Perspectives on Haiti Two Years after the Earthquake

at 4:53 pm the earth shook, and at latitude 19° 00′ N, longitude 72° 25′ W, a Caribbean island lying between the Caribbean Sea and the North Atlantic Ocean was struck by a 7.0 magnitude quake. When the earth settled, Haiti ranked 145th of 169 countries in the United Nations Human Development Index, the lowest in the Western Hemisphere; much of its capital, Port au Prince, was reduced to rubble and debris. It is estimated that 220,500 persons died, 500,000 were left homeless, and at its peak 2.3 million were displaced, including > 300,000 children. 1, 2 Before the earthquake, Haiti had more than 70% of its people living on < $2 per day; 86% of the people in Port au Prince were living in slum conditions, mostly tightly-packed, poorly-built, concrete buildings. Half of the people in Port-au-Prince had no access to latrines and only one-third had access to tap water. After the quake there was an estimated 19 million cubic meters of rubble and debris in Port au Prince. In the wake of the earthquake, governments, non-governmental organizations, medical relief organizations, and individual practitioners mobilized to provide assistance. The many reports and perspectives of the experiences in Haiti are too numerous to cite. On the first anniversary of the quake, a perspective piece in the New England Journal of Medicine devoted to Haiti noted the progress made in public health during the past year, but also the challenges that remained following the unprecedented disaster. 3 Among the challenges to public health during that first year was a cholera epidemic that was declared in Haiti on October 20, 2010. The public health issues and lessons learned from the response to the cholera epidemic in Haiti are the subject of a " Theme Issue on Cholera in Haiti " in the November 2011 issue of Emerging Infectious Diseases. 4 This issue of the American Journal of Tropical Medicine and Hygiene , published 2 years after the earthquake, contains a special section on Haiti that highlights some of the varied and ongoing activities related to the response to the disaster. The section includes eight articles that fall into three broad groups: 1) perspectives based on clinical care delivery in Haiti, 2) findings from surveillance activities in or related to travel to Haiti, and 3) reports of ill persons identified in the United States after travel to Haiti. CLINICAL CARE PERSPECTIVES Three articles …