Planning for the Second Week and Beyond in Haiti
January 17, 2010
Senior Associate, Global Health Policy Center
As Haiti and the world struggle to come to terms with the devastation caused by the earthquake of Tuesday, January 12th, and as a large multi-national relief operation gets underway, we know with some certainty that a disaster of huge magnitude has occurred, with immense loss of life and with many survivors needing rescue, medical care, shelter and other support. We know that many buildings have been destroyed and that some essential services (electricity, phone, transport) have been have been disrupted in the capital of Port-au-Prince. We know that there was significant damage to the port facilities needed to off-load cargo from ships and that the city’s airport is becoming clogged by supplies and aircraft piling up. We know that a sense of frustration at the slow pace of relief is rising among victims and aid workers alike. We know that, before the earthquake, Haiti was already the poorest country in the Western hemisphere. Beyond those media reports, the kind of information critical to effectively planning and managing a major relief operation still remains hard to come by. For example, two published estimates have been that three million people live in earthquake-affected areas and that the numbers of dead was in the “tens of thousands” range. Although the affected population and death toll could easily be in those ranges or even higher, without a real sense of conditions in the rural areas outside of Port-au-Prince, there is yet no reliable way to estimate the numbers of affected people or the ultimate toll.
In addition to the U.S. military units and civilian urban rescue teams already committed and en route, the U.S. government has dispatched a Disaster Assessment and Response Team (DART Team) to begin gathering the objective information to assess immediate humanitarian needs and to guide a longer term relief operation. DART teams, fielded from the Office of Foreign Disaster Assistance (OFDA) at the U.S. Agency for International Development, are staffed with enough expertise in health, water, sanitation, shelter, logistics, infrastructure and coordination to quickly begin gathering this kind of information, summarize it for decisionmakers in the United States and Haiti, and begin the planning, implementation coordination and monitoring of a medium- and longer term disaster response. When, as in this case, U.S. military forces are also involved in a major relief operation, the military is sometimes directly involved in the DART team assessment. In any case, effective coordination should occur between the DART team and the on-scene military command structure.
The major point of this type of more formal assessment is to increase the odds that the external responses, in terms of incoming relief supplies and experts, are responding to the real needs of the population. Although providing cash donations is always an effective way for the American public to help, the still common practice of sending unrequested and unneeded commodities can divert scarce local storage space and distribution systems from higher priority needs.
The information collected by the DART team will of course include the most recent estimates of numbers of individual people killed, still trapped, missing, needing urgent care, etc. from Port-au-Prince, and that information will be used to decide on the contents of airlifted relief supplies over the next few days. However, an equally important assessment in the early stages of a major relief operation is a “big picture” look at the overall situation, including the coordination and capacity of international groups already on the ground and the state of the local and national infrastructure needed to carry out effective relief activities over the longer term.
In addition to figures on direct casualties and other health and nutrition needs of the population, some examples of other issues that the DART team is likely to quickly collect and analyze include:
- Relief efforts already underway in the country by national and international groups (including estimates of supplies and additional relief staff already en route) and how these ongoing efforts, including aircraft and ship arrivals, are being coordinated;
- The existence of medical, food and other stockpiles elsewhere in Haiti - or in the neighboring Dominican Republic - that could be temporarily borrowed and mobilized;
- The severity of the earthquake’s impact on people and structures beyond Port-au-Prince, in other cities and in rural areas;
- Numbers of houses and other buildings collapsed;
- Estimated numbers of people requiring immediate access to water, food and shelter;
- Interruptions of essential services such as electricity, water, sanitation, communications;
- Damage to the transportation infrastructure needed to import relief supplies (e.g., seaports, airports, roads from the Dominican Republic) and estimates of the effort needed to restore their function;
- Extent of damage to the internal transportation structure (e.g., roads, bridges) needed to distribute relief to outlying areas, including helicopters might be needed temporarily;
- Availability of gasoline and other necessary fuels;
- A description of the security situation, including the potential for looting and other violence.
Collecting and analyzing this kind of information is not nearly as dramatic a post-earthquake activity as treating life-threatening injuries or rescuing people trapped in collapsed buildings but the importance of this “needs assessment” process for the ultimate success of a major earthquake relief effort can’t be overestimated.
Phillip Nieburg, a pediatrician, public health physician, and Senior Associate in the CSIS Global Health Policy Center, was involved in numerous refugee and disaster relief operations during his career at the Centers for Disease Control and Prevention (CDC).