Child in Hand - A Hazard Identification, Vulnerability, and Disaster Preparedness Analysis of Orphanages and

Schools in HaitiSrihari Cattamanchi1, Meg Femino2, Bryan Sears2, John Mangino2, Majed Aljohani1,

Abdulrahman Saad Alqahtani1, Amalia Voskanyan1, Gregory Ciottone1

OBJECTIVES

1.Harvard Affiliated Disaster Medicine / Emergency Management Fellowship, Dept. of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 2.Department of Emergency Management, Beth Israel Deaconess Medical Centre, Boston, MA

METHODS

Official hospital of theBoston Red Sox

CONCLUSION

RESULTSINTRODUCTION• Children are most vulnerable to any disaster,

particularly in poor and developing countries. • Historically, Haiti has been impacted by many

disasters, including natural, man-made, technological, hazardous & infectious outbreak.

• Hazard vulnerability analysis (HVA) provides for a systematic approach to risk-stratifying potential hazards orphanages, schools may face.

• Risks associated with each hazard are prioritized to optimize planning, mitigation, response & recovery.

• To identify and risk-stratify hazards specific to each orphanage.

• To make recommendations on prioritization of mitigation activities to build resiliency to these hazards.

• The HVA’s revealed a severe deprivation of basic human needs, including food, safe drinking water, sanitation facilities, healthcare, shelter, education and information, not all inclusive at each site.

• In some centers this results not only from lack of resources but also access to services.

• In our observational and relative risk assessment at each facility, some keep children healthier with simple changes of practice.

• At each site we noted observed numerous physical hazards which could be easily lead to injury or death and easily mitigated with limited resources.

• It is recommended to implement periodic evaluations to document improvement and determine effectiveness of interventions.

• An HVA should be conducted annually and the vulnerabilities should change and re-prioritize as improvements are affected.

• The HVA can assist non-governmental organizations like CiH in developing a prioritized and sustainable improvement plan for Haitian orphanages.

• Over time, we hope environment, daily life & future for children of Haiti improves despite complex issues facing the country as a whole.

• A cross sectional, qualitative study, conducted in Haiti by Beth Israel Deaconess Medical Center Emergency Management Team along with Harvard Affiliated Disaster Medicine Fellowship in April 2012.

• Six orphanages under Child in Hand program (CiH) were identified and an HVA was done individually for each of these orphanages.

• Data was collated using a modified version of the Kaiser Permanente HVA tool.

• The on-site emergency managers, taking into consideration the lack of formal data collected or available, modified this tool.

• We did not complete the hazardous events portion but instead added medical events, which may impact the population at each site and be directly related to a hazard exposure.

• Analysis was completed using a systematic approach.

• First, historical data was researched to determine probability.

• Second, leaders were interviewed at each orphanage regarding frequency of specific events, human impact, and operational impact, and response, resources available.

METHODS• Third, site surveys were completed to observe

processes such as water treatment, sanitation, site condition, and other physical hazards.

• It is noted in each individual site report whether the interviewer considered the interviewee credible or not.

• This is an opinion based on observations, discrepancies witnessed and conflicting information from other caretakers at the same location.

RESULTS• The HVA’s demonstrated that at all CiH sites there is

an extreme lack of resources, with most children living at absolute poverty level.

Society For Academic Emergency Medicine 2013 Conference, Atlanta, GA.