January 19, 2010

USAID is providing us with updates as to the Key Developments and Current Situation as they have assessed daily. We will in turn share them with you. Please see the pdf attached for the full update. Key Developments for yesterday are below. As we receive them, we will post for the latest facts and figures.



On January 17, U.N. Secretary-General Ban Ki-Moon visited Haiti to assess humanitarian conditions and meet with U.N. and government officials on the ground. Ban urged coordination among the international community to sustain the increasingly large aid operation and of the huge amount of aid that is pouring into the country

As of 1100 hours local time on January 18, the USAID Disaster Assistance Response Team (USAID/DART) reported that U.S. urban search and rescue (USAR) teams had rescued approximately 40 individuals from collapsed buildings, including one girl two years of age this morning. On January 17, USAR teams rescued 12 people, including three children between the ages of three and seven. To date, international USAR teams have rescued more than 70 individuals throughout Port-au-Prince, an unprecedented tally for a five-day USAR operation.

International USAR teams have completed reconnaissance in 100 percent of assigned areas in Port-au-Prince; however, search and rescue activities will continue until the Government of Haiti (GoH) decides to cease operations, according to the U.N. Disaster Assessment and Coordination (UNDAC) team.

On January 18, USAID's Office of U.S. Foreign Disaster Assistance (USAID/OFDA), in coordination with the U.S. Department of Defense (DoD), facilitated the delivery to Port-au-Prince of 9,600 ten-liter water containers to serve an additional 19,200 people and 7,602 hygiene kits to benefit an additional 38,010 people for two weeks. An airlift containing 300 rolls of plastic sheeting, which will meet the shelter needs of 15,000 people, is scheduled to arrive at 1400 hours local time on January 18.

With USAID/OFDA support through the U.N. World Food Program (WFP), the U.N. Humanitarian Air Service (UNHAS) is establishing a passenger service from Santo Domingo to Port-au-Prince to transport relief workers, with two daily flights scheduled to begin on January 18.

USAID-DCHA Haiti-Earthquake Fact Sheet #6

January 19, 2010


Last night, we visited Double Harvest Hospital about an hour away from Baptist Mission Hospital.  It is a tremendous facility that is in early stages of establishing a relationship with Harvard's Partners program.  We decided to send one of our surgeons there (Dr. Warren Cooper, who all of my boys have operated or been with in Sudan over the years).  Warren can do it all.

Then back to the hospital compound where we were treated to a fantastic home-cooked meal (I asked, "What's the sauce for the rice?" The cook said "I don't know but you will like.").  Great conversation as everyone gathered in their scrubs, exhausted, to recount their experiences of the day.  The nurses have got things really organized.

We were sleeping in sleeping bags by 10pm. Slept well in room with 8 others. We can't drink water, and there is no hot water. Very comfortable though, seriously.

Up at 5 am to take 45 min. rough journey to town.  Palace in shambles as you see on television back at home.  Thousands and thousands of people displaced to field and the square in front of palace.  Obviously no water and no latrines.  The sights and smells in the early morning hours you don't feel from tv ... Stench, some crying, people searching for water, fires burning.

We are now running to the airport early am for supplies.  Only thing short supply now is cast materials and pins to externally fix broken bones. Ran into a medic (James L. Clark) who is former special forces and who did medical work with me just after Katrina when we were both seeing some of the 3000 patients who flooded New Orleans airport just after levees broke.  Small world and big hearts.

As I'm on the tarmac looking through palettes of supplies, I think how much regular old people at home have helped in response to my personal requests ... The medicines and IV fluids I brought in are now in people saving their lives.  I think of the people at Centennial Medical Center (Tom Herron and Micki Slingerland who met me early Sunday just a few hours after my call) and the people at the local Walgreens on Harding and  Jennifer Dilliard (district manager) who today are sending in some much needed antibiotics. And all the people who have contributed to our foundation Hope Through Healing Hands (I am immediately channeling the money to where I know it can be used on the ground right now, making the most difference.) Thanks to all.



