Mr. Duguid: Welcome ladies and gentlemen. We are in the U.S. Joint Information Center in Port-au-Prince, Haiti. Today with us are Mr. Tom Sizemore, the Principal Deputy Director for Preparedness and Emergency Operations at the U.S. Department of Health and Human Services. Accompanying him is Mr. Peter Bloland, the Associate Director for Science and Programs at the Centers for Disease Control and Prevention. Our guests will talk to you about the current health situation in Haiti. They'll begin with a few remarks and then we'll go to your questions.

Dr. Sizemore: Thank you very much for being on this call today. It's important that the long process of recovery remains visible to the public. Especially to the millions of Americans who through their contributions of money, time, and sympathy, are part of this effort.

As you know, the United Nations, working with the Haitian government and its international partners, our efforts to coordinate effectively have produced a very strong collaboration. It's our shared goal to alleviate the suffering of the earthquake survivors as much as we can, as fast as possible. And in the days following the quake the focus was on responding to the acute emergency needs and that still continues. Now we're taking the steps to address the emerging health risk of the population including some million people who have been made homeless by the quake including tens of thousands of people crowded together and living under plastic sheets.

Yesterday the international teams began doing rapid assessments. These assessments will give us a picture of health, nutrition, and shelter of survivors across the country. Today we're rolling out a general surveillance tool. Whereas the rapid assessment will give us a snapshot of a broad range of indicators, the surveillance system is being deployed and will give us a moving picture of the health threats as they emerge over time. Based on the information collected by the rapid assessments and the general surveillance tool, we'll be better able to use our resources more effectively.

While the U.S. Department of Health and Human Services still has almost 300 doctors and nurses and support staff in six different locations seen, as of yesterday, over 11,600 different human contacts, different nations, men, women and children we are continuing to evaluate and treat.

The rapid assessments and the surveillance tool provide the first steps in rebuilding Haiti's public health infrastructure.

Finally, while I'm extremely proud of all the work Americans are doing here, I want to remind you that this is an international collaboration with the government of Haiti.

Thank you again for being on this call today.

Mr. Duguid: Thank you, Dr. Sizemore.

Dr. Bloland, would you like to say a few opening remarks?

Dr. Bloland: We've been working very hard, as Dr. Sizemore mentioned, to stand up and implement a public health surveillance system. The surveillance system is really designed to do a couple of major things. The first thing is to give us the ability to rapidly detect the emergence of potential outbreaks of infectious disease that might arise from the breakdown of the public health system here in Haiti and the crowding that has occurred as populations have left their homes or lost their homes and moved to temporary shelters.

The second part of that public health surveillance system is really trying to get a sense of the impact of the earthquake. We'll go on to continue to collect information about trauma cases and complications of trauma cases.

The third little component is really to try and assess the impact of the earthquake on provisions of ongoing services to chronically ill patients. Things like chronic heart disease, TB, tuberculosis treatment, and treatment for HIV. We hope together these things will not only give us a sense of the impact for planning purposes, but also allow us to have the ability to detect new disease outbreaks and deal with them rapidly and try to limit their impact.

Mr. Duguid: Thank you, gentlemen. We are now ready to take your questions.

Question: [Jeff Schuegel, Stars and Stripes].

I'm wondering, with the combination of dead bodies and tropical heat, what is the possibility of a cholera epidemic?

Dr. Bloland: I think the evidence from past situations where there have been mass casualties has been that it's very very rare for diseased people, dead bodies in the street or community, to spread disease or be the source of outbreaks. So we're less concerned about that and more concerned about the social and cultural implications and trying to get families to have the remains of their family members interned in a respectful fashion.

Question: [Carol Rosenberg, Miami Herald Newspaper].

Doctors, thank you for taking the call. What kind of diseases are you seeing so far? And do you have any kind of status update on what's going on with the orphans?

Dr. Sizemore: I'll go ahead and start with that, with regard to some of the trauma. As you might expect, the initial results of the earthquake resulted in a lot of crush trauma, broken bones, compound fractures, contusions, concussions, internal abdominal injuries. With regard to diseases, infectious diseases and so forth, I'll turn to my collaborator here.

