2. HopitalSacre Coeur in Milot, northern Haiti (permanent hospital run by international non-profit)
3. USNS Comfort hospital ship, off shore Port au Prince). As patients were stabilized, beds needed to be freed for waiting injured. Three main sites in Haiti assumed responsibility for SCI rehabilitation care, with little to no prior SCI expertise or experience. The need to rapidly train the health workers at these sites, while simultaneously ensuring patients were receiving appropriate care, was paramount. We describe the experience at two of the sites, with aims of informing potential process for future disasters. Three main health service sites in Haiti volunteered to admit patients for rehabilitative care following acute stabilization; Haiti Hospital Appeal (HHA), St Boniface Foundation (SBF) and Project Medishare. HHA and SBF operated pre-earthquake general medical facilities, with local physician and nursing support. Both became essentially dedicated SCI rehabilitation hospitals. Collaborative efforts by small non-profit organizations (all with pre-earthquake Haiti experience) led to rapid deployment of expatriate SCI teams to join National and expatriate staff at both HHA and SBF. A basic but thorough curriculum to train local staff in SCI care and rehabilitation was developed, delivered through rotations of expatriate volunteers, assisted by local experts. Patients and families participated in the education sessions, as did community health workers and trainees. Education model combined peer-mentoring with hands-on delivered care, particularly in the first 4 months following the earthquake. Formal workshops with dedicated instruction on key SCI topics and skills complemented the hands on experience. A Haiti SCI Working Group was formed, with collaboration for training needs, advanced education topics, and discharge planning. Conclusions The resulting increased capacity to deliver SCI rehabilitation by local health providers has led to the formalization of the first SCI rehabilitation centres within the country, and improved outcomes including community discharge for patients surviving their injuries. National staff are now training other health workers in SCI care. This highlights the critical importance of education and training, even in disaster situations, in delivery of rehabilitation care. The development of training curricula for use in disaster situations in countries with limited resources would facilitate rapid training in appropriate skills and knowledge. A designated organization to coordinate SCI care post-disaster in countries without such resources is needed. References O’Connell C, Shivji A, Calvot T. Handicap International Report: preliminary findings about persons with injuries. Handicap International, January 29, 2010. http://wwww.reliefweb.int/rw/rwb.nsf/db900SID/ VVOS-82AMLC?OpenDocument. Anthony S. Burns, MD, MSc, Colleen O’Connell, MD, FRCPC, Michel D. Landry, PT, PhD. Spinal Cord Injury in Postearthquake Haiti: Lessons Learned and Future Needs. PM&R, Vol. 2, 695-697, August 2010