At the Epicenter of the Crisis

USNS Comfort’s Medical Teams Help Hundreds

Por Dialogo
abril 01, 2010

Imagine being in a country when a major natural disaster hits. Now imagine
being one of the people in this same country to whom everyone else will turn to for
answers and guidance. That’s exactly what happened to Lt. Gen. Ken Keen, military
Deputy Commander of U.S. Southern Command, who was in Haiti at the time the
earthquake struck. Lt. Gen. Keen became the Joint Task Force Commander in charge of
the U.S. military relief effort in Haiti and spoke to Diálogo in Port-au-Prince. In
this interview, Lt. Gen. Keen provides his personal insight into the moment the
tragedy occurred and an assessment of the strategic decisions taken in the days that

DIÁLOGO: You were in Haiti when the earthquake hit. What was your
immediate reaction and assessment at that moment?

Lt. Gen. Keen: It was evident immediately that it was a significant
earthquake that was going to have devastating consequences. I was with the
ambassador, sitting on the veranda of his house preparing for a reception that
evening. When it hit, there was a violent shake and it sounded like a large
explosion. Clearly, that wasn’t it. On later reflection, I think what we heard may
have been one of the major hotels nearby that was collapsing. It seemed it would go
on forever, but it lasted about 40 seconds I’m told. We immediately called SOUTHCOM
to let them know where we were and that we would get in touch with them as soon as
we had more information. This was at 4:53 [p.m.], about an hour before the sun goes
down. There was a cloud of dust that covered the entire city. You couldn’t see down
into the valley because all the falling structures had created this layer of dust.
As it started getting dark, you could hear the screaming and yelling from what was
happening below.

The first hours following that were about trying to get in contact with folks
at the embassy, about accountability of your people. Where’s everybody at? Is
everyone OK? Then we started understanding that this was really dramatic. We got
reports that the Hotel Montana collapsed, which is where we had people staying. We
got reports that the homes of embassy staff had collapsed. One of the officers
assigned with me and who was staying at the Hotel Montana showed up with severe
injuries. He had fallen from the fifth floor … but was able to crawl out. He had a
broken leg, a badly injured arm and lacerations. He was brought up to the
ambassador’s residence because the Hotel Montana is nearby. It soon became evident
that the earthquake had created significant damage.
We were unsure of the damage to the airport at first, because a few minutes
after the earthquake, an American Airlines might actually took off. We spoke later
with the manager of American Airlines, and [he said] they were loading that plane
when the earthquake struck. The pilot, after talking with the ground crew, had to
make a decision whether to stay or leave. They checked the runway and it was OK, and
it was still light outside. So they gave passengers the choice to decide whether
they wanted to stay or leave. A few decided to fly out, but most stayed back. So
they flew out. So we knew that the runway was OK, but the tower had collapsed.
The Haitian president sent three of his ministers to the ambassador’s
residence on motorcycles to talk to the ambassador, and the ambassador talked to the
president by phone to get his assessment.The only thing he asked at that time was to
make sure we could reopen the airport because he understood that would be critical
for getting in emergency medical assistance. We alerted SOUTHCOM and they
immediately sent special operations aviation air force teams and they arrived at 9
[a.m.] on the first day and were able to immediately reopen the airfield to operate
24 hours a day, seven days a week. So getting the airfield open was critical from
the very beginning.

The next day at daylight, I went to the headquarters of the U.N. forces. It
had collapsed. I linked up with the chief of staff of the MINUSTAH [United Nations
Stabilization Mission in Haiti] forces there. That started the relief effort. That
night we already knew we had some casualties that had to be evacuated. SOUTHCOM sent
Coast Guard cutters that were nearby to assist, and we started evacuating those
Americans who had been brought to the embassy at first light on January 13th to
Guantanamo Bay.
Everyone in Haiti was in the same boat, whether you were U.N., government
personnel or Haitian civilians; we were all affected by the earthquake. the U.N.
lost 101 people and they were putting their troops that were not affected on the
streets to make sure law and order was maintained. A Brazilian company lost over 15
Soldiers, in just one company. So they were personally and tragically affected by
the earthquake. At the same time they had to address the needs of the people on the
street and ensure law and order.
It took me 2 1/2 hours to drive from the ambassador’s residence to the
airport, which normally is a 30-minute drive, because we would go down one corner
and it would be blocked, we’d try another corner and that was blocked also. There
were people lying in the street who were bleeding and buildings being searched for
survivors. It was utter chaos. Everybody was trying to help everybody as best they
could. the hospitals and medical facilities had also collapsed. So that first
morning no one knew what medical facilities were still operational or not. We later
learned that some, like the Argentine hospital, were working and people were
directed to go there. It was very, very chaotic and unclear in terms of the total

DIÁLOGO: Did you feel frustrated that you wanted to help more at that
moment and didn’t have the assets at hand?

