The quality of education in the Dominican Republic is poor. I could say it in a longer or more eloquent way, but the truth of the matter is that it is bad. Anyone who can afford it has their kid enrolled in private school. Like many small towns, Pedro Santana does not even have a private school. This country spends less of its GDP on education than any other country in Latin America or the Caribbean. They use every school building for two sessions, which means the kids are only in school for four hours tops. With recesses and food breaks, the average student is only in class for around two and a half hours each day. Many teachers are not specialists in what they teach, resulting in lessons copied directly from the book to the chalk board. The students then copy the lesson to their notebooks and are allowed to leave the classroom.
When I first moved here, I was shocked by the kids always milling about outside the school or the fact that the English and French teachers don’t speak a word of either language. Now I don’t flinch when they ask me if I’m studying when I am reading or when teenagers tell me they have never read a book or written a paper. The world map in my house has become a chance to tell thirteen year olds where their island lies and that Nueva York isn’t a country.
As much as one has to accept a different country with all its characteristics and carefully avoid cultural imperialism, I figure if there is one thing I don’t mind pushing, it’s education. Education could make a difference in the lives of the young people in your community. Talking to the school director in my community, it is clear that he is far more knowledgeable than I am about the changes that could be made. When I asked about the quality of education here, he immediately wanted me to clarify if I was talking about the whole country or just his school. Then he explained that they were trying. Things are improving, but it is really slow and they lack resources. The teachers lack expertise and the parents lack value for education. I asked him if I could work with the school in environmental education and literacy and he beamed with delight.
I asked why he thinks the kids don’t read and he quickly told me it is because they don’t have books. The literacy program we have designed together is simple. We will solicit funds to buy more books, reorganize the dusty library currently filled with old text books and then promote reading through the teachers and the library. We will make it possible for the kids to check out books and schedule reading hours, with charts to reward those who are reading. The teachers in the tiny rural schools will also be able to check out books to use in their classrooms. So here is where I ask for your donations! All of the money collected will be used to buy the books from discount stores in the capital, Santo Domingo. While some community members have been involved in the planning of this project, more will be involved the transportation, organization and shelving units for the library. I truly believe that this project is important and will provide opportunities to the younger generation of Pedro Santana.
Please donate to our book drive by visiting the following website and typing "Carver" into the project search:
https://www.peacecorps.gov/index.cfm?shell=resources.donors.contribute.donatenow
Saturday, February 20, 2010
Monday, February 8, 2010
A Long Term Need: Social Service Aid
People are thinking about the damage of the earthquake. The destroyed city, the orphaned children and the unbelievable number of injured people are all on the radar. The medical care is first. Providing food and water and caring for children without family by their side are other immediate priorities. Many are still desperately trying to locate family members and reunite with loved ones. These physical aspects of the tragedy are the most important and urgent areas to focus on in disaster relief. Another topic that I believe also needs long term attention is the area of social services. Three million people have been through an event that most of us could never imagine. We stress social services in the U.S. A huge proportion of our population receives therapy for social and familial problems as well as grief and depression. We send our children to school and activities without fail and think tirelessly about our mental and emotional needs. The Haitian population deserves to be given the same respect that we give ourselves. Raising awareness and funding for all of the longer term relief efforts will be a difficult but important challenge.
Thinking about the Victims
When we speak of the victims of this earthquake, we should refer to everyone who has been affected by the destruction. They could have been physically hurt, lost loved ones, or been left homeless. One truth not acknowledged by much of the media is that not all victims of this disaster were poor. The epicenter of this earthquake hit the capital of Haiti, where almost all of the wealth and industries lie. Port-au-Prince, like most cities, is home to a wide distribution of socioeconomic levels, from people living in mansions to those living in extreme poverty. There has been mention of the survival mentality and tolerance for difficult conditions among the Haitian population as if this should comfort us as we witness the terrible situation they are enduring. Maybe we are trying to make ourselves feel better by saying that they are used to being miserable. This is neither true nor fair. They have no more reason to live in poverty than any of us do. We should think about the Haitian victims as people and try to identify with what it must feel like. They feel like you would feel if the ground shook so hard that buildings collapsed as you watched people die. On top of losing everything you had, you lost limbs and family or became paralyzed. I doubt any of us would be the same person and function in the same way.
