Friday, February 26, 2010
Coordination of the effort-by Dr. Talmor
The effort at the Hospital was being coordinated by US Aid a federal group funded by the US Government and The Clinton foundation. There seemed to be constant conflict with the Dominican Government which was anxious to return the refuges to Haiti as quickly as possible as they were illegal aliens. The day before we arrived, forty patients were acutely transferred by helicopter to a “rehabilitation center” in Haiti. The night of our arrival we were told that the government refused to provide food for the patients anymore I think they were being fed mostly rice and beans twice a day. Helicopters and ambulances were constantly coming and going with patients. The most critical were taken to Santo Domingo. A few made it to the USS Comfort before we got there. Some with surgical needs were brought in from the “rehabilitation” center. It was our hope that given the recent outflow of aid and support that the patients would receive as good or better care in Haiti, but in returning to NY and watching the news this it seems this is not likely to be the case. Many Dominicans expressed their concern that they would have to spend so much caring for the Haitians, but would not receive any aid themselves. Some implied that Haiti was always looking for a handout, and would never become self- sufficient as long as so much aid was provided. There was clearly deep animosity between the neighboring groups, though most of the Dominican we met were very saddened and willing to help us. Our “assistant” Elvis arrived early in the morning to drive us up the dirt road to the hospital each day (about 2 miles). He initially refused to take money for this.
Sunday, February 21, 2010
The Nuns
This little girl, with a 30% burn, was brought to our hospital from the orphange located across the border in Haiti. The nuns from the orphange accompanied her. The patient with the nuns by her side, was later transferred by helicopter to a burn center in Santo Domingo. This child is from the orphanage that the previous plastic surgery team had visited to make assessments of the need for medical care. The helicopter that had been transporting our team back and forth from the hospital to the orphanage had crashed the day prior to our arrival, killing the pilot and owner of the chopper. This patient is one of the many the pilot and owner helped.
Sunday, February 14, 2010
The Interpreters
There were many young men in their 20s volunteering as interpreters. They spoke English, Creole, French and/or Spanish. Olsen was my interpreter-very cheerful and relaxed. You would never know from him demeanor that both his parents were patients in the hospital. He asked me (T) to contact his Uncle Franklin in New York to let his uncle know that Olsen and his parents were OK. I finally reached Uncle Franklin last night; he was relieved to speak to someone who had seen Olsen and his parents with their own eyes. I am in contact with Olsen by e-mail; his mother is being transferred to another facility in Haiti and the family will accompany her. Olsen is anxious to find work. Uncle Franklin is overwhelmed as he now has 4 sisters and 2 brothers in Haiti who have lost everything. Both Olsen and his uncle stress that being alive is most important and that they have faith in God. I will stay in touch with Olsen to see how I can help him and his family in the future.
Thursday, February 11, 2010
Patient Tent
This is one of the several tents behind the hospital where some of the patients' beds are located. It is very windy at the hospital. It is great for a breeze to cool off but horrible for our patients, with all the sand flying around.
Radiology and Pharmacy
Many people donated funds and equipment which made the treatment of patients possible. A heartfelt thank you to all these people. In the early days, there were probably between 800-1000 patients being cared for at the hospital. Initially there was no x-ray equipment. Naturally this made fixing broken bones a challenge. They finally secured an x-ray machine and computer with software to store the digital images. Technology at its best-no way to develop film in Jimani. The pharmacy was well stocked with medications. The hospital even had a pharmacist to keep it organized.
Wednesday, February 10, 2010
A Family Member
This is the young girl who lost her mother and sister in the earthquake. She was with her family, who was taking care of her injured aunt. She is playing with a puzzle, one of many that Mia brought for the children. We were distressed that the puzzles had disappeared from our supply bags when we first arrived and very happy when, the next day, we saw several children in the orphanage playing with them.
The Patients
What we remember most about our work is the people we met, especially the patients. It is hard to describe but they are just very stoic. Sometimes they sing hymms while they are in surgery or you can hear them singing in the shower. Each one has a terrible story to tell.
One patient, a young woman around 20, had an arm injury and she was surrounded by several members of her family-a young man in his 20s, older woman and young girl around 5 or 6 years old. After spending some time with them over a 2 day period, the older woman showed us a very small picture. It was smaller than a wallet size photo. In the photo was a young woman with 2 children, one of whom was the 5 year old girl. The older woman told us that our patient was her daughter and the photo was of her other daughter with her 2 children. The young woman and the infant in the photo had been killed; the 5 year old had lost her mother. Which explained why she was glued to the young man, who was her father.
We were touched by a young man in his 30s who was extremely cheerful, always smiling. He was absolutely devoted to an older woman, who we assumed was his grandmother. It turns out this woman, was his mother and was about 50, the same age as many of the nurses, but looked about 80. This man would fix his mother's hair, feed her, smooth her sheets, etc. One day he told us that his father had been killed and this was his mother; it was clear he was not going to let anything happen to her.
Perhaps the most heartbreaking story we heard was one that Mia found out about. A young woman in her 20s has an open distal tib/fib fracture. In the United States, this type of injury would be treated with a free flap and the limb would most likely be salvaged, restoring full function. Unfortunately, free flaps are not available for these patients. The orthopedic surgeon wanted to perform an amputation, which is the way to treat this type of injury if the bone cannot be covered with tissue. The patient refused. We had been told previously that the patient's husband had been killed by decapitation and that she had small children that she needed to take care of. The patient told Mia that she could not have an amputation because, if she did, she and her children would die because she could not work. Even if she had a prosthetic leg, it is not clear how she would manage. How would she walk over all the rocks and stones, etc. that are the roads in Haiti? She does not have paved roads to walk on in Haiti. This was part of the frustration of the situation; she could be helped but there are thousands like her and it is just not possible to do everything for everyone.
Many Haitians would tell us right away that they would be getting right back to work. It is such a different attitude from that in the US. If a Haitian does not work, they don't eat. So getting back to work is the first priority for many people we met. You know how it is in the US, with unemployment insurance, workman's comp, disability, etc. and the abuse of those programs. When it comes to working, the comparison between the attitude of some US persons and that of a Haitian person is very dramatic, in favor of the Haitian.
One patient, a young woman around 20, had an arm injury and she was surrounded by several members of her family-a young man in his 20s, older woman and young girl around 5 or 6 years old. After spending some time with them over a 2 day period, the older woman showed us a very small picture. It was smaller than a wallet size photo. In the photo was a young woman with 2 children, one of whom was the 5 year old girl. The older woman told us that our patient was her daughter and the photo was of her other daughter with her 2 children. The young woman and the infant in the photo had been killed; the 5 year old had lost her mother. Which explained why she was glued to the young man, who was her father.
We were touched by a young man in his 30s who was extremely cheerful, always smiling. He was absolutely devoted to an older woman, who we assumed was his grandmother. It turns out this woman, was his mother and was about 50, the same age as many of the nurses, but looked about 80. This man would fix his mother's hair, feed her, smooth her sheets, etc. One day he told us that his father had been killed and this was his mother; it was clear he was not going to let anything happen to her.
Perhaps the most heartbreaking story we heard was one that Mia found out about. A young woman in her 20s has an open distal tib/fib fracture. In the United States, this type of injury would be treated with a free flap and the limb would most likely be salvaged, restoring full function. Unfortunately, free flaps are not available for these patients. The orthopedic surgeon wanted to perform an amputation, which is the way to treat this type of injury if the bone cannot be covered with tissue. The patient refused. We had been told previously that the patient's husband had been killed by decapitation and that she had small children that she needed to take care of. The patient told Mia that she could not have an amputation because, if she did, she and her children would die because she could not work. Even if she had a prosthetic leg, it is not clear how she would manage. How would she walk over all the rocks and stones, etc. that are the roads in Haiti? She does not have paved roads to walk on in Haiti. This was part of the frustration of the situation; she could be helped but there are thousands like her and it is just not possible to do everything for everyone.
Many Haitians would tell us right away that they would be getting right back to work. It is such a different attitude from that in the US. If a Haitian does not work, they don't eat. So getting back to work is the first priority for many people we met. You know how it is in the US, with unemployment insurance, workman's comp, disability, etc. and the abuse of those programs. When it comes to working, the comparison between the attitude of some US persons and that of a Haitian person is very dramatic, in favor of the Haitian.
Tuesday, February 9, 2010
The "hospital"
View of the hospital, looking at it as if you are standing at the orphanage. This open field is where many patients were lying on the ground in the early days after the disaster. Since then, this is where the helicopters land to deliver or pick up patients. On the right, you can see a corner of a green tent. Behind this tent, there are many others with patients housed in these tents, including the pediatric patients. Supplies are stacked on the porch of the hospital.
