Health response to the earthquake in Haiti, January 2010

Health response to the earthquake in Haiti January 2010The same study describes the distribution by type of injury. As shown in Table 3.6,approximately half were fractures and 16% were amputations.Table 3.6 Type of injury in persons visited in hospitals in Haiti,January 2010Type of injury Number PercentageFractures 1,233 48%Amputations 407 16%Spinal cord and traumatic brain injuries 41 2%Burns 27 1%Eye injuries 20 1%Other, unspecified 866 33%Total 2,594 100%Note: See note for Table 3.5; reproduced with permission of the authors (Calvot and Shivji, forthcoming).Compiling the statistics from medical teams, if and when available, is further complicated bythe absence of standard nomenclature and definitions of type of injuries.Crush syndromeCrush syndrome continues to be underreported in most disasters worldwide.Crush syndrome is a condition caused by prolonged compression of skeletal muscles leadingto renal failure. There is no consolidated single source on the incidence of this conditionafter the earthquake in Haiti. In addition to the 48 cases referred to the Miami Universityfield hospital and the 88 reported by the surveillance system, 25 the Renal Disaster ReliefTask Force of the International Society of Nephrology working through Médecins SansFrontières (MSF) tallied 51 cases of acute kidney injury (AKI) (Vanholder et al. 2010).Whether those cases are distinct from those reported elsewhere is unknown.When comparing the 51 acute kidney injury patients with crush injuries in the Haitievent with injury in other disasters, the specialized Renal Task Force found that prevalenceof AKI was low in Haiti. In assessing these results, the Task Force (Vanholder etal. 2011) observed:“. . . several factors may have influenced this, such as: the fact that it occurredduring the day, when people are up and about, favoring head and chest traumaand decreasing the compression trauma to muscles; the presence of many buildingswhich were not sturdy enough to cause severe muscle trauma; difficultiesencountered with early rescue; the extrication of most victims by neighbors orfamily members resulting in a selection of less heavily wounded people, anda lack of immediate medical help for the occasional severely affected victim.”2825 While surgical trauma hospitals or specialized teams can be entrusted in this difficult diagnosis, the surveillance system’ssentinel sites are general care facilities providing AIDS treatment and may not be fully familiar with this condition. Thisleaves some doubt about the 88 cases reported by the surveillance system several weeks after the impact.