PORT-AU-PRINCE, Haiti – Doctors and aid workers say treating the tens of thousands of Haitians injured by the earthquake is taxing the country's devastated hospitals — as well as the efforts of physicians from around the world who are providing emergency care.
Basic medical supplies such as antibiotics and painkillers are running dangerously low at some hospitals and clinics in Port-au-Prince, the capital, and in the countryside, alarming doctors who are struggling to keep up with demand.
The shortages complicate the effort to treat 200,000 people in need of post-surgery care "and an unaccounted number of people ... with untreated injuries," Elisabeth Byrs, of the U.N.'s humanitarian coordination office said Friday in Geneva.
Dr. Nancy Fleurancois, volunteering at the damaged hospital in the Haitian coastal town of Jacmel, told a visiting U.N. official Thursday that her team is treating 500 people a day — many for the first time since the Jan. 12 quake — and desperately needs antibiotics and surgical supplies.
"You see people come here and they are at death's door," said Fleurancois, a Haitian-American from Newark, Delaware. "More help is needed."
The doctor aired her concerns to Anthony Banbury, deputy head of the U.N. peacekeeping mission in Haiti, during his tour of Jacmel, where more than 20,000 people are homeless.
Banbury said later he would try to resolve her shortages, but noted there is a "grave need" for medicine all over Haiti. Aid workers say the need for medicine generally falls third behind water and tents for shelter from the blistering tropical sun and looming rains.
The reason the supplies are not reaching people is the same: The need is too great and it's just not possible to get them into Haiti fast enough or distributed in a country with ruined infrastructure.
The struggle to treat people comes amid warnings of a potential public health calamity with tens of thousands of Haitians living in squalid camps where there is a big concern about sanitation due to limited water supplies, Byrs said Friday.
"The health care system in Haiti has been terribly affected by the earthquake," said Joe Lowry, a spokesman for the International Federation of the Red Cross. "Medical staff have been killed and injured, hospitals destroyed and stocks damaged and depleted."
Marcela Sauza, the regional director of the Latin America and Caribbean office of the United Nations Population Fund, said Haiti's maternal mortality rate — already by far the highest in the Western Hemisphere — is expected to jump this year because more pregnant women lack adequate food and health care and are stressed by the earthquake and its aftermath.
Even as aid and emergency workers have poured in from around the world, it is easy to find aid workers struggling to keep up with demand. The U.N. estimates the quake injured about 200,000 people, including thousands who required amputation of damaged limbs and now must have postoperative care to prevent infection.
At the chaotic General Hospital in downtown Port-au-Prince, amputees groan in pain while recovering in canvas tents in the courtyard of the damaged structure. There is a shortage of painkillers as well as crutches, wheelchairs and physical therapy equipment, said Dr. Bob Norris, who leads an International Medical Corps team of physicians.
"We have a country full of people with new amputations who have to learn how to live their lives," Norris said.
At the Bernard Mevs Hospital near the airport, Kathleen Sejour, a hospital administrator, said they are short of such basic supplies as gloves, gauze and antiseptic as well as malaria medicine and treatment for amputees.
"Malaria is becoming a big problem and we don't have enough anti-malaria drugs. There are too many patients we're seeing who have malaria. Most of the kids right now have it. We had a good supply but we can't keep up," Sejour said.
At a clinic run by U.S.-based ACTS World Relief and a Haitian group called Operation Hope in Carrefour, a hard-hit Port-au-Prince district, volunteer Dr. Laura Asher said just about everything they need is lacking as they treat hundreds. She said she had pleaded with international aid agencies and better-funded private groups for help.
"It's a constant need, a constant need. Every day we go out and beg," Asher, of Silver Spring, Maryland, said as patients waited in the shade of the front yard of the clinic, which has been set up in a house.
To be sure, there are any number of small groups providing badly needed medical aid and not all are running low.
Dr. Margaret Degand, who runs a private clinic in Petionville, said she was inundated with patients following the earthquake and ran out of supplies, but her stocks were replenished by a French humanitarian organization.
Sandra Murillo, a Doctors Without Borders spokeswoman in New York, said the aid group is doing well with medical equipment and supplies. The group is working on plans to create a postoperative facility for 100 patients to provide therapy and psychological assistance for about 100 people at a time. It will be in tents because many people are still too afraid to be inside a building, she said.
The International Federation of the Red Cross also has plenty of supplies.
But even some of the largest institutions are feeling the strain.
Air Force Gen. Douglas Fraser, head of the U.S. military's Southern Command, told reporters Thursday that Navy hospital ship USNS Comfort had reached its "care limit" after treating more than 3,000 people. U.S. authorities are now planning a new treatment center for up to 5,000 patients on land provided by the Haitian government.
In addition to the shortages, medical teams are seeing a big shift in the types of cases they are treating, World Health Organization spokesman Paul Garwood said Friday in Geneva. He said there are a growing number of diarrhea cases, as well as unconfirmed reports of a rise in measles and tetanus cases in resettlement camps — a particularly worrying development because of the high population density in the camps, he said.