On
The Ground In Haiti
“Haiti’s catastrophe
will forever divide its history into before earthquake and after.
Dust has not settled.
Flying towards PAP you could
see a thick layer of smog lingering above the city. The air is acrid,
stings the eyes and makes you cough. The airport is its own world. A
spread of tents large and small, containers, supplies, boxes, vehicles,
bicycles, and people wandering about in and out of uniform.
We bumped into Jens, the UN engineer
who had worked with us on the bridge we helped build in Boucan Carre,
who was the last person to be pulled out alive from the UN meeting building.
He had been under rubble for
6-8 days. Needless to say he looked like a walking skeleton and sounded
very jittery.
He simply said, “I had
a lot of luck”.
We drove to the University Hospital
(HUEH). The scene there is truly impressive in so many ways.
Much progress has been made.
 Medical
tents are lined up in a row, and, inside, beds and stretchers lie close
together, most patients are post surgery, bandaged or in casts.
They are now receiving narcotics.
Operating rooms up and running now 24 hours a day.
Patients are lying mostly with
haunted eyes but always respond to a greeting, often waving slow hand.
I had to try to stop greeting them so they wouldn’t have to wave
back in pain.
Last night, I sat outside the
main tent at HUEH on a bench talking to Evan [Dr. Evan Lyon] and David
[Dr. David Walton].
With the lights on inside the
tent, I could see the silhouettes of the relatives tending to the patients,
washing with a rag, feeding or massaging them.
The sadness everywhere is so
palpable. Haitians are usually very expressive in their mourning.
Before quake, a wake would take
place all night with women outside on the ground wailing and shouting
in agony. People often fainted during funerals.
I can’t imagine that happening
here now.
The wailing would never stop.
There is no energy for weeping.
Everything is marked by the quiet. Nearly everyone, adults, and children
have the same expression of flat sadness.
Volunteers run about and some
nurses, both Haitian and American are around though everywhere a lack
of nursing care.
On the campus, the nursing school
has collapsed, pancaked in between two buildings that still stand. Its
rubble holds the remains of the entire second year nursing class.
You can smell the bodies when
you walk past.
Yet people do still walk past
because there is no choice but to get to other places.
It seems so feckless which buildings
crumbled which is why no one feels safe in a concrete structure.
Outside in the courtyards at
HUEH, the patients who evacuated from the ward after the second wave
of aftershocks have constructed makeshift tents over their beds.
It is starting to look like people
are staying – where else can they go?
The main buildings are mostly
still standing on the HUEH campus, but several have major cracks. Patients
are afraid to be inside.
Evan described the days that
have been lost to bringing 80 patients in and out of the wards.
When people felt the tremors,
they pulled out their IVs and just scrambled out the best, fastest way
they could. Polo [Dr. Paul Farmer] described a woman about 35 years
old who had come to the hospital from the south. She was also attached
to oxygen and afraid.
He asked her whether anyone was
with her.
She said no one.
She lost all her family and was
brought to the hospital by a neighbor.
We also saw a woman who had been
brought back to the hospital with tetanus.
She was fine and had been discharged
after the initial surgery on her foot.
But now her neck was stiff her
head tilted back, she looked rigid and very sick.
There will be medical challenges
for many months and years to come.
Other challenges remain too,
including sanitation (there are no real toilets). You can imagine.
So many people are doing such
a stellar job.
Obviously I know it is many many
folks, but Evan and David are shining stars. Old news, I know, but Evan
reinforced how life-saving it has been to have Jim Ansara help get the
electricity going.
No power was responsible for
a lot of deaths in the first few days.
The first night, after touring
parts of the city, I stayed with Evan, David, Jim Ansara, and Chris
Strock with a family in Port-au-Prince.
We slept on the floor inside
their house. The family slept on the ground outside—still too
unsure to go in.
