Links:

• Haiti, a year on in photos

In Port-au-Prince, the earthquake caused widespread destruction. Many buildings and homes were reduced to rubble and thousands of people were left homeless, many of whom live in camps in poor sanitary conditions under makeshift shelter made from tarpaulin and plywood.

Merlin is running three mobile teams in the capital to ensure affected communities receive health care. Five days a week, one of our mobile teams provides health care to the 24,000 people living Acra Sud, a large camp set up in an urban area. The remaining two clinics regularly visit other areas of the capital. The clinics always set up at the same site, on the same day each week; so that communities know when and where health care services are available from Merlin.

Two Merlin mobile teams travel for up to three hours a day through difficult terrain to provide health care to those living deep within the hills, a minimum five hour walk from basic health services. Each week we are making regular visits to eight villages and assessing new areas. Merlin is working with village leaders so communities know about our services and when we are coming. The onset of the rainy season rain is making it increasingly difficult to access many rural communities, so Merlin is training community liaison officers in remote villages to provide basic health care and treatment.

Merlin has raised £3.1 million for the first year of our Haiti programme, with the support of private and government donors. We are working with the Haitian government to assess and meet continuing health needs and at present we plan to be in Haiti for at least the next three years.

We aim to help secure Haiti’s recovery by providing essential health worker training and by strengthening existing health services. It is through this approach, we help to create lasting change. We are currently providing vital on-the-job training for local nurses by integrating them into our mobile clinic programmes.

Merlin will continue to address and identify unmet health needs through assessments and by expanding our network of mobile clinics, as well as providing support and supplies to existing health services.

Links:

• Baby Merline; a remarkable birth in Haiti
• On the road to recovery in Haiti

The earthquake that hit Haiti on 12th January had a devastating effect, killing over 200,000 people, destroying thousands of homes and leaving survivors homeless. In the weeks after the earthquake, many spontaneous settlements developed, with up to 800,000 people estimated to be living in makeshift shelters in Port-au-Prince and over 200,000 relocating to rural areas.

Merlin responded immediately, establishing a field hospital on abandoned tennis courts, just days after the ‘quake struck to provide emergency surgery for injured survivors.

Field Hospital In the 11 weeks since it opened, the hospital has performed 392 operations and treated 7,861 outpatients. The hospital closed on 7th April as the number of people needing emergency surgery has dropped sharply. Merlin will continue to provide outpatient services for the foreseeable future and will move these services to Acra camp, which has a population of approximately 25,000. This will allow us to provide specialised outpatients wound care for patients already under our care plus a wider population.

Mobile Clinics In March, we began providing health care through mobile health clinics. Each clinic has two doctors, four nurses and two cars stocked with medical equipment and drugs. In one month Merlin’s mobile clinics treated 2,164 people in 11 locations close to Port-au-Prince, Petit Goave and Grand Goave, for conditions such as malaria, diarrhoea, acute respiratory infections, sexually transmitted infections and gastric pain. April saw the early onset of the rainy season and Merlin is concerned about the spread of infectious diseases. The camps have limited access to health services, safe drinking water or sanitation. Respiratory infections, diarrhoea and malaria are all common.

In one week in April, Merlin’s team in Petit Goave recorded a 400% increase in the number of malaria cases they saw each day. In Grand Fond, a small camp with 224 adults and 337 children, about 45% of the people attending the Merlin mobile clinic were diagnosed with malaria. Merlin plans to distribute mosquito nets as soon as possible. Moving forward Merlin constantly assesses new areas for unmet health needs. Merlin is planning assessments in Carrefour and Martissant around Port-au-Prince. Both are slum areas which were already quite badly served in terms of health and significantly affected by the earthquake. Similarly Merlin is considering extending its mobile clinic support to Leogane, Miragoane, Gonaives, and to other camps in Port-au-Prince where displaced and homeless people still live. In the longer term Merlin’s strategy will be to support Haiti’s wider health care needs. We are assessing the Orthopaedic Hospital in Port-au-Prince with a view to providing post-operative care, physical rehabilitation and prosthetics.

In the coming months we will be seeking to:

- Train healthcare workers on essential basic health care and the treatment and case management of communicable diseases - Provide midwifery training. There is a shortage of midwives in Haiti – prior to the earthquake, only 150 had been trained. - Train nurses by including them in Merlin’s mobile clinic programme for continued on the job training. - Provide nutrition support to the elderly and disabled. There are reports of increasing levels of severe nutrition and a survey will be conducted in May. - Continue to assess remote areas for unmet health needs, expanding our network of mobile clinics and supporting and equipping existing health services where necessary.

Links:

• http://www.merlin.org.uk/Lists/News-Detail.aspx?id=885

• Merlin's mobile clinics (DOC)