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 fifth dispatch.
Ania is 15 years old. She sits quietly next to her bed in the corner of our post-operative unit. The first thing you notice are her beautiful black eyes. They are almond shaped and narrow. Her hair is short and carefully braided. Her skin is brown and smooth. Most of the time she is reserved but when she smiles, the room is lit up. Her body frame is small with delicate hands. Ania always seems to be staring off to the side almost in deep thought. I wonder what she is thinking and worry about what she is thinking. She is wearing a white polo shirt and sitting on her wheelchair. Her right leg was amputated.
I sit down at the edge of her bed and through an interpreter named Ashley, I listen.
In a soft voice she begins her story.
She remembers hearing a rumble, the walls shaking, and a painting falling off.
Everyone started running for the hallway. Her brother and the little boy were hit by something that fell on top of them, maybe a cement wall. They both died. She was fighting to get out. As she put one foot outside the door, a wooden beam fell on her, and she was trapped. She heard a child screaming in the kitchen. Then silence.
Ania pauses. When she resumes, she says that she remembers that it was hard for her to breathe. Her mouth was very dry.
The following morning, somebody who lives on their block began screaming her name. She responded. Suddenly, a group of people started trying to get her out by moving the couch, ripping chairs, and finally pulling her out. They find her mother and get her out. The little girl was dead. She thinks that her two aunts upstairs were able to get out on their own. Her father, who was at work, was fine and joined her. Family members pick them up and take them to the hospital.
She describes a lot of people who were hurt in lines waiting for help. The University Hospital was packed. They stayed outside waiting for a few days sleeping on the grass. Still injured. She tells us that by Saturday, they decided to go north to Pierre Peyen hospital. She remembers waiting with her mother. That was the last time she saw her.
She pauses again, looks away, holds her tears. She takes a deep breath. On Monday, she found out that her mother died.
She was brought to St. Nicolas hospital in St. Marc by her father and aunt because Nadia, her cousin, works as a nurse here. Ania needed her right leg amputated because the crush injury had caused compartment syndrome which impaired the blood flow and caused necrosis. It is bandaged and she complains of pain. We tell her that part of the pain is from a phenomenon we call phantom pain. The brain tricks the body into thinking that the leg is still there. And it aches. Apparently, to help prevent this, surgeons will sometimes inject lidocaine directly into the nerve sheath for anesthesia prior to the amputation but it doesn't always work.
Ania has touched so many of us. Despite all of the tragedy that she has recently experienced, she sees a bright future. She aspires to become a nurse and admits that her care here has certainly reinforced this decision. She points to Kristen, Rose, and Sergiline as dedicated nurses who have had a significant impact on her. As we finish talking, I think about what she needs. She needs a prosthesis to help her get back to school and move forward with her life.
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