The threat of personal trauma tests character. The way these residents concentrated on patient care rather than their own safety is exemplary.
Each of these surgeons has mentioned the need for better infrastructure and equipment to accomplish the level of orthopaedics needed for their patients. We continue to seek solutions.
Each of these surgeons has mentioned the need for better infrastructure and equipment to accomplish the level of orthopaedics needed for their patients. We continue to seek solutions.
Journal of Dr. Mukkuaka ODA
During the first month after the deadly January 12, 2010, our team took care of about 700 wounded with a ratio of 5 to 10 cases on plain beds without an operating room. I did not count the patients that were being taken care of.
The story I'm about to tell you really happened and I never wanted to share being afraid of what bad memories it could bring up.
At the time of this story I had just become a 3rd year resident with no experience in mass disaster management. I was visiting a friend when the entire house started to shake. I thought it was a small quake as usual, but the first shockwave passed and was immediately followed by the biggest wave I've ever felt. That's when I realized we where hit by the big one.
In the beginning, I resisted the quake and didn't realize the impact of the phenomenon. But when we evacuated the house and saw the mayhem in the streets: wounded people running everywhere and corpses laying almost everywhere you looked. I was as if a bomb had hit the city. The only thing is that there wasn’t a war, this came out of the blue. That’s when I realized what happened.
After securing everyone in my friends’ house, I started to search for my family. I noticed the phone lines were cut and that only increased my anxiety. Each wounded person or familiar face I saw made my heart skip a beat. It was only when I found my relatives uninjured, that I made my way to the General Hospital where I work and study.
The road to the hospital was almost closed with people coming from every direction seeking care. We began identifying the worst cases and then started to work with everything we could find. Soon we find ourselves using sticks for immobilization. The first 48 hours we worked nonstop between the surges of quakes. Many of us slept at others’ homes because we had nowhere to rest. Some friends helped out in hopes of finding their relatives.
Hope was our only goal. We relied on ourselves and no one else. The authorities looking as lost as we were. It was only on the 4th day that the international aid starting to come into our hospital to help. However, they did not work with us in the beginning, which only lead to much discordance. Finally, sharing and good will found their way into everybody’s hearts, which made things better for all.
Journal of Dr. Getho Chertoute
It was 4PM when I went home. I was hungry and wanted to take a bit but I was enjoying the company of my two nephews, one six months and the other 3 years old. Suddenly everything began moving. I never thought it was an earthquake, maybe an explosion nearby? I dialed a friend’s number and explained to him what just happened. He mentioned that he just experienced something similar, however our homes are an hour apart. A few minutes into our conversation, the telephone lines went out.
I left my home by foot and headed toward the hospitals. There were road jams everywhere due to the rubble or the deceased. I arrive at the hospitals two hours later and am welcomed by a terrible surprise: thousands of victims in the yard because the emergency room was not safe, no organized system of receiving patients, it was complete chaos.
Among the doctors, we had a lot of general practitioners and medical students but only a bunch’s worth of orthopaedic residents and attendings, only one to two.
There were no paper goods, nothing. We had to break the nursing doors down to seek help and we organized the few we had and starting doing whatever we could.
It was unbelievable. We could not afford this at all. The parents and relatives of the victims were surprised by our dedication and in their sorrow, they began trying to help us. It was hard but very encouraging.
We had a lot of jobs to do. We worked until we were exhausted. Each of us were a one-man surgical team; we had to sedate our patients, run the surgeries in open air, get the dressings we needed and when the sun set and the light of the day was gone, we had to stop. We went home by foot, took a rest, and prepared ourselves because in the morning we had to wake up and continue with the same practice.
We continue this pattern for days. On the fourth day, we received help from the US Army and the US Medical Corps. The first help we receive was from the WHO-PAO they brought a lot of paper goods, plasters, Povidones, IV’s and so on.
For the months that followed, we continuously had a turn over of constant of helpers from around the world. They settled in their own facilities to increase the service. This was a very terrible and special period, I would use a lot of papers but I would never finish with story of this event.
