Haiti Earthquake After Action Report and Lessons Learned (AAR/LL)

Hastily Formed Networks in Haiti (Naval Postgraduate School)

(8 SEP 2010)

Author: Brian Steckler, Naval Postgraduate School Hastily Formed Networks Center Director (831.402.1584 – steckler@nps.edu)

I. INTRODUCTION AND PROFILE OF NAVAL POSTGRADUATE SCHOOL’S HASTILY FORMED NETWORKS CENTER

The Naval Postgraduate School’s (NPS) Hastily Formed Networks (HFN) Center deployed to Haiti within a week of the January 12, 2010 earthquake that devastated the country. Our group focuses on field research and deploying communications and power technologies in real-world events and austere environments such as extreme natural disasters. Faculty studies and research papers as well as NPS student Masters theses are the usual outcome of the work. We were involved in various activities and were working for a number of U.S. DoD entities while in Haiti. Before addressing all of our activities and observations in Haiti after the earthquake, it will be useful to outline the NPS HFN Center and how this group got started. The HFN Center roots go back to the December 26, 2004 Southeast Asia tsunami. At that time some NPS faculty and students were 3 years into working with the Royal Thai Armed Forces on the use of wireless communications and monitoring equipment to better secure border areas of the country (surveillance and basic connectivity). We were coincidentally scheduled to be in Thailand within a few days of the devastating earthquake in Bande Aceh Indonesia that caused a catastrophic tsunami that landed with devastating effect on the coasts of 9 countries including Thailand. The NPS wireless technology research shifted dramatically as a result of these circumstances and have been focusing on the use of wireless technologies (primarily SATCOM/MESHED WIFI/WIMAX) for Humanitarian Assistance/Disaster Relief (HA/DR) missions ever since. Equipment the NPS wireless researchers had brought into Thailand within days of the earthquake/tsunami was rerouted to the tsunami-devastated Andaman Sea Coastline of Thailand where, working with Joint US Military Advisory Group Thailand (JUSMAGTHAI) and the Royal Thai Armed Forces, we began to support communications for all early responders that were deploying in large numbers to a Buddhist Temple in the town of Takuapa Thailand. The temple had been repurposed as a morgue and grave registration site (largest in Thailand in response to the tsunami).

We began our efforts by setting up a VSAT satellite terminal for access to the Internet backbone, and then set up a meshed WiFi cloud around the temple to provide Internet access to anyone who needed access (free and open access by design). Then we constructed a WiFi bridge link from the temple to the nearby government offices (about 1500 meters away), and from a tower at this government facility we deployed a WiMAX link to the largest tsunami generated Indigenous Displaced Personnel (IDP) camp in the country (about 7 kilometers away). Finally we deployed more meshed WiFi equipment around this IDP camp of about 800 people including survivors, Non-Government Organizations (NGOs), and other support personnel. This Thailand tsunami support mission was then spread out over 5 months with some NPS HFN researchers going back several times to “tweak” the networks and continue to learn from the experiences of deploying wireless communications technologies in extremely austere environments. As a result of the Thailand tsunami effort we began to upgrade our wireless communications equipment, capabilities and know-how to tailor fit our research revolving around working in the HA/DR environment. Over the subsequent 5 years leading up to the Haiti HFN mission in January 2010 we began to participate in multi-national and US Government exercises that focused on disaster communications and interoperability. We also began to conduct research on information sharing, social networking tools, and alternate power options in austere environments. Several months after our SE Asia tsunami experience, in September 2005, we deployed a large team of NPS faculty/students and civilian vendor research partners (Cisco, Redline, etc) to Bay St. Louis and Waveland Mississippi for 6 weeks after Hurricane Katrina which of course devastated the US Gulf Coast on August 23th, 2005. This mission focused on leveraging two Internet access capable VSAT systems we deployed in/around these two communities for all early responders, victims families, and government (local and federal) to use a WiFi mesh network that we made freely available. The Katrina deployment project sharpened our entire HFN approach and provided numerous lessons learned that we have shared with the global community via in-person briefs/presentations and by publishing an online interactive summary of the Katrina HFN deployment (http://faculty.nps.edu/dl/HFN/index.htm).

II. NPS HFN CENTER JANUARY 2010 HAITI EARTHQUAKE RESPONSE TIMELINE The NPS HFN Center response to the Haiti earthquake can be broken down into three distinct phases based timing of when our personnel were deployed as well as the organizations we were working for. The first two weeks we were attached to the Joint Forces Maritime Component Command (JFMCC) that was set up w/in days of the earthquake. This is essentially the Navy portion of the joint US military effort.

The JFMCC were aware of our work in Katrina and the tsunami, and contacted us shortly after the earthquake happened. After agreeing that we could support JFMCC they directed us to deploy initially on the USNS COMFORT, one of the two active US Navy hospital ships (the USNS MERCY is the other). When on the USNS COMFORT the team was directed to support and provide advice (and communications capability as we brought a fair amount of SATCOM/MESHED WIFI/WIMAX and alternate power equipment with us) to the DESRON FOUR ZERO. The DESRON Commodore and his staff embarked onboard the COMFORT immediately upon the COMFORT arriving off the coast of Haiti to lead the maritime mission including all helicopter and boat medical evacuations (medevacs) from shore to the ship. Initially the NPS HFN team consisted of 2 NPS faculty members, one research assistant, 2 USMC NPS masters program students and two civilian NPS masters program students (total team of 7). This team, dubbed NPS HFN TEAM HAITI, deployed on January 18th, exactly one week after the earthquake (January 12th) by flying commercial to Los Angeles, then commercial to Jacksonville Florida, then a military C-9 aircraft to Guantanamo Bay, then via helicopter from GITMO to the deck of the USS CARL VINSON aircraft carrier, and finally via helicopter to the deck of the USNS COMFORT. NPS HFN TEAM HAITI’s orders were indefinite but estimated to be two-three weeks. All but one (Brian Steckler) rotated back to NPS at the two-week point. Steckler ended up staying 32 days the first deployment to continue to manage the NPS effort. One more USMC masters student deployed for two weeks at that point. Joining the smaller NPS HFN TEAM HAITI at around this time were three civilians (volunteers versus contractors) with a history of deployments and other collaboration with the NPS HFN Center. At about this two-week point NPS HFN TEAM HAITI’s mission changed slightly as we were directed to work for and support the larger Joint Task Force Haiti (JTF Haiti) that was formed after the earthquake struck. We were directed to bring to bear our experience with ad hoc rapidly deployed networks in austere environments in support of the JTF J6 (Communications). Slowly over the first 10-14 days the team began to move to the JTF compound next to the US Embassy, staying in tents we had brought along as part of our gear as we planned from the beginning on being self-sufficient for a few weeks if necessary. NPS HFN TEAM HAITI’s first deployment ended in mid-February, just over a month from initially embarking on the USNS COMFORT. Then Steckler returned to Haiti two more times for about two weeks each time, working with and conducting field research with civilian counterparts as well as the NGO community on both of these return trips. These two additional trips to Haiti were in support of the HA/DR interests of the Office of Assistant Secretary of Defense for Networks and Information Integration (ASD-NII) – a long-time research sponsor of the NPS HFN Center. The majority of these two trips was spent embedding with and observing the NGO community and how they communicated and collaborated with the U.S. military and all other organizations.

