With uncounted thousands dead and many thousands more injured, the stricken city of Port-au-Prince is in a vast medical crisis.
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Patience Wears Thin as Haiti's Desperation Grows (January 16, 2010)
Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patients with head, chest or abdominal injuries or whose limbs have been badly crushed need immediate surgery, but given the collapse of hospitals and medical centers, little is available.
Port-au-Prince is an endless refugee camp, with tens of thousands sleeping in the open, raising the threat of cholera. Other diarrheal diseases can spread quickly; colds that turn into pneumonia can kill children.
Relief organizations have plans to set up a huge medical center in the city's main soccer stadium to serve thousands, but doing so will take days if not weeks.
Doctors Without Borders, which can no longer use its trauma surgery hospital in Port-au-Prince, said that it had two surgical rooms open in the city — and hundreds of people waiting for care. Mobile operating theaters and more surgical specialists were en route, but were delayed in the air and on the roads from the Dominican Republic. Medical needs across the city, the group said, were "overwhelming."
"Triage, stabilization of the wounded and referrals for surgical needs are the medical priorities," Dr. Mego Terzian said on the group's Web site.
Dr. Greg Elder, deputy operations manager for Haiti for the group, said, "We started doing some surgery during the night, and we hear there are a couple of hospitals on the periphery of Port-au-Prince operating around the clock but not able to keep up."
"I think they're doing mostly wound cleaning, debridement and amputations," he said, speaking from New York. "Limb-saving procedures are not really the order of the day at the moment."
The desperate periods when rescuers try to excavate survivors carry special dangers. Rescuers who lift debris off victims must be alert for surges of severe bleeding, said Dr. Linda C. Degutis, an expert in disaster relief at the Yale School of Public Health. Pressure from the debris may be preventing a hemorrhage.
After about 72 hours — Friday evening, in this case — victims may start dying of kidney failure as crushed muscles break down into proteins that flood the bloodstream. These patients need dialysis, which is probably not available anywhere in Port-au-Prince. As a stopgap measure, they may be given intravenous saline solution with mannitol, a sugarlike molecule that helps flush out the kidneys.
Those who try to salvage possessions from the debris of their homes can easily turn into victims too, said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University Mailman School of Medicine. They typically suffer cuts, broken limbs and electrocution burns.
Clean drinking water is a huge concern. Measures as simple as digging latrines can save lives.
James L. Phelan, a spokesman for Action Against Hunger, said that if water could not be delivered by tanker, local sources could be run through filters and have alum and chlorine added to remove solids and kill germs. "Bladders" and "onion tanks" of water can be delivered on flatbed trucks with rows of taps attached to flexible piping.
Inoculations will also be important, said Dr. Jon Kim Andrus, deputy director of the Pan American Health Organization. Many of Haiti's children are not vaccinated against diphtheria or measles. The first is rare but often fatal; the latter is common in refugee camps and dangerous to children. Adults may need tetanus boosters to protect against fatal "lockjaw" from dirty wounds.
Corpses present some of the greatest difficulties, both medical and psychological. Port-au-Prince's streets are full of them, and they are piling up in hospital courtyards. Some have already been dumped in mass graves.
It is a myth that bodies start epidemics, numerous experts said, unless the victims died of infectious diseases like cholera or Ebola, which is not the case in Haiti.
A World Health Organization study in Aceh, Indonesia, after the 2004 tsunami found no disease outbreaks even after thousands of drowned villagers lay unburied for weeks in wet lowland areas. However, the stench can quickly become overpowering, and omnipresent bacteria can multiply to be somewhat dangerous to people handling them. Using rubber gloves and spraying weak bleach on and around the bodies helps, until they can be buried or cremated. It is also psychologically important that the living get to identify relatives or at least know where they are buried, Dr. Redlener said. He urged that the dead in Haiti be photographed and that some sort of sample for DNA matching, like hair with roots attached, be kept.
W.H.O. guidelines suggest that DNA matching is too complex for most disasters; they suggest making notes of clothing and keeping items like jewelry and telephone SIM cards. But the United States military, which is in Haiti, is adept at DNA matching.
The W.H.O. also has guidelines on how to dig mass graves — a long trench is ideal, with the bodies laid side by side, not dumped atop each other. They should be numbered, and a sketch kept of the trench to make it easier in case they are to be dug up later for better identification or reburial.
The mental and emotional distress for Haitians is too large to even gauge at this point. Not only is it likely that every Haitian lost a relative, a friend, a co-worker or at least an acquaintance, "but their capital was destroyed," Dr. Redlener said. "It's as if Washington, D.C., was suddenly obliterated — that would be extremely traumatic for Americans. There will be a lot of grieving and significant amounts of post-traumatic stress disorder."
Counseling, he said, will require people who speak Creole, or at least French. "Hopefully," he added, "there will be a lot of support from Canada and France."
Sharon Otterman and Denise Grady contributed reporting.
Government Struggles to Exhume Itself
Damon Winter/The New York Times
Ruins dominated a street in Port-au-Prince, the capital, on Friday as Haiti continued to struggle with the aftermath of a devastating earthquake. More Photos >
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By SIMON ROMERO and MARC LACEY
Published: January 15, 2010
PORT-AU-PRINCE, Haiti — It did not take very long for Edwin Paraison, a member of Haiti's cabinet, to take stock of his losses and deliver a thorough assessment of what remained of his government ministry.
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Challenges in Getting Help to the Victims
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Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patience Wears Thin as Desperation Grows (January 16, 2010)
"This is it," he said, pointing to the laptop computer he was carrying. "My offices are gone."
The Haitian state seemed close to ruin on almost every level on Friday. President René Préval's palace had been crushed. Tourism Minister Patrick Delatour's mother and father were both killed in this week's earthquake. Civil servants who were lucky enough to survive the earthquake were now picking up the pieces of their own lives. Those who even thought of going to work often had no ministry building to work from.
