I arrived in Port-au-Prince on the evening of Jan. 18th with some government officials. The plane was unloaded but we were unable to depart the airport because of security issues. By then, supplies were in high demand and Haitians were desperate. Numerous trucks were being hijacked or raided as they were driven through the streets. Consequently, I was forced to guard the supplies on the tarmac through the night and secured a dump truck and armed personnel the following day. Finally, I departed the airport at 3:30pm and arrived in Leogane at 5:00pm. Along the route, we saw cracks in the road, buildings in rubble, people living in makeshift tents and an increased foul odor. The hospital was still standing but was damaged and considered too unsafe. The nursing school suffered a few cracks but was stable and had served as the only “health care facility” since the day of the earthquake. When I arrived, 5,000 people were already residing on the campus. Their tents consisted of blankets, cardboard, pieces of wood, and scraps of corrugated tin. Measuring approximately 10 feet x 10 feet, each one housed 5-6 people.
Another group of US physicians arrived and we began to organize and construct a more efficient mobile hospital comprising an ambulatory clinic and one operating room. Open and closed fractures, dislocations, large open wounds, gangrene and cellulitis made up a large portion of the cases. Surgical instruments and medicines were still in short supply during the first week. We found an owner standing near the remnants of his local hardware store and purchased a Stanley hacksaw, several blades and a file to improve our capacity to amputate limbs. Acute asthma and upper respiratory infections were common, as well as a multitude of chronic conditions, which only added to the clinic’s burden.
By the end of the second week, we had developed a second OR as more orthopedists and anesthesiologists arrived. The census in the compound had risen to 6,000 people and mobile teams were combing the community in search of victims. Another shipment of supplies arrived in Port-au-Prince and I was able to retrieve it with a U.S. Marine escort. Our capacity continued to improve as we constructed a third OR and received another shipment of medical supplies. Still, even with these additional resources, the suffering was always present. Seven physicians and I stood helplessly as we watched a 19-year-old girl die from diabetic ketoacidosis because of the lack of insulin and monitoring while her mother kissed her on the forehead and grieved. A two-year-old boy with pneumonia and respiratory distress expired prior to a military helicopter landing to transport him to the USNS Comfort. Multiple patients presented with open fractures and gangrene but refused amputations only to return a few days later in septic shock.
But, there were also stories of hope, and we were able to find some joy in the suffering. Several healthy babies were delivered on the ground without difficulty. Very few post-operative complications were noted. We watched a 50 year old man mount his bicycle, say “thank you”, and ride back to his tent only 2 hours after having had a mid-metatarsal amputation of his left foot. Kids found scraps of plastic, two small sticks and some string and ran through the camp “flying” their kites. Relief workers traded granola bars and shared their ready-to-eat-meals (MREs). We listened to hymns of praise and thanksgiving that were sung all through the night.
The resiliency of the Haitians is amazing. Despite poor leadership, limited infrastructure and a minimal amount of natural resources, the people have endured and continue to struggle through another crisis. They are magnificent survivors with an incredible tolerance for pain and suffering. Yes, there is destruction, death, turmoil, disorganization amongst the NGOs, danger, unsanitary conditions and a blazing sun to beat anyone into submission. And yet, they endure.