III. HFN TEAM HAITI EXPERIENCES WITH COMMUNICATIONS Virtually the entire time the NPS team was involved in the Haiti response effort communications was both the biggest challenge and the biggest enabler for the team (and many others). Even before the team departed NPS in Monterey CA on January 18th with 18 cases of luggage, communications, and alternate power equipment, we were awaiting guidance from JFMCC on the personnel security and safety status in Haiti as well as where we were to initially be stationed. The JFMCC, along with the rest of the international responding community, in the initial days of the disaster was having great difficulty communicating with contacts on the ground in Haiti. This was partly due to the fact that the U.S. response (and numerous other nations responding) was just forming up in real-time, and due to the dire conditions regarding the local Haiti communications and power infrastructure, and finally due to the fact that much of the Haiti government and a large number of United Nations (UN) peacekeeping mission personnel operating in Haiti were victims. A large number of Haiti government buildings collapsed which resulted in large scale incapacitation of government systems (of all types) and death or injury of key personnel. In addition, the approximately 1,000 person US peacekeeping mission that had been operating in Haiti the past 8 years (called MUNISTAH) was in complete disarray due to their headquarters building collapsing in the earthquake, taking with it the top two UN employees in Haiti (as well as about 100 other UN personnel in the building and/or around the country). The entire world’s response to the earthquake continued to be significantly challenged to get good and timely on-the-ground status and information (both outside of Haiti, and internally around the country) to decision makers for the first 10-15 days due to the usual disaster chaos and the significantly degraded communications infrastructure resulting from earthquake damage was in large part responsible for this chaos. Adding to the chaos in the first few weeks were the media reports of widespread violence, looting and overall desperation of the affected population. This physical personnel threat to the international responder community of course affected the decision making processes of the JFMCC, the JTF, the UN, the Haitian government, and ultimately the NPS teams’ orders and timing going into the country to deploy communications equipment and/or to conduct communications and power system assessments. NPS HFN TEAM HAITI ON USNS COMFORT. NPS HFN TEAM HAITI’s first few days onboard the USNS COMFORT were a bit frustrating while we waited for the force protection questions, and our ultimate mission assignments, to sort themselves out, as we had a fair amount of idle communications capability and expertise that we were unable to bring to bear as quickly as we had hoped and expected. Finally after waiting for guidance and missions after the first few days, members of the NPS HFN TEAM began to fly ashore either daily or overnight in CH-60 helicopters from the deck of the USNS COMFORT

to assist the COMFORT’s IT personnel who were deployed ashore to facilitate communications between the ship, the DESRON embarked on the ship, and several shore helo or boat landing sites including the National Palace and the US Embassy. One challenge the NPS team had the first week onboard the USNS COMFORT (a 1,000 bed floating hospital with a helo landing platform for medevacs) was that we were having trouble communicating between our team members ashore and those who remained on the ship. Some cell phone service was just beginning to come back online ashore, but it was very inconsistent. Sometimes only cellular voice service would work. Sometimes only cellular data services (text messaging and email) would work. Sometimes neither would work. This was true for all three of the major local Haitian cellular providers. In addition, the COMFORT’s satellite based Internet access and connectivity link to the Internet backbone for voice telephony, Internet, email, etc, was extremely overloaded. The ship had something like 12 phone lines throughout the ship going over the satellite connection as well as the only Internet connection for all mission critical and routine email and web traffic for all parties onboard, including the DESRON staff, the COMFORT staff and crew, the NGO personnel embarked, and finally the media who were onboard the ship. The NPS team began to resort to our ashore and shipboard INMARSAT BGAN satellite based Internet access systems to communicate. BGAN SERVICES. One of the most significant valuable resources being used by numerous early responders (governments, NGOs, etc) was the INMARSAT BGAN network, which provides broadband access to the internet by way of laptop-sized satellite terminals. BGAN was such a powerful communications enabler during the course of the first several weeks in Haiti that it in some ways BGAN became a victim of its own success. The demand for the service often times overtook the capacity of the network, particularly at certain times of the day. NPS HFN TEAM HAITI brought some of this BGAN equipment with us in our HFN flyaway kits -- and had some fantastic experiences with this $2,000 piece of communications gear as well as a few issues that are worth mentioning. One NPS HFN TEAM HAITI unexpected but pleasant lesson learned with the BGAN service was that if anchored offshore we could maintain our own independent Internet connection with one of our Inmarsat BGAN (Broadband Global Area Network) Internet access terminals from the deck of the ship ! We set a BGAN unit up on one of the COMFORT’s bridge wings almost from the day we arrived and were able to use it for all of our email, live text and audio chat (predominantly Skype) and other Internet services. We had expected this to be a lot more difficult than it was due to the ship being at anchor swinging normally at 20-30 degrees, or during windy periods swinging a full 360 degrees. All we had to do when we would lose synchronization with the INMARSAT BGAN satellite network was to simply rotate the BGAN unit around on the bridge wing

deck until it reestablished a connection. We would only have to do this a few times a day most of the time, as the weather was seldom such that we were swinging more than that 20-30 degrees. INMARSAT BGAN does have a maritime BGAN hardware/service option that is tailor made to work while a ship is moving at sea, but it is quite a bit more expensive than the simple basic BGAN units that worked for us in this limited application. One other experience we encountered with the BGAN service during the first couple of weeks after arrival was that the network was beginning to become saturated with too many users and too much traffic through a finite amount of INMARSAT satellite spot beams servicing Haiti. We contacted the Inmarsat engineers about this issue and immediately received back a very thorough explanation of why all BGAN users in Haiti were starting to experience degradation of service. The INMARSAT engineers explained that there were simply too many BGAN devices vying for the amount of bandwidth available in that region, but that as the amount of users declined as expected further into a typical disaster response, the performance would get better. In addition, the INMARSAT engineers informed us that they were working on aiming additional spot beams to cover Haiti, but that even after making these system adjustments to the point of providing maximum coverage there would still likely be too much traffic for fully normal operation. The INMARSAT engineers did inform us that there were certain times that were better/worse to use the service. Apparently evening news on the US East Coast, then the US West Coast, which happened on the hour, was by far the worse time to use the BGAN service as there were many media organizations using the network to send huge video files to their stations in the US. INMARSAT also mentioned that there were options for priority service of the BGAN network and provided us with details on how to obtain such priority service. One common comment on the BGAN service is the high cost of the service itself. Since BGAN service is charged by usage (aka charged per megabyte) versus by flat-rate, over time the costs of operation can go very high, especially if using high data rate applications like sending video files, videoconferencing, or sending large medical imagery files. Another comment often voiced is that it is difficult for the end users to track usage. Each INMARSAT reseller seems to have a different method for usage tracking and so far we have not found any that work particularly well. This can lead to very high costs in a short period of time if not closely monitored manually. One direct experience the NPS team had with the BGAN service while in Haiti was when we inadvertently left a BGAN unit powered up and linked up to the satellite service overnight This BGAN unit was providing Internet for just one laptop. Unbeknownst to the team, the laptop had two applications running in the background that were continuously sending/receiving traffic all night and ended up using over $2,000 worth of BGAN service in less than 36 hours. The lessons learned

