2/9/10 - Team 3, Day 4

As the days and weeks go on since the earthquake, networking lines of medical triage among and between the various hospitals and clinics that dot the country have developed. Key leaders, like our Dr. Cheryl here at the MOH, communicate regularly and try to match patients’ needs with the capabilities of each locale. Prior to the earthquake, MOH was a large clinic with a full time Haitian physician and staff, a lab for basic blood tests, and a pharmacy. This important work continues, if magnified. In terms of MOH’s surgical and emergent care capabilities, now 4 weeks out from the earthquake, we have become the destination for complex wound management and orthopedic injury continuity of care and follow up.

One small concrete-walled building about the size of a 2 car garage houses our operating room, triage station for the most seriously ill or wounded, wound debridement bay, pre op and stage 2 recovery step down unit, and the “doctor’s office” which is a converted closet with two desks and several chairs.

Today, we saw patient after patient with casts, splints, surgically implanted external fixation devices, healing and infected wounds, and many amputations. Many patients we treat in the pre op area, the most serious we take into the OR. Today we did a wound debridement and placed our second wound vac device. She had exposed EHL tendon and tibia at the base of her wound in her lower leg, and she was a great candidate for a vac. Our first case in the OR today was a patient with a retropharyngeal abscess, performed by Dr. Adrian one of our ER docs. Our first scheduled patient tomorrow is also an abscess, this one a right anterior neck abscess on a 5 year old girl.

Today we secured a facility for Dr. Jeffery to perform a VP shunt on a 1 year old. He will travel there tomorrow on our ambulance, and will be brought back when he is through. He is a blessing indeed for this baby and her family, as she has had a “big head” with fluid on the brain since just after birth, and this surgery will allow her head and brain to develop normally.

One example of God’s hand being with these people, was with one of our amputation revision patients. She is one of the patients directed to us from the Mennonite Mission, a joyful young woman who ran outside her house during the earthquake with her family, safely, only to be struck on the leg by her neighbor’s roof, losing it. Two days ago, her staff there diagnosed her with anemia, and arranged for her to receive a blood transfusion, which is a rare commodity in Haiti. Today in surgery, she needed every drop of that blood, as we had major blood loss due to a malfunctioning bovie and tourniquet. She is recovering now in our post op ward, being taken care of by an ICU nurse volunteer from Los Angeles. One on one critical care nursing, in Haiti, God is great.

A short time after dark, as we pulled our ambulance around the dusty corner leading up to the ward, with our last surgical patient of the day, we saw the open air worship pavilion, once again filled with people. Tuesday night worship service. As we rounded on the patients, helping the nurses with foley catheters, meds, monitors, I could see the service and hear the beautiful Haitian music coming through the open windows of the ward. As the service ended, many of the folks wandered over to the ward to check on loved ones, and they squeezed in among us, helping, translating, humming, loving on each other, and on us.

Dr. Laura, Dr. Bill, Tyler and I were the last docs to leave the ward, Bill and Tyler choosing to walk the mile long path up the hill to the MOH guesthouse, Dr. Laura and I hopped a ride in an ATV with an MOH staff member. A delicious, if simple, dinner of rice with pork, on tortillas with lettuce and salsa was held for us, then a quick rinse shower, and off to my tent to rest up for tomorrow. As I type this in my tent, a small group of people are gathered on the wooden door tables just beyond my tent, praying together and sharing devotionals. I pray for strength of faith, for my family who I now miss greatly, for these Haitian people we have come to serve, and for the safety and strength of our medical team as we prepare for another day.

Robert Wills, MD
Austin Pain Associates