Dispatch from Dr. Warren Johnson

Dr. Warren Johnson is the Director of the Center for Global Health at Weill Cornell Medical College

Written January 29, 2010 in Port-au-Prince, Haiti

• 80% of the senior staff returned; the fate of many field workers is not known. After determining the fate of family, concern is for children and their education- virtually all schools in Port-au-Prince closed and many teachers have left. Now, there is an exodus of students to the Dominican Republic/USA.

• At two weeks the mix of patients is changing- new fractures are being replaced by infected or poorly managed old fractures and wounds, diarrheal illness, and fevers. There are major concerns about post-operative care, recovery, rehabilitation- a process that will take months to years. Acute response teams will be gone in several weeks to a month. The University Hospital had 11 teams at peak, 5 now, soon none. The Hospital Director, Alix Lassegue estimates there were over 5,000 operations, 80% orthopaedic, in Port-au-Prince in the first two weeks, and there were thousands more in outlying hospitals and the Dominican Republic. Everyone is waiting for a plan for after the foreign teams depart.

• The GHESKIO Health and Human Services 50 member surgical team and their 82nd Airborne security detail are scheduled to depart in the next several weeks. At this point, there is no plan in place from either the US or Haitian governments for follow-up care and rehabilitation of the thousands of earthquake patients. The medical infrastructure was not capable of providing these services before the earthquake- continuing international support is absolutely necessary.