Updates from Haiti

 

 

February19, 2010

 

 

February 16, 2010

Amputations may have saved the lives of many Haitians injured by the earthquake last month, but without prosthetics or crutches, they will die anyway, said Dr. Houshang Seradge, an Oklahoma City orthopedic surgeon who just returned from the from the country.  It’s a curse,” he said. "An amputated person is condemned to death if they can’t get around to get food or water. They will perish.”  Seradge, who spent two weeks in Haiti operating on earthquake victims, hopes to help them again. He plans to return with crutches and prosthetics in coming weeks and is asking Oklahomans for help. He says tents also are needed because thousands are living with no shelter and in conditions ripe for spreading disease. Wheelchairs won’t be much help in Haiti because of the rough terrain and unpaved roads. Seradge and physical therapist Carrie Baer, both of the Orthopedic Institute in southwest Oklahoma City, were asked by nonprofit Double Harvest to treat patients with orthopedic injuries resulting from crushing. Double Harvest supports a tilapia farm, school and hospital in eastern Haiti. Because the hospital had a sterile operating room, Seradge and others would drive into Port au Prince each day and retrieve patients needing surgery.

They were loaded in the back of a truck for the bumpy ride, but none complained of their pain or discomfort, Baer said.

"These people lost so much, and they were still smiling, still trying, willing to do anything.”  Seradge described Sandina, a 3-year-old girl who was the only one in her family to be pulled alive from the rubble of their home. She lost an arm and had a crushed pelvis and broken femur. For days, she hid her face from medical staff, but slowly Seradge won her trust by offering her bits of candy. One day, she grabbed his finger and would not let go. "That was really heartrending,” he said. When the clinic began running out of crutches, they distributed them one at a time, showing patients how to walk."They were appreciative of whatever they were getting,” said Seradge, who was inspired to work even harder. "That made us wake up earlier and go to bed later.”

 

February 15, 2010

 

 

 

 

Sandina is a shy 5-year old girl.  Her house collapsed in the earthquake and broke both of her thigh -bones and amputated her right hand. When we first met her she was lying on a mattress on the floor of the graveled parking garage that had been converted to a hospital recovery wing. She was easy to spot, because the mattress she laid on was the first mattress as you walked out of the back door of the hospital. She was in a body cast, with a dressing on her right arm.  She would watch doctors and nurses, sometimes having to step over her, as they moved in and out of the hospital.

She was shy and would not speak, nor would she cry. 

 

A young lady lay by her and took care of her.  But she seemed distant from this hurting little girl and it seemed obvious she must not be her mother.

 

Sandia became my patient, as I was to take care of her amputated hand.  The amputation needed to be revised and a skin graft was needed to cover the stump. 

 

Every morning before starting surgeries, I made sure I packed my pocket with a nutritious bar.  The first morning I offered her a bar, it took me more than 5 minutes of sitting on the floor next to her before I could encourage her to take it.  I did the same every morning and every afternoon. 

 

The second day, I took her to surgery and revised her amputated arm and cleaned her wound.  When she woke up from anesthesia she was quiet again watching everyone with her wondering eyes, laying on her back in the body cast.  But this time when I came to give her a bar, she smiled at me.  I sat and watched her eat it.  Then she reached toward me and I gave her my hand.  She still had an IV in her little hand.  She held my fingers tightly. When I tried to leave, as I had to do another surgery, she wouldn’t let go.  Eventually, a translator helped me tell her that I promised to be back.  When she finally let go of my hand, she did not cry, she just followed me with her eyes and continued to smile.

 

 As I left, I asked the translator if he knew her story.  He shared with me that the lady taking care of her was her aunt.  Her 5 brothers and sisters, her patents and her grandparents all died when their house collapsed in the earthquake.  Her aunt was the only family she had left.

 

The next day, I had to take her back to surgery again to clean her wound.  Because she didn’t understand what was happening, she cried for the first time.  She lay on the operating table and kept repeating the one thing she knew and wanted.  What we all want when we are little and we hurt.  She cried  “Mama, Mama, Mama” until the sleeping medicine took affect.  As we started the surgery, we all had tears in our eyes, as we knew she would never see her mama again.

