-Fund raising – Canadian Style

-Canada Leaving-

Supplies 5 truck loads and fencing

Help with nursing – after they beat us in Hockey

It has been over a week since I last wrote and much has happened.  I am presently back in Haiti – a travel story in itself – but I’ll write a series of updates to catch up.  Please check out our new facility in Photo 11 by ND photographer Matt Cashore.

We will start with Surgical Team 5 and Paul Cabral.  It is nice to hear from summary reflections as it gives the best picture of how the hospital is growing and maturing.  Paul writes:

“So the week has ended and spending 18 hours a day working has left me sore feet, but energized.   While there is a lot to be done, allot has been accomplished.

This week we performed 85 surgeries, saw hundreds of patients if not a thousand of patients.

We opened an inpatient adult ward where we hydrated patients overnight, treated infections with iv antibiotics and housed post op abdominal cases.

We had a 24 hour Ed where we fixed lacerations in the middle of might caused by fights or accidents.

We had a inpatient pediatric ward where we nursed preemie twins who delivered in a taxi on the way to the hospital and another who was dehydrated.

Obstetrically we delivered 6 children and performed 1 c section. Helped with a variety other needs.

Logistically ,completed the move of the surgical unit to the hospital, cleaned up the nursing school.  Set up or and inpatient unit and minor procedure room.  We turned Wal-Mart into central stores.  We organized as much as we can.  There is allot more to do.”

Fund Raising Events accomplishes 2 things – it obviously raises  needed money to keep this program going but also keeps awareness of the ongoing needs in Haiti.  Americans are used to quick fixes.  We have a problem and want it fixed immediately and on to the next issue.  Haiti will take years.

This week the Rochester Community came out in full force.  Good friend and master chef Tony Gulace organized “Rochester and InterVol for Haiti” at the Memorial Art Gallery.  Despite a blizzard, over 150 people turned out for an evening of gospel, soul and jazz music featuring the Campbell Brothers and various eating stations by the top chefs of Rochester.  The event raised over 13,000.

The Canadian Military had set up a field hospital just on the outskirts of Leogane.  The Canadian Military is responsible for this sector of Haiti. Over the past 6 weeks we have been working together both medically and on other community projects.  The field hospital will be closing its’ doors in the next week (60 day mission finished).  The staff decided to have a fund raiser to help a local orphanage that was destroyed by the quake – Canadian Style – hey!  4 hirsute  soldiers from the medical unit were offered to the medical staff to have their whiskers cut by the highest bidder.  Obviously they picked a bunch of GQ stud looking guys knowing that it would attract many of the many female soldier  bidders who were only egged on by their male coworkers to bid higher.  I believe the highest bid went for 190 dollars and that was US bucks.  It was a painful but fun shave for the winner. (See photos 14-16)

Sean Farrell- aka “radar” (for those of you old enough to remember MASH) has been volunteering in Haiti for over 4 weeks.  He has done a bit of everything but is responsible for developing a great relationship with the Canadians.  This has resulted in 5 truck loads of  medical supplies (see photo 18)  delivered to our hospital include surgical and medical supplies, drugs and wood for a fence to built around the new hospital.  Simply amazing – hey!  In addition the Canadians have been sending over nurses (disparately needed) to help in our field hospital.  We are greatly appreciative but noted they started coming the day after  they beat us in the Olympic Hockey Finals – coincidence – I don’t think so – hey!

I have much more to come.

Ralph

PS   For those who have been recently added to this update list, older updates and video are available at:

www.intervol.org

http://rochestergeneral.wordpress.com/

www.dooleysociety.com

-Donations,donations,donations!

-Americares and Zimmer

- Dr Dan Alexander  and his C-arm

Many of recent group of docs have been sending me updates of their experience both patient and other:

Dr. Joe Bardenheier writes:

The three aftershocks we have had were a little startling but as far as I know no harm done except they wake up the dogs who raise a fuss for a few minutes.

