Haiti

the  Major disasters in the last 10 years, 2000 – 2010:

2001 – Gujarat Earthquake, India                                20,000 Deaths

2003 – Bam Earthquake, Iran                                      30,000 Deaths

2004 – Indian Ocean Earthquake and Tsunami    230,000 Deaths

2005 – Kashmir Earthquake, Pakistan                       85,000 Deaths

2005 – Hurricane Katrina, USA                                       1,300 Deaths

2008 – Sichuan China Earthquake, Chine                 70,000 Deaths

2008 – Cyclone Nargis, Burma (Myanmar)              150,000 Deaths

2010 – Haitian Earthquake, Haiti                               170,000+ Deaths

These natural disasters have cost hundreds of thousands of lives, displaced and made homeless millions of people, mostly the poorest of the poor, cost billions upon billions of dollars, and their global impact has lasted for years.

There is no reason for us to expect that these moanings and groanings of our living planet will ever stop. Therefore, it is essential that we are prepared for the worst. First, we have to be prepared in our own home, then in our community, our state, our country, and finally the world.

The point of this brief article is to provide you with a list of the principles of being prepared to go, to help, and to unselfishly SERVE others in their time of need.

The Principles that will help you to prepare to go and to SERVE:
SAFETY
SHELTER
SUSTENANCE
SANITATION
STAYING WELL
STRESS

SAFETY

Safety is first and foremost is having a well-thought-out plan and sticking to it.
There is safety in numbers; always travel in a group, and try to work together as a group. Keep the team together.
When moving around, remember that traveling during the day is much safer than traveling at night.
Know where you are going, how you are going to get there, and who is going to meet you.
Find out well in advance if there are any local concerns for safety or if there are dangerous areas that you should avoid.
Ask questions. Don’t guess. Most people are more than glad to answer questions and be helpful.
Have an evacuation plan. You need to know what to do if someone in your group does become sick or injured. The plan should include how to evacuate them to home.
It is a very good idea to have some form of evacuation insurance from a group such as Global Rescue, the American Alpine Club, or Divers Alert Network to name a few.
If you do have evacuation insurance, make sure that you carry the details of the policy on your person with appropriate contact information and phone numbers. You do not want to leave it at home or back at base camp. It needs to be with you at the time of the crisis, so the plan can be easily and accurately activated.

SHELTER

When you go into areas of destruction, you cannot count on there being any housing.
You have to carry your own shelter, i.e. a tent, and in the tropical climates you have to be able to sleep under mosquito netting at night to avoid bug bites.
Warmth. Check the weather conditions and carry appropriate sleeping bag or bed roll for the anticipated climate conditions. Remember, in the tropics 60F is considered cold.
Know how to and be prepared to bivouac, to be able to make an emergency shelter from a sheet of plastic or tarp.

SUSTENANCE

Food and water:
Like shelter, you cannot assume that there will be potable water or adequate foods supplies. You do not want to use up the resources of the people whom you’ve come to help.
Food:
You have to carry enough food for your team. Preferably, food that does not take a lot of cooking time or preparation time.
Carry food that can be eaten without cooking, such as protein bars or food that cooks quickly in boiling water, such as macaroni and cheese, instant potato, rice, or premade meals.

Water:
You have to be prepared to purify all you water.
Techniques of water purification: BOIL, CHEMICAL, FILTER, UVC LIGHT
All these techniques are very effective.
Boil: Bring to a rolling boil to sterilize. You have to have a source of heat.
Chemical: Chlorine or iodine.
Use chlorine for large supplies of water for a group.
Use iodine for individual water supply, one water bottle at a time. Although iodine is inexpensive, and safe to use, it does give the water an unpleasant taste.
Filtration: You can use for a group, but usually used by individuals.
Use a filter that also contains iodine to kill the viruses that are too small too filter.
UVC or ultraviolet C light.
Steripen is used by individuals for their own water bottles.

SANITATION
Sanitation is more than just good hand washing. It involves:
Wear gloves when examining and treating patients. It is essential that you bring lots of gloves.
Having a plan to properly dispose of human waist, urine and feces.
Choices: digging a pit and making an outhouse for the group to use or you can use commercially available potties or toilet bags with proper disposal. You want to avoid fecal contamination of the local water supply.
Staying clean. Keep the perineal area clean to avoid rashes and a painful butt. Applying a thin layer of Vasoline to the area around the rectum will help to stay clean and avoid chafing.
Bring lots of toilet paper and personal wipes.
Women need to bring sanitary napkins or pads.
You have to know how to bathe in a bucket of water, and do so daily.
Rinse out clothing every day with soap and water, i.e. the skill of hand washing.
Check your skin several days for ticks, bug bites, and rashes.

STAYING WELL

Immunizations/vaccinations:
Go to the CDC.gov website, travel advice, for information on travel vaccines and common diseases in the area you are going to.
Usual childhood vaccinations plus; Hepatitis A and B, IPV poliovaccine, Typhoid, make sure tetanus and diptheria are up-to-date, consider yellow fever and meningiococcal.
Antimalarials:
If you are going into an area where there is malaria, take an antimalarial daily such as doxycycline or Malarone. Remember that malaria is treatable, but not necessarily curable; therefore, malaria porphylaxis is common sense.
Know the modes of transmission of disease and practice good body substance isolation.
Insect repellants and insecticides. Do every thing that you can to avoid being bitten by insects – mosquitoes, black flies, ticks, sand flies, etc. Use insect repellants, wear appropriate clothing, and sleep under mosquito netting.

STRESS

Post Traumatic Stress Disorder:
One of the most difficult tasks is trying to determine who is emotionally prepared to face all the destruction and human suffering that you may be confronted with.
During the deployment, try to get your group together several times daily to share in their ongoing experiences, expectations, concerns, and to pray together if appropriate.
Have a follow-up plan for after everyone has returned home. PTSD can be prevented and is treated by talking about the tough work, the difficult things that you saw and did, and the sense of disappointment or even failure that can haunt you once you are back home, safe and secure.

We have to consider the whole human being; the body, the mind, and spirit. One cannot exist well without the others and they have powerful influences over one another. Being mature, having a wide variety of human experiences, a desire to serve as well as being well grounded in faith can be very helpful and important.

This post is an excerpt from the current special edition of the Wilderness Medicine Newsletter and is reprinted here with the permission of the editors.