January 26: Where there are no doctors
Yesterday we just drove down the road and found an open area where we could set up a triage station. We pulled out a tarp, some line to hold everybody back, and just let people come through. We laid out our meds on a table and then just worked through the crowd. Most of the injuries were pretty minor but a couple of them were major, broken bones and such. We probably saw 3 or 4 major cases that morning.
Our team is going to places that haven’t had doctors yet. A man told us that a week ago he’d told the UN that they needed help out here but no one had come out yet. To be honest, I had no clue where we were. We drove about a half hour into the heart of Port-au-Prince, a very poor area, people living in tin huts and surviving off of Coleman camp stoves. But I also saw some big, wealthy houses around here. Some of them have fallen down. If it was poorly built it fell down and smashed people. The construction is terrible; they don’t have any construction rebar, they build with cinderblocks and they only have these tiny wires going through them. Even homes that look well made may only have a thin skin of concrete on the outside. One more aftershock and they may come down.
I haven’t made contact with the navy yet. We wanted to get a feel for what we needed and how difficult it was going to be. So far it looks relatively simple. Right now we’re just trying to find the people who are most sick. There are a lot of people coming in complaining of back aches that they’ve had forever, but since there is a doctor here they all show up.
We had a surgery team show up Sunday and they heard [that there was a need for surgeons]. They went to four different hospitals and all four said that they had all the surgeons they needed and refused to give them any space. Operating space is very limited. These guys are working very hard, 8am to 10 at night.
I’m concerned about follow-up. I asked one doc what he was working on and he told me that he was putting on external fixatures. When I asked him who would be taking these fixatures off, he said, “I don’t have any clue.” When I asked him what had happened to the patient he had just put a fixature on, he replied that she “went back out and lay on the ground.” Somebody, someplace is going to have to take that fixature off and they won’t have clear information on when it was put in. We’re talking 4-6 weeks down stream somebody has to take over these cases and they’re not even in the hospital. A lot of them have been lost to follow up. Like the little girl I saw today: the bandage I put on her will probably be the last bandage she gets.