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Your health - Our mission
Votre santé - Notre mission
Canadian Forces Response to Earthquake in Haiti
Operation HESTIAPresentation to:
AMMA 2010
Commodore HW Jung
Surgeon General/CommanderCanadian Forces Health Services
Your health - Our mission
Votre santé - Notre mission
OVERVIEW
• History of CF DART deployments• Haiti
– earthquake overview– Country profile
• Canada’s response to the disaster• CF response – Op Hestia
– Op Hestia Organizational Structure• Op Hestia Health Services
– What we did– What we learned
Your health - Our mission
Votre santé - Notre mission
CF HUMANITARIAN OPERATIONS
• Recent CF DART deployments:– 1998 - Honduras – Hurricane Mitch– 1999 - Turkey earthquake– 2005 - Pakistan earthquake– 2004/2005 - Sri Lanka earthquake-generated tsunamis– 2010 - Haiti earthquake
Your health - Our mission
Votre santé - Notre mission
SITUATION
• Earthquake on 12 January at 1653L– 7.0 magnitude;– Approximately 13 km deep.
• Deaths: estimated at 150,000 by GoH – Later revised at 230,000 (GoH)– International estimate 92,000
• Injured: 300,000• Affected by the event: 3,000,000• Homeless estimated at 1,500,000
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
JacmelDest: 50-60%
Pop: 40k
LéogâneDest: 80-90%
Pop: 134k
Port-au-PrincePop: 2M
Relocation ext: 469k
EpicentreMag: 7.3
16h53 12/01/ 10
Situation on 12 January 2010
Estimation of Devastation
Dead: 220kWounded: 300khomeless: 1,2Mrelocated: 272kNeeding food: 2M
standard.jpg (21 Ko)
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
• Canadian Forces (CF) participation in a whole-of- government humanitarian response to the earthquake
• Under command of Brigadier-General Guy Laroche • Over 2,000 CF personnel deployed
OPERATION HESTIA
Your health - Our mission
Votre santé - Notre mission
OPERATION HESTIA CAPABILITIES
• Search and rescue• Health Services Support services• Disaster Victim Identification• Food and water • Engineering expertise• Mobility by sea, land and air• Defence and security support
Your health - Our mission
Votre santé - Notre mission
HAITI DEPLOYMENT TIMELINE
0
500
1000
1500
2000
2500
12-J
an
14-J
an
16-J
an
18-J
an
20-J
an
22-J
an
24-J
an
26-J
an
28-J
an
30-J
an
01-F
eb
03-F
eb
05-F
eb
Séis
me OPS start – 1Cdn
Fd Hosp R2
LeoganeOps Start
ArrivalHMCS HAL & ATH
ArrivalDART
Medical Recce
Quake
12-Jan 14-Jan 16-Jan 18-Jan 20-Jan 22-Jan 24-Jan 26-Jan 28-Jan 30-Jan 01-Feb 03-Feb
AO confirmed Last troops arrive
Arrival Comd HS
R1 Embassy R1 Leogane
USNS Comfort-R3
Total pers Op Hestia
Your health - Our mission
Votre santé - Notre mission
Detailed Timeline of Health Services Deployment
Earthquake
12 Jan 29 Jan
15 Jan
16 - 22 Jan
22-27 Jan19 Jan
Move to Trenton
Fd Hosp IOCMND Announces
the deployment of 1 Cdn Fd
Hosp
DART Med Pl IOC
Warning Order
10 Mar
6-19 Mar
Closing of R2
Redeployment
Deployment
21 Jan
Your health - Our mission
Votre santé - Notre mission
Land Component DART
3 R22eR Battalion Group1 Canadian Field Hospital
Maritime Component HMCS ATHABASKAN
HMCS HALIFAX(C2 and CH-124 Helo)
Naval construction troopShips' medical teams
Air ComponentAirfield Operations6 Griffons (Utility)
CC130 (Tactical Lift)CC177 (Strategic Lift)CC150 (Passenger lift)CC144 (Passenger lift)Aeromedevac teams
Search & Rescue technicians teams
Op HESTIA – Force structure
Joint Task Force (JTF) Support Element
Transport, shipping & receiving, contract administration etc.
