Received from Dr M . VanRooyen
|
||||||||||||||||||
|
Source: Harvard Humanitarian Initiative | Harvard University | 14 Story Street | 2nd Floor | Cambridge | MA | 02138
|
Beat Disability-By Embracing It
Equity and Inclusivity
Sabeena Jalal
"To love. To be loved. To never forget your own insignificance. To never get used to the unspeakable violence and the vulgar disparity of life around you. To seek joy in the saddest places. To pursue beautyto its lair. To never simplify what is complicated or complicate what is simple. To respect strength, never power. Above all, to watch. To try and understand. To never look away. And never, never, to forget."- Arundhati Roy
We are also on the face book : "Beat Disability"
Search My Posterous
Subscribe
Haiti Field Hospital at Risk of Closing!
Haitian Singer and His Guitar Fight Urge to Weep. Thought with a passion: "how can one help but not fall in love with a people?"
|
Source: 
Todd Heisler/The New York Times
Beken, born Jean-Prosper Deauphin, sings songs about despair and redemption that resonate deeply with Haitians, especially in times of tragedy. By SIMON ROMEROPublished: March 4, 2010PORT-AU-PRINCE, Haiti — His pack of Comme Il Faut cigarettes was almost depleted. The smell of rotting garbage on the street and fried pork from a stall next to his tent filled the air in Place St. Pierre. Some children looked at his crutch and grew silent. Beken, one of Haiti’s most gifted musicians, exhaled a veil of smoke.
Multimedia Todd Heisler/The New York TimesBeken performed at a small open-air cafe in Pétionville called Break-Time. Todd Heisler/The New York TimesBeken, 54, lost his right leg at age 12 in a car accident. The quake destroyed his home, pushing him and his wife and three children into a squalid tent camp in Pétionville. “I should be in Miami living off the proceeds of my records,” said Beken, born here 54 years ago as Jean-Prosper Deauphin before adopting his stage name (pronounced Beck-ENN). “Instead I’m living in the filth of this place,” he said, summing up a predicament unbeknown to many who revere his songs.
Haiti is astonishingly rich in music, with musicians who are more successful and famous than Beken, including the Port-au-Prince hip-hop group Barikad Crew and the protest singer Manno Charlemagne, who now lives in the United States. But few composers occupy a space quite like Beken’s, whose songs of despair and redemption strongly resonate with Haitians during times of tragedy.
Peddlers sell pirated CD collections of his songs, including “Tribilasyon” (“Tribulation”) and “Mizè” (“Misery”), on the streets of Port-au-Prince for about $1.30 apiece. Gritty photos of Beken, who lost his right leg at age 12 in a car accident, accompany the CDs. He sings in Haiti’s troubadour tradition, playing a guitar and emphasizing contact with the audience in songs of lament, humor and sometimes politics.
“Beken usually sold best after a hurricane,” said Jonas Gaspard, 25, a merchant selling bootleg music on a street near the wrecked presidential palace. “But since the earthquake, demand for his music is the strongest in years,” he said. “The customers love the way he sings about suffering.”
Beken knows a thing or two about life’s trials. Disabled as a child, he excelled in composing music. He enjoyed some success, particularly in the 1980s, when he traveled to play for Haitians abroad in New York, Montreal and Miami, before some bad decisions with his money pushed him into penury. He described himself as a “sentimental musician,” and said he had fallen in and out of love too many times to remember.
Then came the earthquake. It destroyed his home, pushing him and his wife and three children into one of the city’s most squalid camps, in the Pétionville hills. They live in a tent across from the Kinam Hotel, a gingerbread-style mansion where foreign diplomats and aid workers sip rum sours on a porch overlooking a swimming pool.
Despite his reservoir of talent, Beken seemed to be on the edge of desperation in the tent camp. In a rare display of emotion among the often stoic inhabitants of this city’s camps, his eyes became watery and he appeared on the verge of weeping as he described how the earthquake had affected him.
“The only thing I can do is play music, and I haven’t touched my guitar since Jan. 12,” he said. “I’d like to make a song about my school,” he said, referring to the St. Eternité school for disabled children, where several students died in the earthquake. “But I don’t think I have the strength to write songs at the moment.”
At dusk in front of his small tent, Beken begged off an appeal from some admirers that he play a song or two. “Come back another day,” he told them. “Maybe I’ll find my guitar.”
