Dr. Christian Arbelaez, an emergency physician at Brigham and Women's Hospital, has gone to Haiti with a team that will work with Partners In Health in St. Marc to help victims of last month's earthquake. Here is his sixth dispatch.
The team had moved past the initial shock phase of what we were seeing and we began to settle into routines. I hate to say it - but we transitioned into a weird sense of normalcy. I think we got used to the chaos. By now we knew most of the staff and had become partly integrated into the hospital.
The team had also been working non-stop for six days now and fatigue and illness were starting to catch up to us. Dehydration, heat exhaustion, and traveler's diarrhea were common. It was 2:46 am, I suddenly woke up with nausea. I laid there under my mosquito netted tent feeling sick, thinking about the inherent risks for health care workers with a trip like this - malaria, tuberculosis, dengue fever, traveler's diarrhea, hepatitis, typhoid, HIV from needle stick exposures, and trauma from motor vehicle accidents. Risks I was willing to take.
Around 4 am a large group of women started singing in the streets. A man yelled. Dogs barked. I could hear every sound. I could feel my pulse throbbing in my ear. I listened to my watch slowly tick away the rest of the night. That morning Sri, our [Partners In Health] on-site coordinator, finished his deployment and was returning to California. I was asked to take over his role and responsibilities. The first item on my agenda was to coordinate Ania's transfer to a facility that could give her a prosthesis.
For the next several days, we had our routine. Every morning Mitch, Suzanne, Kristin, and I rounded with the ward nurses on the 60 patients in our service. Even though the hospital had a census of 120 patients spread throughout the different wards, the local Haitian doctors managed them. With our patient list, we confirmed bed locations since sometimes patients moved if they noticed a better spot or bed. We discussed their injury, operation, and plans for the day.
Most of them had daily ongoing procedures, such as dressing changes and wound debridements, which needed to be done in the operating room under conscious sedation. The OR team ran an efficient operation despite unimaginable challenges. The two operating rooms had no lights except for the direct sunlight beaming through the windows and the battery operated headlamps on the surgeon's head. Power outages were common and forced the anesthesiologist to disconnect patients from the ventilator and manually breathe for them. Supplies and autoclave sterilization had to be readied for each day. The surgical team had been doing roughly 15 cases per day. An impressive feat given these conditions.
Some of our patients didn't have a home or family to stay with when they were ready for discharge. It was sad to see so many internally displaced persons with essentially all of their belongings around their bed. We provided the basic necessities: water, food, shelter, and security. There were also local missions that began accepting our patients. One day they picked up four families and rode off in the back of a truck. For Ania, we were able to transfer her with her father in a Haitian Red Cross ambulance to the Schweitzer hospital. She was on her way to recovery.
Our last clinical day was full of mixed emotions as we began our own transitions. It was time for goodbyes. It was the end of the lollipops for the children. The patients felt the same way. All were thankful and expressed it in different ways. Some sobbed and others hugged. There were thumbs up and high fives. We each had patients that we would never forget. Some who lived and some who died.
I walked up to Matthew (in photo above), a 16-year-old boy, who was in Port-Au-Prince the day of the earthquake. I shared with him how my two oldest kids and their friends had formed a group called Soccer for the Next Haitian Generation. The group was collecting soccer balls to donate to kids in Haiti with the hopes of raising their spirits through theses tough times. He loves playing soccer and his favorite teams are Manchester United and Real Madrid. I laughed and said that those are my son's favorite teams too. I handed him a new FIFA World Cup soccer ball. His eyes grew big and he instantly smiled.
By this point other kids were surrounding us. He stood up and began showing us some foot tricks. For a moment, I thought about how a group of kids in Needham, Mass. had made a small but real difference in this child who was right here in St. Marc's, Haiti. They had transcended through so much with just a soccer ball.
About white coat notes
|White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at firstname.lastname@example.org. Follow her on Twitter: @cconaboy.|
Gideon Gil, Health and Science Editor
Elizabeth Comeau, Senior Health Producer