, and indicators of trauma, such as having lost someone in the earthquake.
The quake is the newest in a series of hardships that Haiti has faced – hardships that include a presidential assassination, Covid-19, and economic and social instability. It killed at least 2,200 people and caused widespread damage.
GHESKIO is used to responding to Haiti’s needs. The institution was founded by a group of doctors who were interested in what turned out to be some of the symptoms associated with HIV/AIDS, including diarrheal disease and trauma, Morgan explained. After publishing groundbreaking work on the subject, the institution expanded into maternal and child health, primary care, and pediatrics.
They also played an active role in helping people affected by Haiti’s devastating 2010 earthquake, which killed approximately 220,000 people, and in treating the cholera outbreak that followed. Today, GHESKIO works with Haiti’s Ministry of Public Health and Population at sites around the country.
“We look at the person as a whole,” Morgan explained. “What’s your family situation? Do you have stable housing? Do you have food stability? Do you want to be screened for cervical cancer, if appropriate?”
Direct Relief provided to GHESKIO$150,000 in emergency funding and more than $630,000 – about 24,000 pounds – of medications and supplies, including PPE, antibiotics, chronic disease medications, wound care supplies, and hygiene items. All told, Direct Relief has provided more than $8.6 million in medical aid to organizations working in Haiti since the August 14 earthquake.
On the ground
Urgent medical conditions like scabies have begun to wane since camp residents received clean water and health care, but Deschamps said it’s important to stay vigilant. “We don’t want Covid or cholera,” she said. “That would be deadly. Those people are on top of each other.”
Thus far, they’ve been lucky. A few concerning respiratory infections turned out to be bronchitis. But GHESKIO’s staff continue to be concerned. When people are sick, Mathon said, “they’ll just tell you they have a minor fever, and testing is also not [widely] available in Haiti. But Haitian people, in general, really don’t believe in Covid.”
And Deschamps is gravely concerned about the safety of the children in the camp. Parents, eager to earn money, often leave their children at the camp during the day while they work. “They are at risk of unwanted pregnancy, of abuse,” she said.
To prevent this, she identified teachers and parents who were interested in volunteering to educate children, creating “a safe environment where the kids can even learn.” The education and activities keep them safe and occupied, while also sending the message that the situation in the camps is temporary.
“Life is not over, life goes on,” she said.
In addition, concerned about gender-based violence, Deschamps arranged for women to be given whistles, and placed them in positions of authority in the camps.
As they work with patients and keep the camps clean and safe, Deschamps and Mathon say the outside support has been invaluable. “The support from Direct Relief is helping us take care of the people directly at the camp – children, older people,” Mathon said. “Everything that was useful was given.”
For Deschamps, this earthquake feels personal. Born in Les Cayes, she feels “sad to see how an earthquake can destroy it so badly,” she said. “I was happy I took the team and went down to see myself, with my eyes and my heart.”
She’s particularly disturbed that gang activity has made it harder to get aid to the southern part of Haiti. “It’s painful to see a country in such a catastrophic situation,” she said. “I’m an optimistic person, but there are things you just cannot believe you’re hearing, you’re living.”
According to Mathon, this earthquake has shown the resilience of people in the south. He’s seen people act quickly to clear debris, start small businesses, and otherwise care for themselves and their families.
However, he said, they’re impatient to get back home. He estimates that, given the means, 75% of the people currently staying in the camps would return. Identifying ways to get them the necessary financial help or building materials is GHESKIO’s next concern.
Direct Relief is in contact with health centers and local organizations in Puerto Rico to assess damages and supply needs and is monitoring impacts in the Dominican Republic and other countries in the storm's path.