 

 

 

The next morning, when I came with her bar, she reached for my hand instead.  I sat the bar beside her and she grabbed my other hand too.  She wrapped the little fingers of her only hand around both of my index fingers.  She would not let go.

 

 

 

Sandina and I established an un-spoken bond.  She waited for me and I woke up earlier every morning to have more time with her.  The departure day arrived and I went to see her for the last time.  As she saw in my face that this would be our last visit, she reached for me and let me pick her up to sit on my lap.  It was hard to put her back on the floor and leave Haiti, not knowing what will happen to her.  I looked at her from the open yard smiling at me as I walked away.   It tore my heart having to leave her behind.  As I got into our car, I wiped the tears off my face.  I thought of her and the many children we left behind.  I silently promised myself, we would be back.

 

 

 

 

 

February 7, 2010

Lenes is a teenage boy that was dug out from under the rubble of his house.  He had a concrete column fall on him during the earthquake that shattered the bones in his knee. Without the ability to put his broken knee back in place, the Emergency Medical Services Team put him in a splint.  Worse, Lenes thought his family had all perished in the earthquake, as he could find no relatives.

 

We picked him up from Port-au-Prince during one of our daily ambulance runs that took as much as 3 hours each way.  We brought him to our facility and operated on him to fix his broken and dislocated knee.  Lenes was happy to have his knee fixed, but he was very sad for the loss of all of his family. 

 

After his surgery, Lenes was moved to the make shift recovery room next to a woman and her injured baby.  The woman immediately recognized him, and as he woke up from the anesthesia, she told him that she knew his family. She had spoken to his parents since the earthquake.  She told him that his parents had been horribly sad as they were unable to find him and after so many days, they thought he must have been buried under the rubble from the earthquake. She told Lenes that she would help him find his parents so they could be reunited.

 

Everyone that we met had lost some, if not all, of their family members trapped under collapsed homes or buildings.  To see one injured lonely teenager reconnect with his lost family seemed a miracle after such a chain of events. God works in mysterious ways bring a good ending to a sad story.  

          

 

You may recall the story of Yolanda and her struggle a few days ago….

 

Blessings come when we are about to lose hope.  Today was a better day for Yolanda.  She is a strong girl who fought hard for her life.  This afternoon, she was sitting up in bed, eating and drinking.  She smiled at us as we came to her bed to check on her.  It was such a relief , and so heartwarming to see her this way.  Her husband’s eyes reflected a deep sense of appreciation to the doctors and nurses who worked so hard with so few resources to keep Yolanda alive. Medical personnel gave Yolanda their own blood as there was not a blood bank available.  Her husband is thankful that the only remaining member of his family has been saved. Yolanda still needs one more surgery on her leg to revise her amputation.  But she needs a few days to get stronger first so her body can survive another surgery.

 

It will be a very difficult road for Yolanda as it will be for all of the Haitians that have so recently had an arm or a leg amputated.  In Haiti, to have an amputation is considered a curse.  After being in Haiti, it is easy to understand why.  They have such a difficult life just trying to survive each day. They have to walk everywhere they go.  They don’t have anywhere to go to get a prosthesis and often can’t even find crutches or a walker.  There have been so many injuries that even at Double Harvest, the crutches that were abundant in the beginning, have dwindled to short supply in only one week.  Many times we were trying to teach someone how to use only one crutch to maneuver over rocky dirt roads with only a flip-flop shoe or no shoe at all.

 

Yolanda is fortunate that she still has her loving husband by her side to help her.  But there is so much more they will need….

 

February 6, 2010

Gaston Mydream, sat on her father's lap in the sun. He treated her so gently while she waited for a couple of hours to be seen.  She is eight years old and lost her mother in the earthquake. Falling debris took a big chunk of flesh off Gaston’s leg. Her wound was wrapped at a Red Cross emergency unit and had not been changed for 2 weeks.  The little girl and her father speak no English.

 

Gaston’s father, a giant man of 6’10’’ solid muscle mass, carried her in one arm with her pillow and stuffed teddy bear in his other arm.  He put her on the exam table so gingerly and lovingly, you knew he thought of her as precious.  It seems that most of the Haitians who come with bad injuries all have the same fear, that their leg or arm will be cut off.   Despite his fear, Gaston’s father continued to smile at her to show her love and assurance.  It is an amazing scene we have observed among the chaos for these devastated people with lost family members.

