The last few weeks have been a blur. Even before the August 14 earthquake there was rarely a dull moment at HAH. With all the amazing, challenging, and miraculous events taking place, I have been trying to find a few moments of peace in order to share some of the excitement and express gratitude to all of you who are supporting this work.
Since the day of the earthquake the hospital has been overflowing with patients.. One month later the situation continues. We wrap up a big day in the OR, we have 50+ patients on our inpatient ortho service and the clinics are busier than ever. We are all quite exhausted, but on our way out take a walk through the Salle d’Urgence (ER) just to make sure no more cases had arrived. There is a 12 year old girl with a deformed arm, a lady with a pelvis fracture from the earthquake, another lady with bilateral forearm fractures from an accident, two men with acetabular fracture dislocations, a patient with a wound infection, and another guy who had cut his arm and was walking around dripping blood everywhere. The Salle d’Urgence did not look much different than the night of the disaster. We have no beds available in the hospital and many patients are still waiting longer than usual. Meanwhile we try our best to keep up with the case load.
The reputation of HAH is blossoming. Other hospitals, organizations and individuals have been reminded about our mission to give top quality care to all classes of people. Other institutions are constantly calling to transfer cases for a higher level of care. Some patients have come with interesting stories in order to be prioritized with the earthquake victims. We had a motorcyclist who claimed he went down when the ground started shaking, chronic infections exacerbated by falling rubble, an 8 month pregnant lady that started having contractions caused by stress from the quake and an untreated femur fracture from last year that rebroke when a man tried to run. Another patient was in the Au Cayes hospital with a 6 week old untreated femur fracture when the earthquake struck and he had to evacuate. These cases are all reminders of the desperate needs, the suffering, and misfortune in Haiti. They are reminders of the importance of what we do. They are reminders of why we are here long term. Whether earthquake related or not we find the means to take care of all of these people.
I want to follow up on a story about Carlande. She is a 23 year old patient who was interviewed by CBS news in our pre-op room just before going into surgery. When the earthquake struck she ran for her life trying to escape a market.
The roof crumbled before she could get out and trapped her under the debris. Another man beside her lay dead under even heavier rubble.. She suffered bilateral femur fractures and a right hip dislocation. We reduced her hip and stabilized both femurs using SIGN nails. We had to be careful about blood loss as blood is in short supply and she was already anemic. To make matters worse she is O negative which is the “universal donor”, but the worst type to have when you need blood because you can only receive O negative – not that common and highly sought after. Post-operatively Carlande went into respiratory distress. This occasionally happens from fat emboli with this type of surgery. Fat droplets mobilized from the inside of the bones arrive at the lungs and create an inflammatory inferno. Her hemoglobin dropped to dangerously low levels. Fortunately, Merrill a nurse volunteer from Baltimore is O negative and was able to donate a pint of blood. Thanks to oxygen, prayer and great care from Dr. Jeff Cho and others she gradually improved and now is discharged and well on her way to a complete recovery. Carlande is one of many at HAH who have such stories. Every day here is intense.
Even though the situation is not much different than the day after the earthquake, a lot has happened in the last month. The first 4 days after the earthquake Dr. Jacky Jean (ortho surgeon at HAH) and I operated day and night. Soon after that help arrived. Ortho trauma surgeons, anesthesia providers, nurses and a logistics coordinator have all been a tremendous help.
It was providential that we hired 4 new nurses in our OR and trained them in the week before the earthquake. More recently we were able to coordinate a formal rotation for the ortho residents from the state hospital. This is an amazing experience for them and also a big help for us. During a normal month we average about 100 operations, but in the month following the earthquake more than 300 major surgeries were performed.
Again, in spite of reports about kidnapping, gang violence, limited resources, and lack of infrastructure in Haiti we remain safe and focused on our work at Hôpital Adventiste.