Joint Task Force Haiti (JTF-H)Command Element - BGen Guy Laroche
(Command & control, Co-ordination with Cdn and international partners)
Your health - Our mission
Votre santé - Notre mission
NAVY
• Over 500 naval personnel • HMCS ATHABASKAN - destroyer • HMCS HALIFAX - frigate• Sea King helicopter air detachment• Naval Construction Troop
Your health - Our mission
Votre santé - Notre mission
ARMY
• 500 soldiers in total• Two infantry companies from 3 R22R• Engineer company from 5 Combat
Engineer Regiment• Support company
Your health - Our mission
Votre santé - Notre mission
AIR FORCE
• Over 250 personnel• Medical Evacuations• Transport of humanitarian aid supplies,
equipment, vehicles and passengers (including evacuees)
• Jacmel airstrip: air traffic and ground control
Your health - Our mission
Votre santé - Notre mission
CF HEALTH SERVICES - PERSONNEL
Over 180 CFHS members representing more than 18 different Health Services and Support professions/trades
* GD/Flt Surg Medical Offrs (13) * Gen/Orthopedic Surgeons (4)* Anesthesiologists (2) * Radiologists (1)* Intensivist (1) * Health Services Ops Officers * Nursing : ICU, GD,OR, Flt * Pharmacists* Social Worker (1) * Health Care Admin * Advanced General Dentist (1) * Dental Techs* Preventative Med Techs * Operating Room Techs* Laboratory Technicians * Biomed Engineering Techs* X Ray Technicians * Physician Assistants
Your health - Our mission
Votre santé - Notre mission
Roles: – Primary medical care– Clean-up and construction– Safe drinking water – Security
DISASTER ASSISTANCE RESPONSE TEAM (DART)
• Rapid-response capability Total of 200 CF members:• engineers, • Defence & security platoon &• Medical Pl: 47 pers:
• General Duty Medical Officers
• Nursing • Pharmacy• Preventive Medicine• Medical Technicians
Your health - Our mission
Votre santé - Notre mission
DART Med Platoon
Roles:Roles:• Work with/augment local/international health staff to support their objectives; and
• Work with other military and non-government organizations to do the same.
• To provide Primary Medical Care in order to– Stabilize the primary effects; – Limit/mitigate secondary effects; and– Address humanitarian needs while domestic or international mobilizes to facilitate long-term recovery
Limitations:No trauma capability as standard DARTNo surgical capability as standard DART
Enhancements (pull):LaboratoryMental healthForensicsX-RayExtra Holding*Acute Medical Surgical Capability
Your health - Our mission
Votre santé - Notre mission
Map of DART Medical Assistance Ops
DART AOR
Your health - Our mission
Votre santé - Notre mission
Trauma cases
(compartm
ent,
burns, fractu
res, et
c)
Dehydration (h
eadaches, sto
mach
aches) Dres
sing ch
anges
Skin infec
tions (s
cabies),
dehydration (h
eadaches,
stomach pain)
Vaginosis,
parasites,
headache, chroni
DART Medical Ops
Your health - Our mission
Votre santé - Notre mission
Critical Relief 1.5 wk
Stabilisation and FU 1.5 wk
Follow-Up Care 0.5 wkBeyond disaster care
DART Medical Ops
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
Disaster Victim Identification
• CF Dental Services Forensic Odontologist deploy upon request from– Dept of Foreign Affairs – RCMP / Provincial Police / Municipal Police – Coroners / Medical Examiners
• Haitian community saw little value in disturbing buried victims for identification purposes. – Birth and death certificates are not the norm for Haiti – Local customs favoured not disturbing the dead– Most decedents would not have ante-mortem records suitable for
identification purposes• Canada sent three teams of 6 investigators, each for a two week
rotation
Your health - Our mission
Votre santé - Notre mission
CF HEALTH SERVICES IN LÉOGÂNE
• Role 2 - 1 Canadian Field Hospital (1 Cdn Fd Hosp)– 2 operating rooms, – 4 resuscitation bays, – 103 beds: 5 critical care, 10 intermediate care, 88 minimal-
care, – pharmacy, laboratory, diagnostic imaging, and dental svcs.
