Team 1 Day 3 Update Kyla

Port au Prince, Jan. 20, 2010 — 12:45 PM phone conversation with Chris. The team split up into two groups, one working at a clinic by the dock, the other setting up a clinic at a tent city. The tent city group has been seeing "crazy lacerations, this and that, everything, really… little scrapes to abrasions to wounds that have to be…. really severe infections." It's their first treatment day, and they are very busy. They'll give a longer update and answer questions when they home, sometime around 7 PM EST.

Port au Prince, Jan. 20, 2010 — Hour long phone conversation with Daniel, Chris, Thomas, and Jeff. The group split into two teams this morning, and gave separate updates.

Report from Daniel (TEAM BAD IDEA DINOSAUR)

Team Dino included Hexe, Fidget, Daniel, the ER doctor they're working with, and 7-8 more people. This morning they went to the big tent city in a park by the National Palace to set up a clinic. They worked for 6 hours and felt somewhat overwhelmed. There was a good perimeter and the area was …kind of… organized, but there were a lot of people and it was very busy. They met 3-4 Haitians there who spoke English and volunteered with them to help translate.

The early morning was frustrating for this team because they felt ignored within the larger group they worked with. The group seemed disorganized and "crappy;" didn't listen to them. Daniel lamented that he missed working with consensus, and was frustrated by disorganization.

They treated at least 50 patients, with each person seeing at least 10 people, sometimes working in teams. Almost everyone they saw had been treated before, most about 1-4 days ago. The injuries they saw were all "continuing care." They included:

  • Almost all injuries involved taking off a dressing from pre-existing wound, cleaning, and rebandaging
  • Infections
  • Open wounds, like deep scrapes, or huge chunks missing
  • The doctor dispensed pills

Jeff said he saw the worst injury he's ever seen, a ridiculously big gash, a couple inches deep, which covered a chunk of flesh the size of his palm or bigger. They had to rip off a lot of flesh when they took the bandage off.

The doctor was able to arrange it so they could bring 2 patients back to the orphanage where they're staying for longer-term care. One was a little boy with a 2 inch deep cut to the bone on his leg and 6-7 lacerations on his arms and legs, and a twisted ankle. The second was a girl who has a break in her pelvis, and had been misdiagnosed (by other people) with lower back pain and just sent away with drugs.

Thomas noted that this ER doc kicks ass. He's high energy, enthusiastic, very practical, great at improvising, and experienced in third world medicine (11 years' travel in Third World Countries). He said, "I know a lot of doctors and I can't think of one that I'd be more comfortable working with than him."

Report from Chris (TEAM SANJAY GUPTA PISSES IV FLUID)

Chris, Thomas, and 3 volunteers who they'd met on the plane to Haiti drove around to find a place needing medical help. The team was basically wound care (Chris), medications (Thomas), a "pharmacist" and two "nurses" — the volunteers who helped them out. By request from the World Harvest orphanage where they're staying, they checked out another orphanage. All 135 kids were ok, and getting a ride to the US embassy tomorrow, already adopted.

Our team settled in Delmas tent city, where they were told there was one patient who needed attending to. Four hours later, they had treated over 100 people. It was lots of wound management, changing bandages (Chris handled most of the wound care) and dispensing medications and antibiotics (from the doctor at the compound — Thomas handled meds). They cut up gloves to hold meds they dispensed in the fingertips.

One girl's finger was mostly falling off, and was attached by a chunk of skin. It was infected. Her finger needed to be cut off and it hurt so much she would barely allow Chris to touch it. Chris explained that he could have treated this injury, but because Chris did not have the right syringes and needles and because there is not enough anesthetics, he couldn't treat her properly and had to refer her on.

Other injuries included:

  • Someone with sutures on the front and back of their head, with infection
  • Some broken bones
  • Wounds (lots): abrasions, wounds already treated with infections, amputations. The largest wound was 3 inches x 1.5 inches wide, 1-1.5 inches deep w/ bones showing. Lots of flesh wounds but some to bone.
  • Hypertension
  • Diabetes
  • Dehydration
  • Early signs of hunger
  • Urinary tract infections

Thomas handed out 1000-1500 pills today. A lot of people didn't have anything medically wrong (50+ women claimed to have UTIs, only 4-5 actually did), but needed something to make them feel better. Thomas handed out a lot of vitamins as placebos.

They found people there were very receptive to them and calling them "doc" — no one would listen to Chris tell them they aren't doctors. They treated people for a looong while; they became exhausted, treated everyone — every single person. They finally left to go home, but on the way saw a sign calling for "doctors and medical help." They checked it out and found 4-5 patients.

Chris treated a guy who was "really banged up." He'd been stuck under two floors of concrete. He had infected abrasions and wounds on his legs, arms, behind the knees, chest, and back. The man had abdominal pain, was vomiting and dizzy. Chris treated his wounds, and they gave him antibiotics for 6 days, which would be enough to get the guy to be able to stand and get to a hospital. Chris felt there wasn't much he could do for this person: they NEED rehydration IV fluids.

