Trash Talk

Team 6B’s last night in Haiti

Ki jan ou rele? (What is your name?)

Our last night in Croix de Bouquets.

Today we fixed our first acute fracture, a 13-year-old who fractured his femur playing soccer.  First case we were able to use our brand new large fragment set of screws (which was complete!!) that had been hand delivered by Tony, a friend of the Van Wingerden’s, directly to our OR, compliments of Bob Caudle of St. Damien’s (thanks Scott B).  Bob and Tony happened to sit next to each other on the same plane into Haiti.  Small World.
We delivered one of patients with a slow-healing, Grade IIIB wound (which we had been using an OR suction as VAC) to University of Miami Tent Hospital at the airport.  Hopefully she will benefit from short-term VAC and skin graft.
We were able to procure a VAC machine and several sets of VAC supplies (can’t tell you where they came from as it was very “under the table”) so we are excited to be able to provide care to additional wound patients.
We were visited by an orthopedic team from Spain.  An orthopedic surgeon and nurse spent the whole day in the Phase 3 ward, measuring and fitting our amputee patients for prosthesis. They worked in 95 degree heat in long shirts, and brought in all their supplies, medical supplies and meds in 2 large suitcases.  What a blessing to these visitors and they were completely unannounced.
We had our first team casualty in the Valeri, our little sparkplug clinic/ER PA, virtually passed out from some form of stomach illness and spent the whole day in her room with the rest of the team running up IVF’s, Zofran, Protonix, Phenergen, Immodium, Cipro, and more IVF’s. Great news is she is upright again tonight and we pray she makes a speedy recovery. She is so dedicated to this place that she cancelled her flight home tomorrow to rebook a flight a week later.
We spent the evening throwing toys and Slim Jims off the back roof to a gathering of Haitian kids in exchange for them singing Haitian songs to us. Even had freshly baked chocolate cake for supper.  Had no eggs so one of the VanWingerdens’s ran across the street and picked up 6 fresh eggs directly from their chicken coop.  Talk about living the highlife.

Tomorrow we return home. We leave with mixed emotions.  We are certainly anxious to get home to friends and families.  But the patients will stay with us, in our hearts and minds.  The Haitian people that staff the clinic are now our friends.  Our hearts go out to the proud people of this beautiful country.  We will certainly return home having received much more than we gave.  We are sincerely and humbly grateful for being given this opportunity.

God Bless
Tom and
Team 6B

Helping a well-oiled machine – Dr. Malvitz

Kōman ou ye!!!
(How are you?)

Today was another amazing day.  An aftershock was felt today for about 5 seconds and every Haitian screamed and ran out of the clinic.  We were able to transfer our spine patient via a German helicopter to Milot.  (She has an unstable T11/12 fracture dislocation injured in the earthquake who walked into our clinic last week on a walker with incomplete neuro deficits.)  Two German pilots picked her and her husband up in the Double Harvest compound north of our clinic, amid 100’s of Haitian (and American) “gawkers”, me included.  Thanks to Dr. Burgess for making the contacts and giving her a chance. We have learned about Voodoo seizures (hysterical).  We have delivered 6 babies in 4 days (2 via C-section).

We were met with 100’s of new patients in the clinic. Monday is typically the busiest day as Sunday no one does much other than go to church.  Frantz (the DH administrator) was great in establishing order, setting up triage tents across the street, and arranging so all patients were seen. We saw things one would never witness in the States:  6-week-old talar neck fractures treated with cast as they had no x-rays before, non-op treatment of Schatzker 6 tibias (in great alignment!), spica cast changes for bilat distal femurs fractures  in a 3-year-old with shortening of 3 inches (but equal limb lengths and perfect rotation).  Trying to put ourselves in the shoes of those that went before us is impossible but the respect for them and what they did, without any of the resources we now enjoy, grows everyday.