On our way to Barahona Airport
In SD airport just before departing to Barahona airport. If M. looks green, she is!
Friday, February 5, 2010-The Day We Arrive
We arrived in Santo Domingo Airport around 6am, after flying overnight on Jet Blue. M. slept the entire flight; T. awake all night. This would become a common thread throughout the trip, M. sleeping and T. not sleeping; one of many yin and yang experiences we had.
View Larger Map
We were able to bring a lot of supplies needed for the care of amputations, skin grafts, wound care and preventing pressure sores with us. This is due to the generosity of our many "sponsors"-friends, family members and patients of ours who generously contributed, allowing us to purchase many supplies. We were able to transport so much bulk on a commercial airline thanks to Dr. Richard Leinhardt and Jet Blue. Jet Blue permitted us to bring bags that were both larger in number and over-sized than normally permitted. We spoke to other volunteers who were also permitted by Jet Blue to bring oversize equipment for the relief effort, without extra charge. After arriving SD, we took a small plane to the airport in Barahona, a 30 minute plane ride. Another yin/yang moment. T., a "reluctant" flier on jets is extremely happy in this small plane. M., normally a very happy flier on jets, turns green at the sight of this plane.
View Larger Map
It was there that we first met Elvis, who drove us the 2 hours to the "hospital" and would become our most trusted companion. He lives in Jimani, the village where our medical facility is located. Elvis would drive us to and from our lodging and the hospital, take us on errands and back to Barahona Airport. T. thinks he developed a crush on M. when he realized how well M. speaks Spanish (Elvis speaks very little English). Elvis is always impeccably groomed, wearing what appear to be pressed jeans and clean polo shirts in bright colors.
View Larger Map
On the way from the airport to Jimani, located at the end of Route 46 on the map and right across the border from Haiti (upper left hand corner on above map), we passed through many villages. Some of the houses are concrete with ribarb; others are made of wood and extremely primitive. Within the same village some have cell phones and scooters while others live in abject poverty. We arrived at the hospital around 7am. The plastics team we were relieving was a bit shaken as the day before, the pilot and helicopter owner, who had been flying our plastics team into Haiti to visit injured children in an orphanage on their chopper, had been killed when the chopper crashed. It was on the news in the US.
The "hospital" is really a 2 story building that was intended to be a clinic. There is a separate building for the chapel and a 3rd building called the orphanage, originally intended to house orphans. The patients, about 300 in total, were staying in the orphanage. Some patients are in rooms with walls while the "ER" patients are in an open air pavilion with tent flaps on one side to break the wind. In between the orphanage and the hospital is a big expanse of rock covered dirt, which is where many patients used to be "housed", lying on the ground. In this area is also where the choppers would land to drop off and pick up patients. Many patients had been airlifted out by helicopter in the days prior to our arrival and so when we arrived all the patients were housed either in the orphanage or in tents behind the hospital.
Most of the patients we saw had wounds that needed treatment, amputations, external fixator devices for extremity fractures, and infected wounds. There is an extremely high number of amputations. Most patients had family members with them. All of the patients were very stoic and not feeling sorry for themselves AT ALL. The patients are lying on the equivalent of box springs with a very thin mattress that is low to the ground. The family members are on the ground. We will not show a lot of pictures of patients as we felt it was a violation of their privacy.
M and T did some cases on Friday, mostly wound care and dressing changes. The "operating rooms" we used had no lights but they did have windows which let in the light. Unfortunately, no screens on windows, so flies on everything throughout the cases. Ortho had the "good" rooms, with lights, air conditioning and no flies because no windows. The "boys", the team we were relieving and who would leave the next day, mysteriously disappeared while we were operating. We found out later they went "upstream" to bathe in the 2 foot wide "river" of water that runs through the town. M and T think this is hysterical as how can the boys know if they are really upstream and people are doing all kinds of things in this water. You get the point.
After cases, M and T went to orphanage and did dressing changes, adjusted splints, got patients moving their hands and fingers so did not become frozen, etc. The nurses are pleasantly surprised to see us and take us to see as many patients as possible. The patients are very willing to do their range of motion exercises and show the nurses constantly over the next few days that they are doing their exercises. Most of this is communicated through "sign" language"
Went to our house in the village around 7pm and are surprised to see the boys are all cleaned up (after their bath in the "clean" water). S, a plastic surgeon of Italian descent and reformed ladies man, is dressed in pressed jeans, loafers and a fine gauge knit sweater. M and T wonder where he is going and change into a fresh pair of scrubs. We decline their offer of an omelet made with local vegetables and stick to our strict diet of power bars only. The boys get diarrhea; M and T do not throughout the entire trip.