"Not one ministry is operational today," said Mr. Paraison, the minister for Haitians living abroad. "Five of our ministries have had their headquarters destroyed completely."
Haiti has long been known for its political tumult, for its coups d'état, years of authoritarian dictatorship and looting of the national treasury for personal gain.
But recently, the country was on a comparatively stable path. President Préval was elected and re-elected, and has made no move to hold onto power when his final term comes up after elections this September.
Now the nation's leaders are facing a set of challenges that would stymie any government, even the richest and most stable ones. Millions need food and water, but only thousands have begun receiving it, according to the United Nations, fueling a frustration that is slowly building in the streets.
Then there is the bigger question lurking in the background: What will it take to rebuild this rattled country once the immediate crisis has passed, and is the government up to the task?
"It is a completely depressing sight," said Marco Maceo, one of the volunteers delivering emergency medical supplies from the Dominican Republic, Haiti's neighbor on the island of Hispaniola, describing his shock upon seeing Haiti's presidential palace in ruins. "The dome has collapsed, and the president is gone."
At the nondescript police building near the airport that has been converted into Mr. Préval's de facto headquarters, the disarray was clear. Luxury S.U.V.'s were parked at the entrance, which was guarded by members of an elite police unit that seemed, with a glance and a shrug, to let anyone with a heartbeat inside.
Ministers in the lobby of the building compared notes, trying to figure out the extent of the destruction of recent days. Some lamented that Digicel, the private telecommunications company offering BlackBerry service in Haiti, had not yet restored its network, keeping senior officials from communicating with a semblance of efficiency.
Before the disaster, the country's politicians were known for their distance from the people. Leaders wore expensive suits, flying first class to Miami and driving around in luxury S.U.V.'s. There was a stiff formality among them, in their use of French, their bearing, their sheltered lives in the hills overlooking the slums.
And even with the increasing stability under Mr. Préval, the country's dozens of political parties remained as raucous as ever, turning Parliament into a form of political theater. A series of prime ministers, named by the president, had been sacked by the legislature in what most observers considered an excessive exercise of its power.
But if there is a benefit in the neglect that the Haitian people have experienced for so many years, it is that they are far more resilient than most. Although protesting is a national custom, so is surviving on little. That national ethos, the Haitians' ability to scrounge to find enough to fight their hunger pangs, is being tested in full by the current crisis.
The state was scrambling to exhume itself Friday. Within what remained of the presidential palace, a security officer said the situation was dire. "Two of our colleagues are still stuck in the rubble, and we are desperately trying to find them," the officer said.
It takes a die-hard optimist to see the bright side amid such despair. In Mr. Préval's government, that person would be Mr. Delatour, the tourism minister, who had a difficult job even before the earthquake struck: attracting visitors to Haiti, despite its reputation for poverty.
In the last few days, however, he has endured the unthinkable: the death of his parents, the hospitalization of three grandchildren and the virtual destruction of the home where he lives.
Yet in an interview here, Mr. Delatour said he found ample hope in the fact that there had been relatively few reports of post-earthquake looting and violence.
"How many countries could have their population in the streets and still avoid strife through self-policing?" he asked.
Ever the optimist, Mr. Delatour went further in his explanation of why he thought the earthquake might give Haiti a chance to rebuild itself in a more sustainable way.
"This is bad today, but one must remember that we have the historical memory of slavery here," he said. "What can be worse than that?"
Damon Winter/The New York Times
Ruins dominated a street in Port-au-Prince, the capital, on Friday as Haiti continued to struggle with the aftermath of a devastating earthquake. More Photos >
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By SIMON ROMERO and MARC LACEY
Published: January 15, 2010
PORT-AU-PRINCE, Haiti — It did not take very long for Edwin Paraison, a member of Haiti's cabinet, to take stock of his losses and deliver a thorough assessment of what remained of his government ministry.
Multimedia
Graphic
Challenges in Getting Help to the Victims
Graphic
The Magnitude of a Disaster
Photographs
Rescuers Race Clock in Haiti
Related
Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patience Wears Thin as Desperation Grows (January 16, 2010)
"This is it," he said, pointing to the laptop computer he was carrying. "My offices are gone."
The Haitian state seemed close to ruin on almost every level on Friday. President René Préval's palace had been crushed. Tourism Minister Patrick Delatour's mother and father were both killed in this week's earthquake. Civil servants who were lucky enough to survive the earthquake were now picking up the pieces of their own lives. Those who even thought of going to work often had no ministry building to work from.
"Not one ministry is operational today," said Mr. Paraison, the minister for Haitians living abroad. "Five of our ministries have had their headquarters destroyed completely."
Haiti has long been known for its political tumult, for its coups d'état, years of authoritarian dictatorship and looting of the national treasury for personal gain.
But recently, the country was on a comparatively stable path. President Préval was elected and re-elected, and has made no move to hold onto power when his final term comes up after elections this September.
Now the nation's leaders are facing a set of challenges that would stymie any government, even the richest and most stable ones. Millions need food and water, but only thousands have begun receiving it, according to the United Nations, fueling a frustration that is slowly building in the streets.
Then there is the bigger question lurking in the background: What will it take to rebuild this rattled country once the immediate crisis has passed, and is the government up to the task?
"It is a completely depressing sight," said Marco Maceo, one of the volunteers delivering emergency medical supplies from the Dominican Republic, Haiti's neighbor on the island of Hispaniola, describing his shock upon seeing Haiti's presidential palace in ruins. "The dome has collapsed, and the president is gone."
At the nondescript police building near the airport that has been converted into Mr. Préval's de facto headquarters, the disarray was clear. Luxury S.U.V.'s were parked at the entrance, which was guarded by members of an elite police unit that seemed, with a glance and a shrug, to let anyone with a heartbeat inside.
