Haiti Earthquake

Definition

The Haiti earthquake was a 7.0 magnitude earthquake on the Moment Magnitude Scale that took place on January 12, 2010. The earthquake struck approximately 15 miles (25 km) southwest of Port-au-Prince, the capital of Haiti. It was followed by two strong aftershocks measuring 5.9 and 5.5 in magnitude.

Description




Most of the buildings in Downtown Port-Au-Prince still remains untouched and risky, in Port-Au-Prince, Haiti on August 27, 2010.





Most of the buildings in Downtown Port-Au-Prince still remains untouched and risky, in Port-Au-Prince, Haiti on August 27, 2010.
Origins

The Republic of Haiti is a small country located on the island of Hispaniola in the Caribbean. Haiti has a total area of 10,714 square miles (27,750 sq km) and makes up approximately one-third of the island of Hispaniola, with the other two-thirds being made up of the bordering country, the Dominican Republic. The North Atlantic Ocean and the Caribbean Sea surround the other sides of Haiti. Haiti is a republic that gained its independence from France in 1804, becoming the first black republic ever to do so. Haiti was once one of the richest islands in the Caribbean. However, the African slave trade and environmental degradation have left Haiti as the poorest country in the Western Hemisphere and one of the poorest countries in the world.

Risk factors

Haiti's location puts it in the middle of the hurricane belt, so the country is often subject to severe storms and flooding during hurricane season. Haiti also sits on more than eight fault lines and between two major fault lines that comprise the divide between the North American tectonic plate and the Caribbean plate. These active fault lines often produce only minimal movement, but strong and devastating earthquakes are not uncommon in Haiti. Earthquakes occurred in 1770, 1842, 1887, and 1946. Additionally, the country suffers from extreme deforestation, which has led to soil erosion and made the countryside vulnerable to landslides.

Clean drinking water and a high level of most communicable diseases have been ongoing problems for Haiti. Prior to the 2010 earthquake, only an estimated half of Haiti's population had access to potable water, health services, or sanitation. Additionally, a weak government suffering from a high level of corruption reduced emergency preparedness, infrastructure, and the health and education systems in Haiti.

Before the 2010 earthquake, 75% of health services were delivered by nongovernment organizations (NGOs) and faith groups. Life expectancy in Haiti was ten years lower than that of other countries in the region, and the mortality rate of children under five years of age was twice that of its neighboring country, the Dominican Republic. The rate of communicable diseases in Haiti is extremely high, including HIV, acute diarrheal disease, and tuberculosis. Other diseases such as leprosy and anthrax also are common. In addition, vaccine-preventable diseases remain prevalent due to the lack of available health care. Catastrophic natural disasters are not uncommon in Haiti. Even with this knowledge, the Haitian government has done little to prepare the country, improve infrastructure or develop a plan in case a disaster strikes.

These factors magnified the destruction caused by the 2010 earthquake, which was of a similar magnitude to one that struck New Zealand. Despite the similarity, damage in New Zealand was much smaller and recovery was much faster due to the quality of the infrastructure, government structure, and healthcare services available. The U.S. Geological Survey recorded 22 earthquakes magnitude 7.0 or higher in 2010, but over 98% of deaths that occurred from these earthquakes occurred due to the earthquake in Haiti.

Demographics

Haiti is one of the poorest countries in the world and was already the poorest country in the Western Hemisphere before the 2010 earthquake. At that time, 80% of the population was living below the poverty line. Fifty-four percent of the population was living in abject, or extreme, poverty. Haiti suffers from an abundance of unskilled labor and a shortage of skilled labor. The unemployment rate in 2010 was over 40%, with two-thirds of the labor force without formal jobs. More than 70% of the population lives on less than US $2 a day.

In the capital city, over 86% of the population was living in slum-like conditions before the earthquake struck. The poorly built concrete buildings were overcrowded and had minimal structural support to withstand a severe earthquake. At the time of the quake, over half the people in Port-au-Prince had access to latrines and only one-third had access to tap water.

