The powerful earthquake that hammered Haiti Tuesday afternoon has left health care in the impoverished Caribbean nation in even worse shape than before.
Several hospitals have been seriously damaged and others are swamped by casualties from the magnitude 7 quake.
"We are seeing wave after wave of vehicles coming from the Port-au-Prince area and bringing patients," said John Walton, board chairman of the Hôpital Albert Schweitzer, a 120-bed facility in the rugged Artibonite Valley of central Haiti, about 40 miles north of the stricken capital.
The quake's epicenter was about 10 miles southwest of Port-au-Prince and caused only minimal damage to his facility, Walton told MedPage Today.
But news reports say the main hospital in the hillside suburb of Petionville collapsed, and the international medical aid organization Doctors without Borders reported that its 60-bed trauma center in Port-au-Prince was seriously damaged.
The group also said its Maternité Solidarité hospital, a 75-bed emergency obstetrics facility, had suffered structural damage and patients had been moved out of the building as a precaution.
Walton said the reports of casualties caused by widespread structural damage are not surprising because the capital is crowded with nearly half of the country's 9.7 million people, living and working in buildings that are shoddy by North American standards.
"I can only imagine the damage down there," he said.
The city is surrounded by hills that are covered with brick and concrete houses. But few of the buildings are reinforced, and many are surrounded by 10- or 12-foot brick walls, which have collapsed into the streets.
The city also has sprawling slums whose buildings are made of whatever materials come to hand, including packing cases and tin cans hammered flat and nailed together.
One of the most extensive slums is dubbed Cartonville, where the French word "carton" suggests that an important building material is cardboard.
Haiti, the second oldest republic in the Western Hemisphere, is also one of the world's poorest countries, rated 146 out of 177 on the United Nation's Human Development Index. The average per capita income is just $560 a year, and 78 percent of the population lives on less than a dollar a day.
In that context, Walton said, health care is usually rudimentary -- if it's available at all. The Hôpital Albert Schweitzer, which serves about 600,000 people, has the only surgical suites in the region.
Even those facilities, Walton said, are not the high-tech operations North Americans associate with surgery. "We offer very basic care," he said, including basic trauma surgery, emergency obstetrics, and appendectomies.
In the wake of the earthquake, he said, his facility faces "a very daunting task" as patients continue to flood in from the capital.