Helping Haiti Help Herself

Now that I finished this week now what?

First of all, I would definitely work in a field hospital/disaster setting again however it would not be a career choice.

Now, how will Haiti dig herself out of this hole?
What was very troubling to me was that the rubble from damaged buildings appeared to be in the same place they were the day of the quake. There did not appear to be significant active efforts to remove rubble. For the 3hrs that I drove around on Saturday, I saw a single group of eleven Haitian young men removing rubble. Yes I know it was a Saturday, but only one group? Honestly this would be a great opportunity to create jobs.

Another option to build the economy is using the major influx of foreigners as an opportunity to boost up tourism.

But yes I know you need infrastructure to support these things which Haiti does not have, but infrastructure starts somewhere?

The most disheartening part of it all, was that the tent cities did not appear as temporary settlements. They were reminiscent of the shantytowns in Soweto, South Africa and in scattered hillsides of outer Port-au-Prince. It seemed the impoverished were moved from shacks to tents which seems to be placing a slippery bandage on a cut.

Haiti May 2010

Pix

Home:That's It

Home!
We arrived in Miami @ around 11pm last night & I did not know what I wanted to do first. Use the bathroom or take a shower. When Dave and I arrived @ the hotel, Dave got me a rum & coke with I-C-E! I did have ice about twice during the trip but this was the first time, I didn't feel paranoid while drinking it.

I did have one particularly overwhelming emotion as I said bye to each of my patients. Guilt. Yeah, I'm a nice American doctor who volunteered my time in rough conditions but is was only for 1 week. What I experienced for a week was a daily reality for my patients. Yes the fortunate ones live comfortable but they are a minority. Many have no place to go, and had hardly anything before the quake.

As I drove through PAP during the tour I was upset by the numerous tent settlements particularly adjacent to the palace. But was more upsetting was seeing "old" shack settlements which reminded me of what Haiti was before - now it was just worst.

Death in Haiti

Death in Haiti is emotionally taxing experience. Today I a patient with likely scleroderma vs. MTLD passed away in the ER. As we were coding her, we discussed how long we should continue the code as our code meds were limited. I was struck by that. This person's life is limited by the # of meds and resources. It is very likely that this woman would have passed away eventually given the poor prognosis of her condition disease, but it happened so abruptly here. This is the type of patient thar would end up on pressor support therapy in a step down unit where she would have the option of living or dying. But here, a Haitian person doesn't have that luxury. I have another who is dying as well from likely a CVA or stoke. We suspect hemorrhagic as she had unequal pupils but of course no way to confirm as we have no CT scans. When I got signout about her I was told that paternalism was encouraged here and that we should exercise it.

Day 6

Getting used to things today at the field hospital. It almost feels weird leaving, as I am not sure if there will be enough doctors when I leave to fill in the holes. The interesting part is that in situations like this doctors actually do not matter that much. Everyone is helpful here. From the translators, technicians, nursing assistants to doctors and nurses. Everyone has pitched in and has gone above and beyond their typical skill set to give the upmost care. I have mainly been a coordinator of care in most circumstances. Most of my efforts have focused on finding out physical & occupational therapy's goals and coordinating that with social work's efforts in finding patients a home.

Day 6

Woke up to someone yelling "it's stolen!!" I quickly learned that one of my volunteer neighbors' bags was stolen last nite. He woke up to find a hole cut out in the tent next to his bed & a trail of clothes from the tent to the grass and some clothes were also sent aside in a bag. At least the thief was considerate?

Day 3

Last nite went to the UN for dinner. It was a breath of fresh air to get out especially as I had a bout of severe abdom pain during the day when my Dad visited me. I have no idea what it was but it was severe. At the UN there was all sorts of American type food - burgers, fries, BBQ chicken. I only had fries, yogurt. Food is available twice a day - 12:30 to 1:30pm then again at 3:30pm. It isn't the most appetizing but it serves its purpose.
I discharged a pt today whose prognosis was a bit more promising. He is an 18 yo male s/p Mva c/b closed head trauma. He actually had a place to go with both his parents, which is rare.
One thing I've learned from haitian people that they can be very soft spoken and humble...I haven't heard anyone raise their voice this entire time. It is incredible maybe it is b/c I'm seeing them @ their worst.
Today I worked at the mango tree doing triage/clinic. There were about several hundred pts there today. I only worked for 2.5 hrs but I saw about 30+ patients. Most of my pts had chronic complaints of abdominal, back pain & 'acute' ones like PID, STD, & vaginal candidiasis. But some had things we could not even treat. There was young man with a huge neck mass (likely something congenital). It was not acutely infected and we had no ENT docs on the compound, so I had to sadly turn him away.

A better day

Today was a better day. I saw my pts & went to " work". I'm on the medicine team as there were not enough doctors for that grp. There are 5 rows of pts, about 11 each - A to E. I was assigned to E which which are pts with varying spinal cord injuries - paraplegia & quadraplegia- some directly & indirectly related to the quake. Typically in the US all of these pts would b discharged to a rehab facility, but there is no such thing here. One pt I have with quadraplegia who has no active medical issues, cannot b discharged b/c he doesn't have a safe dispo plan - there r no visiting nurse services, home physical therapy. For others who may not need rehab, don't have a home to go to. I have another pt who i am planning to discharge tomorrow who told me she needed shoes, clothes for 3 kids, tent, & money. I was speechless & overwhelmed. How could I get her these things & is it even possible?? Well of course the answer is 'no' which is very unsettling & left me feeling hopeless. I felt like what am I really doing for these people. Finding needs that I can't fulfill or really fix. What's my purpose?