Doctors faced with immense challenges in Haiti

LOS ANGELES Rescuers in /*Haiti*/ are facing monumental obstacles: massive destruction, damaged hospitals, little or no electricity, water and a breakdown of the nation's infrastructure.

"Everything has to be brought in and restored," said UCLA Center for Public Health and Disasters director Dr. Steven Rottman. "There is very little time to make that happen for the acute phase of the disaster."

Dr. Rottman says while the most immediate priorities are search, rescue and the treatment for the victims of trauma, rescuers need to be able to help themselves first.

"What we don't want is for people to go into situations like this and be unprepared to sustain themselves with the very same things that everybody else needs such as: clean water, nutrition, sanitation, safety and security," said Dr. Rottman.

Immediate care needs go to crush injuries, head trauma, amputations and fractures. Preventing wound infection is also a priority. Dr. Rottman says the need to reach people and provide aid is acute.

According to the /*Red Cross*/ 90-percent of the people in incidents like the Haiti quake, perish within the first three to four days.

Dr. Rottman is also concerned about the risk of illness and spread of disease because of the lack of safe drinking water, poor sanitary conditions, and overcrowding in temporary shelters.

Officials will monitor for signs of diseases that have surfaced during other disasters such as typhoid, dysentery, cholera, dengue and malaria.

But looking ahead Dr. Rottman says the United States will be in this for the long haul.

"When things are put back you don't want to put them back the way they were, you want to put them back better," said Dr. Rottman. "You want to make it more robust and resilient."

In the post disaster period, it can take a long time to re-establish medical services. It's also a time when mental health specialists can be especially helpful in dealing with posttraumatic stress and grief issues.

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