Haiti quake injured at risk, food handouts improve

PORT-AU-PRINCE (Reuters) - Foreign doctors treating the injured from Haiti's catastrophic earthquake fear more could die as emergency medical relief winds down, but food distribution was smoother on Sunday using a coupon system.

The medical care worries have increased after the U.S. military on Wednesday stopped flying critical quake patients to U.S. hospitals for treatment, in a confused dispute over where they should be hospitalized and who should pay the costs.

Nearly three weeks after the magnitude 7.0 earthquake killed up to 200,000 Haitians and left up to 1 million more homeless, a huge U.S.-led international relief operation has been struggling to help injured and hungry survivors.

U.S. officials said on Saturday no solution had yet been found in order to renew the U.S.-run medical evacuations.

Hundreds of patients have already been evacuated to the United States for treatment, most to Florida hospitals. But Florida's governor has asked the federal government to share the burden and White House officials say they are working on solutions, including expanding medical capacity in Haiti.

Suspension of the U.S. military medevac flights has increased pressure on emergency medical teams in Haiti who are working around the clock to treat seriously injured quake survivors, either in damaged local hospitals or in fully equipped emergency clinics that have been flown in.

"Obviously it's going to have an impact because the need is so great and we don't have the capacity on the ground to treat the neediest patients," Aurelie Ponthien, field coordinator of an emergency hospital run by the Paris-based medical charity Medecins Sans Frontieres (Doctors Without Borders) said.

Foreign medics are worried about what will happen to their Haitian patients, many with amputated limbs, after overseas doctors leave the country at the end of emergency rotations.

With Haiti's previously fragile health system in ruins after the quake, they see weak and recovering victims going back to the hundreds of crowded and dirty survivors' camps that carpet the devastated capital, where the risks of infection and of illnesses like tuberculosis and AIDS are high.

"People will fall through the cracks and there will be a lot more deaths," said Richard Wenzel, an infectious disease expert working in Port-au-Prince.

Local doctors and medical staff were among quake victims, including more than 100 nursing students buried under the rubble of a five-story nursing school that collapsed in the January 12 quake.

FOOD COUPONS TARGET THE MOST NEEDY

Adding to the worries of U.S. officials, Haitian authorities have arrested 10 American citizens caught trying to take 33 children out of the country without documents proving adoptions had taken place or that the children were orphaned by the quake.

The five men and five women, from an Idaho-based charity called New Life Children's Refuge, were in custody in Port-au-Prince after their arrest late on Friday at the Malpasse border crossing with the Dominican Republic.

They denied any wrongdoing. "The truth ultimately is that we came here to help the children, and we know that God will reveal truth," Laura Silsby, a leader of the group, told CNN.

She earlier told Reuters the group had permission from the Dominican Republic to bring the children to an orphanage there.

Haitian Prime Minister Jean-Max Bellerive told CNN in an interview broadcast on Sunday that he was worried about the risk of illegal adoptions and child trafficking.

"We have already reports of a lot of trafficking (of children) and even of organ trafficking," he said, although citing no specific cases.

On a more positive note, a coupon-based system to feed the masses of homeless Haitian earthquake victims was expanded in Port-au-Prince on Sunday, bringing a new sense of order to a relief effort hampered by often chaotic food distributions.

More than 200 U.S. troops fanned out around a sprawling refugee camp in the capital's Champs de Mars plaza at dawn on Sunday for the distribution of 55-pound (25 kg) bags of rice.

About 1,650 bags of rice were handed out without incident from the back of trucks in a distribution operated by Catholic Relief Services, said Jacques Montouroy, spokesman and logistics coordinator for the aid group.

The rice was given only to women who had received numbered coupons from relief workers who had identified those most in need in the sprawling camp.

"You have to install discipline. ... This is the only way for food to trickle down to everybody," said Montouroy.

In recent weeks, some food handouts turned unruly and violent, with mobs of hungry, desperate quake survivors overwhelming aid workers and their U.N. peacekeeper escorts.

In some cases, U.N. troops have used tear gas and Mace spray and fired warning shots to try to restore order, but without proper control, aid workers say children, the sick and elderly often miss out on getting the help they need.

The U.N. World Food Program and other relief groups have been struggling with huge logistical problems to feed survivors in the earthquake-shattered city, seeking to prevent hungry people's anger over aid delays from erupting into violence.

Bellerive told CNN that as prospects of rains increased, providing tents to shelter 400,000 to 500,000 survivors camped out in the streets was a major priority. He said the government had asked for 200,000 tents.

Peter Nuttall of the World Concern aid group said there were still "a lot of angry people" in Port-au-Prince.

But he added the coupon-based distribution system, under which the United Nations plans to hand out tens of thousands of bags of rice daily at locations around Port-au-Prince, should help the emergency response effort go more smoothly.

"The situation will calm when word gets out that if you get a ticket you get food," said Nuttall.

(Additional reporting by Joseph Guyler Delva; Writing by Pascal Fletcher; Editing by Doina Chiacu and Peter Cooney)