This has been my third trip to Haiti since the January 12^th earthquake that has devastated the country. I am a physiotherapist by profession and my time in Haiti has been divided between working in spinal cord injury rehabilitation and in the training of local Haitian medical staff.  In April 2010, I spent 2 weeks at St. Boniface Hospital and I immediately fell in love with the hospital, its staff and most importantly the patients.  Upon my return home to Canada, a feeling of complete restlessness and longing to return to Haiti overcame me.  This strong desire lead me back for an additional 6 months to the breathtaking mountainous landscape of Fond des Blancs and to the warm and welcoming staff and patients at St. Boniface Hospital. At St. Boniface Hospital, my primary role is to coordinate rehabilitative care of the spinal cord injury patients as well as to provide training for St. Boniface staff.

Six months ago, the earthquake in Haiti led to an immense number of deaths, disabilities and displaced individuals.  A small, yet extremely vulnerable population of those affected were individuals with spinal cord injuries. Spinal cord injury (SCI) results in damage to the nerves that send information to and from the brain.  It is a condition that is extremely individualized, affecting multiple body systems (motor, sensory, urinary, reproductive, digestive, autonomic system).  Patients living with such injuries suffer a multitude of difficulties and there are devastating consequences for individuals and their families.

Prior to January 12^th, 2010, there was limited medical expertise available in the delivery of medical care to individuals with spinal cord injuries. Statistics on the exact number of SCI cases and survival rates were never recorded. As such, SCI Rehabilitation centers as well as knowledge on proper care and treatment were nonexistent. In the days following the earthquake, there was an immense international medical response resulting in the survival of many individuals with SCI.  Having preserved lives in the initial acute phase of care, local and International efforts must now tackle the life-long impairments that remain. The treatment and long term follow up care of spinal cord injury is a resource intensive endeavor focusing on the medical, psychosocial and rehabilitative aspects. The magnitude of the earthquake on the country and its people, has further intensified the situation rendering the majority of these already vulnerable people without homes, having to cope with the loss of other family members and friends, all in addition to their current disability.

The vulnerability of individuals with severe spinal cord injuries is inconceivable. The majority of SCI patients that are treated at our hospital have been severe cases, resulting in an inability to walk, confining them to a wheelchair for the remainder of their lives.  Our patients are young and the majority were previously extremely active in their family and community lives.   Many have lost mothers, fathers, brothers, sisters, and friends and seen their loved ones die in front of their eyes.  They were transported from one hospital to the next in isolation, not knowing if their families were alive, not knowing whether they would survive.  However, amongst all the challenges, the most remarkable thing about each and every one of our patients is that they are positive, strong minded, and wake up each morning determined to make the most of every day.

The long-term challenges are overwhelming but not insurmountable. Proper community reintegration is the ultimate goal for our patients. Accessible living and community based recreational facilities need to be built in order to allow these individuals a chance to be independent and self-sufficient. Consistent & continuous medical care is essential to ensure that specific health complications are properly treated. Proper assistive devices, rehabilitation equipment and vocational training are all essential needs. At St. Boniface, we are currently making these issues top priority and are committed to each and every one of our patients.

However, we cannot take on these challenges without the ongoing assistance and support of the international community. It is essential to our success. The Haitian community has been blessed by the generous post-disaster support from all around the world, which funded the initial life-saving interventions but continuous support for follow-up care and ongoing treatment for life-long impairments is urgently needed.  We are now six months post-earthquake and we continue to focus and work towards solving these chronic issues.  It is now time to build awareness, develop medical knowledge, build facilities and acquire equipment to manage these patients.

Spinal cord injury is a reality for many patients.  Our goal at St. Boniface Hospital is to help provide the resources necessary for spinal cord injury patients to live autonomous, productive, and meaningful lives.  The key rests in utilizing resources to assist in the transfer of knowledge and expertise to local Haitian staff to empower them to take care of their people and their country.