Haiti 2010 Earthquake Response

As Haitians lay dying, US officials quarreled over medical care

Five days ago, airlifts that previously evacuated Haitian patients to the U.S. for sophisticated medical care were halted, reportedly because a dispute erupted over payment for the care. Late yesterday (Sunday) the US government announced that the freeze on medical evacuations had been lifted.

The White House said the flights were expected to begin again within 12 hours. Medical workers in Haiti had said the suspension put seriously injured patients at risk.

“Having received assurances that additional capacity exists both here and among our international partners, we determined that we can resume these critical flights,” White House spokesman Tommy Vietor said in a statement.

Exactly how and why the freeze was ordered on Wednesday still is not clear, but it closely followed a letter sent by Florida Governor Charlie Crist to HHS requesting activation of the National Disaster Medical System that “is typically used in domestic disasters and pays for victims’ care.” A spokesperson for the Florida Division of Emergency Management has claimed that poor coordination and limited resources, not costs, motivated the letter. [WaPo]. But, another spokesperson, Sterling Ivey, appeared to contradict that.

“Florida stands ready to assist our neighbors in Haiti, but we need a plan of action and reimbursement for the care we are providing,” Ivey said. [EUNews]

The U.S. military said the cause was “an apparent federal-state dispute over who would pay for their care” required suspending the airlifts.  But, a White House spokesman said Saturday that the problem was not funding but locating suitable medical facilities close to airports able to handle large planes.  The BBC reports that Barth Green, an American doctor in Port-au-Prince, “said the US State Department, Department of Defense and Department of Homeland Security had until now co-operated with the programme, but an ‘order from above’ had halted the flights.”

At HHS, EU News reports,  “a spokeswoman said the Pentagon decided to halt medical evacuations, while a military spokesman said hospitals were becoming unwilling to take more patients.”  Hospital representatives in Florida said they were willing to accept the Haitians whether or not payment could be made, and suggested Gov. Crist was to blame. The U.S. Ambassador to Haiti, Kenneth Merten, said he didn’t know why airlifts were halted, but the problem should be fixed.

After four days of confusion, the problem has indeed been fixed.  But, it is not clear if the policy change came in time to save a five-year-old girl with tetanus.  Doctors said on Saturday that Betina Joseph would die within 24 hours if not placed on a respirator.  By then, two men with tetanus had already died.

UPDATE: The Philadelphia Inquirer reports that the 5-year-old girl and two gravely ill infants were flown by private plane to Pennsylvania where two of the children are being treated at hospitals in thanks to Partners in Health, a medical aid nonprofit, and Naomi Rosenberg, a medical student who made arrangements for the transfer.  Global Aeromedical Services donated use of its plane and Sen. John Kerry’s office called on the U.S. military to ensure clearance for the flight.

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