Haiti: “It’s astonishing how many injuries we are seeing.”

photos by Christian Theodosis

photos by Christian Theodosis

One week after two medical teams from the University of Chicago traveled to the earthquake-ravaged nation of Haiti, the situation remains critical. In a conference call Monday from the field hospital camp in Fond Parisien, where a six-person Medical Center team, including physicians, nurses and a pharmacist, are stationed, Haiti team co-leader Christian Theodosis gave a sobering reminder that the nation’s recovery is only beginning: “Being injured and homeless and without legs in Haiti is a very bad outcome.”

Though the focus has shifted in some parts of the country from acute surgery to post-operative care and the medical issues that accompany hundreds of thousands of newly homeless people, the need for expert help and supplies remains great. The Fond Parisien camp (pictured above and on Theodosis’ online gallery) is somewhere between a tent hospital and a refugee camp. Built on the grounds of a Haitian orphanage, the rows of tents sheltered 500 people when the University of Chicago team arrived, and now house 230 patients and their families. More patients are arriving every day by helicopter or bus; hospitals in Port au Prince and the USS Comfort – a US Navy ship that has served as a floating hospital since the quake – are sending recovering patients to the camp to clear space in their facilities for more operations. With only one facility equipped for surgical operations on site, medical personnel at the camp have largely tended to the post-operative and displaced, building shelters, vaccinating patients and their families, and providing rehabilitation services.

John Easton and I spoke to Richard Cook, associate professor of anesthesia and critical care at the University of Chicago Medical Center, by phone this morning from the Fond Parisien camp. Though Cook hasn’t been using his primary specialty – “You know, I haven’t given an anesthetic since I arrived,” he said – he has been incredibly busy acting as physician, electrician, construction worker, and anything else the camp needs. He says he’s been shaken by the severity of the injuries, but is comforted by the resilience of the Haitian people.

“I’ve seen more pediatric amputations in my nine days here than I have in the rest of my career combined. The devastation is almost incalculable,” Cook said. “But the Haitian people are stoic, gracious, polite, optimistic, and deeply faithful. They are responding as well as any community possibly could to such a disaster.”

The full interview is after the jump.

What is the current situation for you and the team?

We have established a medical camp at a place called the Love a Child Hospital, near the Haitian town of Fond Parisien. This has become well recognized as a refuge for displaced persons. The camp consists of a small hospital, our medical camp based in tents, and an orphanage that was already here. There is a growing family camp outside the walls of our camp. We currently have about 230 patients and many of those patients have family with them, so there are about 750 people living in the medical camp, all in tents. We have put up about 600 tents. We received a few patients from the Navy’s hospital ship, the Comfort, two days ago and are expecting another 30 patients today. They will come via helicopter. We anticipate getting more patients from them. These patients are recovering after surgery, mostly for orthopedic issues, injuries received during the earthquake. As patients recover they are discharged to the family camp, which is outside the walls and about 1.5 kilometers away.

Are most of the patients you’re seeing from Port au Prince?

IMG_0277A tremendous proportion of particularly the serious orthopedic injuries that we’ve seen are all from Port au Prince. There are also local people who need medical care that we’ve seen. But most of the patients, particularly the significant post-surgical cases and ongoing surgical cases, are people who were in Port au Prince or some place where the earthquake brought down buildings and caused those injuries. And most of those injuries did occur at the time of the earthquake rather than since then. Virtually everyone who was in the earthquake and has a serious injury has now had at least one operation, so most of the people we are seeing are being seen for follow-up operations, care of complications of their earlier operations, and so forth. There’s nobody really coming for de novo surgery -not just “I got a broken leg, it’s sticking out, why don’t you fix that,” it’s people who had a broken leg that was sticking out, it got fixed someplace, often quite hurriedly, now it might be infected and it requires further surgery and further care. That’s who is being cared for in our facility.

Are you seeing any infectious disease in the camp?