here are of course to be aware when the network is active, and to ensure that laptops or computers using the BGAN network should have all automatic software application updates turned OFF. It took some cooperative forensics work by both NPS HFN personnel and Inmarsat engineers to discover this problem. The JFMCC N6 (communications) contacted us and asked if we could help them determine how a US Coast Guard detachment operating at the main Haiti port/pier area was running up a large BGAN service bill (over $5,000 per day at one point). We relayed our discovery about the service being left on with a laptop set to auto-update as well as a few other tricks to the JFMCC J6 and the US Coast Guard unit to try to keep the traffic over the network to a minimum. However, regardless of these few issues with the INMARSAT network, virtually anyone who was using the service would likely consider it indispensable, even though the usage costs were very high and it has these other limitations. The combination of the small, ultraportable and inexpensive hardware (versus larger VSAT satellite systems with flat rate unlimited service at much higher bandwidth), the easy and fast training and setup time (less than 5 minutes each), ability to potentially be used by a ship at anchor offshore (note this is not a normal operating method for this kind of land based BGAN equipment), the option for an ISDN telephone to be connected/used with the hardware, and the almost global coverage add up to a very versatile and useful Internet access device that can dependably obtain connectivity speeds of close to 400 kbps. One other recommendation for BGAN service (and most other satellite services) for Humanitarian Assistance/Disaster Relief operations is that it is ideal to have pre-existing contracts for the service. It can be extremely difficult to order equipment or services immediately after a major disaster. The companies that provide the hardware and service are often inundated with urgent requests and orders, the government contracting process can be lengthy, stocks of equipment can be depleted, etc. INFORMATION SHARING PORTALS AND COLLABORATION TOOLS. The popularity of web based information portals (both static sites and dynamic information sharing sites), social network, and collaboration tools continues to grow. The usefulness of information sharing portals and other Internet based communications tools in response to the Haiti earthquake was quite evident from the very beginning. Real time information was flying in and out of Haiti via social networking systems Twitter, Facebook, MySpace and other such programs. The impact of live chat and video was evident from the first few days of the disaster as viewers worldwide began to get reports on TV from Skype users on the ground in the country. One issue documented seemingly every disaster is that there are simply too many web portals out there. The portals compete with each other for users. Responders often times aren’t sure which portal is best for them to use for a particular disaster. It seems that each disaster breeds even more portals, leading to even more confusion as to which to either seek or to submit information to. NPS

HFN TEAM HAITI did note that two primary portals seemed to differentiate themselves within hours of the Haiti earthquake. One was the UN’s OneResponse.Info portal. The other was the US military’s APAN portal. The relatively new UN OneResponse.Info web portal system launched a Haiti-specific portal to enable UN member organizations (UN agencies, NGOs, etc) to both communicate with each other and to communicate to the larger internal/external early responder community reacting to the Haiti earthquake. We learned that the OneResponse.Info portal was the de facto UN tool to disseminate all types of information by the UN CLUSTER system, which is how the UN organizes function-by-function for major disasters. The UN CLUSTER system briefly divides common disaster functions such as health/logistics/transportation/communications/etc., into teams led by various UN agencies or NGOs. The UNs guidance regarding portals was that OneResponse.Info was the single method for any organization to request support from the UN in Haiti. In addition to putting out information about the various UN organizations, capabilities and services operating in Haiti, the portal provided meeting times and locations, phone numbers and email addresses of key contacts, allowed outsiders to enter the portal and register and then submit requests for aid. Unfortunately, as we observed a number of times during the first month in Haiti, outside aid groups who registered with the OneResponse.Info portal were often turned down for help using this tool as the UN was simply overwhelmed and could not provide all of the food, water, shelter, generators, fuel, security, and other needs to meet the extraordinary demand from around the country. The Haiti-specific instantiation of the US military’s All Partners Area Network (APAN), which used to be called the Asia/Pacific Area Network went live within the first day or two of the disaster. This portal was being managed by both the U.S. Pacific Command and U.S. Southern Command and was supposed to be the primary web portal for the U.S. military to collaborate internally as well as externally with the UN, NGO community, and other early responders. While the process to obtain an account on the APAN system was quite cumbersome and turned off some in the NGO community, it began to get heavy use shortly after the earthquake struck. It is also worth noting that the response community had the choices mentioned earlier about which portal to use: the APAN portal or the UN OneResponse.Info portal or some of both or some other portal. Some in the NGO community simply refuse to have anything to do with the U.S. (or any other) military so for that reason alone would not register for or use the APAN portal. Many of the military personnel (uniformed and civilian) would only use the APAN portal and forego the UN portal just due to time constraints. Others simply did not know about the UN OneResponse.Info portal. Many in the UN or NGO communities were likewise not aware of the U.S. military’s APAN portal as an option. It was also fuzzy as to whether or not the UN wanted militaries to use their OneResponse.Info portal as there was the constant tension and sensitivities of outward linkages and interaction between UN, UN Agencies and NGOs, and the U.S. and other military communities.

In view of the dynamics of UN, NGO and military use of information sharing and collaboration portals, there is a continuing need for both training and exercises for early responders world-wide to be aware of how to use their own tools as well as to know what other options are out there and how to use them. In the case of the U.S. military, the vast majority of those responding to disasters are not trained in disaster relief, but rather are officers or enlisted personnel assigned to a unit who’s purpose is something completely unrelated to humanitarian assistance or disaster relief. While on the other hand the majority of the UN or NGO community’s personnel involved in disasters are veterans of numerous previous disasters and have significant training. Military leadership should consider creating permanent professional career paths in humanitarian assistance/disaster relief for both officers and enlisted personnel. LIVE CHAT. One of the most valuable resources for communications in all phases of the Haiti earthquake relief effort was live chat and video, tools such as Skype. The U.S. Navy used a live chat program for command/control of the entire medical mission throughout the country. Teams from the COMFORT, augmented in some cases by NPS HFN TEAM HAITI members, established themselves at several boat landings and inland helo landing sites with BGAN access to the Internet and established live chat sessions with the DESRON staff on the USNS COMFORT within a day or two of the COMFORT’s arrival in Haiti. This live Internet enabled chat capability often was the only means of communications between teams ashore and on ships as the cellular networks and land-line phone systems were for the most part inoperable, and radio communications systems were slowly coming online. While there are a number of programs that provide live text based chat, real-time audio and video, and other file sharing utilities none seem to be as ubiquitous as Skype. With better than 13 million users online at a given time and a mature well designed interface Skype is a powerful tool. In the case of NPS HFN TEAM HAITI, the author of this report decided within hours of the earthquake to conduct an trial of the use of Skype as a collaboration tool. Within 3 hours of hearing on the news of the earthquake on January 12th he established (while still home in California) a real-time, permanent Skype group chat session – one of the most powerful features of Skype. The author initially invited about 10 of his colleagues from around the world into the informal, ad hoc “Haiti Expert Chat Group” (???) to begin to share information on the situation on the ground. Some initial invitees were assumed to be either preparing to go to Haiti or already on their way when the group chat session was set up. Most of the initial group invitees had worked together in previous major global disasters or HA/DR exercises and for the most part knew each other. Some of the initial and subsequent group members were from the military, industry, academia, media, the NGO community or other entity.