Journal of Dr. Kenslor Hyacinthe
The day of the earthquake, I had just one operative case with our team. Around 5PM I took a break in my room and heard a terrible noise. Suddenly the AC unit started trembling along with the furniture and refrigerator. Caught off guard, I panic and my roommate and I rushed toward the exit. Outside, we saw that everyone was panicking and screaming for Jesus. “Jesus! Save us!”
It was only later that I realized what was happening around me as I began to see people coming in with multiple trauma wounds and limb amputations. People starting flooding in from everywhere, all of which seeking emergency care. My roommate and I try to enter the building and to the operation theater to get gauze and betadine pads. We managed with splints in cartoon and dressed with gauze and by midnight we were running out of lactate ringers and pads. We tried our best to keep going until morning. Those who had hemorrhagic vessel wounds, we made arterial elastic tourniquets to stop the bleeding. We stayed awake the entire night.
The following days we stayed in the yard and opened an emergency cell. We made limb amputations under local anesthesia until the stock ran out. After that, we were forced to amputate on simple sedation.
One week after, foreign teams and nongovernmental organizations helped us. They supported us and wanted to help the Haitian people.
Many of us have to work in difficult situations, but since the earthquake, our operating room became non-functional. The building in which we operate works with the same equipment that we have salvaged. The international teams left the hospital many months later and since then the operating room has been redeveloped and works with many instruments like orthopaedic tables without a C-arm, and surgical lamps. The cauther suction devices usually are not functional and anesthetic machines do not work at all.
The performance of our service cannot exceed more than two cases per day. Under difficult circumstances, we are obliged to provide care to the over 9 million inhabitants with the heart of a warrior.
Since I learned to manage an influx of victims after this disaster, I do not have too much difficulty managing any kinds of fractures and road traffic accidents.
We lack the equipment necessary to provide quality care, we face a poor population who has neither health insurance nor the ability to pay health costs.The residency program is a life of daily struggle, the operation room is operational all day, but it works by itself.
We lack the equipment necessary to provide quality care, we face a poor population who has neither health insurance nor the ability to pay health costs.The residency program is a life of daily struggle, the operation room is operational all day, but it works by itself.
The goals of the residency program of the HUEH is to train residents in orthopedics and traumatology, in order to provide the country with potentialities able to correct congenital deformities or traumatic injuries. After four years of continuous training, we hope to be effective to help the country to equip itself with good orthopaedic surgeons.
Journal of Dr. Stanley Alabre
The Earthquake left a scar that marks any of our compatriots, not only physically but also emotionally and socially. As a doctor, I have the opportunity to meet people and feel the after-effects of the worst experience in my country.
When the earthquake happened, I was not a resident yet. Around 5PM I was sleeping after a long day of studying for the residency exams. The quake hit and I was buried under the rubble that once was my house. This was the beginning of the worst 14 hours of my life.
The rest of my family saved me the next day. Once outside, I was not prepared for the conditions of the situation. I recognized the immediate need for healthcare. Right then, I promised myself to help my people and immediately chose orthopaedic residency.
The first months at the residency were difficult because we were forced to manage the amount of patients with the small number of rooms left. On top of that there was no standard operation room.
The conditions at HUEH are difficult. The hospital has always been neglected by our government. Everyday we deal with the lack of medication and equipment in the emergency room, the operating room, and everywhere else in the hospital. There are only two operating rooms for all surgical services the hospital provides. Unfortunately, we are unable to operate because of the lack of sterile drapes and gowns. Electricity is cut frequently while operating, leaving surgeons to continue with headlamps and sometimes even cell phone light. We think now it is time to do our best to break with these conditions. HUEH should recover and honor its name. It should be the largest medical center in Haiti and should offer quality care to the Haitian people with disregard to the carelessness of the government.
The goals for the residency program are to assure the formation of specialists who will bring quality care to the Haitian people and assure the perpetuation of knowledge for the sake of posterity.
There is a lot to do before we reach these goals. We must first be aware of the problems and we must be willing to solve them. The health and education of the Haitian people should be the first priority of the government.
The earthquake has given me the experience to reevaluate my goals for the future. My first goal is to reduce the immense number of disabled people living in my country. As long as I am an orthopaedic surgeon, I will work to prevent the complications leading to permanent disability. I aspire to learn and practice more for the care of my patients as well as do my best to raise our healthcare system.
Journal of Dr. Gilbert Gourdet
It was afternoon and I had just spent more than 24 hours working in the emergency room. One of my colleagues and I went to our commune rooms to get some rest. As we fell asleep we heard a strange noise and noticed that the furniture was moving. Seconds later the noise was accompanied with shaking and we knew then it was something big. After about 30 seconds we ran outside. All the electrical poles were shaking with their high voltage wires and we heard the sounds caused by breaches in our oxygen containers.
The surgery department was really damaged by the shaking and the nursing school near the hospital went down killing nearly one hundred girls. We noticed the pediatric unit was also down. All of a sudden the hospital yard was full of newly injured patients surrounded by ones previously there. I ran for the OBGYN unit where my mother is the head nurse and I found her with dust all over her body.
I searched and found my father whose clinic is in front of the hospital. Running in the streets I saw the destruction, many people thought it was the end of the world or some kind of bombardment. The people ran around crying for Jesus as one synchronized voice as if they were hypnotized. They were like zombies with their bodies covered by dust
All of the political buildings were down with many of the churches. There was a large traffic jam cause by crashed cars and the injured in the streets. I found my family members twelve hours after the quake thanks only to God. I found some of my friends injured and I found some of them dead.
After the cataclysm the whole world saw all the weaknesses of our health system. One could say we did not have one. The Haitian unit was not organized at all. We were doing what we could individually during the first 72 hours following the quake. We did not have all the people we needed nor the materials and technology that was required. We saved many patients but we lost many more. There was no electricity so we were forced to quit after the sun set. We became more and more exhausted and we had no tools to work.
For more than a week there were no decisions made by the government as to relief efforts or what to do to overcome the disaster. We could only do our best.
Then came the first aid from the Dominican and American teams. They came with mass amounts of people from their health departments and military units. They did a great job. At times it was difficult to work together due to language barriers and such. After them came many other foreign countries in Europe, Asia, and Africa.
Since the earthquake I have implemented my own goals for the future of my residency. In many ways this experienced changed my life. For the first time I felt unprotected by my country.
Weeks before the morning of January 12, I had been living on the equivalent of only $300, giving the rest of what I had to my family so that they could eat. My goal in life is to do all that I can to protect my family from any kind of threat that will inevitably come in the future. I am no longer optimistic in my country’s ability to protect my people. The only way to grow is to be the best that I can be in my work as a clinical physician and to participate with my fellow educators and organizations. This is why I will continue working in Haiti. I wish we could get more investments in this country so we can have more money to protect our people.
At HUEH we continue to benefit from donations of money and medical supplies. We do lack some material but we continue to do our best. There are still departments that are damaged. Our operating room does not have airflow or suction, coagulation or carterisation devices or lights. Sometimes it is like we are performing with our bare hands.
Since I have experience in this country, mainly in hospitals like this, I think the benefit of it all is our developed clinical skills and manual abilities. At HUEH we strive to reach our goal to provide healthcare and to protect the population as well as academic formation and research for medical students and our residency programs.
In order to reach our goals, we must first help ourselves before searching for help from the outside. We must inject money into our health system and initiate more people to participate in the health program of our country. We must also share our knowledge and experience with other countries. We must spread great healthcare structures all over the country, which is unfortunately not the case right now. We need material and technology, research and databases, and most importantly the formation and experiences that we lack so much of.
Journal of Dr. Edme Louidort
It was 4:53 PM and I found myself doing emergency dressings for a patient when the earthquake began. After the shaking, I left the room and in less than 5 minutes the hospital was invaded by a huge crowd of people. Unfortunately, there was not enough material to treat them and the hospital itself was not equipped to respond o this kind of disaster. With our meager resources, our hospital only supports the most urgent cases.
Despite the hospital’s inabilities, the shaking continued to discourage patients. By 7PM, the hospital had received a visit by the director of the department of health and was supplied hardware for the evening. However, it was not enough. We expected the arrival of expatriates delivering the relief of our heavy burdens.
