Everybody's leaving but we're still here

Hello blog-o-sphere, sorry it's been so long since I've made a post.  Seems every time we think things are getting better we are dealt a new deck of cards.  We have been as busy as ever here but with new and varying challenges.  While post-op ortho cases are gradually being discharged and leaving the property we have been plagued with significant traffic in our ER.  To make matters worse it seems that more and more NGOs and government groups alike are ending their Haiti relief missions already.  What this means is that our ability to transfer patients out to places that may have resources we don't is dwindling and will soon be gone.  Our two best transfer options for critical patients have been the USS Comfort and the University of Miami Field Hospital.  Word on the street and confirmed by our own challenges in transferring patients to either, is that both will be ending their missions here in Haiti shortly.  By default, we have become the regional trauma center for the entire west side of Port au Prince and most of the communities on the western peninsula.  This was never our intent and we are ill equipped for such responsibility but, we will carry on and are committed to the Haitian communities we serve.

Sorry to be cynical but apparently the collective goal of many response agencies working here was to: return Haiti's health care system to the pre-quake state and then go home.  Well folks we (LLU and the volunteer groups that have and continue to work here) exceeded that goal just by showing up.  The idea that that goal is an acceptable level makes me want to scream.  This nation has lost upwards of 225,000 people, almost 1 million of the surviving population are without proper food, water, shelter, or sanitation and somewhere between 7,000 - 10,000 have had limbs amputated, not to mention the huge number of patients with surgically treated injuries.  To think that the international community can come here for 6 weeks and then turn their backs is simply unacceptable.  LLU is not leaving our work here in Haiti and we continue to need your support.  Please if you have the means to help our work, click on the red button at the top of this blog and support our cause.

Aftershocks
We have had two 4.7 aftershocks this week both in the middle of the night.  Significant aftershocks continue to be a very real reality here and are detrimental to the already fragile psyche of the Haitian population and our volunteer medical staff.  During an aftershock our patients in the hospital all go running and screaming out of the building, many dragging their IVs on the ground or ripping them out all together.  This is a major obstacle for us to overcome.

Shelving update
I am pleased to report that we have more than 20 shelving units built and in use in the various operational units around the hospital.  We have more shelves being built and more on the way.  This one simple thing has radically improved the efficiency of our operation.

BCFS Texas Strike Team
We have been blessed for almost two weeks now to have a group of volunteers from San Antonio Texas here at the hospital with us.  This team is a highly trained incident management team (IMT) that have worked in multiple disaster zones such as Hurricanes Katrina, Ike, 9/11 and others.  They have helped us implement an Incident Command System (ICS) structure that has dramatically increased the efficiency of our relief effort.  We have implemented specific roles that each of us play in order to decrease overlap of duty and maximize productivity.  ICS stresses the creation and dissemination of very specific objectives to be completed in each 24 hour period.  These objectives are shared twice a day at 7:30AM and 7:30PM in a very structured staff briefing.  Overall this system seems to be steering us rapidly towards our goal of resuming normal hospital operations inside the building.  Much work remains but ICS has been very helpful in moving us forward.

The Chief and The Commander in their ICS vests

Numbers
70 post-op patients still outside in the tents
15 patients inside the various wards in the main building
21 sick babies
10 pregnant moms waiting to deliver
16 volunteer staff with GI issues in the last week
18 hour work days still the norm for Andrew

Keep Haiti in your prayers and thoughts as much work remains here.

Out of the Rubble - Blog

Andrew wanted us to let you know about a blog that myself, Michael Wolcott, and Cosmin Cosma have. The blog is called Out of the Rubble and it's a behind the scenes look at the documentary that we're filming based here at Hopital Adventiste d'Haiti. We try and get pictures and small videos up as much as possible.

