A strategy of cooperation

In Haiti, it was once again proven that disasters have no borders and no flags, and that medicine is a true bridge between cultures and nations.

By ITZIK KRIESS
haiti idf hospital 311 (photo credit: E.B. Solomont)
haiti idf hospital 311
(photo credit: E.B. Solomont)
On January 12, at 16:53 local time, the worst earthquake in 200 years struck near the city of Port-au-Prince, Haiti. Over 200,000 people died, more than 250,000 sustained injuries.
This catastrophic event necessitated a strong public response. Many countries answered appeals for humanitarian help, pledging funds and dispatching rescue and medical teams. Israel did so as well and the our government decided to launch a medical humanitarian mission in order to provide advanced medical care.
The time factor was critical due to the fact that many of the wounded could be saved in the first few days.
Our first challenge was to arrive early at a country over 6,000 miles away. Nine hours after the earthquake and just eight hours after organizing in a soccer field, the hospital was fully operational on Haitian soil. Several factors in the Israeli model enabled such a rapid and effective response: essentially, it is the result of a strategic decision made by Israel to maintain constant readiness to launch a field hospital anywhere in the world, with minimal advance notice, which is implemented at all times by the IDF. Consequently, the continuous maintenance of a high level of preparedness - expressed by staff experience, by the "on-alert" mentality of IDF reserve personnel - was a significant time-saving factor in the current mission.
Moreover, the quick decision-making process at both the military and the government levels, with personal involvement of the senior army leadership, significantly shortened our arrival time. We believe that devotion to the mission, and the fact that rendering humanitarian aid to the people of Haiti was considered a value by Israeli society, helped us to get there as soon as possible.
We went there to assist, to save lives, to extend a helping hand. Our swift arrival, and our ability to provide, together with others, advanced care at that early phase may not only have contributed to  saving lives, but perhaps lead the people of Haiti to believe, to hope.
OUR HOSPITAL consisted of 121 servicemen and women, including 44 physicians and 27 nurses, some of them reservists. Among our personnel were veterans of previous IDF humanitarian missions to Armenia, Rwanda, Kosovo, Turkey and India. More than 1,000 people were treated in our hospital.
As soon as it was operational, the stream of patients was tremendous. In the first phase, we dedicated all the resources to treating injuries caused by the earthquake. More than 300 operations were performed. Many of those operated on were under 15. We also brought life into the world - 16 babies, reminding us that even in the most difficult of times the cycle of life continues.
We tried to perform field medicine at its best. We did not compromise on principles of practice, on academic rigor, on documentation, on meeting professional standards. We made diagnoses, provided treatment. We did not give up.
We wrestled with questions that were not simple - ethical dilemmas. Dealing with these is a challenge for every physician, but especially for the medical leadership in such a mission. We had to confront and make clinical and ethical decisions that we do not routinely encounter on a daily basis, starting with which patients we should accept with our limited resources and continuing with numerous decisions concerning hospitalization and discharge.

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Our goal was to save as many lives as possible. We tried to do so with sensitivity, intelligence,  caring and professionalism.
We did not do it alone. At our side was a skillful support unit comprised of 109 personnel of the Home Front Command and other units, as well as the Foreign Ministry, who, with unlimited dedication, made certain we could concentrate our efforts on patient care. We also had the privilege of working under the exceptional leadership of Brig.-Gen. Shalom Ben-Arie, who is undoubtedly, after 11 humanitarian missions of disaster relief, one of the world's most experienced expert in this field. We were part of an international relief effort.
One of the keys to the success of this mission was the cooperation between various countries, official organizations, volunteers and local teams working in the arena. Together we adopted collaboration as a strategy in Haiti. This international cooperation required direct open communication and included coordination - mainly patient transfer, sharing of knowledge and equipment, and above all, working side by side, civilians within a military unit or soldiers working under a civilian umbrella. Some, like a Colombian military surgical team, were organized as a unit and augmented our operating capacity, while others, like nine American physicians and nurses from USC in Los Angeles or plastic surgeons from the University of Miami and Vanderbilt University, came as individual volunteers whom we assigned to the different sections of our field hospital.
WE WERE continuously struggling for a proper solution to the urgent need for hospitalization. The arrival of the USS Comfort dramatically increased the availability of life-saving procedures by allowing for the transfer of patients to this ship. This was facilitated via the close working relationships we were privileged to forge with Maj.-Gen. Allyn, the deputy commander of the US Task Force, and Capt. James Ware, the commander of the USS Comfort.
In Haiti, it was once again proven that disasters have no borders and no flags, and that medicine is a true bridge between cultures and nations.
We all represented the IDF, the State of Israel and the Medical Corps. In carrying out our mission in Haiti, the eternal words of the IDF Medical Corps Oath loudly echoed: "To extend a helping hand to anyone who is injured or ill, be he lowly or venerable, friend or foe - to any fellow man," and "to bring healing and balm to body and soul, to maintain discretion, loyalty and honor, and to consider our actions with intelligence, resourcefulness and love of humanity."
The Haitians are a special people. Even in moments of terrible tragedy,they were dignified, gentle, and respectful of one another and of thosewho came to assist. I am happy that we were given the privilege ofhelping them, and wish them success in moving forward, with help fromnations around the world, to a better future.
Excerpted from a speech Dr. Kriess gave to the IDF Haiti delegation andChairman of the US Joint Chiefs of Staff Adm. Mike Mullen in Tel Avivon February 15.

The writer is the IDF's head of the strategic planning department inthe planning directorate. He was the commander of the IDF fieldhospital in Haiti.