SIGN In Haiti

The heroes of Haiti

2011-06-21T10:44:00.000-07:00

There have been many articles written about heroes for Haiti. Most have featured foreign orthopaedic surgeons traveling to Haiti to treat injured patients. These journals are intended to chronicle the Haitian orthopedic residents who have not been mentioned in these articles. This article is not to take away recognition for contributions of these many foreign surgeons. The purpose is to emphasize the plight and ambitions of the current Haitian orthopedic residents.

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.

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 4^th 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.

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 12^th.

Building Orthopaedic Capacity in Haiti

2011-03-12T14:00:00.000-08:00

Dr. Sam, Dr. Oda, Dr. Max, and Dr. Zirkle nearly finished with this non union case. The patient is a 78 year old woman. She was injured in 2008 and treated with a K nail. It was removed because it was thought her femur had healed but in 2009 her femur began causing her pain again. She has been disabled for nearly two years now. Dr. Getho will send a photo of her walking again on crutches in a few days.

A happy SIGN patient. Squatting means that her injured leg has healed and she has full function of her knees.

Drill cover after being sterilized. It's in good condition; fabric is relaxed making it easier to use.

Future ortho. operating room. The SIGN cases for today have been delayed because the previous cases were taking longer than expected. We were shown several rooms which are nearly ready to become orthopaedic operating rooms. They are missing equipment to have their own suites, however we can work with IMEC to supply equipment. Once they have the equipment and support staffing these surgeons will be able to treat fractures more timely due to elimination of delays.

Below: Post op of Tuesday's floating knee.

Randy Huebner explains Acumed plates to Dr. Pierre Pierre.

Dr. Pierre Pierre expresses his gratitude of SIGN's support.

Dr. Max describes drill cover to Dr. Pierre Pierre.

Dr. Gilbert shows Jeanne the database that the HUEH residents have built full of cases done since the earthquake. They plan to present a few papers at the SIGN conference from these cases. In turn, Jeanne showed him how to access the Orthoweb database. Designed by Voyant Systems, this database will allow SIGN surgeons to record cases of interest to be shared with other SIGN surgeons worldwide.

Dr. Zirkle gives impromptu discussion on fat embolism to HUEH medical students.

Dr. Zirkle presents Surgical Treatment of Orthopaedic Trauma book to HUEH residents program. Dr. Pierre Pierre is the head of orthopedics at HUEH.

Road conditions unkind to travelers

2011-03-03T11:27:00.000-08:00

Randy's thumb provides excellent frame

for scene of us going over bump.

Were in the back of a pick up here. We got our

15 minutes of vitamin D enriched sunlight.

Road traffic accidents are the leading cause of trauma world wide. Reduced speed has a direct relationship to saved lives. One method used to slow down traffic in developing countries is speed bumps. Mostly used in busy thoroughfares and on the main streets of towns that the highways pass through, these speed bumps (nicknamed sleeping policemen) do provide protection to pedestrians. But they are very disruptive to the comfort of passengers riding in the back of pick ups.

Day 3 in Haiti

2011-03-02T13:33:00.000-08:00

"I'm glad to hear that LEATHERMAN tools are useful everywhere. I've been using mine in Vietnam where Chau and I are visiting her relatives."
-Tim Leatherman

Randy Huebner uses a Leatherman tool he borrowed from Chief Resident Getho to measure patients' humerus'. Today we are working at OFATMA. This patient was injured in a RTA last November. His Injuries included a tibia, femur, and humerus fracture. Initially he was taken to Cabrel in the Dominican Republic which is a SIGN program. Surgeons at OFATMA were surprised to see his femur. Fixed with a SIGN nail. Today we will perform humerus surgery with SIGN nail. Dr. Zirkle will assist Haitian surgeons Max and Getho.

Dr. Getho and SIGN CEO Jeanne Dillner
taking a ride to visit St. Francis Hospital.

Dr. Max inserts a SIGN nail.

There is a shortage of trained surgical nurses so the residents must perform that task as well. Chief Resident Getho assists and hands off instruments. Here he is shown removing the bone from the flutes of the reamer to be used for a bone graft.

Dr. Max and Dr. Zirkle discuss case while prepping the patient for surgery.

OFATMA recycled the trays made up by Portland SIGN.
Now they can be used for SIGN kits.

First Case at HUEH

2011-03-01T11:35:00.000-08:00

This patient has a "floating knee" fracture (one fracture above the knee and another below it). Treatment of this type of fracture requires that they first operate on the tibia then on the femur. The patient was injured four weeks ago in motorcycle accident. There was a soft tissue injury that needed to heal before surgeons could operate on the fracture.

Dr. Zirkle with fellow surgeons during surgery.

During this surgery the drill being used failed but fortunately Randy Huebner brought a Kawasaki drill, drill cover and chuk. Attendees pulled these out and the case continued.

The operating room is in good condition with air conditioning functional which greatly improves the sterile conditions.

SIGN Back in Haiti

2011-03-01T11:34:00.001-08:00

Jeanne Dillner and Dr. Zirkle are back in Haiti! SIGN’s goal is to continue to raise the level of care in Haiti so local surgeons can treat the patients in need. SIGN is also in collaboration with other companies and NGOs to provide additional medical equipment, supplies and training to the doctors and nurses in Haiti.

Our friends Max and Getho met us at the airport upon arrival in Haiti.

They drove us to HUEH where Dr. Zirkle will give a lecture.

We are scheduled for one surgery today.

Residents consult with Dr. Zirkle on SIGN patients.

Residents discuss potential case with Dr. Zirkle

Later stages of treatment of clubfoot.

Tuesday morning: Weekly Ponseti treatment. Residents learned technique at the 2010 SIGN Conference and started Ponseti treatment after that course. Many children have benefited.

Reason SIGN is designing nail trays and sharp trays.

Residents apply cast during the third visit for this child. Infants can start receiving treatment as early as five days old. With the Ponseti method, the tissues forming the ligaments, joint capsules, and tendons are stretched with gentle manipulations each week. A plaster cast is applied after each weekly session to retain the degree of correction obtained and to soften the ligaments. Thereby, the displaced bones are gradually brought into the correct alignment.

The sooner the get treatment the lower the chance sugery will be needed to correct.

This boy may need surgery to correct his deformity.

X-ray of boy above.

Before and After

Randy Huebner explains the Acumed plate sets to Max and Mukkuaka.
The sets were donated to HUEH for use in the poor.

Eldine, female resident from HUEH, shows her flap cases to Dr. Zirkle. She learned from slides from IGOT Flap Course 2010. Eldine hopes to be invited to the 2011 Flap Course.