Other Haitian musicians are also having trouble finding their voices again. Richard Morse, leader of the popular group RAM, said he skipped composing a song for this year’s Carnival because he thought Haiti was not ready for celebration. Mr. Morse, who also manages the bohemian Hotel Oloffson, was evacuated on a military plane for treatment in the United States after being getting a kidney stone after the earthquake. At least seven musicians in his 18-member band are living on the street, their homes destroyed.
“We’ll perform again, but I’m not sure when that will be,” Mr. Morse said.
Beken says he draws inspiration from other Haitian balladeers like Rodrigue Milien, part of a folk tradition that blends acoustic Cuban and Haitian influences.
“This is a beloved role in Haitian expressive culture, the honest but sometimes dissolute social commentator through music,” said Gage Averill, an ethnomusicologist at the University of Toronto.
By one evening last week, Beken had found his guitar, taking it to a small open-air cafe in Pétionville called Break-Time, where people were eating bouillon tet cabrit (goat-head soup) and nursing bottles of cold Prestige beer.
Break-Time’s owner welcomed Beken and got him a chair near the bar. Beken asked for a Marlboro cigarette, which he slowly smoked as he strummed his guitar. Then he began to sing, in Creole, old favorites like “Ambisyon,” “Patience” and a passage from “Imiliasyon”:
For you little peasant working in the fields;
The rain never falls;
Take courage;
This will change one day!
Suddenly, people in the cafe began singing with him. The lyrics seemed familiar to everyone, as if embedded in a place reserved for memories of what life was like before the earthquake wrecked the city. The crowd was singing about suffering, and perhaps forgetting about suffering at the same time.
“Beken should be a rich man but he is not,” said Joseph Guyler Delva, a Haitian journalist in the audience who was one of several people to embrace Beken between songs.
Beken himself had a look of surprise, and something approaching delight, as he performed that night. He returned to his tent amid the stench of Place St. Pierre clutching his guitar. “I can sing again,” he said. “Maybe that means I can write a new song.”
|
Haiti's Road to Recovery - a month later...
|
According to the latest estimates, 212,000 people died in the massive earthquake in Haiti. But there were also miracles,with 211 people were pulled alive from the rubble.
Bill Whitaker reports on Haiti's recovery.
|
An Earth Quake Odyssey- Oct 2005 –Part 2 - Medical Response- Pakistan
|
Contributed By Dr Wasif Shahzad , MD , MHA ( Cornell ) The Aga Khan University Hospital –Pakistan As he joined his hospital’s team of Physicians and surgeons to serve in the Earth quake stricken Areas- an account of how the medical services were delivered. Article Written By Farah Imam
Airline tickets were provide free of cost by Airblue (only the taxes had to be paid. AKUH paid the taxes for 3 employees). A large consignment of medications and supplies was provided by AKUH and the Tabba heart institute for the team to take with them. Besides this, the team was able to collect a little over Rs 300,000 donated by various individuals (from within and beyond AKUH) for the purpose of buying medications, supplies or to be used as required and where needed. Money was also donated by individuals to distribute to the needy people in the affected areas. The teams left Karachi in 2 batches (due to airline seat availability).
The first team arrived in Islamabad at around 9.30 am. We took a coaster through Abbotabad, Mansehra, Balakot and then on to Muzzafarabad. Some observations that we made were: The destruction was selective. A building reduced to rubble could be right next to another whose glass was still intact. Aid agencies sent by the UN, NGOs from various countries were primarily focused in the main cities. Not many were present in the “hard-to-access” areas.
