Sunday, February 28, 2010

A team like no other

Getting to Haiti
After a brief layover in Santo Domingo, I received a donated helicopter ride to Port-au-Prince. As our group flew over the Dominican border, lush vegetation soon gave way to rugged mountains and massive deforestation. The destruction below came into focus as I neared the city, and the images were unlike any I had ever seen.

The helicopter doors opened and immediately the smell of burning refuse filled my nostrils. “SOS” and “HELP” signs hung by the roadside where rooflines crumbled onto the street. People were digging through rubble, collecting metal scraps, large pieces of cinder block, and any other valuable items that could be reused.

University Hospital
In Port-au-Prince, I was introduced to the University hospital. Its campus was once a place where medical and nursing students flourished; now, atop paved stones of a courtyard, tents served as EDs, ICUs, and med-surg beds.

The buildings that still stood housed ORs. Buildings that didn’t survive the earthquake consisted of large chunks of cement, still holding the bodies of those who could not escape.

During my stay, the hospital was comprised of tents. On a typical day temperatures could reach over 100 degrees and we could see 600 or more patients. Cots served as beds, and creative colleagues devised effective equipment when supplies just were not available.

Clinical assessment and critical thinking were crucial in this environment — the diseases were different, space was limited, and treatment varied because of fluctuations in medication availability and a lack of diagnostics.

While evaluating patients in tent one, I quickly realized that pediatric patients waiting in a long line could be triaged separately and seen by me and another pediatric provider. This change improved rapid care of some sick children who otherwise might have died.

Non-traditional treatment of lacerations, meningitis, fractures, malaria, living larvae in wounds and dehydration took place outside the tent, under a makeshift canopy that we deemed the pediatric ED. We also tried to educate patients on the essential components of safe water supply and newborn care. This was difficult, as some new mothers had lost everything in the earthquake and had little if any resources. Children suffered dehydration and sometimes malnutrition. Resources continue to improve though as more Haitian providers offer nutrition services and maternal child primary care.

During my time in Haiti, I was amazed at people’s resilience. Most no longer had homes and even those who did chose to sleep outside because aftershocks were a daily occurrence. Still, I was awed at how thankful they were, offering a smile or a warm hug, when it is I who wanted to thank them.


This experience has left me with many memories, new and old friendships and a reflection on how we practice health care. There is still much to be done in Haiti, and I would like to thank my colleagues for their hard work and perseverance — it was a team like no other.

Rachel Lyons, DNP, CPNP-AC/PC
Assistant Clinical Professor
Columbia University School of Nursing

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1 comment:

Unknown said...

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