After the earthquake

Lack of infrastructure keeps knocking Haiti down again. Robert Millett meets a physio who’s spent six months training local rehab teams

Half a million people were killed or injured by the devastating earthquake that struck Haiti in January 2010. With many of the 300,000 injured still needing treatment, the country was struggling to recover when cholera broke out later that year.

Heavily dependant on external support, Haiti lacks a viable health service. To build self-sufficiency in the long term, it needs to produce competent home-grown clinicians.

But there are few training opportunities. There are only a dozen or so trained Haitian physiotherapists in the country.

Before the earthquake hit, adequate clinical training was only accessible in countries like Cuba (which has for a long time run clinics and health services in Haiti) and the Dominican Republic. In the aftermath, many Cuba-trained health professionals returned to Haiti and clinicians worldwide offered their services.

Ruth Cross, a grade seven physiotherapist from Boston Spa, has witnessed the urgent need for trained physiotherapists in Haiti.

Following an appeal in Frontline (28 January 2010), Ruth offered her services to the Christian Blind Mission and travelled to Haiti in July. Working at Diquini Hospital, in the devastated capital Port-au-Prince, she set up a physio department with a team of six rehab technicians who could operate without expat support. ‘That was my basic remit for the next six months — to train them as much as you can in that time,’ says Ruth.

The team included one who had trained as a physio, three with experience as rehab technicians and two who had previously worked as translators for visiting therapists. They all spoke excellent English, and Ruth is fluent in French, so language was never a barrier. But many patients spoke neither French nor English.

‘In Haiti a lot of people speak and understand French but only about 15 per cent of the population actually use French — they mostly speak Creole,’ explains Ruth. This means that the Haitian trainees (rather than any visiting therapists) are always central in carrying out rehabilitation.     

Combating cholera

Echoes of the earthquake were evident in the types of injuries the team encountered.  ‘There were a lot of fractures and nerve injuries, a lot of hand and crush injuries and some spinal-cord injuries and some amputations as well,’ says Ruth.

Then came a cholera outbreak in November 2010, killing more than 2000 people. When the epidemic began, Ruth organised an educational presentation for the staff. She also travelled with the team to one member’s hometown of Kenscoff, where they gave lectures in churches about cholera. This allowed them to give local people information about signs, symptoms and treatment (including a rehydration recipe), highlight the importance of hand washing and give out bleach so people could keep everything clean.     

Building the future

When Ruth flew home, she left a team capable of running a small physio department. But across the country the picture remains bleak, with training facilities and educational rehab resources severely lacking.

‘There’s a lot of talk about providing training for therapists in Haiti and I would like to be part of that,’ says Ruth. She hopes to help donate items like stethoscopes and a skeleton orbooks.  ‘Someone with multi-pathology needs more rehabilitation, for much longer — and that’s Haiti,’ says Ruth. ‘There are lots of things going on in the world but let’s not forget them. Let’s do something worthwhile that makes a difference.’fl

How you can help

Ruth Cross is setting up a trust fund to raise funds that will facilitate future training for Haitian therapists. For further details, please contact Ruth Cross at:


Robert Millett

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