Our base camp was in Muzzafarabad. Sina healthcare had arranged for the logistics. That inlcuded local guides, our accomodation (in tents), food, and the basic medical infrastructures. A hospital in Lahore had donated a container converted in to an OT with general anesthesia facilities, autoclave etc. The base camp had 2 other operating areas (the container OT was for the Ortho cases), 3-4 OPD tents, and a few tents dedicated to inpatients. Our residential tents were located at about a 10 minute drive from the base camp. We sub-divided the team in to groups. One group stayed and worked at the base camp. This was were the surgery and anesthesia facility was available. The rest went to a place called “Camsur” located at about a 20 min drive from the base camp. There were hordes of people at camsur. There was a dispensary in a tent that was catering to the patients. Part of the group stayed at camsur to set up a medical OPD manned by doctors along with a pharmacy. The other part of the group started trekking up a mountain to a place called “Butbung” which was at a height of about 7,500 feet. The trek took 2 hours and was at a very steep incline. No medical or relief team had been to this area at all. The reat of the team arrived on Wednesday. Most of the members of this team proceeded to a place called “Patika”. This was an 8 hour trek from Camsur and included trekking over mountains and crossing a river on a broken briedge. Again, the area targetted by this team was hardly accessed by doctors. This team worked there till Saturday morning. They were airlifted by an AKDN chopper back to the base camp on Saturday. Another area accessed by the team was Gharhi Duppata. Medical OPD was held there for 2 days. The activity on the various days was as follows: An 18 member team departed for Muzzafarabad on the 25th of October till the 30th. The primary objective of the team was to provide medical help to those who had not been reached by aid/govermental agencies. The team was a diverse one and comprised of employees from AKUH (Full time and Non full time), Tabba Heart Institute and Sina Healthcare. There were members from the Departments of Medicine, Surgery, Pediatrics, Anesthesia, Nursing, ER, a fresh medical graduate and a medical student. The group was aware that under the circumstances, perfect working conditions would not be available. Most would not be able to exercise their specific expertise but what they would offer is medical assistance to those who need it but are not getting it. Wednesday: Base camp:
Camsur: Set up the medical OPD and pharmacy Butbung:
Thursday: Base camp:
Camsur: 200 patients seen Butbung: 65 patients seen on arrival Patika: 7 man team left for Patika
Friday:
Base camp:
Camsur: 130 patients seen Patika: 250 patients seen Gharhi Dupatta: 90 patients seen
Saturday:
Base camp:
Camsur: 400 patients seen Patika: 50 patients seen (2 hour OPD before being airlifted) Gharhi Dupatta: 225 patients seen
The disease pattern was varied and included cases of fractures, infected wounds, URI, scabies, dysentry, pain, G.I diseases etc etc. The stage of intense ortho related disease is slowly being replaced by medical and phychiatric related problems. Some of the things we learnt was:
For future teams, they need to know:
The best thing AKUH can do if they want to provide continuity is link with the army and send medical teams (by chopper) to far off areas that have not been accessed. The teams can be deployed for 2-3 days and work in a camp set up by the army. The composition of the camp can be designed by AKUH and may include a number of tents for OPD, surgeries, equipment and medications. The areas that have been minimally accessed is known to the locals as well as the army. The intention of the team was to treat humans needing treatment. The names of who did exactly what is being held back so that no hero emerges from this trip. There will be those who question our intentions, our sanity, of how we should have directed resources and manpower to suit the skill sets of the various individuals. But those people who we saw needed medical help. They too needed qualified doctors to see them instead of dispensers. Not many were reaching out to them, we wanted to. Within ourselves we know we did the right thing. The trip was fulfilling and worth it. Infact, many in the team realized that maybe the only reason we became doctors was for this event. Part 1: http://beatdisability-byembracingit.posterous.com/fw-re-posterous-re |
Harvard Response to Haiti - Part 1
|
Received From Vincenzo Bolletino
Harvard University, Boston, USA
Source : Harvard Humanitarian Initiative Newsletter
|
||||
Earthquake relief experience of Aga Khan University trauma team
|
Article Contributed to the blog By Dr Masood Umer,
Department of Surgery, The Aga Khan University Hospital- pakistan
Article written by Drs : Masood Umer, Haroon Rashid, Hasnain Zafar, Kamran Majeed
Preparation The magnitude and impact of the disaster shook the whole nation. Everybody wanted to contribute. A top management meeting early on Monday (October 10th, 2005) morning gave a go-ahead to our trauma team and issued directives to all concerned departments to mobilize the required resources. A generous financial sum was immediately allocated by the university to support this cause. Dr. Hasnain Zafar was given the charge to lead a team of 12 volunteers. There were 2 general surgeons, one orthopaedic surgeon, one neurosurgeon, one anaesthetist and one emergency specialist. The support staff included general surgery and orthopedic residents and specialty technicians belonging to the operating room, surgical and orthopaedic clinics. At least 65 cartons of various antibiotics, plaster of Paris, intra- venous fluids, sutures, dressing bandages, antiseptic solutions, life saving drugs, and tetanus vaccines were immediately made available within the same evening. This also included a laparotomy set, amputation equipment, intramedullary nails and external fixators. Besides, the team was provided with tents, sleeping bags, and mattresses, making them ready to function in a field.
