surgical teams serve in haiti

Penn State Hershey medical mission team to head home from Haiti

Wednesday, February 3, 2010

The medical mission team comprised of Penn State Hershey Medical Center doctors and nurses that has been treating quake victims in Haiti for nearly two weeks is set to hand off their patient care responsibilities and return to Hershey this week.

Though they have endured stifling heat, lack of sleep and limited access to essentials like running water and electricity, team members say they will remember most the gratitude and grace of the Haitian people they helped care for.

“The Haitians are beautiful people, very kind, very thankful and gracious about all the help so many people are giving them,” said Shane Johnson, a plastic surgeon at the medical center. “Despite the misery they’ve been going through, the ones we’ve seen and spoken to are generally pretty happy. They had a church service outside the other day with a band playing, and almost everybody came for it despite their injuries.”

“Even if some of them couldn’t physically get to church service they were in their tents singing and joining in and rejoicing that they were being taken such good care of,” said Jay Bridgeman, an orthopedic surgeon at the medical center.

J. Spence Reid, an orthopaedic surgeon in the Penn State Hershey Bone and Joint Institute lead the team, in coordination with a pair of not-for-profit health organizations -- Partners in Health, which has been providing medical care in Haiti for more than 20 years, and Operation Smile (at http://www.operationsmile.org/ online).

The team flew into Port-au-Prince, Haiti, on Jan. 22, and has been stationed at the Love a Child orphanage in Fond Paraisan near the Haitian border with the Dominican Republic since Jan. 26. The campus has grown by 20 to 30 percent each day, team members say, as steady streams of patients and medical care teams from around the world arrive.

In addition to Reid, Johnson and Bridgeman, the Medical Center group includes Patrick McQuillan, anesthesiologist; Johni Bradney, clinical head nurse for orthopaedics; Ami Willenbecher, surgical technologist; Matthew Budge, orthopaedic resident; Jovie Cherenfant, general surgery chief resident; Maureen Kelley, nurse; and Peggy Schroeder, a nurse with PinnacleHealth.

While the stifling heat has added to the difficult working conditions in Haiti, the hot weather has been beneficial, too.

“ Rain would be an utter disaster here,” Johnson said. “There are almost 300 patients and more than 100 medical staff sleeping outside in tents on this compound, and there are a lot of open wounds and dressings that need to be sterile, so rain would just make things messy.”

The situation at the medical compound is good compared to other parts of Haiti, Johnson said. The orphanage is gated and monitored by security personnel. The medical team went stocked with its own food supplies, but a Haitian tent kitchen at the orphanage that provides three meals a day to patients recently started feeding medical staff, as well. Fresh drinking water comes from an artesian well. Cherenfant, a native Haitian, served as the group’s interpreter and used his knowledge of the area and culture to help the team make connections.

The team initially struggled to maintain sterile conditions in the operating room they’d set up in one of the orphanage’s school house rooms. Since then, a special medical tent with proper air circulation and ventilation, as well as a floor that can be easily sterilized, has drastically improved their ability to keep the surgical environment sterile.

Most of the patients seen at the medical compound have either non-life threatening crush injuries from the quake or surgical wounds left from hastily performed procedures at other sites soon after the quake, when emergency medical providers were overwhelmed. The Hershey surgical team has handled 13 to 15 cases each day in the makeshift operating room, a hefty case load considering they can’t operate at night. Generator-powered electricity reaches the compound by way of wires strung through tents and taped to walls, but the occasional light bulb isn’t enough to operate by.

“The majority of the surgical care we’re providing here is cleaning wounds, some of them small and some of them requiring pretty aggressive surgical treatment and reconstruction,” Johnson said. “Occasionally we do amputations of limbs or a finger, and because of the conditions, the wound infection rate is high, at least above 80 percent.”

For these patients, follow up care is critical to help their wounds heal properly. The Operation Smile/Partners in Health team organized wound care teams to change dressings daily and monitor patients for complications or infection. And the team established a patient charting system so all patients are identified and given a medical record. The team also administered tetanus shots to some 800 patients using vaccine carried by the Hershey group. Some 300 doses were donated by the Pennsylvania Department of Health and 500 doses paid for with money raised by the New St. Peter’s Presbyterian Church in Dallas, Texas.

“Every day, more and more medical teams arrive from everywhere, so we’ve been able to set up pre-operative and post-operative care nursing teams, physical therapy teams, and other plastics and orthopedic surgery teams,” Johnson said.

“We met a few Haitian nurses who have lost their whole families in the earthquake, and the places they worked are gone, so now they are here and all alone. It’s like going from having a normal life to being homeless, like that,” Bridgeman said. “We’ve put them with our nurses so they now have jobs again and a new community of support.”

For those more sever surgical cases, patients can be transported to the OR of a gynecological hospital and mission that opened a year ago in Haiti. The OR had never been used and medical teams were asked to take advantage of its more advanced technology for more complex cases, in which reconstruction might help avoid amputation.

“If you could be here and see just how poor this country is, you would understand that here, an amputation means you are crippled for life,” Johnson said.

“In the U.S. an artificial leg is relatively easy to get and therapy is extremely helpful,” Reid said. “Here it devastates your life, your family. So there’s going to be orthopedic work and wound work for years to come in Haiti.”

Staff at Penn State Hershey Therapy Services in the Department of Orthopedics are accepting donations of used crutches and canes to be sent to Haiti. View the story related to that effort at http://live.psu.edu/story/44312 online.

Team members say they feel ambivalent about returning home after seeing the results of what they’ve accomplished in their time in Haiti.

“There’s still a lot of unfinished surgery we would love to be able to stay and finish,” Johnson said. “We would like to see everything to completion here but you’d need to be here another three months to do that.”

The Operation Smile/Partners in Health team transitioned medical care and operations at Love a Child orphanage to a second Operation Smile team, including three staff members from Penn State Hershey Medical Center, today. The Hershey group from the first team is scheduled to be back in Hershey by Friday.

To see photos of the Hershey Medical Center medical mission team in action, visit http://live.psu.edu/stilllife/2210 online.

Contact Megan Manlove mmanlove@hmc.psu.edu 717-531-8604

Copyright © 2010. Penn State Hershey Medical Center.