I stepped off the plane Friday into what I thought was a war zone. I had never seen anything like it in my life. The airport in Port au Prince has been converted into a military only fly zone and there were military aircraft flying all over. Once we hit the ground, I could see military in every direction. There were tanks, trucks, personnel, guns, and anything else you could think of. I was immediately blown away by the help that was here, for the people here, and by the overwhelming presence of everyone here.
I had left Richmond alone and had met up with 3 other people who would be coming down with me in Ft Lauderdale. So, the team that came in on Friday consisted of 4. We loaded up our truck with supplies that we had brought with us, and two of us sat on top of the truck to hold everything on. We left the airport and set out for this clinic that I’m at. I immediately understood the desperate needs of the people. They saw us coming up the road with boxes of labeled food and water and began screaming for food. When we got caught up in traffic, I was worried they might loot the truck, but they just stared at us with sad eyes and let us be.
We arrived at the clinic and instantly got to work. Let me explain a little about this set up. There is an organization that started out as an orphanage, here in Haiti. They had been running it for awhile and then realized that there is a strong need for women’s health care here in the city, so they started a women’s health clinic. They were giving women prenatal care, delivering babies, and doing post-natal teaching (breastfeeding, baby care, mother care, etc). They also teach them life skills so they can work and be self sufficient. When the earthquake hit, they started taking people in to help them from around the community. This particular neighborhood was not hit as hard as the downtown area, so they didn’t have a great need in the neighborhood. Apparently people started hearing about the clinic and started coming in. They needed more help, and they needed it fast, so they started gathering supplies and staff, and on January 18th, opened a fully operational hospital in the women’s clinic. We have one room that is our “OR”. It consist of two tables. Then we have a “med/surg” room that has three tables on one side for all non-operating patients, and on the other side there area a bunch of blankets on the floor for the recovery room for the OR. There is an area outside with chairs set up for our “fast-track” patients, which are those who really don’t have to be in the building. There is an ambulance team that runs out into the tent city and the slums several times a day and ask, “Who needs medical care?” They bring the patients back to us, and we treat them.
These people are so thankful for what we are doing for them. They do not whine, they do not complain, and they do not ask for pain medication. All they want is treatment and to know that everything is going to be ok. We offer them food and the scarf it down like they have never eaten before, but they will not ask for it. We give them water, and they drink like they never have, but they will not ask for it. We have given some kids clothes that came in naked. We have given them toys too, like the miniature military figures. Not ONE single patient has complained about anything, not one.
When patients are cleared, they either are driven back to the tent city and dropped off, or we “admit them” and send them to the orphanage to be cared for overnight. Sometimes we have patients that need more care than we can give and they will be taken to the navy ship to receive care we can’t give them. We had one lady today that we took over to the ship that had a crush injury to her pelvis the day of the quake. We were able to make note that her urinary track and vaginal track are no longer in place and are pretty much one big hole. She has not urinated since the day of the quake. She will need major reconstructive surgery on her pelvic area to live. So, she is the type of patient that we take to the ship. Those that are not in need of major surgery, are held at the site of the orphanage. We have a large front yard where the patients are sleeping on mattresses that came out of the cribs for the children. They are released when they no longer need iv antibiotics. We send these people with amputations, crush injuries and broken bones home with Advil, and they are so thankful!
The spririt of the people here is something I will never forget. They have been through so much, and sometimes it’s hard for me to remember what it was that happened. I see the destruction and the devastation, but since I’ve never been here, I don’t know what life was like for these people before. I am blown away by their ability to pick up, move on and to do what needs to be done without thinking about it. I’m starting to hear more and more of their stories, about what they went through, and I am just humbled. I do not think there is any one here, including our baby born today, that has not been severely traumatized by this event. I am not sure how they are going to move on from here, but I know, because I see it in their eyes, that they will!
January 30, 2010
12:56
I arrived home from Haiti on the morning of January 29th, shortly after midnight. I’ve been home for around 36 hours now, and I’ve been asked by many people for further updates and to talk about all of the things that I saw and did while down there. I’ve decided to pick up from Sunday night’s post and add to it. I’ll cover some of the major events we had happen, and then talk about the new dynamics that are occurring there. The shift in what’s going on is amazing.
Injuries we’ve see…..
Burns, lots of them. I didn’t realize there would be so many of these, and I wasn’t expecting them to be so prevalent. But, with the quake occurring at 5pm, many people were starting to make dinner. We had children who were near the stove and had large pots of water fall on them, covering them from the top of their head, down in burns. We had people like Manushka who had propane explosions. I just never imagined that we would see so many of them.
Crush injuries galore! Feet, arms, hands, heads, you name it, they were crushed. We saw a man with a large indention in his skull with a gaping hole, over two weeks after the earthquake and no one had seen him before us. We saw a young boy who had a large cinder block fall on his hand, crushing it, and as he was pulling it out from under the block, the skin covering his hand came right off. He has no skin from his wrist to his fingers and there is no way any type of skin grafting can ever be done on it, making it impossible to heal.
Amputations, or at least, the need for them. Many people were “seen” by medical people immediately after the quake and had a simple 4X4 piece of gauze slapped on with tape and left. As we found them, many of them had become so necrotic from the infection that they required amputation. We also have a lot that are occurring because of the crush injuries. They were not seen afterwards, developed compartment syndrome and have become necrotic, or the injury itself was so bad that nothing else could be done. Many amputations were being done with little or no anesthesia on our foldable tables using unsterile procedure and with Motrin given for pain medication. We have children being amputated, all the way up to adults. It’s sad, but the next generation of Haitians will be known for their amputations. Some of them will never be able to function again, because prosthetics just don’t seem feasible.
