First, thank you to all of you who contributed to the HTF/Team Ange effort.  Many of you indicated that you had already contributed in the days after the earthquake to various Haiti relief charities, but made an additional contribution to HTF/Team Ange to support their efforts in Jacmel, Haiti in response to my email.  Your support is greatly appreciated.  There is still a lot of work to be done in Haiti, but we were able to do some good.

Mission Summary:

1. •Delivered approximately 1,000 lbs of supplies collected by Angel Flight East for the Team Ange clinic/hospital in Jacmel, Haiti.
   

2. •Flew a total of 16 sorties between the Dominican Republic and Jacmel, Haiti, delivering 19 doctors, nurses and aid workers, and an additional 5,000 lbs of supplies.
   

3. •Brought 11 doctors, nurses and aid workers out of Jacmel, Haiti.
   

4. •6 aircraft.  Over 10,000 combined nautical miles flown.
   

Photos and Videos:

1. •Short video taken by one of the Team Ange organizers.  Gives a good sense of the conditions on the ground.
   

2. •Photos of Jacmel
   

3. •Photos from our mission
   

Background:

We all know a little bit about the plight in Haiti.  Rocked by political turmoil for decades, Haiti is by far the poorest country in the western hemisphere.  According to the CIA World Fact Book, fully 80% of the 9 million Haitians live under the poverty line.  Its GDP was a little over $11.5 billion (or barely “real money” by Senator Dirksen’s standards) at purchasing power parity, or about $1,300 per capita—roughly $3.50 per person per day.  By this measure, Haiti is the 25th poorest country in the world out of the 228 listed in the CIA World Fact Book.  It also suffers from extreme inequality, with a Gini coefficient of 59.2, making it the 8th most unequal country in the world.  It’s economy is deeply dependent on foreign aid—remittances from abroad account for an astonishing 25% of GDP (bigger than receipts from exports).

Haiti has suffered often extreme political violence for much of its history.  However, with the appointment of Michele Pierre-Louis to the Prime Ministership, and the appointment of Bill Clinton as the UN Special Envoy to Haiti, things were just starting to look promising.  It is in this context that the magnitude 7.0 earthquake struck on January 12, 2010.

About Jacmel, Haiti:

Jacmel, Haiti is a city of about 40,000 inhabitants located roughly 35 miles southwest of Port-au-Prince.  Despite this proximity, it is physically isolated from Port-au-Prince by a mountain range with 7,000-8,000 ft peaks which makes transport arduous in the best of times.  Thus the city has largely been left to fend for itself.  As in Port-au-Prince, many buildings in Jacmel, including the main hospital, collapsed in the quake.

I was astonished to be told that many of the buildings in Haiti were built from cinder block without any reinforcing columns, tie beams or even rebar.  For the most part, they were simply held together by mortar in the seams.  So it is not particularly surprising that many buildings came down in the earthquake.  A month since the disaster, the streets and some of the wreckage has been cleared up.  At this point, there are very few trauma cases resulting from the earthquake.  However, the people in cities like Jacmel are living in tent cities—afraid to live in concrete buildings even if their house was spared destruction.  With an estimated 600,000 displaced in Haiti, tent cities are popping up in town squares, ball fields and parks.  People are living under these conditions often without proper access to clean water and even basic hygiene  To compound matters, the rainy season is coming in a few short weeks, and there is concern about an impending medical crisis.

Team Ange (Ceole for Angel) from the Doctors United for Haiti (www.dufh.org), and the Hatian Timoun Foundation has established a base of operations in Jacmel, quickly setting up a clinic/field-hospital nearby.  They have committed to providing three months of free post-earthquake healthcare to the people of Jacmel and surrounding communities.  The services the clinic provides in many cases exceed any care these people have previously received in their lives.  As a result, literally hundreds of people show up on a daily basis with medical needs ranging from untreated cancers, to ob/gyn issues (including deliveries), to improperly healed fractures, to infections, and other diseases.  (In Haiti, Malaria is a common problem.  One suspects that given the post-earthquake living conditions, diseases like dysentery will be as well.)  The purpose of our mission was to bring in personnel and supplies for the clinic, as well as transport out going personnel.

The Mission:

Phase One: Deliver supplies donated to Angel Flight East to Jacmel, Haiti.  We basically stuffed as much cargo into our Cessnas as they would carry, and flew down the coast stopping in North Carolina (KSUT), Florida (Fort Lauderdale, KFXE), the Bahamas (Stella Maris, MYLS) and Santo Domingo (El Higuero, MDJB) to refuel and pick up gear (like life rafts).  Along the way we were surprised by the generosity we encountered—from the fellow pilot Steve and his wife who put us up for the night and fed us exceedingly well in NC, to the breakfast place near KSUT that gave us free breakfast upon hearing of our mission, to the FBOs who extended “Haiti relief fuel rates.” The two aircraft carried a total of about 1,000 lbs of supplies—everything from generators, to fluids, to surgical equipment, to plush toys for the kids—destined for the Team Ange Hospital in Jacmel Haiti.

Phase Two: Transport personnel and supplies arriving in the Dominican Republic to Jacmel, Haiti.  While we were there, commercial flights were not yet available to Haiti.  (As of the last week of February, limited commercial service to Port-au-Prince has resumed.)  As such, all civilian volunteers were being routed through the Dominican Republic. The geography of Hispaniola (with 5,000-10,000 foot mountain ranges separating Haiti and the Dominican Republic) made transport by small aircraft the most effective method of transporting personnel and supplies in and out of Haiti for the time being.

Much of Friday the 19th and Saturday the 20th were spent ferrying medical personnel and supplies in from El Higuero airport on the outskirts of Santo Domingo, DR. to Jacmel Airport in Haiti.  In total, we made 10 flights using 4 different aircraft—the 2 of ours from NJ, and 2 more that just “showed up”.  One pilot, Glenn, who was supposed to be vacationing in Jamaica heeded our urgent call for more pilots and planes by showing up with his Mooney.  Over two days, we transported 11 personnel in, 11 out, and brought an additional 3,000 lbs of material in.  (To give you a sense of the situation in Haiti, three aid workers from the DR had been waiting for three days in Jacmel to get a ride out.)

The logistics involved were often challenging.  Clearly, the infrastructure at El Higuero “International” Airport was stretched to the limit—traffic volume no doubt increased many fold from typical levels.  The staff there had to contend with not only crazy Americans (like us), but Germans, Japanese, Swiss, Israeli (to name just a few we encountered while we were there), non of whom spoke much Spanish to the consternation of the locals.  The staff—ground personnel, customs and immigration—were often unmotivated, and clearly showing signs of “donor fatigue”. Add to that the usual bureaucratic hurdles—such as the requirement that the “Pilot in Command” (I guess that’s me) file flight manifests for each trip (by paper, in triplicate, without copiers)—the challenges of flying in an unfamiliar air traffic control system, dealing with controllers whose native language was not English, and the magnificent but harsh terrain we had to fly around.  And of course, ATC in Haiti was at best, spotty. This was by far some of the most challenging flying I’ve done.  Oddly enough, the island of efficiency in this sea of seeming chaos was Jacmel Airport.  A lone strip tucked between the sea and the mountains, it was run by the Canadian military who had set up a “tower” in the half completed terminal building.  The “tower” consisted of two officers sitting at a folding table with laptops and a table top radio.  Nevertheless, they got the job done with extreme professionalism.

A big part of Saturday’s flights were a surgical team from Kansas City.  The team of 6 brought 2,000 lbs of supplies which the staff were donating to the clinic. No checked baggage fees here—the airlines are waiving their extra baggage fees for rescue workers. (Nice to know that the majors can still do something right.) If you think about it, a surgeon without her gear is basically a tourist, so it was critical that we get all the gear in to Jacmel.  It took us all day to do it, but we did.  That, in spite of refueling stops that took over an hour (in the states it would take 10 minutes), and in the case of my plane an oil change that took 3 hours (again, it should have been done in about 45 minutes)—such is the pace of life in the Dominican Republic.  One of the surgeons we delivered to Jacmel in the first flight had performed an emergency appendectomy by the end of the day—that news certainly made our day.

Sunday’s mission was to pick up a team of 8 arriving from Virginia, with another 1,400 lbs of equipment in Santiago (MDST) and deliver them to Jacmel.  The arrival of three additional aircraft (including the aforementioned Mooney belonging to Glenn) helped tremendously in this effort.

