Hundreds of grievously injured Haitian earthquake victims remained in limbo Saturday, waiting for the U.S. military to resume airlifts to American hospitals four days after the flights were halted amid finger-pointing from the state and federal governments.
The Obama administration insisted late Saturday that the flights ceased because of logistical challenges -- and not over questions of who will pay the hospital bills in the United States, as the military had said earlier in the day.
Flights stopped on Wednesday amid a bewildering flurry of accusations and confusion over intentions, visas and costs -- and an angry surgeon's prediction that 100 of his patients would die if military flights didn't resume.
Military officials blamed Florida hospitals, saying they wouldn't take more injured Haitians. Hospital spokesmen strongly denied saying it.
Premium content for only $0.99
For the most comprehensive local coverage, subscribe today.
One hospital administrators' group blamed Gov. Charlie Crist, who insisted he neither asked for a halt to the flights nor suggested it. Crist said that the feds misunderstood his request for their help earlier in the week.
Early Saturday, Navy Capt. Kevin Aandahl, a spokesman for U.S. Transportation Command in Illinois, said the military had stopped the flights because states, including Florida, were unwilling to accept Haitian patients without knowing they would get paid.
"It comes down to this: U.S. Transportation Command cannot do an air evacuation medical mission without an accepting medical hospital on the other end,'' Aandahl said.
A White House spokesman said there was "no policy decision by anyone to suspend evacuee flights -- this situation arose as we started to run out of room.''
Spokesman Tommy Vietor said the problem was finding hospitals that have capacity for patients and are close to facilities that can land giant military C-130s.
Yet dozens of hospitals in major cities around the country have offered to accept and treat injured patients from Haiti, said Dr. Barth A. Green, chairman of neurological surgery at the University of Miami's Miller School of Medicine, who was in Haiti on Saturday.
"We have offers from almost every major university in the United States to take patients,'' said Green, who called his field-hospital patients in Port-au-Prince "the sickest of the sickest.
"We can't care for them either on the ground in Haiti or on the USNS Comfort,'' a hospital ship off the Haitian coast, he said. "We all agree they need to be medevacced out, but all medevacs by the armed forces have been stopped and Homeland Security will not give us paroles for the people.
"We have hospitals waiting to receive them,'' he added. "But at the highest level of the U.S. government, they can't seem to get them out.''
Green estimated that "a few hundred'' injured Haitian quake survivors need medical evacuations to U.S. hospitals, and added that many could be treated in four to six weeks and then be reunited with their families in Haiti.
Though tens of thousands are estimated to have been seriously injured by the 7.0-magnitude earthquake that struck Haiti on Jan. 12, Green said tent hospitals are not well-equipped to care for patients with spinal injuries and complex pelvis fractures.
Private planes still can carry Florida-bound patients, but Green said that's not realistic for most Haitians. "Each flight would cost thirty, forty, fifty thousand dollars.''
Five-year-old Betina Joseph was among the patients hoping to be sent to the United States for medical care.
She arrived at the University of Miami field hospital stiff and unconscious, and doctors diagnosed her with a life-threatening case of tetanus.
Cathy Burnweit, a Miami Children's Hospital doctor working in Haiti, said Betina likely needs a tracheotomy. If she survived that, she would need long-term medical care.
"It would be great if she was medevacced,'' Burnweit said.
On Saturday, Denise Exima sat on her daughter's hospital bed, staring blankly at the wall and running her fingers through Betina's hair.
"I'm hoping she can get to the United States to get better medical care,'' she said. ``I'm praying.''
On Wednesday, Crist wrote to Kathleen Sebelius, secretary of Health and Human Services, asking her to activate the National Disaster Medical System, which helps state and local authorities manage the medical impacts of major disasters -- including costs.
Crist warned that Florida hospitals were "quickly reaching saturation.''
More than 1,000 hospitals around the country have contracted with the federal government to provide immediate and longer-term medical care through the system.
It is unclear, however, whether the earthquake in Haiti qualifies for the system.
Vietor, the White House spokesman, said military medevacs did not stop because of Crist's letter or concerns about cost.
"This is not about funding,'' he said. He acknowledged that the administration is working with states on reimbursement, "but that is not preventing people from getting care.''
The day Crist made his request, with 136 Haitian evacuees hospitalized in Broward, Palm Beach and Miami-Dade counties, a state health task force member formally requested that victims be sent north -- in part to make sure Miami emergency rooms are ready for the Super Bowl.
At that point, more than 450 victims of the Jan. 12 earthquake had been treated in Florida hospitals, most at 32 South Florida facilities.
Green, the UM surgeon in Haiti, said Saturday night that he was waiting for the Obama administration to activate the federal system and resume the military evacuations.
"This is a crisis. This is an earthquake. This is carnage like you've never seen before,'' he said. "It's just not our finest moment right now.''
Miami Herald staff writers Daniel Chang, Fred Tasker, Jacqueline Charles, Kathleen McGrory, Jose Pagliery and John Dorschner, and Lee Logan of the Herald/Times Tallahassee Bureau, contributed to this report.