Dr. Bloland: Before the earthquake Haiti certainly had its public health challenges. Things like malaria, deng deng, respiratory disease, diarrheal disease. A number of different vector borne diseases that really caused them some difficulties in terms of providing care, keeping their population healthy. That hasn't changed because of the earthquake. What has changed is really the disruption of the health care system, the healthy provision system, an interruption of the type of services one would hope would be available to recognize when people are sick, and particularly if it's affecting a large number of people.

So we expect there would continue to be the problems that Haiti has always had, the same list of diseases that I mentioned before. But I think what we need to do now is get a system that can rapidly identify outbreaks should they occur. Because people have congregated in fairly large temporary communities that don't have the kinds of services to provide clean water and sanitation and because of the crowding that's occurring, we need to be very vigilant about things such as respiratory disease and diarrheal disease. Really, those are the types of things that we're most focused on because those can crop up very rapidly, affect a large number of people, particularly in a crowded situation.

Question: [Miriam Falco, CNN].

You said hundreds of thousands of people living outside or in what's called a tent, but is a blanket and a branch. You haven't had any rain in Haiti yet, but that is surely to come. How are you going to deal with that? What are the chances of more disease spreading once you've got water on top of close quarters, lots of people, and you mentioned no sanitation and fresh water, et cetera. How concerned are you about that?

Dr. Bloland: I think we're very concerned. Certainly heavy rains will not improve the situation by any means. But I think part of what the rapid assessments are aiming to do is to really get a good sense on what shelter is out there, what the needs are. That's going to be an essential planning tool, to try to understand how best to serve the needs of the population.

As you can imagine, many of these people have lost their homes, many are afraid to go back because of the earthquake and the impact that they've seen. So we have to be sensitive of this, what it appears they might have, or their situation. I think it's going to be important to try and understand what services are needed and to plan very carefully how to provide them so that the impact of rains that might come and the sanitation concerns and so forth will be met by the Ministry of Health and other partners.

Question: But if you wait for the assessment, won't the tents or whatever you can provide come too late?

Dr. Bloland: Assessments will be done in the next couple of days. The rains aren't expected for a few more weeks and months. So we are under a tight line and we're certainly going to, the international community is certainly going to try and meet those challenges. But I think the combination of understanding what the needs are, getting the international community to help the Haitian government to meet those needs, and setting up systems to recognize when something bad is happening as rapidly as possible, those things together will help us address the challenge.

Question: [Steven Smith, Boston Globe].

Good afternoon. Thank you for taking the call.

What I have heard from field hospital doctors is that they have seen this pattern emerge where the first few days they were encountering Haitians who had various injuries and complications directly related to the earthquake. What they have begun seeing in more recent days are wounds that have become infected because of the inability to keep them clean, cases of tetanus in some closed wounds, rashes, GI illness. I'm wondering in that regard if you are hearing similar things and what you make of that.

Dr. Sizemore: That's a great question and a good point. What we do see in fact, as I said earlier, initially were the injuries, and now the number of new injuries ahs leveled off. We are seeing infections from sound care problems and so forth.

With regard to tetanus and things that can be prevented by immunizations, the government of Haiti has announced an immunization program starting up pretty soon. I'll turn to Captain Bloland here and let him talk a little bit more about that if he would please.

Dr. Bloland: I think what is currently being proposed by the Ministry of Health and its partners are really to look at what vaccinations might make sense in the current situation. The types of things they're considering would be the normal childhood vaccinations, Diphtheria and other things that might pose a problem, particularly in this kind of setting. So they are working with their partners to try and understand how to put together the kinds of evacuation campaigns that will be necessary to get this out to the communities as rapidly as possible.

Operator: I'm not showing any further questions from the phone at this time.

Mr. Duguid: If someone would like to pose a follow-up question, we're ready to answer those. If not, we thank everyone for their time.

Thank you for your time in dialing in, and we wish you well and goodbye from the U.S. Joint Information Center in Port-au-Prince Haiti.