Torrential Downpours Flood Artibonite Valley

2010-07-21T07:38:00.000-07:00

July 20, 2010
Hospital Albert Schweitzer (HAS) Haiti

Major Flood Impacts Artibonite Valley

Five years ago on this date, a short but powerful rain created a flood which rushed down the Les Forges ravine and washed out the Deschapelles market and most of the houses below the bridge which leads to L'Escale, a residential village belonging to HAS.

On Sunday, in the late afternoon, a similar rain created a flood of the same magnitude. Trees are piled up around the houses below the canal, cars and motorcycles are covered with mud, and the interiors of many houses are flooded to a height of about 3-4 feet.

By Sunday evening, it was still raining, and the floods had receded, but it was impossible to walk very far without slipping in the mud and tripping over trees and branches. Thus far, there are no reports of physical injuries or losses, but we can see a substantial impact on the residences, courtyards and fields of food crops. Also, we have not heard from the upland communities, which will have endured the same rains.

Our extended family here at HAS has suffered losses. Manite, employed at HAS since the very early days, found her house was flooded to the height of her waist, washing away many of her treasured herbal plants. Another long-time HAS employee, Tyranie, also lives in that lacour, a small cluster of homes, and her house was flooded as well. The children from that lacour were brought over here to my house, and we had a bit of a camp party there with hot chocolate and blankets.... Fortunately, guests left yesterday, so we have space for the temporary visitors.

In Haiti, we live very close to nature, and its vagaries impose themselves without warning or selection. But the poor suffer more, because they are less well protected, and the margins on which their lives are led are so narrow. The miracle is the resilience of Haitian people, and their ability to carry on in the face of disaster, and to be able to visualize a better situation even in the face of disaster.

Our role is clear; to be considerate and concerned, to share resources as they may be available, but to share with them the experience of loss and also of recovery, hand in hand and shoulder to shoulder.

This incident may not be carried on your national or regional TV shows; the media who were here last week to mark the 6-month anniversary of the earthquake left before this new challenge emerged. Our son Edward came back from Port au Prince yesterday evening along the coastal road, and he reports that the devastation is remarkable all along the road, with flooded rivers and mudslides down from the steep mountains, and people wandering out to and into the road in a state of shock. Today will bring a broader perspective, one of loss and disaster, but ultimately of perseverance and hope.

Ian Rawson
Managing Director

For updates, please follow our blog at www.hashaiti.org

Dr. Zirkle Receives Salvation Army’s Highest Civic Award

2010-05-05T12:35:00.001-07:00

SIGN supporter Ralph Curran named Volunteer of the Year

An honor not seen in the Tri-Cities in a decade was given to SIGN Founder and President Dr. Lewis G. Zirkle Jr., MD, Monday night.

The occasion was the Salvation Army’s annual dinner in Richland and the honor was the organization’s Others Award. The event recognized community members for their humanitarian efforts and Dr. Zirkle was honored for his relief work in Haiti treating victims of the January earthquake. The Others Award is the Salvation Army’s highest national civic award and is given to a select few nationwide. The last time a Tri-Citian received the award was 10 years ago.

Dr. Zirkle and SIGN CEO Jeanne Dillner made two trips to Haiti following the massive earthquake that devastated the country. During the two visits, they treated fracture patients while also teaching the SIGN technique to North American volunteer surgeons working in seven different hospitals. They left behind SIGN sets at each hospital so the surgeons could continue using SIGN to treat patients.

The meaning of the Others Award, which honors individuals or organizations exemplifying extraordinary spirit of service, dates back to when the Salvation Army’s founder used the word “others” to describe the nonprofit’s selfless mission.
Also honored Monday night was Richland Kiwanis Club member and SIGN volunteer Ralph Curran, who was given the Volunteer of the Year Award. Kiwanis Clubs throughout the Pacific Northwest have raised more than $400,000 for SIGN since 2002.

Students at Marcus Whitman Elementary School Raise $465 for Haiti

2010-05-05T06:48:00.000-07:00

Students at Marcus Whitman Elementary School in Richland proved that a little change can make a big difference. The students raised $465 in a coin drive over a two-month period and donated the money to SIGN for its relief work in Haiti. Students of fourth- and fifth-grade teacher Danielle Clark and fifth-grade teacher Diane Peters encouraged their fellow students to bring coins to school to help the people of Haiti.

“We had a coin jug in the office and kids would drop their coins into,” said Danielle, who worked at SIGN from 2003 to 2006. “We’d empty it when it got full and they’d fill it with coins again. The kids were excited that SIGN was a local organization working to help Haiti. They were amazed that the coins added up to that much money.”

Thank you, Marcus Whitman Elementary School!

SIGN Article To Be Published In Orthoworld

2010-04-20T08:11:00.001-07:00

SIGN Founder and President Lewis G. Zirkle, M.D., and SIGN CEO Jeanne Dillner recently submitted an article for publication in Orthopreneur magazine. “Preparing for Disaster Response” highlights their Haiti trip following the earthquake and the lessons learned. The article will be published in the May-June issue.

www.orthoworld.com/site/index.php/main/orthopreneur

Queensgate Village Benefit Concert

2010-04-19T13:25:00.001-07:00

Help Haiti & Chile - Queensgate Village Benefit Concert

Casa Vino Wine Bar and Storybook Homes

present a benefit concert on Saturday April 24

2010 at Casa Vino, 1970 Keene Road, Richland, WA

11:00 am to 7:00 pm

All proceeds will benefit Dr. Zirkle and SIGN (Surgical Implant Generation Network).

The concert is from 11:00 am to 7:00 pm with live perfomances by Tony Ganoza, Steve Haberman & Felicia Darwin, Bluezett, Eddie Manzanares & Cafe Blanco, Chase from the Reach, and Zac Mason. Admission is free/accepting donations; $5 food, $5 wine, $5 beer, and soft drinks avaialbe. Form more information please call 509-521-6295.

Badger Mountain Elementary School Fundraiser For Haiti

2010-03-24T12:49:00.000-07:00

When the earthquake struck Haiti in January, the students at Badger Mountain Elementary School in Richland decided they wanted to lend a hand.

After learning that Vista Hermosa Foundation in Prescott, Washington was matching donations to a select group of organizations working in Haiti, the students chose to raise money for SIGN, the only local nonprofit the foundation was supporting.

With the help of Badger Mountain Elementary School counselor Teresa Nastri, the students organized a money drive they called Helping Hands for Haiti. Over a two-week period, the students brought in donations to the fund. Members of the student council spoke to each class, asking them to donate and encouraging them to get their friends and family to contribute, as well. Parents pitched in by dropping coins and dollars into a collection can as they took their children to and from school.

By the time the fund drive was over, the students had collected $1,938, an amount matched by Vista Hermosa Foundation for a grand total of $3, 876!

