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Sunday, February 14, 2010

2/12/10 - Team 3, Day 7

Friday, Day 7, Team 3
Dr. Oscar and I slept late until about 8 AM this morning, tents hot from the sun by that time. The rest of the team opened up clinic and pre-op. Tyler also slept in, Dr. Bill attending his IV, one of three of our team members who have gotten ill. We are not exempt from statistics. It has not been unusual to see a couple of IV bags hanging on the iron posts holding up the corrugated tin roof of the guesthouse patio from time to time, pumping fluids and anti-emetics to various volunteers here.

The patients scheduled for procedures today included a woman from CAM needing wound debridement, a distal radius fracture needing open reduction and plating, a central line for IV access in a patient with an infected BKA wound and no peripheral access, and ultrasound exam of a possible scrotal abscess. Our medical patients on the ward include a gentleman with probable rabies encephalitis, several admitted with dehydration and fever, a 16 year old girl with altered mental status, weak and dehydrated.

Our debridement patient did very well, the sisters and staff from the Mennonite Mission picking her up afterwards, placing her on a mattress in the back of their open bed truck, with still about 30 minutes of pain relief on board from her spinal to help with the bumpy ride back to CAM. Dr. Oscar placed a right internal jugular line with an 18 gauge angiocath on our BKA patient, and the US revealed orchitis rather than an abscess in our young male patient, he should do well with IV and then PO antibiotics and pain medicine. We postponed our radius fracture patient for Dr. Smoot’s team, arriving on Sunday, for lack of enough 14 mm fully threaded cortical screws. We have them now; Dr. Laura personally obtained them from the ortho supply tent at General Hospital later in the day.

Dr. Laura’s trip to General and Miami hospital in PAP was quite successful. She went down with Tim, Bob and David from HCBC. They arrived at MOH the day before, bringing with them a surge of energy and planning, both short and long term. Bob was here the first two weeks right after the earthquake, with Team 1, and knows how to get things done in Haiti. Dr. Laura got orthopedic surgical supplies from the ortho tent at Miami, ultimately getting a young US Army soldier to pop open the lock, when no one could find the keys. She also borrowed equipment form General hospital, for our cases. These hospitals in PAP are eager to share and send patients to MOH for surgeries, our surgical infection rate remains at 0%, due to the unique nature of our set up: small completely enclosed room with single air conditioner, strict aseptic technique with use of autoclave. The larger hospital facilities in PAP have had major post op infection problems, they are using chemical sterilization for lack of an autoclave and have open air surgical pods, leading to contamination of surgical wounds. Bob brought back four additional patients from these places, to MOH, who need surgical procedures best performed in our sterile setting.

New equipment and patients to care for were not the only blessings from Dr. Laura’s trip. The team stopped to visit our paralyzed GSW patient, recovering at General Hospital. Vanessa from MOH had befriended this young man, and right there along with the pastoral team from HCBC, he accepted Christ as his savior, squeezed in tight on the ward row among the suffering, the recovering, the chaos that is now the medical care delivery system in Haiti. God is great.

Back at MOH, we are celebrating the first of three days of prayer recognizing the month passed since the initial quake. Services across the country are to go from 6 AM to noon, then 5 PM until 8. The worship pavilion at the MOH was at full tilt. As I walked down the gravel path from the ward towards the loud, rhythmic, musical din I noticed the pavilion packed well beyond its open metal grated roof support column capacity. Families, kids, teens were strewn across the yard on blankets, cardboard flats, some standing arms outstretched to heaven, many moving, dancing, singing. I wiggled in to my usual section in the back, and squatted on the warm concrete with them, immediately surrounded by these people we have all grown to love, respect. It was already close to 9 AM, having finished helping with ward rounds, and these people had been worshiping the Lord for 3 hours now. They came and went down all the aisles, sharing space and water containers. To my left a young teen looking after a group of youngsters opened a plastic wrapping of Twizzler pieces. Each long strand had been cut into about 1 inch pieces, and as she passed them out to the kids with her, each turned and passed some on, reaching across blankets and pews, spaces and groupings, as a quick bright red wave of color spread around me like paint splatter. Then the red was gone, another ounce of strength for each, another demonstration of the love and communal strength of these people, their tactics for survival in the face of so little.

The evening was more relaxed tonight, Dr. Cheryl and Lawrence sat with us and talked about their long term hope to establish a full time, full service hospital complex at the mission. The school year is approaching, and we need to move the patients from the schoolhouse ward, into a different space. All of this provides challenge and opportunity. We took pictures and said goodbyes to the many medical volunteers we worked shoulder to shoulder with this week, we leave for the PAP airport around noon tomorrow, to begin our travel home.
God bless.

Robert Wills, M.D.
Austin Pain Associates

(At the time of this posting, Dr. Wills and Team 3 have returned to Texas)

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