Ministers in the lobby of the building compared notes, trying to figure out the extent of the destruction of recent days. Some lamented that Digicel, the private telecommunications company offering BlackBerry service in Haiti, had not yet restored its network, keeping senior officials from communicating with a semblance of efficiency.
Before the disaster, the country's politicians were known for their distance from the people. Leaders wore expensive suits, flying first class to Miami and driving around in luxury S.U.V.'s. There was a stiff formality among them, in their use of French, their bearing, their sheltered lives in the hills overlooking the slums.
And even with the increasing stability under Mr. Préval, the country's dozens of political parties remained as raucous as ever, turning Parliament into a form of political theater. A series of prime ministers, named by the president, had been sacked by the legislature in what most observers considered an excessive exercise of its power.
But if there is a benefit in the neglect that the Haitian people have experienced for so many years, it is that they are far more resilient than most. Although protesting is a national custom, so is surviving on little. That national ethos, the Haitians' ability to scrounge to find enough to fight their hunger pangs, is being tested in full by the current crisis.
The state was scrambling to exhume itself Friday. Within what remained of the presidential palace, a security officer said the situation was dire. "Two of our colleagues are still stuck in the rubble, and we are desperately trying to find them," the officer said.
It takes a die-hard optimist to see the bright side amid such despair. In Mr. Préval's government, that person would be Mr. Delatour, the tourism minister, who had a difficult job even before the earthquake struck: attracting visitors to Haiti, despite its reputation for poverty.
In the last few days, however, he has endured the unthinkable: the death of his parents, the hospitalization of three grandchildren and the virtual destruction of the home where he lives.
Yet in an interview here, Mr. Delatour said he found ample hope in the fact that there had been relatively few reports of post-earthquake looting and violence.
"How many countries could have their population in the streets and still avoid strife through self-policing?" he asked.
Ever the optimist, Mr. Delatour went further in his explanation of why he thought the earthquake might give Haiti a chance to rebuild itself in a more sustainable way.
"This is bad today, but one must remember that we have the historical memory of slavery here," he said. "What can be worse than that?"
Relief Groups Seek Alternative Routes to Get Aid Moving
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By ALAN COWELL and SHARON OTTERMAN
Published: January 15, 2010
As a limited number of relief flights landed at Port-au-Prince airport on Friday, international assistance agencies struggled to find alternative routes for aid in the face of survivors' angry criticism that no help was getting through.
The Help That Haiti Needs
Given Haiti's political instability and crumbling infrastructure, what kind of aid should be sent and how?
Join the Discussion »
Multimedia
Graphic
Challenges in Getting Help to the Victims
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The Magnitude of a Disaster
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Rescuers Race Clock in Haiti
Officials at international aid organizations in Geneva and Rome said in telephone interviews that supplies had begun to arrive via Santo Domingo in the neighboring Dominican Republic, and that vessels with built-in ramps capable of delivering supplies to the badly damaged port in the Haitian capital were being organized.
The logistical challenges in and around the capital — damaged roads, little fuel — were daunting, but there were small signs of progress, the organizations said.
Organizations distributed tarps and other materials to 4,000 people without shelter on Thursday, and 8,000 more people were expected to receive similar assistance Friday. Ban Ki-moon, the United Nations secretary-general, said the World Food Program was feeding about 8,000 people several times a day, with high-energy biscuits and ready-to-eat meals. The mass devastation, however, dwarfed the effort.
"It is still a drop in the bucket," said Elisabeth Byrs, a spokeswoman for the United Nations Office for the Coordination of Humanitarian Affairs in Geneva. "But step by step, it will increase."
Confusion and chaos on the ground was mirrored in the air, with private aircraft clogging the airspace above Port-au-Prince's airport, blocking some humanitarian fights from landing. By Friday afternoon, the Federal Aviation Administration, which has been coordinating air traffic control at the Port-au-Prince airport, issued a stern warning: no planes bound from the United States, military or civilian, would be allowed to land without express permission from the agency.
Exceptions would be granted only to humanitarian planes, based on arrival times and on the availability of space at the airport, a notice from the agency said. The F.A.A. warned pilots that fuel still was not available at the airport, and any aircraft bound there would need to have enough fuel to circle the airport for at least an hour.
The move may ease some of the deadlock that has been preventing relief from getting through. The World Food Program, for example, had been attempting to land a plane filled with food supplies to shore up existing stocks in the city, but as of Friday afternoon, it had not succeeded. The agency estimates that 2 million people are in need, said Greg Barrow, a spokesman.
On the ground, the deteriorating conditions were underlined by reports of looting, including at warehouses stocked with the remaining 6,000 tons of the World Food Program's provisions in Port-au-Prince, Mr. Barrow said. The food relief agency, which says looting is not unusual in such crises, reported that it had recovered most of the food.
Emilia Casella, a spokeswoman with the agency, which is based in Rome, noted that regular food stores in the capital "have been cleaned out" by desperate Haitians, a report by The Associated Press said.
Ms. Byrs of the United Nations said relief agencies had started to shuttle staff and supplies by road, small plane and helicopter to bring in personnel from Santo Domingo, but that the arrangements remained irregular. She said that she believed survivors could still be found.
"There's still hope; that's the important thing," she said.
Mobile operating theaters and more surgical specialists were en route, but were delayed in the air and on the roads from the Dominican Republic.
Doctors Without Borders said it had landed two cargo planes directly into Toussaint Louverture International Airport in Port-au-Prince, but others have had to go through Santo Domingo.
To the extent that Toussaint Louverture airport was able to function, it was thanks largely to the two air traffic controllers from the United States Air Force who had taken over the damaged tower and the United States Army soldiers who were directing ground operations.