The experience was very difficult for me but it did give me disaster experience. As an orthopaedist I must manage patients with great efficiency and facilitate management.
The experience did showcase the need for a well equipped trauma hospital. As a healthcare provider, we must develop a partnership between foreigners and express the need for proper training of managers.
In this present moment, there are a alot of patients who suffer because of the lack of materials and trainers in the hospitals of Haiti.
Journal of Dr. Eldine Jacques
Like an ordinary Tuesday we had just made a locking nail... I was in my room at the hospital, talking to my friend Jean-Ralph about the next case. Suddenly everything crumbled to the ground. At first I didn’t realized what was happening. I looked at Jean-Ralph just as he leapt from the bed and was running toward the door. Out of instinct I grabbed his arm immediately and said that we can’t go outside. We ran to the corner of the room and held on to each other until it passed. Everything was shaking and it seemed that the house would fall on us. I realized then that we were experiencing an earthquake, a big one. It was my first experience with a quake of such magnitude. After the first shockwave, we tried to run outside but were stopped by another surge. Calm came a few seconds later but we couldn’t make a move. Haggard, paralyzed, and petrified, we clung to the wall with the sensation that if we move again the nightmare would start over.
We saw Dr. Gourdet and he told us that we must get out or risk being asphyxiated. We didn’t realize the severity of the event. We came out into the hall where everything was white from the recent collapse of the nursing school and we could see nothing. Once outside, we could see blood in the yard. I figured it was from one of us so I asked all the residents I met if they were bleeding, like a leitmotiv.
We gathered in the yard and I noticed that some had been lost. My eyes began to swell as I asked myself what happened to my house, to my family? Some of the residents began to cry. We all tried to phone home but there were no means of communication. I finally reached my home and my mother. The house had collapsed with my one-year-old nephew. He was alive and asking for milk. He did not know what was happening. Bless the childhood. I was reassured when I found my family only until later when I found out that three of my best friends were unaccounted for. They did not find their bodies.
In less than one hour the yard was crowded with the injured and the deceased. Everybody was screaming for the lost and the missing. We had two attendings with us and we started to organize our team to help. Fortunately, the hospital had IV solutions. All interns and residents at the state university have a first aid kit. With phone flash, penlight, and everything we could use, we started to put in some IVs, some tourniquets, and make some dressings.
It was a total horror. I will never forget the 12 year old with a degloving of his four limbs. We administered three IVs but he was so agitated that he took them off. Another woman in her 40s came to us with her face in her hands begging us to fix it. I still don’t understand how this happened. We ran out of materials quickly and the batteries discharged. It was getting dark. The crowds were yelling at us and people were becoming desperate. All of this suffering around us and there was nothing we could do. People were angry because they were in pain.
The attendings said it was no longer safe to stay there because there was nothing that we could do. We went back to the dormitory and upon arrival I saw the post operative patient that I operated on in the morning. I asked him how he got there but he said he didn’t know, he just ran.
It was the longest night of my life: we were hungry, thirsty, cold, frightened, and above all we were tired. The after shocks continued and were so strong that sometimes we had to lie on the ground.
At 4AM we grouped together to walk home. It was indescribable in the street. Cars could not pass, there were decapitated corpses, houses were collapsed; it seemed to us that this was the end of the world. We covered several kilometers on foot on our way home. When I reached my neighborhood there were many injured people waiting on me. I had a first aid kit at home and made dressings. They brought me a 30-year-old man who was suffering from cardiac arrest. I performed resuscitation for an hour but unfortunately it was too late. I asked the remaining injured parties to head to the hospital. Things finally began to organize on Thursday.
The mortuary was in ruins so the corpses were left in the yard. You couldn’t breathe the air. The atmosphere was dreadful. We worked in a septic environment.
We were tired and we had no more resources. We worked until dark in the fetid environment and coped with the situation the best we could. Flaps, grafts, and resumption were our daily bread. We struggled and will keep struggling despite the lack of support and tool.
I once had a professor in medical school that always said, “Haiti is the country where impossibilities become possibilities.” This phrase took on life after January 12th.
