disaster and humanitarian assistance jung

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



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



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



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



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)



• 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



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



HAITI DEPLOYMENT TIMELINE

0

500

1000

1500

2000

2500

12-J

an

14-J

an

16-J

an

18-J

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20-J

an

22-J

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24-J

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26-J

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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



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



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)



NAVY

• Over 500 naval personnel • HMCS ATHABASKAN - destroyer • HMCS HALIFAX - frigate• Sea King helicopter air detachment• Naval Construction Troop



ARMY

• 500 soldiers in total• Two infantry companies from 3 R22R• Engineer company from 5 Combat

Engineer Regiment• Support company



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



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



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



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



Map of DART Medical Assistance Ops

DART AOR



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



Critical Relief 1.5 wk

Stabilisation and FU 1.5 wk

Follow-Up Care 0.5 wkBeyond disaster care

DART Medical Ops



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



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



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



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



1 Dental Unit

1 Dental Unit



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



CC-177 Globemaster III strategic airlifters

LESSONS LEARNED



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



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”



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



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



QUESTIONS

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