Friday, Update

Jo flew back to Santiago to take care of family issues and should be returning again next week.   Always a crisis to manage here, I received a text message from one of the DART team members from our hospital in the east end of Jacmel that a woman was "bleeding out" after trying to perform a spntaneous abortion and they were requesting blood.  Unfortunately phone services were not working well and I was unable to connect with them.  In the end, they found an O negative donor, which is a universal blood type and were able to do a direct transfusion.  The woman improved within a short period of time.  We had discussed the issue of having blood available to us in the past at our health meetings but we did not have an adequate "cold chain".   There are so many contingencies that it is hard to prepare for them all.  I think now we need a standby list of possible blood donors so that this process can be faciliated in the future.   As we hear of self induced abortions, I'm concerned of what will happen to the birth rate in the next 9 months.  Many women in Haiti use the injectable 3 month birth control but with the collapse of the health system it means there will be many moer unwanted pregnancies.  As disaster relief is turning more to long term planning, these are issues that will need to be dealt with.   In terms of coordination, I met with members of Cayes Jacmel and St Michel hospital to discuss strategy for coordination.  We discussed having someone fill my position and I have received a few emails of interested people which is promising.  Our team has grown to 8 at present and we still need a few more.  One of our concerns is the need for a coordinated effort for future health care in the region.  I see myself as having a long term role to play in this situation.  I did have a potential job offer from the Director of the Dominican Red Cross.  I would love to continue in this role, but it is difficult without full funding and I have my work responsibilities as a full time Emerg doc in Bermuda.   In terms of coordination, internet, satellite and mobile technology are going to have  a large role to play.  I met an organization yesterday called "Make it Right".  They are going to assist us with mappiing coordinates of clinics in the region.  I had actually been working on a mobile phone technology project with my friend Paul Stevers from Bermuda.  Paul, more than ever Haiti needs this.  If we can map clinics, give each doc or nurse a blakberry for communication, have a central server abroad to compile data and have telemedicine we can improve long term care in Haiti.  This is needed, and we are on the brink.  I am hoping that the South East may set an example for the rest of the country.   Tiffany   Tiffany Keenan, MD CCFP Haiti Village Health www.haitivillagehealth.ca www.haitivillagehealth.blogspot.com "Sustainable Health Care in Haiti"   7 Marley Beach Drive Warwick WK08 Bermuda. 441-599-7709 Canada. 506-474-2429 skype.  tiffany.keenan.1971

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