Aftershock

My experiences in Haiti began shortly after the earthquake in 2010. Available medical staff struggled to keep pace with the volume of casualties needing care. Much of the treatment came from volunteers, who often were poorly equipped.

Because a large amount of the medical care was provided on an emergency basis, and without proper equipment or experience, frequently the treatment of choice was amputation. The result of this strategy is a country with an abundance of amputees, often unsupplied with needed prosthetics.

One of the many volunteer groups that responded and quickly sent facilities (in the form of a hospital ship), as well as volunteers and equipment, was Project Hope. Project Hope managed to secure a number of modular prosthetic labs that needed to be installed, but these facilities required sufficient infrastructure. In addition, Project Hope had to understand which organizations it should support because it had only enough infrastructure to maintain the systems it was given.

So, Project Hope recruited a team of volunteers to analyze various healthcare facilities throughout the country. The team consisted of architects, engineers, and a biomedical engineer. I was one of the engineers who volunteered for this mission.

That first mission started in the mountains of the island, beyond the big cities, where the devastation was relatively less severe. Eventually, though, we found our way back to the raw, oozing wound that was (and is) Port au Prince. What I saw in all of these places moved me such that I could not return from that first trip, could not leave those people, without promising them and promising myself that I would come back and do what little I could to help them.

Over the next several months, I contacted and met with various UN officials, as well as Haitian government officials. Reaching the Haitian officials was more difficult, as most government facilities had collapsed and the officials, who were struggling before the earthquake, became even more powerless.

Over the last year, I have worked with the Haitian government on a mostly collapsed tuberculosis hospital; with Europeans on a hospital that, due to government rules that patients could not be charged in the aftermath of the earthquake, was subsequently forced to shut down operations and convert into an orphanage; and with a hospital on the North Coast of the island, where I led a team of volunteers armed with hundreds of thousands of dollars of donated equipment to completely replace the electrical distribution for the system, radically improving their ability to support caregivers and the reliability of services. We are currently providing pro bono design services for a new emergency department/ICU in Hinche, the site of the recent cholera outbreak on the island.

When I first entered Haiti, I had considered myself an expert in the area of green buildings, and, especially, green healthcare buildings. Like many in the West, I fancied that I knew a lot about what it meant to create a sustainable set of solutions for a healthcare organization. When I thought about where, outside the United States, I might learn more lessons about green healthcare buildings, I thought of Europe, where many of us have made a tour through hospitals that are doing some remarkable things.

What I found in Haiti (and, later, in China and India, as well as in Central America and Africa) was that while we can learn a lot about how to better develop sophisticated green solutions, like those in Europe, we can learn more about how to make our buildings greener through simplicity and moving with the rhythms of nature. Following are some of things I have learned.

Primacy of engineering for water and power systems over all other concerns