January 18, 2010

We're clearly still in the FUBAR stage of the Haiti relief efforts, as this offshore medical facility goes largely unused. Many of the earthquake victims are suffering from complex compression injuries and the field hospitals aren't equipped to handle them:

ABOARD THE U.S.S. CARL VINSON--Seven earthquake victims from Haiti, including a newborn baby, were being treated Saturday evening in a state-of-the-art, 50-bed medical clinic aboard the aircraft carrier U.S.S. Carl Vinson--the first non-American victims believed to be treated since the carrier's arrival Friday morning.

Lack of medical facilities and doctors for tens of thousands of injured people in the decimated Haitian capital is one of the major problems facing aid efforts in the aftermath of Tuesday's earthquake. U.S. Naval officials said earlier Saturday that the Vinson nevertheless didn't plan to take on care of earthquake victims, and was awaiting arrival of a ship with more operating rooms to arrive Sunday or Monday and a hospital ship to arrive a few days later on Thursday.

Lt. Cmdr. Ron Flanders, a spokesman for the U.S. Navy 4th Fleet, the headquarters responsible for naval actions in Haiti, said Saturday afternoon that the Vinson's primary mission is using its 19 helicopters to ferry supplies onshore. Using the carrier as a floating hospital, he said, "would completely change the mission of the carrier. That could potentially impact the [carrier's current] mission."

Until Saturday evening, the carrier had made an exception for two victims, one a U.S. citizen and the other presumed to be so, Naval officials said. When the clinic was observed by a Wall Street Journal reporter Saturday afternoon, all the beds were empty. Lt. Cmdr. Jim Krohne, a spokesman for the aircraft carrier and its captain, responding to a reporter's queries, said the vessel's mission was "sea-based" and the primary focus of the clinic was to treat American citizens. Others, including Haitians, would be treated if they were sent by military commanders in Port-au-Prince, he said.

The seven Haitian residents were accepted on board later in the day when a Coast Guard helicopter pilot had to abandon plans to ferry them to onshore medical facilities outside the city. Poor weather and then darkness forced a mid-flight correction, said Naval officials and the pilot, Lt. Tim Williams. So Lt. Williams, normally stationed in Clearwater, Fla., diverted to the Vinson for its facilities.

The situation aboard the Vinson highlights a dilemma being faced by the U.S. military and other organizations bringing medical aid to Haiti, as residents of its capital face the threat of a continuing wave of deaths from disease and lack of treatment. In some cases, life-saving supplies and expertise stand tantalizingly close to the devastated capital but still out of reach of those in need, and the enormity of the emergency has caused some rescuers to re-examine their procedures.

Cmdr. Alfred Shwayhat, the senior medical officer who is an endocrinologist, said he had a plan to "treat 1,000 Haitians if necessary," when interviewed aboard the ship on Saturday. But he had received no orders to do so. "If the captain authorizes it, I will take anyone," he said. The Vinson's facility, he said, "exceeds anything in the civilian sector, bar none."

The Carl Vinson's clinic is staffed by 52 workers altogether, including an anesthesiologist, surgeon, critical-care nurse and radiation technician. It has laboratories to test for infectious disease, three intensive-care beds and gets blood donations from the ship's personnel when needed. The pharmacy offers medicines including special stocks for treating diseases common in the developing world, such as anti-malaria medicine and drugs that attack parasitic worms.

On Saturday afternoon, the Vinson sent two doctors, including the ship's flight surgeon, and three other medical personnel to a beach clinic set up by the Coast Guard, Lt. Cmdr. Flanders said, even though doing so left the ship short of its normal medical staffing for its own crew of 3,600 people: "You're down to just a few doctors" on board, he said.

The U.S. has deployed the hospital ship U.S.N.S. Comfort to Haiti, but it won't arrive until Thursday, according to a military announcement. Another ship with three operating rooms, the U.S.S. Bataan, is scheduled to arrive Sunday or Monday.

"There's a unified medical response," Lt. Cmdr. Flanders said. The Bataan has more of the "hard-core casualty" facilities to take on wounded Haitians, he said, adding the Carl Vinson is "really not equipped for...a sustained large amount of people coming in."

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