ORIGINAL RESEARCH Haitian Earthquake Relief: Disaster Response Aboard the USNS Comfort Ryan M. Walk, MD; Timothy F. Donahue, MD; Zsolt Stockinger, MD; M. Margaret Knudson, MD; Miguel Cubano, MD; Richard P. Sharpe, MD; Shawn D. Safford, MD ABSTRACT Objective: The Haitian earthquake of January 12, 2010, was a disaster essentially unprecedented in the Western Hemisphere’s recorded history. The USNS Comfort departed from Baltimore, Maryland, within 72 hours of the earthquake and arrived in Port-au-Prince harbor on January 19. During the subsequent 40 days, the ship provided one of the largest relief efforts in the US Navy’s history. Methods: The data analyzed included all patients evaluated and treated by the USNS Comfort between January 19 and February 27, 2010. A medical chart with a unique identifier was created for each patient on admission. A patient database was created from these records and used for this analysis. Results: A total of 872 patients and 185 patient escorts were processed aboard the ship. Ages ranged from younger than 1 day to 89 years: 635 were adults and 237 were children. Of those admitted, 817 of the patients were admitted for longer than 24 hours; the average length of stay was 8.0 days. The need for surgery was sub- stantial: 454 patients went to the operating room (OR) 843 times for 927 cumulative procedures. A total of 58 patients underwent amputations. Conclusions: Haiti was almost completely reliant on foreign medical teams for trauma care. Analysis of the data illustrates the challenges of triage and treatment in a humanitarian mass-casualty response. The remarkable coordination and cooperation among the Haitian Ministry of Health, nongovernmental humanitarian aid or- ganizations, and the US military highlighted the responders’ respective capabilities and demonstrated the im- portance of collaboration in future disaster response efforts. (Disaster Med Public Health Preparedness. 2012;6:370-377) Key Words: disasters, earthquakes, Haiti, disaster relief planning, trauma, surgical procedures, operative O n January 12, 2010, a magnitude 7.0 earth- quake devastated the nation of Haiti. Cen- tered approximately 16 miles from the popu- lation center of Port-au-Prince, an estimated 230 000 people were killed and another 300 000 were injured. Most of the city’s public buildings, roads, private resi- dences, hospitals, sanitation, and water systems were de- stroyed. More than 2 million people were left homeless in the aftermath. The level of devastation, the island nation’s geographic isolation, and the relative lack of options for in-country land-based medical evacuations resulted in an unprecedented need for the treatment of casualties weeks after the quake. In response to the disaster, the US Naval hospital ship, USNS Comfort (T-AH 20), was activated on January 13, 2010, and dispatched in record time on January 16, 2010, from its home port in Baltimore, Maryland. For 40 days of its 2 months’ service, the USNS Comfort provided medical and surgical care to earthquake victims. In conjunction with military units ashore, Operation Unified Response repre- sented one of the largest disaster relief efforts in the US Navy’s 235-year history. The USNS Comfort is 1 of 2 Navy hospital ships and is designed as a fully functional trauma facility at sea. Dur- ing combat operations, the ship has a theoretical inpa- tient capacity for up to 1000 patients, including 80 in- tensive care beds. The ship has radiology services to include fixed and portable x-rays, ultrasonography, 64- slice computed tomography, and an interventional ra- diology suite. Its blood bank stores up to 3000 units of fresh red blood cells, 2000 units of frozen blood, and car- ries a limited supply of fresh frozen plasma and cryopre- cipitate. The main surgical complex has 12 fully func- tional operating rooms. For peacetime operations, the ship can be arranged into 2 primary configurations that differ based on the mis- sion type. The first mission organization is known as hu- manitarian civil assistance (HCA). This configuration is designed for long-term humanitarian missions such as Operation Continuing Promise, the annual mission to the Caribbean and South America. During these mis- sions, the ship is equipped to meet lower acuity needs. The second mission configuration is disaster response (DR). In comparison with the HCA configuration, in the DR configuration the USNS Comfort is equipped to deal with a higher number of acutely injured pa- 370 Disaster Medicine and Public Health Preparedness VOL. 6/NO. 4 ©2012 American Medical Association. All rights reserved.