Lessons in volunteering

The best advice I got from Dr. Rob Fuller and Matthew Howell: “When you volunteer in a disaster you feel like you have to work, work, work, and you think you need to do it all because no one can do it as good as you will…but you need to remember you are not here forever; you are here for a short period of time. When you accomplish your mission it is your responsibility to start training the next group of volunteers or better yet start training the Haitian nurses. This is their hospital, and they will ultimately be the ones working here. Be sensitive to their culture and training and do your best. You want to go back home with the feeling of accomplishment and knowing you did everything within your resources to continue what you started.”


I would like to pass this along to my nursing colleagues…you are not “Superman.” You need to remember to keep hydrated and take care of yourself before you are able to take care of anybody else. It was very hard for me to remember to drink, much less eat. I had “travel diarrhea,” so if you’re going to Haiti, ask your primary care practitioner about taking Cipro for prophylaxis. I had to receive I.V. fluids once during the stay so if you feel dehydrated, have someone start an I.V. It won’t hurt, especially if you know you haven’t hydrated adequately.

Some suggestions as to what to take if you are going to volunteer: dermabond to cover scratches, mosquito repellant, electrolyte drops to add to the water, Gatorade powder in individual packages (you can just suck on it if you can), protein bars, and Imodium. Hydrate, hydrate, hydrate!

In Haiti, I had to make the most difficult decisions in my nursing career. I would have never thought I would be placed in a situation where my decision was the “last call” on who was treated and what I had to “let go” because of limited resources, lack of medical professionals, and over-abundance of wounded people. I kept telling myself, “Gaby you can not save the world. You can only do what you are able to do. Stay focused!”

I had to keep in mind age, co-morbidity history, presence of HIV, severity of injury, and date of seeking treatment when making decisions. I wanted to treat everyone, but I had to take into account that I couldn’t waste any time or resources, from medical volunteers to supplies. I couldn’t give family members false hope when I knew the outcome would be devastating.


As a nurse—and as a human being—all I wanted to do is take away their pain and suffering. The way they would look straight into my eyes sent chills up and down my spine as their eyes told their story. Even with a language barrier, I felt a bond I never thought I could have ever experienced. Many people were left without families, a place to live, jobless, starving, and were just begging to survive! It was the most heart-wrenching experience.

Not once did I ever fear for my life or feel unsafe. The Haitians were the most grateful human beings. Coming from the U.S. you see family members bring their loved ones to the hospital and expect you to give all the care from the time they are admitted to the time they are discharged. They don’t want to spend the time to bathe or toilet their family members and push the call light instead. In Haiti, we were never asked by the patient or family members to toilet or bathe them. Even when we offered, they would say no and thank us for just being there. We often just gave patients pain meds because not one complaint would come out of their mouths. I think in a culture like Haiti you are not used to complaining. People are content with what they do have.

Nurse Gabriela McAdoo
Photos by Margaret Aguirre

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Travel, triage and the importance of training

The overall trip to get to Haiti was exhausting, and I was anxious about the “unknown.” We departed San Francisco airport on January 15, 2010, at noon and made it to Santo Domingo the morning of the 16th. Staff from the International Medical Corps, my volunteer group, picked us up and took us to stay in a Clarion. We had breakfast, took a shower, and were driven to the Santo Domingo military base.


We waited for hours and were told we weren’t a priority because of the numerous VIPS traveling into Port-au-Prince…along with the food and water being flown there. Dr. Bob Norris, one of our team members, spoke with representatives from International Medical Corps. It was decided we would take the bus to Port-au-Prince, and we headed out the evening of January 16. Forty-five minutes into our drive, the bus broke down. An hour later our replacement bus showed up.

We arrived in Port-au-Prince the morning of January 17.

The ride into Haiti was surreal: people around town walking everywhere, many living in makeshift dorms, women cooking outside, and kids running around. I spotted a couple of the children digging into dumpsters for food. There were dead bodies stacked randomly throughout the town, people burning dead bodies, and dogs eating and chewing bodies (including babies) and dragging bodies around like rag dolls. It was a scene of absolute depression and desperation.

University Hospital, Port-au-Prince, Haiti

As we drove through the tall green gates, we were mesmerized by the mass amounts of collapsed buildings and the few that were still standing from the 7.0 quake. In the middle of the compound there was a “garden area” we named “the jungle.” Patients and family members were everywhere! We made it to the back of the compound to a building designated as International Medical Corps’ headquarters. About 400 yards east of the building was the morgue, where over 500 bodies were stacked before our arrival, waiting to be picked up, disposed of and buried. The concrete was stained from the decomposition of the bodies and liquefying of adipose tissue. The smell was indescribable. We put Vick’s vapor rub under our noses and wore N-95 masks, but the smell was still very strong. I found myself unable to deal with the “smell” and almost threw up. I realized I was in a state of shock.