Frist Arrives at Baptist Mission Hospital

At First Glance

Jan 18 2010

January 18, 2010

At First Glance

Baptist Mission Hospital -- Fermathe, Haiti

Its 3:30pm and we have been on site for 5 hours. The Baptist Mission Hospital here in Fermathe has two doctors and about 100 beds. Since the hospital is 20 miles north of Port au Prince, it is normally used as a referral hospital. But it is all pretty simple; it did not have even a basic lab until last month; it does not have blood for transfusions; and it is very elementary.

For example, we have one patient being transfused.  She had a gastrointestinal bleed last night and her hemoglobin is only two.  There is no blood, so she is being transfused directly from the vein of a doctor of the same blood type.

All serious injuries are coming here.  The hospital consists of a single functional operating room, two large ward rooms, and a single long hall connecting them all. It has been overwhelmed.

It has been packed all day. You can barely move through the hallway.  We quickly toured the facility, made an initial assessment, and then we met with the exhausted limited medical staff.

Findings: Shortage of nurses, no triage going on, no medical records, no place to house postoperative patients. We have an anesthesiologist with us, but we lack basic anesthesia equipment. 

Patients: All ages, mainly fractures, the wounds that are now 6 days old are all infected. There is a shortage of pins and plates to stabilize the wounds.

I'm in a meeting now with 6 Samaritan's Purse members and hospital leadership addressing the issues above.

More later.  We need to unload the antibiotics.

Bill Frist, M.D.


Frist with Samaritan's Purse en route to Baptist Mission Hospital, witnessing devestation and rubble.

Picking up supplies along the way for hospital.



January 18, 2010

The medical need in Haiti is desperate -- in particular for surgeons.  Having responded in this capacity just after the tsunami in Sri Lanka and four days after the levees broke following Katrina, I decided to join fellow physicians from Samaritans purse in Haiti.

On Sunday I spent the morning at Centennial Medical Center in Nashville going through their basement, picking out medical supplies most notably antibiotics and intravenous fluids, they generously provided for the victims of the earthquake in Haiti.

Last night I loaded up the boxes with Karyn, and then with the help of  the agents at Delta, got the ten heavy boxes of supplies down to  southern Florida. Our medical team of ten departed for Haiti at 6am this morning.

Haiti is different than the last 2 disasters I responded to.  In the tsunami and Katrina, most died quickly of drowning. In Haiti most of the injuries are due to the crush of the collapse of structures, with broken bones common. Infection and shock (low blood volume) set in quickly, thus the need for fluids and antibiotics.

Centennial has offered a great supply, but we need more. Hopefully in the next couple of days we can get a plane load into the hospital there to meet this critical need.

As I can, I will be blogging daily to report what is happening on the ground. I invite you to visit www.billfrist.com and www.hopethroughhealinghands.org to learn more about the disaster of Haiti over the course of the next week.


Frist packing supplies with Centennial Medical Center pharmacy staff.

Karyn packing boxes with Dr. David Allen at Centennial Medical Center.

We welcome donations: HAITI DISASTER RELIEF FUND.




January 13, 2010

As the facts slowly emerge revealing the extent of the devastation in Haiti in the aftermath of the earthquake yesterday, we are learning that perhaps over half a million lives have been lost.

Major officials and dignitaries lost their lives yesterday. Moreover, governmental buildings, the national palace, and other historic buildings have collapsed.

Haiti is the poorest country in the western hemisphere suffering from extreme poverty. This natural disaster will create extraordinary need in a country where it is being estimated 1 in 3 Haitians have been affected by the earthquake.

Many have written and asked: Where should we send money? Hope Through Healing Hands will be collecting a fund where 100% of the monies will be donated to the best organizations, on the ground in Haiti, with whom we partner and work. You can donate directly to Hope Through Healing Hands: Haiti Disaster Relief Fund in the next 24 hours on our website.

We will give you updates from these organizations as to the usage of the funding over the next month.

How can you help? Donate today.

And, please keep the people of Haiti in your thoughts and prayers.


Bill Frist, M.D.

P.S. The Haitian Disaster Relief Fund will be up shortly, if it is not already. Please check back soon if the website has yet to have it posted. Thanks for your patience.