We’ve had very little of that. It’s the dry season now in Haiti, which is helpful. Camp hygiene is exceptionally good, we have toilets and latrines that are working and we have a clean supply of water, so we haven’t seen any dysentery, typhoid, anything like that. We just got a big batch of measles vaccine and we’ve been vaccinating everybody for measles because that’s a potential epidemic disease in a camp like this. Right now there’s nothing terribly worrisome in terms of the sorts of epidemic diseases that you might see after a major disaster, most of which are associated with sanitation-type problems. Sanitation conditions in the camp are currently quite good.

How do conditions in Port au Prince compare to the camp?

Photo: Justin Ide/Harvard University News Office

Photo: Justin Ide/Harvard University News Office

The contrast between what’s here and in Port au Prince is stark and disturbing. This is a comparatively luxurious setting: it’s highly secure, it’s well watered, there’s ready access to sufficient food, we have some electricity so we can run some lights and so forth. Most of all it’s orderly and not filled with chaos. Port au Prince is still a place of great, great trial and tribulation and enormous disruption and extremely bad circumstances. We had some people down there yesterday who reported it was a really awful, awful situation with lines of people waiting to get into the hospital and devastation all around. So we are very, very fortunate to be here. And the people who are here recognize how good their luck is to be inside the walls. On Sunday, there was a lot of church here, which is very big in Haiti. People put on the best clothes that they had – very few people have a change of clothes, but we saw the kids dressed up and everybody was spruced up and everybody went to church and everybody was singing. It was quite a moving experience.

What kind of medical care are you providing?

You know, I haven’t given an anesthetic since I arrived. I haven’t done a surgical procedure since I arrived, because the Operation Smile people who are here have got their operating room set up and are doing all of the surgical procedures and the anesthesia. But we’ve been doing general medical care. I’ve been diagnosing every possible illness you can imagine and treating all sorts of things in a rough way. There are a lot of things we don’t have yet: an X-ray machine, we don’t have much by way of laboratory studies, though the Ecuadoreans provided us a new set of laboratories which will help us do blood counts and look for various diseases and so forth. But I’ve been very much a general medical doctor, I’ve also been stringing wire and doing electrician’s work, I’ve been building stuff and making things and moving stuff around and hauling people off of helicopters and triaging folks and feeding babies and whatever there is to do. The situation is fluctuating and change is very common here so you do what you next can do.

What has the experience been like for you?

It’s astonishing how many injuries we are seeing, I’ve seen more pediatric amputations in my nine IMG_0279days here than I have in the rest of my career combined. The devastation is almost incalculable. The Haitian people are stoic, gracious, polite, optimistic, and deeply faithful. They are responding as well as any community possibly could to such a disaster. They are a constant inspiration to the people who are working here. The children are beautiful beyond belief, and the wounds will break your heart.

Do you feel like the team is making a difference?

You know we’re too busy to ask that question, but we’re making a difference to those people we see. Rex Haydon [assistant professor of surgery] is spectacular and everybody recognizes him as a true leader and an incredibly important resource in the community since so many patients we see coming off of helicopters and out of buses are indeed orthopedically injured already with operations. His ability to assess them and decide what to do is just absolutely priceless. So yes, it’s really wonderful.

The nurses ability to speak Creole to these people and also to know their culture and to be from their culture is one of the greatest things I’ve experienced in my professional career. They’re absolutely spectacular in terms of talking to people and figuring out what’s going on with them. And they are the strongest people that I think I’ve ever worked with. We are exceptionally, exceptionally blessed with wonderful, wonderful people who are doing very important stuff under conditions that almost defy description.

For more information on the University of Chicago’s relief efforts in Haiti, visit the Haiti Relief blog. If you wish to donate to Haiti recovery efforts, the Chicago Studies program has built a website with links to several aid organizations.

About Rob Mitchum (525 Articles)
Rob Mitchum is communications manager at the Computation Institute, a joint initiative between The University of Chicago and Argonne National Laboratory.
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