Immediately the group began to share information with each other, to invite other experts into the group chat session, to socially network with other experts, to pull in or link other information sources, etc. Once the NPS team got to Haiti we used this Skype group chat session to inform all group members of what we were seeing and experiencing on the ground. We would also often ask members of the group for advice of various kinds to aid our efforts while on the ground. Over the course of the next 4-6 weeks this Skype group chat session had a life of its own, evolving into a collaboration capability that grew to over 50 members ! One very useful feature of this kind of medium is that all of the text can be captured and accessed at any time. So if one contributor provided some advice, or maybe a URL, or provided a point of contact a week ago, another member could simply go back a week to find this information, read it, or copy/paste it into a new chat session or an email or post on a blog or web portal. One other handy feature is that any member could open up a separate 1, 2 or multi-user chat session to go off-topic with a smaller group, with text chat or audio or if just two people a live video session. We did this often when the conversations tended to be more personal or of less relevance to the entire chat group. Below is just a small sampling of the actual group chat session to give an idea of the format and the informal ad hoc nature of the capability. Note that there are parts of several sessions appended and in chronological order, with hours or days skipped in between, with dates and times as indicated, and with separations between sessions annotated by several dots (…..).

[1/12/2010 7:08:35 PM] Brian Steckler: January 12, 2010. Hello all. I am establishing this ongoing Skype group chat session with this social network of experts that I know or have worked with in various fields involving humanitarian assistance/disaster relief. I did the same thing last year for Cyclone Nargis in Myanmar (some of you participated in that ongoing chat session) and it was a very valuable capability to have such brainpower in such diverse fields able to be in the same ongoing Skype chat session. I hope you participate and find this a valuable resource as we all try to help the people of Haiti and all of those responders out there. I will add others to this group chat if you recommend them and provide their Skype contact info. Or if you are able to add others (not sure) please feel free to. Looking forward to meaningful dialog as the event unfolds. R - Brian Steckler ….. [1/13/2010 8:31:37 AM] John Holloway: Situation update from Logistics Cluster Initial reports indicate a high number of casualties and heavy damage to Port au Prince. There are also reports of looting in the capital.

* Infrastructure: Water supply, electricity and communication lines have been damaged * Buildings in the United Nations compound in the capital have been destroyed, except for the World Food Programme Office which is now hosting colleagues from other UN agencies * Access to affected areas is restricted by road debris * The status of the airport in Port au Prince and access roads are being verified and an updated report will be issued Immediate needs Search and rescue; emergency health; water and sanitation; shelter; food; logistics and telecommunications Response * WFP and United Nations Humanitarian Response Depot (UNHRD) are planning to airlift 86 mt of high energy biscuits (HEBs) from the satellite logistics hub in El Salvador and emergency relief items from UNHRD Panama in support of the affected population. 125 mt of HEB are already positioned in Haiti * The Global Logistics Cluster Support Cell is deploying Baptiste Burgaud (baptiste.burgaud@wfp.org; +39 3490507280) to Port au Prince via the Dominican Republic, where he will initially establish a Logistics Cluster cell. Edmondo Perrone (edmondo.perrone@wfp.org; +509 37012341) is the Logistics Cluster coordinator in Haiti and will return to his duty station via Panama on 15 Jan * WFP Logistics is deploying Andrew Stanhope, Logistics Officer (andrew.stanhope@wfp.org; +503 78615152) * A WFP Aviation Officer is on standby in the Dominican Republic * THW is sending an assessment team to Port au Prince * World Vision Haiti will distribute first aid kits to survivors along with basic materials such as soap, blankets, clothes and bottles of water as an initial response * Deployments from the French and US military are on their way to Haiti [1/13/2010 8:31:53 AM] *** Call ended *** … [1/18/2010 5:21:24 AM] ericrasmussen: David, this is Eric and Nico. We' love to come chat. Where are you exactly (lat/long...) [1/18/2010 5:21:53 AM] David Hoffman: standby [1/18/2010 5:23:04 AM] David Hoffman: 18.577334,-72.285708 is the MAF hangar, right next to the national terminal (east of the int'l terminal) [1/18/2010 5:23:17 AM] ericrasmussen: I thing we're REALLY close. [1/18/2010 5:27:20 AM] David Hoffman: N18 deg 34.647' W72 deg 17.107' [1/18/2010 5:28:47 AM] ericrasmussen: We are 680 feet from you. [1/18/2010 5:28:50 AM] ericrasmussen: Feet! [1/18/2010 5:33:38 AM] David Hoffman: the GATR is hard to miss :) [1/18/2010 5:33:57 AM] John Holloway: a big beach ball [1/18/2010 5:35:48 AM] David Hoffman: green

[1/18/2010 5:50:02 AM] Brian Steckler: The one bouncing down the stands at Rose Bowl ??? :) [1/18/2010 6:19:01 AM] ericrasmussen: Good talk with David. He came over here just as we were getting more taskings for GPS information' [1/18/2010 6:19:31 AM] ericrasmussen: May not be able to share, but we'll look at it all carefully [1/18/2010 6:19:54 AM] ericrasmussen: (and thanks for the time, David - I know you had a lot going on) [1/18/2010 6:41:35 AM] Brian Steckler: David, is your location near line of sight to harbor in an area the COMFORT may be (pier or anchored?). I'm thinking WIMAX link from you to ship.....for NGO net on ship to save one of our scarce BGANs. Already being asked to link two ships and two shore sites.....no surprise eh. The link budget geeks on this list may help us do the software/google earth calculations while we're enroute. THen we need to find a lot more WIMAX. … [1/18/2010 10:58:45 AM] brooks_king: Alex Carver just forwarded this over, from a Friday report found here [1/18/2010 10:58:59 AM] brooks_king: http://www.arrl.org/news/stories/2010/01/18/11293/?nc=1 [1/18/2010 11:49:17 AM] Larry Wentz: A Haiti country page will be setup on the OneResponse Website (by the end of the day) where all clusters will be able to share and access information. Current ETC information will be transfered to this page Register into the OneResponse Website in order to have access to the ETC restricted areas: http://oneresponse.info/GlobalClusters/Emergency%20Telecommunications/_layouts/OneResponse/applicationpages/NewGlobalUserRequest.aspx UN OCHA contact Caroline Teyssier Project Management Officer Technical Coordination & Partnership Unit Communications and Information Services Branch (CISB/OCHA) Tel: +41 (0) 22 917-2013 Mob: +41 (0) 79 535-0434 Room D.609, United Nations, Geneva http://ochaonline.un.org http://www.reliefweb.int http://www.irinnews.org Larry Wentz [1/18/2010 11:49:54 AM] Larry Wentz: I have also posted this to APAN [1/18/2010 12:54:34 PM] *** Luke Beckman added Sagar Doshi *** [1/18/2010 2:07:48 PM] Eric Rasmussen: Hey, Joe! Sorry I missed you. XX The Comms Cluster (IT Cluster) meets at 1130am in the UNDAC tent. Small group led by