January 11, 2010

From: PneumoALERT at preventpneumo.org

Call to USAID to Take Action on Pneumonia and Diarrhea

Dear Colleagues,

I am excited to tell you that on January 7, 2010, Dr. Rajiv Shah was sworn in as USAID Administrator. This is a great opportunity to welcome Dr. Shah to his new leadership position and to call on him to take up the cause of pneumonia and diarrhea, the world's two leading causes of child mortality.

Dr. Shah has led and worked with many of the initiatives that are defining best practice in the field of development, including the Global Alliance for Vaccines and Immunization, the Global Fund for AIDS, TB and Malaria, the Alliance for a Green Revolution for Africa, and the Bill and Melinda Gates Foundation. His tireless efforts to immunize children around the world have helped save countless lives.

Please take a moment to sign and submit a letter welcoming Dr. Shah as he begins his important work as head of USAID and to bring to his attention the need to increase support for child health. Dr. Shah is now at the center of the important US aid effort to help families around the world in their struggles against poverty and disease.

Millions of lives can be saved by increasing access to antibiotics and vaccines against pneumonia and diarrhea, the two leading killers of children under five. By taking on these two common and preventable killers, the US can save millions of young lives and send a powerful message to countries everywhere about our ability to protect the health of the world's youngest citizens.

In November 2009, nearly 100 leading global health organizations joined forces to commemorate the first-annual World Pneumonia Day. Close to 100 events took place in over 30 countries across 6 continents. As a partner of the Global Coalition against Child Pneumonia, we urge individuals to capitalize on this momentum by sending this letter to Dr. Shah.

Please click here to sign and submit the letter. Please forward this link http://www.change.org/actions/view/call_to_usaid_to_take_action_on_pneumonia_and_diarrhea  to any colleagues or friends you think might be interested.

In December 2009, we announced the launch of a new International Vaccine Access Center (IVAC) at Johns Hopkins School of Public Health. We are pleased to have the opportunity to bring together a group with diverse skills and perspectives to accelerate access to lifesaving vaccines in populations that need them most through the development and implementation of evidence-based policies. I invite you to continue checking IVAC's new website for information on projects and new findings.

Thank you for your action and support.

Orin S. Levine, PhD
Executive Director, IVAC
Johns Hopkins Bloomberg School of Public Health
Follow me on Twitter @orinlevine
Read my blog at www.huffingtonpost.com/dr-orin-levine



I was welcomed back to the United States with those infamous words, "is there a doctor or a nurse on board" over the loud speaker of the airplane. Though I was the closet to the patient and the first to volunteer, I was happy to hand over my responsibilities to the doctor that eventually came from the back of the plane. Besides, there was not too much that anyone could do for shortness of breath related to pulmonary hypertension in mid-air other than apply the oxygen mask. Until that trip, I never knew how many gadgets and medical contraptions were hiding out in that first overhead bin on the airplane. Though we were met by EMS when we taxied into the gate, the patient walked off the plane without difficulty. Needless to say, it was an eventful homecoming.

It has been about a week since leaving Guatemala and I am still trying to adjust to the reverse culture shock of my return. The clinic will reopen again this week, after being closed for the last two weeks for the holiday. I can't stop thinking about the patients that patients that will be there this week when I am not. In the past 3 months I saw over 50 new patients and 80 patient visits including follow-ups. However, there are the few special patients that will stick out more than most.

Doña Celia's baby is almost a month old now. I am sure that she is already so much bigger than the last time that I saw her. Pretty soon she should be given her name. In Guatemala, the newborns are usually given their name in a ceremony at about 1 month. Last time that I saw her, she was wearing the one-sie that the clinic had given her. Her eyes had turned from jaundice yellow, back to white after a week of sunshine therapy. Their family was the very last that I saw on my way home from clinic, and after over a week of home visits and check-ins, certainly the most difficult and teary good-bye.

Doña Rosa's c-section that dehisced is totally healed without signs of infection. She is finally able to lift things other than her newborn baby, who also has been given her name since the time that I left. I will miss her younger son who was so giggly and easily amused by rubber-glove balloons and water filled syringes as I cleaned and packed mommy's stitches daily.

Doña Clara's CAT scan came back negative for evidence of pituitary tumor or adenoma and she can now go back to focusing on getting surgery for her daughter with cleft lip and cleft palate. Doña Ramona exams have come back negative for any remaining evidence of endometrial cancer posterior to her radiation treatment in the capitol.

