Internally Displaced Persons Surveillance System, Haiti – post quake, 2010: Implementation and preliminary results

Background: The January 12, 2010, a 7.0 magnitude earthquake in Haiti displaced 2,000,000 people and created high risk for communicable disease due to overcrowded, unsanitary living conditions. Hundreds of non-governmental organizations (NGOs) established temporary clinics for the internally displaced persons (IDP). Given the need to detect potential outbreaks in IDP settlements, the Haitian Ministry of Public Health and Population (MSPP), Pan-American Health Organization (PAHO), and CDC implemented the Internally Displaced Persons Surveillance System (IDPSS), monitoring 19 conditions of outbreak potential in settlement clinics. Methods: MSPP, PAHO, and CDC engaged NGOs serving large settlements and providing long-term health services. The agencies worked to establish rapport with survivors, followed trends of reportable diagnoses among clinic visits, undertook epidemiologic investigations of disease clusters, and established an internet-based Google communication forum.

Results: As of April 24th, 33 sites on average reported weekly. Of 96,472 clinic visits, 23,183 (24.0%) were cases of reportable conditions; 9186 (39.6%) were among children <5 years of age. Of all clinic visits, the most common reportable conditions were acute respiratory infections (9.2%), suspected malaria (5.1%), and watery diarrhea (4.7%).

Conclusions: Implementing post-disaster emergency surveillance is possible even with a dynamic population served by multiple NGO partners, by focusing on diseases of greatest outbreak potential, providing timely feedback, and developing internet-based communication techniques. Survivors typically go through a stage of anger, which can hamper relief efforts if trust and credibility are not established. Frequent reports bolster trust, strengthen the credibility of disaster managers, and minimize resources spent following up rumors.