Haiti Journal by Bobi Wall, NP
I found out Saturday, January 16 that I had been approved to go with a team of thirteen others to help with Haiti earthquake relief. I just had two days to pack and prepare for this unique and challenging experience. The others on the team were: an anthropologist from New York, an LSW, an MPH, two security people from Wisconsin, one PA from Colorado and another from Jacksonville, a first year resident from Brown University, one trauma surgeon from UF Shands, (better known to journal readers as Dr. Joan Huffman, Editor-in-Chief) one trauma psychologist, two nurses and me, the NP. Some of our team had been to Haiti before and had worked at clinics there. Some were new to the whole experience, like me. We worked on arranging medical supplies through Project Blessing before we drove on Tuesday, January 19 to Miami for a chartered flight to Haiti.
One week after the earthquake, we were on a flight headed to Haiti to provide much needed relief assistance. Flying in we could not see much due to dust clouds. As we landed, the airport scene was overwhelming. Military helicopters were everywhere. There were tents erected Iran, Mexico, and France and many Brazilian planes. We passed through the airport building and I noticed water all over the floor as well as cracks and sagging ceilings.
As we approached the other side of the building, hundreds of faces lined the perimeter of the fence. All of those people were shouting to get the job of helping arriving relief workers with their bags. Pallets of supplies lined the runway, and we lost our 10 boxes of medical supplies in the disorder. All we had left were the supplies we each brought, our surgical instruments and a saw for amputations.
We took a van to the clinic at Hospice St. Joseph. At first I thought the destruction seemed mild, but as we left the airport area I saw the destruction was rampant. When we got to St. Joseph’s, the courtyard where we were to set up and clinic and work was too small and it was filled with trees and a cracked cement slab. The clinic location had to change. We also changed our sleeping accommodations from an apartment floor to inflatable mats outside on the ground. There were too many aftershocks, so a clear space on the ground was safer.
The first day of clinic, we found some bags of meds. One PA stayed at the courtyard and set up a clinic while one surgical group went out in the surrounding area looking for those needing medical care. We had acquired 12 volunteers for first responders and translators at St. Joseph’s from the pool of their workers who all lost their homes. Many also lost family.
I was a part of the second team (an intern, a nurse, and some volunteers). We hiked about a mile. We found people who had numerous infected wounds and fractures. Someone had done a lot of these people a disservice and sutured the wounds closed. Much of my day was spent cutting sutures, debriding, cleaning and redressing wounds. There were lots of infected scalp wounds. I mobilized a volunteer to cut bamboo and make me some splints for fractures. We wrapped them with ace bandages, had canes made out of bamboo and sent the people on their way with ibuprofen. We did not send anyone away without giving them some medicine. We had to decrease the frequency of administration as our supplies were limited at this point. I also utilized the psychologist after I saw some folks who had great need of him. The temperature was in the 90’s to 100 during the heat of the day.
At one point an aftershock occurred and the people yelled,"shake, shake, shake" and ran into our one-room clinic. The people waiting to see us were endless. We saw over 200 at this clinic that day. One of the most frustrating parts was the flies crowding the wounds as we tried to treat them. At 3 p.m. we wrapped up our clinic, packed our supplies, and set off to return to Hospice St. Joseph. The route was uphill and considerably dusty through tent cities. I wore a mask and Vicks to filter the dust as well as the odor of decay.
As I climbed I began to wheeze considerably. Taking off the mask did not help. Finally I was given a chair at one of the tent camps and I sat and wheezed while the intern ran to try to retrieve an inhaler. At one point I thought I might be left here until after sunset to try to walk again. Unfortunately, we had no inhalers, which as the days went on, was an absolute essential for a lot of the children. The van made it part way, and I was able to scramble to its safety after a brief rest.