Dr. Doug Hargrave writes “The experience has been great… “  He goes on to tell of an interesting case.  We have all seen our share of problems we don’t encounter back in the States.  More to come when I get pictures.

David Cywinski MD writes:

“ Thanks for your email, it really gets to the heart of the issue: helping people. The clinic remains extremely busy while the hospital (portable OR) continues to be in the stages of transition. Everyone here is functioning at their capacity bringing their special skills and talents to this process. At the heart of this is logistics. If I could put a wish list together, it would include a logistician that was a constant from week to week so that the wheel would stop being reinvented. The physicians could then focus on delivering medical care, in the clinic and in the hospital, not to mention mobile clinics.  As it has been said “It takes a village to raise a child.” This clinic and hospital are children that need  the talents of many.

It continues to amaze me how much you can get done from the states to help the people of Haiti, I want to thank you for this.”

Dr Dan Alexander writes:

“We all are working hard, seeing patients and stocking supplies. Yesterday we saw about 300 people (about 80 ortho). Lots of wound care including open fracture treatment, casts on and off. Many patients with fever/diarrhea, especially kids- the effects of unclean drinking water. We continue to handout thousands of water purification tablets after clinic in town. The haitian people are incredibly grateful for this. “

Dan is also one of many who have made significant donations to the cause.  It may take a village to raise a child but it takes a lot of money to build a hospital.  Fortunately we have many generous donors.  Dan donated his C-arm fluoro unit from his office.  we are arranging to place it on the 40 ft conatiner leaving Rochester next week for Leogane.

Joe Bardenheier told about a donation from Zimmer via Americares of a dermatome for a recent trip he had to Vietnam to do relief.  I followed up with both and happy to say Zimmer donated 11,000 dollars worth of equipement which include an electric dermatome, blades and the motor to run it.  I plan to bring it down with me next week during my next trip.   Don’t forget about the very generous donation of a field hospital to WWV.  In addition the Notre Dame Haiti Program has purchased 250 tents and 3,000 lbs of food for the container next week in addition to the ongoing housing facilities in Leogane.

Joey Leary has been amazed at all the help with donations.  He states it feel like a wedding shower except the bride is our new hospital and the gifts are medical supplies, equipment, food and housing.

I am sure there will be more coming.  Many thanks for all the efforts to date.

Ralph

-Field Hospital Transition

The events of the past 5 weeks has been a marriage between long standing programs providing various types of help/aid to Haiti (Leogane in particular), various NGOs, government and corporate.  Some of these organizations include:

The University of Notre Dame’s Haiti Program (http://haiti.nd.edu/) has been working for almost 20 years to help eradicate lymphatic filariasis which afflicts over 20 % of the Haitian population.  The ND residence (know as Residence Filarose) has served as  the command center for the various groups working to provide aid.  In the past few years ND alumni doctors have been making routine surgical missions to treat the secondary effects of LF – hydroceles in men (over 200,000).

World Wide Village ( http://www.worldwidevillage.org/)  has been focused on Haiti prior to the quake with nutrition and micro enterprise programs.  Two of their doctors – Chris Buresh and Josh White started a Community Health Initative in Leogane years ago.  These teams of doctors have/are providing medical care on a regular basis.

Children’s Nutrition Program of Haiti ( http://cnphaiti.org/index.html) has been working in Haiti, specifically Leogane, since 1998.  Their programs address infant and child nutrition.

There are many more groups (Save the Children, etc) which are involved and will be discussed at a later time.  The purpose of this update is to thank the various corporate donors who have contributed in so many ways. The recent downturn in US economy has caused most to view the corporate world in a very negative way.  Their are many exceptions.  Some corporations/benefactors just do the right thing.  Their are many examples that all the above organizations can share.  I would like to spotlight a Rochester based corporation – Constellation Brands.  They provided a total of 4 corporate jets (Falcon 900 – think big plane) over a 1 week period to transport docs, nurses and 8,000 lbs of needed medical/surgical supplies.  This was within the first 2 weeks after the quake when it was hard to get anything into PAP let alone Leogane.  That was coupled with the air bridge from Santiago, DR coordinated by CNP.  Recently a volunteer from the InterVol/ND Team 1 wrote a thank you to Constellation that says it all.  I would like to share portions of that letter with you.

