Miami, Florida—When I arrived in Port-au-Prince, Haiti, on Jan. 22, 2010, ten days after the earthquake, the first thing that struck me at the airport was the smell of dead bodies as soon as I got off the airplane, even before walking down the steps to hit the ground. That was a clear warning of the magnitude of the disaster that claimed more than 200,000 lives on Jan. 12, 2010.
The place looked like a quiet war zone. The U.S. Comfort we saw in the harbor from the plane, the enormous military presence at the airport, the avalanche of health care volunteers—the whole picture was like a war zone with colossal casualties. From the airport to the hospital, I saw it all. Massive numbers of homeless pedestrian survivors were walking toward and away from the airport. Their facial expressions suggested thirst, transpiration, discomfort, hunger, sadness, loss and grief. I quickly understood that the media did try but was unable to really depict what the Haitian people have been afflicted with. All I had to do was look from side to side to see the magnitude of the devastation. Houses are grounded from top to bottom, block after block. Vanished household members’ belongings, including kids’ shoes, clothes, and toys were still hanging over the rubble. The tough smell of dead bodies, embedded in the rubble,gave a clue as to how many powerless human beings had been trapped and killed.
When I arrived in the hospital yard, all I could do was start moving and working right away. I felt that my time was precious. I knew that any second spent helping someone in this setting would make a huge difference. One of my first patients was a young lady who reported to me that she was rescued from the rubble after four days. She presented herself, more than a week after the earthquake, with a dislocated shoulder, which she was trying to treat with a warm compress. The compelling story she told me explained the ordeal very well—not only the physical but also the psychological trauma—that survivors have to go through. She told me that when she was trapped for four days, she was talking with three neighbors encouraging each other, but they could not see each other. When luckily she was rescued through a hole from a collapsed multi-story house, she told her rescuers that there were more people down there. She was told it was too dangerous to go back. The rescuers moved on and these people have never been rescued. Such a story is one of the stories of countless number of people, children, youngsters, adults and elderly buried alive. I realized that, even in this circumstance, one way of dying is worse than another. The story of those buried alive (and who probably died many days later knowing they will die) is the untold story on TV of the tribulation of the trapped Haitian victims.
I worked mainly in the post-op unit of the hospital, making follow-up rounds on amputees and wounded victims. On many occasions, I diagnosed compartment syndrome, displaced fractures, and surgical wound infections. The post-op ward is made of small and medium-size tents packed with numerous victims lying down side by side on the ground in the hot sun and the cold night. The pharmacy had a random stock of antibiotics and analgesics. You gave what you could find. Plain x-rays were the only luxury diagnostic tools available. There was no lab. No CT scans. There was a strong health care providers’ response. However, the supply of medicines, especially antibiotics and analgesia, had been very disorganized and insufficient. Pain management had been a big time issue. Most post-op amputees, crutched injured, dislocated limbed, fractures, spinal cord injuries, facial trauma, rib fractures, head trauma, surgical wound infections patients were given just acetaminophen or ibuprofen to deal with their pain. After the physical trauma and nasty injuries, the people have to feel the pain of their wounds. They continue to suffer because of a lack of supply of pain medications. While we saw in Haiti a good showing of orthopedic surgeons, we should have had a similar number of pain management specialists. That would help a lot, that would help ease the pain. But I can only salute these volunteer helpers who risk a lot to be in the graveyard of Port-au-Prince and the field of Haiti despite continuing life-threatening aftershocks.
I must say something about the resilience of the Haitian people, the courage and grace they have shown in time of greatest despair. This is illustrated in their gratefulness for the simplest care given to them. Because nothing in life has ever been given to them easily, they feel like they owe volunteers something for giving them so much. They pay volunteers with their smiles, their kindness and their strength. The reason they are so resilient in such tough circumstances (surviving in the street without water, power, shelter, food, with overwhelming loss) is because in fact most of them have been living the tough life since birth. The daily hardships they had experienced were training on how to survive such a horrible tragedy. When it was time for me to return to Florida, I had one thing in mind: if only I could stay longer, if only I could go back ASAP. I should not return to the routine of my privileged life in the U.S. not remembering and doing something about my experience. I must remember the survivors. I must do something to help. Now is the time to help or never.
Kansky J. DeLisma, MD, MPH | Reede Scholar Class of 2006
Founder: Direct Initiatives to Support Haiti, Inc. PO Box 566264 | Miami, FL 33256
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