ACSC public health course brings Haiti crisis into focus

Published Feb. 1, 2010
By Kimberly L. Wright
Air University Public Affairs

MAXWELL AIR FORCE BASE, Ala. -- The crisis situation in earthquake-stricken Haiti has captured the attention and concern of the world, bringing a massive humanitarian response from the U.S., both from the military and other organizations and individuals. A group of Air Command and Staff College students has also been keeping track of the disaster response as part of their coursework.

The course, Public Health from Zero - Establishing Community-level Public Systems in Troubled Spots, has drawn upon the enormous catastrophe in Haiti as a way to make the course's concepts come into clearer focus. Students are made cognizant of complex issues one must face when responding to public health needs in a country that, not only has been shattered by a natural disaster, but had minimal resources before the quake.

"Mother Nature presented us with a catastrophe the day before the class' first meeting," said instructor Dr. John C. Kelliher. The students spent the first day of class brainstorming the disaster response issues. "Frankly, I think our students could have staffed that response," said Dr. Kelliher.

Dr. Kelliher, a former state public health veterinarian who was an Army major and helicopter pilot in Vietnam, is teaching the course alongside Auburn University College of Veterinary Medicine faculty members Dr. Kenneth E. Nusbaum and Dr. James Wright. "We are honored to teach at ACSC and awed by the combined experience of these nine majors," said Dr. Kelliher.

The course is designed to provide public health resource options for military officers working with communities in troubled nations. According to the course's instructors, the course explores citizen-driven development of public health system components using the skills and resources of the U.S. armed forces. Basic health needs (food, water, waste disposal) are being discussed, along with the critical role of animal health in developing nations.

This seminar was designed to allow students to explore the complexity of establishing public health infrastructure and systems in minimal-resource environments.

The students came from the Air Force, Navy and Air Force Reserve, and included nurses, communications officers, logisticians, a JAG officer and a tanker pilot.
Maj. Adam Shirriff said he was intrigued by the course when he saw it listed on the ACSC curriculum. "There's an emphasis on stabilization efforts in our operations, and public health feeds into that," he said. He said he has enjoyed the class so far. "It's great to be exposed to different topics you take for granted, which are important when you help communities and are very applicable to today's current operation," he noted.

For the second meeting of the class, the students, who divided into groups of three, made presentations on several key areas of the disaster response, including infrastructure, security, water and transportation. A naval nurse, Lt. Cmdr. Bobby Hurt, gave a detailed presentation on the USNS Comfort, a state-of-the art, large, floating 1,000 bed trauma center and one of two hospital ships in the U.S. military, the only armed forces in the world to have hospital ships. The Comfort, which can only be deployed by direct order of the president, provided support during Operation Desert Storm in 1991, Operation Noble Eagle in response to the 9/11 terrorist attacks, Iraq in 2003, and the Katrina response in 2005.

Another nurse gave a listing of the various desease-causing agents and other medical issues that survivors and volunteers face. The poverty of the island nation only complicates the disaster recovery. "For instance, they will be facing public health risks associated with crowding such as measles, meningitis, HIV and pandemic H1N1," said Maj. Ada Collier. Measles, diphtheria, tetanus and polio outbreaks are also possible, as only 53 percent of the Haiti population get routine vaccinations, compared with more than 90 percent of the U.S. population.

The lack of proper medical equipment for the medical crews there has caused a great deal of medical improvisation, said Dr. Nussbaum.

Commander Hurt said relief personnel are providing valuable services despite the risks. "You just go with your humanity, do the best you can and try to protect yourself," he said.

Other critical needs addressed by the students include infrastructure, the availability of water and security. Maj. Jeffery Paget said clean water, an essential need for survival, is a critical issue because the price of water in Haiti is currently estimated at $6 a bottle, three times the average daily wage. "Even before the quake clean water was really hard to come by," Major Paget said.

Aerial delivery, desalination kits and relocating people out of the stricken capital, Port-au-Prince, were listed as three ways to address this need. Security is critical at the port, hospitals, convoys, food distribution points, camps, orphanages and other public places, said Maj. Taralynn Olayvar. Any U.S. or international troops providing security should be complemented by what remains of the Haiti police force, said Major Olayvar.

Maj. James Hewitt reported that the infrastructure of Port-au-Prince remains challenging, though the U.S. Air Force has taken control of the airport to help increase its efficiency. The airport is bringing down 200 planes a day. Roads are wrecked, and the port has been made unusable due to debris in the water and loss of offloading equipment.

The discussions even turned to the problems arising with the dead bodies of those killed in the disaster. Students emphasized that even though tens of thousands of bodies need to be buried, they must still be treated with care for the comfort of the grieving families.

Major Paget noted that one quote he heard from someone on scene resonated with him: "I have to take chaos and make it manageable."

The instructors were impressed by the thoughtful way students approached the disaster response. "I think we reinforced many of the ideas we discussed last week," said Dr. Kelliher. "The enormity of the challenge is clear to all of us and all of America."