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Prehospital Characteristics in the North East Department of Haiti: A Cross-sectional Study from a Low-income Setting Without Prehospital Systems

Published online by Cambridge University Press:  12 May 2014

Adam R. Aluisio ,
Robert Gore ,
Isnelle Decome ,
Annelies De Wulf  and
Christina Bloem
Adam R. Aluisio*
Affiliation:
Department of Emergency Medicine, Division of International Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA
Robert Gore
Affiliation:
Department of Emergency Medicine, Division of International Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA
Isnelle Decome
Affiliation:
Fort Liberté Hospital, Fort Liberté, North East Department, Haiti
Annelies De Wulf
Affiliation:
Department of Emergency Medicine, Division of International Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA
Christina Bloem
Affiliation:
Department of Emergency Medicine, Division of International Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York USA
*
Correspondence: Adam R. Aluisio, MD, MSc Department of Emergency Medicine SUNY Downstate Medical Center 450 Clarkson Ave Brooklyn, NY 11203 USA E-mail [email protected]
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Abstract

Introduction

Although prehospital care is recognized as key in health systems development, it has been largely neglected in Haiti. The North East Department is one of the poorest areas of Haiti, and is a region where no data on out-of-hospital health care exists. This research assessed prehospital characteristics in the North East Department with the aim of providing baseline data to inform prehospital systems development.

Methods

In this observational study, data were collected from patients presenting at the Fort Liberté Hospital, the public regional referral health center in the North East Department. Data were accrued from April 2, 2012 through June 5, 2012. All patients accessing acute care at the hospital were eligible for enrollment. After obtaining consent, data on demographics, health needs, and prehospital information were gathered via a standardized questionnaire administered by hospital staff trained in study protocols.

Results

Data were collected from 441 patient visits. The median age was 24 years, with 62% of the population being female. Medical complaints comprised 75% of visits, with fever and gastrointestinal complaints being the most common reasons for presentation. Traumatic injuries accounted for 25% of encounters, with an equal distribution of blunt and penetrating events. Extremity injuries were the most common traumatic subclassification. The majority of patients (67.2%) were transported by motorcycle taxi and paid transport fees. Trauma patients were more likely to be transported without charge (OR = 9.10; 95% CI, 2.19-37.76; P < .001). Medical patients were most commonly brought from home (78.5%) and trauma patients from a road/street setting (42.9%). Median time to presentation was 240 minutes (IQR = 120-500) and 65 minutes (IQR = 30-150) for medical and trauma complaints, respectively (P < .001). Eleven percent of patients reported receiving care prior to arrival. As compared with medical patients, trauma victims were less likely to have received prehospital care.

Conclusions

Assessing prehospital care in this low-income setting that lacks surveillance systems was feasible and required minimal resources. Motorcycle taxi drivers function as the primary emergency transport mechanism and may represent an access point for prehospital interventions in the North East Department of Haiti. Out-of-hospital care is nearly nonexistent in the region and its development has the potential to yield public health benefits.

AluisioAR, GoreR, DecomeI, De WulfA, BloemC. Prehospital Characteristics in the North East Department of Haiti: A Cross-sectional Study from a Low-income Setting Without Prehospital Systems. Prehosp Disaster Med. 2014;29(3):1-7.

Keywords

emergency careHaitiprehospital care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 3 , June 2014 , pp. 230 - 236
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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