Nov 16 2015

AYITI (HAITI) AIR AMBULANCE Americans and Haitians Blend to Mend Posted 9 years 43 days ago ago by Admin

 

HAITI

That simple, short two-syllable word immediately brings to mind another two-syllable word—EARTHQUAKE. However, the ramifications and repercussions from that tragic event were not short and simple. Even today, more than five years after the 7.0 MW catastrophic quake ruptured rocks—and lives— the reverberations continue.

Yet, it would be another tragedy to still see Haiti through the images of misery and mayhem that flooded the news media those years ago. For out of that rubble and ruin, forces arose more powerful than past casualties and chaos. Those forces: restored lives and hope. Yes, Haiti is still the poorest country in the Western Hemisphere with many problems to solve. However, its proud people are anything but poor in spirit. They are determined to climb to new heights—in new ways.

One new way they are reaching those heights is through Ayiti Air Anbilans (Haiti Air Ambulance), a nonprofit organization that arose out of the 2010 rubble. In North America helicopter air ambulance is often taken for granted. In Haiti on the island of Hispaniola, it is seen as something to fight for and cherish.

HELL UNLEASHED

The Caribbean tectonic plate creeps eastwards about 0.79 inches a year in relation to the North American plate. Separating these two opposing siblings are numerous fault zones, including one with a peaceful sounding name: the Enriquillo–Plantain Garden. For 250 years it was indeed peacefully locked. But it was continually building up pressure year after year … after year. Then on Tuesday, 12 Jan. 2010 at 4:53 p.m., a subterranean key was suddenly inserted about 16 miles WSW of the capital city of Port-au-Prince … and all hell was unleashed on Haiti.

The death toll was estimated around 200,000, although we may never know exactly how many lost their life. Morgues were overwhelmed with tens of thousands of corpses as mass graves were opened to receive the dead. For survivors fortunate to be alive, life was far from fortunate. An estimated 3 million people were affected. The Haitian government estimated that 250,000 residences and commercial buildings either collapsed or were severely damaged. No place was spared because of its stature or importance: the Presidential Palace, the National Assembly building, Port-au-Prince Cathedral, all were either severely damaged or destroyed. Even the United Nations Stabilization Mission betrayed its name and collapsed, killing many.

The entire infrastructure, urgently needed to provide relief, lay in ruins in the quake’s wake. Transportation facilities, communications, and all hospitals in Port-au-Prince’s metropolitan area ceased to function. For weeks survivors spent their nights outdoors, fearful to go inside lest aftershocks drop what was left of their homes upon their heads.

ANGELS TO THE RESCUE

While it seemed to some that God had forsaken Haiti, in truth He had many angels flying to the rescue. Two were named Patrick Dolan and Rymann Winter, willing to do what they could to alleviate the suffering they were seeing on their screens in the U.S. Their wings were more conventional than the white-feathered imaginations of artists; they were fixed-wings filled with supplies. Once in Haiti, they piloted doctors, nurses, and relief workers to where they were most needed.

Another curiosity about these two angels is that although they were certainly on the same side of goodness and mercy, they did not know each other before their missions and never met while in Haiti. Still, they returned to their separate homes with a shared determination that something more must be done.

Both had seen that Haiti-based medical air transport was critically needed. Winter, the president of a flight school in Los Angeles (the City of Angels) attempted to start a nonprofit foundation, yet kept running into roadblocks. Dolan, the president of a metropolitan New York City cable news operation, picked up Winter’s internet tracks when he typed “air ambulance Haiti” into a search engine. The two angels were about to meet.

FROM NAPKIN TO NONPROFIT

Dolan and Winter got together in 2012 and quickly realized that their ideas were not only on the same page; they were on the same napkin—the document they used to draw up their initial vision for what would become Ayiti Air Anbilans. Of course, much more complex and detailed documents and endeavors followed, such as feasibility studies and filings that obtained the nonprofit organization’s tax-exempt 501(c)(3) status.

Qualified Haitians were recruited for the organization’s board. (It’s a requirement that 40 percent be Haitians.) Initial funding was raised in the U.S. Then vacant land was cleared and buildings and helipads constructed near Port-au-Prince for the air ambulance’s base headquarters.

One person instrumental in shepherding the startup was Ralph McDaniel, a veteran of the HEMS industry who managed and developed helicopter base operations over a 40-year career. He was at his Georgia home when he received a fateful phone call from Dolan, a call that inspired him to help. “After I sold my helicopter operations and retired, I was sitting around watching Oprah too much,” he says in a recent interview from Haiti. “I had never been to Haiti and had no idea what to expect; my only international travel had been on a cruise ship.”  

