PDA

View Full Version : Paperwork Hinders Airlifts of Ill Haitian Children


Wigglytuff
Feb 8th, 2010, 11:38 PM
PORT-AU-PRINCE, Haiti — Private medical evacuations of critically injured Haitian children to the United States for treatment have largely stopped because aid workers, doctors and government officials are worried about being accused of kidnapping if they transport the children without first getting paperwork that is slow to arrive or is unavailable.

Before 10 Americans were arrested trying to take children out of Haiti late last month, the largest pediatric field hospital in Haiti was airlifting 15 injured children aboard private flights to the United States each day.

But since the arrests, it has been able to evacuate only three children on private flights to American hospitals, according to Elizabeth Greig, the field hospital’s chief administrative officer, who has been in charge of trying to get the necessary Haitian and American approval.

At least 10 other children have died or become worse while waiting to be airlifted out of the country, she said. Dozens of children are in critical need of care, and there has been no shortage of American hospitals or pilots willing to take them.

But before being permitted to evacuate the children, some doctors said they were now being asked by American and Haitian officials for documents proving that the children were orphans or that the adult traveling with them was a parent — a challenging task considering that many residents’ birth certificates and other records remained buried under the rubble.

“They’re all at risk of dying, and none of these children should still be here in Haiti,” said Dr. Shayan Vyas, an American pediatrician changing an IV at the pediatric field hospital, which is based here at the Port-au-Prince airport and handles most of the private pediatric airlifts out of Haiti.

Other clinics here in Haiti have also conducted private evacuations, but they, too, are wrestling with the burden of proving that they are not illegally transporting children, according to those involved in the relief effort.

Whatever intentions the 10 jailed Americans had when they tried to whisk the children across the border without government approval, many Haitians and aid workers say the case has become a dangerous distraction for a country still in the throes of a huge humanitarian crisis.

Last week, Haiti’s prime minister, Jean-Max Bellerive, observed that reporters were “talking more now about 10 people than they are about one million people suffering in the streets.”

Dr. Lee Sanders, an American pediatrician at the airport field hospital, took the point a step further. “For these kids the kidnapping case isn’t just a distraction,” he said, as he changed a dressing on a girl’s infected leg. “It has become the difference between life and death.”

Previously, doctors, pilots and aid workers air-lifted children with life-threatening conditions out of the country immediately after triage, and then completed the paperwork after the children were stabilized.

No longer.

“Everything has slowed down, and most pilots are backing out of these medical missions with kids,” said Scott Dorfman, a pilot from Atlanta who has flown 50 flights since the earthquake, moving supplies, doctors and patients. He said he planned on flying a critically ill Haitian baby to an American hospital this week even though he was nervous about it.

“No matter what, I’m not taking off until I know we have those papers in hand,” he said. “If it means the patient doesn’t go, that’s what it means.”

Adding to the list of problems, Ms. Greig argued, the American Customs officials who issue the so-called medical parole forms allowing children to be evacuated have sometimes failed to coordinate with the pilots who need completed forms in hand before they can take off.

American officials in Haiti declined to respond to repeated questions about the problems with getting clearance to evacuate the children, but the kidnapping concerns are not the first problem for doctors trying to evacuate critically injured patients.

Medical airlifts being flown by the American military were suddenly halted on Jan. 27 because hospitals and state officials were short on space and worried about shouldering the cost of receiving more children, according to military officials.

Since the military flights resumed on Feb. 1, Dustin Doyle, a spokesman for the Air Force, said that on average they had been flying eight patients a day to the United States.

But doctors said that only a handful of children in need of care had been able to take advantage of those military flights because getting approval was slow and only patients at risk of dying in 24 to 48 hours had been permitted.

In fact, most of the patients airlifted to the United States since the earthquake struck have flown on smaller private flights arranged by a diversity of nongovernmental organizations and private citizens, according to doctors at the airport field hospital.

The paperwork for these private flights has been a challenge from the beginning. After the earthquake struck, pilots and doctors were getting in shouting matches daily on the runway, with pilots saying they feared losing their licenses and being fined $400,000 if they did not have the medical parole forms from Customs.

The impact of the evacuation delays could not be more evident. Leaning over a premature baby girl at the field hospital here, doctors took turns squeezing an air bag to keep her lungs functioning and used heating packets from ready-to-eat meals to raise her body temperature because they lacked an incubator.

Across the sweltering room, a 5-year-old boy lay moaning on a stretcher, his back broken by a wall that collapsed on him during the earthquake. Behind him, a 15-year-old girl stared at the infection running down her leg toward what is left of her amputated foot.

Florida hospitals had already volunteered to take them. Pilots were waiting with planes ready to fly them there. All three had at least one person claiming to be a parent with them, but none had documents to prove it.

The baby has since been flown to another hospital in Haiti, but is still struggling to survive. The other two are still in the field hospital awaiting clearance to leave

Some doctors at the city’s general hospital and at the airport clinic said they had consulted lawyers to see if they could be liable for arranging and often paying for private planes to take Haitian children without having first ensured there were proper papers.

The doctors said they had since tried instead to get the children onto the Comfort, a military hospital ship docked in the port, but had failed because space there was limited.

“This is not how medicine is supposed to work,” Dr. Vyas said.