For distribution April 28, 2010 on the Occasion of “Hot Topic” Discussion Group, Weston, Florida Guest Speaker Colonel Joseph Napoli, United States Southern Command, Miami
HRDF AND U.S. SOUTHERN COMMMAND ARE “HOT TOPICS”
As Americans, we are glad to have the capability within our armed forces to respond promptly and peacefully when other countries experienced disasters. In the case of the January earthquake in Haiti, the large Haitian-American community particularly appreciated the arrival of the USNS Comfort and its stay until last month, and the services of the parts of the Humanitarian Assistance Program (HAP) of the US Military Southern Command (SOUTHCOM).
Probably, few Americans knew of the existence of SOUTCOM HAP until the Haitian earthquake. On the other hand, many Haitians, including physicians, nurses of Haitian hospital and clinics have benefited from SOUTHCOM HAP over the years. Their presence, however, has been episodic not continuous. Patients who may have been seen and treated by American medical personnel may never again see a doctor or a nurse. Clearly, public health practices require continuity and this something that HRDF believes SOUTHCOM HAP could or even should have a role in.
SOUTHCOM HAP AND HRDF 2004 – 2007
Until 2004, Haiti had not benefitted from SOUTHCOM HAP, while it regularly visited the rest of the hemisphere and invested heavily in disaster preparedness not just disaster response. Investment included clinics, schools, warehouses for emergency equipment and supplies and emergency operation centers. The entire mission amounted to millions of dollars a year.
In February 2004, SOUTHCOM HAP added Haiti to its program for the Western Hemisphere. For this, it appropriately invited a select group of Haitian-American physicians, engineers, geographers, administrators social workers and other professionals to accompany, support and advise about its involvement in the humanitarian field in Haiti. This was a first for the US military. The mission purpose was to improve Haitians’ ability to respond to disasters, such as hurricanes that had recently struck the country. The teams – American military and Haitian-American advisors together – visited several cities and rural locations and assessed the adequacy and readiness of schools, hospitals, fire stations, civil defense and airfields. They met the American ambassador, the Haitian Prime Minister and his Cabinet, and interviewed community leaders throughout the departments of the West, North, Northwest and South.
The assessment revealed a) the absence of pre-hospital emergency care and response training b) the absence or inadequacy of emergency room and intensive care units, c) the inadequacy of trained medical responders, d) here was no radio communication in the ambulances and e) fire services had no search and rescue capability. As a result, SOUTHCOM HAP contracted for significant health and safety improvements, including the renovation of the emergency wings, operating rooms, intensive care, radiology unit, and laboratory facilities. It also began the construction of an emergency operation center in Port-au-Prince.
The intention was that these investments would accompany by education and training in emergency medicine, biomedical and disaster response. HRDF was a partner in all of this. To us, it was the Golden Age of SOUTHCOM HAP participation in Haiti because for the next three years SOUTHCOM HAP did not follow-up.
SOUTHCOM AND HRDF FROM 2007
For many years, SOUTHCOM has conducted Medical Readiness Exercises (MEDRETES) in the western hemisphere. These exercises provide foreign field experience for American military personnel. Typically the exercises last from two weeks to three months. 2007 was the first MEDERETE in Haiti, and was done with the advice, coordination, teaching, treatment of patients and public relations of the Haitian Resource Development Foundation and the Association of Haitian Physicians Abroad. The two organizations also advised on helped locations and introduced SOUTHCOM to Haitian medical and community leaders. MEDERETES exercises continued, but without significant investments in Haitian health infrastructure.
Then the earthquake struck this January. Haitians were neither prepared nor had sufficient health infrastructure to cushion the blow. As a result, American and other emergency responders had very few Haitian facilities where personnel could be accommodated, supplies safeguarded, and patients gathered. HRDF believes this is due to years of foreign service in Haiti without commensurate equity in Haiti. It is an unfortunate policy that could be changed to save lives and promote preparedness.
THE FUTURE OF SOUTHCOM HAP IN HAITI
Two million or more Haitians, environmental refugees, are in dire need of more than simple humanitarian assistance. SOUTHCOM HAP has historically shown its concern and ability to do much more than emergency response, for example its sizable investments in Haiti in 2004. If these investments had continued into 2010, Haitians and Americans alike would have been in better shape to deal with this year’s earthquake.
Haitians have always welcomed SOUTHCOM HAP investments in public health infrastructure and community development. To them, this is a more relevant definition of the term “humanitarian”. HRDF concurs, this deserves consideration among SOUTHCOM HAP and its Haitian-American partners.
Aldy Castor MD, President, Haitian Resource Development Foundation (HRDF)