First reports are now emerging from MSF's teams who were already working on medical projects Haiti when an earthquake measuring 7.0 on the Richter Scale struck the country early January 12. MSF staff immediately started treating hundreds of people injured and have been setting up clinics in tents to replace their own damaged medical facilities.

The Martissant health centre in a poor area of Port au Prince had to be evacuated after the earthquake because it was damaged and unstable. The patients are now in tents in the grounds and the medical staff have been dealing with a flow of casualties from the town. They have already treated between 300 and 350 people, mainly for trauma injuries and fractures. Amongst them are 50 people suffering from burns, some of them severe, frequently caused by domestic gas containers exploding in collapsing buidings.

At the Pachot rehabilitation centre another 300 to 400 people have been treated. In one of MSF's adminstrative offices in Petionville, another part of Port au Prince, a tent clinic there has had at least 200 injured people. More are getting assistance at what was the Solidarite maternity hospital, which was seriously damaged.

One of MSF's senior staff, Stefano Zannini, was out for most of the night, trying to assess the needs in the city and looking at the state of the medical facilities.

"The situation is chaotic,” he said. “I visited five medical centres, including a major hospital, and most of them were not functioning. Many are damaged and I saw a distressing number of dead bodies.

“Some parts of the city are without electricity and people have gathered outside, lighting fires in the street and trying to help and comfort each other. When they saw that I was from MSF, they were asking for help, particularly to treat their wounded. There was strong solidarity among people in the streets."

Another MSF coordinator there, Hans van Dillen, confirmed that Port au Prince was quite unable to cope with the scale of the disaster.

"There are hundreds of thousands of people who are sleeping in the streets because they are homeless,” he said. “We see open fractures, head injuries. The problem is that we can not forward people to proper surgery at this stage."

So many of the city's medical facilities have also been damaged that the healthcare is severely disruption at precisely the moment when medical needs are high.

But MSF is also working to get more staff into the country. Around 70 more are expected to arrive in the coming days. MSF is sending out a 100-bed hospital, with an inflatable surgical unit, consisting in two operating theaters and seven hospitalization tents. Nephrologists to deal with the affects of crush injuries will also be part of the team.

However, transport links are difficult and it is not yet clear whether supplies and medical staff will have to go in through neighbouring Domican Republic. MSF is concerned about the safety of some of its own staff. There are 800 of them and not all have yet been accounted for because of the poor communications and general disruption.