The SIGN staff is grateful for the generosity of the students at Badger Mountain Elementary School and thank them for helping SIGN help the people of Haiti.

Badger Mountain Elementary School

SIGN Disaster Relief Handbook

2010-03-23T15:37:00.001-07:00

A SIGN Disaster Relief Handbook has been published online and is designed to document lessons learned from Haiti and use them to be better prepared for the next phase of treating earthquake victims as well as for future disaster relief missions.

The handbook can be found at www.orthopaedia.com. Dr. Lewis Zirkle Jr. is encouraging orthopaedic surgeons and other medical professionals to read the handbook and offer their input. Comments can be sent directly to SIGN at signcom@sign-post.org.

Ellen Ochoa Middle School Raises Funds For Haiti!

2010-03-22T13:40:00.001-07:00

View all the photos!
SIGN CEO Jeanne Dillner got the royal treatment when she visited Ellen Ochoa Middle School in Pasco on Monday, March 15.

Jeanne received a check for $218.15 from the students and was treated to the song, “Can You Hear?” The choir students and two other classes began collecting money for the people of Haiti after seeing reports of the January 12 earthquake on the news.

Choir teacher Heidi Nelson said the class wanted to donate money to a local organization which would use the money to help the earthquake victims. Ms. Nelson recommended the students give the money to SIGN and their fund-raising efforts culminated on Monday with the check presentation and performance for Jeanne.

Watch the video: http://www.youtube.com/watch?v=xLFO0bPq7tw

Jeanne spoke to the students about SIGN’s work in Haiti and presented a slide show of photos taken during her visits to Haiti in January and February with SIGN Founder and President Lewis G. Zirkle, Jr., M.D. Judging from their questions afterward, it was clear the students have a great interest and concern for the people of Haiti.

All of us at SIGN want to thank the generous and talented students at Ellen Ochoa Middle School.

View all the photos!

Hope In Haiti!

2010-03-04T15:38:00.000-08:00

In the immediate aftermath of the earthquake that devastated Haiti on January 12, there was little evidence that hope could arise from the rubble and destruction that permeated Port-au-Prince. After all, much of the Haitian capital’s infrastructure was brought to the ground. Among the casualties was the city’s medical community with hospitals destroyed and medical personnel lost to the quake.

But as we approach the two-month mark since the earthquake, we found during our second trip to Haiti that there is reason for optimism and evidence that hope is on the rise. SIGN, along with other humanitarian organizations, has begun to lay the foundation for a re-built medical community with surgeons trained in 21st century orthopaedic techniques and equipped with the appropriate tools and instruments.

During the two trips to Haiti following the earthquake, Dr. Lewis G. Zirkle Jr. and SIGN CEO Jeanne Dillner worked in 10 hospitals or clinics treating victims and teaching the SIGN technique to surgeons. During their stays, they gained the trust of the patients as well as the medical personnel. They left behind SIGN sets and nails, ensuring that appropriate treatment of fractures patients would continue into the future.

2010-03-03T14:54:00.001-08:00

Dr. Zirkle to present at the AAOS 2010 Annual Meeting next week March 9 - 13 in New Orleans. His presentation will emphasize SIGN's ongoing mission of "Creating Equality of Fracture Care Throughout the World" as well as share lessons learned in Haiti. Your donations have made and continue to make a real difference in lives of thousands of trauma victims! Thank you to all who donate!!

Click here for a map of where our booth will be.

Pennies For Haiti

2010-02-24T13:37:00.000-08:00

Prosser Heights Elementary School students know the value of a penny. The students spent the week of February 8-12 collecting pennies for the people of Haiti. Their efforts resulted in a grand total of $448.03, which was donated to SIGN to help the victims of the January 12 earthquake. Additional donations pushed their overall total to $600 – more than enough to pay for a day of surgery.

In addition to the money, the students wrote well-wishing cards to the people of Haiti. Among the thoughtful sentiments expressed in the cards include:

“Hope your tears turn to smiles!”

“I’m sorry what happened in Haiti but I hope you and your family are OK! And I promise you will be OK!”

“I hope your country recovers quickly. I am sorry what happened.”

“I am sorry that you lost your home and I hope your family is OK.”

“We’ll never forget you. We’ll always remember you. I hope you’re safe.”

“May my prayers be with you and open your heart and love will always find its way in.”

The staff at SIGN wants to express our heartfelt thanks to the generosity of the students at Prosser Heights Elementary School. We will make sure the money will be used to help those who need it most and that the cards find their way to the people of Haiti.

SIGN’s Stacie Robinson, left, and Shasta Meyers with several dozen well-wishing cards the students at Prosser Heights Elementary School wrote to the people of Haiti. The students also raised $448.03 for Haiti during a penny drive.

SIGN Wraps Up Second Trip To Haiti

2010-02-23T15:10:00.001-08:00

Dr. Zirkle and SIGN CEO Jeanne Dillner arrived home Saturday after an 8-day trip to Haiti, their second since the January 12 earthquake. And, while Dr. Zirkle was able to operate on new fracture patients during the trip, he and Jeanne also had the opportunity to conduct follow-up exams on patients they treated during their previous visit in January.

All of the fractures treated with a SIGN nail during the previous visit were healing well and infection was virtually non-existent, an amazing result considering the lack of clean water available at the hospitals and clinics they worked in.

This trip also afforded Dr. Zirkle the chance to use a new distractor developed by SIGN engineers. This new tool is particularly useful in treating older fractures in which the muscles of have contracted, moving the bone fracture out of alignment. The distracter was first designed after a trip to Pakistan following the 2005 earthquake. It was modified for the recent Haiti trip by Randy Huebner and Joel Gillard of Acumed in Portland and SIGN engineers. Dr. Zirkle said he was pleased with the results, noting that many of the fractures they treated were five weeks old.

Dr. Zirkle and Jeanne have expressed their gratitude to everyone who has supported SIGN and its mission to help the people of Haiti. Financial contributions, donations of medical equipment, volunteers giving their time and expertise, and the thoughts and prayers of so many have made a genuine impact and will continue to do so as Haiti moves forward to rebuild for the future.

Donation of Crutches for Haiti

2010-02-23T15:09:00.000-08:00

Read the full article from the Tri-City Herald

Double Harvest Ward

2010-02-22T07:56:00.000-08:00

This is the other ½ of the ward at Double Harvest. Notice the unusual wheelchairs.

One Month Since the Earthquake

2010-02-22T07:48:00.001-08:00

This man's femur was crushed by the bricks that fell on him one month ago when his home collapsed. One month is a long time to be bed ridden, waiting for help.