Causes and symptoms

On January 12, 2010, a 7.0 magnitude earthquake on the Moment Magnitude Scale struck the country of Haiti followed by strong aftershocks ranging as high as 5.9 in magnitude. The earthquake shook Haiti for 35 seconds and was located only 8 miles (13 kilometers) below the earth's surface and had an epicenter 15 miles (25 km) away from the densely populated capital city of Port-au-Prince. The initial damage caused by the earthquake included death and injury due to collapsed structures and falling debris. Eighty percent of the town of Leogane was destroyed, in addition to many important government buildings in Port-au-Prince, including the president's palace, Parliament, the Law Courts, and the Ministry of Health. According to the post-disaster needs assessment, 105,000 homes were completely destroyed and more than 208,000 were damaged. In addition, over 1,300 educational establishments and 50 health centers and hospitals were damaged to the extent that they were no longer useable. A portion of Haiti's main port became unusable from the earthquake, and damage was also done to the airport's guidance system.

Immediate health issues included a shortage of equipment, health professionals, and space to treat the injured. Health centers and hospitals were damaged to the point of being unusable. Hospitals that had suffered minimal damage struggled with a shortage of information, including no registry of patients or health files. The estimation of deaths and injuries due directly to the earthquake varied and changed throughout the first month after the event. The Haitian prime minister officially announced on February 4, 2010, 24 days after the earthquake, that as many as 200,000 people died and another 300,000 had been injured. Injuries included fractures, amputations, head and spine injuries, burns, abrasions, and eye injuries.

Common diseases and disorders

The most common injuries sustained from the earthquake were trauma, fractures, head and spine injuries, eye injuries, amputation, and burns. After initial injuries, infected wounds due to a shortage of postoperative care became the most commonly treated condition.

On October 19, 2010, ten months after the earthquake in Haiti, the Haitian Ministry of Public Health and Population (MSPP) became aware of a sudden increase in patients being treated for diarrhea and dehydration. The Haiti National Public Health Laboratory identified the pathogen as cholera on October 21, 2010, and officially announced the outbreak one day later. This outbreak became the largest of cholera in recent times. Within one year of being declared, it had affected over 470,000 people in Haiti and killed over 6,600 people.

Treatment

Immediate treatment of injuries was limited due to the number of healthcare professionals and supplies. As foreign aid was able to enter the country, the number and success of treatments grew.

Immediate treatment

The initial response after the earthquake included stabilizing the injured and treating the most serious injuries. Unfortunately, many hospitals and healthcare centers in Haiti were damaged in the earthquake or only equipped to handle minor procedures, delaying many treatments of more serious injuries to when outside aid could arrive. With the arrival of foreign agencies, field hospitals, hospital ships, and health centers were set up and used to diagnose and treat patients, perform surgery when necessary, and provide postoperative care. Limited supplies and space made treatment difficult, and often patients were forced to leave the health center within 39 hours of having a surgical procedure. This led to a high number of infected wounds, which became the main condition treated after the immediate earthquake emergency.

Long-term treatment

Public health role and response

Due to the damage caused to Haiti's main port and the airport's guidance system, response time for those outside the immediate area was slowed. Additionally, damage to communication methods such as phone lines made spreading information difficult. Language barriers and administrative difficulties, such as obtaining approval for movement and clearing customs, made response times difficult and delayed. However, even with the delays, the first help was able to reach Haiti by January 14, much faster than in many disaster situations. Together with the help of many individuals and organizations, there was a massive response and aid effort put forth by both Haitians and foreign nations.




Health workers of an hospital working under difficult condition in a makeshift tent on August 26, 2010 in Port-Au-Prince, Haiti.





Health workers of an hospital working under difficult condition in a makeshift tent on August 26, 2010 in Port-Au-Prince, Haiti.
Emergency response

Humanitarian organizations already working in Haiti played a role in initial emergency response. An estimated 9,000–10,000 NGOs were already in Haiti when the earthquake struck. Within hours, many organizations had begun helping the injured and looking for the missing. The International Committee of the Red Cross, which had stockpiled medical supplies in case of urban tensions and hurricane disasters, began handing out supplies by the morning after the earthquake.