When they came back to the compound, they saw the doctor had set up a hospital at the church there (with Daniel's two patients). The doctor said Chris could bring his last patient there, but it was too late today and they will try to get him tomorrow.

SUPPLIES NEEDED

I asked each person I spoke with to list as specifically as possible what supplies they need.

  • Gauze, 4x4s
  • Wound disinfectant creams, bacitracin, wound cleaning stuff (anything to limit infections)
  • Medications/meds for:
    • antibiotics
    • topical anesthetic (lidocaine)
    • local anesthetics for cleaning and infections
    • high blood pressure
    • Tylenol
    • diabetes
    • UTIs
    • parasites
    • vomiting
  • IV antibiotics
  • IV narcotics (Thomas is working contacts by phone to get them)
  • Matching syringes & needles
  • Rehydration stuff, IV fluids are very hard to get
  • Nutrient supplements — lots of people who are not fed too well
  • Iodine
  • Sutures
  • Water purification tablets to donate to people
  • Aftercare packs with soap, gauze, antibiotic ointment, tape and instructions: really really important, helps people do selfcare
  • Basic hygience stuff: cases of bar soap

Note: There is less of a need for trauma stuff, less anticipation for trauma, and trauma supplies are abundant! They team is completely selfsustained with water and food — enough to sustain selves in the backwoods for 2 weeks.

Thomas will e-mail a list of herbs & meds, but he has concerns. It's hard to do a travelling herbal clinic; he would need a permanent clinic because herbs/teas/tinctures are bulky and heavy. BUT, if he can find a place for a clinic, would that be taking up a place for a family that needs a home? He's not sure clinic is the best use of space right now. Longterm, a clinic would be good but maybe not yet.

SUGGESTIONS FOR THE FUTURE OF OUR GROUP

Continuing care here in Haiti will be essential. People could use things that help them become self-sufficient, even in urban setting, including:

  • ways to cook w/out charcoal (Haiti is 99% deforested, yet charcoal is the main cooking method)
  • basic sanitation
  • water purification

Thomas has a proposal: People have been doing great job fundraising. Thomas proposes we set money aside for future disasters and not limit our group to what's up in Haiti. Our group would be much cooler if it's ready to respond faster than we could this time. We got here 4 days too late. We're still doing a lot of good but could have done more if we'd gotten here sooner.

TEAM 1 EMOTIONAL HEALTH

Thomas reported "we all felt good today, a couple felt they were underskilled for some of the wounds they saw, but overall, all did wonderful." Thomas and Chris felt awesome being in an area where no treatment had been before — they will try to follow up daily with those patients.

Jeff said he's been bouncing between extremely shocking things and really great, tight group dynamics. He mentioned how the very Christian orphanage where they're staying was pretty leery of these punk kids (Jeff & Hexe), but then they found some scrubs and put them on and suddenly everyone became super respectful, haha. Thomas noted that they are staying with hardcore Christians. It can get very uncomfortable — prayer before meals (not everyone on the team is Christian), no cursing/smoking/alcohol. Hexe got rebuked for exclaiming "fuck" to something for which "fuck!" was absolutely an appropriate exclamation. Thomas thinks the people at the compound at first would have liked to see them go, but that our team is starting to grow on them. Thomas is appreciative of them arranging flights and housing; it's not ideal, and teams coming in the future need to think about this relationship with hosts.

Chris (and I!) emphasized how cute and attractive this team is, it's amazing (check out the attached picture!). When I talked to them, they'd been fed, were chilling outside, bonding. It's still "motherfucking hot." He said, emotionally, they are watching over each other. Thomas stopped Chris when he got too consumed in his work and forgot to drink water.

They lived through another aftershock today, a light one.

RECOMENDATIONS/THOUGHTS FOR OTHER TEAMS

Team consensus: DO NOT BRING ANOTHER TEAM until they have better ground logistics. We need a long term project and there is not support in housing or transportation now. It would be a bad idea for another team to come in now.

Transportation: Transportation is at max capacity (17 ppl in 12 person van, 7 in a geotracker + supplies). As of now, our team is relying on other volunteers and the orphanage for transportation.

Housing: Chris is working on a few options, like his mom's house in Haiti — but they'd need to arrange tranportation.

If they had another team there IS work for them: not first aid — wound management, passing out pills. Thomas thinks the current team could absorb 2-3 people effectively, but it's very important to think about what skills they bring. For example, he thinks he can convince the ER doctor to convince the orphanage to accept Carrie (trauma nurse).

Note from Kyla

Being this point of contact is draining work. I had originally volunteered to be an emergency contact… and as these things go, I've ended up being the single line of communication between an unwieldy and quickly changing organization in the states and our busy and sometimes hard to reach friends in Haiti… and, as a lot of you know, it can be very hard on one to hear these stories without being in a place to do anything about them. I start classes on Monday, and will have significantly less time (grad school = no sleep). If Team 2 decides to delay their departure, I would like to have another person step up to be Team 2's point of contact, and slowly wrap up my role as team 1 comes home.

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