Canadian Forces Health Services: Going above and beyond to help Haiti

By Lieutenant (Navy) Kelly Rozenberg-Payne

Port-au-Prince — Over time, members of the Canadian Forces Health Services (CFHS) treat a lot of people, but every now and then they face challenges that call on their ingenuity and intuition as much as their skills and knowledge. Operation HESTIA in Haiti is full of those challenges. CFHS members have had to adapt quickly to a complex and ever-changing environment to ease suffering and save lives.

CFHS members were among the first Canadians to deploy to Haiti in the immediate aftermath of the 12 January earthquake. Arriving only 48 hours after the initial tremor, the first medics on the ground went to work with the Disaster Assistance Response Team (DART) at the Canadian Embassy in Port-au-Prince. They took care of the Canadians who took refuge there, and visited hospitals to do what they could for injured Haitians.

“More than 180 members representing 16 different health care trades are serving on this mission,” said the Task Force Surgeon, Lieutenant-Colonel Linda Garand. “This is one of the most impressive and rapid deployments of health services assets, working together to provide critical emergency and primary medical care to CF members deployed in Haiti and to people effected by the earthquake.”

Once the DART Reconnaissance Team completed its tactical-level assessment, the DART deployed to Jacmel, a city on Haiti’s southern coast with an urban population of around 25,000 and some 40,000 more in the hills surrounding the town. Estimates place the number of earthquake-related deaths in Jacmel around 500.

The DART Medical Platoon established its Role 1 clinic on the pier in downtown Jacmel, opening for business on Monday, 18 January 2010. While waiting for their own facility to reach full operational capability, the physicians, nurses and medical technicians augmented the staff of the Hôpital St-Michel.

The line-ups outside the DART clinic are often long. At its peak, it treated almost 500 patients a day for problems ranging from broken bones to dehydration. “We even delivered two babies, which was a success. In the first week, we literally saved lives and limbs,” said Major Annie Bouchard, the officer commanding the DART Medical Platoon. “Even with limited resources, we were able to change lives for the better.”

CFHS members serving on Op HESTIA have a great advantage: most of them speak at least some French, as do Haitians, so they don’t have to work through an interpreter to diagnose and treat patients. With a common language, Canadians can also build a rapport with their Haitian patients, lending a personal touch to the medical care they deliver.

After more than a month, the DART clinic continues to average 250 to 300 patients a day, a significant challenge for the 45 staff members and a facility designed for a daily patient load of up to 250. “The professionalism and dedication of the DART Medical Platoon has been exceptional. Each day they push themselves to do more and to provide relief to the local population who need our help,” said Maj Bouchard.

The other CF area of responsibility in Haiti is centred on Léogâne, a city of approximately 130,000 residents located 20 kilometres from Port-au-Prince, at the epicentre of the earthquake. Like the nation’s capital, Léogâne was extensively damaged by the quake. According to some estimates, about 90 percent of the city was destroyed.

Because of its desperate need, Léogâne became the destination of 1 Canadian Field Hospital, a CFHS contingency unit based on equipment assets held in Petawawa, and medical, logistics and engineering personnel from across Canada. The mandate of 1 Cdn Fd Hosp is to deploy to a theatre of operations and rapidly set up a Role 2 or Role 3 medical facility in temporary accommodation — i.e., tents.

Establishing a Role 2 hospital is no small task. The team assembled in Petawawa included personnel from 21 regular and reserve force Health Services units across Canada. Deployment began on 15 January, and the Role 2 hospital accepted its first patients on 29 January. At time of writing in mid-February, it has treated more than 2,000 patients and conducted more than 100 surgical procedures.

According to the officer commanding, Maj Patrick Brizay, staff at the Role 2 hospital treat cases ranging from simple sprains to fractures and traumatic amputations caused by the earthquake “We have seen medical conditions and diseases rarely seen in Canada, like severe cases of tetanus and coetaneous anthrax,” he went on.

One of the biggest challenges the Role 2 staff faces is caring for infants and the elderly. “Their care requires not only expertise in the field, but also specialized equipment and drugs we normally do not carry,” explained Maj Brizay. He noted that 1 Cdn Fd Hosp does not normally stock diapers, so a bit of initiative and a quick trip to a local big-box store before leaving ensured they were set.

CFHS professionals are trained to deal with military casualties — fit, young adults with traumatic injuries. (In fact, most members of 1 Cdn Fd Hosp have served in Afghanistan.) “It was a real change of pace and a bit of an adjustment to have to care for a population that doesn’t have access to regular health care, with medical conditions or injuries we do not often see,” said Maj Brizay.

The Role 2 hospital complements the DART clinic in Jacmel, initiatives by non-governmental organizations, and other nations’ military medical units such as the Role 2 facilities deployed by Brazil and the United States. “We have taken over the care of patients who have had external fixations done by local NGOs to ensure a permanent fixation is done,” said Maj Brizay.

When enough medical staff and supplies had arrived in Haiti and hospital activities were running smoothly, medical teams began venturing out to outlying communities to see patients people who could not travel to Jacmel or Léogâne.

On a Village Medical Outreach visit to the hill town of Tom Gato about 15 km from Léogâne, a team of 13 CFHS personnel “treated between 130 and 140 patients for fractured arms, broken hips and a broken pelvis,” said DART physician Captain Robert Ennis of Gagetown.

Operation HESTIA has given CFHS members a chance to put their training and ingenuity to the test, to excel, and sometimes even to do the impossible. On this mission, flexibility, patience and co-operation have proven to be just as important as knowledge and skill to the successful execution of humanitarian relief operations. Everyone involved in the deployment of the DART Role 1 clinic in Jacmel, the 1 Cdn Fd Hosp Role 2 facility in Léogâne, and the Role 1 clinics at Joint Task Force Haiti’s various camps believes the Canadian Forces have demonstrated the will to exceed expectations in the delivery of emergency and primary medical care.

“We have learned a lot from this opportunity. The mission has been very successful in many respects,” said LCol Garand. “We will take time to analyse the lessons learned so that we continue to be responsive and ensure future success.”

Lt(N) Kelly Rozenberg-Payne is a Public Affairs Officer from CEFCOM Headquarters in Ottawa. She is deployed in Port-au-Prince with the headquarters of Joint Task Force Haiti.