The tragedy in Haiti is at the forefront of most newscasts. Experiencing the tremendous suffering through your television may tempt you to join the many Americans who have volunteered to go to Port-au-Prince to assist with the relief effort.
Traveling outside the United States can be a rewarding experience. However, traveling to an area wracked by such devastation requires special precautions. Aid workers will encounter incredible scenarios. They will also be exposed to diseases and hazards rarely encountered in this country. Watch the WHO Haiti Health Response video.
As an Infectious Disease (ID) Specialist, I am a bit like a medical detective. I examine difficult cases, looking for clues to identify the culprit and solve the problem of a difficult infection. I also see healthy patients planning to travel to foreign countries where they may be exposed to diseases. I provide special information to help keep travelers safe and healthy abroad.
Environmental Dangers
Relief workers will be exposed to many health hazards associated with the tragedy itself: loose power lines, falling building materials, leaking sewer lines, and unstable (or non-existant roads.)
With the latest estimates at greater than 200,000 dead, relief workers will undoubtedly encounter decomposition of people and animals. Blood-borne viruses and diarrhea-causing bacteria are a risk to an aid worker, as well as survivors. Full protection – a mask with face shield, gloves with an anti-cut layer, and strong-soled footwear are essential. The Centers for Disease Control (CDC) provides complete information on personal protective equipment.
Water is especially dangerous. There is no specifically safe source currently available in Haiti, so aid workers must bring supplies to purify water, or only consume bottled water. Brushing teeth, ice cubes – all must be from purified or bottled sources only.
Mosquito-borne illnesses such as malaria and dengue fever are common in Haiti. Relief workers should use insect repellent (bug spray) and wear long sleeved shirts and long pants. When sleeping, insecticide-treated bed nets (ITNs)are recommended.
Diseases in Haiti
Many diseases and other hazards are wide-spread in Haiti.
- Tuberculosis, anthrax, typhoid, polio, measles and insect-borne diseases malaria and dengue fever occur in Haiti; and some: rabies and HIV, are prevalent there.
- To prevent exposure, an Infectious Disease physician can inoculate a traveler against many of these diseases, and provide preventative medications. Using specialized programs, we also provide a custom-designed packet of information to a traveler with recommendations from the Centers for Disease Control and World Health Organizations on current hazards and recommended actions. This information is accessed and updated in real-time.
The Stress of Providing Relief Service
Being faced with the enormity of the devastation as seen in Haiti presents mental stress which relief workers sometimes react to in unusual ways.
According to the CDC, profound sadness, grief and anger are common reactions. Workers may not want to leave the scene until the work is finished and may try to override stress and fatigue with dedication and commitment. The need to rest and recover may be resisted as well.
Aid workers will want to limit on-duty work time, rotate between high and lower stress functions, and take frequent breaks from the scene. Staying in touch with family and friends, and working in teams will help identify and relieve stress as it occurs.
Upon Return
Approximately one-third of aid workers report depression shortly after returning home, and more than half of returned aid workers have reported feeling predominantly negative emotions on returning home, even though many reported that their time overseas was positive and fulfilling.
As a Methodist Travel Clinic physician, I sometimes detect diseases which do not manifest themselves for awhile after travel. Once you return from an International trip, be alert for unusual fever or flu-like symptoms, which may be caused by exposure to diseases rarely seen here.
