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The role of physical therapists in natural disasters: what can we learn from the earthquake in haiti?

On January 12, 2010, the lives of Haitians changed forever when a large 7.0 earthquake struck the Haitian capital, Port-au-Prince—one of the most densely populated cities in the western hemisphere. Haiti is the poorest country in the Americas; unsafe buildings, poor roads, and a grossly inadequate health care system served to amplify the earthquake's catastrophic impact. Reports cite more than 200,000 people dead, 300,000 injured, and almost 600,000 internally displaced.1 
 
Particularly striking, however, are the implications of this crisis for disability and rehabilitation. It is speculated that the consequences of the Haiti earthquake will far surpass those of the 2004 tsunami in South Asia in terms of disability, because the traumatic nature of the event left vast numbers of people with spinal-cord injuries, amputations, head injuries, and other forms of disablement. Furthermore, disability rates are likely to be worsened by the fragile state of Haiti's rehabilitation system, which has been further compromised by the earthquake. 
 
As a result, many Canadian physical therapists (PTs), physical therapy programmes, and institutions providing rehabilitation services are questioning their roles and asking how they can best contribute to the response. Should organizations send a rehabilitation team? If so, which skills would be most useful on the ground in Haiti? 
 
While increasing numbers of Canadian PTs are becoming involved in global initiatives,2,3 research to inform constructive and meaningful international engagement for PTs is limited. In particular, literature on rehabilitation roles in post-disaster settings is scarce and largely anecdotal.4–8 Glaringly absent is a body of research based on physical therapy experiences in previous disaster settings that could inform and direct the current response in Haiti. 
 
We argue that the PT community has a social responsibility to identify and investigate timely, important, and appropriate research questions that will enable us to learn empirical lessons from the experience in Haiti and thereby inform responses to future disasters. If we fail to engage in meaningful research on this phenomenon, we risk repeating past errors of omission, forcing the difficult question, How many disasters must occur before we start figuring out how best to mount PT responses?