Over the course of a week in Haiti’s Central Plateau, a team of six physicians and medical professionals from the School of Medicine and Yale-New Haven Hospital (YNHH) provided care to approximately 400 victims of the January 12 earthquake. The team—which included an anesthesiologist, an orthopaedic surgeon, and others—worked at Hôpital Sainte-Thérèse de Hinche in the city of Hinche, about 90 miles northeast of Port-au-Prince near the Dominican border.
“We chose a poor rural hospital and for us it was the right choice,” said Gregory Luke Larkin, M.D., professor of emergency medicine. “There were no other physicians or nurses with our training there.” Although the earthquake struck Port-au-Prince, hundreds of thousands of people are being sent to other sites across Haiti for medical treatment. Hinche has an airport with a single dirt runway that will accommodate small planes carrying relief workers and supplies.
Other members of the team included Donald MacMillan, PA (emergency department); Tom Kimberly, R.N., (emergency department); Nousheh Saidi, M.D., assistant professor of anesthesiology; and Peter Boone, M.D., an orthopaedic surgeon from St. Vincent’s Hospital in Bridgeport. Ralph Jean-Mary, business manager of the YNHH emergency department and a native of Haiti, accompanied the team and coordinated the logistics of their stay. The team joined forces with Partners in Health, a Boston-based organization that has been working in Haiti for more than 20 years.
Knowing that provisions would be in short supply, the team brought $12,000 worth of medical equipment and supplies donated by YNHH, including a cardiac monitor and defibrillator. They also brought their own food and water and found a place to stay, thanks to Jean-Mary’s family. “We didn’t need to drain any of the local resources,” said Larkin, adding that well-intentioned relief workers often arrive at their destination without adequate preparation.
The group treated fractures and crush injuries, many of which were worsened by delays in obtaining medical care. Wounds that would have been minor if treated early became grossly infected, often requiring limb amputation. Sometimes surgeons had to repeat an operation, cleaning wounds in patients who had previously undergone surgery. Part of the challenge was dealing with such underlying chronic illnesses as severe malnutrition, typhoid, malaria, and anemia.
Saidi, who lived in the neighboring Dominican Republic for four years, was familiar with conditions in the region. She was able to communicate with her patients and their families in French, which is spoken by many people in Port-au-Prince. (Most Haitians speak Créole, a French-derived language.) While Saidi described the team’s work as a “drop of water in an ocean,” she was glad to be able to help some of the victims. “If the team wasn’t there I don’t know when or if they would have had surgery,” she said.
Saidi administered postoperative pain relief in addition to providing anesthesia during surgery. Since the recovery room was taken over for dialysis—a necessity in treating crush injuries—Saidi went from room to room to check on her patients. She and her colleagues could work during daylight hours only due to a lack of electricity. Once the sun went down, she was forced to use a flashlight to illuminate her way when she needed to administer medications.
Medical teams continue to arrive in Haiti, relieving one another in an attempt to stem the tide of devastation. “We handed off the baton,” said Larkin, “but the road to recovery is a long one.”