Organizations Impressed

The Pan American Health Organization (PAHO) and the United States Agency for International Development (USAID) have visited the campus in the last few days. All indications are that when some of the temporary medical facilities leave Haiti, Hopital Adventiste d’Haiti will be the most advanced hospital in the country. Among the many reasons for this is the water filtration system. Once the system is up and running this might be the only hospital in the country to have potable water running through it’s pipes. Another big reason is the condition of the campus, the hospital building is in great shape. Perhaps the most important reason is the relationship between Adventist Health International, Loma Linda University, and Haiti. AHI and LLU have had a presence here in Haiti and they will continue be here in the future. When some of the more advanced medical facilities leave Haiti, this hospital will most likely be the place where critical patients are sent. The Haitian people working along side the volunteers have made tremendous strides since the earthquake making this hospital one that the people of Haiti can turn to in the midst of this crisis.

A million words...

So if a picture is worth a 1000 words what's a video worth?  The video at the link below was shot during my brief visit home and gives you some further insight into our efforts here.

http://www.llu.edu/public-health/haiti.page

Thanks to Cosmin and Michael for the post yesterday.  I may need to rely on them even more as it seems things are as busy as ever for me.  Besides they take better pictures and do this kind of thing for a living.

Thanks to you all for your continued prayers and support.

New Autoclave

A quick introduction: I’m Michael Wolcott, myself and Cosmin Cosma from the office of University Relations at LLU are in Haiti for a couple of weeks. From time to time we’ll try and help Andrew out a little by updating this blog.

A new autoclave came to the hospital today. The US Navy and US Army brought it and unloaded it. It was quite a feat and great to see my tax dollars at work. The autoclave will allow the hospital to safely sterilize more equipment.

There’s also word about the shelving that will allow all of the supplies to be organized. It sounds like it might be arriving tomorrow.

We’ve been here for two days and are amazed by the work of the volunteers, a stream of people pour into the hospital and they’re able to see patient after patient day and night.

Happy Valentines Day from Haiti

We have had a couple of slower days at the Hopital due to the national day (or 3 days) of mourning which was Friday Feb. 12th, one month after the initial earthquake.  While patient load has been less there has been plenty of work to be done.  We have received so many supplies in the last 3 days that we have filled our 4 supply rooms to capacity, and have started filling up the ramp again.  We are still waiting for our shelves but are hopeful some will arrive this coming week.

LLU Team 2 arrived on Friday night and includes:

• Brock Cummings, MD Ortho Surgeon
• Everly Lafontant, MD Family Medicine
• Christa Chandy, MD Internal Medicine
• Brook Beck, RN
• Donna Pidder, RN
• Marc Julissme, RN
• Tim Hickman, Supplies & Facilities

While we are excited about each and every one of our volunteers, we are particularly excited about Brook, Christa, and Tim, who have committed to stay here with us for multiple months.  Longer volunteer commitments really help us create continuity of service, something we desperately need around here.

Things to look forward to this coming week:

• A higher bandwidth Internet connection - Thank you ACTS & High Alert
• A second Autoclave - Thank you Hopeforce
• 3 more LLU Medical Students from the class of 2010
• The LLU/AHI Media Team
• The Maranatha Team of 6 along with their 6 structures to build on the property
• And all the other volunteers that will be heading our way

and now how bout some pics:

 

CURE Intl. Team 1 heads home

 

CURE Intl. Team 2 plays with the kids on their first day

 

A German helicopter lands in front of the ADRA warehouse to take aid supplies to remote camps

  

 

We have various accommodations here for our volunteer staff

 

More volunteer housing

 

The General Store - supplies left behind for others

 

The supply ramp full again.  It was empty when I returned less than a week ago and now continues on like this another 30 or so feet around the corner.

 

The supplies are in the ramp because we have 4 supply rooms that look like this.

Please pray for the people of Haiti, our volunteers here, and that we get some shelving this week.

Thanks for reading.

Numbers & Toys

Well it's been a whirlwind couple of days here.  Every night I say to myself tonight you're going to do a blog posting.  Unfortunately that conversation usually occurs around 10:30 or 11PM.  After a 16-17 hour work day, the pillow tends to overrule the keyboard.  So tonight's posting is happening at 9:30PM but is still going to be brief.

