On Saturday, April 16, the news circled the planet: an earthquake measuring 7.8 on the Richter scale had struck the provinces of Esmeraldas and Manabí, killing over 650 people and causing incalculable material damages, as Dr. José Ernesto Betancourt Lavastida, National Director of Defense and Civil Defense at the Cuban Ministry of Public Health, told Granma International.
That very weekend, the 7th Congress of the Communist Party of Cuba was being held in Havana, and the revolutionary leadership of the island immediately decided to send medical aid. In less than eight hours, the 21st Brigade of the Henry Reeve International Contingent of Doctors Specialized in Disaster Situations and Large-Scale Epidemics was put together. The Henry Reeve International Contingent was created in 2005 and has undertaken efforts in over twenty countries to date.
Betancourt Lavastida, who led the group, added: “22 professionals were mobilized for medical attention, accompanied by 26 members of the Interior Ministry Fire Department’s Search and Rescue Command (including a dog handler), for a total of 52 compañeros. Once the search for survivors had concluded, the Cuban rescue workers returned to the homeland on Wednesday, April 26.
“In our group 11 doctors specializing in surgery, orthopedics, neurosurgery, anesthesiology, pediatrics, psychiatry, epidemiology, comprehensive general medicine, as well as nine nursing and two physical rehabilitation graduates, made the journey.
“We traveled from the José Martí International Airport to the military airbase of Manta, on a chartered Cubana de Aviación flight, which left at 9:00 pm on the 17th and arrived at approximately 2.00 a.m. on Monday, 18th. We were received by the Cuban Ambassador to Ecuador, Rafael Dausá Céspedes, who accompanied us to the medical brigade’s first destination.
“It’s worth noting the activities undertaken by the designated military commands, to direct the Emergency Operations Committees (COE) at the various levels, which, under the leadership of a senior government official, appointed by the President of the country, together with local authorities, organized the immediate response measures to the impact of the quake. The COEs established a 24-hour, seven days a week work regime, addressing all situations relating to the victims.
“On Monday morning we continued our journey to the city of Portoviejo, where the search and rescue personnel, dog handler, together with six of the nurses and two of the rehabilitation graduates were based; all of whom participated in the search for earthquake victims in this city.
A DEVASTATING SCENE
“The rest of the 15 members of the medical brigade headed for the city of Bahía de Caráquez and were based at the Ecuadoran National Penitentiary Training School, in the province of Manabí, in Cantón Sucre (municipality). This facility was being prepared to transform it into a territorial field hospital. The health units of the surrounding areas had totally or partially lost their response capacity, given the impact of the quake.
“We began working there on the afternoon of Monday 18th, cooperating with the deployment of 30 hospital beds, 10 for multifunctional emergency care (pre and postoperative), as well as a reception/classification area.
“We stayed in multiple rooms of 2, 3 and 7 beds. The food was supplied by the field hospital administration, which allowed us to provide cold rations for the compañeros providing care in the local communities.
“There was strong cooperation between Ecuadoran and Cuban professionals, we joined the municipal government’s evening meetings, where we received information regarding the identified care demand for the following day.
“On the evenings of Wednesday, 21st and Thursday, 22nd, we had the opportunity of receiving a visit from the President of Ecuador, who announced the decision reached with the Health Minister of Ecuador, Dr. Margarita Guevara, that our brigade move to the Health Center of the neighboring municipality of Jama on Saturday, April 23, where the whole group would work together, including the eight compañeros who had stayed behind in Portoviejo with the rescue workers.
“During the five days of efforts in the Bahía de Caráquez facility, our brigade evaluated 503 patients, 319 of whom were aged over 15. Six pregnant women were monitored and two physiological births were undertaken, with two healthy babies born. A total of 28 surgeries were performed and nursing procedures rose to 263. Nine community visits were also undertaken to settlements where residents had not received any medical attention.