Maggots. We have one little boy infested with them in his ear. They are all the way down in the ear canal feasting away. We keep trying to pull them out, but they are laying more eggs and they are hatching. Not sure at this point whether he’ll even be able to keep the ear anymore.
Leprosy. I didn’t think this was around anymore, but apparently it is. We saw two people with it actually. Not exciting, ok, maybe it was just to glance at it, but not to get near!
Malnutrition. These were not well-fed people to begin with. But now that there is no food left, it’s getting even worse. I saw this one kid the other day that was so malnourished that he was nothing more than bone. He was probably 3 or 4 but didn’t look older than 18 months old. People are looking everywhere they can for food. But the wild thing about it is, they aren’t really getting violent about it. You hear stories on the news about people looting and such, but what else can they do for food. It’s not mass hysteria; people are actually standing in lines to wait for food. They aren’t trampling each other down to get to it. They are waiting. With the malnutrition comes dehydration. There is no good clean water. And this also effects the babies, Haitians don’t like to breastfeed because they believe that formula MUST be better because it comes from the “richer” United States. How can you mix formula when you don’t have water? If you can even find it to begin with.
Fractures. Like the crush injuries, you name it, it’s been broken. Legs, feet, arms, skulls, pelvic bones, ribs, etc. There are so many people in cast right now.
The Shift….
Things are changing so much in Haiti right now. I don’t want to get into politics, I just want to talk about what I’m seeing in our clinic and in the people that we are interacting with. On Friday, the 22nd when I arrived, things were so chaotic. There were only enough supplies to give people the most basic of all treatments. We didn’t have anesthesia, we didn’t have morphine, we didn’t have casting materials, and we didn’t have most antibiotics. There was a person to be in charge, and a medical director. We had a podiatry doc, an ob-gyn doc, an ER doc, an orthopedic PA, a PA, an anesthesia doc, a midwife, and two nurses. The types of injuries that we were seeing were people that had never been seen by anyone, and they were very sick. The shift started to occur on Tuesday of this week when we started receiving more supplies. We received a casting saw and casting material so we could set fractures and put them in cast. We were also seeing that people we were picking up, were people that were coming back for re-checks of their injuries. We were seeing less and less of people that had never been seen and began to see more and more follow-up care. We also saw that the medicine was going from primitive third world practices, to more of an organized care. We went from just doing whatever we could, to having time to think about what the best option was and choosing from several different scenarios. At first there were no choices to be made, we just did what we could, which wasn’t much. The organization is improving. Nurses are starting to worry about how things are charted, and the organization of daily task. Doctors are starting to think of alternatives, and correct medication dosing for their patients. The clinic is looking at changing their dynamics too. They need more long term, “inpatient”, care and less critical ER/OR care. Instead of putting all of the resources into fast assessment and treatment, they are starting to look at how to care for these people in the long run. This was an orphanage just over a year ago, and look at where they are now. How long are they going to be able to keep this up without making a decision to turn this into an official clinic. Should they consider opening clinic. Is this the direction that they are going to be headed? What comes next for them?
How am I doing now…..
This would have been a rough question to answer yesterday. At first, I couldn’t do much, other than lay in bed and cry. The things that I saw and the things that I participated in were nothing short of horrific. I didn’t want to come home. I didn’t want to leave the people of Haiti there with no food, no water, and no medical care. I wanted to stay and rough it out with them. I didn’t want to sleep in my bed. I didn’t want to eat food. I didn’t want to drink clean water. I didn’t want to take a shower. I didn’t want to do anything that the people of Haiti couldn’t do. It didn’t seem fair for me to have all of those things so easily accessible and to leave them with none of it. I still can’t turn on the TV or the radio. I’m afraid I will see the people of Haiti, there without me, suffering while I sit at home and watch. I feel helpless, like I could never do enough for them. I want to go back, but I also don’t feel like right now is the right time for it. I feel like I’m supposed to wait for another time and then go, and I’m sitting here waiting for that to happen. I am on anti-malaria drugs, as Malaria is very bad down there and I am covered in bites. I am not able to sleep. I’m having nightmares. I can’t close my eyes without seeing children being amputated. I have visions of downtown Port-au-Prince and the devastation there. I feel ill, and I think it is from the sheer exhaustion of working 12-18 hour days, and even 24 hour days with no rest and very little food. And we are talking HARD work, unlike anything anyone in America would ever have to do at work. I’m clinging to my family and trying to pull comfort off of them. And, it definitely doesn’t help that it was 90 when I left Port-au-Prince on Thursday and it is now snowing like crazy outside!
What’s next…..
I have no idea what is next. I’m waiting to see. I have been taking each hour at a time, and trying to get through them. I have to return to work on Tuesday night, and I know that is going to be difficult. Taking care of Americans with modern medical equipment and treatments, I just don’t know how I’m going to do it. And, as I said earlier, I’m waiting, for the time that I’m supposed to go back. I have no idea when it will be. It could be next week, it could be a year from now, or it could sadly be never. Now, I just wait to see what I am to do next.
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