• Role 1 - 3 R22eR Battalion Group– Physician, Physician Assistant (PA) and Med Techs
• Village Medical Outreach clinics in isolated communities;• 1 Cdn Fd Hosp augmentees
• Primary Care- HMCS ATHABASKAN– Physician, PA and Med Techs embedded with other teams
Your health - Our mission
Votre santé - Notre mission
130’
120’
320’
Dental
Triage
OR 2
OR 1
CSS
MIR
WARD B
WARD C
WARD D
Support/Engr
Generators
TOC/CS8
RESUS
HQ
CCW
Lab
Diag Imag
Pharmacy
FMED
Reefer
WARD A
Entrance
1 Cdn Fd Hosp
Your health - Our mission
Votre santé - Notre mission
1 Canadian Field Hospital STATISTICS
• 4922 patients seen in 40 days – 711 children
• 178 surgical procedures– 123 General Surg– 55 Ortho Surg
• 364 dental patients– 421 extractions– 258 surgical procedures
• 243 admissions– 18 ICU admissions
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
1 Dental Unit
1 Dental Unit
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
Your health - Our mission
Votre santé - Notre mission
CF HUMANITARIAN HEALTHCARE SUMMARY
# of patients
Patients / consultations 22 447
Surgery 198
Medical Outreach in rural regions 5 558
Strategic Aeromedical Evacuation to Canada of Canadian Entitled Persons
62
Canadian Entitled Persons seen at Embassy 438
Total Canadian Entitled Persons evacuated 3291
Your health - Our mission
Votre santé - Notre mission
CC-177 Globemaster III strategic airlifters
LESSONS LEARNED
Your health - Our mission
Votre santé - Notre mission
LESSONS LEARNED: Health Services Support to Future Humanitarian Operations / Disaster Response
Lesson # 1: Arrive rapidly in location within 7-10 days of the event
Need to balance capability with mobility
Lift Requirements need to be minimized
Task Force Movement Tables / Sequencing essential
Your health - Our mission
Votre santé - Notre mission
LESSONS LEARNED: Health Services Support to Future Humanitarian Operations / Disaster Response
Lesson # 2: Health care delivery must be tailored to the population at risk:
Standards of Care
Medical / Dental Rules of Eligibility
“Filling the Right Niche”
Your health - Our mission
Votre santé - Notre mission
LESSONS LEARNED: WAY AHEAD
• Refining of the DART primary care high readiness module• Public Health module • Fwd AE/ Ground evacuation module• Disaster Victim Identification module • High Readiness Acute Medical Surgical module
Your health - Our mission
Votre santé - Notre mission
Scalable Acute Med/Surg Module (48 hrs NTM)
Basic Functional Module:Bed Count (30):
2 OR beds4 CCW/Resus/PACU 10 ICW 16 minimum care beds
Total Personnel Required: 92Lift Required: 3 CC-177 Chalks Sustain: 14 DOS• This module could be added onto
the DART Med Pl module which contains an existing 50 pers and 30 minimum care beds
Follow On module if required:Additional Beds (50):
6 CCW/Resus/PACU 12 ICW 32 minimum care
Additional Personnel Required: 26 Additional Lift: 1.5 CC-177 chalks
TOTAL: 80 beds 118 personnel4.5 C-177 chalks to move
Your health - Our mission
Votre santé - Notre mission
QUESTIONS