Lt. Gen. Keen: I don’t know if frustration is the right word. It’s more
a recognition of reality. An earthquake strikes without warning and we were in a
country that did not have a lot of infrastructure and capacity to deal with this. It
was a matter of determining quickly what capabilities were available to provide
relief. One aspect that probably has not been recognized sufficiently is that the
loss of life would have been a lot worse had there not been U.N. forces here. Even
though the U.N. forces were heavily impacted, they had the most forces on the ground
to maintain law and order. the U.N. had troops and they were out trying to do the
best they could, even though they were seriously affected. We clearly saw that our
job was to immediately inform Southern Command and our leadership in Washington,
D.C., what we could see on the ground so that decisions could be made on what
resources would be made available to support the people of Haiti.
It was clear that we were going to need as much as they could possibly send
this way, and in fact they had already done that. Decisions had already been made
the night before to move the aircraft carrier USS Carl Vinson this way, as well as
the USS Bataan, other ships and the 26th Marine Expeditionary Unit. We were also
talking about how much support we would get from the 82nd Airborne Division. the
first day we sent Coast Guard helicopters and Airmen to open the airfield. On the
second day we saw the lead elements of the 82nd, and on the third day we saw the
lead elements of the maritime component coming in to include helicopters from the
Carl Vinson. It was evident we needed to push as much as we could to support the
people of Haiti, recognizing that the need was to save lives and set up search and
rescue teams.
I could tell the commander just by driving from the ambassador’s residence to
the airport that every third building had collapsed. So there were lots of people
that needed to be rescued under this rubble, and it’s not going to be hundreds — but
thousands. the Department of State and USAID [U.S. Agency for International
Development] have search and rescue teams that do this all over the world
professionally, the two most wellknown from the U.S. being the one out of Fairfax,
Va., and the one out of Los Angeles. theose teams were alerted immediately. It’s a
72-man element of the best fire fighters who respond to this type of crisis. there
ended up being about 30 of those teams from around the world here. the Hotel Montana
at one time had six teams alone because of the number of people trapped there and
the number of lives that needed to be saved. I think there were over 120 lives
rescued over the course of this, which by all accounts, is unprecedented in a
disaster like this.
So first, you need search and rescue teams to save lives and then medical
assistance. Under the best of circumstances, if no hospitals would have been
affected, it would have been overwhelming. the fact that almost every hospital was
either affected or completely destroyed made it almost an insurmountable obstacle to
overcome. It became clear early on that they needed to push in as much emergency
medical assistance as possible, whether it’s field hospitals from nongovernmental
organizations or hospital ships that the U.S. set up, getting the USNS Comfort here,
which was in dock when the quake hit. they had to start the engines and man it with
all the doctors from all different places and get it going in record time.
The accomplishments of the hospital ship Comfort had never been done before
to this magnitude. They performed over 850 surgeries. They saw more patients in a
short period of time than they had ever seen and treated the most desperate trauma
cases that could not be treated by other medical facilities in Haiti. They only sent
them the very worst cases and those needing major surgery. The amount of medical
assistance provided by NGOs here was also incredible.
We also knew that providing food and water was going to be critical as well.
Prior to the earthquake, over 1 million Haitians were getting food aid to survive,
so obviously, this was going to be even worse. We have 3 million Haitians who were
affected in the earthquake-hit areas who are going to need some type of food aid. So
getting food and water in became a big role to facilitate from a military stand
point. We needed to open the airfield and then we needed to assess the port, which
we did during the first 24 hours, and determine how to get the port back into
operation. Before the earthquake, the airfield was taking 13 flights a day. It was
running between 6 in the morning to 10 at night. Once we started operating it after
the earthquake, within 24 hours, it was averaging over 150 flights a day and it was
running 24 hours a day. theat was all it could take. It’s an airfield with only one
runway and one taxiway. It has a limited capability to put airplanes on the ground.
But it was the only way to get supplies into the country, because the port was
Whole sections of the pier dropped into the water and the pylons, all 220 of
them, were damaged to some degree. Although it wasn’t completely destroyed, it
couldn’t be used until repair work was done. It took two weeks to bring in barges,
get divers into the water and determine what we could use to bring supplies in
through the port. We have turned the airfield back to the Haitians. Before the
earthquake, there were 100 containers coming into the port every day, today that
capacity is over 500, because we put in artificial piers and barges in place that we
brought in from the U.S.

