12 October 2012

Lessons Learned From Haiti's Earthquake Response

  1. Celebrities do not necessarily run good aid/relief organizations.
  2. Even skilled volunteers are not the best answer.
Yele Haiti

The charity started by musician Wyclef Jean came under some criticism at the time of the earthquake in Haiti. A report by Debroah Sontag in the New York Times gives further evidence to the concerns by showing how little the NGO has done in the two years since the quake.
On the ground in Haiti, little lasting trace of Yéle’s presence can be discerned. The walled country estate leased for its headquarters, on which the charity lavished $600,000, is deserted. Yéle’s street cleaning crews have been disbanded. The Yéle-branded tents and tarps have mostly disintegrated; one camp leader said they had not seen Yéle, which is based in New York, since Mr. Jean was disqualified as a presidential candidate because he lives in Saddle River, N.J., not Haiti. 

This summer, the charity foundered. 
At the end of August, Derek Q. Johnson, Yéle’s chief executive, announced his resignation to supporters. 
“As the foundation’s sole remaining employee, my decision implies the closure of the organization as a whole,” wrote Mr. Johnson, a former Time Warner executive who replaced Mr. Jean at Yéle’s helm when the musician declared his candidacy in August 2010. 
His resignation came after Mr. Jean declined to accept a settlement proposed by the attorney general covering the charity’s pre-earthquake activities, and he hired Avi Schick, a lawyer who had been a member of Attorney General Eric T. Schneiderman’s transition team.
According to Sontag, an audit of Yele found that $256,580 'illegitimate benefits' to staff and board members.She also highlights examples of more questionable expenses, such as "$125,114 on travel and other matters related to a “60 Minutes” report on “Wyclef’s mission to help the people of Haiti and his personal success story” because it appeared to have heightened awareness of Yéle" that were considered to be legitimate expense by the organization.

The organization became flush with cash following the earthquake and managed to spend half of its money on overhead costs, generally a red flag for an NGO. A lack of focus meant that Yele largely only accomplished surface level impacts which contributed to incomplete projects.

Certainly celebrities are not inherently prone to fraud and bad aid. Though Sean Penn has personally taken criticism from this blog and other places, I understand that his J/P Haitian Relief Organization is doing good work and has gained the respect of aid workers in Haiti. Yele is an example of how a large personality can lead people to support without asking questions. Fortunately Sontag's fine reporting helps to uncover a poorly run NGO.

Medical Volunteers Lessons Learned

Andy and Jennifer Day, an anesthesiologist and registered nurse, respectively, from Indiana were moved to volunteer during the response to the earthquake in Haiti. Untrained in disaster experience, the two headed to Haiti with a local surgeon.

Andy was told that he did not have to worry about the medicine, but it turned out that the drugs used for anesthesia were ineffective. “My suspicion is we had these medicines that had been sitting in a 100-plus-degree heat in this uncirculated, unventilated, un-air-conditioned facility,” he told Amy Costello in an interview for Tiny Spark. “And I suspect some of those medicines were either rendered ineffective while in storage down there, or maybe were expired, old stock from other places that had been donated and were long since ineffective.”

Costello speaks with the Days about their experiences and lessons learned while profiling the challenges of medical volunteering during a disaster situation. It turns out that the majority of volunteers are unprepared for what they will face and do not know to bring basic supplies like water and medicines in order to perform their medical work.

Procedures that work in the United States do not necessarily work in response to disaster to the earthquake in Haiti. Unfortunately  that means that measures that could have prevented people from losing limbs were not undertaken. PRI the World highlights an example:
Experts who have studied the medical response in Haiti point to other serious problems that stemmed from disorganization or basic lack of experience among volunteers. 
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Of the thousands of amputations performed in Haiti, many may have been avoidable, experts say. 
And the medical procedures used to save injured limbs may have been inappropriate, too.
In one of those procedures, known as external fixation, surgeons place a metal rod along a patient’s limb (as opposed to encasing it in a cast). Doctors then stabilize the rod by screwing pins into the patient’s bone. 
Fixators work well in Western hospitals. They are also used in war zones, where troops are whisked from the frontlines to recuperate in sterile environments. 
Fixators didn’t work so well in Haiti, according to Harvard’s Stephanie Kayden. 
“External fixators have to stay in the skin, screwed into bone underneath the skin, for three months,” Kayden says. “And during that three months or so, you have to keep it from getting infected. In Haiti, where people are living in tents or in open air, it’s very difficult to keep them from getting infected. And I would say, in Haiti, it created a big problem for a lot of people.” 

Kayden and others say simpler, less invasive techniques to treat broken bones would have been a better option in Haiti.
While skilled volunteers add more value than unskilled, especially in a disaster situation, there are time when they can make matters worse. That is why some are advocating for better response systems and training to ensure that professionals have the right experiences to assist in a disaster situation Listen to the full show from Tiny Spark: