Haiti Update 2-12-2010

-Field Hospital Update

-Field hospital Name

-Team Marty to Leave

-Team Chuck Staying on

The generator for the field hospital has been delivered and they are working on setting it up.  A well is being dug for a water source.  Overall thinks are progressing and maybe the facility can be used this week.

Ashley Aakesson (Children’s Nutrition Program of Haiti)  was happy to report  that Bishop Duracin has given his blessing to name the field hospital  “Hopital Sainte Croix”  under the leadership of World Wide Village until a new permanent facility is built.  This is really great new for those you familiar with local politics and allows the group of NGOs who have working hard to continue with community support.  We will never forget “Leogane Shock Trauma Hospital” , our home for the first month after the quake.  This is where all came together for one purpose, worked together under extreme circumstances even though we came from different groups (NGOs) and parts of the US.  It is something I will never forget.  The name may change but  the spirit and cooperation will continue.

Marty Dineen leaves today.  I have to say a few words about his enormous contribution.  He joined us on 1 day notice and has stayed an extra week to help transition the surgical teams.  Although he does talk my ear off (he is Irish and gives my partner a run for his money), you just have to love his spirit, willingness to help and hard work.  Marty has many firsts – first graduate of the LSTH Plastic Residency Program, LSTH Poet Laureate and now he has written his summary of the InterVol/ND team 3 week of activities.  He interviewed the members of this team and asked their thoughts about this journey.  It is very insightful and a pleasure to read.  I would encourage others to put their thoughts, emotions experiences in print as they happen.  It is not only therapeutic but helps others understand what we experience.  I have taken the liberty to mildly edit  some of this manifesto and will share it over the next few days.

Marty’s Report:

February 6, 2010, Leogane, Haiti

Dr Ralph the rest of the RGH gang departed on the last Tradewinds Caravan flight out yesterday at 4 p.m. from the now world renown Leogane International Airport complete with curbside service, luggage pick up, overhead dusting by UN helicopters, and perimeter protection by US Marines who are happy to be here rather than Afghanistan.

http://video.nytimes.com/video/playlist/front-world-americas/1194811622195/index.html#1247466881755

We keep hearing that it is the last but “fluid” has become the operative word and who knows – maybe the PR generated by the video clip will allow them to fly a few more flights. Perhaps the insurance companies back home who are alleged to be the guilty parties for putting a stop to this may change their minds and allow more flights.

February 12th, Leogane Haiti

I had promised Ralph that I would be his eyes and ears on the ground once he was gone and would be an “Alfred” to his “Batman”.  Daily I was to write stories of all that was going on and forward them to our rather extended Notre Dame family so all could keep abreast of what has been going on. Sadly I have failed miserably to do this.  I wanted to operate more than administrate.  However….

This morning 6 of our people left Leogane for Jacmel and as I write this they are over the skies of Haiti in little flour seat aircraft heading toward Santiago, DR and from there to JFK and onward to Rochester New York (From +95 degrees and relentless sun to -95 degrees and no sun). 

Prior to leaving I asked each of the six last night and this morning what they remember of their trip, high points, low points and points in between.  I thought I would let their brief comments speak for themselves.

Gloria Berent – Director of Nursing at Rochester General Hospital (I wasn’t to ask for how many years but she admitted to being a Mom to a 22 and 19 year old). Upon arrival

she spent three days organizing boxes of operating materials playing “Radar” to our respective “Mash” characters and then became the scheduling board “witch”.  Actually in these days of political correctness we cannot publish what she really called herself.  You can use your imagination. (We don’t believe that witches have any political standing at the moment and feel safe with that moniker). She came here looking for something “bigger” than herself – can’t really explain it—just something from within.

 Most rewarding she found teaching the Haitian nurses to teach other Haitians. With amazing ingenuity she had to make do with what we had.  She tried to teach sterile technique.  We used the little plastic sheets that came with pre packaged spinal kits someone donated to our anesthesia gang as “sterile drapes”. We operated through the little holes.  Anesthesia kept thing sterile in other ways. These sheets then became all the more a challenge as instruments would slip off and on to the floor.  Believing they were a help the nurses would often pick these instruments up and put them back on the drape (5 second rule?). So much for sterility!!  As surgeons we try anything to get out of wearing a gown. So when Gloria announced that we had to choose between using the gowns to cover our selves or as sterile sheets over the patient, well…… (I think we thought that at 110F the sweat that rolled off of us sterilized itself on the way to the floor if it didn’t drop on to the patient first – all except for Tim O’Connor (Irish refugee and the only person older than Ralph) –we figure he generated 120 degrees from body mass alone and thus rendered his sweat not only bactericidal, but fungicidal, sporacidal and viracidal as well – his spirochetes were resistant however).  She organized the PACU and would troll the outside tents sorting through literally hundreds of patients requiring some sort of surgical intervention tasked to our group. Leaving the pure medical needs to the tune of 150 to 300 patients a day to our brethren from World Wide Village (University of Iowa and others).

