Filed under: Global Health Care, Help Haiti, Undocumented Aliens
This past Sunday, the White House resumed military airlift of injured Haitians into the United States. The halt on incoming Haitian patients had happened just days earlier, springing from the economic and logistic fears of many state officials of Florida, where the majority of patients from Haiti were being sent for care. After finding a solution to the hospital capacity issue in Florida, and fully knowing that they could not keep certain patients in the medically hazardous environment which is Haiti, White House officials reopened U.S. hospital doors to badly injured patients. Yet, the resounding question “who is going to pay for this emergency care?” remains.
The costs are not insignificant. One Florida hospital executive estimates costs to her hospital alone to be in the millions, and while she hopes some of this cost will be lessened through federal government assistance, other hospitals have already started to initiate reimbursement for the costs themselves through private donations. In addition, many doctors and nurses are volunteering their services to help reduce the high cost of the care.
The U.S. Department of Health and Human Services announced on Monday that they would supply funding for the emergency care through the National Disaster Medical System, which is usually accessed only in times of domestic emergencies. As described in the announcement, “activation will allow U.S. hospitals that treat Haitian patients evacuated with life-threatening injuries due to the earthquake, to receive federal reimbursement for the costs they incur.” The reimbursement for the care to Haitians is equal to 110% of Medicare rates.
Since the announcement of aid through the National Disaster Medical System, hospitals in other areas, such as Atlanta, are agreeing to treat patients. Hospitals in the Atlanta and Florida area are able to provide assistance due to their proximity to Haiti and their “extensive medical resources.” Other hospitals in the New York, New Jersey, Philadelphia, and Boston areas have been notified that their medical centers may also be tapped for help in treating the Haitian patients.
Because some of the patients that are being treated at American hospitals are American citizens who were in Haiti when the earthquake hit, some of the medical care can be reimbursed through the insurance coverage that those patients may already have or be eligible to receive. Interestingly, Haitians who are not legal residents of the United States might also qualify for insurance through Medicaid, but to qualify, the patients would have to be granted “Humanitarian Parole” by U.S. Citizenship and Immigration Services. Up until this point, Humanitarian Parole visas, which last for a year, have mostly been granted to orphans who were already in the process of being adopted before January 12th. Only 50 Humanitarian Parole visas have been granted to those who were sent to the United States for health care; due to the difficulty in tracking patients after their care is complete, the Immigration Services is hesitant to grant more such visas.
While the federal government appears to have systems in place to aid Haitians who are in dire need of medical care for now, questions about long term help still linger. International aid experts want to see systems of sustainability put into place so that Haiti can once again stand on its own after the foreign aid ends. Maybe our nation’s leaders will be able to give to Haiti the health care reform it needs, even if they can’t give it to America itself.
The BBC recently reported that medical organizations with members serving the Haitian communities affected by the earthquake on January 12th warn that one of the larger issues for Haitians will likely be the need for increased medical supplies, such as prosthetic devices and rehabilitation services.
Concerned about infection, doctors in Haiti have had to amputate the limbs of a great many injured patients. In addition to the need for such resources as medical devices and prosthetic equipment, doctors are also still in need of simple medications. Antibiotics are needed to prevent the spread of infections and painkillers to help damaged patients simply make it through the day.
Because many of the country’s hospitals were also destroyed by the earthquake, doctors in Haiti are performing most care in makeshift open areas. And in such environments, infection spreads fast. Though the few hospitals that are running are reported to be in relatively well-organized condition, many of the patients in those hospitals are not leaving as they have nowhere else to go, except perhaps the streets– where infections await their open wounds. So they stay, Doctors are left with fewer and fewer areas to treat, and the number of patients increases. To remedy the situation, there are plans at present to quickly build a convalescent center.
The present medical needs are only the beginning. The concerns of some medical experts extend to the years after the media eye has turned away from Haiti, after the NGOs have left the country, and after foreign doctors have returned to their home-countries. These experts worry about how the Haitians that are being treated today will be able to continue with one less leg or one less arm in the future. Without proper rehabilitation services or necessary follow-up medical care, many Haitians will lack the physical capabilities to rebuild their lives. Mark Hyman, a doctor and volunteer with Partners In Health, calls these future medical needs of the injured Haitian community the “third wave,” and he finds that such aid is not yet realized:
Soon, very soon, there is the need for rehabilitation, helping the thousands with lost or broken limbs get back on their feet or foot again. There are no physical therapists, no facilities, and no place for them to go for care. As the immediate surgical needs are slowly addressed, the psychological needs explode magnified by each minor aftershock.
Some medical device companies have already donated supplies to aid the doctors’ efforts as well as money to support the other necessary aid efforts in Haiti. While such donations are helping address an urgent need, they are being outpaced by the number of amputations being performed. Hope lies in the idea that health care systems will be put in place before the external help exits; that prosthetic devices will ultimately be made available to the patients that need them; and that Haitian medical workers are trained to be able to properly care for those who cannot care for themselves.
The needs of the Haitian people are great, and the impact of this disaster will be felt for years to come. Please give to help those who are working hard towards rebuilding Haiti. Click here to find a list of the different organizations through which you can donate. And if you happen to be a part of a prosthetic device company which wants to do something amazing, we’d love to write the story.
Those looking for means to get help quickly to the people of Haiti, devastated by an earthquake, should consider an emergency donation to Partners in Health. PIH has a long track record of providing excellent health care directly to the people of Haiti. It has personnel in the country, and facilities available to provide help. From a recent bulletin on the PIH web site:
In an urgent email from Port-au-Prince, Louise Ivers, our clinical director in Haiti, appealed for assistance from her colleagues in the Central Plateau: “Port-au-Prince is devastated, lot of deaths. SOS. SOS… Temporary field hospital by us at UNDP needs supplies, pain meds, bandages. Please help us.”
With our hospitals and our highly trained medical staff in place in Haiti, Partners In Health is already mobilizing resources and preparing plans to bring medical assistance and supplies to areas that have been hardest hit. In Boston, our procurement and development teams are already fielding numerous offers of support and making arrangements to deliver resources as quickly as possible to the places where they are needed most.
Donations can be made on-line through the PIH web site. PIH has a long history of providing health care directly to the neediest in Haiti. Some background from the web site:
PIH was founded in 1987, two years after the Clinique Bon Sauveur was set up in Cange, Haiti, to deliver health care to the residents of the mountainous Central Plateau. PIH co-founders had been working in the area for years. The Clinic was just the first of an arc of successful projects designed to address the health care needs of the residents of the poorest area in Haiti. In the 20 years since then, PIH has expanded its operations to eight other sites in Haiti and nine additional countries and has launched a number of other initiatives.
If you’re looking for a trustworthy organization able to immediately turn donations into direct assistance to Haitians, think of PIH.