February 18, 2010

The Constellation Family

207 High Point Dr., Bldg. 100

Victor, New York  14564

Dear Constellation Family,

Sleep, even three weeks later, does not come peacefully.  The screams from amputations being performed without anesthesia as we first arrived in Leogane, Haiti.  The premature child dying in my arms, sitting in the back of a U.S. Marine humvee awaiting an evac helicopter, mother at my side as I pumped on her premature infant’s chest. Watching a man swinging a sledgehammer, on top of a four-foot pile of rubble that was once his two-story home, knowing that a loved one was entombed just below.  The suffering and tears were immense.  The memories are still vivid and raw.

Then, I rise up, open my computer, and look upon other photos – this time brining a smile and the deepest personal and professional satisfaction of my life.

These pictures, and hundreds of others, would not have been possible if not for the Constellation family – employees, management, and pilots.  Too often the credit for medical success goes to a select few.  However, the story of our successes in Haiti is akin to a beautifully tuned engine – it takes all eight cylinders working together in harmony to cruise down the road.  So be careful of taking a picture of just one cylinder – the other seven are also humming along as a team.  Many of those cylinders were the Constellation family.

Each time we tore open a box in haste, trying to meet yet another crisis situation, the vision of the Constellation staff who met to pack the boxes, label the contents, and load the medical equipment came to mind.  All of you gave of your time, energy, and love to enable the mission, and without your efforts we could not have succeeded. Thank you from the bottom of our hearts as our work would have been impossible without you.  Your care and concern rose from the supplies and filled our work.

To the pilots of Constellation – Paul, Richard, Rick, Dave J., Chris, Dave T., – you were simply amazing.  First and foremost, you got our teams there safely and professionally.  But upon arrival you were then out on the ramp in the sultry heat helping us move boxes, handing out water, ushering us through customs, and in the final scene for me sitting at the side of an elderly Haitian woman, terrified at now being in this strange land of America, comforting her and promising to stay with her no matter how long it took for her new family to arrive at the airport.

Ginny Clark, with her amazing blend of professionalism, compassion, and laughter will forever be a friend of mine and of the Haitian people.  Greeting us with a cheery smile on the freezing Rochester runway, allowing us to feel that Constellation supported our every effort, sharing tears as we drove amongst the ravaged homes and thousands of homeless living in bed sheet tents as we approached our soon to be hospital (a partially destroyed nursing school dormitory building) or holding a Haitian infant on his way to a new home safely aboard the returning jet.  Ginny was simply a magnificent representative of Constellation, and continues to this day to support the overwhelming need for continued relief efforts in Haiti.

Finally, to Mr. Rob Sands, Mr. Richard Sands, and the entire Constellation Management Team, I stand in awe.  In these difficult economic times challenging corporate profits and P/E fixated stockholders, you simply chose to do the right thing.  The gift of your jets was magnanimous beyond belief, critical to our mission, and I am sure representative of the human compassion by which you manage Constellation.  The earthquake happened over five weeks ago, but to this day teams still cannot get into Haiti smoothly.  Your decision to allow Constellation support to this effort came with swiftness critical to saving lives, unconcerned with the cost, and that is in the end what literally saved the lives and limbs of so many.

Tonight, when you slip into bed, try and remember the faces on the two photos I have shared.  There are many, many more like those children.  Photos showing children, and their parents, who will awaken along with you to a brighter day – a day made possible by your sacrifices.  To share a simple Creole word expressing gratitude on behalf of the entire medical team, and all those in Haiti we were able to touch, let me simply say “mesi” – thank you.  It is a simple word, but one deeply felt by all of us on Teams Leogane I and II.  You allowed all of us, working together, to enable the Haitian people to begin living out another Creole phrase, “pazapa” – step by step.

