Monday, February 1

Haiti Crisis: Making an Ark out of many ships: a proposal to temporarily berth ill earthquake survivors on cruise liners.

REMINDER: This February HBO is re-broadcasting the documentary "Terror in Mumbai," which I discussed in the December 20, 2009 Alden Pyle in Pakistan, Part 2: Once upon a time in Saigon and Mumbai. See the HBO website for the airing dates.
On Saturday I came across two claims:

  • Haiti has significant oil and natural gas reserves and that the U.S. and other foreign governments have been machinating with regards to these, going back years, and at the expense of Haiti's poor.

  • Orphanages and schools in Haiti run by foreign charities are taking care of children of well-off Haitians while the donors in the foreign countries are under the impression they're giving money to help Haiti's poorest. I don't think the claim extends to every such facility but the person who made the claim alleges he worked in Haiti's 'aid industry' for ten years and that from his experience the rackets are widespread.

  • With regard to the latter claim, according to a CNN TV report it is true that in Haiti the term "orphan" is used in a way that's understood differently in the USA and other Western countries. In Haiti it means a child who lives in an orphanage but is not necessarily orphaned. Evidently many Haitian families put their children in orphanages run by foreigners because the children get better food, education, etc., that way.

    However, CNN made no mention of a racket and neither did the report suggest that donors were being misled, or that only children of well-off Haitian families were being served by these facilities.

    Yet of course the opportunity for abusing such a system would be there. And the system explains why the Haitian government is adamant that children who are survivors of the earthquake not be taken out of the country until it can be determined whether they have family, even if they're connected with an orphanage.

    I am not going to provide links to either claim at this time because I want to show them to a few colleagues and get their input before I start a riot. The only reason I'm mentioning the claims now is because I am sensing donor fatigue. Yet if only a fraction of the two claims are true, what can I say, except that Haiti's poor have certainly been run over from every direction you can think of.

    So despite worries that with such vast amounts of aid money being poured into the country there's bound to be theft, waste, etc., this is not the time to close the checkbook. Not with the potential for a second catastrophe bearing down on the survivors, and which will hit the poorest and weakest the hardest. That catastrophe is the rainy season on top of the earthquake and aftershocks.

    According to reports last week the rainy season will arrive in Haiti in four to six weeks (CNN) or in a couple weeks (PBS NewsHour). I assume the CNN estimate is more accurate; in any case, according to what Haiti's president said last week there are only 2,500 tents in Haiti, whereas at least 200,000 are needed. "More than exist in the world," he added

    Whether or not his figures are strictly accurate, he's in the ballpark. And even if there are that many tents for sale and they're waterproofed to take heavy rains for weeks on end, donation money has to be split between water, food, medicine, supporting the army of aid workers now on the ground in Haiti, and a thousand other critical items.

    That means aid agencies are now in a race against time before mudslides and water-borne disease threaten to escalate Haiti's present catastrophe into one of unimaginable proportions. Not to gross you out, but realize that the survivor encampments are generating virtual mountains of rotting garbage that are stacked on the outskirts of the camps, and that large amounts or human feces are deposited near those camps. Come the rains, all that stuff will start flooding into the living areas of the camps including the cooking areas.

    Haiti's large shantytown, Cité Soleil, escaped mass deaths during the earthquake because most of the homes there had tin roofs, which meant that even if the cinder block walls collapsed, people who survived the quake could clamber out of the rubble. However, big mudslides could swallow up the town's shaky structures, which are built almost on top of each other.

    As for present shelter arrangements, most Haitian survivors are living in 'tents' that are made from sheets and blankets. In recent days some Haitians have been scavenging wood and tin to make more permanent living structures but these are placed in camps that have no drainage, no running water, and no PortaPottys.

    There are a certain number (exact number not known) of Haitians in those tent camps who have homes that are still standing. But they're afraid to return to the homes because they fear the next tremblor will collapse the structure. That's a viable worry, particularly when the rainy season will further erode foundations already weakened by the earthquake and aftershocks.

    All of that is on top of other crises that have settled over the Haitian survivors. Readers who've been following the story don't need the laundry list. But just a few highlights:

  • It was not until this Saturday that a rational food distribution strategy was finally worked out by the World Food Program, with the help of the U.S. military. But the WFP is just delivering bags of rice -- no cooking oil, vegetables or high quality protein. Rice can sustain life but it's not enough to rebuild health. There are still huge logistical problems with getting food and water aid to the survivors. These have led to some near-riots that had to be dispersed with tear gas and shots fired overhead, and which meant no food was distributed.

  • The electricity grid is still down, and from a CNN television report last week it could be another month before it's up at least in part. Why is it taking so long? Because the grid was only operating at a fraction of capacity before the earthquake. That's because the country was hit by a series of devastating hurricanes last year, which took down the grid. Since it went back online it was only operating eight hours a day before the quake. That explains why gasoline was in such short supply when the quake hit. Everyone who could afford gas-powered generators -- government buildings, embassies, hospitals, hotels, etc. -- was using generators when the electricity was cut off daily to prevent the grid from crashing.

