One year after the devastating earthquake rocked the world of Haitian people, I traveled to Port-au-Prince with Project Medishare out of Miami University . My one week deployment was marked by sensory overload. There was the hot sun, the humidity, the mosquitoes. Proud Haitian citizens lined the streets in their colorful garb. The roads were bumpy and strewn with cement chunks. Tent City extended as far as the eye can see. One can only imagine life under those tarps. I learned that they are ruled by self-proclaimed "chiefs". Children are sold for money; they must work for their new families.
Bernard Mevs / Project Medishare Hospital is within a gated compound of structured buildings now, re-located from the tent hospital at the airport approximately 6 months ago. It is the only critical care / trauma hospital in Haiti . The hospital accommodates approximately 30 patients.
The facilities within the compound for the volunteers are adequate at best. Bottled water is provided, however running water to bathe shuts down frequently. Haitian food is provided at 10am & 2pm. It is an acquired taste that is difficult to acquire within one week. Lodging is a small room packed with bunk beds, plywood walls & a dirt floor. Generated electricity will go out periodically throughout the day for brief intervals. Homeless persons are everywhere, even within our gated hospital.
I worked in the Emergency area from 6pm - 6am for seven consecutive nights. Countless people benefited as a direct result of the volunteers. Not speaking Creole was easily solved. Interpreters were readily available and invaluable for patient teaching. But by far, the best communication with the Haitians was a warm smile, gentle touch, and eye contact.
Patients came in a continuous flow through the Emergency area. Some were routine visits: 32 year-old man with a kidney stone, 18 year-old girl in sickle cell crisis needing IV fluids, Congestive Heart Failure patient treated with medications and released. She surely would have been admitted to the hospital if in the United States . A woman with an intracerebral hemorrhage and very poor prognosis was loaded into the back of a truck by her family to go home to die. Malaria and typhoid were among the complaints.
Lots of pediatric patients came to ED for a variety of problems. A sixteen year-old cholera patient was to be transferred to "cholera camp”; transportation was in an open pick-up truck in the rain. A 24 hour old newborn had umbilical oozing; fortunately it was not infected, the "string" was not tied tight enough. The physician clamped it with a traditional clamp. A lifeless four-year old girl was brought in by her father. She was electrocuted from faulty power. The father brandished a gun threatening to kill the mother. He was detained by the police. A 13-year old girl in the pediatrics unit needed mitral valve surgery; she arrested and died on Tuesday. Her transportation to the United States for surgery was scheduled for Thursday. The premies in NICU cling to life. There are no NICU ventilators, yet even a 0.7 Kg baby survived for days. These patients and families need to be held and comforted. As nurses, we can provide solace and compassion. These patients and families are not demanding at all. A smile, a word, a touch are appreciated; their eyes tell it all.
There were many trauma patients brought to the facility. We treated many lacerations, contusions, and wounds. Some were a result of rocks being thrown. There is rioting in the area due to political dissent. Rioting, for the most part, consists of the people throwing the cement rocks. Some trauma patients were due to basic lack of safety, especially driving. Cars are precious commodities; they are packed with people hanging out of the vehicle (some without any doors). The bumpy roads would eject passengers while the driver drove fast and furious! Small buses called "Tap-taps" raced through the roads. The passengers “tapped” the top of the bus to signal for a stop.
The most disturbing trauma patients were from street violence. Civil unrest undermines basic humanitarism. A twenty year-old male was brought in with a screwdriver rammed completely through his head. He had resisted when two men tried to take his cell phone. Domestic abuse is common. Women came in severely beaten by their spouses. An adult male patient came in with a head bleed, pneumothorax, and fractures. He had been caught stealing and the police had beaten him. They had him handcuffed to the gurney despite the injuries.
Supplies are meager. It is not uncommon to wash specimen containers or medication cups to re-use. Ability to improvise is essential. The experience has given stewardship a whole new priority for me. There is one C-t scanner available, however it is a two hour journey to get there. C-t scans do not get ordered unless absolutely critical to the outcome of the patient.
The American volunteers gather on the roof in the evenings. The wind is gentle, the moon is full, and we are all going through the same incredible experience. The comradery is almost palpable. We bonded in a special way and continue to exchange e-mails and photos. Our departure was of many mixed emotions. This experience will take time to process.
I hope that my work serving others is a testament to the mission of Providence .
A sense of pride, fulfillment, awe, and selflessness are my gifts as a direct result of my mission to Haiti . by Jo Birdsong
Jo Birdsong is planning a medical mission to Haiti in July 2011 with Project Helping Hands. This will be a two-week deployment working outdoor clinics, as well as outreach to the Tent Cities and orphanages. One Nurse At A Time awarded her a $1000 scholarship to help defray her expenses for this mission.
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