DIÁLOGO: What was the most challenging requirement in the therst days
after the quake?

Lt. Gen. Keen: the most challenging element was to ensure we maintained
an open line of supplies into the country. Initially, that was the airport for all
relief aid coming into this country. Unless you were going to land in the Dominican
Republic and drive across, you had to fly in through there. The other most
challenging perspective from my standpoint was how to coordinate everything that was
going on with the government of Haiti, because we were here to respond to their
needs, and the United Nations, which was clearly responsible for the security of the
country, whether it was working with the Haitian National Police or their own
forces. That was their responsibility before the earthquake and that has continued
after the earthquake. We had to coordinate with them and all the non governmental
organizations — there are almost 1,000 here now — and then all the countries that
wanted to help.
You need to coordinate to know what everyone is doing and what the priority
is. the U.S. military was here in support of USAID, and they were the lead federal
agency. We were working with them to determine what they wanted us to do. It was a
collaborative effort. It wasn’t as if the U.S. military was in charge of this
operation. We were just one of several organizations that were helping.
As we addressed those needs in the first week or two, it allowed all the
other civilian organizations, like the NGOs, USAID and U.N. organizations, to
establish their capability. As they have extended their capability, there has been
less of a need for the U.S. military. In disaster relief operations, whether they
are in the United States or abroad, after you get through the initial emergency
relief and response period, the civilian organizations that do this for a living and
do the more robust relief and recovery, stay on — this allows the military to
redeploy its assets.

DIÁLOGO: Can you summarize the task force involvement from the therst
days until the present?

Lt. Gen. Keen: This is about as much no-notice as you can get for a
military operation, because there is no warning. Unlike a hurricane, you don’t see
it coming. Unlike a military operation, there are no indicators that a situation is
developing that lets you prepare. the immediate response was to push everything you
can this way and we will sort it out.
What we need to do is save lives and we need to relieve the suffering of the
Haitian people. theat’s as simple as it gets. theat’s going to mean search and
rescue teams, delivering food and water, working with the U.N. forces already here
in terms of providing humanitarian assistance and security. It was obvious to me
that we needed a Joint Task Force, and it needed to be robust enough to control a
fairly large contingent.
The first thing we focused on was getting the airport open, because I knew
that I could not help those that are under the rubble in the city if I didn’t get
the airport opened to allow the search and rescue teams to come in and the aid
organizations to come in. It had to be functional and it had to stay open. So we
needed to get the best Airmen in the world in there as fast as we could.
The priorities now are for shelter for about 700,000 people. The camps are
overcrowded, with 40,000 people where there shouldn’t be more than 10,000. A fourth
or even a third of the city is in rubble, and you need to remove rubble so that
people can go back to their homes and live. In front of the presidential palace,
there are 29,000 people living in tarps and tents. In addition to that, you have to
have land so that people can move and create a settlement. The government has five
plots of land to set up settlements where they can have facilities for medical
treatment and security, so that folks feel they are not subjected to the gangs and
criminals on the street.

DIÁLOGO: What lessons have you learned from this

Lt. Gen. Keen: There are a lot of lessons to be taken away. One benefit
is the relationships that we have with our fellow comrades in Latin America, which
have come to fruition in situations like this, as well as my personal relationship
with [MINUSTAH Commander] Maj. Gen. Floriano Peixoto. It was important to have known
him before, to have complete confidence in his professional abilities as an officer
and a leader. I had no doubt that the U.N. forces under his leadership would carry
out their duties in a truly professional manner. We fully coordinated everything. We
immediately agreed that everything we did on the ground would be joint in nature. If
there were U.S. troops doing something, it would be alongside the U.N. troops. At
the same time, their role and mandate from the U.N. was respected, and if a
situation arose from a security standpoint, we would call his forces to deal with
Another thing is that regardless of what we do, we all focus on the same
thing: saving Haitian lives. No one here is concerned about who gets credit. We just
want to do what’s right. My biggest take-away is the great relations we have with
the militaries in the region, such as the Colombians. We were able to assist them in
setting up a field hospital and coordinate with the U.N. so that they can get to
work saving lives. People are just doing what it takes to make sure that people get
With the Venezuelans, we had a request for aid at the port to help them
unload a ship. they are here to support and we will do whatever we can to help any
country that wants to help the Haitian people. We are all working on behalf of the
government of Haiti.