Warmly,

Daniel J. Towle, M.D.

Team Leogane I, VII

The transition into the field hospital – Hospital Sainte Croix – continues.  It is no different than setting up a new hospital from scratch.  The biggest issue is getting inventory control.  We are now database what we have and what we need.  It may sound simple, but with new teams coming in and out every 7-9 days – it remains difficult.  Most docs, especially surgeons – aren’t into inventory or inventory control.  They are now learning how importance many of the “back room” functions that we take for granted back home.

As always – more to come

Ralph

Team Leogane 1,2,6,7

-Leogane Shock Trauma Hospital (LSTH) Alum to fund raise for tents

-New Surgical Team arrives

-New Video features Dr. Brett Hendel-Paterson

It started raining a few days ago.  There was 3 days in a row with rain.  Soon we will be in the rainy season with a whole new set of problems.  First the homeless are living in structures that will not protect them from heavy rain (see attached photos).  In addition the refugee camp in front of the ND residence is in low lying area which typically floods.  this combined with tight living space is a recipe for spread of disease.  They will have to be moved and they need tents to live in.

Dave Polonet is an orthopedic surgeon from NJ who is a LSTH alum who helped a few weeks ago.  He is back in NJ and is setting up a tent drive to either get tents donated or money to purchase tents. This is very timely given the above.  We hope to ship the tents in a container we hope to get out soon (working on customs issues).

We switched surgical teams recently.  The new team is:

InterVol/ND Team 5: Fri Feb 19 – Sat Feb 27

1. Dan Alexander MD – orthopedic surgery; Rochester, NY;

2. Dave Cywinski MD – internal med, pediatrics, peds intensive care, non-operative orthopedics; Rochester, NY;

3. Joe Bardenheier MD – general surgery; Florida;

4. Doug Hargrave MD – plastic surgery; Albany, NY;

5. Susan Knott RN – OR nurse; Albany, NY;

6. Phil Spanheimer MD – surgical intern; Albany, NY;

7. Jim Bates MD – anesthesia; Iowa City, IA;

8. Tara Hata MD – peds& adult anesthesia; Iowa City, IA

9. Paul Cabral MD – OB/GYN; Rochester, NY

Many thanks to Team 4 for their hard work and unpredictable travel schedule.

InterVol/ND Team 4: Feb 12 – 20:

Jean Joseph MD – urologist, U of Rochester

Johann Piquion Joseph MD – OB/GYN Rochester General

Gary Tebor MD – orthopedic surgeon w/ pediatric training

Krystof Neumann MD – anesthesiologist

Cyndi Babcock – CNRA (certified nurse anesthetist)

Rachelle Nesbitt – RN w/ ICU&trauma focus

Bill Willett – PA

A special thanks to Craig Hawkins who came on very short notice and stayed for 2 weeks.  He finally goes home.  He was a constant and helped greatly with not only transition of the teams but to the field hospital.

As you know the surgical teams work with the medical teams which are coordinated by World Wide Village via Chris and Ginny. Recently one of their docs – Brett Hendel-Paterson – had a very nice video documentary published by a Minnesota newspaper.  It shows the work being done by Bret and his group while at the original LSTH.  It also highlights the people we serve.  I have mentioned waking up in the early hours to singing by those homeless  living in front of our facility.  This is beautifully portrayed.

http://www.startribune.com/video/84746192.html

I add new names of those interested in these updates.  Please note older updates are at www.InterVol.org

As always – more to come.

Ralph

[Pictures: How the Haitians are living after the earthquake]

On Sunday Feb 14 the docs, nurses, staff started moving into the new field hospital donated to World Wide Village which will be named Hospital Sainte Croix.  Two cases were done in the new operating room.  12 -15 more were scheduled for the next day.  Attached are photos courtesy of Kara Talesmanick.