Deployment After six hours of waiting at the Chaklala airport, we were finally requested by the army to base ourselves at the Kahuta Research Laboratory (KRL) Hospital, Islamabad. Senior personnel in the army and Dr Kamran Majeed, director KRL Hospital, were able to convince us that such a specialized team would be most productive in a hospital setting rather than in any field capacity. It was at 11pm on 12th October that we were received by Dr. Kamran at the KRL hospital.
Operation Few earthquake victims (EQV) were already admitted a day before our arrival. Our first surgical case was an adolescent boy with fracture of both femurs. Surgery started at full pace with sometimes four parallel theaters running. Almost 95% of these were orthopaedic cases . Running parallel to the main theaters was the all important minor theater where all the cases of dressings were being handled by our other team members. Our census in the first three weeks remained around 12-15 major cases per day and about 25 cases of dressings per day. All the medicines, equipment and plaster that we had brought in were being fully utilized. These were real tough days with the total census of EQVs reaching to as high as 90 for few days. Ten to fifteen patients were being admitted daily and soon the hospital was looking for a suitable place to act as a step-down unit whereby stable patients could be transferred. Initially 'Sehar' and later 'Sheltar' proved very useful and allowed us to transfer our stable postoperative patients there. Daily work started at 0830 and sometimes it was well past midnight that we finished our evening rounds of the patients in these step-down units.But team spirit remained very high and nobody ever looked exhausted. We dealt with all kind of patients; male, female, children and elderly. Our aim was to get them on their feet at the earliest. A wide array of orthopaedic injuries was being admitted daily. After the first ten days the spectrum of acute injuries started changing. Even closed fractures were difficult to reduce and almost all of them required open reduction and lot of struggle. Within the second week we admitted patients who had open wounds and had now become infected. We also visited other hospitals of the city and collected numerous patients from there which we thought could benefit from our specialized expertise. By the second week, we had brought in our full equipment of Ilizarov apparatus and were applying it regularly to our patients. Also by this time an expertise in local soft tissue coverage came in and thereafter we regularly performed local flaps in patients who so required. This combination of applying Ilizarov apparatus and soft tissue coverage procedure with a local flap helped us save many limbs with bad infections that were otherwise destined to be amputated. We only did one amputation out of a total of more than 500 surgeries performed over the last 8 weeks. Conclusion Overall this was a very gratifying experience where for the first time a lot of us coming from a private hospital performed in a charitable situation and helped the needy totally free of cost. A total of 52 people rotated in our team at different points in time and all of them were very happy to have played their part and were extremely thankful of the excellent KRL hospitality. Lessons learnt An early start of the rescue operation could have saved many lives. Triage of patients from disaster zone must be done by professionals of multiple teams themselves. Being away from the disaster zone our team missed this opportunity. This made our expert general surgeons almost redundant as they were mostly busy doing orthopaedic surgeries. A better control over triage would have enabled us to divert thoracic and abdominal injury patients to our trauma team.Transfer of patients to other bigger cities of the same province or country should parallel the evacuation process. There were many patients with spinal injuries. Their total number may run in thousands. Almost all of them required surgical care. As spine surgery service was scarcely available in the town (including our team) these paraplegic patients were the most neglected of all. We saw a lot of them in shelter places with other post-operative patients. They were suffering badly because of lack of proper surgical and nursing care. The number of lower or upper limb amputees was a greater burden. As a country we lack good orthotic and prosthetic industry. Whatever we have, probably could not cater for this heavy load. This deficiency was highlighted during this disaster management. The trauma team has to be lead by example; there must always be a team leader who is available all the time and is putting up the maximum by his own personal work schedule. This keeps the whole team motivated and prevents discouragement among team members. The leader-ship must also be replaced regularly. Potential future team leaders should be identified in peace times. A strong organizing team back home forms the back-bone of any trauma team which ventures out in the disaster zone. This permanent team of managers based within the index institute facilitates all the requirements of the trauma team. Regular communication facility with the main organizers back home is a major requirement. This facilitates monitoring and placement of new orders for medicines and implants, and manpower replacement. Regular replacement of all members of the team is very essential. The work load is usually enormous and fatigue sets in early. A biweekly rota should be made by the organizers for regular replacement. People should never be forced to join this activity. All trauma teams must leave with full surgical equipment relevant to their manpower expertise. Things as simple as a drill machine to perform orthopedic surgeries may be difficult to find in a new environment. A permanent resource of relevant implant sets must be developed. This may include a Laparotomy set, amputation set, and external fixation set. Depending on the circumstances and working conditions of the team other