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Saturday, February 13, 2010

Haiti Medicine

Post provided by Scott Smith, M.D.

It goes without saying that things are different in Haiti. Things were different in Haiti before 1/12/10. Things are definitely different now. This includes health care. It is quite ironic that in the USA we are debating health care reform (>$1.0 trillion expenditure debate) when in Haiti they'd take any healthcare. That's a future post. The performance of medicine in Haiti has many different hurdles to clear.

In my five days in Haiti I saw the problems as:

Access: Access to patients, or in other words, the ability of patients to get to providers. In America dial 911 and in less than 10 minutes trained professionals will come and take you to other trained professionals to be evaluated and treated. In Haiti, we had people present to our clinic two weeks after the quake with bones still sticking out of their legs. TWO WEEKS!!! Yes that compromised their outcomes.

Disposition: Where people go home to. In the US, we'd go home to our comfortable, clean, air conditioned house. In Haiti, the reason most people have fractures is that their house fell on them. Therefore they have no homes. They go "home" to a tarp tied to a tree. They lay on thin mats or blankets on the ground. If they have an open wound (which they all do) dirt, bugs, and other "bad" things have access to it. Less than ideal for healing.

Supplies/ Tools: In the US we have essentially an unlimited amount of tools, bandages, medicine and implants with which to treat injuries. In Haiti, what you have is what you carried there. We did not have xrays. This sometimes forces the healthcare providers to think outside the box for treatment options. This is improving as more trips are made to Haiti.

Quantity of injuries: The number of injuries is just immense. I never got a complete grip of the scale of injuries. I don't think anyone has yet or ever will. I'm not sure other than wartime if there has ever been anything like this. The injured people just keep coming. The type of injuries are not uncommon. I see similar crush injuries and fractures here in Austin. It's the volume of them that is unprecedented.

Poor nutrition/ secondary medical problems: Malaria, typhoid, HIV, cholera and others are all very prevalent in Haiti. So is malnutrition. If a patient's body is fighting these battles, it is less likely to heal injuries sustained in the quake.

Progress is being made but to say it is an uphill climb is an incredible understatement. Texas Orthopedics and the people of the USA will continue to support the efforts in Haiti. Every volunteer minute, every dime and every prayer makes a difference.

Scott Smith, M.D.
Texas Orthopedics

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