Volunteer Groups Forming Long-term Outreach Plans

2010-02-18T10:27:00.000-08:00

Dr. Zirkle and SIGN CEO Jeanne Dillner reported that members of Medical Teams International (MTI) attended a meeting last Saturday of volunteer health teams at the campus of the International Christian School in Port-au-Prince. The campus, five acres in all, is filled with tents housing U.S. military and medical teams who have come from all over the world to help out in Haiti.

Requests go out on a nightly basis from school staff for medical help to treat the injured. Those requests are answered by the leaders of volunteer teams who are providing doctors, nurses and other medical personnel. Jeanne said this “new avenue of teaming with other organizations will provide further outreach opportunities for volunteer groups in Haiti.”

Along those lines, MTI developed a 48-hour transportation plan to get volunteers to all of the places where they are working around Port-au-Prince. MTI is also working on an organizational chart assigning key functions of various people on its team, forming the basis for the beginning of a long-term response plan in Haiti.

Encouraging News In Haiti

2010-02-18T10:19:00.000-08:00

After treating patients with femur fractures at St. Francis Hospital, Dr. Zirkle and SIGN CEO Jeanne Dillner had the opportunity to visit Adventist Hospital to conduct follow-up visits on patients they had treated earlier.

“We saw many SIGN patients who were all doing well, ambulent with crutches, well enough to return home,” said Jeanne.

Unfortunately for many patients, there is no home to return to, only temporary tents at the hospital. The tents at the hospital provide much better protection than the makeshift tents that are outside. The tents, however, are in short supply. And those lucky enough to have a tent will still be vulnerable to severe weather conditions such as when heavy rains batter them during the upcoming rainy season.

However, according to Jeanne, a solution may be available.

“I met a man from Holland who has made an excellent design for a small concrete house which would provide shelter for a family and could withstand both eartquakes and hurricane,” she said. “He estimates that it would cost only $4,000 and the future owner of the house could participate in its construction. He thinks it would only take 2 to 3 weeks to build. This was so encouraging.”

Surgery At St. Damien Pediatric Hospital

2010-02-16T10:14:00.000-08:00

As with most of the hospitals we've been to, St. Damien was not set up for orthopaedics. Thanks to the efforts of Bob Caudel, Tom green, Lyle Sorenson and scrub nurse Mary, their operating room is well organized and well supplied. They were able to get a lot of orthopaedic equipment donated and have worked very hard to get the OR organized. See the above link "Locations in Haiti" for a look at where this hospital is located. "St. Damien Hospital is the only free pediatric hospital in Haiti. It is funded through donations from benefactors all over the world, primarily in Europe and the United States." Read More

Life Outside

2010-02-14T23:12:00.000-08:00

This is Peterson. He survived along with his sister and eight year old brother but they lost their mother and father. The other two are brother and sister. They live on hospital grounds with their mother, two other siblings and 80 yearold grandmother who received a SIGN nail. Their house was destroyed so now they live in a tent.

This 16 year old girl has a head injury and is blind in one eye. This "beauty parlor" is just another indication of how people are coping with life as it now is.

2010-02-14T22:05:00.001-08:00

These operating rooms were under construction before the quake. The shock trauma gruop is under contract with Catholic Releif Services to provide ongoing orthopaedic care. They set up the operating room and have developed systems which bring consistency of treatment and administration from week to week as surgical groups rotate through. This young medic does what he can to keep young children entertained.

This is what is left of the six story ward that housed the recovering patients nursing students and faculty. They are all still buried in the rubble. The odor is distinct. All the senses are sombered. There were six operating rooms. This is the door that patients were transported in an out of.

2010-02-14T21:54:00.000-08:00

Quebec set up a pre-op tent and the French outpatient care.

This is one of hundreds of spontaneous tent cities that have sprouted up throughout Port-au-Prince.

Back In Port-au-Prince

2010-02-12T15:41:00.000-08:00

Today is the one month annivesary of the earthquake. The government has put on a three day time of mourning. Patients awoke this morning to a national prayer service on the radio. They joined the radio in singing hymns. A touching sound to the American nurse who has been helping here for the past week. Please continue to pray for the physical and emotional healing for the hatian people

Today we arrived at Port-au-Prince around 1pm. First stop was Kings Hospital where we had done several SIGN cases. We talked with the CEO Dr Junie. She thanked us for the help we gave during the first few weeks after the eartquake. She said that now in her hospital she isn't seeing anymore eartquake injuries. She told us that she hopes we can succeed in locating and working with the Hatian orthopaedic surgeons. She told us how much she valued the training that the missionary doctors had given her early in her career. It was clear that she did not see a need for us at her hospital

We then visited the Double Harvest compound. I will write more about this later but they have this wonderful program where they grow food raise chickens and goats that feed all the folks that live on the compound. Prior to the quake they operated a day clinic. This has been turned into a hospital with 2 ORs. They were asking MTI to connect them with SIGN because they have some femurs that need fixing. We hope To go there tomorrow.

Students Raise $10k For SIGN's Work in Haiti

2010-02-12T13:02:00.000-08:00

Friday, Feb 12th, Dr. Zirkle and Jeanne Dillner arrived in Port-au-Prince to rejoin the dedicated medical teams working there to treat the many remaining victims of the earthquake. Meanwhile back home on the same day, an excited crowd of students at White Bluffs Elementary school presented SIGN with a check in the amount of $10,875! Congratulations to this awesome group of young people and thank you from all the staff at SIGN!

SIGN To Help Rebuild Orthopaedics In Haiti

2010-02-10T12:33:00.000-08:00

"The purpose of human life is to serve and to show compassion and the will to help others.” Albert Schweitzer

Dr. Zirkle and Jeanne Dillner return to Port-au-Prince on Friday, February 12, 2010. Their two predominate goals are to:

Continue to provide training on SIGN technique and deliver orthopaedic implants to at least 3 new hospital sites.
Gather more information about the orthopaedic medical system within Haiti in order to further develop a longer range plan for orthopaedic care beyond the current influx of volunteer surgeons and medical personnel.

They will be working in conjunction with representatives from Medical Teams International (MTI), World Relief, University of Maryland, Cooperacion Ortopedica Americano Nicaraguense (COAN) and others to achieve these goals. They express their gratitude to these organizations and to Missionary Flights International as well as Missionary Aviation Flights for their assistance with travel and other logistics necessary to complete their mission.

SIGN is dedicated to rebuilding orthopaedic capacity in Haiti now and into the future. Please click on the Donate button to support our mission in Haiti.

Regular updates from Haiti to the SIGN website and blog will resume on February 13th.

Radio Interview with Dr. Zirkle on ReachMD XM Radio

2010-02-09T12:22:00.000-08:00

Listen Now

Program Description

Several weeks after the devastating earthquake in Haiti, we revisit the medical response with three physicians, all with different specialties and all with a deep connection to Haiti. Hosts Dr. Matt Birnholz and Dr. Michael Greenberg speak with Dr. Anthony Alessi, host of ReachMD's NeuroFrontiers and a practicing neurologist, currently in Haiti on a medical mission. We also also speak with Dr. Lewis G. Zirkle, Jr., an orthopedic surgeon who recently returned from Haiti, where he has introduced the SIGN (Surgical Implant Generation Network) program. Additionally, our hosts speak with Dr. Daniel Fitzgerald, from the Weill Cornell Medical College, about his work with Gheskio Relief in Haiti.

SIGN Staff Returning To Haiti This Week

2010-02-08T09:13:00.000-08:00

Less than two weeks after returning from Haiti, SIGN is finalizing plans for a second, 10 day trip to the earthquake-stricken country.

Dr. Lewis G. Zirkle Jr. and SIGN CEO Jeanne Dillner are scheduled to leave Thursday, February 11 with a team from the University of Maryland. While in Haiti, they will be working out of four hospitals where they will train surgeons in the SIGN technique. They will also set up new SIGN clinics that can continue to treat fracture patients long after the SIGN team returns home.

Four additional SIGN clinics were established during the January 18-29 visit to Port-au-Prince. SIGN headquarters is currently receiving orders for medical supplies that will be shipped to Haiti in support of our ongoing work there.

Please continue to donate as your gifts are the vehicle of our mission, "To Create Equality of Fracture Care Throughout the World."

Serving In Haiti - In Their Own Words

2010-02-04T12:28:00.000-08:00

These two surgeons have each shared their personal journals in the hope that others will be inspired to serve and to give. In these pages, you will see and hear about treating earthquake victims from the personal perspective of doctors who are doing so.

Dr. David Hooper | Dr. Robert Caudle

From the Seattle Times

2010-02-03T08:24:00.000-08:00

This Seattle Times article is a good report from two returning orthopaedic teams that summarizes the great need remaining to be met in Haiti. Each new program that SIGN establishes costs $25,000 to equip the surgeons with implants, instruments and training needed to fully implement the SIGN technique.

Help SIGN help the people of Haiti - Donate Now!

SIGN Continues To Preserve Limbs

2010-02-02T13:44:00.001-08:00

"Life is an exciting business and most exciting when lived for other people." Helen Keller.
These x-rays reveal the desperate need for expanding the SIGN IM Nail System in Haiti. This woman's fracture cannot be healed with external fixation alone. Dr. Robert Caudle sent these x-rays to us to show the need for the SIGN IM Nail System in St. Damian hospital where he has been working for the past week. His organization, Cooperacion Ortopedica Americano Nicaraguense (COAN), usually serves Nicaragua, however, his colleges felt the call and have been working alongside Haitian medical personnel to provide healing for their fractures. The SIGN IM Nail System they requested will arrive on February 3rd. Read Dr. Caudle's journal .

Even as we were boarding the C-5 for our return flight to the USA we were already planning our return to Haiti. Our job isn't done until we assure ourselves that surgeons have the equipment they need to treat these terrible fractures. We will always remember the patients suffering from the emotional trauma of lying under rubble, waiting to be rescued. We will carry with us, too, the memories of patients with physical trauma in the form of severely broken femurs and tibias which, left untreated, will leave them permanently disabled. One patient told us that she was injured as she ran down the stairs of her house. She described the terror she felt as the walls tumbled down around her entrapping her for several hours until she was rescued by her family.

Dr. Zirkle and I spent the weekend preparing for our return to Haiti and arranging for the SIGN equipment to be sent out to hospitals in Port-au-Prince and surrounding areas affected by the earthquake. Orthopaedic surgeon Anthony Brown, a former SIGN board member, has been in Haiti for more than a week. He started out in Limbe, but the mass of patients is actually located in Port-au-Prince and surrounding suburbs. He connected with Tim Kostamo, a Canadian orthopaedic SIGN surgeon, who is working with the Canadian Medical Assistance Team in Leogane. Tim has worked with SIGN in the past in Banda Aceh. Anthony is on his way to deliver the SIGN system and to perform surgery which will be a huge help in covering the backlog of patients. The SIGN IM Nail System is so useful to the surgeons because it does not require power in order to conduct the surgery. Electrical power is still irregular in Haiti and most of the places we worked in received their power from diesel-run generators. Early on the diesel was hard to get so they limited the hours of power. Medical Teams International had access to a truck which they used to transport diesel they purchased out of the Dominican Republic. Most operating rooms have windows so we could operate by sunlight, at one point as dusk fell, we used a flashlight to give the surgeon the light he needed to confirm reduction and finish the SIGN surgery.

Your gifts to the SIGN Haiti project will go directly to providing orthopaedic training and equipment to treat the injured patients. SIGN is committed to the Haitian people and will continue to give orthopaedic training and equipment to the Haitian surgeons as their medical system is restored.

The Ride Home

2010-02-01T07:13:00.000-08:00

Patient Care

2010-02-01T07:06:00.001-08:00

This is the little girl whose house collapsed around her. A C-Arm was used in this case to confirm that the interlocking screw was in place. With 2 weeks having passed now since these injuries occurred, fractures are starting to stick. Distractors will be needed soon.

On Board the USS Comfort

2010-02-01T06:42:00.000-08:00

This is where sterilization of implants and instruments take place.

Training took place where ever and when ever the opportunity occurred.

Welcome Home!

2010-01-29T12:48:00.000-08:00

Dr. Zirkle and Jeanne Dillner are scheduled to arrive back in Pasco, today at 2 p.m. PST.

On The Tarmac - Coming Home!

2010-01-28T12:54:00.000-08:00

Teams Carry Out Mission With Compassion And Respect

2010-01-28T08:16:00.000-08:00

We are waiting on the ramp to get a helicopter flight back to Port-au-Prince airport. Yesterday we worked until 2 a.m. doing five SIGN surgeries. All were Haitian patients injured in the earthquake. One young woman was injured as the three-story building she lives in toppled down upon her as she was trying to escape down the stairs. She was fortunate. Her family extracted her that day.

We are very impressed with the surgeons, nurses and surgical techs who've been working 16 hours a day for more than a week treating some of the worst fractures and soft tissue injuries they've ever seen in non-war times. They treat the Haitian patients with respect and compassion. Navy personnel with Haitian language skills were brought on board to translate and advocate for the patients.

Captain Daniel Unger, chief of orthopaedics for the U.S. Navy Medical Corp, set the tone by remaining focused through the night. He was back at it at 6.30 a.m. to conduct the morning planning meeting.

Please keep all members on board the USS Comfort in your prayers. They believe in their mission of healing and are putting 110 percent out to treat every possible patient.