Though I have resolved these patient cases, I can't help feeling a lack of closure. This week I start phone interviews to look for at least a temporary replacement until we can figure out a more permanent solution as to how to staff the women's clinic. We will be holding a large fundraiser and silent auction at Vanderbilt University the February 12th to raise money for free pap smears for all patients in the women's health program. Our next goal is to start a more structured prenatal program as has been the biggest request by the women of the community. Until then we will be able to keep the clinic running with the remaining funds from the Hope through Healing Hands Scholarship. I cannot begin to explain how incredibly fortunate I feel to have been given this unique opportunity. The women of Primeros Pasos have affected my life and practice in a way that seems almost impossible to describe; I will never forget them. Thank you to everyone who has supported me in this endeavor.

The latest in gifts that last a lifetime

Originally published December 21, 2009 at 7:05 a.m., updated December 21, 2009 at 7:05 a.m.



By Bill Frist and Orin Levine


Think it's impossible to find a child a hot, new gift for a modest price? If you're hunting for one of those trendy electronic hamsters, you might be out of luck. But take heart: $10 or $15 can still go a long way - and even save a child's life.

New vaccines at those prices can prevent the two biggest killers of young children - pneumonia and diarrheal disease. As a nation we have a great opportunity to extend a spirit of generosity to the world's children with the highest risk of dying.

In a season when gathering with family is a joyful tradition, reflect on the nearly 9 million families that lost a child under 5 this past year to preventable and treatable diseases.

Almost all these families live in the developing world. Unfortunately, they didn't have access to the new vaccines or the even less expensive treatments - like antibiotics or oral-rehydration fluids - that have been around for years. Yearly, pneumonia and diarrhea kill nearly 4 million small children. Preventable neonatal infections and malaria are the other major killers.

AIDS, the focus of nearly three-quarters of current U.S. global health funding, accounts for less than 3 percent of these child deaths worldwide. It's truly inspiring that over the past several years the United States has granted 2 million people living with HIV and AIDS a new lease on life through access to drug treatments. Amazingly, for just a fraction of the $5.7 billion we'll spend fighting AIDS this year alone, we could deliver life-saving services to tens of millions of children who lack access to basic health care.

We can do both.

We would dramatically reduce the number of children who die needlessly each year.

The United States already has an admirable track record in saving children's lives. We've helped make measles and tetanus vaccinations and life-saving oral rehydration therapy widely available around the world - preventing millions of child deaths. In Bangladesh, Nepal, Mozambique and Ethiopia, broad-based, U.S.-funded programs have been integral in cutting child mortality rates by more than 40 percent since 1990. These programs work, and they have shown that making affordable and effective health interventions available can save lives, even in very poor countries.

Such scientifically proven, remarkably cheap options include oral rehydration solution and zinc, low-cost drugs to treat pneumonia and malaria, and breastfeeding counseling. Add the new vaccines for pneumonia and diarrhea to the mix and we now have the tools to achieve revolutionary reductions in under-5 deaths.

In May, President Obama pledged to emphasize basic health care for mothers and children as part of his new global health initiative. But he didn't ask for much more money this past year, and last week Congress approved only a modest $54 million increase for maternal and child health care, as well as $400 million more in AIDS and malaria funding that will in part benefit children.

Using figures published in The Lancet medical journal, experts estimate that $1 billion in increased funding for child and maternal health could save 1 million children's lives a year. U.S. leadership would inspire other wealthy nations to join the cause. And, by working with developing nations to ensure health interventions reach children and families on the margins, the U.S. would help those countries strengthen their national health systems to improve the children's health for generations to come.

Let's encourage President Obama to be as bold in exercising U.S. leadership on global health as he has been in responding decisively to the global hunger crisis. In this season when children anxiously await their gifts and we their smiling faces, Americans can all be part of the greatest gift for children everywhere - the chance to survive and thrive.



Former U.S. Senate Majority Leader Bill Frist, a physician, is the chairman of Save the Children's Survive to 5 campaign. Orin Levine is executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.

