Lost Limbs and New-Found Hope

Working closely with the Haitian Ministry of Health, Project Medishare is planning to move out of its tent-based village at the Port-au-Prince airport to a permanent, fixed facility. In addition, Project Medishare, focusing now on long-term prosthetic care, is planning to build a Prosthetic and Orthotics Center. Their goal is to fit 1,800 amputees with new limbs. It is estimated now that anywhere between 4,000 and 6,000 Haitians were left without a limb as a result of the January earthquake, numbers which are roughly comparable to the number of amputee U.S. veterans returning from Vietnam. For ever $300 donation, Project Medishare is able to ensure another amputee will walk again. Typically, 6 months of physical therapy is require before getting fitted. Adults require a replacement every 3-5 years, while children need one every 6-12 months.

In addition to issues such as cost, distribution, and durability, cultural sensitivity is a chief concern. Dr. Fitzgerald and Dr. Vanek recall looks of apprehension and dread in the eyes of patients and family members when faced with the reality of a potential amputation. "Either we let these people who lost their limbs face a life of begging or worse, or we say this is our chance to make this a vibrant disabilities rights movement in Haiti," remarked Dr. Paul Farmer, co-founder of Partners in Health. Three Haitian-Americans have founded an advocacy group for Haitian amputees called S.A.V.E. 509 (Support and Action for the Victims of the Earthquake). Their mission is to "empower those suffering from limb loss in Haiti by providing assistance, relief, emotional, physical and psychological healing. The organization agency for the disabled while enabling amputees in Haiti to have access to prosthetics, crutches, wheelchairs and rehabilitation services so that one day they can regain their mobility thereby becoming independent, walk again and return to their daily routine." MSNBC has a project called Building a Life Worth Living, which will follow the work of groups delivering prosthetic limbs and "explore the experiences of those who've lost limbs and the struggle they say is not just to survive, but to build a life worth living."

Advantages of Monetary Donations

(re-posted from the website of USAID, the principal U.S. agency to extend assistance to countries recovering from disaster)

Monetary donations are the most effective form of assistance because they allow humanitarian organizations to purchase (often within the affected region itself) the exact type and quantity of items needed by those affected by the crisis. Monetary donations therefore have several logistical advantages over commodity contributions:

• Monetary donations are more cost-effective than commodity contributions, because the cost of international shipping usually exceeds the cost of procuring the commodities within the region.
• Monetary donations, unlike commodity contributions, do not involve international transportation and handling, which can be very complex and time consuming.
• Humanitarian organizations can use monetary donations to specifically procure items on a priority-needs basis in the exact quantity and quality require - while commodity contributions often involve use of scare resources (transportation, staff time, warehouse space, etc.) for non-crucial or inappropriate commodities.
• Commodities procured by humanitarian organizations using monetary donations can be sorted, labeled (in the appropriate language), and packaged in exactly the manner required for storage and distribution and will reach the affected region much quicker than commodity contributions would.

In addition to these logistical advantages, monetary donations to humanitarian organizations also help to ensure that relief efforts contribute to the long-term sustainability and self-reliance of the affected region. This is because commodities that have been procured by humanitarian organizations using monetary donations:

• are more likely to be culturally and environmentally appropriate, and consistent with traditional practices and consumption patterns
• support the economy of the affected region when procured locally, thereby contributing to the eventual goal of self-reliance and economic growth

Thinking Outside the Tent

C. Setchell, a USAID/OFDA Shelter, Settlements, and Hazard Mitigation Advisor, wrote an article in November 2008 on why tents are not suitable shelters in a post-disaster environment.

He writes, "tents are useful when there are absolutely no other shelter options, but this is hardly ever the case, as disasters and conflicts rarely generate complete and total destruction of permanent structures." In the most recent USAID fact sheet on the Haiti earthquake, 32,000 structures have been inspected in habitability assessments. 44 percent deemed safe for habitation, 32 percent could be made safe with repairs, and 24 percent are unsafe and require demolition. Relief agencies have reached approximately 100 percent of the target population requiring emergency shelter assistance. Typically, this is in the form of two pieces of plastic sheeting per household, which is a more flexible solution than tents and more adaptable to a family's specific needs. Setchell also notes that the "total cost of tent provision is often greater than [...] salvage-based options," and that because of the small size of tents, it is "understandable, then, why people get sick, why protection issues emerge, or why psycho-social issues emerge when they have to live in undersized tents for more than a short period of time."

With more than 2.1 million people displaced and 1,300 spontaneous settlements throughout Haiti, the goal now is to repair damaged structures and move displaced people back into more permanent structures. This is especially vital as the rainy season commences in May and hurricane season arrives in June.

St. Constantine and Helen Greek Orthodox Church

On February 14, Dr. Fitzgerald spoke at a luncheon program at the St. Constantine and Helen Greek Orthodox Church in Cleveland Heights. The local chapter of the Greek Orthodox Ladies Philoptochos Society, a philanthropic organization at the heart of the Greek Orthodox Archdiocese of America, raised $500 for Project Medishare. Special thanks to Ted and Irene Theodore for their support.