Trauma
I was asked to translate during an incident that ended up broadening my perspective of this tragedy. There was an assumed theft that turned out to be a false accusation. An American volunteer in the relief hospital had stumbled upon a room where patients’ family members were staying. The room contained luggage, electronic items and clothes that appeared to be from America, causing the volunteer to think they were stolen. In reality, most of the items were from Haiti and the others were gifted from medical professionals. Some people were very offended and others very embarrassed. As everyone looked at each other, processing the situation, a 25 year-old man, standing tall, collapsed in utter pain and sadness. He told us he lost everything and now he was being accused and disrespected. A woman started screaming and crying and others began to break down. One said he had lost his whole family and he was sick of being strong. As I hugged a strong adult man overcome by grief, it was the first time I really thought about it, how tragic their life is and how few people were crying.
As an aftershock shook, patients and families evacuated the buildings. Two patients jumped off of a second story, resulting in repeat surgeries. Some are acting irrationally or not talking. We can diagnose them with post traumatic stress disorder or simply call them amazing survivors. Regardless of how we talk about it, we have to acknowledge the fact that the shock is immense. They have experienced ultimate insecurity and some of the aid as we proceed through this crisis should focus on the mental well being of the victims. Maybe refugee camps can begin to integrate programs to address the grief and trauma aspects of the disaster. This could be in the form of one-on-one counseling, support groups or a focus on new beginnings like small businesses, crafts to be sold, community gardens or recreation.
Physical Therapy
To imagine being paralyzed or losing a limb is impossible. Because of the nature of this disaster, the amount of paralysis and amputations is enormous. On January 12, 2010, able bodied people lost the feeling and control of their body. Quadriplegics are sentenced to a life of immobility, arguably one of the most difficult conditions known to human beings. Some relief hospitals are performing as many amputations as patients meaning many people have had multiple limbs removed. Others have fractures in one or more locations. Many children sit with spider casts, a treatment for two broken legs. All we can do is try to understand the enormity of this life change and regard these patients accordingly. Prosthetics and physical therapy are needed as long term care. Treatment facilities will become an important aspect of the relief effort and should be thought of in the future when so many forget about the disaster and disregard the constant need for resources.
Child Services
As in most natural disasters, there has been some stress on affected children. In news stories, you can find pictures of hurt children and those who are lost and orphaned. We should expand the focus to the entire youth population and think about longer term programs. While kids may be more resilient to trauma and grief, we cannot expect them to be immune to the emotional pain. They have endured a catastrophe so immense and their lives will never be the same. Schools were just starting the second term of the year when the earthquake drastically transformed everything they knew. Ever since then, life has been full of loss and displacement. Haiti has been utter chaos as aid programs try to organize and provide the bare necessities for as many people as possible. Now, as we look into the future, we should begin to think about integrating activities and programs for children in this relief effort. There should be an attempt to add normalcy to the lives of these millions of youth.
In refugee camps, like most other professionals, there are probably many certified Haitian teachers. Simple schools could be started as well as extracurricular activities like sports and art. Clubs and groups could reduce stress, occupy children’s time and provide therapy in a very natural way. Other disaster relief efforts have shown that the well being of youth after a traumatic experience can be significantly improved simply with playing. The future of the Haitian population could be positively impacted by kid games and programs in refugee camps and other earthquake affected communities.
I had had no experience with disaster relief before this earthquake and have still only seen a minute portion of the Haitian relief effort. I am looking at a complex system through a small window. The extent of the damage is overwhelming and the solutions are far from straightforward. However, as Haiti is given food, water and medical attention, I believe we must think about the future from more lenses than one. As Haiti builds a new physical infrastructure, we should also focus on constructing a social service system. As always, donations have slowed as other news stories hit the front pages. While resources are always difficult, the welfare of the devastated population should not be forgotten.