Lack of extensive international travel experience did not deter McDaniel from committing to temporarily go south. “We started out with a six-month agreement to help; that was going to be it—and here we are two years later, ” he says, now as the executive director of Ayiti Air Anbilans. “It’s just such a brilliant project in such a highly needed location that it’s hard to walk away from. I want to do this as opposed to feeling that I need to do this.”

That sentiment is shared by Associate Executive Director Ron Reid. “I’m an old retired Army pilot, who then went to Air Methods. I left Air Methods to take this job. It’s the most honorable thing that one could do; it’s very rewarding. It’s a challenging job, but gosh I haven’t been this challenged and felt this good about what I do in quite a few years.”

Although Reid no longer works for Air Methods, the U.S. company still works for him and everyone at Ayiti Air Anbilans. That’s because Air Methods is the vendor that provides air medical transport for the nonprofit. They brought the first helicopter down to Haiti in 2014. Such professional transport does not come cheap. “Some people see us and say, ‘Oh, they’re not-for-profit.’ Yes, but we still have to pay for stuff. Our vendors don’t see it as not-for-profit; when the bill comes we have to pay it,” says McDaniel.

FLIGHT OPS & OBSTACLES

Air Methods operates under FAA Part 135, so Ayiti Air Anbilans not only has to meet Haiti Office of National Aviation Civil (OFNAC) regulations, but also FAA regulations. The result is that flying is conducted as if it were in U.S. airspace. “Aviation is right down the line of what you’d expect in the U.S.,” says McDaniel. “It’s when you’re on the ground—the infrastructure and communication, or educating enough people on the ground to establish and secure a landing zone—that it’s a little bit different.” OFNAC doesn’t have many rules and regulations for helicopter air ambulance operations, because they’ve never had one before. So they lean on Ayiti Air Anbilans to operate within the guidelines of the FAA. “If the FAA is a book of regulations, OFNAC is a page,” says McDaniel.

One regulation on that OFNAC “page” is a prohibition against night flight. Even if OFNAC eventually eases this restriction, Haiti’s infrastructure—or lack of it—makes flying in the dark too risky. McDaniel explains, “Someone might run a thin wire across a soccer field designated as a landing zone to tap into the power line, and even with NVGs you’d never see it.”  

Not flying at night can be frustrating. In Haiti it is not uncommon to have events leaving 20 or more dead, and another 20 or more injured. When incidents like this happen, the helicopter transports patients, one at a time … until they run out of time. McDaniel laments that there have been situations when “We probably could have picked up 10 more, but then we ran out of daylight.” Likewise, if an incident occurs at night, assistance can be delayed for hours until dawn.

There are other flight deterrents in Haiti that one doesn’t usually find in more developed nations. For example, there are only two aviation fueling locations in the entire country: Port Au Prince and Cap-Haitien. So, while Ayiti Air Anbilans can cover almost the entire island, the far southwest corner is out of range. Similarly, they can fly out of range of the island’s flight radio communication system. It’s then that cell phones are used.

THE BEST CARE

Few hospitals in Haiti are equipped to offer critical care, and those that can stay full. McDaniel says, “I can’t begin to tell you how many times we’ll have a patient in dire need, but there’s no hospital to accept them because the two ventilators at this hospital are already being used, or the five at another hospital are being used, or the 45 beds at another hospital are already full.”

These sad scenarios make the care that Ayiti Air Anbilans offers even more crucial. “It’s almost as if the best quality health care you’re going to get in Haiti is in that helicopter,” says McDaniel.  The medical director of a local hospital agrees. After seeing the aircraft’s equipment, he remarked, “I’d get better care here in this helicopter than I would in my own hospital.”

The medical flight crew that provides such stellar care is a multinational team that works as one. An Air Method’s pilot (who work a 21-day-on/21-day-off schedule and is provided housing and transportation) flies either a medical doctor or flight paramedic, while a nurse and flight EMT are always are onboard. The hierarchy is physician, nurse, paramedic, then EMT. Yet, Dr. Jerry Chandler, a Haitian who flies many missions and is Ayiti Air Anbilans’ operations director, is quick to emphasize that while there is a hierarchy, every role is equally crucial. “We work as a team. Everyone has their role and importance in providing care. I like to say that we’re all important and none of us can be left out. We act as one.”

To further underscore every member’s essential service, Dr. Chandler places special emphasis on the EMTs. All three are Haitian (One flight nurse is also Haitian.) and thus fluent in the local Kreyòl language. “The EMTs are very important. Not only do they act as caregivers, but they also help nurses and paramedics with language barriers. Again, all of the positions are important and each person has their role in what we do.”
 
THAT’S FOR ME TOO?

