In a January 18 report on the society's Web site (www.isn-online.org), RDRTF Chairman Raymond Vanholder, MD, PhD, summed what task force members encountered in Port-au-Prince this way:
“The situation with which our team is faced is dramatic. Most wounded people are lying in the streets without care, although the situation is improving (or rather is not as bad as at the beginning). All local hospitals are overcrowded. There is a shortage of all kinds of medical material including drugs, as well as of water and electricity.”
The RDRTF team observed a 5% mortality rate among patients treated for acute kidney injury, Dr. Vanholder told Renal & Urology News. Some 35% of patients were lost to follow-up because they disappeared a day after being delivered to their hospital wards, he said, noting that nursing surveillance was absent during the night because of major safety issues. If it is assumed that these patients also died, the overall mortality rate would be 40%, “which is exceptionally high but circumstances were extremely bad,” said Dr. Vanholder, Professor of Medicine at the University of Ghent in Belgium. “We were also delayed in starting dialysis by a massive amount of logistic hurdles.”
The RDRTF announced that it would be ending its renal intervention in Haiti on February 27, noting that activities in the dialysis unit in Port-au-Prince remain stable and that its main task is to treat acute kidney injury.
Large dialysis providers also did their part. For example, Fresenius Medical Care supplied the USNS Comfort with dialyzers, blood lines and the “consumables” that would allow personnel to restock the vessel, and made a dialysis technician available on the ship to service its dialysis machines, said Babajide Salako, MD, Director of Global Pandemic Response Operations for Fresenius Medical Care North America.
With earthquakes, Dr. Salako explained, the success of relief efforts depends heavily on the extent of pre-existing facilities in the devastated area. From a renal standpoint, places to dialyze patients, the availability of personnel to look after patients, and the availability of diagnostic tools are the most important considerations.
“As in all disaster response, team work is very important, thus our very successful collaboration with the ASN and KCER enabled us, upon their request, to donate and deliver over 10,000 pounds of acute dialysis supplies to Prof. Vanholder's team through the Dominican Republic a week after the earthquake,” Dr. Salako said.
Gambro said it is working with the Dominican Republic's Ministry of Health and its nephrology society to establish a temporary dialysis clinic in Jimani. Gambo is donating five portable water treatment systems along with dialyzers, bloodlines, concentrates, and blood access products, according to a company press release. The clinic, which is expected to run for four to five months, will treat an estimated 15 to 20 patients suffering from trauma or crush injuries.