Thinking about the Victims
When we speak of the victims of this earthquake, we should refer to everyone who has been affected by the destruction. They could have been physically hurt, lost loved ones, or been left homeless. One truth not acknowledged by much of the media is that not all victims of this disaster were poor. The epicenter of this earthquake hit the capital of Haiti, where almost all of the wealth and industries lie. Port-au-Prince, like most cities, is home to a wide distribution of socioeconomic levels, from people living in mansions to those living in extreme poverty. There has been mention of the survival mentality and tolerance for difficult conditions among the Haitian population as if this should comfort us as we witness the terrible situation they are enduring. Maybe we are trying to make ourselves feel better by saying that they are used to being miserable. This is neither true nor fair. They have no more reason to live in poverty than any of us do. We should think about the Haitian victims as people and try to identify with what it must feel like. They feel like you would feel if the ground shook so hard that buildings collapsed as you watched people die. On top of losing everything you had, you lost limbs and family or became paralyzed. I doubt any of us would be the same person and function in the same way.
Trauma
I was asked to translate during an incident that ended up broadening my perspective of this tragedy. There was an assumed theft that turned out to be a false accusation. An American volunteer in the relief hospital had stumbled upon a room where patients’ family members were staying. The room contained luggage, electronic items and clothes that appeared to be from America, causing the volunteer to think they were stolen. In reality, most of the items were from Haiti and the others were gifted from medical professionals. Some people were very offended and others very embarrassed. As everyone looked at each other, processing the situation, a 25 year-old man, standing tall, collapsed in utter pain and sadness. He told us he lost everything and now he was being accused and disrespected. A woman started screaming and crying and others began to break down. One said he had lost his whole family and he was sick of being strong. As I hugged a strong adult man overcome by grief, it was the first time I really thought about it, how tragic their life is and how few people were crying.
As an aftershock shook, patients and families evacuated the buildings. Two patients jumped off of a second story, resulting in repeat surgeries. Some are acting irrationally or not talking. We can diagnose them with post traumatic stress disorder or simply call them amazing survivors. Regardless of how we talk about it, we have to acknowledge the fact that the shock is immense. They have experienced ultimate insecurity and some of the aid as we proceed through this crisis should focus on the mental well being of the victims. Maybe refugee camps can begin to integrate programs to address the grief and trauma aspects of the disaster. This could be in the form of one-on-one counseling, support groups or a focus on new beginnings like small businesses, crafts to be sold, community gardens or recreation.
Physical Therapy
To imagine being paralyzed or losing a limb is impossible. Because of the nature of this disaster, the amount of paralysis and amputations is enormous. On January 12, 2010, able bodied people lost the feeling and control of their body. Quadriplegics are sentenced to a life of immobility, arguably one of the most difficult conditions known to human beings. Some relief hospitals are performing as many amputations as patients meaning many people have had multiple limbs removed. Others have fractures in one or more locations. Many children sit with spider casts, a treatment for two broken legs. All we can do is try to understand the enormity of this life change and regard these patients accordingly. Prosthetics and physical therapy are needed as long term care. Treatment facilities will become an important aspect of the relief effort and should be thought of in the future when so many forget about the disaster and disregard the constant need for resources.
Child Services
As in most natural disasters, there has been some stress on affected children. In news stories, you can find pictures of hurt children and those who are lost and orphaned. We should expand the focus to the entire youth population and think about longer term programs. While kids may be more resilient to trauma and grief, we cannot expect them to be immune to the emotional pain. They have endured a catastrophe so immense and their lives will never be the same. Schools were just starting the second term of the year when the earthquake drastically transformed everything they knew. Ever since then, life has been full of loss and displacement. Haiti has been utter chaos as aid programs try to organize and provide the bare necessities for as many people as possible. Now, as we look into the future, we should begin to think about integrating activities and programs for children in this relief effort. There should be an attempt to add normalcy to the lives of these millions of youth.
In refugee camps, like most other professionals, there are probably many certified Haitian teachers. Simple schools could be started as well as extracurricular activities like sports and art. Clubs and groups could reduce stress, occupy children’s time and provide therapy in a very natural way. Other disaster relief efforts have shown that the well being of youth after a traumatic experience can be significantly improved simply with playing. The future of the Haitian population could be positively impacted by kid games and programs in refugee camps and other earthquake affected communities.
I had had no experience with disaster relief before this earthquake and have still only seen a minute portion of the Haitian relief effort. I am looking at a complex system through a small window. The extent of the damage is overwhelming and the solutions are far from straightforward. However, as Haiti is given food, water and medical attention, I believe we must think about the future from more lenses than one. As Haiti builds a new physical infrastructure, we should also focus on constructing a social service system. As always, donations have slowed as other news stories hit the front pages. While resources are always difficult, the welfare of the devastated population should not be forgotten.