We were immediately greeted by volunteer Dr. Rob Fuller, MD, chief of Emergency Medicine at the University of Connecticut and Dr. Matthew Howell, an emergency physician from Tampa Bay, Florida along with representatives from International Medical Corps.

We broke into teams. A few days later, I was asked to team with Dr. Howell to open up a designated triage area, and an organizing supply room.


When we arrived at University Hospital on January 17, 2010, a group of surgeons were doing amputations around the clock. Volunteers were just starting to trickle in. There were more physicians than nurses, which made our jobs challenging.

Physicians in the states are used to directing care, and nurses are used to providing care. It didn’t always work this way in Haiti.

We had to teach our physicians to do many things, including mixing antibiotics and connecting primary and secondary IV tubing properly (to them, all IV tubes are alike).

Being nurses and well aware of getting “scope of practice” pounded into our head, it was very hard to move away from our training in third world disaster medicine. As long as the physician is comfortable with your skills, you are up for anything and everything you are competent and can be trained to do. Dr. Howell, along with other physicians taught me many procedures during my stay such as; nerve blocks, hematoma blocks, needle decompressions, fracture reducing/splinting, debridement, paracentesis, thoracentesis, and conscious sedation. It is amazing to see yourself using the nursing procedures to save lives. The other nurses and I diagnosed, prescribed, treated, and “discontinued” medications; we were “acting physicians” in a time of crisis.

I didn’t think twice or regret anything I did within my stay. My time in Haiti set a new precedent of what matters most and what suffering truly is. Tears still fill my eyes knowing that people who would have been saved with the technology back here in the United States were dying before me without any control of their fate.

In the United States, only “seasoned” nurses triage. In Haiti we had military personnel doing triage, and they were as capable as nurses in seeing who was in distress and who could wait. Black and white …it was either a decision that they were able to be saved with the limited resources, or it just was not in our capabilities to save their lives.

One day a nurse came in to work in triage when I had some of the military staff filing out triage forms…

The nurse looks at me and says, “Wait, they aren’t qualified to triage. They aren’t even medics.” I looked him in the eye and reply, “Do you plan on living here the rest of your life and triaging, or would you rather train people so when you leave you know that at least you handed the torch over to the next group and the system we all worked so hard to initiate won’t break down?”

Nurse Gabriela McAdoo
Photos by Margaret Aguirre

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Nurse Gabriela McAdoo: He will always be my little "Haiti Angel."

On Jan. 13, a day after a 7.0 earthquake occurred in Haiti, I got an e-mail from Patrice Callagy, RN, assistant nurse manager at Stanford Hospital and Clinics, asking for volunteers to help in Haiti. I was one of many nurse volunteers to reply and was on site the day after. I volunteered with International Medical Corps. In Haiti, I was asked to team up with Dr. Matthew Howell to help in the initial set-up of triage and emergency area.

There I met Monley.

Monley survived eight days under the rubble from the Haiti earthquake.

Monley's uncle had found the 5-year-old boy after eight days under rubble and brought him to the hospital. I was Monley's primary nurse. Dr. Colleen Buono was his primary doctor from University Califon a head-to-toe-assessment, we did not find any obvious fractures or signs or symptoms of internal injuries. We resuscitated him with fluids, and four hours later he was transferred in stable condition to the Swiss Red Cross pediatric unit for overnight observation. We were amazed by his recovery and happy to see this little miracle walk away with no major trauma. The next day, we learned he had been discharged.

As I was triaging that afternoon, I felt a little tap on my shoulder. I turned my head and there was Monley. I was so happy to see him well. He came to see me every day at the hospital. I never thought I would have bonded with Monley the way I did. It was automatic; and although we could not communicate by the normal means of language, we understood one another. His eyes told it all! During the end of my assignment, we had a psychiatrist from International Medical Corps meet with Monley and me so I could tell him goodbye and make sure he would not feel abandoned. Our farewell was heart wrenching because Monley had come to see me as a "mother figure." His mother had been killed in the earthquake.

Monley and I were interviewed by CNN's Anderson Cooper during the "Help For Haiti Now Tele-a-Thon" and were featured on NBC Nightly News "Making a Difference." Our farewell is an experience I will forever remember. I love and miss Monley and still stay in contact with his family through text messaging. He will always be my little "Haiti Angel."


CNN's Anderson Cooper interviews Monley and me during the telethon.

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