Gloria found hardest turning away those with huge hernias and horribly disfiguring/disabling hydroceles that just aren’t safe to do now.  It is our prayer that Notre Dame can continue this work under sterile conditions in a few months’ time.  Gloria and others would clean wounds and dress them only to find them crawling with maggots the next day which for most tends to ease off one’s appetite (except for mine (aka Dr Big Tummy) and Dr O’Connor’s).  It turns out that there are good maggots and bad.  (Funny — the things you learn here).  The good maggots tend to clean the house and make for a tidy wound.  The bad maggots tend to bury down deep within the wound prior to departing this earth and make for a mess in their quarters. Damned if I can tell the difference.  That said, we have the bad maggots.

Speaking of nursing students most were staying here at the school on the day of the quake. Many don’t know yet the fate of their parents or siblings.  Several live far away and with no phones, no mail, no communication, well…. (some of these sentences are just too tough to complete without tearing up).  At the end of the day they go home with a small ration of food (rice +) and return the next day ready for work looking better/cleaner than most Americans. How they do this is amazing to all of us who feel like we have been at Camp Tapakegabeer for a week (or Notre Dame for a semester in the 70’s) and have yet to see a shower (even though we have access to one).  Martha (28 years old) was the valedictorian of last year’s nursing class and has stayed to help Hilda (Dean of the Students) with the needs of the students.  Her English is excellent and she routinely makes fun of my Creole (essentially non – existent).  She runs around our make shift OR helping our DON’s (in this case Gloria) translate our needs to the students.  One night I asked Jean Marc Brissau where he was off to.  He said he was giving Martha a ride home. Thinking that could be miles away I asked where that was.  “On the street like everybody else.”

Anne Marie Blanchard.  Works at Clinton OB-GYN. She received a call from Cindy – volunteer coordinator for Intervol who put out the word for a PA in OB. A need to help, a special time in her life, a VERY supportive husband (leaving him with their five kids ages 13 to two) brought her here with 36 hours notice.

      The fortitude of the people was most amazing to Anne Marie.  A lady would have her baby and within 15 minutes and be heading back to her shack/shanty/tarp, etc. She did one C-section with Headlamps (coal miner lights) sewing a torn urethra literally standing on her head.  She went on to deliver 12 more children with what she describes as the best anesthesia team in the world.  Although grateful to have been part of a great team and to be able to do what she could she was frustrated that she could not deliver better care because of a “lack of sufficient/proper medicine”. While “going to a place that is going to tear my heart out” she went on to describe a baby that couldn’t breast feed but was sent home anyhow. She describes that some nights “you just want to go back and cry your heart out.” 

Yet she went on to describe a vaginal delivery with no fetal heart tones.  They were able to intubate the child and found a facility in PAP to accept the child in transfer.  Stuck in traffic they ran out of oxygen.  Realizing the baby surely would die without the oxygen they had no choice but to extubate the child and let God’s will be done.  Evidently His will was done and now two days later we have heard that the baby is alive and well. She believes that things hardest in our lives probably become the most meaningful of experiences.  We are not asked to carry a cross heavier than we can handle.  She feels that none of us have been able to do enough but is most proud of fixing up the OB room to the extent she was able leaving it in good shape for the crew arriving tonight.  No matter what you read or hear in our news media the Haitian people are grateful that we are here.  “Did you really leave your family to help us?”

Marty’s Report – to be continued tomorrow.

Final note on Craig Hankins.  Over 1 week ago we were short an orthopedic doc for a few days.  Marty made one phone call and within 24 hours on the last flight into Leogane International came Craig Hawkins.  You knew he had to be a friend of Marty – even if he is a Gator – to come without any notice to help.  And in Marty’s tradition – he is staying on another week to help transition our new group  :

Bill Willet PA

Rachel Nesbitt RN (trauma/icu)

Cindy Babcock (nurse anesthetist)

Krystof Neumann MD (Anesthesia)

Gary Tebor MD (ortho incl pediatrics)

Johann Piquion MD (OB/GYN)

Jean Joseph, MD (urol)

We are very fortunate that Jean, Johann and Rachel are all from Haiti.  They now live and practice in Rochester, NY.  I wish their team the best.

As always, more to come tomorrow.

Ralph