Health response to the earthquake in Haiti, January 2010

ForewordEvery disaster brings new lessons of general application that we must learn beforethe next sudden-onset disaster strikes. The Haiti earthquake is no exception.This publication, for practical reasons, focuses on the first three months of theresponse. A similar study might be needed for the mid- and long-term recoveryand reconstruction process that occurs after the first three months.The key lessons outlined in this publication are not merely the views of the author,Claude de Ville de Goyet, and co-authors, Juan Pablo Sarmiento and FrançoisGrünewald. They reflect the collective vision of a large number of partners andexperts. International experts of the review group made significant contributionsto the findings and conclusions of this important publication.The 12 January 2010 earthquake could not have occurred in a more vulnerableenvironment than the capital of Haiti. The immediate health impact of the earthquakein absolute terms— number of dead and injured—was among the highestin recent times. When the needs are compared to the national response capacity,this disaster was truly unprecedented.The international community responded rapidly with an outpouring of generosity.Beyond traditional global donors, relief came from Haiti’s immediate neighbors,as well as from every country in Latin America and the Caribbean. Suchsupport offered an encouraging example of solidarity in the true spirit of Pan-Americanism.If the impact was unprecedented, the organization of the response was not. It followedthe same chaotic pattern as in past disasters. Information was scarce, decisionswere often not evidence-based, and overall sectoral coordination presentedserious shortcomings. Management gaps noted in past crises were repeated andamplified in Haiti. The humanitarian community failed to put in practice thelessons learned.The “proliferation of actors”, to borrow an expression used in the evaluation ofthe tsunami, ensured a massive offer of services from competent partners. Theoverwhelming number of people in need of immediate assistance ensured thateach minimally prepared and equipped health responder provided valuable healthassistance. However, this proliferation also included a number of wholly unpreparedor even incompetent health actors who bypassed the overburdened coordinationmechanisms. The WHO initiative to launch a global registration processof foreign medical teams and field hospitals is most timely. It should be a first steptoward national accreditation of those actors.V