This is a major step in our efforts to provide care But we still have a long way to go.  The current structure is a shell which needs to be outfitted.  Some of the basic things needed are:

-water supply (running water not from buckets)

-latrines

-oxygen source

-equipment for the operating room -  operating room table(s), delivery table, anesthesia machine, monitors, sterilization equipment and supplies, etc

This is to mention just a few.  But one should realize and take thanks that we have come a long way in the past 4-5 weeks.  When  working out of Leogane Shock Trauma – the nursing school -  the number of patients seen and operations performed was miraculous given the circumstances,  the fact we started with nothing,  had to bring all supplies in and recruit docs/nurses/support staff on practically no notice.  Over 7,000 patients have been evaluated and treated, over 250 operations performed and we are averaging 2-3 deliveries per day, many by c-section.  Incredible is an understatement!

We must keep the effort going and try to remind others the need is still great.  The Olympics will distract most of the world from the continued need.  As we start we the rainy season – a whole set of problems will start.  Please share these updates with as many as possible to keep the interest.

Please look for anyone interested in donating needed equipment.  Full needs list to come.

Ralph

[Top: Sick Bay; Bottom: Water system]

-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

I have started to refer to the two rotating teams InterVol/ND and WWV/Uni of Iowa.  This is to keep logistics simple as we coordinate travel groups.  Many docs are from other areas and hook up with these 2 groups.  All efforts are greatly appreciated and these groups are not restricted.  Quite the opposite – we welcome all.  As a matter of fact Marty Dineen -full time urologist, recent grad of LSTH Plastic Residency program is now trying to be the “Poet Laureate” of the LSTH.  He wrote an ad which I modified slightly that  we can use to get more docs as we look to fill the spots for the next 4-6 months:

Dear Fellow Doctor,

Are you doing anything next week? You have been looking a

little run down lately and need a break.  What would you say to putting

your entire life on hold, canceling your office and coming here to

Haiti. Most of the world has no clue or won’t believe you as to what it

costs you to do something this crazy BUT I can promise you only what

will probably have been the most rewarding -devastating-eye-opening-life

changing experience of my life.

I know this is short notice, but I only got

about 48 hours notice myself — you could come to Santiago Friday or

Saturday night out of Miami and we could probably get you into Jacmel,

Haiti from there and we would pick you up there and drive you here to

Leogane.  You would be a “guest” at the Notre Dame Filariasis

Residence.  (Complete with your own chance to catch filariasis, dengue

fever, malaria, etc.)

You’ll go home sweaty and exhausted but no nurse

will tell you your H&P isn’t done, you haven’t marked which side you are

operating on, you didn’t dictate your op note and you don’t have to

worry about any lawyers.  Just a group of incredibly grateful and strong

people who have nothing but an amazing faith, a will to live, and

literally the cloth on their back.  They live in tents and little huts

made of corrugated metal and wood pulled from the rubble.  Besides it

will give you a chance to brush up on your Creole.  We have amazing

people on the ground in the US who are able to help you get here to us.

We need you now and in the next few months.  Please help!

Sincerely…….

I couldn’t sum it up any better.

I want to thank the current InterVol/ND team 3 group for giving their time on very short notice.  Most had to cancel work, patients and family activities.  I can tell you that your patients are proud to have doctors who give, and our institutions – Rochester General Hospital and all its affiliates- has rallied behind you and continue to support us both emotionally, financially and with great pride.  These folks include:

Bruce Kleene – anesthesiolgy

Bob Young – anesthesiology

Tim O’Connor – Plastic Surgery

Rocco Perrone – Plastic Surgery Resident under the Plastic Surgery Group of Rochester

Gloria Berent – operating room nurse

Ann Marie Blanchard – PA Ob/Gyn

The next team leaves on 2-11 from Buffalo and will arrive 2-12.  Since the Leogane International is closed, they will fly to Jacmel and ND folks will pick them up and transport to Leogane.  More to come on this group later.

