Saturday, September 11, 2010

Hopital Adventiste d'Haiti photographs. April, 2010

It has been months now since I packed my bags and left Carefour, Haiti. The massive challenges faced by Hopital Adventiste d’Haiti are far removed from my life of comfort in California, but never far from my heart. I am grateful that I was able to be a small part of the volunteer army that spontaneously gathered in Haiti’s time of crisis. We were a band of physicians, nurses, physician assistants, dentist, midwives, physical therapists, plumbers, electricians, carpenters, pastors, teachers and students making a difference. I was able to observe up close an amazing team of selfless volunteers. Their countless hours of arduous work, teaming together regardless of profession saved and healed many lives.

Orthopedic surgeon Dr Scott Nelson speaking at the volunteer's worship on the front steps of Hopital Adventiste d'Haiti on a typical morning.

The OR board. On some days we would have over 30 cases. On this day, CURE International surgeons and LEAP plastic surgeons were operating along with the orthopedic cases.

Drs Terry Dietrich and Scott Nelson placing an external fixator.

The ortho surgeons kept the donated C-arm xray unit busy, helping save limbs and lives.

Orthopedic surgeon Dr Hasan Sayed operating on an injured arm. He is assisted by a Haitian physician.

Dr Dietrich moping the surgery floor for his next case. Turn around time was kept to a minimum by everyone pitching in. One patient to recovery and the next patient on the table! Many had been waiting since the earthquake, 3 months ago for repair of their injuries.

After the external fixator surgery a wound vac was applied over the wound on this man's leg.

Preparing for a re-amputation of a woman's leg that had been crushed by rubble in the quake.

Drs Anthony Coletta and Constantine Kokenes preparing to operate on an expatriate volunteer who's arm had been badly cut. Because all 3 surgery rooms were in use, preparation was begun in the OR hallway.

Dr Jeffrey Hartog performing plastic surgery on a 3 month old boy. This infant lives in a tent with his family after loosing their home in the quake. Their mosquito net had caught fire and he sustained severe burns on his head and hands.

Dr Burt Rappoli performing abdominal surgery. Dr Constantine Kokenes was the anesthesiologist.

Jessica Claridge, 4th year LLU medical student assisting Dr Nelson with a spinal fusion. This patient sustained a broken back during the earthquake. He had worn a body cast for months, but it would not heal. He had waited and waited for this surgery that would give him mobility once again. His sweet wife and two little children waited outside under a tree during his surgery.

Joseph Fritzner is preparing for an epidural before surgery for left leg wound debridement. He had broken both arms and femurs as well as his left tibia.

Because of Joseph Fritzner's left leg compartment syndrome, twice Dr Dietrich considered amputating his leg. Today his bones and wound has healed and he is able to walk with a cane. An amazing recovery!

A hydrocephalic toddler having a shunt inserted.

A leg amputation.

Karen Fields, Ortho PA is pictured here on fly patrol with the electric zapper to prevent insects from landing on the operating field while Dr Joseph Wujek operates and Liz Dickinson, RN assists.

A Haitian preparing for orthopedic surgery to her injured arm.

With OR nurse Lillian. Long hours, many surgeries, but good times, too!

Wally Jeanty, Romel Sajous and others in our translator / assistant OR team. They were always there to help us communicate in French or Creole to our patients and with the Haitian staff.

Drs Joseph Wujek & Barbie Phelps-Sandall removing fibroid uterus. Liz Dickinson, RN is assisting.

Several fibroid uterus' were removed during my stay. As is the custom in Haiti, any removed organs are placed in a bag with formaldehyde and given to the patient. So I had the honors of presenting this uterus to it's owner when she woke up!

Dr Terry Deitrich, Karen Fields, Ortho PA, and Jan Kass, RN placing a wound vac on a patient after wound debridment.

Drs Terry Dietrich and Hasan Syed placing an external fixator. Jeanie Dietrich RN was circulating and preparing for the next case.

Instructions being given to a family member during morning rounds.

Dallas Koperski, 4th yr LLU Medical Student seeing an ER patient in a temporary structure outside the hospital. He is assisted by Lance a paramedic/fireman from San Diego. Oftentimes more than 150 patients would be seen daily.

Seventeen year old Andre is an orphan. He had been cared for by his uncle who broke his neck during a voodoo ceremony. He has been in this cast while waiting for surgery to stabilize his cervical spine.

With an amputee patient by her tent on the hospital grounds. I was making rounds one day and she asked if I would take a picture with her and offered her thanks for the excellent care she had receivd. I found Haitians to be a grateful people.

In the evening the halls of Hopital Adventiste are at last quiet. There are cots in the hall for our many overflow patients. Family members oftentimes sleep on the tile floors beside the cots.

Thursday, July 1, 2010 "Out Of The Rubble" Revisited "Out Of The Rubble" Revisited

The reality of Haiti, the amazing people, the talented volunteers, and the utter devastation. You'll also meet 8-year old Sebastien Lamothe, who was trapped under the rubble for three days.

Wednesday, June 30, 2010

As our plane winged its way in final descent into earthquake torn Haiti I peered out the window at Port-au-Prince below. Thousands of bright blue dots in the scattered tent cities caught my eye. The captain’s voice came over the loud speaker, “Ladies and gentlemen, most of you on this flight have come to help Haiti. I thank you and wish you blessings during your stay.”

It is April. Four months ago it is estimated that 230,000 people died here in just 35 seconds of time. Since that day volunteers have been arriving by plane, sea and over dusty, potholed roads. As our van pulls away from the airport it lumbers along the bumpy road weaving through the rubble untouched since the quake and past mounds of trash and debris at times many feet high. We pass by the crumbled Presidential Palace and Catholic Cathedral. But the eye is drawn to the people walking along the road, to the enormity of the disaster they have and continue to endure.
About an hour later our van of volunteers pulls through the gates of Hopital Adventiste in Carrefour a suburb of Port-au-Prince. It is a 70-bed two story hospital that was built 32 years ago. Even though it was less than 2 miles from the epicenter of the 7.0 earthquake, it suffered no significant damage and has since been a beacon of healing in Haiti. The hospital campus is strewn with tents housing the overflow of patients and their families. Inside the hospital we find the halls are lined with army cots and the wards and patient rooms are overflowing. Each patient has one or more family members or friends who attend to their needs. Should someone not have a family member accompanying them it would not be noticeable as another patient's family cares for them as well. And I would later find, in the night family members would sleep on the floor beside each patient.

We are shown to our living quarters, a large veranda on the top floor divided into 5 areas accommodating 40 volunteers. There are eight of us sleeping together in one area; 2 pediatricians from Washington, an ER doc from Montana and his wife charged with supply management, a PA from Wisconsin, a physical therapist and nurses from Connecticut and California.

Before dawn the next morning we are wakened by the wails of 11-year old Miralda in the orthopedic ward nearby. She is recovering from broken bones crushed in the quake and has a broken heart that will not heal. All her family excepting her mother perished in the quake. The narcotics she has been taking to manage her pain have left her addicted. She is being weaned from them and suffers so. As her cries subside, the roosters begin to crow. So begins each day at Hopital Adventiste during my stay.

Liz Dickinson, a friend and fellow nurse is the Senior Vice President of Patient Care at Loma Linda University Medical Center. We came to Haiti together. Our fathers were friends at Loma Linda University Medical School years ago. Her father, Dr Roy Bowes, a frequent short term missionary to Mexico provided seed money when my father, Dr Stephen Youngberg began his Honduras mission in 1960 where he was a missionary for over 50 years. So it only seemed natural when the earthquake struck Haiti that we began making plans to go. Global Health Institute with Loma Linda University coordinated our service and travel.

For Nurse Appreciation Week at Loma Linda University Medical Center the nurses chose to share gifts with the nurses of Hopital Adventiste, a sister institution of Loma Linda’s with Adventist Health International. And we were privileged to be the ones to deliver them to the Haitian nurses here. During the reception we provided for them, each nurse was given a bag with a watch, stethoscope, pen light, scissors, pen, lanyard, tooth brush and paste along with a Hopital Adventiste inscribed blazer. I thanked them for representing our nursing profession when the 7th deadliest disaster in recorded history struck their homeland. Many of us from around the world liked to have been there to help them in those first few weeks but we could not. After refreshments as a token of thanks they sang to us a song, “Merci” in Creole. If only the nurses of Loma Linda could have been there to share that day with us.

Liz and I enjoyed working with the Yvrose Morency RN, the Director of Nurses and her assistant Yanique Poustin RN.

Dr Scott Nelson, the orthopedic surgeon who came to Haiti two days after the quake has been spearheading the tremendous work at Hopital Adventiste these many months. Through his and his team’s care hundreds of limbs have been saved from amputation and lives have been saved. A physician volunteer from Israel commented, “In Judaism, we say that Pikuach Nefesh, the saving of human life trumps almost all other obligations, moral, legal, or religious. . . The people I encountered from Loma Linda were responsible for the savings of hundreds of lives. The amount of pikuach nefesh these people achieved in such a short time is on a scale that few can ever attain.”