Ayiti Air Anbilans serves all in Haiti that need flight medical service—regardless of ability to pay. While there are some paying patients through insurance companies and membership plans (An individual plan is $36/year.), the vast majority served cannot pay. Therefore, most Haitians are shocked when they realize that they are also afforded the same treatment by Ayiti Air Anbilans as the minority with money. “A lot of folks here can’t believe that our service is for anybody,” says McDaniel. “We have the poorest people say, ‘You mean that’s for me too?’ They just can’t believe it. We’re there for those people. We’re also there for the chief of police too if he needs us. It really is for anybody and everybody.”

Ayiti Air Anbilans’ crews often receive coconuts as token payment for their hard work. “It’s really one of those touching rewards that you can’t get anywhere else,” says McDaniel. “They feel this grand blessing of what this helicopter can do and what it means for their country. I wish I had a dollar donation for every time I heard ‘Thank you for what you’re doing for Haiti.’  The people realize that this service is here to take care of them, and not to take anything from them.”

STOMPING ELEPHANTS, PROUD PEOPLE

Sometimes when large international relief organizations come to Haiti, it’s like elephants arriving to help a mouse. The elephants stomp around, excited to accomplish great things—while the mouse gets trampled in the process. McDaniel says, “Haitians are real accustomed to international organizations coming in with a fury, and a month later they’re gone. They don’t really leave anything behind for them.”

Ayiti Air Anbilans has a different plan. “In our organization we realize that all the Americans are here to work themselves out of work. We want to turn it over to the Haitians,” says McDaniel. There are already several Haitian employees in medical care, maintenance, and dispatch, and he believes that while the transfer is “light-years” away from a piloting standpoint, it can happen perhaps as soon as two years on the medical side. For example, Dr. Chandler was told on his first day of work that he was expected to eventually take over as executive director. “He’s taken that seriously and very much to heart. He’s trying to learn every aspect of this operation so that when the day comes that the blanc (white) leaves, he’ll be able to run it completely,” says McDaniel.

Dr. Chandler’s enthusiastically agrees. “On behalf of the Haitian staff, I say that we believe and know it’s going to happen,” he says. “A couple of years ago we could not imagine having helicopters and this level of care, but it’s happened. We think big, dream big, dare, and go. Ayiti Air Anbilans is going to be a model for health care in Haiti.”

THE HOPE IN HAITI

Ayiti Air Anbilans’ has a $4 million annual budget. While some of those funds are used for initial infrastructure needs, the organization also has great recurring expenses. For example, maintaining two helicopters while keeping two pilots at base headquarters on call at all times does not come cheaply. With most of its patients unable to pay in something more transactional than coconuts, the nonprofit’s life blood is donated by those with more legal-tender means.

“What we most need is funding,” McDaniel says, not in a pleading tone, but as a sober statement of fact. “A consistent, steady revenue stream to make this thing sustainable is an absolute must. I know that major donors at some point in time will have to stop. If I could get 5 million people to send us a dollar, then we could take care of this thing forever. It’s just hard to find those 5 million people willing to send that dollar.”

McDaniel is hopeful this article—and its readers—will help. “I believe it will get to a lot of people whose eyes and ears we have not been able to get to,” he says. “Somebody somewhere will read it and also want to help us.”

That is the hope in Haiti.

If you would like to learn more about Ayiti Air Anbilans and how you might help, please visit their website: HaitiAirAmbulance.org

 

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A Personal Note: Why Haiti?

Most often, as a consequence of chasing a story, I end up in this—or that—location. In Haiti, I’m thankful it was the other way around.

My wife, myself, and our 14-year-old daughter were already in Haiti as part of a missionary team doing development work. My wife, a career teacher, participated in teacher training conferences. My daughter worked in children’s ministry, while I taught business classes to entrepreneurs as part of a microfinance program. While in Haiti, I decided to seek out a helicopter story at Ayiti Air Anbilans.

Although my wife had served in Haiti before, it was my first trip. Even though I’d traveled to many third-world locations, the particular place we were, Cite Soleil, had some of the most staggering poverty I had ever seen. Despite their circumstances, I found a great amount of inspiration and beauty in the Haitian people and their culture. In my desire to do a good work in their nation, I know they did more of a good work in me. I am better for it.

 

While Haitian people may lack material wealth and resources, they have an over-abundance of resilience, hope, determination, and faith—all combined in a true sense of community. I believe there is a direct connection between the strength I witnessed in the people of Ayiti, and the future of Ayiti Air Anbilans.

I will be in Haiti again in 2016 on a similar mission, and pray that I will see continued success in both the country’s proud people and their EMS program. Until next year, na we pita zanmi wen!