Jeanne Dillner, SIGN CEO

SIGN's New Partner - The US Navy!

2010-01-27T08:41:00.001-08:00

Monday evening, SIGN board member Dr. John Staeheli shared with me an email conversation he was having with a surgeon aboard the USS Comfort. The surgical staff there was having trouble keeping up with the number of femur cases due to a lack of C-Arms typically used for real-time imaging during implant operations. Dr. Staeheli informed them that The SIGN IM Nail System does not require a C-Arm.

This of course was great news and prompted the surgeon to write and request Dr. Zirkle and myself to come aboard the USS Comfort to demonstrate the SIGN technique. Today there are five cases lined up, during which Dr. Zirkle will train their surgeons in the SIGN Technique. We will leave the surgical instrument sets onboard so they can continue to treat the Haitian earthquake victims.

Last night we heard that the USS Comfort has treated some 300 patients afflicted with various injuries. We have handed over enough SIGN equipment for them to do 45 cases.

Yes the helicopter ride was a thrill! I was surprised at how smooth the ride was. I was so focused on getting the Twitter photo of Lew and I that I didn't even realize we had lifted off.

From the air you can see more of the devastation. This view is much less personal then the images we saw while driving from one hospital to another.

Will write more later. Wake up call just exploded from the loud speaker. Time for chow.

Jeanne

SIGN Enroute To The USS Comfort

2010-01-26T12:06:00.001-08:00

Staying In Touch With Team Back Home

2010-01-26T10:26:00.000-08:00

A New Day In Haiti

2010-01-26T08:49:00.000-08:00

"The Three Musketeers" Anesthesiologist, Ashok Shroff with Dr. Zirkle and SIGN CEO, Jeanne Dillner. Ashok is leaving us soon and will be greatly missed.

Thank You Ashok for giving of yourself to come to the aid the people here.

Patients are now starting to be treated by local medical staff.

Another Day In The OR

2010-01-26T08:46:00.000-08:00

Scrub Nurse Jeanne preparing for surgery and Dr. Junie

This fracture, typical of earthquake victims, has many bone fragments.

In The Recovery Room

2010-01-26T08:32:00.000-08:00

Left: This woman can go home just as soon as she can walk with crutches.

Right: This woman is 8 months pregnant and already walking following surgery.

"I Praise God for you Dr. Lew. God used you to help me!"

Its All About Patient Care Now!

2010-01-25T11:41:00.000-08:00

Dr. Tim Brown and Dr. Zirkle repair the femur of young woman whose leg was crushed in the earthquake.Supplies are on hand and the OR is in full swing.

This young woman suffered a distal femur fracture.

Dr. Zirkle met with nursing staff to discuss todays case load while these patients lay waiting for treatment.

SIGN & LLU at Hopital Adventiste d’Haiti

2010-01-25T09:11:00.000-08:00

Dr. Zirkle and Jeanne Dillner at Adventist Hosptial. This picture was taken by LLU staff who have posted many other great pictures on their blog as well. There is a link in our Partners section.

"We were blessed with the arrival of Dr. Lew Zirkle of Sign foundation an innovator in orthopedic implants for the developing world. With Dr. Zirkle’s assistance and equipment the surgical team tackled our pending femur fracture patients." LLU Blog

Badly needed surgical supplies arrived this morning!

2010-01-25T08:04:00.000-08:00

The US Coast Guard provided helicopter delivery of a new anesthesia machine donated by Hope Force. While residents assist with unloading this precious cargo.

The US Military is providing much needed assistance in the distribution of medical supplies. Here they help with the unloading of our 9 pallets of surgical supplies that arrived in PaP at 3 a.m. this morning. Great Teamwork! Thank You Acumed, DePuy Ace, KCI, Stryker Corporation and MTI!

Smiles From Haiti

2010-01-24T09:48:00.001-08:00

Dr. Zirkle and nurse Lisa examine 13 year old Joulet before surgery to treat his fractured femur.

Sunday Morning in Port-au-Prince

2010-01-24T08:59:00.000-08:00

Future president of the Orthopaedic Trauma Association watches a SIGN case before heading to St. Catherine's Hospital.

People take whatever transportation options are available.

Prayer Requests

2010-01-23T18:15:00.000-08:00

We appreciate everyone's prayers. We spent last night doing surgery until 4 a.m. then slept on a cold concrete floor. Pray for good sleep tonight and wisdom about where to take SIGN equipment next.

I was kissed by the head of logistics this morning when I told her we were from SIGN! It's an odd feeling to walk into a five hundred bed hospital and receive so much gratitude by the person who is policing the entrance and thus not even a surgeon.

The US Adventist surgeons were eager to scrub with Dr. Zirkle today. We made the decision to leave by 4 p.m. today so that we could sleep on mattresses tonight but plan to return here tomorrow as the need is so great.

A Time To Play

2010-01-23T18:04:00.001-08:00

Dan from Medical Teams International takes some time out to play with Haitian orphans.

It Takes A Can Do Attitude

2010-01-23T12:16:00.001-08:00

The sterilizer being used to sterilize the SIGN Instrument Set broke so we are using a "field sterilizer" now, other wise known as a pressure cooker!

Dr. Nelson and Dr. Duane Carlson work simultaneously on the next fractured femur case.

Sign cases like these line the entry to the operating room.

Training In New Recruits

2010-01-23T11:58:00.000-08:00

Volunteer surgeons shown here do their first SIGN case under the watchful eye of Dr. Zirkle. These new SIGN surgeons will continue on their own with the remainder of the cases.

This is the SIGN model in living color, supplying instruments, implants and knowledge to surgeons working in the developing world, in the midst of disaster relief, and meeting the epidemic of Road Traffic Accidents head on.

Training like this multiplies SIGN's impact around the world and is why SIGN has been operating in Haiti since 2006.

A New Day At Hopital Adventiste d’Haiti

2010-01-23T11:28:00.000-08:00

SDA's Dr. Scott Nelson, the first orthopaedic surgeon to start work in Haiti following the quake is joined by Dr. Lewis Zirkle as they begin their day in this outdoor operating room.

Ongoing assessments of structural problems created by the powerful aftershocks and predictions of coming seismic activity are driving many care providers to abandon existing medical facilities and to opt for outdoor alternatives such as this.

This x-ray, typical of an earthquake fracture patient, is the first of 11 cases waiting at Adventist Hospital, Hopital Adventiste d’Haiti as it is called in Haiti.

Follow SDA's story as well at www.lluinhaiti.blogspot.com

In this photo you can see the "new normal" for many families, living in tent cities where they are doing everything they can to support recovering family members.

A Very Long Day

2010-01-22T23:12:00.001-08:00

10 p.m.
Surgeries are continuing long into the night. Jeanne reports that they will continue treating an additional 6 patients at Haitian Community Hospital yet tonight.

