Living the Dream

Working day 5, Megan and I got split up. It wasn't intentional, some general SNAFU stuff happened at General Hospital, which caused more people to be shunted to our team going to the camps. We ended up with a team of 9, including 5 paramedic/EMT guys from Portland. Now, in Haiti, 9 people is almost enough to staff an entire hospital, so it seemed too much to send to one tent city – even though, really, the need at Delmas 31 was so great we probably all could have worked around the clock and still not seen the end of it.

For medical professionals, we had Megan, Myself, Cortney (just barely finished med school and not in her internship yet), and the Portland guys. We also still had Carson, the amazing woman with no medical training who somehow organized and facilitated every organization she was attached to. Cortney didn't feel comfortable being being the lone medial director of a group, and Megan had promised patients at Delmas that she would be back for follow up. So I teamed up with 2 paramedics and an EMT. Unfortunately, no one knew about the split before we got there, so we had to unpack, sort, split, and repack everything to stock 2 clinics.

So off I went with 3 kinda cute emergency med guys (Jason, Chris and Gordon) up through the very crowded, winding streets of Petionville. We passed through a huge street market, selling everything from knock-off purses to live chickens. On the trip, we worked out that we would have 3 clinic stations and one person as float / runner / triage / pharmacy. We initially thought we would switch out, but Jason turned out to be fantastic as the float so we stayed in our roles the whole day. I was the medical director, and the guys came to me with any complex patient questions. It was a little dream come true – me getting to boss around 3 action/adventure guys on a tropical island.

We entered a small camp, all enclosed in a fence with a gate, which had an open area covered in chairs and benches (and luckily some tarps for shade) in front of a still-standing house. It looked like an open-air church, filled with people nodding cordially and wearing their best clothes. I wondered what the event was – but it was us. We were the first medical team to visit the camp since the earthquake and just about everyone who lived there and the surrounding neighborhood at least stopped by to see the show. The people at this camp weren't as poor as Delmas 31. The neighborhood had been wealthier and more people spoke French or even a little English. There was still desperate need, though. The kids were still skinny, the adults exhausted and traumatized, and we saw several patients who would have been turfed immediately to the ED if I saw them in clinic at home. Still not much of an option here. Highlights included a child with a bad asthmatic bronchitis which we cleared pretty well with steroids and inhalers (we made the family stay for a few hours so we could keep an eye on him). I saw an older guy who probably had a DVT – luckily he knew someone with a car and could get to a hospital. The team saw 3 different adults with systolic blood pressure > 220. (We kept a close eye on them, too, and saw there BP's go down with meds). We still saw the majority of “since the earthquake, I've got a headache, I've got a stomach ache, I don't sleep, I get exhausted easily”. The kids had thin limbs, scabies and worms. I began to perfect my PTSD speech “We are seeing so many people here with your same symptoms and it is very normal. After a trauma, most people feel very stressed in their bodies and their minds. These symptoms are not life threatening. They will pass as life becomes more normal, but I know you are uncomfortable and I would like to help you with that”. Most people seemed reassured, and then we gave them the “Haiti Gift Bag” (named by the paramedics) of Tylenol, Zantac and Vitamins (plus anything else acutely we needed to treat). I was again blessed with a terrific translator named Alex, who is hoping to get back to university soon.

That day my team saw > 100 people in 5 hours. We also accomplished 2 great things. When we got back to Quisqueya, we told Miquette and the staff about the camp, and they assured me that they would send another team there in 1-2 weeks with more cardiovascular and asthma meds. So hopefully, these people will not be abandoned and they will feel more secure and cared-for. With less worry about basic health and survival, they may be able to move forward, start working, start repairing, start buying, start rebuilding (is re- the right term for a place that was such a mess to begin with?).

The second great thing we did, was with a little boy named Peter Lee. Peter Lee is 9 years old. 2 years ago, he started complaining of pain in his right hip. There was no preceding injury. He started limping, developed pain to his back and knee. He is in constant pain, and could barely walk without support. Chris saw him and called me in to consult. I'm pretty sure Peter Lee has something called avascular necrosis at his hip joint – this can be repaired with surgery / therapy, but definitely needed more than some Ibuprofen. We got his mother's contact information (strangely, everyone in Haiti, even very poor people have cell phones – Digitel, the cell phone company is the most profitable business in Haiti), and Miquette called her that night to arrange for Peter Lee to be transferred to a hospital for X-rays and a orthopedic referral. I saw Peter Lee the next morning before transport and was able to give his mother a bag including a blanket, towel, and some extra food. I'm looking forward to contacting some people still at Quisqueya to find out about him. Miquette told me the mother was crying on the phone, so grateful that we had kept our promise.

I think the experience I had with this family was a microcosm of what the world needs to do with Haiti. WE NEED TO KEEP OUR PROMISES. If the world offers aid, then we need to go, triage the major issues, choose problems that we CAN help with, be honest about WHAT we can do to help, give realistic timelines, educate people scrupulously on how to sustain any improvements, train local leaders and staff to manage ongoing progress, and allow constant local feedback so Haitians know that they can and must ultimately take care of themselves. This process can work with health care, infrastructure, education, government, you name it. I hope that whoever is in charge – Preval, the UN, the Clinton Foundation, the Red Cross, the World Bank have this kind of framework in mind when they think about aid. I also hope that they get off their butts and start applying aid soon, while the country is in such a teachable moment.

Jamie said something to me that I love – she wants to get her emergency medical training, so someday she can be part of a delegation where Haiti sends aid to some other country in need. She and most other educated Haitians I met feel strongly that Haiti needs more than aid, it needs to become self sufficient and develop national pride. If there is enough people who think like she does, and the right help is applied at the right times, it might just happen.

Thanks again, everyone for your attention and support. Love, Rachel.