One final story. We picked up a “hitch-hiker” out of Jacmel—a Canadian aid worker who had to get back to his wife who had gotten ill.  He flew with us to Florida where he picked up a commercial flight.  He was an electrician by trade.  He had volunteered when he was told that his skills as an electrician would be needed to set up the makeshift clinic.  Instead, he spent the better part of two weeks being a field nurse—inserting IVs, dressing wounds, and generally caring for the patients.  He sported impressive facial hair—and I asked if it was not uncomfortable in the warm weather.  He replied that he was told not to shave—that given the quality of the water there a cut while shaving could lead to an infection.  Such are the conditions there.

Totals: 19 people in, 11 people out, over 6,000 lbs of supplies and equipment in.  6 aircraft, 16 sorties, over 10,000 combined nautical miles flown.  I think we did some good.

(Separately, if you are interested in a pilot’s perspective intended primarily for other pilot’s and people interested in flying, I have a separate write up here.)

Some observations and prognosis:

There is definitely a sort of “aid bubble” forming in Jacmel, as I suspect in other parts of Haiti as well.  When we landed, we were met by a rather official looking woman in a nice crisp uniform (which was in itself unusual enough).  She offered some assistance in filling out various forms (which were entirely superfluous given the conditions), but her primary purpose was to collect a $22 (US) landing fee.  (That’s pretty high even by U.S. standards, and was probably a week’s wage down there.)  We didn’t object too vocally, since this level of petty graft at the local level seems to be the cost of doing business in such an impoverished country, and in any case this seemed like a way (however inefficient) to get hard currency into the local economy and get it going again.

Also, there were a dozen or so men milling about the airport, ready to help us unload our aircraft.  No doubt they were hired by the NGOs to help around the airport, and keep an eye on the incoming supplies.  Again, not a bad way to generate some employment, and inject some cash into the economy.

That said, the traffic into Jacmel has already slowed considerably from its peak, and one suspects will decline dramatically as commercial flights into Port-au-Prince resumes, and the core infrastructure is restored.  One wonders what will happen to the economy (both of graft and honest employment) that has been built up around the current relief efforts. We know that the key to managing a bubble is to attempt to engineer a “soft landing” when the bubble inevitably bursts.  This means that in the next few months, we need to continue to pump “relief” money into the local economy, and not allow a precipitous drop.  So, even though many of you have been so generous, I urge you to continue to do what you can.

That said, I urge you to give mostly to “mainline” charities (e.g. UNICEF, American Red Cross, Americares, Save the Children, Doctors Without Borers, Partners in Health, Water Missions International, Habitat for Humanity International, etc. just to name a few), or charities that provide a unique service (such as those NGOs with a lot of local knowledge, or operate in areas not reached by these major charities—such as DUTF/Team Ange/HTF, Hope for Haiti, Haitian Health Foundation, etc.). There is an estimated 10,000 NGOs currently operating in Haiti. That is an astonishing number—one NGO for every 900 Haitians.  (The only other country with that many NGOs is India, and they have a slightly larger population.)  All of these NGOs and their aid workers clearly mean well.  But there is also clearly a lot of duplicated effort and unnecessary overhead.

The prognosis for Haiti is pretty grim.  Coming from a earthquake-prone country, I have a pretty good idea of what is involved in the recovery phase.  For example, after the Kobe earthquake, it took a good few years before the scars of the earthquake were completely erased from that city, and 7 or 8 years before the last person moved out of “temporary post-disaster” housing.  This in the second richest country in the world, with pretty effective government at all levels.  Sichuan, China (another country with a reasonably effective government) is still rebuilding after its earthquake in 2008 with a long ways still to go.

The already fragile infrastructure in Haiti is being stressed to the limit.  In a country of less than 10 million, there is now an estimated 300,000 dead and 600,000 displaced population.  The trauma emergency is largely over—those who needed urgent trauma care either got it, or have passed away.  But now there is an impending medical crisis.  Haiti is a malarial climate to begin with.  But now with a large population living in tent cities with minimal sanitation, infections and communicable diseases like dysentery is a concern.  And, the rainy season is rapidly approaching, followed a few months later by hurricane season, which will only make matters worse.  So, Haiti may be faced with a second crisis over the next few months.

One imagines that the recovery and reconstruction in Haiti will be a decade long affair.  If we really care about doing something for these people, we have to be thinking in those terms.  We have to continue to give 6 months, 12 months, 2, 3 years down the road.

Thank you again to all those who contributed to HTF/Team Ange.