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Remembering the people of Haiti

By Melissa Kerr
November 2010

J. Nadine Gracia, M.D.
Gracia, above, serves as chief medical officer to the HHS Assistant Secretary for Health Howard Koh, M.D., M.P.H. (Photo courtesy of Steve McCaw)

William Stokes, D.V.M., left, and William Suk, Ph.D., right
Many attended Gracia's talk, including Rear Admiral William Stokes, D.V.M., left, director of the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods, and William Suk, Ph.D., right, director of the Center for Risk and Integrated Sciences and Superfund Research Program. (Photo courtesy of Steve McCaw)

J. Nadine Gracia, M.D., left, and NIEHS/NTP Director Linda Birnbaum, Ph.D.
NIEHS/NTP Director Birnbaum moderated the question and answer session following the seminar. (Photo courtesy of Steve McCaw)

The immediate crisis in Haiti may have passed, but according to guest speaker J. Nadine Gracia, M.D., Haitians face a colossal effort as they try to rebuild their health care infrastructure. Gracia described the obstacles in restoring and improving health care in Haiti, particularly the educational and training infrastructure, in a talk Sept. 29 at NIEHS. NIEHS/NTP Director Linda Birnbaum, Ph.D., hosted the talk and welcomed Gracia to speak on "Rebuilding health professions education in Haiti."

Haiti in turmoil

A devastating magnitude 7.0 earthquake hit the most populated area of Haiti Tuesday, Jan. 12, 2010. The epicenter was near the town of Leogane, approximately 16 miles west of the capital city Port-au-Prince. The Haitian government reported that approximately 230,000 people died, 300,000 were injured and 1 million lost their homes. The estimated damage was $7.7 billion, with $11.5 billion in reconstruction costs. The destruction of hospitals, clinics, and medical training institutions jeopardized the future of the health care workforce in Haiti.

"The building that housed the Ministry of Health collapsed and was completely destroyed," Gracia explained. "The sad part was that many of the people who would have been vital to rebuilding the country's health care system perished in that collapse. The workers who were left had no place to work and very few colleagues to get the job done."

The U.S. helps its neighbor

Gracia said that President Obama reacted to the crisis by insisting there be a swift, but coordinated and aggressive effort across the federal government to help support the recovery efforts in Haiti. The National Disaster Medical System constituted the primary response, with several medical and surgical teams activated days after the earthquake. According to Gracia, they saw more than 30,000 patients, performed 167 surgeries, and delivered 45 babies. In addition, the U.S. Department of Health and Human Services (HHS), in partnership with the Haitian Ministry of Health, administered mass vaccinations to stave off potential epidemics of infectious disease.

While some teams focused on helping the living, other teams concentrated on giving back dignity to the dead. Garcia added that the mortuary team faced a particularly daunting task of identifying victims, since Haiti lacked an established dental records system before the catastrophe.

The health care profession rebuilds

Gracia maintained that one of the biggest challenges was just getting the debris out of the way. Although debris removal is still an ongoing issue, she said training institutions have asked for help in setting up tents, prefabricated buildings, or any kind of temporary structure that will allow health care students to return to class.

According to Gracia, several HHS-hosted meetings recently brought leaders together from American and Canadian academic institutions, as well as representatives from the Ministry of Health and Haitian medical schools, to discuss how to rebuild the medical education system. As a result, a national committee developed the North American Initiative to Rebuild Medical Programs in Haiti, an HHS-lead consortium that would govern the development of graduate medical education. The plan would cover rebuilding medical institutions, development of infrastructure, evaluation of curriculum, recruitment and training of professors, and development and integration of a public health program into medical education.

"My work in the Haiti recovery has not been work," Gracia concluded. "My purpose is to work with both American and Haitian governments in order to move forward on the HHS proposal."

(Melissa Kerr studies chemistry at North Carolina Central University. She is currently an intern in the NIEHS Office of Communications and Public Liaison.)

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