Summary

So, I was delinquent in posting during my last 4-5 days in Haiti, but I think sometimes it's easy to spend too much time writing and not enough time living, and believe me there was a lot of living being done this week...

So the 9 scariest words I heard this week were "So how would you feel about running the ER?" I'd planned on coming to just do manual labor, clearing rubble, not try to delve headfirst into a career I left 5 years ago, but the need was there... My first day in the hospital center here in Leogane was an interesting foray into field medicine. Worldwide Village, in cooperation with the University of Notre Dame, has set up a provisional hospital and surgical center in the tiny village of Leogane, the epicenter of Haiti's earthquakes. The hospital was unlike anything I'd seen before, 6 interconnected and fully enclosed tent structures, complete with air conditioning! Well, when it worked, or we didn't run out of fuel for the generators, that is. Still, on my first day, as I approached the structure, I saw a line of people, young and old, waiting to be evaluated at the clinic. This was going to be a challenge.

The first challenge we faced in the ER was our lack of organization. American hospitals are nothing if not efficient and orderly. At first glance, this situation was neither, but we had some amazing volunteers with HODR and a crew of three wonderful Haitian translators that helped us bring order to chaos. We saw patients as screened by our translators, and began to establish who needed surgery and what interventions could be performed outside our very limited sterile room.

"Medicine by committee" is the best way to describe what occurred. Our two staff physicians, a urologist and a plastic surgeon, we joined by an ER physician midweek, which eased our patient load somewhat, but I, along with a handful of nurses, often saw, treated, and discharged patients without a doctor ever seeing them. We quickly came to realize that all of our patients are dehydrated, which made IV access tricky. At one point, after attempting IV access 6 times on an 18 month old boy with 40& coverage partial thickness burns, we realized we had to give the child fluids, or he would die. Normally, this would mean giving IV fluids through what's called an IO (interoceous) line, which goes directly into the marrow of a large bone, like the femur, the bone in the upper leg. One problem. We don't have any of the special needles needed to perform an IO. Soooo... "I've heard that in infants, if you absolutely have to, you could possibly use a short 14 gauge needle to possibly start an IO, and it should hold." Everyone looking at the child turned and looked at me. One of the doctor's said, "Well, sounds good to me, have you done it?" "Um, no... I mean, it's been a while since I've done any of this, I'm just throwing out ideas." "Well, sounds good to me, let's try it!" Thankfully, the procedure worked. These doctors really were incredible in the ways they were able to think outside the box and adapt to limited equipment and surroundings to save lives. I'm proud to say that during the entire week we worked, we only lost one patient, of hundreds we were able to treat.

I was consistently amazed at the strength and resilience of the Haitian people. I've never worked on patients that were so calm, cooperative, and thankful. These people have seen so much loss and dealt with so much pain, it's almost like they've become immune to suffering. I watched as our plastic surgeon informed a 17 year old girl that she'd need to lose her leg, which was rapidly deteriorating with gangrene, to save her life. She calmly replied, "Take my leg, I want to live." I can't imagine that happening here. No 17 year old girl in America would take that news so calmly. Heck, I wouldn't take it that well! What a portrait of strength.

As we left Haiti on our last day I was ready to go, but with a new attitude about the experience. This nation, so ravaged by destruction and heartache, and facing the hurricane season, was smiling. Everywhere we looked, people were smiling, children were playing, people were working. Much like an ant hill that's been kicked, people were rebuilding, despite the odds. We in America have no idea what tragedy and loss really are. And, it seemed, neither did these people. The sad reality dawned on me that this community was probably not much worse off than before the earthquake. The word "loss" implies you have something to lose. With nothing before or after, well, why grieve? This tiny village, so full of life, but so devoid of resources, was further proof that, while we're all created equal, some are more equal than others.

So, in summary, this trip was a bittersweet reminder to be thankful for each breath of freedom and opportunity I've been given. Like I said to someone before we left, it could just as easily have been me rebuilding my life that'd been torn to shreds. The freedom, money, and education we've been given are gifts we need to cherish and share with all of God's children. I am, indeed, my brother's keeper and I've never before seen the need so vividly.