Just about every route for relief supplies seemed to have problems. Mr. Barrow, the spokesman for the World Food Program, which is heading up logistical operations, said that on the narrow road from Santo Domingo, vehicles took 12 to 18 hours to reach Port-au-Prince. With unloading equipment damaged at the capital's port, he said, the World Food Program was planning to charter vessels with ramps — which can unload without cranes — to bring in food. But sailing time for such vessels from the nearest point in the United States was three days.
"Realistically, for us to bring in food, the priority is by sea," he said.
Once aid arrives at the airport, it will face additional logistical challenges. There was only one warehouse to hold the expected influx of materials and no clear plan of how to distribute supplies from the airport to the city.
DHL, the international shipping company, said 14 of its employees were on the ground to help manage arriving air freight in order to prevent bottlenecks at the airport. The team will assist in the distribution of these goods once roads are stable, working with the Red Cross, UNICEF and World Food Program, it said.
Commercial air service to Port au Prince is suspended until at least Sunday, the F.A.A. said.
For many organizations, the work in Haiti has been transformed into exploring every route to bring in relief supplies and to expect the unexpected when earlier plans fall part.
Catholic Relief Services, for example, plans to ship water and food rations for 500 families over the road from Santo Domingo on Saturday, but reports of looting near the Haitian border have made their drivers nervous. So now, they are trying to get a United States military escort for the convoy once it crosses into Haiti.
A boat with thousands of metric tons of vegetable oil and soy-fortified bulgur wheat that has been en route for weeks is also due to arrive Saturday at Port-au-Prince. After a day of negotiations, it now looks like the ship will be rerouted to a functioning port, Les Cayes, in the south.
Staff members, meanwhile, continue to arrive at the Port-au-Prince airport when they can manage it.
"It's about work-arounds," said Schuyler Thorup, the director of Latin American operations for the organization. "There are tremendous challenges."
Alan Cowell reported from Paris, and Sharon Otterman from New York. Reporting was contributed by Damien Cave and Marc Lacey from Port-au-Prince, Haiti; Micheline Maynard from Detroit; and Liz Robbins and Maria Newman from New York.
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By ALAN COWELL and SHARON OTTERMAN
Published: January 15, 2010
As a limited number of relief flights landed at Port-au-Prince airport on Friday, international assistance agencies struggled to find alternative routes for aid in the face of survivors' angry criticism that no help was getting through.
The Help That Haiti Needs
Given Haiti's political instability and crumbling infrastructure, what kind of aid should be sent and how?
Join the Discussion »
Multimedia
Graphic
Challenges in Getting Help to the Victims
Graphic
The Magnitude of a Disaster
Slide Show
Rescuers Race Clock in Haiti
Officials at international aid organizations in Geneva and Rome said in telephone interviews that supplies had begun to arrive via Santo Domingo in the neighboring Dominican Republic, and that vessels with built-in ramps capable of delivering supplies to the badly damaged port in the Haitian capital were being organized.
The logistical challenges in and around the capital — damaged roads, little fuel — were daunting, but there were small signs of progress, the organizations said.
Organizations distributed tarps and other materials to 4,000 people without shelter on Thursday, and 8,000 more people were expected to receive similar assistance Friday. Ban Ki-moon, the United Nations secretary-general, said the World Food Program was feeding about 8,000 people several times a day, with high-energy biscuits and ready-to-eat meals. The mass devastation, however, dwarfed the effort.
"It is still a drop in the bucket," said Elisabeth Byrs, a spokeswoman for the United Nations Office for the Coordination of Humanitarian Affairs in Geneva. "But step by step, it will increase."
Confusion and chaos on the ground was mirrored in the air, with private aircraft clogging the airspace above Port-au-Prince's airport, blocking some humanitarian fights from landing. By Friday afternoon, the Federal Aviation Administration, which has been coordinating air traffic control at the Port-au-Prince airport, issued a stern warning: no planes bound from the United States, military or civilian, would be allowed to land without express permission from the agency.
Exceptions would be granted only to humanitarian planes, based on arrival times and on the availability of space at the airport, a notice from the agency said. The F.A.A. warned pilots that fuel still was not available at the airport, and any aircraft bound there would need to have enough fuel to circle the airport for at least an hour.
The move may ease some of the deadlock that has been preventing relief from getting through. The World Food Program, for example, had been attempting to land a plane filled with food supplies to shore up existing stocks in the city, but as of Friday afternoon, it had not succeeded. The agency estimates that 2 million people are in need, said Greg Barrow, a spokesman.
On the ground, the deteriorating conditions were underlined by reports of looting, including at warehouses stocked with the remaining 6,000 tons of the World Food Program's provisions in Port-au-Prince, Mr. Barrow said. The food relief agency, which says looting is not unusual in such crises, reported that it had recovered most of the food.
Emilia Casella, a spokeswoman with the agency, which is based in Rome, noted that regular food stores in the capital "have been cleaned out" by desperate Haitians, a report by The Associated Press said.
Ms. Byrs of the United Nations said relief agencies had started to shuttle staff and supplies by road, small plane and helicopter to bring in personnel from Santo Domingo, but that the arrangements remained irregular. She said that she believed survivors could still be found.
"There's still hope; that's the important thing," she said.
Mobile operating theaters and more surgical specialists were en route, but were delayed in the air and on the roads from the Dominican Republic.
Doctors Without Borders said it had landed two cargo planes directly into Toussaint Louverture International Airport in Port-au-Prince, but others have had to go through Santo Domingo.
To the extent that Toussaint Louverture airport was able to function, it was thanks largely to the two air traffic controllers from the United States Air Force who had taken over the damaged tower and the United States Army soldiers who were directing ground operations.
Just about every route for relief supplies seemed to have problems. Mr. Barrow, the spokesman for the World Food Program, which is heading up logistical operations, said that on the narrow road from Santo Domingo, vehicles took 12 to 18 hours to reach Port-au-Prince. With unloading equipment damaged at the capital's port, he said, the World Food Program was planning to charter vessels with ramps — which can unload without cranes — to bring in food. But sailing time for such vessels from the nearest point in the United States was three days.
