Tuesday, March 16, 2010

A story of a medical trip to Haiti

We found this great first hand account of the aftermath of the Haitian earthquake from the website Bio-IT World. Chris Dwan and his wife went to Haiti to provide medical care to the walking wounded. The Dwan's were part of a team that were provided by the organization Family Health Ministries that has been working in Haiti for over 15 years.

In Chris Dwan's account, he talks about being stunned by the resiliency of the Haitian people and even more stunned by the devastation the earthquake left behind.

On the day we arrived, we set up a triage area, a system for taking vital signs, physician rooms, and a pharmacy/waiting room. We were not planning to see the seriously injured—our clinic was intended as an ambulatory care center for the “walking wounded.” Each day by sunrise, there was a line of at least 100 patients waiting on rows of benches outside the gate. We worked through the day with a break for lunch, generally closing up around sunset. With 6 health care providers and 9 other supporters, we saw more than 1,500 patients over six days.

During our time there, we treated broken bones, wounds, infections, and severe dehydration in perhaps 10% of the patients we saw. Each day, we could think of 5 or 10 people who would likely have died except for our help. For the remaining 90% of the patients who came to see us, we took time to listen to each person’s story and to provide basic medications. We treated what we dubbed “Earthquake Survivor Syndrome”: inability to sleep, night terrors, acid stomach, and generalized body pain. Every person who set foot in our clinic was able to tell their story at least three times (in triage, to the providers, and again in the pharmacy). Nobody left empty handed, although we felt incredibly helpless handing out ibuprofen, TUMS, and Tylenol to people in such straits.

Each person on the team had multiple roles; I worked in our makeshift pharmacy, counting pills and mixing suspensions. I also organized the meager laboratory, running blood sugar and hemoglobin tests and the occasional pregnancy test. In the evenings I worked on the satellite uplink and sorted out software issues with the clinic computer. Our resident architect had the much more daunting task of examining standing and fallen buildings through several of the poorest communities in Port-au-Prince. The loss of so many lives in Haiti was directly related to poor quality concrete, insufficient structural support, and non-existent building codes. Whereas steel can flex and retain most of its strength, concrete shatters under duress. Because of this, many surviving buildings are essentially death traps, made up of materials (in his words) not suitable for a dog house.

There are many positive things that came out of our trip to Haiti. In the week that we had to prepare, people showed astonishing generosity. My Bioteam colleagues provided a mobile satellite Internet uplink that we used while bringing the building’s link back online. This allowed the medical team to post blog updates (read mine at http://blog.bioteam.net/tag/haiti/). Friends, coworkers, and local institutions came together providing materials until my living room looked like a medical supply depot.

Some images stay with me: The little girl with severe dehydration who sat next to me for hours, taking tiny sips of rehydrating solution every couple of minutes until she was able to eat a little and walk home with her mother. The man who began demolishing the building next door to the clinic, using a 5-pound sledgehammer and the strength of his arm. “If he hasn’t given up hope, how could we?” became a touch phrase on the team. The people who came to see our unshaven and motley crew of providers were dressed in their Sunday best—they somehow found a way to shine their shoes and press their shirts even though they were sleeping under tarps near their ruined houses.

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