Haiti

Haiti Journal: Pop Tarts, Courtesy and Patience

Posted in Haiti on February 4th, 2010 by MMS – Comments Off

By Mavis Jaworski, MD

If you come to Haiti, bring food and your own eating utensils and can opener/bottle opener/knife/scissors.   I did not have any of these.

As a team leaves, they pass down to the newcomers, their prized Glad plastic containers, Sharpies permanent makers, ink pens, batteries, snacks, and extra DEET.   They are mindful of also leaving food for their translator who worked without pay.

Your heat source may be a microwave, a hotplate, or a campfire so bring items you can heat with various sources.   One of my tent mates brought an electric tea pot.  It proved to be a necessity in many ways.  It was used for tea, coffee, MRE’s, dehydrated food, instant oatmeal, etc…

Just after the earthquake, the only food available for medical personnel was Strawberry Pop Tarts.  It was breakfast, lunch, and dinner.  As more food was donated, the plentiful Strawberry  Pop Tarts were still a staple in the diet, though maybe a dessert after a can of tuna.

I will always think of Haiti when I see Pop Tarts. They proved to be easy to eat and no preparation. As a child I loved the cinnamon or chocolate ones and would have loved having these flavors as well.  A nurse who was covering so many locations, lamented,  “Here I am running around thinking I am going to lose weight here, but I think I am taking in more calories than at home, because I keep eating those Pop Tarts. You know those are addicting.”

DSCN1075Take protein bars that do not have chocolate coatings which will melt and make a mess when you open them. Bring nuts, trail mix, and electrolyte items (Jelly Beans were yummy).  As I saw a patient I would give him some miniature marshmallows, chocolate chips, or nuts.

Haitians are beautiful people and so loving to their children and family. They are courteous and patient and ever so quick to say “Merci.”  Children would see that I was giving out things to eat and put their hands out as I approached them, their parents who were very thin and hungry too would keep their hands down.  I would have to say “MaMa?” or “PaPa?” and then they would offer their hand to receive some food.

Would a line of Americans behave in the same polite manner?

Mavis Jaworski, MD, is a family physician from Beverly, Mass.

“I Think of How Broken Haiti Is …” – A Physician Returns and Reflects

Posted in Haiti on February 3rd, 2010 by MMS – Comments Off

Mark Pearlmutter returned from Haiti earlier this week, after caring for earthquake victims. I spoke with him this morning, and asked him to reflect on what he did and what he saw.

Dr. Mark Pearlmutter’s Video Journal from Haiti

Posted in Haiti on February 2nd, 2010 by MMS – 1 Comment

Dr. Mark Pearlmutter, a member of the MMS and chief of emergency medicine for Caritas Christi Health Care in Boston,  has just returned from Haiti, serving with many other colleagues from Caritas Christi.

Here is his video report.

Caritas Christi Haiti Relief Fund from EnFocus Media on Vimeo. (If you can’t see the video window above, watch the video here.)

Mark blogged extensievly about his experiences while in Haiti.

In his Jan. 26 post, “Surrogate Child,” he wrote about one particular child’s struggle:

It amazed me that although we had 250 patients in our hospital compound, the entire team was emotionally connected to the fate of this child.  Part of this was because not one of us had diagnosed seen or treated a case of tetanus.  But I’m convinced it was more to do with the dependent fragility of a sick child who was alone without her parents.  We all assumed a surrogate role that went beyond simply being medical caregivers.  Now all we could was hope and pray that the exceptional care being provided on the US Comfort would make a difference.

The next day we got word that the parents arrived by bus (a 36 hour ordeal) from Port au Prince.  Our hearts went out to the parents as we told them about their child.  We showed them pictures of their child, initially intended for didactic purposes.  Who would have known that these pictures would be the last they would see of their child.  Their daughter, our surrogate child, had succumbed to the effects of overwhelming tetanus infection.  Although we all mourned the loss of this child, we took solace and were even somewhat uplifted when the parents thanked us for all that we had done.

As I watched them leave our compound, I couldn’t help but feel that the entire country of Haiti had become our surrogate child.

Mark’s full post from that day is available here.

Read also Mark’s remarkable post on Jan. 24, Haiti Impressions: Day 2.

What They Saw in Haiti: Physicians Tell Their Stories

Posted in Haiti on February 2nd, 2010 by MMS – Comments Off

Physicians everywhere have responded to the medical and humanitarian crisis in Haiti. The following post is compiled from interviews by physician-author Lisa Gruenberg, M.D.

On January 12, plastic surgeon Stephen Sullivan, M.D., checked his phone messages before boarding a flight from Florida back to Boston. The last one read, “So sorry to hear about Haiti.”

Plastic surgeon Helena Taylor, M.D., changes a compressive dressing on a Haitian woman with a fractured humerus.

“That’s how I first learned about what happened,” Dr. Sullivan said on January 25, having just returned from eight days of medical relief efforts in Cange, Haiti. He was there under the auspices of Boston-based Partners In Health (PIH), which has been bringing modern medicine to Haiti for 20 years and currently works in collaboration with the Ministry of Health to support 12 hospitals and clinics there.

Ironically, just before receiving the message about the earthquake, Dr. Sullivan had spoken at a combined plastics and orthopedics conference, asking for more involvement among orthopedic surgeons in PIH activities.

“We were at a conference asking orthopedic surgeons to be more involved, and then suddenly there was this huge event in Haiti that would require their involvement,” Dr. Sullivan said.