Patients lie in makeshift recovery rooms until they are able to leave.

Conditions require conversion of any and all space for the purpose of patient care.

Keep On Truck'n

2010-01-22T14:11:00.000-08:00

Update on our shipment: Just left Salt Lake City headed for New Orleans. Should be in Louisiana by late tomorrow.

The donated jet has removed passenger seating to make room for all 9 pallets.

Arrival time in Port-au-Prince: 3a.m. on Monday! That works :)

Team Work Extraordinaire!

2010-01-22T13:30:00.000-08:00

Synthes external fixator being used by surgeons from Mississippi at Haitian Community Hospital.

Patient had a broken femur one week old but will walk again!

Nurses who are qualified to assist with orthopaedic procedures are in short supply. Lucia, shown in this picture, came from Cure International Hospital in the Dominican Republic at the request of Scott Nelson. She is a gem!

Update from Dr. Scott Nelson At SDA

2010-01-22T08:54:00.000-08:00

Sorting though recent shipment of SIGN implants.

There are currently 20 cases waiting!

Friday, Mid-day Report

2010-01-22T08:44:00.000-08:00

We are currently at Haitian Community Hospital (HCH), enroute to SDA. Within minutes of our arrival here, Dr. Zirkle was involved in two separate surgical cases. HCH is a much busier hospital than previous location. More to come soon.

On The Move

2010-01-22T08:35:00.000-08:00

Dr. Zirkle and Jeanne are now moving from Kings Hospital to the SDA Hospital sponsored by Loma Linda University to assist orthopaedic surgeon Dr. Scott Nelson. Scott has been treating patients there since the ground quit shaking.

Our team effort with MTI is focused on creating multiple, well equipped and staffed, orthopaedic clinics in several locations. This activity is designed to create a long-term sustainable treatment plan that can then be staffed by medical personnel rotating into the county in the weeks and months to come.

The bags being loaded into this vehicle contain surgical implants that just arrived yesterday. The external fixator kits provided by Randy Huebner from Acumed in Portland are also here now.

As we made the 1 hour drive to SDA hospital, we passed numerous neighborhoods, flattened by the earthquake. And then, a sign that life goes on… just passed a tennis court where a doubles game was being played! Another positive sign; each day we are in country, we see new side walk markets opening.

SIGN & MTI Supplies Are On The Way!

2010-01-22T08:00:00.000-08:00

At 8 p.m. Thursday night this amazing scene unfolded at SIGN’s headquarters in Richland, WA! This truck, carrying 6 fully loaded pallets of emergency medical supplies, drove away from our loading dock heading for Portland, OR.

In Portland, they picked up another 3 pallets from our partner Medical Teams International (MTI).

At time of this writing, the driver reports they are making great time enroute to New Orleans, Louisiana.

The entire load will then be transferred onto a private jet, donated for relief work in Haiti. The plane is scheduled for departure on Sunday!

These supplies will be on the ground in PaP by Monday morning! Amazing team work! Thanks to everyone who made this happen!

Patient Care Is Now Everyone's #1 Priority

2010-01-21T14:19:00.000-08:00

Dr. Zirkle is working alongside other orthopaedic surgeons to maximize treatment for as many patients as possible.
SIGN continues to make headway into securing transportation for 6 pallets fully loaded and ready for shipment into Haiti.This shipment contains a wide assortment of supplies and equipment badly needed by surgeons to treat the flood of patients and to minimize the need for amputation.

Transportation will continue to be a financial challenge well into the future.

Please donate today to keep these supplies moving.

SIGN Surgical Sets Arrive in Haiti

2010-01-21T11:31:00.001-08:00

These boxes contain two additional sets of surgical instrumentation needed to perform SIGN's IM Nail Insertion operation. There were also 100 implants included. All total, the tools needed for two teams of surgeons to treat 100 fractures that otherwise would be amputations. Thanks to all the volunteers and donors that are making this happen!

Kiwanians Gave, Now It's Coming Back

2010-01-21T10:39:00.000-08:00

SIGN received this e-mail yesterday from two of our SIGN surgeons at the Davao Medical Center (DMC) in the Philippines. It captures the spirit of generosity and goodwill of our surgeons throughout the world and we wanted to share it with all of our supporters. DMC-SIGN center was funded by the Kiwanis International Foundation and dedicated by Nelson Tucker, the Kiwanis International President.

Dear Friends of Surgical Implant Generation Network (SIGN),
Greetings and good day.

At present Dr. Zirkle is in Haiti. He has brought SIGN with him. He has brought hope to yet another group of people in need. He is helping them as he has helped us in the past and in the present.

I am like you, a friend of SIGN, and most probably also like you, a beneficiary of SIGN. Not only have our patients benefited from SIGN, but so have we. SIGN has changed the lives of thousands, patients and doctors alike. We have been on the receiving end for too long. Now it is time to give something back to SIGN.

Last year, SIGN celebrated its 10 year anniversary and has had over 50,000 SIGN patients under its records. We have been part of that. We know how much SIGN and Dr. Zirkle has helped us all these past years.

As a fellow friend of SIGN, we are urging other friends of SIGN from all around the world to give patronage and recognition to the man who has changed our lives. We are writing every week to the Oprah show, a well-known TV show in the United States that can also be seen around the world. We are writing to the producers of that show. We want you to tell them of what SIGN and Dr. Zirkle has done for us. We want you to tell them that SIGN has changed our lives for the better. We request you to write to Oprah about how SIGN has made a difference in the lives of your patients. www.oprah.com

Please help us let the world know. Let us give back to SIGN and to the man who has already given us more than we can ever repay him.

Thank you.

Dr. Bhaskar Pant
Dr. Luigi Andrew Sabal
Friends of SIGN
Davao Medical Center, Philippines
www.orthodavao.com

Aftershock Update

2010-01-20T12:14:00.000-08:00

The tremor that shook Port-au-Prince today was actually a 6.1 magnitude aftershock. Jeanne said the patients at King’s Hospital all left the hospital and do not want to go back.

Jeanne was able to assist in a surgery today in which a SIGN implant was used to treat the fractured femur of a female patient, five months pregnant, injured during the January 12 earthquake.

Jeanne said the patient, Darlene, is happy with the surgery, but wants to recover outside because she is scared to be inside the hospital building. She said she saw buildings crumble down as she was carried out from the rubble during the first earthquake.

Alarm Clock - Haitian Style!

2010-01-20T08:08:00.000-08:00

The SIGN team awoke at 6 a.m. this morning to the word “earthquake,” and not the one that occurred on January 12. A small tremor was felt and everyone evacuated. Everyone is fine, but they are now wondering if the hospital they are working in has been impacted, not to mention the state of mind of the patients.