Thursday, February 4, 2010
Relief Work in Jimani
I will not pretend that I understood everything or even most of what was going on in my time at Good Samaritan Hospital, a relief hospital on the Dominican side of the border in Jimani. I arrived nearly two weeks after the earthquake on January 25, hoping to be of use but imagining that most of the hard work was over. I expected to do some Spanish to English translation and offer support where needed. As it turned out, the other Peace Corps volunteers and I were presented with so much work and problem solving, I had a hard time leaving on February 2. I was feeling unfinished, like I could have done so much more. We were faced with the administrative challenges of organizing volunteers and patient records as well as a responsibility to advocate for patients and families.
Good Samaritan Hospital is an incredible operation offering high quality medical treatment crucial to the lives of these victims, yet inevitably faces huge organizational challenges on every level. Every worker is dedicating time, energy and resources for the victims of the disaster and while thinking about improvements, this should still be acknowledged and appreciated. Beginning as an emergent crisis scene, it is bound to be chaotic. The health of the patient should always be the first priority and in the beginning, everything else could and had to wait. In time, however, it became more important to keep records, collect data, and focus on the logistical aspects of the program. Without this, the sustainability of the program is very vulnerable. With a frequent turnover of management and no one person clearly responsible for organization of Good Samaritan Hospital, the road from chaos to order is rough.
Progress
In the nine days I was there, the evolution of the hospital was impressive. We went from records written only on paper to electronic logs of patients, volunteers, evacuations and medical procedures. It went from patients barely receiving consistent food to steady meals for every patient and family member. There was great confusion about patient names with language barriers and misunderstandings in naming norms. This presented the task of finding all of the medical information for each person written with various names to assure correct patient records. Now, every patient has an ID number and bracelet functioning to safely track their condition and location. The hospital implemented a track of patients within the wards as well as those transported to more appropriate care facilities to be given to their families.
Medical volunteers are now obligated to register with their license and passport. In the beginning, there was little time or attention given to volunteer credibility. In the nine days, the security of the center went from almost non-existent, with threatening raids and other safety difficulties to a fairly well controlled system. The coordination of all volunteers became a priority and responsibilities are now more appropriately delegated. There has been a huge effort of organizing Haitian and Dominican volunteers and treating them fairly.
Volunteer Commitment
The volunteer commitment is an incredible demonstration of dedication and generosity. There is a group of expertly trained medical professionals from Spain who are committing three months of consistent support running three wards of the hospital day and night. Medical volunteers are showing up after days of travel, ready to work any necessary position and shift. They work with limited equipment and supplies in an environment very different from their home hospital. They serve patients outdoors on ground mattresses and still do everything they can to provide care and contamination management. Non-medical volunteers are willing to exert themselves carrying patients and supplies for long hours in the hot sun and take on tasks such as security and transportation with little prior experience. With limited volunteer accommodations, many stay in tents or on floor mats, adjusting to the conditions as necessary.
Volunteers are not just visitors from developed countries. Haitian families are doing an incredible amount of volunteer work without which, the hospital would not function. Families feed their patient, help them readjust positions, go to the bathroom and advocate for their care. When patients need to be moved short distances, it is usually family members carefully transporting their loved ones. Haitian as well as Dominican nationals distribute food and supplies, assemble and transport donated items such as beds and tents and carry out many of the maintenance tasks. The translators, Creole to English or Creole to Spanish, are some of the most important people in this effort. With a medical volunteer population almost entirely speaking only English or Spanish, they play a crucial role in the communication between patients and families and medical professionals.
Difficulties of the Operation
While interpreters played a vital role in the hospital, the disorganization of this group of volunteers became a difficult and sensitive problem. The whole operation began as a frantic effort, the patients needing to be treated immediately. Time for organization was limited if not nonexistent. At this time, anyone with an understanding of English and Creole was of emergent use. This became a group of an undefined number, with varying language proficiency and no management. With a lack of security and coordination, the delineation between official volunteer and family helper was difficult to establish. The equality of treatment and accommodations provided for volunteer doctors versus an English speaking family member was impossible. The food provided for the volunteers was, at times, refused to translators or unintentionally given to non-volunteers. The appointment of these volunteers was unclear and resulted in inconsistent availability of translators in the hospital. All of the confusion resulted in many volunteer interpreters who felt unappreciated and discriminated against. This challenge eventually led to a translator strike that was resolved with more structure, official uniforms and appropriate benefits for these positions.
