surgical teams serve in haiti

A physician’s dispatch from Haiti

The following account was sent in early March by Michael Patterson, MD, a pediatrician in Santa Fe, New Mexico:

I apologize for the group email, as I usually do not do that. However, this is the first time I've been on a computer since arriving here a week ago. The people with whom I work are incredible! They are volunteer physicians, nurses, and nurse practitioners from all over the US and Britain. Much of the paid staff are Brits and/or Aussies, at least by their accents.

I have not had the opportunity to work alongside my wife, Susan. She works at an outlying clinic with another American physician, 2 Haitian physicians, and Haitian nurses. I work at the Haitian hospital in the middle of Port-au-Prince. International Medical Corps has set up an emergency department in three tents and staffs it 24 hours/day. The IMC volunteers rotate shifts. I started off in the orthopedic tent but have done a variety of other tasks as well.

We have interpreters available in our tents and as we transport patients to other tents serving as makeshift wards. We are not involved in the "wards," which are staffed by other NGOs [nongovernmental organizations], Haitian docs, or no one. There is an “intensive care unit" tent that our staff have just taken on; otherwise, these critical patients would just die. They have 4 oxygen concentrators and some large oxygen tanks. Some incredible pathology! Extremely disturbing seeing the medical conditions that lead to death here, conditions which are preventable and/or treatable if intervention is early.

On Sunday, I was ready to leave this place. I had done my second transfer of a sick child who we had intubated. I was ventilating him with an Ambu bag and O2 while we finally found a facility that could take him. We believe he had typhoid, which caused a bowel perforation and overwhelming sepsis. The 82nd Airborne contingent has been very gracious in providing transport. They took the mom, patient, and me in the back of their cracker box ambulance, which was like a dimly-lit sauna. I bagged the child all the way on the bumpy ride through town. We had no idea the route, as there were no windows. [The child did not survive.] The Mom and I rode in the back with this body bag. It was surreal, as we bounced back to my locale; the pregnant mom chatted on her cell phone with various people who called. Took the child to the Haitian morgue, then went back to work. Two others died that afternoon, one a young woman with an ectopic pregnancy! All of us had seen patients with ectopics but never had one die!

Yesterday was a better day, as I helped coordinate transport of four orthopedic patients, one a 7-year-old girl in a spica cast since the earthquake with unhealed femur fracture. Ambulance crew with some Canadians took them to an American facility an hour away for ortho surgery. A Swedish ambulance crew transported another woman with a dental abscess, who had sat in our ER tent for nearly two days, to a Brazilian facility with an oral surgeon. Despite being a "good" day, it still had bad things. A man with a gunshot wound to the head, still alive and thrashing, but no neurosurgery available. Comfort care was provided until he expired. Meanwhile, activity all around, and patients numb to all this horror.

Overall, the Haitians are amazing with their composure and strength. Also, their faith is strong, despite all their ill fortune. Things are starting to normalize at the hospital, with Haitian staff returning to work and starting to provide the care that IMC primarily had been coordinating. What is amazing is that we've been told that most of these staff lost family, have no home to return to, have not been paid and, often, do not have the respect of the patients. It is wonderful that they're returning to work at all.