Andrew. Andrew was over here in our gazebo an hour ago, and Catherine (OCHA IM) just before that. I hope to run across you tomorrow. [1/18/2010 2:15:01 PM] Joseph Donahue: I'm not there, but Chuck Conley, Carl Kinkade and Carter Stone are, and Dave ARmitt will be tomorrow, followed by Beat Schock. Main problem now is getting a bunch of equipment in, but they're getting it sorted. [1/18/2010 2:56:40 PM] David Hoffman: Eric, sorry to have missed you this afternoon. I stopped by but you weren't there, and then on my way back I ran out of time [1/18/2010 3:16:13 PM] Eric Rasmussen: No trouble. Where did you end up? I came over with UNDAC staff and saw you were gone. Where did you land? [1/18/2010 3:19:03 PM] Paul Gierow: Eric, David is in route to the hotel near the World Concern. He has some options on what to do next. [1/18/2010 3:59:01 PM] Eric Rasmussen: Options are fun! I'd like to throw in my vote for UNDAC. They are in very bad shape, and they are in charge of a lot of the response. [1/18/2010 4:05:05 PM] Brian Steckler: FYI NPN HFN TEAM HAITI got hammered by storm getting out of Monterey as planned this morning....with our 20+ cases of COMMS gear. Looked dismal to get out at all today but finally got out and are now at LAX awaiting a redeye to JAX via Atlanta. Due in at JAX at 0830 tomorrow morning if all goes well and LA's storms cooperate. [1/18/2010 4:10:09 PM] Paul Gierow: I'm trying to get Dave heading that direction. [1/18/2010 5:21:15 PM] Rosa Akbari: NPS ryan burke - comms check [1/18/2010 5:21:16 PM] foard.copeland: comms check w/ brian at nps - status? [1/18/2010 5:23:52 PM] *** Brian Steckler added Erin Mote *** [1/18/2010 5:57:01 PM] Brian Steckler: Back online. … [1/22/2010 7:45:59 AM] John Crowley: seems like we could embed better XML schemas inbound and outbound, esp using UN formats for describing the clusters [1/22/2010 7:47:34 AM] John Crowley: it needs the ability to add new forms to capture important things of interest, like req for supplies from hospitals, req for patient transfers, req for food/water, observations of disease outbreaks, etc [1/22/2010 7:47:41 AM] John Crowley: blogs don't do that [1/22/2010 7:48:04 AM] John Crowley: it's what we got, so we'll work with it. [1/22/2010 7:54:53 AM] John Holloway: @JC xx I've sent your QSO with my and the one with Larry up to my boss asking how do we fix this ASAP. I'll keep you posted. [1/22/2010 7:58:47 AM] John Crowley: @johnh we're already getting direct requests from the Vinson, Bataan, 22nd MEU, and 82nd AB for access to structured data that Ushahidi, Sahana, OSM, and other platforms are generating. WFP and USCG are using Ushahidi to map medical facilities and encampments. Already have several hundred camps mapped, and hospitals are coming along quickly. These data need to get back out to JTF, and a few embedded maps on APAN are not going to cut it. They need access to the raw data in the same way that field workers do: spreadsheets,

downloadable kml files. The web requires connected use; files that you can download don't. [1/22/2010 7:58:58 AM] John Crowley: it was a key lesson learned from SA-III. unlearned here [1/22/2010 7:59:14 AM] John Crowley: I know: I developed the SA-III web site. [1/22/2010 8:10:09 AM] John Holloway: John xx working on getting Higher Mgmt to weigh in to get this fixed. I really appreicate all your comments xx my boss is currnetly in court, part of jury, and today is the sentancing phase. Said he should be back on line abt 1300 xx I'll what he can do to make this happen ASAP. [1/22/2010 8:11:52 AM] Paul Gierow: @JH fyi, new GATR set up at Jimani DR Hospital camp at 18D28’ 58.94” N 71D 51’ 50.25” W. [1/22/2010 8:12:06 AM] John Holloway: Tks Paul [1/22/2010 8:13:42 AM] John Crowley: Paul, do you have coords of the other public GATRs? I can pass to OSM/Sahana so people know where there is connectivity. You guys rock. [1/22/2010 8:18:18 AM] Paul Gierow: GATR at UN site until 4PM today 18^ 34.691' N, 72^ 16.492W [1/22/2010 8:18:42 AM] Paul Gierow: Then at MAF hanger after that will send lat long. … [1/24/2010 5:09:03 PM] Brian Steckler: Finally have decent 'net connection. Got to AMEMB at 1630 today. Getting settled in. Will start to collect contact info, maps (four of our six person team got here yesterday morning and have been to UN compound, met a number of folks, etc. Larry we'll go offline with you and assimililate all this then post to the group once we get a format. OK? [1/24/2010 5:10:01 PM] Larry Wentz: brian works for me when would be a good time to call tomorrow [1/24/2010 5:10:31 PM] Brian Steckler: John, you get the price for the most acronyms in one skype post ! Some on group chat have no idea what you are saying. [1/24/2010 5:14:21 PM] Larry Wentz: brian i had to guess at a few [1/24/2010 5:18:26 PM] Brian Steckler: you can call tonight Larry. Or, better we can do a Skype vx call (we have an unlimited BGAN sim on our unit here). Just give me some time to get some critical emails and chats out. [1/24/2010 5:18:38 PM] Larry Wentz: john made changes and just emailed you the latest version with your inputs [1/24/2010 5:18:46 PM] Brian Steckler: I meant PRIZE of course ! :) [1/24/2010 5:19:51 PM] Larry Wentz: brian i need to good eat so let me try a little later [1/24/2010 5:22:03 PM] Brian Steckler: Super. I'll share with our Haiti and Monterey dets real time then. PLEASE no more emails to me than necessary. When on ship it's a very small pipe with a large amount of people using it and it's going to get more critical as they fully man up. [1/24/2010 5:23:13 PM] Larry Wentz: got it i have been holding off thought you were at embassy with reasonable net connection

