Notes on Haiti — CEO Journal
Wednesday, March 10
While we continue to discuss our recent visits to Haiti and consider the need and our options for support and relief going forward, I wanted to share with you some more comments from members of the last relief team. As I’m sure you can tell from their words and the words of everyone who has been part of this relief effort, our work made a significant difference in a country far from home and made a significant impact personally on those who were able to participate.
Not mentioned in the comments, but equally as valuable are the lessons we learned about post-earthquake environments and what we can expect should San Diego, Los Angeles, or any nearby region suffer a major earthquake. From the types of injuries we can expect, to equipment and medications we should have on hand, I want you to know that all of what we learned will now be incorporated into our disaster planning and shared with others.
Meanwhile, here are comments from Michael Sykes and Dr. David Smith:
From Michael Sykes, RN
Chris,
As you mentioned in our departure briefing, several past team members expressed challenges in getting back on track once they returned from Haiti. I too find that to be the case. In fact, it started the moment the plane left the island. The sights, sounds, and smells have lingered longer in my mind than I had anticipated. The sheer number of people affected by this tragic event is hard for anyone who has not been there to imagine. I am slowly getting “back to normal” physically and mentally, and the support from my teammates has greatly helped.
There are many images that stand out for me from my visit to Haiti, but there are a couple things that stand out more than others. For example, the amount of destruction from the earthquake and the number of people living in tents was overwhelming. Although I had seen the pictures from previous teams, seeing it in person had a profound impact on me. From what I could see, the living conditions where worse than any human being should have to endure, especially in the “tent cities.” As we passed multiple tent cities each morning and evening on our way to and from the hospital, I was amazed to see the number of people who were able to find just a glimmer of joy and the ability to smile and laugh through all of the suffering they have had to witness over the past few weeks.
One evening I, too, was able to smile. With the backdrop of wall-to-wall tents and make-shift shelters, charcoal smoke in the air, and what seemed like hundreds of people selling whatever they had on the sidewalk, I saw two small boys standing on a pile of stone and rubble at the edge of one of the tent cities, flying a small purple kite they had made from a small 6x6 inch piece of torn plastic. They seemed happy and full of joy.
Thanks again for the opportunity to represent Scripps on this very important mission.
From Dr. David Smith
I wanted to first thank you for giving me the opportunity to go to Haiti. I was thankful before I left, but now I am also grateful to have had the opportunity and experience.
The effects of the trip were more profound on me than I imagined, even though I heard everyone before me state that. My first inclination when we were planning on leaving Haiti was that I was not ready to go; I wanted to stay through the weekend, see more patients, learn more about the country, see more of the devastation and setbacks to an already fragile system, but watch the resolve and stoicism of the people. As I am home, my senses have been heightened to sounds, smells, sights. My mind continues to go back there a bit, despite my trying to be “back home.” However, my appreciation at home, work, and with family is fresh.
We saw too many patients to be able to hear all of their stories but, over the hours and days of listening to them speak, examining them, watching them with their family, I could begin to understand more. Most of what we saw has been discussed some. But it was a grave exacerbation to what has affected the city prior to what they referred to as the “catastrophe.” Most everyone I saw — adult or child — appeared anemic; very pale mucous membranes — this from a combination of malnutrition and worms. Infectious disease is another big problem. From scabies and fungal rashes to malaria, typhoid, diarrheal illnesses, and TB, these will continue to climb given the living conditions, close proximity of the population in the tent cities, water sources, hygiene, and the beginning of the rainy season. My understanding is that only 50 percent of kids are vaccinated. I hope this figure is wrong, as I fear a larger increase in Tetanus then they have already seen. An outbreak such as measles could kill populations.
We also saw some exacerbations of chronic illness: hypertension and diabetes. We had a patient who most likely had an MI, and mild cardiogenic shock that was treated without the availability of an EKG, chest X-ray, cardiac enzymes or nitrates. We did have some aspirin, beta blockers and, eventually, some oxygen. Attempts were made to transfer him out to the University of Miami site, but that was unsuccessful. The patient seemed to improve daily, despite the lack all of our normal modern capabilities at home. Time and resolve.
One patient that I saw — on his third visit — had been treated for a cellulitis because of a wound infection. He now had massive swelling of his left leg. I suspected a very large DVT, which we were able to confirm with an ultrasound that one of the anesthesiologists from the University of Maryland had. What struck me most about this patient was his patience. He must have been in a lot of pain, could not walk, but had been sitting all day, quietly, waiting for us to see him.
The patients were many that we saw, close to 150/day and, for the most part, all came at 7:30 a.m. They would sit and wait patiently all day. Despite their living conditions, they would all come in clean, pressed clothing. We also had the benefit of working next to a few young Haitian physicians for a few hours a day — they would see another 40–50 patients. Many of the patients clearly wanted to be seen partly because they could. In the best situations prior to the earthquake, it seems that health care was very compromised. Now that the word was out that patients could and would be seen, I think a lot of them wanted to be heard. So many are under life stresses that we can’t even imagine — all of them have suffered losses, either family or friends, property, jobs, schools, churches. So allowing them to be heard was important to them. Many were seeking something and seemed to at least leave with some sort of hope and faith that somebody was helping and cared.
Although I was impressed with the amount of activity, assistance, aid, relief, etc., the lack of leadership in the country was disturbing. In spending time with the Nuncio, I was impressed by the leadership of the Catholic Church. They do have a large footprint on the country, schools, orphanages, and hospitals. But, it was hard for me to leave hopeful in this regard. Who will organize all of the aid, the rebuilding of schools, hospitals, communities. Unfortunately, the Haitians have seemed to live from tragedy to tragedy. Despite this one being massive, maybe they can continue on as they have for decades, until a brighter future arrives.
I also, can not stress enough how great our team was. The leadership and maturity of John and Patty in a compromised and unsettled environment was remarkable. Working alongside them, Michael, Charles and Katrina was a pleasure and comforting in a stressful work environment.
Thank you to the above team members and to all who volunteered to serve and who picked up extra tasks at home so others to go. As I’ve said before, this was truly a team effort and every one of us felt the support you provided.
Chris