On August 14, a 7.2-magnitude earthquake rattled the nation of Haiti, killing more than 2200 people and leaving thousands of Haitians injured and in need of assistance.1 Beyond the casualties, 66 health facilities were either damaged or destroyed, putting an impossible burden on an already fragile healthcare system.1
Haiti is the poorest country in the Western Hemisphere. Even before the earthquake it endured drastic health inequities and limited access to care, as well as a shortage of physicians and nurses across the country. “Haitians deserve a better healthcare system,” said Society of Critical Care Medicine (SCCM) member Amado Alejandro Baez, MD, MPH, FACEP, FCCM. “Healthcare shouldn’t be a privilege, it should be a right. There have been a lot of people working to improve healthcare [in Haiti], but it’s very complicated.” Dr. Baez is codirector of the Master in Clinical Translational Science program at the Medical College of Georgia at Augusta University. He was born and raised in the Dominican Republic and this past January was appointed Director of Health Diplomacy for the Dominican Republic by President Luis Abinader.
Recent complications include the assassination of Haiti’s President Jovenel Moïse five weeks before the earthquake, civil rest, government instability, and the ongoing COVID-19 pandemic. Parts of Haiti are also still trying to recover from the 2010 earthquake that, while not as strong as this year’s, resulted in approximately 250,000 deaths. “It’s the perfect storm for good people suffering,” Dr. Baez said.
While the challenges are great, they also present an array of opportunities to help. Two days after the earthquake, SCCM sent communications to members in the area and
a call to membership for donations. Dr. Baez responded with a grant proposal for a tele-critical care pilot to increase the response capacity of disaster health services in affected communities in Haiti. The goal of the project was twofold: first, to optimize human resources in acute care and critical care to respond to patients directly or indirectly affected by the earthquake and, second, to improve the referral system and flow of patients to higher-level care centers to decongest the health system.
SCCM accepted the proposal and provided initial funding for the project. “This project is an opportunity for SCCM to expand its ability to directly support underserved healthcare professionals who are responding to patients affected by the earthquake or who do not have specialized resources in their area of care,” said SCCM Chief Philanthropy Officer Mark Lenhart. “ICU physicians are neither common nor abundant in developing countries, yet like everywhere else in the world, there is a demand for ICU services, and patients need and deserve high-quality ICU care.”
In Haiti, two-thirds of all healthcare resources are centralized in the capital city of Port-Au-Prince and its vicinity. SCCM is hoping that the pilot, as well as a potential Fundamental Critical Care Support (FCCS) course, will provide working ICU knowledge to medical professionals across the country. By training these physicians and implementing ICU admission protocols, SCCM hopes that more patients can be treated outside of Port-Au-Prince, thereby limiting the number of patients sent to the big referral hospitals in the city.
Dr. Baez explained, “What we’re trying to do is a capacity-building effort that [includes] deploying the FCCS course, training physicians and nurses in Haiti via this course, and then connecting them with Haitian intensivists . . . who speak Creole, understand their system, work in the Dominican Republic as intensivists, and are willing to help.” In 2010, Dr. Baez set up a similar training system in the aftermath of the earthquake. In that instance, he helped coordinate the provision of acute care support in the Dominican Republic—work that earned him a special SCCM recognition award. With the advances in technology since then, as well as evidence for the power of telemedicine during the ongoing COVID-19 pandemic, Dr. Baez thinks support today can be far greater than it was in 2010. “The big gift from this pandemic has been the understanding of the value of anything tele-,” he said. “More people understand the impact of it.”
The pilot is expected to run through February 2022.By having intensivists available to train and consult on patients in Haiti and provide ICU training through an FCCS course, Dr. Baez thinks the pilot has the potential to be a force multiplier and capacity builder when it comes to critical care coverage across the country—and potentially beyond.
“The earthquake is just the catalyst,” Dr. Baez said. “Before the earthquake, Haiti needed this project. Before the earthquake, there was the pandemic, and I’m pretty confident that critically ill pandemic patients were not getting the right care because of a paucity of services. And even before the pandemic, critically ill patients needed a higher level of care. We’re catalyzing change based on an immediate need, based on the fact that the earthquake put Haiti on everybody’s radar, but I think any developing nation that does not have adequate critical care services can use this model and reproduce it.”
Mr. Lenhart agreed. “As more and more areas worldwide continue to be impacted by shortages of trained ICU clinicians, this program will allow SCCM to provide immediate and tangible help for critically ill and injured patients,” he said. “Tele-ICU allows well-trained specialized ICU physicians to be available anywhere in the world, permitting high-quality care to be rendered remotely to those who need it most.”
Donations from SCCM members helped make these activities possible.
Learn more about donating to SCCM.
References
- Reliefweb. 2021 Haiti Earthquake Situation Report #1. September 1, 2021. Accessed November 19, 2021. https://reliefweb.int/report/haiti/2021-haiti-earthquake-situation-report-1-september-1-2021