Some of you reading the blog have already been here as volunteers and have asked for updates about what we are doing and what our current census is.  Well here you go:

Report for yesterday Thursday 2/11/2010
431 New patient visits
57 Admissions
~250 Patients on site
~1000 Total number of people living on the hospital grounds
14 Surgical procedures performed in the indoor O.R.s (STS Graft, 4 ORIF humerus reductions, Hernia repair, Thyroidectomy, Laporotomy, anoplasty, Foot Flap, I&D Subscapular abscess, ORIF Tibia, Leg STSG, Femur ORIF)
8 -10 out-patient surgical procedures performed with IV sedation

And now for those of you who don't have a clue as to what those procedures are...  
One of the fun parts of this job is the opportunity to hand deliver gifts from kids in the states to our patients.   Here are a few of our kids here as the receive hand made cards from the LLUC Childrens division and a few toys from my boys.

 

  

  

  

 

Thank you all for your prayers and your support. 

Back at the Hopital

I am back in Haiti at Hopital Adventiste d'Haiti.  There have been many changes here while I was gone.  Indeed as I had heard there is now water in the hospital's pipes 24/7.  Actually we have too much water right now and the cistern is overflowing, but that should be solved in the morning with the installation of a flow control valve.  We also have moved 25 patients back inside the building and our outdoor census is just a little over 200 patients.  While we only have 225 patients our daily population on the hospital compound soars to over 1000 with patient family members and our volunteer staff.   There is much more to tell but it is getting late and I am tired.  Here are a few pics...

 

Dr. Nelson with a patient in a private room

 

Surgical transport picking up a patient from our indoor Pre-Op room

 

More indoor treatment rooms

 

Even an indoor Post-Op room now

 

We really need some shelving!

Going back to Haiti

I am writing this post from LAX while waiting to board a red-eye flight to Miami.  From Miami I'll fly to the Dominican Republic where I will overnight at the Nelson home.  Early Tuesday morning I will fly back into Port-au-Prince on board the same little yellow Piper Chieftan that got me out of Haiti last Tuesday.  While my trip home was brief it was so good to see my family and enjoy a few moments of rest.  To say I stopped working while I was home would be a farce.  Keeping connected with the work at the hospital, gathering supplies, communicating with the various NGO's and military contacts in Haiti, conference calls,  press interviews, and making sure the Florida team met their ride at the PaP airport kept me on the job even if I was in So. Cal.

While leaving my family again after such a short visit is heartbreaking, I am anxious to return to the Hospital and the work waiting for me there.  I am carrying in two huge duffel bags filled with surgical supplies, many of which were requested just today.  I am looking forward to seeing the progress on the central supply shelving, and the construction of the water main from the 60,000 gallon tank up at the university.  I'll be sure to get pics of those soon.  Reports from those on the ground at the hospital are of increased organization, and the movement of some patients back into the hospital.

Volunteers - We are thrilled to announce that we have teams of medical personnel scheduled to serve at HAH well into April.  If you are interested in volunteering at HAH please visit the LLU Global Outreach website and fill out the volunteer form.  LLU Global Outreach is coordinating the volunteer staff for HAH in partnership with Adventist Health International, CURE International, Florida Adventist Hospital, and Park Ridge Adventist Hospital.

Heading home for a few days

I am writing this post at 35,000 ft above Louisiana.  I am heading home for a few days rest, but am planning to return to Haiti and Hopital Adventiste d' Haiti early next week.  Jason Wells from the Parkridge team has taken the reins in my absence and is doing an amazing job.  The Parkridge team has their own blog that will provide updates until I return to Haiti at: http://parkridgeinhaiti.blogspot.com/

Getting out
Dr. Nelson, Dr. Archer and I made the decision that if I was going to return home, it was better for me to go quickly while Scott and Jason were there to help provide overlap of leadership, thus by mid-day on Monday we started making plans for me to return home.  We left the hospital Monday night at 7:30PM for what I thought would be a routine run to the airport to hop a USAF flight out of Port-au-Prince.  The USAF have been flying multiple flights a day back to the states for US citizens.  This has been the best way out for many of our volunteers for the last week.  Sunday night we made a similar run delivering DuWayne Carlson and had confirmation of his arrival in Florida early Monday morning.  Upon arrival at the airport, I jumped out of the hospital ambulance said my good byes to Jason and Jim and walked the 300 meters to where I would meet the folks organizing the USAF flights.  As I walked up to the I.C.E (Immigration and Customs Enforcement) I got a sick feeling in my stomach which was soon confirmed, NO MORE USAF FLIGHTS.  I turned to see the hospital truck driving away in the distance.  To say I was in a bad situation would be significant understatement.  Not only were there no planned flights, they were no longer letting people into the airport secure area to wait or try and thumb a ride.  My options were sleep the night on the curb, run about a mile down a dark and dangerous street to the other end of the airport where the truck was headed to pick up goods, or take a very scary taxi driver up on his offer to "help" me for $20.  While I had some contacts written in my book in my backpack I had given my Haiti cell phone to Jason with all of the important contacts in it.  I chose to take the western option, fall back on your trusty iPhone.  Called Jerry in states, to get Jason's U.S. number... quickly tried to call Jason who was in the truck, no luck.  Who else to call?  How about email... Jean-Marc, Scott's ultra resourceful french friend here in Haiti, no phone # for Jean-Marc... wait, there, it's the hospital truck driving on the other side of the airport fence... wave the iPhone they might see the light... PRAY... Yes, the truck is slowing... the truck turns my way.   While incredibly thankful to not have to spend the night on the ground at the airport curb, I was sooooo bummed.  The drive back to the hospital was a solemn one as I considered that my next possible return home would not come until the 20th of February.  I got back to the hospital slipped a note under Scott's door telling him I was still there and went to bed.

6AM Tuesday morning Scott knocked on my door, said pack your bags we're getting you home one way or another.  "bags" well that was kinda funny since all of my stuff other than my laptop and the clothes I had worn the day before were locked in his room.  I grabbed my backpack and we were off.  A stop off at the community hospital and a quick call to CURE international and my hope was restored.  CURE had a small charter flight of major donors in the air coming from the D.R. that I and two other CURE surgeons might be able to get on to return to the D.R.  We jumped back in the car and raced (through horrendous Haiti traffic) to the airport.  The procedures at the PAP airport are a new deal everyday you go.  Knowing that the plane coming in was small, and that all small international arrivals had been coming to the General Aviation ramp that is where we went to meet it.  The plane was supposed to arrive at 9:30 and we made it with 1 min to spare, but there was no plane.  By 9:45 we started to get nervous and decided that one of the team had better head to the other part of the airport to see if the plane was there.  10 minutes later he came racing back waving his arms and yelling to get in the truck as the plane was loaded with other passengers and was getting ready to leave.  We raced through the international terminal with various security and people wondering what we were doing but we didn't care, got our passports stamped and ran out on the tarmac and into our little plane.  1 hour later we were on the ground in Santo Domingo headed to the CURE hospital for a bite to eat and then to the International airport for flights to the states.  An overnight in Florida, I'm currently over Dallas soon to be in landing in Los Angeles.  If you see me, take a wide berth, I'm in the same clothes I had on Monday night when I started trying to come home.

Please continue your prayers for our work at the hospital.  The situation there continues to be very dynamic, tenuous, dire, and very stressful.  I believe we are making a difference there now and can do great things in the future.  As always, please continue to give via the donate now button at the top of the page as this is truly the best way you can help the people of Haiti now and for the long term.

And now for some long overdue pictures

 

(Photo credit: Jason Wells)

  

The Old SDA Church at the University

 

  

  

  

  

  

  

The Nelsons in front of the bakery at the university

 

The new PEDS unit

 

His only toy

 

Sharing pictures of my boys with my little friends

 

A vendor in the Ally behind the hospital

  

The very hot and humid hospital kitchen

 

Non-functional hospital laundry

 

Functional hospital laundry

 

  

Heading home

 

Our ride out of Haiti

Sorry...

Sorry folks but I've been too busy to even think about the blog.  We were without Internet for quite a while today thus had lots of messages to catch up on.  Will try and get some pics and text up tomorrow.  I miss you all and thank you for your continued support.