Again, I apologize for not getting this report out sooner. Last night I got the first full night’s sleep since arriving here, and I confess that I simply put off the report too long and wasn’t able to get it finished before we launched out this morning. But I am SO glad to be able to report that in many ways I believe we have “turned the corner” in our relief efforts. There are still an unbelievable number of very badly injured people here who need to be linked up with definitive (surgical) care because of their injuries. But, with the release of the volunteer medical personnel into the ecosystem at last, there are no longer the crippling shortages of skilled personnel that made the first week after the quake so nightmarish. What we are seeing now are pinpoint shortages of critical medical equipment in some places; uneven distribution of medical personnel in many places; and a continuing inability of many ordinary Haitians to get access to the most basic medical evaluation and care, let alone definitive surgical resolution of the infected crush injuries that are so devastatingly commonplace. These are problems that Team Rubicon has been attempting to address and we have found some solutions that merit a broader readership. So, if you read this report and think “huh, that makes sense” then please forward it on to others. But in any case, THANK YOU for reading, caring, and keeping us and our Haitian siblings in your prayers.
So anyway. Yesterday we set out to assess some “refugee” camps. (Frankly I think the word “displaced persons” is a lot more appropriate here, and thus I would call these sites “displaced person camps” or DPCs. But refugee or DP or what have you, the bottom line is the same: these are ordinary people who have lost their homes, their jobs, their possessions, and their family members, and who now are living under plastic sheeting and sleeping on sheets of cardboard on the ground.) We went with representatives from Catholic Relief Services, and frankly I wasn’t all that impressed with their intel regarding truly needy DP populations. Our first stop proved to be a middle class neighborhood where various people assured us that no one in the neighborhood had eaten since the quake, or had anything to drink in 3 days, or had any access to medical care of any kind -- while carrying half-empty water bottles and standing next to other people who had fresh plaster casts on their arms and legs. We moved on.
However, the next area we arrived at, just a few miles away, was a very different place. The people were polite and there were many stained bandages in evidence. We set up a triage station (using a very nice dresser from someone’s house, a little the worse for wear as missing drawers and mirror) and got to work. We really have a solid routine by now, and we were able to triage and treat patients very quickly and effectively. The problem was, the more complex stuff was WAY beyond our capabilities. The most heartbreaking injuries are the pediatric cases -- a couple of badly infected hand wounds in little girls really bothered me. But as I said, there just wasn’t anything we could do about them. We made arrangements to send them to a nearby hospital, loaded them into various vehicles, and wished them the best. It wasn’t terribly satisfying, but we took the best care we could of every patient. And then, after we got done with our work, we played with the kids. And they were great! Also, to be frank, so are the new members of our team. Watching Seth (who with his shaved head looks pretty scary) chasing happily screaming kids in a great game of “monster tag” had us all rolling. And when Brother Jim did sing-alongs in Kreyol wit the kids it was beautiful. I did a little singing myself, but that was earlier, when I was bandaging a woman’s leg and we had another aftershock; she started praying (“O Jesu, Jesu, Jesu...”) and I started singing a hymn while continuing to bandage her leg. The neat thing was, she joined in in Kreyol, and harmonized until we both felt better. The day was utterly unremarkable and very pleasant, and noteworthy only because we definitely saved at least one life (boy with lower extremity compartment syndrome) and preserved both life and limb function for another four patients, including the two little girls. I believe that we really made a difference and I fell asleep that night with a wonderfully contended feeling right down to the tips of my toes.
That was the day when our first team members departed (we lost Jeff, Craig, and Eduardo because they all had to go back to work). We also acquired still more medical team members, so many that I can’t keep them all straight. I only know nicknames so far: Big Ivan the doc; Spiro the doc; Trauma Bob and Ortho Dave the two PAs, Rosite the nurse from Haiti, and Dr. Mauricio from Chicago. Since we had this heavy medical contingent, our first mission of the day was to get these personnel set up in a hospital. So we saddled up our ever-expanding motor pool, consisting of two tap-taps and a mini-pickup truck, and headed out to the CDTI or Sacre Coeur Hospital. We were very impressed with this hospital after the chaos at General; it was overburdened, short on everything but patients, and parts were unusable due to the earthquake, but it was functioning like a single organism rather than a bunch of uncoordinated spasming body parts. (As Jake put it, “Every time I asked anybody something, they always sent me to the right person to answer the question.”) We left Docs Ivan and Spiro there along with Seth, Karem, Trauma Bob, and Ortho Dave, and set out to find them some patients. (They didn’t really NEED any more patients, but we wanted to do our part.)
We went to CRS again to find out where the DPCs were, but frankly they were not terribly useful. Although the organization has a whole lot of vehicles and personnel, most of the little SUVs were still parked in the same places as on Monday. There also seemed to be a certain amount of confusion about the basic question as to which DPCs had, and which hadn’t, been visited by medical teams. (Then again, I can’t knock the Catholics; I’m a Mormon, and when I was stateside and called my own church headquarters to find out how I could help in Haiti, all I got was a recorded message that said they had all the personnel they needed and please donate cash instead. I did see an “LDS HOSPITAL” SUV today, but it was going the other way on a busy street and we Mormons have yet to develop a secret yodel or something that lets us pick each other out in a post-earthquake disaster area...)