M and T decide to go to bed around 9pm. Despite the poverty, a local establishment in the village residential area, that sells beer and is a pm gathering place, has DJ equipment and begins blaring salsa music around 6pm. At very high decibels. So even when we are in the house, it sounds like you are in a major club with the speakers right in front of you. This continues throughout the night, until about 4 am. M sleeps through this, T does not. The recurrent theme of M sleeping versus T not sleeping. Since it is hot in the house, T stays on the porch (with the 4 dogs; unclear whether they have fleas or not); decides it doesn't matter as it is cooler there and listens to salsa music until 4 am when it stops. It is this first night that T heard "Yo no se manana" (and heard it in the same repetition approximately 500 times) and falls in love with this song. M has no idea what song she is talking about the next morning as she slept through the entire "concert". However, whenever T mentions "Yo no se manana" to any local, they immediately start singing it, so she knows she is onto something good. She plans on making it the ring tone on her phone.
Will pick up on Saturday morning next blog and post some photos. Our thoughts and prayers remain with the people of Haiti.
View Larger Map
We were able to bring a lot of supplies needed for the care of amputations, skin grafts, wound care and preventing pressure sores with us. This is due to the generosity of our many "sponsors"-friends, family members and patients of ours who generously contributed, allowing us to purchase many supplies. We were able to transport so much bulk on a commercial airline thanks to Dr. Richard Leinhardt and Jet Blue. Jet Blue permitted us to bring bags that were both larger in number and over-sized than normally permitted. We spoke to other volunteers who were also permitted by Jet Blue to bring oversize equipment for the relief effort, without extra charge. After arriving SD, we took a small plane to the airport in Barahona, a 30 minute plane ride. Another yin/yang moment. T., a "reluctant" flier on jets is extremely happy in this small plane. M., normally a very happy flier on jets, turns green at the sight of this plane.
View Larger Map
It was there that we first met Elvis, who drove us the 2 hours to the "hospital" and would become our most trusted companion. He lives in Jimani, the village where our medical facility is located. Elvis would drive us to and from our lodging and the hospital, take us on errands and back to Barahona Airport. T. thinks he developed a crush on M. when he realized how well M. speaks Spanish (Elvis speaks very little English). Elvis is always impeccably groomed, wearing what appear to be pressed jeans and clean polo shirts in bright colors.
View Larger Map
On the way from the airport to Jimani, located at the end of Route 46 on the map and right across the border from Haiti (upper left hand corner on above map), we passed through many villages. Some of the houses are concrete with ribarb; others are made of wood and extremely primitive. Within the same village some have cell phones and scooters while others live in abject poverty. We arrived at the hospital around 7am. The plastics team we were relieving was a bit shaken as the day before, the pilot and helicopter owner, who had been flying our plastics team into Haiti to visit injured children in an orphanage on their chopper, had been killed when the chopper crashed. It was on the news in the US.
The "hospital" is really a 2 story building that was intended to be a clinic. There is a separate building for the chapel and a 3rd building called the orphanage, originally intended to house orphans. The patients, about 300 in total, were staying in the orphanage. Some patients are in rooms with walls while the "ER" patients are in an open air pavilion with tent flaps on one side to break the wind. In between the orphanage and the hospital is a big expanse of rock covered dirt, which is where many patients used to be "housed", lying on the ground. In this area is also where the choppers would land to drop off and pick up patients. Many patients had been airlifted out by helicopter in the days prior to our arrival and so when we arrived all the patients were housed either in the orphanage or in tents behind the hospital.
Most of the patients we saw had wounds that needed treatment, amputations, external fixator devices for extremity fractures, and infected wounds. There is an extremely high number of amputations. Most patients had family members with them. All of the patients were very stoic and not feeling sorry for themselves AT ALL. The patients are lying on the equivalent of box springs with a very thin mattress that is low to the ground. The family members are on the ground. We will not show a lot of pictures of patients as we felt it was a violation of their privacy.