We rethought day two as the surgical team did not see as many people. Dr. Huffman did amputate two fingers from a lady, using only local anesthetic. We combined the two teams and headed en masse to our original site. Now we had two tent coverings. This freed us up to concentrate more in each of our own areas and to consult quickly with one another. We started to see more children with headaches and dehydration. We had rehydration packs for children and children’s Tylenol. Both days clinic was cut short as we ran out of our own water supply. It was hard to keep track of our supplies and the water kept disappearing.
The team members started to get chills, weakness and headaches. We all avoided diarrhea by taking 1 Cipro 500mg every day. We also took a daily acidophilus and malranone to prevent malaria. I got some intense mosquito bites sleeping in the open at night. We did have coils and clip on fans with repellent which helped but did not eliminate mosquitoes.
And the end of the second day of clinic we got a ride back to the hospice. When we arrived, we were welcomed with a Haitian meal of pasta and Creole sauce, cole slaw with vinegar dressing, plantains, tomatoes, and lettuce. Most people were eating now, and we paid them to help their economy, to cook for us. Yes we ate right along with them. They cleaned their vegetables with potable water and two drops of Clorox which is a standard for them.
This night turned out to be more troubling than most. We were blessed with a couple nite lites because of a revived generator which made sleep easier. The team all slept on the cement slab of ground and the Haitian volunteers also on the ground on the other side of the cement steps. Our dog, a resident mutt, chased rats away at night and the cat chased bugs.
The next day was full and we were very tired. The clinic changed to another site. We passed a much worse hit area of the city just beyond a soccer field and another massive tent city into a gated courtyard run by the sisters of Mother Theresa’s group. Stench of death was much stronger in this area. En route to this area we passed a canal with minimal water filled with rubbish which would serve as a reservoir for multiple diseases when the rains came. Large numbers of children and families came to the clinic. Today’s complaints, in addition to the ubiquitous wounds, were cough, fever, and stomach aches. Many people had not eaten in days. They had water but not much. Dust was everywhere. A lot of people also complained they were unable to sleep. Every day there were aftershocks. We had to be more creative in dealing with these complaints. Babies were listless. We started multiple IVs. On one patient we could not get an IV started so I did the old hypodermaclysis. I also saw a younger lady that had lost continence, so I referred her to Dr. Huffman and the lady was transported to the MASH hospital.
Today we began to feel more overwhelmed. The needs were so immense just for the basics of food and water. If we had those they would relieve some of the headaches and stomach aches. We also needed masks to filter dust. I am beginning to feel like I cannot make a difference.
Saturday evening, January 23, we heard Haitians singing hymns until late in the night. Even with all that has happened to them, they are steadfast in their faith. On Sunday we decided to take a break as most Haitians will not come to clinic and will observe the Sabbath instead. But even today a few needy people straggled in to the clinic. We had a girl come with an external fixator on one leg, it needed debrided, and the bone was showing through. So several of us helped Dr. Huffman debride it and cover. We only had local anesthetic, so during the procedure the girl passed out. I was holding her head and as I turned to look behind me, I was inches from the edge of a cement cliff. We all got through today.
There were a couple more days the same as before and then we mobilized the whole team and left Haitian first responders to manage the base clinic. Today we found out the newborn baby who had been in our clinic a few times, died. We are all saddened.
Our last night arrives, so we must organize some of the inventory for the next group arriving to provide medical relief. They should be in by the end of the week. We pack little of our own items and leave most of what we brought for the Haitian people.
As we return to the airport on January 26, we see the airport building is no longer open. We were given pills to deworm us before we left. The team got split up in the C17 airplane. We slept the 2-hour flight to Orlando. The Red Cross was waiting to help us. I got a tangerine from them…sooo good. We rented a car and drove to Jacksonville.
After returning, I was still on hyper alert. Diarrhea set in and my thoughts are disorganized. I cannot bring myself to download pictures yet. Some moments I want to sob. I left behind new Haitian friends. Some moments I just wish I could purge my body of this tragedy, but I make plans to return to work and my life. Yet, I am not ready or able to process all that happened to me in Haiti.
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