Tuesday, 23 February 2010
Tuesday, 16 February 2010
Tonight we are more or less in emergency mode with people at the door vying for a little food or water. The Belinda Stronach Foundation cannot underestimate how valuable their food shipments to Airline Ambassadors have been.
When even the police consider themselves lucky to shake you down for a case of water (they’ll take less if you tell them to come by the next week) things are indeed bleak in the whole city.
When I see armies staging and building giant new compounds everywhere around the airport, it only means one thing to me. It’s a shame the global community can’t put ALL its efforts into building an economy rather than building a fortress.
We are a minority of small NGO’s not living in the fortress and not engaging in the 16 cattle call food distribution points (80 lb. bags of rice that safely slide down a hill where they are gathered by fighting and desperate people). Do the math: just 16 food distribution points in a two million person area the size of the San Francisco peninsula with almost no economy...
We thank the Foundation profusely for its precious deliveries.
AAI Board Member
Friday, 12 February 2010
The smell of death is strong here tonight after a day of national prayer marking the first month after the January 12 earthquake. The hot, humid weather ensures the rapid decomposition of the thousands of bodies still buried under the rubble. It pervades the air everywhere hanging over the hundreds of thousands of living, praying, gently singing citizens of Port-au-Prince.
It is 2am now and in a few hours we will be distributing almost 80,000 pounds of food and water to our 70,000 desperate neighbors. Luckily we have help: the 82nd Airborne, which will help to ensure crowd control, has been BEYOND AWESOME, giving us hope that we may yet have a peace-keeping force we can all be proud of....
We are in 3 days of prayer after the tragedy and before the rains make it an even greater tragedy. As a small non-government organization we are filling in gaps and supporting programs of all kinds in very significant ways to the best of our very stretched resources.
With tomorrow's distribution, Airline Ambassadors' aid delivered to date will reach 2 million pounds of food, water, medicine, tents, etc, combined with facilitating the transport of over 600 medical personnel on 15 flights from the United States. We are also supporting as best we can the highest-rated public-private hospital in Haiti: CDTI (formerly Sacred Heart Hospital), which promises to be the best teaching hospital in the country for orthopedic after care (amputations and RE-amputations because of infection, breaks, etc). It's amazing what the volunteers have accomplished so far.
AAI Medical Director
Wednesday, 10 February 2010
When we were setting up our initial Airline Ambassadors medical outreach effort right after the quake Solino was the very first place we sent a team, which was the first medical team that had reached them. The news that Sean Penn has promised to build a clinic there is very exciting.
In other news the Airline Ambassadors has been working with USAID (the lead agency in directing all U.S. aid to Haiti) to keep the doors of the irreplaceable CDTI Hospital open. Dr Savain, the principle owner of CDTI (a true saint) is laboring to keep it operational with his own funds, and with no help monetarily so far. Just a lot of promises, hopes, ideas. Dave Rivard (Nancy's husband) is working with USAID officials so as not to lose this most precious resource, with AAI Haiti president Dr Roger Jean-Charles coordinating the efforts with the Haitian government. Keep this project in your prayers.
Friday, 5 February 2010
Back home, I can't describe my appreciation for the "simple joys" that before I had always taken for granted: food, running water, clean drinking water, toilets, and a WARM shower! My last day in Haiti, as I gathered my clothes and supplies to donate to some new friends, I realized just why my hair had never really felt clean, even after a good garden hose shower: the "conditioner" that I had been using all week actually turned out to be body lotion. Woops!! Yet another draw-back to showering in the dark by flashlight.
Leaving Haiti and all those still suffering has been more difficult than I had imagined. I have so many mixed emotions right now. I'm so grateful to be back home with my wonderful family whom I have missed so much. Yet, I can't help but feel an enormous amount of guilt for those that I have left behind. My time there feels too short, with so much left unresolved and unfinished.
Regardless, I am thankful for the time I was able to spend there and humbled by all that I experienced in such a short time. I will try very hard to remember it every day. It's a good reminder to stay grounded and appreciative of ALL that we have to be thankful. I hope this experience can be the first of many more.
Wednesday, 3 February 2010
Another long, busy day in surgery full of fracture repairs and wound debridement. The smell of the 3 week old wounds is overwhelming. Poor sanitization conditions combined with long hot days spent in crowded tents with little to no ventilation. Thank heavens for Vicks Vapo rub!
I left the hospital around 8pm to return to camp. We now have running water! Immediately headed straight for a shower, which really consists of bathtub and garden hose pulled through the bathroom window. It's freezing cold, but I can't wait to "come clean" of today. I yell for someone outside to "turn on the hose!" and not more than 2 minutes later hear a voice outside running down the alley & coming toward the clinic. A nurse from the hospital pounds on the door for me to "come quick" to the hospital..."a stat c-section". Still soaking wet, I throw on scrubs, call for Sandra (the other anesthetist & native Haitian), and we follow her back to the hospital.