… [1/25/2010 3:40:27 PM] John Holloway: USSOUTHCOM CAC BATTLE STAFF (CDR Clark) 6:34 pm JTF-Haiti - Below is a good news story and an additional request for security --- this was emailed by the Chief Pilot for one of Ross Perot's companies.......... Good afternoon, sir! First and foremost, let me thank you and your team, the task force in Haiti, and the entire U. S. military on behalf of CURE International, and the doctors and nurses whom our group has been asked to support, for your professionalism and quick response to our “request for troops” this past Saturday, January 23rd. Less than an hour after you asked me to forward to you the urgent email I had received from the CURE doctors on the ground at the Hopital de la Communaute Haitienne in Port-au-Prince, I was sent a message by the Chief of Staff that “troops just arrived!” That, sir, is impressive and commendable! Following the arrival of the security personnel which arrived as the result of your action, other security personnel with whom we made contact were able to travel to the hospital and provide additional security. It is my understanding that the forces which you were instrumental in arranging have since returned to other responsibilities. Also, the additional security personnel whom I referenced ARE ONLY ABLE TO REMAIN AT THE HOSPITAL UNTIL THIS THURSDAY, 28 JANUARY. All that said, a very visible security presence at the hospital continues to be of the utmost importance and remains our highest priority. I was just told that a patient’s family has recently stolen a significant number of MRE’s (to be sold) which were stored in the hospital to directly support the medical staff currently working there! I’m sure you can use your imagination to conjure up additional scenarios requiring a keen security presence. My question, sir, is this: Is it possible for you to convey this email to the task force command post on the ground in Port-au-Prince to ask that they continue to keep the Hopital Communaute “on their radar” and, if at all possible, to ensure that an appropriate level of security continue en force there beyond Thursday? Our current plans have my team ‘extracting’ the medical team currently in Port-au-Prince this Thursday night, and ‘inserting’ a replacement team to take over where the first leaves off. It is simply not fair to ask that these doctors and nurses continue their work while constantly having to look over their shoulders to make certain they are safe. Again CDR Clark, I thank you for all your efforts and look forward to your response. VR,

Ched … End of Skype Haiti Expert Group Chat Session. As evidenced by the few copy/pastes of the kinds of information that was being passed around on this unofficial ad hoc Skype chat session that was started within hours of the Haiti earthquake, it is clear that this is a powerful real-time tool with very little downside. This session lasted about two months and grew virally in both variety of users and in types of conversations and information being shared among the group. HASTILY FORMED NETWORK – LEVERAGING SATCOM/MESHED WIFI/WIMAX. At about the three week point the JFMCC tasked the NPS HFN team with supporting the U.S. Coast Guard security detachment stationed at Haiti’s main commercial port and pier complex. The 120-person Coast Guard security unit was responsible for ashore and coastal waters security in and around the commercial port area, had taken over a small island in the heart of this commercial pier area, and had set up a command post on the island. They had earlier set up a BGAN unit to provide wired Internet access to a few laptops in their command post for mission critical email. The JFMCC asked NPS to use some of our equipment to augment the USCG network, as a BGAN unit was obviously insufficient for such a large group of users. We deployed a SweDISH VSAT satellite Internet access system to provide about 1 MBPS of connectivity, then installed some high end Cisco meshed WiFi equipment that had recently been donated to us for use in Haiti, so that the whole USCG island was wirelessly connected to the Internet. USCG personnel could use the network for both official and personal use, finally allowing them to contact their loved ones back home via email and Skype, etc. The NPS team then began to deploy a WiMAX link from the island to other U.S. military units further down the port area, but had to forego completing those links as several large ships had moved in around the USCG island to block line of sight to the other end of the link. The timing of NPS HFN team deploying the mesh network at the USCG security detachment island coincided with the Super Bowl. The USCG security detachment was unable to obtain a satellite TV connection at their site, unlike the U.S. Embassy and other larger U.S. military facilities, and were quite disappointed that they apparently would not be able to watch the game. Steckler offered to set up a connection to his personal/home TV via SlingBox, a commercially available hardware/software system that allows remote connection to a TV over the Internet. Since he already had the system up and running in California, all that was needed was for the USCG unit to get the software set up on their end and a projector. They set up a make-shift outdoor screen, benches, and some barbeque grills and everyone took Sunday afternoon off to watch the Super Bowl. It was a small example of how to leverage the Internet in unusual ways, but was also a huge morale booster for the 120-person Coast Guard unit.

MINI CASE STUDY – HAITI COMMUNITY HOSPITAL. Perhaps the most revealing anecdote NPS HFN TEAM HAITI was involved with during the two-plus months we had personnel on the ground in Haiti was on January 31st at the Haitian Community Hospital of Petionville (HCH) – the same hospital referenced in the letter above but a week later. Within two hours of Steckler and one more NPS HFN TEAM HAITI member, Research Associate Dave Nystrom, arriving at this hospital we became involved in an urgent life-threatening medevac. Our rental SUV became a makeshift ambulance while our team transported a critically injured Haitian to the U.S. Embassy’s helo landing zone in the dark, in heavy traffic, through roads still full of rubble, one hour away from the hospital, so the patient could be helo’d out to the USNS COMFORT. The days’ events at the Haitian Community Hospital were the epitome of how communications was both a direct cause of a life-threatening problem, but also became the solution to the problem and thus saved a life. By January 31st the NPS team had been camped near the U.S. Embassy at the JTF Haiti complex for about one week and were still supporting the COMFORT, the DESRON, the JFMCC and the JTF J6. The COMFORT graciously provided us a large white SUV (rental) with a large white placard with a large red cross and “USNS COMFORT” on the front windshield dash. Our goal that day was to go out to the community to a typical hospital to assess the status of communications and power as well as to observe first hand some of the devastation all around us. Steckler and Nystrom arrived at HCH at about 1500 and immediately began to gather information about the hospital. It was one of the largest mostly intact/operating hospitals in the country, a 75 bed privately run facility in the heart of Petionville, a community on the hillside above the capital of Port-au-Prince. The hospital was bursting at the seams with critically injured patients to the point that make-shift tents had been set up all around the outside grounds and parking lots of the hospital. The central open-air courtyard of the hospital even had patients on the ground and on make-shift beds (doors, plywood, etc), completely covering the courtyard. Many of the patients were crush injury victims of the earthquake. The families of the injured were also all over the place, inside the hospital, in the open-air courtyard, outside on the grounds among the make-shift tents, and right next to the hospital grounds. It was close to 100 degrees and 100 percent humidity outside. Much of the hospital had no air conditioning. In fact power was only available in parts of the hospital. The situation was extremely chaotic and quite intense to say the least. There were 30-40 expat volunteer medical personnel including doctors, nurses, EMTs and others from around the world there helping the few normal hospital staff try to get a handle on the huge volume of patients. We saw such expat volunteers from Japan, Korea, France, Belgium, the United States, the U.S. Virgin Aisles, and