Couldn’t be more proud of our team. Andria has been jumping in and is doing everything.  She is a scrub nurse, cast tech, comforts the babies and has been a great team player. Dr. Jim and Valeri our ER PA, run the clinic with a caring, professional attitude despite seeing things that none of us has ever seen before.  For example, a lady with huge untreated goiter and even tropical illnesses (2 malaria cases today)… Dr. Chad (the General Surgeon who joined us from Indy) has jumped in and taken off casts, done dressing changes, and in between he and his team have done orchiectomies for 20-year-olds with undescended testicles, hernia repairs, breast biopsies, and assisted Dr. Jonas with  C-sections.  Dr. Elysee has been involved in every aspect of our work and even gave us a lecture about Haitian medicine at night.  Vicki has run the nursing service nonstop including working with the Haitian nurses to cover 3 wards.  Kathleen took over the PACU and has everyone’s total confidence. Dr. Tim is throwing in blocks on every extremity and organizing 3 CRNAs to run 2 OR’s and a sedation room for dressing changes.  Dr. Karl has administered our patient lists, entertained the patients and his peers, and still found time to do surgery.  And Stephen has worked harder than any time in his life, doing everything anyone asks and even has time to get every patient out of bed, range extremities as instructed in rounds (BID), modify wheelchairs to fit kids with ex fixes (even tape part of a crutch to wheelchair to serve as leg extension?). I couldn’t be any more proud of him.

The VanWingerdens have been the most gracious hosts imaginable.  They personally cooked all of us dinner, which included steak, fresh tomatoes with ranch dressing and baked potatoes.  Even brought cookies and Milky Way bars.  They occasionally make rounds with us.  They fix the generator, suck up the bees into a shopvac that are infesting our storeroom and suck the water off the tarp roof in the middle of the night to protect our patients during rainstorms.

This is an amazing place. (I know I have said this before).   There is a reason so many of the people that have worked here want to come back.  Becky Hanna left us on Saturday and already has emailed me that she wishes she was still here.  The connection one has with patients is different that anything one has in the States.  They pray for you.  They laugh and cry with you.  They care about each other.  On behalf of our whole team, thanks to all for this opportunity to make a real difference.  We are all (too) well fed.  Showers are not really that cold.  We drink the water out of the tap and feel as safe here as we have anywhere else in the world.  We appreciate our partners covering for us so we can be here.  We miss our families. But each of us is sincerely grateful for the opportunity to make a difference here.

Signing off from:
18°, 32’, 47.17” N,
72°, 11’, 36.22” W
Double Harvest

Tom
Team 6B

Back in Grand Rapids!

Team 6a has arrived home safely.  Happy to be back.

SDB

Taking over the reigns

Team 6 will hopefully be home safe tonight.  We are all extremely indebted to each of the Team 6 members for making the transition so successful. We humbly took over the reins of a well-oiled machine and will do all we can to make you all proud.  This is an amazing place.  The highs and lows are exponentially greater than any we encounter in the States.  Delivering boys without OB’s (all named Scott??), incredibly gracious  patients, supportive families, fatal PE’s, no VAC’s for many open wounds, sporadic internet (none for first 2 days here), long days, but falling asleep with a sense of making a difference…

We all feel blessed to be here.  Thank you to all that came before us.  To all our families and friends, we are all well.  We miss you, but are grateful to be given this opportunity.

God Bless

Tom Malvitz
Team B

Making contact and gaining connections

Hello from Haiti.  We are well and happy to have team 6B here with us.  We have had a lot of trouble with communications and the internet service has been down for the last few days.  We continue to be busy, averaging 6-7 surgeries per day, with many times more injuries that are seen in follow-up or treated nonsurgically.  Communication within Haiti continues to slowly evolve.  We finally made contact with and visited the Miami field hospital based at the airport.  This is a very impressive operation with great organization but no ability to treat fractures with internal fixation due to a near 100% infection rate.  We were able to help them with a couple of fractures and they will help us with a couple of our chronic wounds.  I have also made contact with surgeons from North Carolina whom I trained.  This has enabled us to get some more implants and transfer a spine patient for operative treatment.

We have been blessed with lots of supplies through the gracious efforts of ISOH and the US Navy who paid us a visit today.  They are offloading the USNS Comfort and provided us with supplies and possibly a team to organize our pharmacy and stock room as well as repair our medical equipment!

It has been an exhausting week with miracles and losses.  We are all well and eager to return home and be with our families and friends.

We pass the torch to team 6B in the morning and pray for their continued efforts to heal the people of Haiti.

Scott Burgess

Keeping up with the pace in Haiti – Dr. Burgess

The 36 hours that followed our update has been a constant flurry of activity.  As with many things in Haiti there were miracles and disappointments.  During the early morning hours on Tuesday, we had two women arrive in labor and multiple patients who were vomiting.  The nurses and Dr. Ann Knapp worked tirelessly to help these people through the night.  Come morning, one new child was born and the other was having a c-section assisted by Dr. Russo (his first!).  The rest of the day pressed on with 7 surgeries finishing up in the evening.  We continue to treat injuries from the earthquake and many infections.

