Reality presents itself often when the dream is so good it shouldnt end. As we left Miami Executive Airport Feb. 15 on a private 14-seat Lear jet, I was thinking, This is no sweat. I was flying in a nice plane, sitting in a plush reclining leather seat with ample legroom. I had access to a stocked mini bar, including every snack, fruit, beverage and accompaniment imaginable. Best yet, I didnt pay a dime for this sweet ride; the cost of my travel was part of a large corporations donation used to transport healthcare personnel to and from Haiti.
The dreamed ended when we exchanged our cool, comfortable plane for the tarmac of Port-au-Prince, where it was 88 degrees with soaking humidity.
Our ride from the airport to our compound was in a new SUV with a sign in the back window stating Clinton Foundation. We traveled on roads full of potholes often deeper than the wheels of the SUV. Our driver, a Haitian, drove 30 to 45 mph on roads no wider than a single lane, passing slower traffic and pedestrians and swerving when oncoming traffic forced a retreat into his lane. In fact, for the five days we were in Port-au-Prince, we found it normal to speed through the streets dodging cars, pedestrians and animals. I thought I was going to be a trauma alert at any given time.
My hospital system, Broward Health in Florida, collaborated with the organization Partners in Health to provide nurses and doctors to help staff the General Hospital in Port-au-Prince as well as our accommodations. Those accommodations consisted of a tent with two-inch mattresses spread over a courtyard of an old school. Staying indoors was not recommended as predicted aftershocks could knock down the school at any time.
We soon learned that the rainy season had started. In the early morning of our second day, heavy rains flooded our courtyard with eight inches of water. I woke when my Blackberrys light came on and I saw the light floating by my mattress. Everything I brought to Haiti was soaked, including my tent mates laptop computer, my satellite phone, two cameras and all of our clothes.
At 2:45 a.m. I was too tired to worry about stuff. I moved my sleeping pad to a step and attempted to get maybe one hour of sleep for the night. Sleep was hard to come by because people came and went from the compound throughout the day and night as several shifts were created to staff the 400 to 700 inpatients at the hospital. Additionally, the roosters would crow throughout the night and the stray dogs (all dogs were strays) fought all night. Our accommodations included breakfast and dinner provided by a local Haitian restaurant. Lunch was on your own, and I usually ate a Powerbar and drank a bottle of water. There was one place on the hospital campus that had three faucets of potable water, which was provided by volunteers from Spain who specialized in purifying water.
In the HospitalThe only functioning x-ray at the hospital.
The General Hospital is the only public hospital in Haiti that offers free care. It was an incredibly busy place before the earthquake, and now that most of Port-au-Princes population is homeless, living in 12 x 12 plots of land with cardboard as makeshift homes, the hospital was busier than ever before.
Only two structurally sound buildings of the original 12 were left to house patients.
Large tents served as patient care areas, with two tents, each housing about 15 patients, making up the ICU. This ICU had cardiac monitors and few ventilators because oxygen was limited or not available. Tractor-sized generators provided power but often sent surges that would cause ventilators to alarm and not function.
The temperature in the tents reached 90 to110 degrees F during the day, and we found most medical durable goods, such as the point-of-care chemistry test machines we had brought with us, did not function in such extreme heat.
On my first night at work we lost two children under 2 years of age because we didnt have the equipment to intubate them. Even if we had had what we needed, we lacked any oxygen or ventilators. In addition, our electricity came from a large generator that created power surges, which would have been a problem with ventilators.
Diagnostics were almost nonexistent. I relied heavily on my physical assessment skills, including percussion. I saw patients with malaria, Dengue fever and typhoid fever, all of which I had only read about years ago but became common problems in our patients. Despite being in the ICU, most patients had family members stay with them. At night they placed a piece of cardboard on the floor and slept under the beds of their sick family members. Families bathed the patients. In some cases they brought food, fed the patients and performed almost all hygiene functions, including providing bedpans, emptying them and cleaning their loved ones.
Haiti vs. Other Disasters
The Haitian population worked to stay clean under very difficult circumstances. On every street where there was running water, they bathed or washed their clothes. I never saw a Haitian smoking, but I saw plenty of Americans and Europeans taking smoke breaks. Obesity in Haiti was almost nonexistent before the quake; but then to smoke or eat in excess is costly, and money has not been a plentiful commodity in Haiti.
I returned to Florida from Haiti on Feb. 19. Having deployed to several domestic incidences, including Hurricanes Charley, Jeanne, Katrina and Rita, with our Disaster Medical Assistance Team, I have lived in and worked in austere conditions. Yet despite these catastrophes, economic and healthcare systems, as well as overall infrastructure remained. In Haiti, there is no infrastructure. It is literally survival of the fittest there. In some places, as far as the eye can see there are 12 x 12 plots with tents and cardboard to make homes for all of the displaced Haitians. I dont see how this poor country is going to recover anytime soon.
Despite the austere conditions of providing care to the people of Haiti, I left with memories of healthcare professionals from countries all over the world working together to provide incredible care and Haitian patients and families saying over and over again, Merci, merci, merci.