more. All of these health care workers were obviously quite fatigued but also absolutely committed to doing whatever was necessary to save lives or limbs. When some of the expat healthcare workers saw our large white SUV with the big Red Cross and “USNS COMFORT” sign prominently displayed they immediately came up to us and asked if we were from the COMFORT. We told them yes but that we were there not as health care providers but as researchers conducting communications and power assessments. That was fine with them as we quickly learned that both communications and power were huge problems they were having. So, they brought us to the Haitian hospital administrator and the expat “Doctor in Charge” and we made mutual introductions and began to learn more and more about the status of the hospital in general, and about communications and power specifically. First, the 75 bed hospital was over capacity to the tune of about 150 moderately to critically injured patients. The expat volunteers were from a completely ad hoc variety of small non-profit organizations from around the world all rotating in for 2-3 week shifts. Some were faith based. Some were very mature organizations that had been operating in Haiti for years and years. Some were brand new organizations that formed up just to go to Haiti to help with the disaster. The volunteers were for the most part all camping on the roof of the hospital in tents, as there were virtually no hotels or other public/commercial lodging options anywhere in the Petionville and surrounding communities. The main exception to this was that the French doctors/nurses, with their Belgian armed security escorts, were staying at the French Embassy and coming over to HCH during the daytime each day and concentrating on the overflow patients in the tents outside the hospital. One real concern of all of the health workers (expat and Haitian staff) was that this facility had NO official U.S. or U.N. support or presence. Without any U.S. or U.N. presence the hospital was being turned down on a daily basis for even basic help such as food, water, shelter, medicine, fuel for generators, and security. The hospital administrators were told by both the U.S. (US-AID) and U.N. MUNISTA and U.N. Health Cluster that they had to have official personnel on site in order to obtain any sort of support or supplies. They were directed by the U.N. to go to the OneResponse.Info web portal and register as well as to indicate their status and need for supplies and other services. But without adequate connections to the Internet, this was a problem for the hospital administrators. Then, once they were painstakingly able to register on the OneResponse.Info site, they either heard nothing, or on occasion were told that they could not be helped for the reasons stated above regarding lack of official U.N. presence at the site. There were only a few local cell phones among them all and at this point the cellular networks were working only 20 to 30 percent of the time if that. They had no satellite phones whatsoever. The hospital’s normal commercial Internet service (wireless broadband via WiMAX) was just beginning to come back online but they could not maintain a connection to the Internet for more than an hour at a time. They did not have current contact information or an ability to have voice

communications with most of the government, with the U.N. Health Cluster, or with other nearby hospitals or clinics. The Haitian land-line phone system was in very bad shape before the earthquake, and after it was completely out of commission, so there was not an option to pick up the phone and phone book and call some other hospital or clinic nearby for help. One hundred percent of the food, water, shelter, medicine, etc, was being flown in hook-or-crook by the new teams of volunteers rotating in. The expat Doctor in Charge told us at this point that they were very concerned about security at night, as when the French doctors and their Belgian armed security escorts left just before dark every day, there was no security whatsoever for the grounds inside and out. The night before we got to HCH there was a shooting on the grounds. Gunfire was happening almost on a daily basis in the community nearby. As noted in the CURE International letter above this section, incidents such as MRE’s being stolen were occurring. The Doctor in Charge asked us if there was any way we could help them get support from either the U.S. government or the U.N. We promised that we would try to help and at least confirm that the U.N. and U.S. governments were aware of the situation at the hospital. We were not aware at this point that over a week earlier there was briefly some U.S. government/military presence. At this point it was about 4:30 p.m. and we were not supposed to be away from the U.S. Embassy and JTF Haiti compound after dark, so began to make our way outside the hospital and to our SUV for the hour-long drive back to the U.S. Embassy. Then, one of the EMT’s ran up to the Doctor in Charge that was giving us the rundown and tour of the hospital and told him that they had a gravely injured 26 year old Haitian man who was going to die within 2-3 hours if he did not get out to the USNS COMFORT for care. This victim was in a motorcycle accident earlier that day, hitting some earthquake rubble on the ground and flying off of his motorcycle. We heard then that the victim’s stomach was pushed up into his chest and lungs and he had a severe compound leg fracture, and that the hospital had only a manual intubation machine that was not working well enough on such a severe case – the patient was choking to death. The EMT that was delivering the message and asking the Doctor in Charge what to do, then noticed our SUV with the big red cross and “USNS COMFORT” sign and told us the hospital had been trying to reach the USNS COMFORT about this patient for several hours. He said that either the medevac phone number they had at the hospital for the COMFORT (actually the number was for the DESRON’s Medivac Coordination Watch Floor) was getting a busy signal, or they’d briefly connect with their cell phones and either their end or the COMFORT’s end of the call would drop. He said this happened over and over again and that they were never able to communicate long enough with the COMFORT to get an OK to get the patient out to the ship. He then asked us if we could help get ahold of the COMFORT and to arrange for this patient to be immediately medevac’d out to the ship. They knew

nothing about the COMFORT’s ship-shore chat system and did not have any email addresses to the ship to request medevacs or any other service. While we unfortunately did not have one of our BGAN units with us to either chat with the COMFORT via the medivac chat network, or to make VoIP calls out to the ship, we did have (relatively speaking and sporadically) a working international cell phone, a working local cell phone and a satellite phone. Dave Nystrom then took the satellite phone and dialed the DESRON Watch Floor on the COMFORT and after a couple of tries was connected but with static and a weak garbled connection. He explained who he was (Dave Nystrom, part of the Naval Postgraduate HFN team assigned to the COMFORT), where he was (at a hospital in Petionville) and the purpose for the call (to request an OK for an immediate medevac of a gravely injured patient). The DESRON Watch Floor then contacted the COMFORT’s Medical Mission Watch down inside the ship, in the Casualty Receiving (CASREC) section and a back-and-forth dialog commenced to get more details on the patient and whether or not it was appropriate for the patient to be transported out to the COMFORT. While this conversation was going on the calls from Nystrom to the ship dropped several times. Steckler used one of the cell phones to make a simultaneous call in the hopes that between the two (satellite phone and cellular phone) we would be able to keep a connection long enough to make all arrangements for the patient and a doctor and EMT to travel with him out to the ship via U.S. Navy helicopter from the U.S. Embassy’s helo landing zone. As with the satellite phone, the cell phone kept either getting busy signals or would connect and then drop almost continually. Finally after about 30 minutes of on and off again call attempts we were able to obtain an authorization to medevac the patient out to the COMFORT as long as it could be done before dark, as the DESRON informed us that civilian personnel could not legally fly after dark on Navy helicopters. By this time it was after 5:30 p.m. and we still had an hour of driving through traffic and debris to get down the hill to the U.S. Embassy’s landing zone. It would be dark around 7:00 p.m. and we were cutting it very close. We simultaneously learned that there were no ambulances around (most in the country were either unavailable or destroyed in the earthquake) and the hospital staff did not have any vehicles that would fit a critical patient on a stretcher plus an EMT to hold the patient monitoring equipment and a doctor to oversee the tricky transport of a patient barely breathing. They asked us to take the patient, EMT, and doctor down to the Embassy helo landing zone in our SUV. We of course had no choice and agreed to do so. We then found out that the patient needed oxygen to survive the transportation on the helo out to the ship (about a 10 minute trip), but also learned from the DESRON Watch Floor (via on/off phone connections once again) that the helo did not have oxygen and that we’d have to bring another vehicle with an oxygen bottle along with us to the helo landing zone. So, Steckler loaded up the patient, EMT, and doctor in his rental SUV – with the doctor scrunched between the driver and passenger seat up front, and the EMT squatting in back holding up