 

Gaston’s wound was badly infected and she had to be taken to surgery.  I operated on her, leaving her wound open to start healing from the inside out so later it can be covered with a skin graft. Gaston and her father stayed at Double Harvest for 2 days so we could clean her wound and change her dressings daily.  Carrie and I took care of her until we taught Gaston's father how to do the dressing changes at home.  She needs one more surgery to cover the defect with a skin graft, but she has to wait for 4 days to give the infection a chance to clear up.  We gave them all of the necessary supplies and medications.

 

Before they left, the translator told me the father said that he had a small problem doing the dressing changes.  When I asked what the problem was, he told the translator that since he lost his house in the earthquake, he and his daughter have been sleeping on the ground, with the open sky as their roof.   He looked painfully sad and ashamed as he appeared to be a proud father who worked hard to provide for his family, and now he could not even give a roof to cover his daughter's head.

           

We took him away from the crowd to save his dignity, and gave him what we brought with us; a tent, dried rice and beans, towels and blankets. Carrie gave Gaston a new t-shirt, and she quickly put it on.  The father looked at Carrie and me, with a tear dropping from his eye and running down his big, powerful face.  He tapped his chest over his heart with his right hand twice gently, and then extended both of his hands towards my heart and Carrie's, saying, in broken English, "Thank you".

 

We gave Gaston a hug and shook her father’s hand wishing them well.  When we turned to go back to the clinic, our faces were wet with tears too.

        

 

February 5, 2010

 

Our days here are getting longer and longer.    We go to bed later and wake up earlier to go to care for patients we operated on and the new ones that come in every day.   Yesterday, we started at 6:30 in the morning and did not finish until 2am.   We had a very busy and emotional day.  With 2 operating rooms, the group of doctors at Double Harvest performed more than sixteen surgical cases, some very major, yesterday.  The last surgery was for a 22 year old woman named Yolanda.  

 

Yolanda lost her two children when her house collapsed in the earthquake.  She was pinned down under the rubble with her 2 children dying around her. Her husband was outside of the house when the earthquake struck but he clawed his way in and eventually was able to rescue his wife after many hours.    He had to lift a large piece of concrete that had pinned one of her legs and her thigh.  He was able to save her, but her leg was very crushed with large parts of her muscles torn away, large enough we called it a “shark bite”.   She had to be operated on several times the get her wounds clean and to possibly close the wound.  However, we were very concerned because of the way she was injured with heavy concrete laying on her leg for so long.  We knew it probably cut off the circulation to her leg causing a situation where the muscle, over time, would slowly die. 

Because her wound was so bad, she lost a lot of blood.  2 days ago, we decided she had to have a blood transfusion in order to live.  But there is not a blood bank so two of our nurses give her a direct transfusion with their own blood.   

 

Late in the afternoon yesterday, she went into shock again and we had to take her back to surgery and cut her leg off right below her hip joint.  Her blood was so low that her pulse rate went to 160 beats per minute and her blood pressure dropped to 60 over 20.  Two of our nurses and one doctor gave blood, and again, we transfused her directly.    We were all so happy to see her come out of shock.   Then, just as she was doing better, she started shaking and spiking a fever.   She was hit with acute malaria.   She was fighting an uphill battle for her life already, and now she received another blow.   She teetered on the edge, fighting for her life all night.  Her husband, who had already lost his children, never left her side.  We are very short of nurses, so the same nurses and doctors that worked all day, took 2 hour shifts throughout the night to watch her.   In the morning she was better, but still fighting for her life.

                    

 

 

February 4, 2010

Dr. Seradge’s update from Double Harvest – At 7:00 a.m., the crowd is already gathering outside

the clinic with many people still needing medical attention. Carrie is hard at work attending to wound care and rehabilitation needs of many.

The DH “ambulance” which is really a cargo truck pulls out empty, but will return full this afternoon. They will go into Port-au-Prince and surrounding areas and pick up people that still need surgeries, and bring them here.  A lot of them are coming from the hospital tent that has been set up in Port-au-Prince. There, they have a lot of patients that need surgery, but no facilities.  So patients are brought here for operations.