Friday, February 26, 2010

To sum up what we did, we saved lives

My name is Greg Hynes (that's me on the left with Jonathan Gardner) and I have just returned from a leave of absence taken to travel to the Haitian capital and surrounding area. I am sure that everyone knows that the earthquake on January 12th at 1643 was devastating to the already challenged Haitian infrastructure.

I received a phone call at 1500 on the 14th of January from International Medical Corps while in Park City Utah. This is the same non-governmental organization (NGO) that I went to Indonesia with after the December 26th Earthquake and Tsunami. They asked me to join the Emergency Response Team (ERT) that was departing the next morning. With an incredible amount of desire to help like many of my colleagues and friends I of course said yes.

I was very well supported by my admin and team members that happily stayed late working to get all of my shifts covered, they were/are amazing.

I packed my "go" bag left the critical paperwork copies at home and was given a flight to Santa Domingo in the Dominican Republic the next morning at 1100 from DIA. I was extremely happy to be going but due to the news reports had a slight feeling of apprehension about the security in and around Port au Prince (PaP).

Arriving in Port-au-Prince
I arrived at 2200 on the 15th into the DR. Spent the night till 0300 assisting with logistics of people arriving and plans for the next day departure to PaP. None of use wanted to sleep but we all knew we needed it to function for the next few days.

Up at 0630 for buying of supplies and getting the rest of the team from the airport that was arriving from California. After not being able to get on the UN flight to PaP due to airport security problems we hired two buses to take us into PaP. We drove 14 hours on a trip that should take 5-6. The border was a bit mad. Finally at the general hospital in PaP.

Originally a 500 bed hospital now had anywhere between 400-700 patients in and around the hospital grounds. Three general surgeons from the USA and one from France were working feverishly. Three ED docs from International Medical Corps team and one Haitian administrator where attempting to coordinate pre/post-op. No other staff were present.

One might blame the local staff for not being there, remember that many were dead most were not eating and getting to and from the hospital was nearly impossible. Many probably had family members that needed to be cared for or dug out of rubble as well.

We had a contingent of 17 staff 9 ED docs, 6 nurses, one family med doc and an EX SF army medic. We divided up the areas of patients and began to give care with the supplies that we had brought in with us. Almost all care was given in the dark with a head torch with the supplies carried on your back. Sit it down and turn around and it could disappear.

The patients were mostly serious orthopedic injuries, crush injuries and a small contingent of thoracic injuries that had survived to this point. We had a few tetanus cases already starting. The patients had no care to this point from health care providers since the earthquake. We had to perform a reverse triage with numbering system on the patients. The sharpies come in handy in many situations.

The basic situation was no power no running water no toilets, about 500 dead bodies 95 degrees and 90% humidity. This all sounds terrible, it was, but despite this the Haitian people impressed me so much with how stoic and thankful they were. They were in so much pain with such life altering/threatening injuries. Most of the patients had just also lost at least one close family member and/or friends not to mention a complicated amputation coming in the near future. Still just before we left the first night before sunset, we had to leave then for security reasons, the area of patients that I was in the first day all began to sing. About 25% of the patients in that area had died, replaced by others the next day. Still, patients would say thank you and sing happily again each night prior to our departure.

Everyday was better than the last and more people and equipment came. The 82nd Airborne came and secured our hospital on the 4th day as the groups of people and security where getting a bit concerning at times. USAID then began to get us tents to treat the patients in since the majority were outside due to building fear and most buildings being destroyed.

More surgeons started arriving and patients started getting better and better care. This was also the day the USS Comfort was arriving and was due to start taking patients the next day. It was also the first day that I was sent outside the hospital grounds into the internally displaced peoples camps (IDP).

Mobile Clinics
We went out to multiple locations to assess the need for medical care and coordinating with other NGOs that had started to arrive and offer the help that they could. We were also providing daylight mobile clinics at these sites. This meant the camps were going to get care as most of these people had no way of getting to the few hospitals still functioning.

The type of injuries that we saw when making a "tent call" were the types of things that would get a patient a helicopter ride in Colorado for sure. Yeah these people are tough beyond belief.

The largest tent city that I saw was Petionville with about 50,000 residents. The residents had started to name the streets. Life carries on for sure. We helped a few babies into the world and saw hundreds of patients in these clinics with everything from malaria, chickenpox to fractured pelvises and gunshot wounds. Yes life does go on in every way good and bad.

Back to University Hospital
After about a week of being out in the mobile clinics I moved back into the hospital grounds to work in the ED tents that we had set up with the assistance of the 82nd Airborne. We started by only seeing about 200 patients a day but it quickly grew to over 400. They were seen with 8 docs and 4 nurses. Most were not sick but we still had the drop off gunshot wound, about three a day. We saved one victim and that lifted everyone's spirits. He was shot in the flank right outside the hospital gate and we had him on the OR table in less than 25 min for injury.

The OR staff was amazing, doing surgeries without access to oxygen anesthesia gases or clean rooms. They sterilized their own equipment worked with poor lighting in 95 degree heat with people tasked with brushing the flies away for the surgical site. Post op we had an amazingly low infection rate especially for the conditions in which the operations were done. We however did not suture anything closed - everything had to heal from the inside out. Once again a testament to the strength of all the people who lived there and came to help them.

To sum up what we did, we saved lives. Why did we do it? Because they needed it. Who did it? Every person that donated money or time, wished us luck, prayed for us or helped get people down to be there. Where did it happen? All over Haiti the work was done but the help came from all corners of the globe. Thank you from the people whom you all have touched.

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