With such a high rate of volunteer turnover and very few people committing more than one week to the effort, the consistency of every aspect of the operation is vulnerable. In the beginning, patients and families went periods of time without receiving dependable food because of a lack of management and order. The consistency of meals faltered because while volunteers would commit to food supply, common donations lasted short periods of time, leaving an important responsibility without a guaranteed substitute volunteer. For example, there was a mission group taking the responsibility of providing meals to patients and families who filled this important position for several days and then left without finding a replacement group.
With an uncoordinated volunteer population and little management, there was also a misallocation of labor and attention. We ran out of bottled water while a storage room sat full. Ambulances would run out of gas and there would be no working vehicle to fill up the tanks. This left volunteers to transport patients while a functioning ambulance sat empty. The systems of supply, food, transportation, and communication between the wards are completely dependent on volunteer work. While everyone does their best to maintain and improve the organization of these processes, the departure of volunteers with these roles is not always smooth.
The medical volunteers also faced challenges with their volunteer turnover. Many arrived in groups and stayed less than one week. While the medical care at Good Samaritan is very high quality, a completely new group of nurses and doctors have to take over wards on a regular basis. These staff members may not have the knowledge of the patients essential to providing the best possible care. Even the appointed medical directors were cycled through the center quickly, impeding their efforts for organization of the whole operation.
Similar to the inconsistency of volunteers, there was an inconsistency of supplies. While there were items needed, many organizations and volunteers came with supplies to equip the operation. The priority of resources of all types was not organized by any one person. The effort could benefit from someone identifying the most crucial needs whether it is transportation, shelters, food, water or medical. Many people want to help, yet do not know what is most needed or most urgent. Without someone on the ground with this information and perspective, the supply and volunteer solicitation and input is inefficient and chaotic.
Potential Improvements
It appears that one huge improvement to the Haitian relief effort could be a centralized management group dedicated to the large scale logistics. If there was someone with a handle on the needs of the operations, as well as the contributions ready to be given, they could solicit to meet the needs as well as redirect money, supplies and expertise. Specifying and redirecting materials is extremely important to the greater relief effort as resource allocation is still very chaotic. A lot of this comes down to communication on every level- locally in each operation, between the operating relief centers, and with all of the supporting organizations donating resources. An institution acting as a control center, gathering information from all the specific programs could drastically improve the efficiency of the relief efforts.
For example, US military helicopters transported patients from Good Samaritan hospital in Jimani, Dominican Republic to Sacred Heart Hospital in Milot, Haiti. Most family members were not transported with the patient and therefore left on foot to reunite with their loved ones in Milot. The distance and route of the trip is incredibly difficult and there was little knowledge in Jimani of the resources in Milot. While the medical care at Sacred Heart is strong, they do not provide any accommodations for family members such as food or tent shelter. As organizations such as USAID were unclear on resource needs in Good Samaritan, asking for solicitations, more transparency and communication could have redirected resources for patients and families to Milot.
Another illustration of needs for communication about allocation of resources was a visit from a Dominican foundation to Good Samaritan. They had come to advocate for the patients at the public hospital in Azua, another Dominican location taking in earthquake victims. They reported that the hospital in Azua did not have enough medical supplies, doctors, or space to care for their patients. There were patients who needed operations such as amputations and had been waiting for two weeks being treated for pain only. If there was more transparency and knowledge of situations like these among regional medical coordinators, those patients could have been treated in other facilities. Because space and transportation proves to be difficult, doctors and supplies could also be reallocated. As far as I know, this specific situation has not been resolved.
People travel long distances visiting hospitals to find out if their family member is in there in that hospital. Each hospital can check their database and, if the patient is not in the records, inform them of other possible locations or give advice about using the websites set up to look for loved ones. The truth, however, is that we, like many programs, are not contributing our database to these websites resulting in what is a very limited function. Like so many other aspects, each program does not have a great understanding or knowledge of other programs available to people leaving our facility.