Ralph

-MSF  Medecins Sans Frontieres (Doctors Without Borders)

-First Preemie Delivered at LSTH

-Final Prop Plane Leaves Leogane International Airport

-NY Times article and video

-InterVol Team 2 comes home

Friday was another day of excitement, international cooperation and sadly InterVol/ND Team 2′s last day.  But it was adventure packed.

Dr. Benjamin Gold is a Swiss doctor working with MSF who had a small field hospital in downtown Leogane.  He stopped by and asked Andy an I to help with a 6 yo child with significant blood loss who lost his all her forehead skin down to exposed bone 3 weeks earlier during the earthquake.  They had no access to plastic surgeons. Then word filtered out about the two at the new LSTH.  He stopped by and asked if we should come by and consider operating at their Operating Room – outdoors but still very hot.  We went by this morning and received a brief interrogation by their anesthesiologist Joe from New Orleans.  I guess he thought we were a bunch of yahoo plastic surgeons and was very worried we would get into too much bleeding and leave him in trouble.  We kept our cool and said we thought we could perform the surgery (large scalp flap and full thickness graft) with blood loss less than he expected (which is always double of what surgeons say it will be).  He was unsure but agreed to proceed.  All went well.  They had 2 things we didn’t.  An anesthesia machine (which made us realize how good our guys were doing) and an electrocautery – ah the smell of burnt flesh was never so good.  Half way through the case, with bleeding much less than predicted,  he said his initial impression of us was wrong and that we were pretty darn good.   Now, when Andy and I took off our gowns, the sweat poured out from the inside.  It looked like we jumped into a pool – see photo – look at lower legs – only thing dry (this is the fluid reference from yesterday).

Having brought the north and south back together with the aid of a Swiss General Surgeon, we returned to LSTH only to find that our anesthesiologists  and medical docs relived a preemie after mom literally showed up at our front door and delivered.  The baby was estimated to be around 26-28 weeks turned blue with respiratory distress.  Jeff was able to get a few breaths in with an ambu bag larger then the baby’s head.  the team then got an ET in and started an iv.  Now what does one do.  The USNS Comfort was full and doesn’t take anything less than 30 weeks – lesson learned – always lie about the age.  While various docs continue to hand ventilate we were able to transfer to children’s hospital in Leogane and the Japanese Military team took the baby there.  Not bad for teamwork on all sides.

Team 2 then got ready to leave.  There were mixed feelings but it had been a long 8 days and most needed a break.  We headed off to Leogane International Airport to catch the last Tradewinds Caravan Prop plane back to Santiago.  For insurance reasons, Tradewinds was forces to stop their heroic and life saving flights.  Doc, Nurses and pilots were willing to risk their lives to land on this piece of road over 60 times.  But the risk assessment folks and the lawyers decided it was too much of a gamble for the insurance company.  I could express what I think but have to keep this a PG rated page.

We had 8 that went out on this last plane and I felt I was in a Bogart movie – Casablanca.  When we got to Santiago we all thanked and congratulated the pilots.  We had 6 hours before our red eye left to JFK.  I guess because we looked pretty bad and smelled worse they offered us their hotel rooms to shower.  We didn’t pass it up and had diner and drinks after.

Earlier in the week the NY Times sent a reported and videographer to do a story on these plane flights. It appeared in print and on line at

http://www.nytimes.com/2010/02/05/world/americas/05planes.html

The video connection is on the left partly down the page.  For all the InterVol volunteers in Rochester, NY who spent many nights packing medical supply boxes, for RGH who donated much needed equipment and for those who collected so many crutches in the past and wondered what we would ever do with them – check out the video.  In the hardest of circumstances the little guys came up big for a little town.  Again kudos to Constellation Brands for giving us 4 trips on the corporate jets and Tradewinds for the air bridge to Leogane.