Apparently, the info I received about the Miami hospital was inaccurate.  They have committed to the long haul, but are not treating any fractures by open means.  They are in tents and have an extremely high infection rate, but they are at least managing ex-fixes and casting.  They also have a wound management program we will try to utilize as we were unable to connect with our wound vac source (they left Haiti yesterday).

I had read all the blogs from those who preceded us.  They discussed how the experience changed them.  It’s kind of like reading about a sunset.  You can’t understand it until you experience it.  I can’t put it to words (maybe it will take a long time), but I can feel myself changing.  To be able to provide critically needed care to a people so desperate for help and hope, is rewarding.  To see how their lives are devastated is heartwrenching.  The whole team is unbelievable in their abilities and efforts.  We are thankful to serve.

Team 6B arrives today.  Their assistance will be crucial to maintaining our momentum.

We are all well and miss our loved ones, but know we are changing lives here one (sometimes more) at a time.

SDB

Team 5 on its way home

We are in Miami and will be in GR tomorrow. Have a good week and continue to carry the torch.

Bill

(Sent on February 22, 2010 at 11:26PM)

The new team hits the ground running.

We hope that team 5a made it home safe and sound.  After a beautiful sunrise, we ate a wonderful meal prepared by Chef Richard. One of egg and sausage omelettes, french toast, mac and cheese – mixed with potato and hash – and fried cakes.  You just don’t waste anything here in Haiti.  Richard, after an elegant diatribe, bid us goodbye to leave for Nicaragua.  An incredible loss.
Today started at a rapid pace and did not let up till late afternoon.  We had the opportunity to perform surgery on six patients today.  Our OR teams did an outstanding job.  Ann and the clinic team evaluated over a hundred patients finishing around 5 pm.  In between surgeries Scott and I were summoned to see several post-ops for follow-up many who were struggling with difficult-to-heal wounds.  None of them complaining, and all of them thankful to have people who care about them and are there to care for them.  The nurses are incredible, deep in the trenches, keeping the machine oiled and running.
We scheduled six surgeries for tomorrow.  After which, I will leave with Guy, Grace, and David on a field trip to the University Hospital to pick up more patients.  Scott B. received a call from the ER doctor at the University Hospital who said they have 500 patients with orthopaedic needs.  More to come.
Along the way we will stop to pick up a modified VAC dressing, several patients are in need of this.
This evening we were paid a visit by Linda Greene and her team from ISOH, a charity with significant resources.  They will be staying with us at DH – it gets cozier by the minute.  They have committed verbal support for urgent issues that we currently have such as medications.
The sunset today was beautiful, a fitting way to end a challenging but fruitful day.  We all look forward to tomorrow and the wonderful opportunities it will bring. We all are healthy, but welcome your thoughts and prayers.
Till tomorrow may God bless you all.
Scott R.

Continued dedication to help Haiti – Dr. Burgess

As the sun rises over the mountains of Haiti, Team 5B left for the airport for their trek home.  We are left with a manageable workload, heading into the beginning of the week.  We were able to do five surgeries yesterday and then headed into the city to pick up patients from the University Hospital.  They still have no orthopaedic surgeons but a steady inflow of patients in need of help.  The word is that the USNS Comfort is leaving this week and the Miami field hospital is trying to pull out.  Although the acute need from the quake is waning, there is no standing/functional medical infrastructure here.  As people pull out, the need for help increases.  On a positive note, we ran into a team from Boston that has developed a field wound vac, we will be getting five tomorrow on our next trip into Port-au-Prince.

The Hatians are strong people, working tirelessly to put their world back together.  We are greeted with smiles by even those who have had the greatest personal loss.  The amount of physical damage is staggering and numbing – piles of rubble everywhere that used to be someone’s home or business.

We are blessed with a talented team.  All 11 are outstanding and are working hard.  The locals and those at other hospitals are continually impressed with the talent and commitment of the teams coming from Grand Rapids.  Our sustained commitment is unique and appreciated.

We are all well, but will never be the same.

Dr. Burgess

Team 6 gets started in Haiti – Dr. Burgess

Team 6 has arrived safely at Double Harvest.  We had a great flight in, thanks to Steelcase, we spoke briefly to the departing Team 5, then headed to DH.  The atmosphere is quite surreal – to drive through town, see crumbled buildings and tent cities then arrive at the beautiful mission.  The teams before us have blazed quite a trail, and the remaining Team 5A has eased our transition.  We have a few cases to do tomorrow, then we will make a trip downtown to the University Hospital to find more people we can help.  Looking forward to getting to work!

Dr. Burgess