This essay is available to McClatchy-Tribune News Service subscribers. McClatchy-Tribune did not subsidize the writing of this column; the opinions are those of the writers and do not necessarily represent the views of McClatchy-Tribune or its editors.


(c) 2009, Save the Children

Distributed by McClatchy-Tribune Information Services

Raj Shah and America's Development Future
Dec. 17, 2009, 12:12 p.m.
By Bill Frist
Special to Roll Call

In most years, Senate deliberations over a nomination for administrator of the United States Agency for International Development, which leads American efforts to fight poverty and disease in the developing world, would pass without note.

This year is different. American efforts to improve the lives of the world's poorest people have never been so important. The Senate Foreign Relations Committee voted last week to refer the nomination of Dr. Rajiv Shah for USAID administrator to the floor for a full vote, which is expected soon. Dr. Shah should be confirmed without delay for three key reasons.

First, successful outcomes to our most pressing national security challenges, including the war in Afghanistan and instability in Pakistan, depend just as much on our ability to provide health services and economic opportunity to struggling people as on our combat operations or diplomatic efforts. Both President Barack Obama's new Afghanistan strategy and the Kerry-Lugar-Berman Pakistan aid package make substantial new commitments based on this idea.

Second, the global fights against HIV/AIDS and other deadly diseases have reached a turning point. U.S.-led programs such as former President George W. Bush's Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria, have helped poor families and communities move from a moment of crisis toward a moment of opportunity. We need to work twice as hard to maintain and build on this progress.

Third, the Obama administration and bipartisan Congressional leaders are in the midst of a transformative debate about how to make U.S. foreign assistance more effective and accountable. The unprecedented momentum in this debate is on the side of those who believe we need a new development strategy and a more efficient foreign assistance system that produces greater returns for recipients and taxpayers alike.

Given the gravity of these issues and the costs of inaction, Dr. Shah's development leadership is needed now. He is a medical doctor and health economist who led the Bill and Melinda Gates Foundation's $1.5 billion vaccine fund and played a key role in launching its global development division, which now disburses hundreds of millions of dollars for agricultural security and financial services for the poor. These experiences, coupled with the fact that he came of age professionally as revolutionary new programs like PEPFAR, the Global Fund, and the Millennium Challenge Corp. drove landmark progress on global poverty and disease, prepare him well to manage America's development future.

If confirmed, Dr. Shah will face resistance from entrenched bureaucrats in USAID and the dozens of other government offices that oversee development programs. With political support from the Obama administration and Congress, he will need to assert himself immediately to gain control of this fragmented system, or risk being swallowed by it. To do so, Dr. Shah should assume a visible leadership role on foreign assistance reform and help drive it to a successful conclusion, but he must also focus on other specific issues.

For example, U.S. support for PEPFAR and the Global Fund has helped create massive new systems for prevention, testing, and treatment of HIV/AIDS, TB and malaria in poor countries. These systems have greatly enhanced the ability of developing countries to meet the needs of their people, and we must figure out whether we can effectively expand them to offer even more life-changing services such as comprehensive family health care, entrepreneurship education and small-business loans. The Obama administration is taking initial steps in this direction through its marquee food security initiative ‹ developed in part with Dr. Shah's leadership at the Agriculture Department ‹ which focuses on linking food security, a development priority, to nutrition, a global health priority. This is a promising sign.

We must also direct our precious development resources to more effective, low-cost health interventions such as vaccines, breast-feeding and increased access to skilled family care in rural communities. And we must invest our development dollars in programs that are showing measurable results, including multilateral efforts such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the GAVI Fund, and the Alliance for a Green Revolution in Africa.

Changes like these are never easy. But we can't let inertia drag us down at this moment in time ‹ a moment when the future of the world's so-called bottom billion, and our own American future, hangs in the balance. Dr. Shah has what is needed to carry on President Bush's global health legacy and fulfill President Obama's extraordinary development vision. The Senate should confirm him, and the Obama administration should give him the political support and resources he needs to succeed. Millions of lives will be affected by this choice.

Former Senate Majority Leader Bill Frist (R-Tenn.), a heart surgeon, is a member of the Millennium Challenge Corp.'s board of directors.


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