A new InterVol/ND group has taken over and joins the docs/nurses/etc teams coordinated by World Wide Village and the docs from University of Iowa to continue giving care.  The walls of the field hospital are up.  We have a long way to go.  Share this with friends and other colleagues – we will need their help to continue for at least 6 months.

I will continue to provide updates from the folks on the ground but not every day.

Ralph

-Central Supply

-Field Hospital Update

-InterVol Team 3 Arrives

-Plastic Surgery Studs Raise Money

I have yet to talk about what Bill Joyce, EMT and InterVol veteran of many trips (Africa, Haiti, Belize) has been doing.  Bill accompanied Save the Children mobile clinics.  The US Marines went out to remote villages mostly accessible by 4 wheel drive and/or foot path.  They then reported back to various NGOs who sent mobile medical teams.  Bill went to villages with Save The Children.

They were located 4 and 6 km from Jacmel or about 2 hours by 4 wheel vehicle.  At one they treated over 100 patients and the other 25.  Most of the wounds were similar to what was seen at out makeshift hospital in leogane – lower extremity and scalp wounds – none treated since the quake.  They also provided basic primary care needs (see photos).  Again, much destruction of simple buildings.  At one village many of the children had not seen a Caucasian before.  Bill certainly scared the hell out of them at first but then won them over with his charm.

Emmy Branigan – (or Capt Branigan because she runs a tight ship) is another InterVol veteran nurse.  She coordinated all the surgical supplies that were sent down, did inventory and set up the surgical supply room  After the first week things got sort of distorted and she straighten things right out.  She was able to keep the surgeons happy with their various equipment needs.  Fortunately, she had very low need and demanding surgeons (if you believe any surgeon is low maintenance then I have a bridge to sell you in NYC).

Our anesthesia team – Paul Cross and Jeff Wasserman have been outstanding.  There wasn’t a case they couldn’t tackle.  They worked as a team and they were always one room ahead of the surgeons.  They had to deal with everything from preemies to new born to children to adults.  All without an anesthesia machine.  One thing for certain, they have now set the standard for what I expect at home – 2 anesthesiologists for everyone of my cases.  if they can do it at LSTH, then they can do it at RGH.

Jeff has also been the victim of many pranks.  The best was when I told him the hospital lwayer called and said the insurance deal feel through.  He was whining and miserable for hours.  I was just waiting for him to call Lyle back at the homestead but phone connections were not good.  Finally I couldn’t watch him suffer anymore and told him the truth.  I know I ‘ll get mine.

Field hospital walls going up today.  Hopefully will move in soon.

New InterVol team came today via Leogane International Airport.  They arrived at the same time the top UN General and USMC General were leaving from the helicopter landing zone after a meeting.  There were USMC soldiers and UN soldiers all over our airstrip.  At first I thought it was the new security system for our new airport.  The I realized they just wanted to impress the Newbies.  This group includes:

Gloria Berent -    OR Nurse

Bob Young -     Anesthsiologist

Anne Marie Blanchard -     PA OB/GYN

Bruce Kleene -   Anesthesiologist

Rocco Perrone   Plastics Surgeon

Tomorrow Marty Dineen’s buddy comes in to help with ortho – Craig Hankins.  We had one plastic surgeon who couldn’t make it.  Tim O’Connor to the rescue.  He will arrive Monday.

Finally Andy Smith and I decided to raise money by posing for SQ – Surgeons Quarterly (similar to GQ but for surgeons) and PlaySurgeon magazines.  Attached is our above the neck shot.  Wait until you see the whole body shot tomorrow – it is very fluid.  The money will be used to help with our ongoing relief efforts.  For autographed copies at 100 dollars – just let me know.  It’s a good cause.

Ralph

Additional photos of the mobile clinic:

Weight scale found at the mobile clinic: