A Surgeon’s Haiti Journal

January 22, 2010

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As founders of Hearts Afire we unanimously decided based on the prompting of God that we must send in a team.  Being the surgeon and one of the founders, I was the obvious choice.  I never had a desire to go to Haiti; never felt called to Haiti; but realized that God “calls” people, and God “send”s people on different assignments. I was being SENT on this one.  Our Dominican missionary friends sent me an email asking when I was coming, and since we had a team leaving in February, I said, “We have a team coming in Feb.”  She emailed me back…”We need surgeons, anesthesiologists, and orthopedic surgeons NOW”.   She made it clear that the conditions were getting worse in Haiti and it was a disaster of unimaginable proportions. After speaking with my wife, the decision was made and now the work had to begin.  I had remembered reading in the book “Jesus, MD” that the author stated “a call is often nothing more than seeing a need and recognizing that you have the ability to meet that need.”

Now the phone calls started…the CEO of Blake Hospital…”I need medicine, amputation saws, suture, and orthopedic materials”  The response was “Take what you need.” Next was the office.  I had surgical cases and office scheduled so I needed to reschedule everything.  The office staff would take care of it.  Call coverage…”not a problem” was the response of my colleague.  Then the flights.  American had a flight leaving the next afternoon.  I was going to be on it.  God will make a way when there seems to be no way.

1/18/10

After a long day of travel we arrived in Santo Domingo at about 11:30 PM.  By the time we arrived at the Corazon del Siervo guest house at 1 AM.

1/19/10

When the rooster crowed at 5:21 AM the first thought to enter my mind was…”No wonder they eat so much chicken!”  We would be getting up around this time to leave for Haiti, but the van is broken, so we have to wait until the rental agency opens to get a rental van.  Now we start the day with prayer.  Planning for the day… how to enter at the border (by land or air) and where to work because the need is so great. 12:45 the van is packed and we are leaving Santo Domingo.  God is with us, and the plan is to enter at Jimani, have World Vision help us across the border, then meet up with Ernest and spend the night on the Haitian side. 13:30  Dave Sugar received a text message from his mother…”the situation in Petit Goave is desperate, no food, no water, no help.” So now we know that we HAVE to go there!  I ask, “Lord, what should we expect?”  The Lord says, “Expect to be my hands, feet, and heart.  I am there already.”  18:30 Met with World Vision in Jimani.  With their hats on we will pass through the border.  Then on to Port au Prince tonight.

1/20/10

Happy Birthday Rhonda. (my wife’s birthday today).  We arrived last night in Port au Prince.  Just crossing the border into Haiti felt like crossing into a war zone.  The closer we get  to PaP the more people there are.  In PaP there was rubble all over.  You could see that some had already been started to be cleaned up so the streets would be passable.  Concrete walls, portions of buildings down, and one building almost collapsed into the street.  And occasionally empty lots were full of people just sleeping on the ground.  And we will see in the daylight just how bad it really is.   We met up with Ernesto (a Christian Internist from Santo Domingo) in front of the UN and he had us follow him to Quisqueya (a Christian school untouched by the earthquake and now a command center for medical teams).

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The Quisqueya Chrisstian School is in Port au Prince.  They are a Christian School that educates a lot of missionary kids, and their buildings are essentially untouched by the quake.  It is a gated compound and they have stopped school except for the seniors.  God has laid it on their hearts to be a central command for medical personnel.  The U.S. Army has opened a post in one of their buildings for now.  They will identify needs in the area and offer deployment travel to medical and surgical teams.  The teams are provided a place to sleep (anywhere on the grounds you can find), water, food, and Vonage phones as well as wireless internet for communication back home.  What a blessing.  Last night we slept on the floor in Mrs. Debrasee’s preschool classroom and the floors were rock hard.  They fed us when we arrived last night (hot dogs and rice) and while were eating I saw a rat the size of a football crawling around. This didn’t give me a thrill thinking about sleeping on ground level.  But all for God.

During the night on the hard floor at Quisqueya I had a vision of many small lights in the room.  I know it was angels because I had seen this many years age.  The first time I had seen them years ago they were “floating in the room” and slow moving.  But in this vision they were not uniform and almost blurred.  I asked the Lord what was it, and He said they appeared that way because they were “working so fast”.

Later as I was thinking about the vision and I felt it wasn’t complete; I wanted more information so I tried to reproduce it.  Then the Lord told me “It was not you (meaning I didn’t form it), it was for you”.  As I tried to go back to sleep I then saw another vision of what appeared to be small black flecks of floating debris in the air.  Almost as if tiny pieces of charcoal or the muck from the bottom of an undisturbed pond would be stirred up and “floating” in water.  I was fearful at first, thinking this was fallen angels coming to disturb me, when the Lord said to look more closely.  When I did I could see that it was, in fact, debris.  He said,  “This is just the dead remnants of the spiritual warfare after the demons have been destroyed”.

After a little more rest, we will head to Petit Goave.

Haiti 2010 #2 Dr. Joe copy

8:30 AM (Still 1/20/10)

We left PaP about one hour ago and as we go along the coastal road, the devastation is worse and the clean up is less.  Even the road has cracks in it.  In some places the road has dropped as much as two or three feet with cracks all along the side.  As bad as it is, some people still seem to be in good spirits.

9:30-10AM

We finally arrive in Petit Goave.  It was not quite as bad as expected, but still not good, and I wonder if we are just getting used to seeing all the destruction.  There is some food at the makeshift market, but no stores are open yet.  No gas stations will open either, for fear of theft.

The rest of the day on 1/20/10

We visited the outdoor clinic with the Wesleyan doctors from Michigan and Indiana right next door to Ed’s house (the American missionary to Haiti).  They were holding a general medical clinic, but there was a lot they couldn’t handle.  Mainly orthopedic injuries a week old since the earthquake.  Some lacerations look like they were sewn up by a layperson in the kitchen the day after the quake.  Many of the injuries were pediatric so we had the perfect team.  The anesthesiologists (Tom and Trey) would sedate them so Dave could reset them and splint or cast them.  Some would probably eventually need amputations if their wounds aren’t cared for.  But there was a great ongoing collaborative effort.

We visited the hospital to see if we could use the operating rooms.  We met with the hospital administrator and the hospital was completely empty.  It consisted of four or five buildings, two of which were completely collapsed and unusable.  The administrator told us that he didn’t know if the building was safe to use (there was an appropriate fear of the people to enter any building).  In order to use the hospital he said we must first meet with the leader of the Sri Lankan national guard which was part of the local jurisdiction. Something happened at that meeting that determined the course of where we would work and how God would use us.

Mano was Ed’s “right hand man” and he was a local Haitian who had grown up in Petit Goave.  He served as our ride and our translator.  When we met with the Sri Lankan leader, it wasn’t clear if anything would really get done, so we momentarily contemplated going back to PaP where we knew our skills would be used.  Then I looked in Mano’s eyes and saw hope leaving and despair coming upon him.  When he said, “If you don’t stay nothing will happen and nobody will get help”, I realized that God had given us the opportunity to meet the need of people whom otherwise would not have a need met.  It was that moment that we knew we needed to stay.  And at that moment things started to happen.

One of the Swiss first response people came with us to that meeting where it was determined that when the Swiss structural engineer arrived later that day, we would have him make that determination.  I walked through the hospital with him, and his feeling was that only one area of the hospital was safe to use.  He didn’t know it, but that was the area we needed; the operating rooms.

Now the Swiss arranged for the Polish EMTs to put up the tents for triage and recovery.  Then Doctors Without Borders donated some anesthetics and we were ready to start.  So the collaborative effort of countries, teams, and faiths looked like this:

Sri Lankan National Guard provided the okay to use the tents

Swiss provided structural engineer opinion and triage help

Polish EMTs provided triage help

Another organization provided medicine

Cuban physicians helped with triage and recovery

And our team provided the Surgeons and Anesthesiologists

And we slept on the property of the Mormon church

Every day and all day long there were aftershocks.  None were as severe as the 6.0 we experienced in PaP, but there was one that was a 5.3 while we were finishing up an operation.  Many of the patients were afraid to even enter the operating room, either out of fear of earthquakes, or because of the amputation stories they heard from PaP.

Some of the important highlights I would like to make at this point are that we realized we were filling a great need when as soon as we arrived there was a 15 month old with a hip fracture requiring a SPICA cast.  This type of cast is best applied by an orthopedic surgeon, one of whom we had with us.  Mano was a joy and inspiring to us.  His attitude despite everything was an attitude of gratitude.  One of my emails out to the prayer team while we were on our way in was for multiplication of food, help, medicine, etc. and when we arrived we noticed that God was in fact providing everything.  Even the missionary, Ed, said, “What a difference a day makes”.  We could probably rephrase that as “What a difference God can make”.  Also, on the van ride in God told me to “weep for the children” and while I was weeping I saw a child who had lost his entire family and needed to know that God loved him.  One of the first children we treated was a seven year old who had lost his entire family!

1/21/10

This morning we took a ride through Petit Goave and we saw the real devastation.  Some streets had nearly every home crumbled as if it was just a pile of rocks.  Many people were sticking out their hands for food.  Then we went to the hospital and did some work.  Mostly, we did debridements.  Up to this point we only had to do one below knee amputation.

2:30 in the afternoon

The polish EMT’s are in one tent that is set out on the hospital parking lot. There are Cuban Doctors in another tent.  Both sides are triaging, but in the one tent with the Cuban Doctors, the recovery area is set up.  Also, there is triage through Doctors Without Borders.  MSF (Medicine Sans Frontiers).   Marta, a Cuban Anesthetist, who came to Haiti in January 2008, runs the operating room here.  She is the one that keeps making things happen.  And she is helping in amazing ways.  It seems in these developing Nations that there is always one woman who is a nurse or anesthetist who seems to keep things running.

1/22/10

I did forget to mention that yesterday while we were driving around town we saw an amazing site.  There was a building that was completely gone; except there was a woman sitting in her chair with her baby and the crumbled house was around them.  As it turned out, it was the child that had the SPICA cast applied the day before.  The family was very happy that we took the opportunity to take a photo of them.  Also today, we touched base with Dr. Malarino; she apparently is bringing a team to Port a Prince General Hospital.  Then on Saturday January 23, there is a plastic surgeon, orthopedist, and anesthesiologist that will be coming to Petit Goave.  We are going to see the school that Ed Lockett runs and then we will be heading back to the Dominican Republic.

Later that day…

It is almost strange being back in the Dominican Republic and seeing the building intact.  It seems like such an advanced country after being in Haiti.  It’s clear that the work in Haiti is just beginning, but by God’s grace we will continue to come and help and expect great things from this experience.

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