Dr. Sullivan had spent 2009 working as a global surgery fellow in Cange, the location of PIH’s first Haitian hospital, “Cange was like a home to me,” Dr. Sullivan said. “There is no way I wouldn’t be back there right away to help.”

Accompanied by his wife, plastic surgeon Helena Taylor, M.D., and 23 others, Dr. Sullivan was flown by private jet to Haiti on January 15. “Our trip went like clockwork,” he said, noting that “PIH has the advantage of being on the ground in Haiti already, and they are very well connected.”

Attending to a Haitian woman with a leg fracture in the village of Cange are (left to right) a Haitian nurse; Thierry Pauyo, a Haitian student at Harvard Medical School; Newton-based orthopedic surgeon Alfred W. Hanmer, M.D. and surgeon  Robert L. Sheridan, M.D., of the Shriners’ Burn Institute in Boston.  Photo by Stephen Sullivan, MD.

Meanwhile, Robert Sheridan, M.D., chief of the burn surgery service at the Boston Shriners’ Hospital and former director of the trauma service at Mass General, was already in Cange helping train Haitian colleagues when the earthquake hit. As injured patients from Port-au-Prince, 35 miles to the southwest, started arriving in Cange, the hospital community rallied with Dr. Sheridan to address the unexpected influx.

Using only physical exam skills (the quake had knocked out X-ray equipment and lab capabilities), they triaged the worst injuries for the operating room. Haitians and Americans worked side-by-side to relieve compartment syndromes, repair degloving injuries, and deal with fractures as best they could.

They performed three laparotomies and many amputations in crushed, devitalized extremities. The first wave of patients was acutely injured, Dr. Sheridan recalled. In subsequent days, patients presented with septic crushed extremities, rhabdomyolysis, multiple fractures, and renal failure.

 “We arrived in Cange at 9:00 p.m. and were in the OR at 10:00,” Dr. Taylor recalled. The teams Drs. Sullivan and Taylor worked with operated on more than 100 patients during their eight-day stay in Cange. Despite the surge of seriously injured patients, there were no cases of lethal sepsis because wounds were treated so expeditiously.

“For me, it was an incredible privilege to work with the Haitian and PIH staff and with Drs. [Alfred] Hanmer, Sullivan, and Taylor,” Dr. Sheridan said.

Dr. Taylor emphasizes the need for a long-term relief strategy in Haiti. ”The acute phase — dealing with rescue and treatment of abdominal injuries, wounds, sepsis, and amputations — is coming to a close,” she said. “The next phase, caring for displaced populations and closing and grafting wounds, will take months. The psychological and physical rehabilitation will take years of work. We hope others will join us.”

Lisa Gruenberg, M.D.

Photos by Stephen Sullivan, M.D. To read the captions, hover over the photos with your mouse or pointer.

A Physician’s Diary from Haiti

Posted in Haiti on February 2nd, 2010 by MMS – Comments Off

DSCN1076

Dr. Mavis Jaworski, a family physician from Beverly, was one of many Massachusetts physicians who went to Haiti to help in the earthquake relief effort. Here are her observations from field, sent to us on Jan. 27.

I am currently in Haiti. Physicians need more assistance with organized flights to and from Haiti, ground travel coordination and experienced drivers; maps of Haiti with locations of hospitals and contacts; Creole lessons on medical issues; paper and plastic products for eating, and cleanup.

A lot of time is being wasted trying to get to Haiti then trying to locate your destination and getting there, and then having to spend too much time on standby for the return because all flights are full; I have to go two days earlier so that I do not miss my flight from Florida to Boston.

Can’t sleep. The penthouse is hot. Neighbors are coming and going. Tomorrow night we may move up to the next roof which has no walls. Our current home has walls which block breezes.

Sesame Street Ernie hangs from our tent. My tent mate saw it and said “This establishes ownership.” I chuckled to myself. He has been up practicing Creole after trying it in vain with a person, only to find out that the woman spoke English.

What is needed? Organization. So many various teams are coming and going. We need to coordinate ER. Now I go back to penthouse. And the fragrance of DEET.

One doctor is elated to be going home after six days; another is sad to be leaving after six days. Dedicated teams, all named by state or country. Some teams only want to do certain things. Coordination of travel and ER, OR is much needed.

Things one should bring to Haiti:  DEET, tent, bedding for a hot climate, lightweight scrubs, English/Creole translation book, global phone, camera, journal materials so you never forget, disinfectant cloths, comfy shoes to work all day, easy-to-eat protein (nuts), a cup to make coffee or tea in, Melatonin (after what you see it is tricky to sleep, but you must).

More: Sticky labels for your personal items, and for attaching to a patient bed (waiting for surgery, waiting for x-ray, waiting for medication, etc.) to avoid redundant work ups by different docs; back-up eyeglasses; toothbrush, toothpaste, gargle.

Is there an inexpensive MP3 player that can be loaded with Haitian music and given to Haitians? They are at a loss as what to do, they wait and wait. They need music. They need something to write or draw with. We need melatonin for them. We need to help them calm their nerves. We need to provide human touch. The eyes are vacant. They are stunned. It is sad.

We need dry erase white boards with markers. We need a large and small bulletin boards with pins. Get office supply places to donate. Get Crayola to donate crayons and paper for children to play with.

It would be helpful to have identification bracelets or necklaces with cards of information attached for patients (to write brief history on them, e.g., previous medical visits, prescriptions) Bill Gates help us coordinate set up of efficiency in places.

We need communication devices for teams. Nextel?

Thanks,
Mavis Jaworski