  • From a PBS NewsHour report yesterday, about 200,000 Haitians are suffering from earthquake-related injuries/illnesses. We can assume a large number of these are children. The airlifts of critically injured patients to Miami hospitals are being restarted after a five-day suspension, which happened because the hospitals were overwhelmed and caught in reimbursement red tape. The reimbursement issue has been settled but the Miami hospitals (and ones in Dominican Republic) are still filled to capacity with seriously injured Haitians.

  • And even if hospitals in other parts of the USA and the world can take in more of the seriously injured patients even a generous estimate of 50,000 hospitalizations would leave 150,000 injured and ill Haitians, many of them children, to face the rainy season while they are in bad shape. Meanwhile, cruise ships ply the Caribbean -- ships that could easily be converted into recuperation facilities.

    So I propose an emergency plan, to be in effect during Haiti's rainy season and/or until sufficient tents and sanitation measures can be deployed. The plan is to sequester cruise ships that can, within a week, reach shores or near to shores in Haiti, Dominican Republic, Cuba, other Caribbean ports, and even Miami. Then airlift ill/injured Haitians to airports near the port cities and have them board the cruise ships there, or ferry them to the ships.

    I asked RBO's Brenda J. Elliott to do preliminary research on major shipping lines that sail the Caribbean, and the number of passenger berths in each ship. She graciously put aside her own research for the project.

    I was stunned by what she turned up; one cruise liner -- the world's largest -- has 5,400 berths. And she informed me that she'd only provided a sampling of the cruise lines, and that the other ships average 2,000 berths each.

    Just among four of the largest cruise lines that sail the Caribbean, the total number of berths for 68 ships is 165,825 -- that's if you take 2,000 berths as an estimate for ships owned by those companies that are not on Brenda's list. (See below.)

    If you could get half or even a quarter of that number of Haitians on board cruise ships over the next month to six weeks, and keep them there for several weeks until aid agencies/governments were able to build safe temporary encampments for them, you might end up saving many lives.

    And while the airlift and preparations would be a massive project, it would be more do-able than the vague idea being floated by the UN of somehow relocating a million people to a mega-tent city -- if the tents can be found. Even so, there is no time before the rains to set up such an encampment, not one with toilets and a drainage system.

    Brenda pointed out that the cruise-ship plan might be trading one set of problems for another. First, the shipping lines would have to be indemnified as well as reimbursed for lost business. Yes. The companies would also have to be supplied with the food and other items the survivors would need as well as guards, monitors, and medical staff, if the cruise line didn't want to use its own staff.

    And she mentioned that the cruise ship generates its own set of communicable infections. That is a serious point. However, while I'm not the expert on this, I think most of those cruise-liner disease outbreaks amount to vomiting and or/diarrhea, and can be treated with antibiotics and other simple medical procedures.

    And I assume that the biggest breeding grounds for the bacterial outbreaks on the ships are self-serve food bars, fresh vegetables and fruit, and water sport/relaxation areas -- pools, water slides, hot tubs, etc. The water areas could be shut while the Haiti survivors are on board. And the self-serve food bars could be shut except for holding box meals. And bottled fruit and vegetable juices could be largely substituted for fresh produce.

    Also, the cruise ships could be much more liberal with disinfectants than they would for customers, who don't want their vacation smelling of Clorox. I doubt the survivors would complain on that score.

    Another point is that hospitals are notorious breeding grounds for infectious outbreaks -- life-threatening ones. At least on a cruise ship the Haitians could get out of their cabins, and get fresh air. Most importantly they could be away from the horror of Haiti's present for a few weeks.

    All that would give strength to fragile immune systems and help people, especially children, heal emotionally. And a bonus is that the big cruise ships are floating playgrounds; they have all kinds of toys, games, etc. for kids.

    Also, there is plenty of clean drinking water on board these ships so people won't be dehydrated. And of course there are toilets and showers -- and laundries, so that clothes and bedclothes stay clean. There is also privacy in the sleeping quarters and round the clock protection so the people who have lived in terrible conditions for weeks can get some decent sleep. All that would put people who are injured or ill, but not critically so, quickly on the mend.

    Another benefit of using the cruise ships is that up to this point, civilian volunteer medical, nursing, and aid workers who've been in Haiti since the quake have been going on adrenaline. They will soon start falling like flies. The volunteers are risking their health to work with people in the tent camps. And simply surviving the stress of working in the post-earthquake settings takes a huge toll because the volunteers have to keep functioning.

    So, volunteers could be berthed on the cruise ships for three days so they could get sleep, rest, eat good food and de-stress, then be rotated out to make way for another group of volunteers in need of rest.

    Brenda mentioned that alternative medicine practitioners and therapists who specialize in stress-relief techniques (e.g., massage, acupuncture, aromatherapy) treated rescue workers in New York after the 9/11 attack and in New Orleans after Hurricane Katrina; the healers could visit the cruise ships to help the aid/health care workers working in Haiti and Haitian survivors. (She mentioned that Acupuncturists without Borders is requesting volunteers to go to Haiti.)

    Another reason for transforming the cruise ships into a kind of networked Ark is that this finally makes manageable the Herculean task of sorting through survivors and getting personal data on them. There has to be a lot of sorting out, particularly with regard to the orphans -- matching up those who have families and identifying the ones who don't.