There are many hospitals and clinics, refugee camps and food distribution centers that could be contacted. The information about services, accommodations, capacity and current availability could become organized and available. These programs could also contact the centralized location with resources that are needed as well as specialized volunteers. If this system was functioning, maybe groups or institutions wanting to donate aid or serve could be directed toward the most appropriate center. In reality, I know so little about relief efforts as well as the expanse of programs involved in Haiti that maybe this system already exists. It became clear at Good Samaritan that if it does exist, it is not being utilized to its full potential.
Good Samaritan Hospital is an incredible operation offering high quality medical treatment crucial to the lives of these victims, yet inevitably faces huge organizational challenges on every level. Every worker is dedicating time, energy and resources for the victims of the disaster and while thinking about improvements, this should still be acknowledged and appreciated. Beginning as an emergent crisis scene, it is bound to be chaotic. The health of the patient should always be the first priority and in the beginning, everything else could and had to wait. In time, however, it became more important to keep records, collect data, and focus on the logistical aspects of the program. Without this, the sustainability of the program is very vulnerable. With a frequent turnover of management and no one person clearly responsible for organization of Good Samaritan Hospital, the road from chaos to order is rough.
Progress
In the nine days I was there, the evolution of the hospital was impressive. We went from records written only on paper to electronic logs of patients, volunteers, evacuations and medical procedures. It went from patients barely receiving consistent food to steady meals for every patient and family member. There was great confusion about patient names with language barriers and misunderstandings in naming norms. This presented the task of finding all of the medical information for each person written with various names to assure correct patient records. Now, every patient has an ID number and bracelet functioning to safely track their condition and location. The hospital implemented a track of patients within the wards as well as those transported to more appropriate care facilities to be given to their families.
Medical volunteers are now obligated to register with their license and passport. In the beginning, there was little time or attention given to volunteer credibility. In the nine days, the security of the center went from almost non-existent, with threatening raids and other safety difficulties to a fairly well controlled system. The coordination of all volunteers became a priority and responsibilities are now more appropriately delegated. There has been a huge effort of organizing Haitian and Dominican volunteers and treating them fairly.
Volunteer Commitment
The volunteer commitment is an incredible demonstration of dedication and generosity. There is a group of expertly trained medical professionals from Spain who are committing three months of consistent support running three wards of the hospital day and night. Medical volunteers are showing up after days of travel, ready to work any necessary position and shift. They work with limited equipment and supplies in an environment very different from their home hospital. They serve patients outdoors on ground mattresses and still do everything they can to provide care and contamination management. Non-medical volunteers are willing to exert themselves carrying patients and supplies for long hours in the hot sun and take on tasks such as security and transportation with little prior experience. With limited volunteer accommodations, many stay in tents or on floor mats, adjusting to the conditions as necessary.
Volunteers are not just visitors from developed countries. Haitian families are doing an incredible amount of volunteer work without which, the hospital would not function. Families feed their patient, help them readjust positions, go to the bathroom and advocate for their care. When patients need to be moved short distances, it is usually family members carefully transporting their loved ones. Haitian as well as Dominican nationals distribute food and supplies, assemble and transport donated items such as beds and tents and carry out many of the maintenance tasks. The translators, Creole to English or Creole to Spanish, are some of the most important people in this effort. With a medical volunteer population almost entirely speaking only English or Spanish, they play a crucial role in the communication between patients and families and medical professionals.
Difficulties of the Operation
While interpreters played a vital role in the hospital, the disorganization of this group of volunteers became a difficult and sensitive problem. The whole operation began as a frantic effort, the patients needing to be treated immediately. Time for organization was limited if not nonexistent. At this time, anyone with an understanding of English and Creole was of emergent use. This became a group of an undefined number, with varying language proficiency and no management. With a lack of security and coordination, the delineation between official volunteer and family helper was difficult to establish. The equality of treatment and accommodations provided for volunteer doctors versus an English speaking family member was impossible. The food provided for the volunteers was, at times, refused to translators or unintentionally given to non-volunteers. The appointment of these volunteers was unclear and resulted in inconsistent availability of translators in the hospital. All of the confusion resulted in many volunteer interpreters who felt unappreciated and discriminated against. This challenge eventually led to a translator strike that was resolved with more structure, official uniforms and appropriate benefits for these positions.