Yesterday, we had a leadership meeting with Loune [Loune Viaud], Fernet
[Dr. Fernet Leandre], Joia [Dr. Joia Mukherjee], Louise [Dr. Louise
Ivers], Lambert [Dr. Gregory Lambert] and Polo to talk about the mid-
and long-term response, particularly a community-based outreach movement—we
spoke of ten specific communities—with a massive training of Community
Health Workers for follow-up wound care and chronic care.
We discussed key partnerships
with food and water organizations.
Joia also returned yesterday
and has a plethora of details to be shared and refined.
Paul and I headed to Cange following
our meeting.
Silence everywhere and a sort
of stoicism I had not seen here before.
It is impossible to greet colleagues
and friends and not see that their hearts are broken.
We went first to visit the church,
which has probably 70 patients lying on mattresses in rows on the ground.
All of them have casts on limbs
or white bandages over their stumps.
Dressings are changed every day
by Haitian staff and volunteers and need to continue to be changed for
weeks to come.
In the corner of the church is
an overflow pharmacy, the piano has become a work top and meds cover
the altar.
Lovely Dr. Jon Crocker was seeing
patients with a team of volunteers.
And, as always, relatives help
their loved ones with simple tasks.
There is mostly quiet, no one
is talking much, but there is a sense of community.
Apparently, some patients moved
to other wards have asked to some back to the church.
We will have mass today in the
Clinic Externe.
In the hospital all wards taken
up with amputees, fractures, some in need of spinal care.
Probably 200 patients.
The team reported having done
1,150 x-rays in Cange.
The x-ray room is a miserable
place to be for those who have made the long trek, limbs must be placed
in best position to get a good film and it is painful.
But the films help ensure surgeries
go smoothly.
There is a long road ahead for
plastics with skin grafts and wound care.
We are planning for all that.
We’ll need a big infusion
of prosthetics in a few months.
Perhaps tens of thousands of
amputees – hard to count. Koji [Dr. Koji Nakashima] says there
are some landmine NGOs with good experience (Cambodia etc.) –
we should reach out because it is clear it can’t be done cottage
industry style, with donations here and there.
Also, there is loads of PT needed
– it is so hilly, hard to imagine life here without both legs.
I’m deeply moved by our
staff – many are suffering huge loss but are still here. One of
our lab techs lost her husband and her son suffered head trauma and
kidney failure, yet she keeps coming to work.
Having volunteer teams working
with our staff is going well – team from CA here right now are
lovely people.
The operating rooms are working
hard – we’re able to do roughly 16 surgeries per day.
There are three rooms available,
but one is kept for emergencies and C-sections, which of course still
go on.
I am struck by many things, but
the silence is deafening.
The road from Cange to Hinche
used to be a busy thoroughfare with trucks hurtling back and forth all
day and blasting their horns.
Yesterday, I counted only a handful
of trucks.
The trucks used to be loaded
with food and things for market.
Now there is just quiet –
a sign that we are far from any sort of economic normalcy.
Patients are still arriving in
a steady stream from Port-au-Prince.
I’m heading to Hinche and,
hopefully, to St Marc tomorrow."
Ophelia Dahl
www.pih.org
Donations: click
here Or mail to: Partners In Health, P.O. Box 845578, Boston,
MA 02284-5578.
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So
we like Boston, Massachusetts-based Partners In Health.
As
Lufthansa Cargo moved 77 tons to SDQ to help in Haiti—CEO Carsten
Spohr looked out a window at the FRA ramp last week and said: "When
the driving snow brings German infrastructure to the limits of its possibilities
we can only imagine the state of things in Haiti after the catastrophic
earthquake. 
“If
there is need for an additional flight, we will be there," Spohr
said without specifying whether Lufthansa Cargo will assume all the costs
again. 
Justin
is not alone in his willingness and ability to re-focus his attention
in response to the crisis in Haiti: he, along with several of his colleagues
from every department at PIH, has learned very quickly to implement PIH’s
plans to deploy medical personnel and supplies to Haiti by ensuring the
safe arrival of dozens of flights over the last ten days.