We quickly gather whatever supplies we can find through all of the mess of medical equipment just shipped in (thank you to all who donated!). Turns out there are in fact two c-sections, but only one surgeon. The most critical goes first: umbilical cord wrapped around the baby's neck. Spinal block and within 4 minutes the baby is pulled out, blue, completely limp, and almost lifeless. It was then that we realized that there was no one available to take care of the baby, who is cyanotic and silent. Sandra takes over care of mom, while I attempt to stimulate and suction the baby screaming for help the entire time. A Canadian ER doctor hears me and comes to the rescue. Together we stimulate and suction large amounts of aspirated meconium, and soon....crying. The most beautiful sound in the world!
Sandra and I must quickly get ready for the second c/sec. I wheel the last newborn into the room with us. Again, there are so many things wrong about the conditions we must work under, but we must just adapt and adjust to what we have. There is no NICU. New babies and moms get sent back outside to the yard (literally) just after delivering. This baby was nowhere near stable enough to be left unattended so came in to witness a birth after just being born.
Sandra & I were getting ready to do a spinal block on the next mom when a code was called on a baby that had been rushed into the hospital from the "tent village". She just cried and pleaded (in Creole) to help her baby. The infant was intubated and coded for over 20 minutes before time of death was called. I tried to hide behind my glasses and mask as I cried right there in front of everyone. It was unbearable. And still, after experiencing such heartache, I had to return to the OR to finish the last c-section.
I'm thankful I stayed. As difficult and cold as it felt at the time, I needed a "happy ending". I got just that. One loud, crying, healthy baby. As two new lives were brought into the world tonight, one was taken away...
The hardest part about tonight was wondering and questioning myself, "what if?" ; "what if this baby had been in the US?". ...same baby, same illness, only with better medical access. Would the outcome have been the same?". I heavily doubt it. That's what makes it so hard...wondering why some are so fortunate and privileged, just by the geographical location in which we have been born; while others are born into nothing. It's just seems so harsh and unjust.
He says the surgery volume is tapering down now. Time to get the non-surgical medical pipeline open at full throttle.
That's all for today.
Tuesday, 2 February 2010
Sorry no update yesterday. It was one of my longest, most challenging days so far. The public health clinic was closed because it was Sunday, so I spent the entire day in the OR doing anesthesia.
It still amazes me that nearly 3 weeks after "the event" many with broken bones and large wounds are just now getting to the hospital for treatment. At this late timing, outlooks are poor and infection is rampant. I've never seen so many gangrenous limbs.
Anesthesia is difficult because no one will allow general anesthesia. No one wants to go to sleep. They are all afraid that we might amputate their legs while they are "asleep". Their fears are understandable (during the early response after the earthquake, out of desparation and lack of resources, many doctors had to resort to amputation to save the patient) and so, my skills in spinal blocks have gotten lots of practice.
I feel like I am working at the United Nations. In one case, I might have a surgeon from France, one from China, a circulating nurse from Thialand....oh, and an anesthetist from Illinois. It has really been remarkable to see so many people of such different backgrounds come together for the same united cause.
The hospital, though it has suffered severe damage, is one of the few hospitals in Haiti left standing. There are many great big cracks in the concrete and foundation and some parts of it have fallen, but just the fact that some of it remains "serviceable" is more than most other buildings surrounding the epicentre of the earthquake.
Aftershocks are still occurring, though I haven't felt any since I've been here, which makes working in the hospital a bit scary at times.
With so many hundreds injured and so much damage to the hospital, there is no room for patients. Instead, they have created "tent villages" to which patients have been assigned. Rows of tents fill the entire yard within the confines of the hospital gates. Tents are so close they are touching. There are so many sick people, it's often hard for us to locate patients within the tent village to be able to bring them to surgery. Patients have become identified by their tent number.
Pre-op and inital ER is outside too. There are even tents still set up as operating rooms outside from the first days when limbs were being amputated outside. Tonight I even ran a code on a women rushed in from the "village", her family yelling 15! 15! 15! (her tent #). She was carried to the outdoor OR tent, which consists of 2 large blue tarps and one dimly-lit ancient floor lamp. The OR table is nothing more than a slab of metal on blocks. It was really a disturbing scene; as if I was back in the Civil War era..,only this is 2010. Like nothing I could have imagined I would ever witness in my entire life.
This is Haiti right now. The scariest part is that this is not temporary and not going away any time soon. In fact, I'm afraid for the weeks ahead. I'm afraid of infections, effects of long-term immobilization, severe malnutrition & dehydration. While Haitian people are very peaceful and appreciative, in the face of hunger and starvation, people become desperate. I don't ever feel unsafe, though. People recognize the need for doctors & nurses and are extremely grateful for help.
I randomly ran into my Haitian friend, Frandy, at my clinic the other day! The world (& Haiti) is so small.