Once transportation to Haiti was possible, massive numbers of foreign teams came to provide health assistance. More than 30 countries, including the usual humanitarian donors, sent urban search and rescue teams. Many of these teams brought basic health equipment, and others brought entire field hospitals. Many countries sent governmental medical teams. For example, the United States sent teams from the Office for Foreign Disaster Assistance, the U.S. military, and the U.S. Health and Human Services Department. The United Nations (UN) and UN-related agencies such as the World Health Organization (WHO), UNICEF, World Food Programme, and the International Organization for Migration sent teams to assist in healthcare efforts. The Red Cross system also sent teams from many national Red Cross groups.

The disaster in Haiti spurred the support from hundreds of NOGs, from large, internationally known names to small and virtually unheard of groups. Hospitals and universities offered support and sent staff and volunteers to assist in the health efforts. Small social and religious organizations sent members to Haiti to help with the healthcare efforts. Many of these organizations were developed specifically to the earthquake. Many smaller organizations played a vital role in forming one-on-one relationships with the Haitian people.

In certain cases, the injured were transported outside of Haiti, many to the Dominican Republic, the United States, and French territories. Others were treated on hospital ships off the coast of Haiti brought by countries such as Columbia, Spain, France, the United States, and Mexico. One of the largest problems faced by medical teams in Haiti was what to do with patients after surgery. On average, patients were discharged within 39 hours of their operation. Having a large number of doctors but small number of nurses resulted in a limited amount of postoperative care, leading to a high rate of infection. Several successful partnerships were developed between teams providing surgical procedures and teams providing postoperative care. For example, the NGO Love a Child in Haiti worked with Hospital Buen Samaritano in the Dominican Republic. Patients were treated in Haiti and then sent to the Dominican Republic where they could receive postoperative care.

KEY TERMS
Abject poverty—
The most extreme poverty which occurs when individuals cannot meet their basic needs for food, water, shelter, sanitation, and health care. The World Health Organization defines abject poverty as living on less than US $1.25 a day.
Cholera—
An infection of the small intestine caused by a type of bacterium. The disease is spread by drinking water or eating seafood or other foods that have been contaminated with the feces of infected people. It occurs most often in parts of Asia, Africa, Latin America, India, and the Middle East. Symptoms include watery diarrhea and exhaustion. Cholera is often fatal to young children and the elderly.
Potable water—
Water that meets the U.S. Environmental Protection Agency water quality standard for water that is safe for human consumption.
Long-term response

The long-term response to the earthquake in Haiti was carried out for the most part by the MSPP and large international organizations such as the Pan American Health Organization, WHO, the Red Cross system, and those who were already working in Haiti before the earthquake. Long-term response focuses on providing safe and clean shelter for those left homeless, rebuilding or repairing educational and medical facilities, and controlling the outbreak of communicable diseases such as cholera. The CDC and its partners played a large role in developing a treatment plan for the cholera outbreak in Haiti, along with tracking its success and educating healthcare providers. An emphasis was placed on training healthcare workers in Haiti about cholera, with over 10,000 workers trained by March 2011. Additionally, cholera treatment sites were set up along with oral rehydration points, and information was given to Haitian news outlets with the hope of educating the public about cholera and the best ways to prevent getting sick.

Haiti received an estimated $4.59 billion in international pledges for reconstruction, and as of August 2012, there were still many organizations in Haiti assisting with earthquake relief. Shelter is one of the main areas of concern because without safe and clean shelter, the likelihood of disease and injury increases. The World Bank estimated that in 2012 there were over $400 million in large-scale permanent housing solutions underway in Haiti. However, rebuilding was slow, with only an estimated 15,000 repairs complete and 5,700 new permanent houses completed as of August 2012. Many people question where the donated money went due to the fact that a minimal number of permanent structures have been built and so many Haitians were still lacking safe and secure shelter.

Some volunteer organizations focused on relief outside of housing. For example, Oxfam, helped over 100 small businesses expand in the Port-au-Prince area; Save the Children provided over 1,200 grants to families to provide training and support to 22 small construction businesses; and Concern provided 75,000 people with clean water and sanitation services. These are just three of the hundreds of ongoing projects in Haiti that are part of the long-term response effort.

Prognosis

The exact number of deaths and injuries caused by the 2010 earthquake in Haiti is unknown; however, it is estimated that around 200,000 people died, 300,000 were injured, and over one million people were displaced. Additionally, one year after the cholera outbreak in Haiti, there had been over 470,000 reported cases of cholera and more than 6,600 deaths, making it the worst cholera outbreak in recent history. By October 2011, the case fatality ratio had dropped to below the WHO standard of 1%. It is believed that the efforts by the CDC, WHO, and other organizations brought the ratio down from its initial mortality rate of 4%. In 2012, cholera remained a problem faced by Haiti, although the number of reported cases continued to decline. As of July 2012, a total of 581,952 cases of cholera and 7,455 deaths had been reported.

As of August 2012, hundreds of thousands of people were still living in unsafe and unsanitary housing conditions. It was estimated that over 600,000 Haitians were living in tents, including over 390,000 Haitians who resided in one of the 575 camps. Many of these camps lacked basic necessities and had only one shower for every 1,200 people and one working latrine for every 77 people. Other Haitians were living in homes that were too damaged for safe habitation. Often, more than eight people were forced to live in one room. Thousands of others were completely homeless. The shelter shortfall caused more injuries and disease outbreaks, because proper sanitation and water treatment could not be met.

QUESTIONS TO ASK YOUR DOCTOR

Prevention

While earthquakes are not preventable, strong infrastructure of buildings and roads can limit the amount of damage a country sustains from an earthquake and the number of injuries caused by collapsing buildings and falling debris. Additionally, emergency plans and stockpiled medical supplies can reduce the response time for treating injuries and searching for the missing.

Cholera is uncommon in industrialized nations. Access to safe drinking water through the use of water treatment and good sanitation facilities can reduce the number of cholera cases to almost zero. Additionally, individuals can take precautions to protect themselves from contacting cholera. The CDC recommends people in areas with a risk of cholera infection take these five precautions to stay safe:

See also Cholera ; Disaster preparedness ; Earthquakes ; International Red Cross and Red Crescent Movement .

Resources

BOOKS

De Ville de Goyet, Claude, Juan Pablo Sarmiento, and Francois Grunewald. Health Response to the Earthquake in Haiti. Washington, DC: Pan American Health Organization, 2011.

Schuller, Mark, and Pablo Morales. Tectonic Shifts: Haiti Since the Earthquake. Sterling, VA: Kumarian Press, 2012.

WEBSITES

Centers for Disease Control and Prevention. “Outbreak Notice: Cholera in Haiti.” http://wwwnc.cdc.gov/travel/notices/outbreak-notice/haiti-cholera.htm (accessed September 16, 2012).

Sontag, Deborah. “Years After Haiti Quake, Safe Housing Is a Dream for Multitudes.” http://query.nytimes.com/gst/fullpage.html?res=9800E4DB153BF935A2575BC0A9649D8B63&ref=haiti&pagewanted=1 (accessed September 16, 2012).

World Factbook. “Haiti.” https://www.cia.gov/library/publications//the-world-factbook/geos/ha.html (accessed September 16, 2012).

ORGANIZATIONS

Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, 30333, (800) 232-4636, cdcinfor@cdc.gov, http://www.cdc.gov .

International Committee of the Red Cross, 19 Avenue de la Paix, Geneva, Switzerland, 1202, 41 22 734 60 01, Fax: 41 22 733 20 57, webmaster@icrc.org, http://www.icrc.org .

Pan American Health Organization, 525 23rd St. NW, Washington, DC, 20037, (202) 974-3000, Fax: (202) 974-3663, www.paho.org .

World Health Organization, Avenue Appia 20, Geneva 27, Switzerland, 1211, 22 41 791 21 11, Fax: 22 41 791 31 11, info@who.int, http://www.who.int .

Tish Davidson, AM

  This information is not a tool for self-diagnosis or a substitute for professional care.