five questions

Students line up at the Louverture Cleary School in Haiti, where Brown physician Timothy Flanigan spent time as a volunteer in 2008. The school and its students are safe, Flanigan says, but the surrounding neighborhood has been destroyed.

Credit: The Haitian Project

Hope for the injured in Haiti

Timothy Flanigan, an infectious-disease expert on the Brown medical faculty, has seen Haiti’s public-health challenges firsthand. He talks to Today at Brown about what will be needed to alleviate the suffering of earthquake victims and prevent fatalities in the days to come.

By Anne Diffily  |  January 14, 2010  |  Email to a friend

Dr. Timothy Flanigan, professor of medicine at the Alpert Medical School, is a nationally recognized expert in delivering community-based HIV treatment to underserved populations in the United States and abroad. Twice in recent years he has visited Haiti to volunteer with several organizations. While there he observed the Caribbean nation’s health-care system as well as the perennial optimism of its people.

Flanigan spoke with Today at Brown on Thursday, January 14, about this week’s earthquake disaster and its health consequences for one of the poorest nations on earth.


Dr. Tim Flanigan: Dr. Tim Flanigan As a physician, if you had been in Haiti this week when the earthquake hit, what would you do?

It’s hard for us to comprehend the challenges of caring for thousands of wounded in a country as poor and damaged as Haiti. You are doing triage, but finding a hospital that is open and operational is difficult. Traveling even a mile can be difficult when roads are blocked. And there may not be consistent access to electricity, water, and communications. Haiti is worse off than most other struggling countries because its infrastructure has been poor for so many years.

My immediate response would be to organize rescue efforts to free people who are still alive and buried in the rubble. Then you need to keep the wounded alive; they will have suffered crush injuries and open wounds. There is a high risk that wounds will become infected and that survivors will contract contagious diseases, such as diarrheal and respiratory illnesses. Epidemics are common in the wake of large-scale natural disasters.

The last phase of response is beginning to rebuild infrastructure. Haitians will need access to clean water and housing in order to survive. Medical care providers will need supplies and drugs to stem developing illnesses.

You’ve done volunteer work in Haiti twice in recent years. How did you get involved?

I was in Haiti in 2008 and 2009. My first contact was with Brown alumnus Patrick Moynihan (’87) of The Haitian Project, which runs the Louverture Cleary School on the outskirts of Port-au-Prince. [Dean of Medicine] Ed Wing had been there several times and suggested I contact Patrick. I worked there and also at the Albert Schweitzer Hospital in Port-au-Prince and with the Missionaries of Charity, Mother Teresa’s order, who provide crisis relief and children’s programs in the city.

What did you learn about public health while you were there?

While in Haiti I observed a number of health issues. Malnutrition is extremely prevalent — the worst I’ve seen in my medical career. We saw severe pneumonia, soft-tissue infections, malaria, HIV/AIDS, and tuberculosis. And that was under normal conditions, not during a disaster. Haiti does not have good census data or a robust public-health infrastructure to monitor the statistics, which will make it difficult to know how many people die from the effects of the earthquake. We know that the toll will be very high.

What is your hope for Haiti as it takes steps to recover?

The Haitian people are very resilient and able to carry on in the midst of terrible suffering. What they will need now and later is financial help from industrialized nations, and substantial individual commitments and partnerships. As we saw at Louverture Cleary School, there are many excellent centers in Haiti where its citizens can work with committed volunteers from developed countries, such as the Partners in Health organization’s clinics and the HIV/AIDS clinic run by Dr. Bill Pape.

How might the United States as a nation contribute to the effort?

The United States has an opportunity to help Haiti as few other nations can right now. Just as our Navy played a tremendous role in providing health care and security and beginning to restore the infrastructure after the South Asia tsunami, our armed services could go into Haiti now on a humanitarian mission to contribute their superb organizational, medical, and technical skills. This would provide immediate hope for people who are at risk of dying.

Prayers would also help.