Saturday, February 27, 2010

Letter from Port-au-Prince, February 23, 2010

It has been rough: hard work, very hot, and sometimes dangerous.

We constantly talk about securing our sharps but today, while walking through a tent, an improperly discarded scalpel blade went through the sole of my shoe into my toe —fortunately it bled a lot and I washed it very well. Will start antibiotics just in case.

It was quite a sight though; me sitting next to my patient, who happened to be a Port-au-Prince police officer, while pulling off my bloody sock and washing my foot. At some point he left to find someone else to take care of him!

With 7 days in Haiti I am now a "veteran", so I have agreed to take over some administrative functions. Between patients, my job is to count all the beds, evaluate the admissions, and then find the right beds for them. It means making rounds through all the tents and all the buildings a few times a day. The big part is moving Emergency Room admissions to these empty beds.

But it is impossible to find transporter personnel or even a wheelchair, so this takes time. They have not been paid for a month or more I'm told. So sometimes patients die before I can move them, such as yesterday with an impossibly tiny 1-year-old baby with pneumonia — brought in by mother with obvious Kaposi’s sarcoma (an advanced sign of AIDS). Of course transport wouldn't have made any difference here and usually the ER is the best place for the sickest patients — at least there a doctor is always present.

One of our medics from the 82nd airborne volunteered to take him to the morgue. Imagine a huge paratrooper in full battle dress uniform carrying this tiny soul in his arms. Like most of us, he happens to sweat profusely here and his glasses are persistently steamed, but I think he was crying. My first day in I taught him how to suture and we have become friends here since.

Each morning I walk the wards and the dead are being carted off. Going through a pediatric tent (now run by the Haitians after a hand off by the Swiss), I saw another dead child, apparently left on her cot for many hours. Dismayed families tugged and pointed as I walked through, saying "MORT! MORT!." The parents appeared to be gone. The other kids in there hopefully couldn't comprehend how close by death was. I will bring stickers donated by my children with me tomorrow. A small distraction.

Death is common here and people must be getting numb to it. I have watched many here pass, some under my care, but I am not there yet.

Dr. David Ghilarducci, February 23, 2010

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