"Realistically, for us to bring in food, the priority is by sea," he said.
Once aid arrives at the airport, it will face additional logistical challenges. There was only one warehouse to hold the expected influx of materials and no clear plan of how to distribute supplies from the airport to the city.
DHL, the international shipping company, said 14 of its employees were on the ground to help manage arriving air freight in order to prevent bottlenecks at the airport. The team will assist in the distribution of these goods once roads are stable, working with the Red Cross, UNICEF and World Food Program, it said.
Commercial air service to Port au Prince is suspended until at least Sunday, the F.A.A. said.
For many organizations, the work in Haiti has been transformed into exploring every route to bring in relief supplies and to expect the unexpected when earlier plans fall part.
Catholic Relief Services, for example, plans to ship water and food rations for 500 families over the road from Santo Domingo on Saturday, but reports of looting near the Haitian border have made their drivers nervous. So now, they are trying to get a United States military escort for the convoy once it crosses into Haiti.
A boat with thousands of metric tons of vegetable oil and soy-fortified bulgur wheat that has been en route for weeks is also due to arrive Saturday at Port-au-Prince. After a day of negotiations, it now looks like the ship will be rerouted to a functioning port, Les Cayes, in the south.
Staff members, meanwhile, continue to arrive at the Port-au-Prince airport when they can manage it.
"It's about work-arounds," said Schuyler Thorup, the director of Latin American operations for the organization. "There are tremendous challenges."
Alan Cowell reported from Paris, and Sharon Otterman from New York. Reporting was contributed by Damien Cave and Marc Lacey from Port-au-Prince, Haiti; Micheline Maynard from Detroit; and Liz Robbins and Maria Newman from New York.
For the Trapped, Rescue Is but the First Hurdle
Maggie Steber for The New York Times
Ajnor Amel and Lina Blanxfort listened Friday as an American doctor explained that their son Herby's foot might have to be amputated for him to be rescued. He was saved with his foot intact. More Photos >
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By DAMIEN CAVE
Published: January 15, 2010
PORT-AU-PRINCE, Haiti — Herby Amel's father dug through the collapsed college building first, pulling out a body so he could reach his son, trapped 20 feet into the pile. But when a rescue team from Miami arrived early Friday morning, Herby's left ankle remained pinned under a fallen beam.
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Challenges in Getting Help to the Victims
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The Magnitude of a Disaster
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Rescuers Race Clock in Haiti
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Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patience Wears Thin as Desperation Grows (January 16, 2010)
He was trapped, alive and awake, in a crevice just wider than his shoulders. The American rescuers considered amputation, then chose instead to sedate Mr. Amel and carefully pull him back through the rubble.
It was 3:17 a.m., and the dark street was crammed with relatives and friends, their hands bright white with concrete dust from digging. Finally, "up" came the call. Mr. Amel, 21, emerged, a thin, young man with swollen legs. One rescuer wiped away tears.
It was, by most disaster measures, a successful rescue, though being pried from the rubble was only a beginning, by no means assuring survival. Mr. Amel's fate reflects the complications and struggles of the current aid effort in Haiti. His drivers were not sure they would find a hospital with room for him. With or without the amputation that doctors thought he needed, his life was threatened from toxic shock and infection.
And the search-and-rescue experts from Miami who saved him had spent 10 frustrating hours on the ground before they could set out to dig for survivors.
The group of 80 had been ready to go on Wednesday, less than 24 hours after the catastrophic magnitude 7.0 earthquake hit. But just before their scheduled departure, they had to cancel. They were told the airport would not let them land.
They rescheduled for Thursday, and were fortunate enough to find themselves on the loud, crowded tarmac here at Toussaint Louverture International Airport by 10:30 a.m. after some circling in the air. Transportation to the United States Embassy appeared relatively quickly, too, within two hours.
But bad news followed. A cargo plane with their pneumatic hammers, lights, tents and other equipment had been delayed. Later, they found out that it had been rerouted to Santo Domingo, in the Dominican Republic.
The group chafed at the holdups. Rudolph Moise, a barrel-chested doctor and colonel in the Air Force Reserve, who grew up in Haiti, paced. By 2 p.m., little had changed. Leaders from the three task forces here at the time — Fairfax County, Va., Los Angeles County and Miami-Dade County — met in an embassy conference room to plan out strategy. Maps were blown up and hung on the walls.
Team leaders complained of equipment they did not have and of delays.
But at this point, Carlos Gimenez, a hard-charging firefighter from Miami with a chin as square as a cigarette box, just wanted to get out. With some pushing, he commandeered a handful of vans and S.U.V.'s and drove toward downtown at 3:35 p.m. Within minutes, he saw bodies alongside the road. Eight on a hilly street of the Nazon area. Two others a few hundred yards up, with legs protruding from gray rubble.
"Man, there are a lot of kids," said Mr. Gimenez, looking at a small body under a sheet.
Crowds of Haitians streamed by on foot, some with rags over their mouths to prevent breathing the stench of decay. Farther into Nazon, a sheared-off wall of a home revealed a living room with a painting still on a peach-colored wall.
Only 20 minutes out of the embassy's gate, Mr. Gimenez had identified three areas that they might need to come back and search. The fourth, however, looked more urgent. A crowd of young men stood on what looked like a small mountain poured like sand from an hourglass: G.O.C. University.
The team was told of at least four people trapped below. Mr. Gimenez crawled down into a hole, where he could hear a young woman's voice. Two men seemed to be hidden underneath an area across the roof.
The fourth person was being pulled up by Haitians. He emerged around sunset, unable to move or speak with anything louder than a whisper. "He's calling for his mother," said a young man standing beside him.
Mr. Gimenez grew more intense. "We need to go," he said. The crowd, he feared, would soon become more demanding and more frustrated when they were unable to reach the people who were trapped.
Back at the embassy, he tried to find a way to return. Two hours later, at 7:30 p.m., he was still without his equipment, and swearing. "It's frustrating," he said. "Half our gear is in Santo Domingo."
Maggie Steber for The New York Times
Ajnor Amel and Lina Blanxfort listened Friday as an American doctor explained that their son Herby's foot might have to be amputated for him to be rescued. He was saved with his foot intact. More Photos >
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By DAMIEN CAVE
Published: January 15, 2010
PORT-AU-PRINCE, Haiti — Herby Amel's father dug through the collapsed college building first, pulling out a body so he could reach his son, trapped 20 feet into the pile. But when a rescue team from Miami arrived early Friday morning, Herby's left ankle remained pinned under a fallen beam.
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Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patience Wears Thin as Desperation Grows (January 16, 2010)
He was trapped, alive and awake, in a crevice just wider than his shoulders. The American rescuers considered amputation, then chose instead to sedate Mr. Amel and carefully pull him back through the rubble.
It was 3:17 a.m., and the dark street was crammed with relatives and friends, their hands bright white with concrete dust from digging. Finally, "up" came the call. Mr. Amel, 21, emerged, a thin, young man with swollen legs. One rescuer wiped away tears.
It was, by most disaster measures, a successful rescue, though being pried from the rubble was only a beginning, by no means assuring survival. Mr. Amel's fate reflects the complications and struggles of the current aid effort in Haiti. His drivers were not sure they would find a hospital with room for him. With or without the amputation that doctors thought he needed, his life was threatened from toxic shock and infection.
And the search-and-rescue experts from Miami who saved him had spent 10 frustrating hours on the ground before they could set out to dig for survivors.
The group of 80 had been ready to go on Wednesday, less than 24 hours after the catastrophic magnitude 7.0 earthquake hit. But just before their scheduled departure, they had to cancel. They were told the airport would not let them land.
They rescheduled for Thursday, and were fortunate enough to find themselves on the loud, crowded tarmac here at Toussaint Louverture International Airport by 10:30 a.m. after some circling in the air. Transportation to the United States Embassy appeared relatively quickly, too, within two hours.
But bad news followed. A cargo plane with their pneumatic hammers, lights, tents and other equipment had been delayed. Later, they found out that it had been rerouted to Santo Domingo, in the Dominican Republic.
The group chafed at the holdups. Rudolph Moise, a barrel-chested doctor and colonel in the Air Force Reserve, who grew up in Haiti, paced. By 2 p.m., little had changed. Leaders from the three task forces here at the time — Fairfax County, Va., Los Angeles County and Miami-Dade County — met in an embassy conference room to plan out strategy. Maps were blown up and hung on the walls.
Team leaders complained of equipment they did not have and of delays.
But at this point, Carlos Gimenez, a hard-charging firefighter from Miami with a chin as square as a cigarette box, just wanted to get out. With some pushing, he commandeered a handful of vans and S.U.V.'s and drove toward downtown at 3:35 p.m. Within minutes, he saw bodies alongside the road. Eight on a hilly street of the Nazon area. Two others a few hundred yards up, with legs protruding from gray rubble.
"Man, there are a lot of kids," said Mr. Gimenez, looking at a small body under a sheet.
Crowds of Haitians streamed by on foot, some with rags over their mouths to prevent breathing the stench of decay. Farther into Nazon, a sheared-off wall of a home revealed a living room with a painting still on a peach-colored wall.
Only 20 minutes out of the embassy's gate, Mr. Gimenez had identified three areas that they might need to come back and search. The fourth, however, looked more urgent. A crowd of young men stood on what looked like a small mountain poured like sand from an hourglass: G.O.C. University.
The team was told of at least four people trapped below. Mr. Gimenez crawled down into a hole, where he could hear a young woman's voice. Two men seemed to be hidden underneath an area across the roof.
The fourth person was being pulled up by Haitians. He emerged around sunset, unable to move or speak with anything louder than a whisper. "He's calling for his mother," said a young man standing beside him.
Mr. Gimenez grew more intense. "We need to go," he said. The crowd, he feared, would soon become more demanding and more frustrated when they were unable to reach the people who were trapped.
Back at the embassy, he tried to find a way to return. Two hours later, at 7:30 p.m., he was still without his equipment, and swearing. "It's frustrating," he said. "Half our gear is in Santo Domingo."
After an hour that felt like an eternity, a partial solution emerged. The Miami team would borrow equipment from Fairfax County. First, though, they needed drivers, and the men who took them out in the afternoon refused. "No go, tonight," one said. He offered no explanation.
Multimedia
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Challenges in Getting Help to the Victims
Graphic
The Magnitude of a Disaster
Photographs
Rescuers Race Clock in Haiti
Related
Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patience Wears Thin as Desperation Grows (January 16, 2010)
Other drivers were found, and the group was back on the road at 8:50 p.m. They headed to pick up equipment at a search site, at the Hotel Montana, where Dr. Moise had stayed just a few months earlier. The half-dozen vans and S.U.V.'s spent nearly half an hour to climb the road, get what they needed and turn around.
They turned a sharp corner. They had reached the path up to the mound of G.O.C. University. A crowd of Haitians headed down, shouting, running with what looked like a body. It was the young woman Mr. Gimenez had heard speaking five hours earlier. Her leg, red and damp with blood at the knee, moved just a touch in the glare of headlights — she was alive.
The crowd asked the Americans for transportation. Mr. Gimenez told his group to stay in their vehicles. He called for Dr. Moise. They tried to calm the agitated crowd and explain that search-and-rescue teams were not equipped to be ambulances.
A local police truck that had driven by suddenly began to back up. The young woman was placed in the back, and more than 20 people elbowed and squeezed to get in the back with her.
It was time for the Americans to search for others. There were conflicting reports about two young men being pulled out by locals. Maybe they were saved, or maybe they died, but after sending three search dogs over the pile and using high-tech cameras and listening devices, the Americans found no signs of life. They could see at least four bodies in the pancaked floors below.
Gerald Jeanty Jr., 29, who stood halfway up the path, said he had been searching through the rubble for his cousin, a professor at the university who answered his phone Thursday morning. His wife had called, and he said he was trapped. She called over and over again, but there was never another answer.
"It's all collapsed," Mr. Jeanty said, noting that his cousin worked on the first floor of the seven-story building. "And he's at the bottom."
As they gathered again at their vehicles, the Americans seemed disappointed. The team from Fairfax had taken back their listening equipment just as they were trying to determine whether they heard a faint tap-tap-tap from deep within the tangle of rock and steel. The people they imagined saving were gone.
But when they arrived at the Collège du Canapé-Vert, they knew they could help. The candles Mr. Amel's father had placed in the rubble, like medieval torches, guided them to Herby, who was studying to be a teacher.
They found a second person near the top of the rubble, crammed into a staircase where he apparently fled during the tremor. It would take much longer to get him out, but they were hopeful. In previous earthquakes, they had found survivors up to 14 days later. In this case, though, he died where he lay.
What they tried not to think about was what happened next for those they saved. The hospitals were full, and the United States Embassy, with its two Air Force doctors, told them not to bring back Haitian patients.
Mr. Amel and his mother, father and sister drove off into the dark. They were all quiet and calm, if only temporarily. The Americans had given him a fighting chance, but the ketamine used to sedate as they tugged him out would wear off in an hour. Pain, struggle and reality would soon be setting in.
Multimedia
Graphic
Challenges in Getting Help to the Victims
Graphic
The Magnitude of a Disaster
Photographs
Rescuers Race Clock in Haiti
Related
Relief Groups Seek Alternative Routes to Get Aid Moving (January 16, 2010)
Patience Wears Thin as Desperation Grows (January 16, 2010)
Other drivers were found, and the group was back on the road at 8:50 p.m. They headed to pick up equipment at a search site, at the Hotel Montana, where Dr. Moise had stayed just a few months earlier. The half-dozen vans and S.U.V.'s spent nearly half an hour to climb the road, get what they needed and turn around.
They turned a sharp corner. They had reached the path up to the mound of G.O.C. University. A crowd of Haitians headed down, shouting, running with what looked like a body. It was the young woman Mr. Gimenez had heard speaking five hours earlier. Her leg, red and damp with blood at the knee, moved just a touch in the glare of headlights — she was alive.
The crowd asked the Americans for transportation. Mr. Gimenez told his group to stay in their vehicles. He called for Dr. Moise. They tried to calm the agitated crowd and explain that search-and-rescue teams were not equipped to be ambulances.
A local police truck that had driven by suddenly began to back up. The young woman was placed in the back, and more than 20 people elbowed and squeezed to get in the back with her.
It was time for the Americans to search for others. There were conflicting reports about two young men being pulled out by locals. Maybe they were saved, or maybe they died, but after sending three search dogs over the pile and using high-tech cameras and listening devices, the Americans found no signs of life. They could see at least four bodies in the pancaked floors below.
Gerald Jeanty Jr., 29, who stood halfway up the path, said he had been searching through the rubble for his cousin, a professor at the university who answered his phone Thursday morning. His wife had called, and he said he was trapped. She called over and over again, but there was never another answer.
"It's all collapsed," Mr. Jeanty said, noting that his cousin worked on the first floor of the seven-story building. "And he's at the bottom."
As they gathered again at their vehicles, the Americans seemed disappointed. The team from Fairfax had taken back their listening equipment just as they were trying to determine whether they heard a faint tap-tap-tap from deep within the tangle of rock and steel. The people they imagined saving were gone.
But when they arrived at the Collège du Canapé-Vert, they knew they could help. The candles Mr. Amel's father had placed in the rubble, like medieval torches, guided them to Herby, who was studying to be a teacher.
They found a second person near the top of the rubble, crammed into a staircase where he apparently fled during the tremor. It would take much longer to get him out, but they were hopeful. In previous earthquakes, they had found survivors up to 14 days later. In this case, though, he died where he lay.
What they tried not to think about was what happened next for those they saved. The hospitals were full, and the United States Embassy, with its two Air Force doctors, told them not to bring back Haitian patients.
Mr. Amel and his mother, father and sister drove off into the dark. They were all quiet and calm, if only temporarily. The Americans had given him a fighting chance, but the ketamine used to sedate as they tugged him out would wear off in an hour. Pain, struggle and reality would soon be setting in.
Patience Wears Thin as Desperation Grows
Damon Winter/The New York Times
An off-duty police officer brought water to distribute to a large crowd near the airport. More Photos >
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By MARC LACEY
Published: January 15, 2010
PORT-AU-PRINCE, Haiti — As tension rose here in the battered Haitian capital, relief workers scrambled on Friday to deliver desperately needed food, water and medical care, recover survivors still trapped in the rubble and collect thousands of decaying bodies from the streets.
Multimedia
Video
Death in the Streets of Port-au-Prince
Video
Haiti Earthquake
Interactive Feature
A Closer Look at the Damage
Graphic
Challenges in Getting Help to the Victims
Graphic
The Magnitude of a Disaster
Video: NBC's Ann Curry Reports From Haiti
Video: Haiti Searches for Survivors
Photographs
Rescuers Race Clock in Haiti
Related
Agony Sets In as Medics Focus on the Survivors (January 14, 2010)
Is the U.S. Doing Enough for Haiti?
What are America's obligations to Haiti in the aftermath of the earthquake?
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The New York Times
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Readers' Comments
Readers shared their thoughts on this article.
Read All Comments (346) »
An immense relief operation was under way, with cargo planes and military helicopters buzzing over the crowded Toussaint Louverture International Airport. But three days after the earthquake struck, with many cries for help going silent, not nearly enough search and rescue teams or emergency supplies could make it here. The United Nations said it had fed 8,000 people, while two million to three million people remained in dire need.
Patience was wearing thin, and reports of looting increased, as another day went by with no power and limited fresh water.
"For the moment, this is anarchy," said Adolphe Reynald, a top aide to the mayor of Port-au-Prince, as he supervised a makeshift first aid center that was registering long lines of wounded people but had no medicine to treat them. "There's nothing we can do. We're out here to show that we care, that we're suffering along with them."
The United Nations said that 9,000 people had been buried in mass graves — and collecting bodies had become one of the few ways to earn money.
"They pay me $100 a day," Valencia Joseph, 32, said Friday at 2 a.m., as he was called to tug a body free of wires. "We must have picked up 2,000 bodies."
He added, "And there's more."
In Washington, Secretary of State Hillary Rodham Clinton said she would visit Haiti on Saturday to show support for the victims of the 7.0-magnitude quake. The Obama administration, cautioning that it would take time for all the aid to reach those in need, granted Haitians living in the United States protection from deportation for 18 months and permission to work.
Mr. Obama said he had spoken with the Haitian president, René Préval, and pledged the United States' full commitment in helping rebuild from a quake that, according to United Nations estimates, destroyed at least 30 percent of the capital and half the buildings in some neighborhoods.
"As I told the president, we realize that he needs more help and his country needs more help — much more," Mr. Obama said. "And in this difficult hour, we will continue to provide it."
The United States, in fact, took firmer control of the emergency operation on Friday. After three days of chaos and congestion at the airport in Port-au-Prince, Haiti's government ceded control of it to American technicians, to speed the flow of relief supplies and personnel.
The Federal Aviation Administration, which began managing air traffic into Haitian airspace, issued a stern warning to allow aid to flow in a more orderly way: no planes from the United States, military or civilian, would be allowed to land without express permission from the agency.
Exceptions to the new rule would be granted only to humanitarian aid planes, based on arrival times and on the availability of space at the airport, a notice from the agency said. The <a href="http://topics.nytimes.com/top/reference/timestopics/organizations/f/federal_a
Damon Winter/The New York Times
An off-duty police officer brought water to distribute to a large crowd near the airport. More Photos >
comments
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Single Page
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By MARC LACEY
Published: January 15, 2010
PORT-AU-PRINCE, Haiti — As tension rose here in the battered Haitian capital, relief workers scrambled on Friday to deliver desperately needed food, water and medical care, recover survivors still trapped in the rubble and collect thousands of decaying bodies from the streets.
Multimedia
Video
Death in the Streets of Port-au-Prince
Video
Haiti Earthquake
Interactive Feature
A Closer Look at the Damage
Graphic
Challenges in Getting Help to the Victims
Graphic
The Magnitude of a Disaster
Video: NBC's Ann Curry Reports From Haiti
Video: Haiti Searches for Survivors
Photographs
Rescuers Race Clock in Haiti
Related
Agony Sets In as Medics Focus on the Survivors (January 14, 2010)
Is the U.S. Doing Enough for Haiti?
What are America's obligations to Haiti in the aftermath of the earthquake?
Join the Discussion »
The New York Times
More Photos »
Readers' Comments
Readers shared their thoughts on this article.
Read All Comments (346) »
An immense relief operation was under way, with cargo planes and military helicopters buzzing over the crowded Toussaint Louverture International Airport. But three days after the earthquake struck, with many cries for help going silent, not nearly enough search and rescue teams or emergency supplies could make it here. The United Nations said it had fed 8,000 people, while two million to three million people remained in dire need.
Patience was wearing thin, and reports of looting increased, as another day went by with no power and limited fresh water.
"For the moment, this is anarchy," said Adolphe Reynald, a top aide to the mayor of Port-au-Prince, as he supervised a makeshift first aid center that was registering long lines of wounded people but had no medicine to treat them. "There's nothing we can do. We're out here to show that we care, that we're suffering along with them."
The United Nations said that 9,000 people had been buried in mass graves — and collecting bodies had become one of the few ways to earn money.
"They pay me $100 a day," Valencia Joseph, 32, said Friday at 2 a.m., as he was called to tug a body free of wires. "We must have picked up 2,000 bodies."
He added, "And there's more."
In Washington, Secretary of State Hillary Rodham Clinton said she would visit Haiti on Saturday to show support for the victims of the 7.0-magnitude quake. The Obama administration, cautioning that it would take time for all the aid to reach those in need, granted Haitians living in the United States protection from deportation for 18 months and permission to work.
Mr. Obama said he had spoken with the Haitian president, René Préval, and pledged the United States' full commitment in helping rebuild from a quake that, according to United Nations estimates, destroyed at least 30 percent of the capital and half the buildings in some neighborhoods.
"As I told the president, we realize that he needs more help and his country needs more help — much more," Mr. Obama said. "And in this difficult hour, we will continue to provide it."
The United States, in fact, took firmer control of the emergency operation on Friday. After three days of chaos and congestion at the airport in Port-au-Prince, Haiti's government ceded control of it to American technicians, to speed the flow of relief supplies and personnel.
The Federal Aviation Administration, which began managing air traffic into Haitian airspace, issued a stern warning to allow aid to flow in a more orderly way: no planes from the United States, military or civilian, would be allowed to land without express permission from the agency.
Exceptions to the new rule would be granted only to humanitarian aid planes, based on arrival times and on the availability of space at the airport, a notice from the agency said. The <a href="http://topics.nytimes.com/top/reference/timestopics/organizations/f/federal_a
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