M and T did some cases on Friday, mostly wound care and dressing changes. The "operating rooms" we used had no lights but they did have windows which let in the light. Unfortunately, no screens on windows, so flies on everything throughout the cases. Ortho had the "good" rooms, with lights, air conditioning and no flies because no windows. The "boys", the team we were relieving and who would leave the next day, mysteriously disappeared while we were operating. We found out later they went "upstream" to bathe in the 2 foot wide "river" of water that runs through the town. M and T think this is hysterical as how can the boys know if they are really upstream and people are doing all kinds of things in this water. You get the point.
After cases, M and T went to orphanage and did dressing changes, adjusted splints, got patients moving their hands and fingers so did not become frozen, etc. The nurses are pleasantly surprised to see us and take us to see as many patients as possible. The patients are very willing to do their range of motion exercises and show the nurses constantly over the next few days that they are doing their exercises. Most of this is communicated through "sign" language"
Went to our house in the village around 7pm and are surprised to see the boys are all cleaned up (after their bath in the "clean" water). S, a plastic surgeon of Italian descent and reformed ladies man, is dressed in pressed jeans, loafers and a fine gauge knit sweater. M and T wonder where he is going and change into a fresh pair of scrubs. We decline their offer of an omelet made with local vegetables and stick to our strict diet of power bars only. The boys get diarrhea; M and T do not throughout the entire trip.
M and T decide to go to bed around 9pm. Despite the poverty, a local establishment in the village residential area, that sells beer and is a pm gathering place, has DJ equipment and begins blaring salsa music around 6pm. At very high decibels. So even when we are in the house, it sounds like you are in a major club with the speakers right in front of you. This continues throughout the night, until about 4 am. M sleeps through this, T does not. The recurrent theme of M sleeping versus T not sleeping. Since it is hot in the house, T stays on the porch (with the 4 dogs; unclear whether they have fleas or not); decides it doesn't matter as it is cooler there and listens to salsa music until 4 am when it stops. It is this first night that T heard "Yo no se manana" (and heard it in the same repetition approximately 500 times) and falls in love with this song. M has no idea what song she is talking about the next morning as she slept through the entire "concert". However, whenever T mentions "Yo no se manana" to any local, they immediately start singing it, so she knows she is onto something good. She plans on making it the ring tone on her phone.
Will pick up on Saturday morning next blog and post some photos. Our thoughts and prayers remain with the people of Haiti.
Monday, February 8, 2010
Just returned
We just got home. We are gathering our thoughts and will post soon more details about the trip. The people of Haiti are wonderful and stoic, despite all they have been through. They are getting a lot of help and will continue to need help in the future. We want to be sure and say a heartfelt thank you to everyone who supported the relief efforts for Haitians with their generous donations. We have some ideas about the best ways to help as we go forward. More to follow.
Friday, February 5, 2010
Bone tired and going to bed listening to bacchete music blasting outside the window. Apparently this goes on every night until 3 am. Everyone very friendly and we are totally safe. Got the OR schedule set up for tomorrow. 40 patients who were more critical airlifted out yesterday and today a 30% burn pediatric patient was choppered out after being transported to the hospital for hours in the back of a truck.
Thursday, February 4, 2010
Wednesday, February 3, 2010
Final preparation for trip
The main project yesterday was finding the correct HIV meds to bring with us. In case of an HIV exposure, we will take PEP (post-exposure prophylaxis) meds. In Haiti the HIV strain can be very drug resistant. So we checked with the docs on the ground in the HIV clinics in Haiti and they told us which meds to get. Unfortunately, the pharmacies only carry 30 day supplies, as that is what they receive from the drug companies and the cost is $2000. My better half, Ira, was able to find a local pharmacy, which will sell us a few days supply. So special thanks to Kings Pharmacy on 3rd Avenue in New York City. We really appreciate it!
Tuesday, February 2, 2010
Thanks to Jeff Lipson at Henry Schein
Thank you to my sales rep, Jeff Lipson, and the Henry Schein medical supply company. They are providing us with desperately needed supplies at cost for our medical relief trip to Good Samaritan Hospital. Without their help, we could not do it. Henry Schein has also donated $1 million in supplies to the relief efforts.
Monday, February 1, 2010
All set to go
Mia Talmor, MD and I are getting ready to leave for the Dominican Republic on Thursday night. We take a 12:55 am flight which will get us in around 5 am. Six hour car ride to the hospital. Gathering medical supplies and filling our duffel bags. Many offers of support and contributions. Will let you know when we arrive.
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