“It took several days for the Medical Teams International (MTI) crew to convince patients it was safe to stay inside,” said SIGN CEO Jeanne Dillner this morning. “We’ll get there in about an hour” to assess the situation.

Wednesday morning’s tremor followed a power outage the day before. The lights went out in King’s Hospital Tuesday during surgery, but that didn’t stop Dr. Zirkle and the rest of the SIGN team from carrying on. “I asked for the flashlight that Frank (Faultersack, SIGN engineer) got for us and we kept going,” said Jeanne. They were able to do two surgeries on Tuesday.

King’s Hospital had been undergoing a renovation prior to the earthquake and wasn’t ready for surgical procedures when SIGN arrived this week. Jeanne said the folks from MTI did an “amazing job” getting it set up and running. “I was put in charge of the OR so I spent the morning getting our stuff set up and then worked on organizing the medical supplies,” said Jeanne. “I was really getting in a groove when Lew asked me to scrub!”

Kings Hospital in Port-au-Prince

2010-01-19T07:32:00.000-08:00

First Surgical Case Complete!

Jeanne Dillner, SIGN CEO and Dr. Zirkle, SIGN Founder, along with other medical NGOs, are currently working out of Kings Hospital in Port-au-Prince. Equipment is being organized and prepared to begin surgery. The hospital operating room just went online yesterday and we are expecting many cases.

King’s Hospital has 300 beds to treat the most seriously injured patients. Jeanne has e-mailed SIGN with instructions to ship out more instrument sets and implants, along with other medical supplies. She reports they are receiving a massive influx of patients.

SIGN is working directly with Medical Teams International. Another humanitarian organization, World Relief, is also working out of King’s Hospital providing medical aid to the earthquake victims.

Meanwhile, SIGN is still awaiting word on the availability of a military jet to pick up supplies in Pasco, Washington, and fly them directly to Port-au-Prince. At the moment, SIGN has instructions to send about 2 tons of medical supplies to Haiti.

Behind The Scenes

2010-01-18T17:09:00.000-08:00

SIGN is currently awaiting approval from USAID for access to a U.S. military jet that would transport just under two tons of medical supplies to Haiti.

Dr. Andrew Pollak of Baltimore, Maryland contacted the office of Sen. John Barrasso of Wyoming, which, in turn, contacted USAID regarding the availability of military aircraft to assist SIGN in getting much-needed supplies to Port-au-Prince.

In the meantime, we are also working on securing the use of private aircraft to carry supplies to the disaster-stricken countries.

Dr. Zirkle and SIGN CEO Jeanne Dillner are on the ground in Haiti assessing available hospitals to determine which ones are best suited to perform surgeries on the earthquake victims. Once a hospital has been selected and a list of needed supplies is provided to SIGN headquarters in Richland, Washington, aircraft – whether private or military – will be scheduled to arrive in Pasco to transport the supplies over to Port-au-Prince.

At Port-au-Prince Airport

2010-01-18T13:04:00.000-08:00

Dr. Lew Zirkle and Ashok Shroff (anesthesiologist)at airport in Port-au-Prince

On The Way!

2010-01-18T12:46:00.000-08:00

A spirit of excitement and nervous energy surrounds us as we wait for our plane to take off in Fort Lauderdale and fly to Port-au-Prince. There are about four different teams with us on this flight and all are bringing medical personnel. They include pediatric surgeons, EMT nurses and other personnel. Another group is with an orphanage. There have already sent tents ahead which will be stationed at a soccer field.

It’s still dark now. There were 35 of us vying for a seat on two propeller planes. It was actually a well-organized process weighing bags and deciding what gets left for the cargo flight that will follow us. Two of our bags will follow two hours after our plane leaves. MFI kindly provided water, Gatorade and breakfast bars. They were very much appreciated as we left the hotel at 3:30 a.m., too early for the 6 a.m. breakfast.

Ashok and Lew have been discussing plans for surgery. Please continue to pray. We are all lacking sleep and need to be clear headed upon landing in Port-au-Prince.
We are all grateful to the tremendous support given to us as we prepared for our trip to Haiti during the past week. We had dozens of community members call to volunteer and the donations we received locally as well as from around the country was overwhelming. Our greatest need remains financial contributions as we will continue to ship medical supplies to Haiti in the weeks and months to come.

You can donate now by visiting our website at www.sign-post.org or send a check made out to SIGN to 451 Hills Street, Suite B, Richland, WA, 99354.

SIGN Team Ready for Departure To Haiti

2010-01-16T13:22:00.000-08:00

SIGN personnel and volunteers are making final preparations for a humanitarian mission to Port-au-Prince, the site of the catastrophic earthquake that has devastated Haiti. SIGN was contacted by Medical Teams International (MTI) out of Portland within an hour of news of the earthquake. MTI asked to partner with SIGN to provide medical and orthopedic aid the earthquake victims. SIGN has been working with other nongovernmental organizations to coordinate first response assistance.

SIGN Founder and President Lewis G. Zirkle Jr., M.D., and CEO Jeanne Dillner will fly Sunday to Fort Lauderdale before connecting with a charter plane to Cape Haitian. Joining them will be anesthesiologist Achok Shroff, M.D. They will be taking the SIGN system which can be used without operative x-rays to treat fractures of the femur, tibia and humerus. MTI is focusing on the immediate care of the injured, as well on-the-ground logistics. SIGN is grateful for the outpouring of donations and volunteers. Corporate partners such as Stryker, DePuy, Acumed and KCI, as well as local organizations and pharmacies have donated supplies. Local residents have donated their time and money to help us treat the injured and poor in Haiti. We are also teaming with CURE and Loma Linda University to get orthopaedic surgeons, medical personnel and supplies to the hospitals still functioning in Port au Prince.

Conditions are still changing in Haiti and we are preparing for the different types of wounds, facilities and personnel that may be available. Many orthopedic surgeons, anesthesiologists and other talented medical personnel have volunteered their services. As logistics improve, these volunteers will be put on a rotation.

At last, we received the first word today from one of our SIGN surgeons working in Haiti. Dr. Serge Sabalat reported that he is in the streets of Port-au-Prince helping victims any way he can, despite the lack of medical facilities, equipment or personnel. We were relieved to hear from him and assured him we were on our way with supplies, equipment and personnel.

We ask for your prayers and contributions as we prepare for a long-term humanitarian effort. SIGN expects to have a disaster relief presence in Haiti for at least the next six months. Our biggest needs now are financial contributions to pay for the enormous shipping costs and travel expenses for our medical volunteers.

You can donate now by visiting our website at www.sign-post.org or send a check made out to SIGN to 451 Hills Street, Suite B, Richland, WA, 99354.