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Kevin Cullen

Big choices, small strides

By Kevin Cullen
Globe Columnist / March 9, 2010

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Last month, Larry Ronan, the great globe-trotting doctor at Massachusetts General Hospital, got back from Haiti and described hellish scenes and difficult choices.

Doctors and nurses cut off limbs to save lives. But they didn’t have enough wheelchairs and crutches and therapists, and Larry Ronan looked down the road, a road that was bumpy before Haiti’s earthquake and looks unnavigable since.

“How,’’ he asked, “are we going to help all these newly disabled people?’’

This month, Crystal Sannella and a team of a dozen doctors, nurses, and therapists from Beth Israel Deaconess Medical Center went to Port-au-Prince and tried to answer that question, at least for a week.

Sannella is 25 years old and works at a hospital where she opens the supply closet every day and finds it full of everything she needs. The other day, in Port-au-Prince, she needed to make splints for a baby who seemed impossibly small, but there was no supply closet. The neonatal intensive care unit was a small tent. The baby was 2 weeks old, born prematurely, and abandoned.

Sannella went on a scavenger hunt to fashion the smallest plaster splints she has ever made, to put them on the smallest legs she has ever seen. She used a fan to dry the plaster - achingly slowly - in the 100-degree heat.

The patient beds are not beds but cots. Relatives sleep on the ground, under the cots.

Sannella is an occupational therapist by training, but she found that in a disaster zone you have to be other things. A man who had his stomach removed needed his dressing changed. Bile oozed from his abdomen, and flies landed on the ooze. She and Meghan Delaney, a physical therapist, looked at each other.

“Meghan and I hunted down an ostomy bag and figured it out ourselves,’’ she said.

While they changed that man’s dressing, the man in the next cot began breathing fast and shallow. Blood drained from his chest tube. Sannella and Delaney called for a doctor but all the doctors were busy elsewhere. In the 20 minutes it took them to change the dressing, the man in the next cot bled to death. The local staff covered him with a piece of tarp, and then only the flies paid attention to him.

“You go from feeling helpful to helpless in a second,’’ Sannella said.

Dr. Jon Crocker, the great humanitarian at Partners in Health who had prepped Sannella’s team for the trip, told them to remember three things, and Sannella kept repeating them to herself, like a mantra: flexibility, humility, patience.

The patience part paid off in Elsie’s case. Elsie is an old woman whose son brought her in. She had suffered a stroke and couldn’t move her left side. Sannella watched as the son fed his mother on the cot. The family was living in a tent, with nothing for Elsie to lie on or sit in. Sannella and Delaney knew she needed a wheelchair, but wheelchairs are like diamonds in Haiti: coveted and hard to find.

The two young therapists searched high and low and found an old, rusty beat-up wheelchair in one of the few buildings that did not collapse Jan. 12.

They presented the wheelchair to Elsie’s son, but hours later one of the local nurses came to reclaim it, saying they used it to transport medicines.

Sannella and Delaney were crushed. But Elsie’s son said he understood.

“You did your best,’’ he told them.

A few hours before they flew out of Haiti, Crystal Sannella and Meghan Delaney went on one more scavenger hunt. They searched everywhere. They had all but given up when they saw a brand-new wheelchair in the corner of the International Medical Corps camp.

“Take it,’’ a doctor said.

Crystal Sannella flew back to Boston yesterday, feeling guilty over leaving Haiti. After a week that changed her life and everything she thinks about life, she knew only one thing for sure: Elsie got her wheelchair.

Kevin Cullen is a Globe columnist. He can be reached at cullen@globe.com.