Since the earthquake, supplies had been pouring into our hospital in quantities that outstripped the ability of the overworked and short handed staff to organize them. Liz and I helped bring better order to the surgery area. As the sterile prep room doubled as a decontamination area it was important to move the decontamination sink where dirty instruments were washed to its own room to prevent the spread of infection. So with the help of many willing hands it was accomplished. Then hundreds of instruments that had recently arrived or were found in storage were organized and many were sterilized.

While the freshly painted shelves were drying a staff member, Richard drove us into Port-au-Prince to purchase baskets for categorizing the instruments. After going to three stores and finding no storage containers we providentially found just what we needed on the roadside stacked on the rubble of a crumbled building! As we journeyed back to the hospital Richard stopped by what had been a three story home that was now a pile of bricks. He recounted to us that this was where his uncle, aunt and his cousins lay entombed. It was sobering to know stories such as his could be told over and over and over again.

While we were organizing the OR, when the need arose to help with surgeries in one of the three operating rooms, Liz would scrub and I would circulate for the surgeons. We had external fixator placements, amputations, a spinal fusion, 2 cesarean sections, several fibroid tumors removed, cleft palate repaired, skin grafts and daily wound debridment, just to name a few. I also became proficient in manning the C-arm x-ray unit during orthopedic surgery and in recovery. The surgeons worked tirelessly oftentimes late into the night, and some days performed over 30 cases a day. Pictured here are Drs Scott Nelson and Terry Dietrich being assisted by Karen Fields, PA.

Kimerlee, pictured with Liz Dickinson, is a 12-year old girl who had severe contractures of both knees. She had crawled all of her life, as evidenced by
the calluses on her knees. Dr Nelson surgically lengthened her tendons and within just a few days it was a thrill to see her taking the first steps of her life.

Lucia Hernandez RN from the Dominican Republic is with six-year old Chantale Codio who was severely burned by a kerosene lantern months ago. Scaring prevented her from standing upright, or move her right elbow or shoulder. Plastic surgeons have given her life changing improvements.

One afternoon orthopedic surgeon Dr Terry Dietrich debrided an infected ankle wound on 22-year old Denise’s external fixated leg. After surgery she awoke from anesthesia suffering flashbacks of loosing her 10-month old baby, her only child during the quake. Between sobs she would cry out her daughter's name. As she was wheeled to recovery her face was bathed in tears. Several hours later she recounted to me the tragedy of how her leg had become trapped as the earth shook and she could not reach her dying baby.

On Sabbath, our day of rest, activity at the hospital was scaled back. In the afternoon we walked to the Adventist University near the hospital grounds. When the earthquake struck in January some of the walls around the university grounds tumbled down and the campus was flooded with over 20,000 homeless Haitians. Some have left in the months following the quake but thousands remain. We had an eventful time sharing beanie babies and candy with the children and visiting with refugees with our accompanying hospital interpreters as our guides.

The Haitians are a devout, religious people. At times someone would break out in song while in the hallway waiting to be seen by a physician. An intercom on the hospital grounds would play heavenly tunes throughout the day. Frequently I heard Creole singing of “Praise God from Whom All Blessings Flow.” In spite of it all, there is gratitude to God for life, for food and for medical care. They too must know that only God is capable of watching over Haiti.

During these two week much had been accomplished in OR organization with the help of the Haitian staff. I was privileged to work side by side with the local nurses, some who have lost family and homes yet still were there to help others. As I was preparing to leave they said they wanted to give me a special gift in thanks. But, they said, “We have nothing to give you, so we want to give you our love."

All too soon my stay comes to a close. In spite of the long, long hours of work in stifling heat I am profoundly grateful that I had the opportunity to help. It has been a life changing experience. I have been privileged to worked with an inspiring and outstanding group of volunteers from many parts of the world and to witness the gratitude and kindness shown to us by the Haitian people.

As I traveled to the airport past the rubble and devastation, the enormity of the need and unimaginable loss was overwhelming. And I could not help but wonder about the road ahead for the people of Haiti. Mother Teresa’s words came to mind; “We ourselves feel that what we are doing is just a drop in the ocean. But the ocean would be less because of that missing drop.”

A Story of Haiti