sets of instruments can be called for from the primary institution. This was highlighted when our team brought in the Ilizarov instruments and implants in the third week of the earthquake. This helped us save many limbs subsequently. The hard voluntary work done by any team must be generously rewarded at either the institutional or national level by respective organizations. Future Unfortunately natural disasters cannot be predicted. Warnings systems may also not work. We need to plan carefully for the future. This can be done at multiple levels: Individual level We need to identify specialists in the field of disaster management. They will be volunteers who have an interest in trauma management and have preferably done some trauma training/courses. This cohort of specialists will include general surgeons, orthopaedic surgeons, neurosurgeons, spine surgeons, plastic surgeons, physicians, psychiatrists, anaesthetists and emergency medicine specialists. These specialists will enroll themselves in a national trauma personnel registry and will also mention the time frame they can volunteer themselves for. It will be essential for them to be prepared for working in a setting of a field hospital and live and sleep outdoors. A previous outdoor adventure experience will be an advantage. The minimum time duration for such voluntary work should be 2 weeks. Individual hospitals Each tertiary level hospital, public or private, interested in participation should declare its commitment to national disaster management. All hospitals need to formulate their disaster plans and work towards developing necessary manpower and logistic resources for its immediate implementation. As a first step each department in the hos-pital should write in black and white its own indigenous plan for disaster management. City level All hospitals interested in admitting disaster patients should then merge their individual disaster plans into a comprehensive city-wide disaster plan for each major city. Once this is done, it would be known to everybody that city 'A' can cater for 'x' number of patients and so on. A disaster can strike at any place in the country, but this knowledge would help us know the finite limits of a city and help the author ities in early dissemination of sick patients to adjacent bigger towns. This phenomenon of transfer to other cities did happen in the recent earthquake but, in our opinion, too late in the process. Pakistan Orthopaedic Association (POA) Level Ninety-five percent of the patients in the recent earthquake had orthopaedic injuries. This could amount to >70,000 patients. The importance of organizing the orthopaedic community cannot be over-emphasized. All of these 70,000 patients required immediate, specialized and sustained orthopaedic care. The POA leadership should immediately activate its members from a unified forum and act as a central liaising body in the whole affair. A list of volunteers should already be known to them. POA has a great role to play in all of the following activities: 1.Triage 2. Deployment 3. Provision of implants and instruments 4. Manpower re-enforcements. Capacity building for future emergency situations should now be a top agenda. An immediate national level meeting of the heads of institution should be called to agree upon the plan of action. This should include facilitating the development and training of manpower resources in disaster management. A database should be formed about the actual number of individual fractures. The analysis of this database would give us the rationale to procure the approximate number of implants, external fixator, and POP. Understanding should be reached with all implant vendors about the procurement of these implants as well as instruments required for such operations at the lowest possible cost. This would form the permanent resource of POA which will be made available to disaster teams within the first 24 hours of the declaration of emergency. Funds would need to be generated for this purpose. The POA members and philanthropists and international donor agencies should be contacted for fundraising. All volunteers should be hooked to a POA disaster website, whereby they can continuously keep themselves aware of whatever is happening. Unless we plan and build now, it will be very difficult to plan during a future emergency. Triage has to be done in combination with a general surgeon and a emergency physician. POA representation in filed triage is essential. That will be the anchor place for dissemination of patients, data about their severity of injury, their volume and the emergency services provided. If adequate health facilities are not available then long-distance transfer of patients to bigger towns should be recommended. Manpower fatigue is another issue that crops up within the first week of declaration of emergency. The workload is immense and work never finishes. Rest is scarcely available and everybody wants to put in his/her maximum. This requires regular re-enforcement of the man- power with fresh blood. Nobody should be allowed to stretch themselves beyond two weeks of continuous work. Web-site: Immediate and efficient communication can be achieved by creating a web page for all disaster related activities. National Level The public and private sector along with the army should formulate a national disaster policy. The blueprint of field hospitals and triage has to be developed in black and white at the national level. Manpower has to be identified to be able to do triage and run field hospitals in any future disaster. Concrete plans to channel out the injured patients have to be identified. Full article can be found at :http://www.jpma.org.pk/PdfDownload/804.pdf. |
AN EARTHQUAKE ODYSSEY - October 2005 - Pakistan Experience
|
Global Empathic Response to Haiti- Lessons learnt from Past Earth Quakes - an interconnected and inter dependant world.
|
World Bank disaster expert Christoph Pusch says Haiti may be able to replicate earthquake-recovery efforts used in Pakistan after a 2005 earthquake
|
