1. Cooperation in
Humanitarian
Disasters
Rolf Maibach, MD FMH Ped, Ilanz/Switzerland & Deschapelles/Haiti

2. Balancing
between
cultures

3. EARTHQUAKE IN HAITI 7 M
January 12, 2010 WHERE TO GO?

4. Haiti: 10 Mio inhabitants
Hôpital Albert
Schweitzer Haiti
316’000 killed 400’000 injured
2 Mio displaced >6’000 amputees

8. HÔPITAL ALBERT SCHWEITZER HAITI

10. HÔPITAL ALBERT SCHWEITZER
HAITI
1315 injured, 90% open fractures,
transported 4-8 hours on trucks

11. Lè ou bezwen, ou dwe pi
intèlijan.
When you are in need, you must be
more intelligent.

12. No telephone available: 80 volunteering
surgeons, anesthesiologists, orthopedic
surgeons

13. infrastructure, ressources

14. laboratory, blood bank, medicaments

15. external fixations

20. Life goes on
Diphtheria

23. PROSTHESIS LAB AT HAS
HANGER IVAN R. SABEL
FOUNDATION

24. 40 new prosthesis every week!
1500 prosthesis, 5600 follow up

25. MITHA, 29 y. buried
under her house for
several days,
amputation of both
legs, abandonnend
by her husband, her
four children being
listed as missing

26. MITHA on
training with all
her four children

27. Smile, whenever you are
stressed!

30. Orthopädische
Uniklinik Balgrist
Zürich
Dr. Thomas Böni

31. NAOMIE
The only surviving of
a large family in
Port-au-Prince.
Surgeon in small
team overwhelmed,
did not have time to
treat open fracture.
Too many
amputations in
Haiti?

32. Too many amputations in
Haiti?
• Many small organizations without
technically skilled personnel and
insufficient technical ressources
(Swiss army knife is no surgical
instrument!)

34. Too many amputations in
Haiti?
• Many small organizations without technically
skilled personnel and insufficient technical
ressources
• Unethical behaviour? Kick ? Lack of
responsibility?

35. Too many amputations in
Haiti?
• Many small orgizations without technically
skilled personnel and insufficient technical
ressources
• Unethical behaviour? Kick ? Lack of
responsibility?
• Absence of any control mechanism,
governmental organization.

36. Visiting foreign
doctor ?
Art exposition at
the Oloffson
Port-au-Prince
Haiti
November 2011

39. In the the last few years we had
several disasters in Haiti. HÔPITAL
ALBERT SCHWEITZER played a major
role in disaster relief!

40. Other disasters
• August 2008: 4 Hurricanes with
inundations (Gonaive/Artibonite)
• Several truck accidents with >50
severely injured people
• End of 2010 and Summer 2011:
severe Cholera epidemics, HAS
treated more than 7000 patients

42. Cholera

46. Cholera 2010 / 2011

48. It has been widely
recognized, that Hôpital
Albert Schweitzer Haiti was
very successful in handling
these disasters. Why was it
so? Which qualifications are
prerequisites for succesful
medical and surgical
interventions in a disaster
situation?

49. Which qualifications are
prerequisites for a medical
disaster intervention team?

50. Which qualifications are
prerequisites for a medical
disaster intervention team?
1 Technical competence, speed

51. Which qualifications are
prerequisites for a medical
disaster intervention team?
1 Technical competence, speed
2 Infrastructure, sufficient ressources

52. Which qualifications are
prerequisites for a medical
disaster intervention team?
1 Technical competence, speed
2 Infrastructure, sufficient ressources
3 Excellent interpersonal communication

53. COOPERATION=SUCCESS

54. Which qualifications are
prerequisites for a medical
disaster intervention team?
1
2
3
4
Technical competence, speed
Infrastructure, sufficient ressources
Excellent interpersonal communication
Cultural adaptability

55. Which qualifications are
prerequisites for a medical
disaster intervention team?
1
2
3
4
5
Technical competence, speed
Infrastructure, sufficient ressources
Excellent interpersonal communication
Cultural adaptability
Competent leadership – Cooperation at
eyes level

56. COOPERATION AT EYES LEVEL!

57. COOPERATION AT
EYES LEVEL
RESPECT

58. REVERENCE FOR LIFE

60. COOPERATION AT
EYES LEVEL
RESPECT
MODESTY

62. COOPERATION AT
EYES LEVEL
RESPECT
MODESTY
DETERMINATION

63. DETERMINATION
New Medical
Director at HAS
Dr. Herriot
Sannon

65. COOPERATION AT
EYES LEVEL
RESPECT
MODESTY
DETERMINATION
HUMOR

66. NATHALIE lost a
leg, but did not
loose her humor !

68. COOPERATION AT
EYES LEVEL
DETERMINATION
RESPECT
MODESTY
HUMOR
LOVE

69. JULIETTE
ET
FRÉDERIC

70. • Nouveaux
jambes,
nouveaux amis!
• New legs, new
friends!

72. DAS GLÜCK IST DAS EINZIGE, DAS SICH
VERDOPPELT, WENN MAN ES TEILT
THE FORTUNE IS THE ONLY THING THAT
DOUBLES, WHEN YOU SHARE IT. A S

73. CONCLUSION
• The first two days everyone has to
focus on live saving measures,
hopefully in an organized way.

74. CONCLUSION
• The first two days everyone has to focus on live
saving measures, hopefully in an organized way.
• Thereafter healthcare has to be given
first and foremost by institutions or
organizations, technically well
equipped, being on the ground or with
experience on the ground.
•

75. CONCLUSIONS
• The first two days everyone has to focus on live
saving measures, hopefully in an organized way.
• Thereafter healthcare has to be given first and
foremost by institutions or organizations,
technically, well equipped being on the ground or
with experience on the ground.
• NGOs and surgical teams with skilled
personnel and aware of cultural
sensitivities may collaborate with
these institutions and reinforce them.
•

76. Nampwen zamlèt san
kase ze.
There is no omelet
without breaking some
eggs.

77. One must make
necessary sacrifices to
get a desired result.
Sometimes it is
necessary making
unpopular decisions to
achieve your goal.

78. CONCLUSIONS
• The first two days everyone has to focus on live
saving measures, hopefully in an organized way.
• Thereafter healthcare has to be given first and
foremost by institutions or organizations,
technically well equipped, being on the ground or
with experience on the ground.
• NGOs and surgical teams with skilled personnel
and aware of cultural sensitivities may collaborate
with these institutions and reinforce them.
• Never, ever underestimate local
knowledge!

79. Never, ever underestimate local knowlegde

80. LESPWA FÈ VIF
Hope gives life

82. MESI ANPIL!
MERCI
BEAUCOUP!
THANK YOU!
ENGRAZIEL
FETG!
VIELEN DANK!
www.hopitalalbertschweitzer.org
www.hashaiti.org