the vital sign monitoring equipment and took off. Nystrom loaded up a full size oxygen bottle in another smaller vehicle and followed behind. Once on the road the traffic proved to be heavier than expected and we saw that we were in danger of arriving at the helo landing zone after dark and being stuck with the patient and unable to get him and the EMT and doctor on the helo. Steckler then used one of the team’s local cell phones to call the rest of the NPS team members who were already back at the JTF Haiti compound at the NPS camping site and instructed them to run over to the helo landing zone at the opposite end of the Embassy/JTF complex, about a 10 minute walk, and to hold the helo as long as they could as well as to be ready to help move everything and everyone onto the helicopter. Once again, calls would drop often, but the message was delivered. Steckler also asked one of the team members to bring along one of the team FLIP HD video cameras to document the next phase of the medevac. The two-car caravan arrived at the Embassy helo landing zone simultaneously with the balance of the NPS HFN team, but it was now dark and the helo crew told us (via screaming through the noise of the helicopter idling nearby) that they could not fly with civilians without an override from the DESRON on the COMFORT. Once again, Nystrom called the ship, explained the situation, and after some dropped calls and several minutes of debate the proper authorizations were passed to the helo pilot and the NPS team helped the EMT and doctor load the patient onto the floor of the helicopter and off they went, in the dark, to the COMFORT. We learned the next day that the patient was still critical but would survive. Again, the moral of this story is that communications directly contributed to the problem, but also to fixing the problem resulting in a very positive conclusion. MINI CASE STUDY – HAITI COMMUNITY HOSPITAL – PART TWO. The very next day NPS HFN TEAM HAITI returned to the same Haiti Community Hospital of Petionville and experienced once again how communications was the root and also salvation of problems in disaster response. This time the mission was to complete our assessment that was interrupted the day before, but also to temporarily set up and loan them one of our BGAN units and to have some of our team members try to determine why the hospital’s two separate Internet connections kept failing. After successfully obtaining both of these goals, the team was preparing to return to the JTF Haiti Compound when once again a hospital EMT came up to us and asked if we could help. A young Haitian woman was severely injured in the earthquake with a severe leg crush injury and needed blood or would die in 2-3 hours. Since the hospital was without power for a few days the meager supply of blood in their one refrigerator was bad and they didn’t know how to reach other sites or blood banks to get the necessary 3-4 pints of blood to keep the woman alive.

The hospital volunteer asked us once again to use our SUV and better communications options to first locate a blood supply, then to drive to pick it up and return it to the hospital as quickly as possible. We then started making cell and satellite phone calls to various points of contact with the U.S. military as well as the U.N. and other hospitals around Port-au-Prince rumored to be operating and that may possibly have extra blood of the right type. We finally connected with one clinic that was right next to an existing Haitian blood bank one hours’ drive away from us. However, we were unable to reach the blood bank after several attempts with the cell and satellite phones. At this point we learned the general area (neighborhood and street) where the blood bank was supposed to be located. We then drove our SUV to the area and found the blood bank but it was almost 4:00 p.m. and they were about to close. We begged the lone employee to stay open long enough to get us the O-Negative blood (universal blood type as the hospital could not determine the blood type of the patient). She then informed us that we were supposed to have a chit from a doctor and a sample of the blood to obtain any blood from the blood bank. Of course nobody at the hospital knew or cared about this minor detail and we had neither of these things with us. It took another 20 minutes of begging the blood bank employee to waive the chit/sample requirement in view of the earthquake and critical nature of the request – that the Haitian victim was going to die in a couple of hours without a transfusion. Finally she relented and gave us the blood. We called the hospital (dropped calls on and off) and informed them that we were on our way back with the blood. Upon arrival at the hospital and delivery of the blood they gave her a transfusion on the spot on the floor of the central open-air hospital courtyard and she survived. We were all amazed that both of our visits to this hospital resulted in being involved in saving lives and in leveraging communications to do so. At this point everyone on the NPS HFN TEAM HAITI decided to “adopt” this hospital and help them with communications as long as we could. Then over the course of the next couple of weeks someone on our team visited HCH almost every day to check or fix their Internet connection, to drop off a few cases of bottled water, a few boxes of MRE’s (meals ready to eat) and in a few cases we even bought and dropped off some large rat traps as we learned that rats were scurrying around the hospital grounds, inside and outside) and potentially biting helpless patients and spreading disease. Almost every day that our team visited the hospital one or the other of their Internet connections was down and the team fixed it. We also loaned them a BGAN unit, installed the COMFORT medevac chat program, instructed them on how to use the chat program, and continued to try to get either US-AID or the U.N. Health Cluster to recognize the hospital and to provide supplies, security and other necessities. In the end, we were unable to get either the U.N. or US-AID to do so, but were able to bring several senior U.S. military personnel there to observe what conditions were like at a hospital where there was only foreign expat volunteer teams running things. At one point we were able to arrange for a U.S. Coast Guard unit to volunteer

their time and materials to visit the hospital and build doors and shelving for the pharmacy and to repair the generator and fix other things as they could. Ironically the day we brought the U.S. Coast Guard unit commander to the hospital to do a site survey for his unit to return and help out as volunteers we found ourselves in the middle of yet another medevac of a critically injured patient, a 9 year old boy, out to the COMFORT. We used our NPS HFN TEAM SUV again, but drove the patient to the U.S. Coast Guard units camp at the Port-au-Prince main port/pier area and then the Coast Guard took the patient out to the COMFORT on one of their fast boats. This patient survived as well. Altogether members of the NPS HFN TEAM HAITI were involved in five medevacs or similar incidents (like the blood excursion). Only one of the patients we transported did not make it, and that was a previously gravely ill AIDS patient who would have died no matter what intervention was made. IV. SUMMARY/CONCLUSION While the main mission and assignment of the NPS HFN TEAM in Haiti was not to support hospitals and conduct medevacs, the experiences we had in doing so were quite educational for the team as well as to our research sponsors at the Pentagon and elsewhere. The team not only encountered various and sometimes compounded communications challenges, but we also noted a number of DoD and U.S. government policy issues that need to be addressed. These policy issues, while beyond the scope of this book, ranged from how DoD interacts with the U.N. and NGO community to how we interact with host nations and even the interaction, interoperability, information sharing, collaboration and overall communications between U.S. and other responding foreign military units. The experience of beginning our mission on the USNS COMFORT was also valuable as we could witness first hand how medevacs were conducted from the Navy’s point of view, and in particular how the voice and data communications process worked and/or did not work. We could also see how challenging it was for the Navy medical and other operational personnel to deal with disaster relief of this magnitude. We saw that the medical personnel often had to make life and death decisions and that their capabilities were sometimes overcome by the sheer volume of need ashore, and that 20-hour days were the norm for the majority of these personnel. It was also useful to see how the Navy interacted and supported both the NGO community (on the ship and ashore) as well as the media. It was clear while on the COMFORT that bandwidth is one of the most sought after commodities and that there seemingly was never enough to go around to keep everyone happy. Haiti NPS HFN Group AAR/LL Document author: Brian Steckler (NPS HFN Center Director, 831.402.1584, steckler@nps.edu.