Team 4 Update 5 Jeff

Field Hospital, Saint-Marc, Haiti, Feb 13, 2010, ~930pm — The team has been working dawn to dusk at the hospital in Saint Marc. We finally had a short conversation over the phone tonight, and were able to do a bit of a check-in before they had to get off the call.

They are being housed by their local contact Odson just a few blocks away from the hospital. The team has been working with local hospital staff as well as a crew of Boston-based doctors from Partners In Health, and have a positive relationship with most everyone. It was explained that the doctors are good, but a bit pushy in the stereotypical American way. Charles related that every team of American doctors to come through this particular hospital has "pushed everyone out of the way and some of them [the Haitians] blame us…" The current bunch of doctors is leaving soon and will be replaced with medical professionals from Florida (arriving today) and St. Louis (arriving Tuesday). Most of the local Haitian nurses are cool with the team being involved, but a few people (understandably) can't tell the difference between pushy Americans and Team Montana. The team is definitely working on the language barrier to make sure they're on good terms with everyone. They're also having to spend some time making sure people understand that they are not doctors themselves.

As for their involvement at the hospital, they are doing everything. The team has direction and everyone is fully engaged all day. Outpatient care, Inpatient care, Pre-Op, Post-Op, they're doing it all. Roman has spent the past two days helping with surgeries. Charles has definitely mentioned them balancing helping where they're needed with staying within each members' individual scope of practice.

They are seeing what was described to me as "unreal wounds, massive infections and crushing injuries", but also many, many people suffering from a chronic shortage of medical care. Saint-Marc is inundated with refugees, with more reportedly on the way, and the hospital is slowly being overtaxed. The WHO change in policy is NOT helping; all health care is now "pay as you go" and the team is seeing things such as amputees being sent home without crutches because they couldn't pay for their care. It is especially frustrating, as the team knows for a fact that the hospital has a "warehouse full of supplies".

The team has not needed to use much of their personal stock of supplies yet, and is working with Odson to devise a plan to distribute most of it in the surrounding community where it will do the most good. Although they would like to secure supplies from sources other than the WHO, they don't feel that going to Port-au-Prince would be an effective use of their time. It was fairly time consuming and expensive for them to travel from Petionville (outside PaP) to Saint-Marc, and the team doesn't want to repeat the trip until they're exiting the country.

Their exit plan is the one weak link at this point. Charles described getting from Saint-Marc to Petionville and onto a bus to the DR as "one of the biggest challenges we will face". Although the team was able to work out transportation from Petionville to Saint-Marc for $400 (two trucks) on the way in, they do not have a solid plan for leaving the country… yet. Noah and I are working on it, and I have more travel information I will be feeding to them during our check-in tonight. We probably won't be able to help them much with their transportation between Saint-Marc and Petionville, which will probably be an arrangement they will have to make locally. We are currently researching schedules for the Caribe Tours buses from Petionville to Santo Domingo, as well as looking around for any info on flights from Port-au-Prince to the Dominican Republic. They have expressed willingness to spend the night in Petionville or PaP if necessary on their way out of the country. The team is very motivated to get their exit plan worked out as early as possible.

Comms have continued to be tricky as best. Emails through the team blackberry are reliable so far, but phone connections are poor, and internet through a computer is not fast enough to be of much use for them. We have found a combination of phones that works for calls, but they are unsure of the international plan for their particular phone (a different phone than the original choice for the daily calls), and are currently researching the costs involved. Tonight I will be suggesting that they let folks in the states help them figure it out so they can focus on working. Still unsure about getting a phone through digicel.

Physically, the folks on the team are hanging in there. Two members are coming down with a stomach bug. I know one of them is Trenton, but didn't have a chance to ask who the other was. Rest assured I will be finding out tonight! I will be advocating for a team day of rest, starting with the call tonight. I'm going to be pushing for them to take a day off (or at least work a half day) maybe Wednesday. Everyone is tired and overwhelmed, but positive about the work they are doing. They're stressing to me that there is NO shortage of work to be done for folks with the proper training. Emotionally, they seem a little flat to me. We haven't really had enough "voice time" on the phone yet, which is a bit frustrating, but they are working hard on the phone situation and we should be able to have longer check-in calls soon. Odson continues to be very solid, and has been helping folks on the team with providing a safe, quiet place to sleep. Last night he apparently showed up with beer and "rotgut whiskey" and the team was decompressing a bit after being at the hospital all day.

The team is very inspired by the resilience of the Haitians they are treating and working with. Everyone on the team seem very happy to be where they are, helping as much as they can. Reading their emails and talking to them on the phone moves me to tears every night. They are working very, very hard every day. Team Montana is definitely in "treatment mode" and is giving their all.

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