title: An organized, comprehensive, and security-enabled strategic response to the Haiti earthquake: a description of pre-deployment readiness preparation and preliminary experience from an academic anesthesiology department with no preexisting international disaster response program.
abstract: BACKGROUND
  On Tuesday, January 12, 2010 at 16:53 local time, a magnitude 7.0 M(w) earthquake struck Haiti. The global humanitarian attempt to respond was swift, but poor infrastructure and emergency preparedness limited many efforts. Rapid, successful deployment of emergency medical care teams was accomplished by organizations with experience in mass disaster casualty response. Well-intentioned, but unprepared, medical teams also responded. In this report, we describe the preparation and planning process used at an academic university department of anesthesiology with no preexisting international disaster response program, after a call from an American-based nongovernmental organization operating in Haiti requested medical support. The focus of this article is the pre-deployment readiness process, and is not a post-deployment report describing the medical care provided in Haiti.
  
  
  METHODS
  A real-time qualitative assessment and systematic review of the Hospital of the University of Pennsylvania's communications and actions relevant to the Haiti earthquake were performed. Team meetings, conference calls, and electronic mail communication pertaining to planning, decision support, equipment procurement, and actions and steps up to the day of deployment were reviewed and abstracted. Timing of key events was compiled and a response timeline for this process was developed. Interviews with returning anesthesiology members were conducted.
  
  
  RESULTS
  Four days after the Haiti earthquake, Partners in Health, a nonprofit, nongovernmental organization based in Boston, Massachusetts, with >20 years of experience providing medical care in Haiti contacted the University of Pennsylvania Health System to request medical team support. The departments of anesthesiology, surgery, orthopedics, and nursing responded to this request with a volunteer selection process, vaccination program, and systematic development of equipment lists. World Health Organization and Centers for Disease Control guidelines, the American Society of Anesthesiology Committee on Trauma and Emergency Preparedness, published articles, and in-country contacts were used to guide the preparatory process.
  
  
  CONCLUSIONS
  An organized strategic response to medical needs after an international natural disaster emergency can be accomplished safely and effectively within 6 to 12 days by an academic anesthesiology department, with medical system support, in a center with no previously established response system. The value and timeliness of this response will be determined with further study. Institutions with limited experience in putting an emergency medical team into the field may be able to quickly do so when such efforts are executed in a systematic manner in coordination with a health care organization that already has support infrastructure at the site of the disaster.
authors.affiliation: Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, 3400 Spruce St., Philadelphia, PA 19104, USA. mccunnm@uphs.upenn.edu
authors.forename: Maureen
authors.initials: M
authors.lastname: McCunn
authors.forename: Michael A
authors.initials: MA
authors.lastname: Ashburn
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Floyd
authors.forename: C William
authors.initials: CW
authors.lastname: Schwab
authors.forename: Paul
authors.initials: P
authors.lastname: Harrington
authors.forename: C William
authors.initials: CW
authors.lastname: Hanson
authors.forename: Babak
authors.initials: B
authors.lastname: Sarani
authors.forename: Samir
authors.initials: S
authors.lastname: Mehta
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Speck
authors.forename: Lee A
authors.initials: LA
authors.lastname: Fleisher
mesh_terms: D000533:Altruism; D000761:Anesthesia Department, Hospital / Q000458:organization & administration*; D002959:Civil Defense / Q000458:organization & administration*; D003299:Cooperative Behavior; D004189:Disaster Planning / Q000458:organization & administration*; D055866:Earthquakes; D017598:Efficiency, Organizational; D004632:Emergency Medical Services / Q000458:organization & administration*; D004864:Equipment and Supplies / Q000600:supply & distribution; D017408:Guidelines as Topic; D006205:Haiti; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D054527:Mass Casualty Incidents; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration*; D010414:Pennsylvania; D010560:Personnel Selection / Q000458:organization & administration; D015397:Program Evaluation; D013685:Telecommunications / Q000458:organization & administration; D013997:Time Factors; D013996:Time and Motion Studies; D014838:Volunteers / Q000458:organization & administration