With such a high rate of volunteer turnover and very few people committing more than one week to the effort, the consistency of every aspect of the operation is vulnerable. In the beginning, patients and families went periods of time without receiving dependable food because of a lack of management and order. The consistency of meals faltered because while volunteers would commit to food supply, common donations lasted short periods of time, leaving an important responsibility without a guaranteed substitute volunteer. For example, there was a mission group taking the responsibility of providing meals to patients and families who filled this important position for several days and then left without finding a replacement group.
With an uncoordinated volunteer population and little management, there was also a misallocation of labor and attention. We ran out of bottled water while a storage room sat full. Ambulances would run out of gas and there would be no working vehicle to fill up the tanks. This left volunteers to transport patients while a functioning ambulance sat empty. The systems of supply, food, transportation, and communication between the wards are completely dependent on volunteer work. While everyone does their best to maintain and improve the organization of these processes, the departure of volunteers with these roles is not always smooth.
The medical volunteers also faced challenges with their volunteer turnover. Many arrived in groups and stayed less than one week. While the medical care at Good Samaritan is very high quality, a completely new group of nurses and doctors have to take over wards on a regular basis. These staff members may not have the knowledge of the patients essential to providing the best possible care. Even the appointed medical directors were cycled through the center quickly, impeding their efforts for organization of the whole operation.
Similar to the inconsistency of volunteers, there was an inconsistency of supplies. While there were items needed, many organizations and volunteers came with supplies to equip the operation. The priority of resources of all types was not organized by any one person. The effort could benefit from someone identifying the most crucial needs whether it is transportation, shelters, food, water or medical. Many people want to help, yet do not know what is most needed or most urgent. Without someone on the ground with this information and perspective, the supply and volunteer solicitation and input is inefficient and chaotic.
Potential Improvements
It appears that one huge improvement to the Haitian relief effort could be a centralized management group dedicated to the large scale logistics. If there was someone with a handle on the needs of the operations, as well as the contributions ready to be given, they could solicit to meet the needs as well as redirect money, supplies and expertise. Specifying and redirecting materials is extremely important to the greater relief effort as resource allocation is still very chaotic. A lot of this comes down to communication on every level- locally in each operation, between the operating relief centers, and with all of the supporting organizations donating resources. An institution acting as a control center, gathering information from all the specific programs could drastically improve the efficiency of the relief efforts.
For example, US military helicopters transported patients from Good Samaritan hospital in Jimani, Dominican Republic to Sacred Heart Hospital in Milot, Haiti. Most family members were not transported with the patient and therefore left on foot to reunite with their loved ones in Milot. The distance and route of the trip is incredibly difficult and there was little knowledge in Jimani of the resources in Milot. While the medical care at Sacred Heart is strong, they do not provide any accommodations for family members such as food or tent shelter. As organizations such as USAID were unclear on resource needs in Good Samaritan, asking for solicitations, more transparency and communication could have redirected resources for patients and families to Milot.
Another illustration of needs for communication about allocation of resources was a visit from a Dominican foundation to Good Samaritan. They had come to advocate for the patients at the public hospital in Azua, another Dominican location taking in earthquake victims. They reported that the hospital in Azua did not have enough medical supplies, doctors, or space to care for their patients. There were patients who needed operations such as amputations and had been waiting for two weeks being treated for pain only. If there was more transparency and knowledge of situations like these among regional medical coordinators, those patients could have been treated in other facilities. Because space and transportation proves to be difficult, doctors and supplies could also be reallocated. As far as I know, this specific situation has not been resolved.
People travel long distances visiting hospitals to find out if their family member is in there in that hospital. Each hospital can check their database and, if the patient is not in the records, inform them of other possible locations or give advice about using the websites set up to look for loved ones. The truth, however, is that we, like many programs, are not contributing our database to these websites resulting in what is a very limited function. Like so many other aspects, each program does not have a great understanding or knowledge of other programs available to people leaving our facility.
There are many hospitals and clinics, refugee camps and food distribution centers that could be contacted. The information about services, accommodations, capacity and current availability could become organized and available. These programs could also contact the centralized location with resources that are needed as well as specialized volunteers. If this system was functioning, maybe groups or institutions wanting to donate aid or serve could be directed toward the most appropriate center. In reality, I know so little about relief efforts as well as the expanse of programs involved in Haiti that maybe this system already exists. It became clear at Good Samaritan that if it does exist, it is not being utilized to its full potential.
Wednesday, February 3, 2010
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