Anyway, CRS led us to a medical supply warehouse which was also where the local community disaster response awareness team was set up. A brief discussion demonstrated that the level of awareness was relatively low. The warehouse/CDRT personnel knew approximately where major DPCs were located, but had little additional information and no knowledge of who had/had not received medical aid. So, we set out for the first place on the list. Our lead tap-tap promptly died. We were pulled over by the side of the road, trying to come up with a plan, when a local man in a pickup trip pulled over and asked what had happened. We explained, and according to Brother Jim, the man said, “You are here and you want to help, when you could be home with your wife and children.” (The comment was well meant; he didn’t know Jim was a Jesuit brother...) The man continued, “People are dying here every day because they do not get medical help. I’ll take you anywhere you want to go and do whatever I can to help you. My family is safe, and I’ve been doing this for the past two days: just driving around looking for people who need help. Today I’ll help you.”
While marvelling at yet another miracle, we very quickly unloaded our inop taptap, loaded up our volunteer pickup, and headed off t o look at the sites on the list. The first one, in the Petion-Ville country club, did not house DPCs, but rather international aid workers. The second one, on the neatly terraced hill surrounding the vice-president’s palatial residence, had a variety of aid organizations present, with a variety of nice vehicles and well-dressed representatives. It also had, as far as we could tell, a non-trivial number of injured people who still needed medical care. So, Rubicon’s Field Team Bravo set up shop. Field Team Alpha then left, and since I’m on Alpha, I left as well. The reports from Bravo show that their experience largely mirrored our own, so I’ll confine my remarks to what I experienced directly.
We went from the breezy hilltop back down into the gritty city, to a location called Place Boyer. It was a DPC a little smaller than the one we worked at Monday, and we followed our usual pattern. We pulled up, sent a leadership team to find the camp security and camp leadership, asked permission to set up a medical triage site, and requested the community leaders to send us patients with injuries from the earthquake. The line formed before we got our tarps up.
Again, we didn’t see anything nearly as dramatic as the sheer misery we found on Monday. But we did see plenty of relevant injuries, some treated, some not, and some healing, and some not. The difference today was that now we knew that the hospital we sent them to would definitely be able to care for the patients. Another extraordinarily helpful thing were offers from passing Haitian and Haitian-American people with cars, who would pull up and ask if we needed any help. In this way we were able to evacuate waves of patients, by threes and fours; we sent out several infected wounds, head trauma, and a baby girl with a fractured femur, to name a few. And, we continued seeing patients. Today there was no time for playing soccer with the local kids, even if there had been a soccer ball available. Instead, we would work our way through all of the patients, and then more would show up. Even other medical organizations came to us for help... I’ll mention in passing that when I was preparing to come down here, I contacted Medecins sans Frontieres (Doctors without Borders) to see if I could assist them; their message again was “we have all the volunteer support we will need in Haiti; please just send money.” So, it was certainly a surprise when representatives from MSF came to Team Rubicon’s field clinic to ask for help. They asked us to care for a patient who had been brought to them after being operated on at another hospital (“it was near the airport”). Because of inadequate postoperative care (according to the MSF representative, “She has the bugs in the wound, how do you say, from the flies, the maggots”), this patient will probably lose the leg that was so painstakingly repaired. This was well beyond our ability to address at our field site, so we turned Wayne’s Mennonitemobile (just returned from the DR) into an impromptu ambulance, and took the patient to Sacre Coeur to be treated by our doctors there.
This led, for me, to one of the most inspiring moments in my entire time here. While I was helping bring the patient with the post-op infection in to the hospital, I passed a woman in the courtyard who looked very familiar. After delivering the patient to the hospital staff, I looked back at the woman, and saw that she had a sleeping baby in her arms. On the baby’s leg was a neat, well-made, white Ortho-glass cast. It was the mother and daughter from Place Boyer! In less than four hours, this girl had been professionally triaged and stabilized by one of Team Rubicon’s volunteer treatment teams; transported by local volunteers for hospital care as directed by a Team physician; and received definitive care from Team personnel at that hospital. We provided the girl’s mother with money for a taxi back to Place Boyer, and a little extra for the family’s other immediate needs. The baby slept like a baby, the mother was gracious and grateful, and every one of us agrees that this single patient care episode is a good reason for us to be here.
So, we are going to continue with this general scheme of maneuver, using two field teams for triage, treatment, and transport, and a rapidly growing hospital team to provide these patients with definitive medical care. While some of these patients will receive care that makes the difference between life and death, most of the patients we are seeing now are at a point where definitive medical care makes the difference between a lifetime of decreased function, and a lifetime of lost function. We are saving hands and feet, arms and legs, physical function and an economic and personal future in a bare-bones society with no social safety net, where a physical handicap often condemns men and women to lives that are poor even by Haitian standards. And today, we were able to be of service to a baby girl who, God willing, will grow up with two good legs, able to run and play, dance and work, and live a life free of disability, thanks to a motley band of volunteers and the vast outpouring of support from home that makes everything possible. From the bottom of my heart, I would like to say, to everyone who supports Team Rubicon financially, personally, professionally, and most importantly with your continued prayers for our safety and usefulness, THANK YOU so much. If you feel what I felt today, when I saw that baby sleeping in her mother’s arms, then you, like me, although you may have set out to be of service to others, have already received a reward that is greater still. God bless you!