    The cruise-ship plan addresses other problems, as well. The survivors who are injured or ill are a drain on the fragile health care system in Haiti. Removing the sick to ships that can function as recuperative facilities would reduce strain on the system.

    Another benefit of using the cruise ships is that it takes a little pressure off Haiti's seaport and the airport runways, as well as overland distribution. The cruise ships could be berthed near coasts of neighboring countries and supplies airdropped onto the ships, or loaded from piers that are in better shape than Haiti's main port. In this situation "a little" pressure off translates to big savings in terms of manpower, gasoline, wear and tear on trucks, etc. And it disperses distribution points, cutting down on delivery bottlenecks.

    All right, that's enough to sketch the proposal. What's needed next is for logistics specialists to tear into it. If the troops in Haiti are tied up -- what about Wal-Mart? Those people have geniuses working on the logistics of supply and distribution. Same for several giant corporations that must move around large numbers of people and goods.

    Up to this point private industry has been confined to writing out checks to help Haiti's earthquake survivors. The checkbooks need to stay open but brainpower is also desperately needed right now. I would like to see private industry get involved in a hands-on way at this critical stage.

    There are a couple questions and one final point I've saved until last. One question is deciding how to prioritize which groups among the injured and ill get onto the ships. Not to wimp out but this is getting into triage and triage is above my pay grade. However, if you could remove even 100,000 ill and injured people from Haiti's health care system for several weeks, that is thinning the forest, isn't it? In theory it would allow for more care of those left behind.

    The other question is how the cruise companies would respond. Some months ago I saw a CNBC program that looked at the business angle of cruises. The cruise companies were hurting because of the economic downturn. So getting paid by governments for a full house would be great for them.

    And I should think the great free publicity the shipping lines garnered from taking the Haitians on board would translate into more business than they knew what to do with, in the next year or two.

    Brenda's list does not include the Disney cruise ship (there might be more than one) and I don't know if they sail the Caribbean. Yet if those ships, which are set up for children, took on board Haiti's earthquake survivor children -- I think Disney would almost be willing pay to take them because the company couldn't get that much good publicity at any price.

    Finally, even in the tightest-run charities and government aid programs there is fraud, waste, price gouging by suppliers, accounting errors, etc.; it's unavoidable. This is particularly true in the early weeks of relief efforts, which are always chaotic.

    But cruise line companies are very hard nosed about waste and graft, very sensitive to price gouging for supplies they purchase. And they are set up to handle huge supply purchases. Those cruise ships are floating towns. By removing anywhere between 100,000 and 200,00 Haitians from the chaotic situation on the ground in Haiti, and putting the cruise lines in charge of ordering the supplies for their Haitian passengers, you'd stretch the aid money.

    Of course the cruise companies would bill extra for accounting services. Yet I believe it would work out cheaper. And the fun part is that it's really hard for supplies to sprout legs and walk off cruise ships.

    Below is Brenda's list. (I did not add the last cruise line to my calculations because I'm not familiar with the company.) And again, for the ships that Brenda did not name, but which are also owned by the big four, I estimated 2,000 berths per ship.

    I'm hoping that readers who think the proposal is worth exploring, and who've taken vacations on the ships Brenda lists, might call the cruise lines and suggest the proposal. And of course you could also contact your congressional representatives, the State Department, USAID, and even the White House, about the proposal.

    And I hope readers in the military/National Guard who know someone who specializes in logistics will pass along the proposal for review and comments.

    Oasis of the Seas (Largest Cruise Ship in the World) can carry 5,400 passengers
    - Explorer of the Seas can carry 3,114 passengers
    - Voyager of the Seas can carry 3,114 passengers
    - Brilliance of the Seas can carry 2,501 passengers
    - Enchantment of the Seas can carry 2,446 passengers
    - Jewel of the Seas can carry 2,501 passengers

    Carnival Cruises
    - Carnival has 23 vessels
    -- Conquest can carry 2,974 passengers
    -- Destiny can carry 2,642 passengers
    -- Dream (Superliner) can carry 3,646 passengers
    -- Ecstasy can carry 2,616 passengers
    -- Splendor can carry 3,006 passengers
    -- Valor can carry 2,974 passengers

    Norwegian Cruise Line
    . owns 11 vessels
    - Norwegian Gem can carry 2,394 passengers
    - Norwegian Jewel can carry ? [figure 2,000 average]
    - Norwegian Dawn can carry ? [figure 2,000 average ]
    - Norwegian Epic can carry 4,200 passengers
    - Norwegian Pride of America can carry 2,156 passengers
    - Norwegian Sky can carry 2,400 passengers
    - Norwegian Sun can carry 2,400 passengers

    Celebrity Cruises
    .owns 12 vessels
    - Eclipse can carry 2,850 passengers
    - Solstice can carry 2,850 passengers
    - Summit can carry 2,046 passengers
    - Mercury can carry 2,200 passengers
    - Constellation can carry 3,450 passengers

    Azamara Club Cruises
    - Journey can carry 694 passengers
    - Quest can carry 694 passengers

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