“On Saturday, April 23, the group was reunited on the coastline of the Ecuadoran Pacific. We stayed at the Health Center, which belonged to the Jama-Pedernales District administration. The brigade reorganized here, the representatives of the Ecuadoran Health Ministry requested that we base two Basic Health Teams in mountainous communities, one in Cantón de Jama, in “La Mocora,” and the other in Cantón Pedernales in “Cheve Arriba.”
At both sites a team composed of a Comprehensive General Medicine specialist and two Nursing graduates was located, who would live and work there, providing care in remote health centers and visiting settlements in the area.
“They also requested that we base a specialist in Epidemiology and a Physical Rehabilitation and Physiotherapy graduate, directly subordinate to the Pedernales Health Center. At the Jama Health Center the remaining 13 members of the medical brigade worked from April 24 through June 15, to complete the 62 days of our stay in Ecuador.
“In this period, specialized consultations in pediatrics, psychiatry, surgery and orthopedics were organized, in addition to consultations and emergency care, 24 hours a day, together with Ecuadoran doctors.
“From this center, 105 visits to communities, refuges and shelters were undertaken, connecting the care offered across the territory with that offered at the Health Center. 10,443 consultations were performed, in both areas. Of this total, 6,872 were with patients over 15 years of age. The nursing graduates undertook a sustained increase in nursing procedures, reaching 16,484, of which 3,392 were curative.
“In the particular case of the Pediatrics specialist, he consulted an average of 20-25 cases every day. In total, 3,571 minors aged under 15 were treated, including those in the communities, to the great satisfaction of their parents and relatives.
“The psychiatrist attended cases at the Jama and Pedernales health centers, with a high number of patients with post-traumatic stress disorder, states of panic, and acute stress reactions, associated with the impact of the disaster, especially during the first month of work.
“It should be noted that 100% of patients with injuries due to the quake, who our surgical team cared for, completely recovered. The daily average number of cases increased from 25 during the first week to 42 from the third onwards, while operations increased from 12 per day the first week to 22 from the third. In total, 787 surgeries were performed, 647 on minors and 140 on adults.
“The epidemiologists provided advice on the creation of the Temporary Refuges and the Temporary Emergency Shelters, undertaking systematic visits during their creation and following the placing of survivors in them.
“In addition, Physiotherapy and Physical Rehabilitation treatment sessions were organized in the Jama and Pedernales health centers, from April 27, with two graduates in this field, who treated 844 patients who underwent 3,238 treatment sessions, with a total of 840 patients rehabilitated or with their condition notably improved.
“The epidemiological surveillance work and the anti-epidemic measures in the communities, refuges and shelters, were undertaken in conjunction with the Ecuadoran primary health care personnel, who were available 24 hours a day at these sites, while the State of Emergency lasted.”
ACCOMPANYING LOCAL AUTHORITIES AND IMPACT ON THE POPULATION
“The Henry Reeve Contingent in Ecuador was magnificently supported, both by Ecuadoran authorities at the central level, and at the district level, and in the Jama, La Mocora and Cheve Arriva health centers.
“The Ecuadoran military were responsible for the distribution of bottled water, industrially produced foodstuffs, tents and other cleaning and personal hygiene supplies, donated to the victims located in the so-called “Ground Zero,” most impacted by the quake. The equitable distribution of these supplies helped ensure no epidemics broke out.
“They also organized the “Temporary Emergency Refuges” in the first instance, and the “Temporary Emergency Shelters” in the second stage, including their administration, according to international humanitarian aid norms and best practices of coexistence and collective hygiene.
“A special mention must go to the Cuban Medical Mission in Ecuador, for their systematic and unconditional support, which allowed us to identify and understand the particularities of the Ecuadoran health system and helped us to organize our efforts with local and provincial authorities.
“Once again, the unconditional and solidary vocation of health workers and combatants of the Interior Ministry was demonstrated following a disaster in a sister nation. This also allowed us to evaluate experiences in response to an earthquake of great intensity, which may be applicable to our country given a high impact disaster such as this.”