From Jacqueline Koch, a Seattle-based writer, photographer and native French speaker, for The Seattle Times. Koch is senior communications officer for the non-profit Merlin USA, an international medical relief organization. Since 2005, she has documented and reported on Merlin health programs and medical emergency response in Sri Lanka, Indonesia, Myanmar and Kenya. She is now in Haiti, where she wrote this post describing efforts to rebuild from the perspective of a local field hospital.Pictured: A large chunk of concrete tore away much of the tissue from Claudine Souffrant's wrist. The 15-year-old needed specialized treatment at Merlin's surgical field hospital, including a skin graft to try to restore function to her hand.
Each day, we are 12 people cramming into a little minibus that leaves the office/housing base located at Delmas 83 on the edge of Port-au-Prince. Departure time is 7:15 am, an early start to avoid getting stuck in the city's infamous and stultifying traffic. I've joined the medical and surgical team who've come to treat emergency trauma patients, injured in Haiti's January 12 earthquake. They are working at a field hospital that opened January 20 and was established on abandoned tennis courts.
We make our way through a dusty urban landscape radically redefined by the earthquake's seismic spasms. The landmarks of our daily journey to the hospital reflect the scale of disaster and the start-and-stop pace of recovery: a four story building flattened to resemble a stack of plates; a neighborhood blanketed in the flimsy patchwork of blue and white plastic tarps, and a side street housing a colony of tents, baking under the hot tropical sun.
Now two and a half months since the earthquake, the dissonance between the utter destruction and the push toward rebuilding a stronger Haiti leaves me overwhelmed at the enormity of the task ahead.
Red spray paint announces a call for help alongside the new address for thousands of homeless people: "S.O.S. Refugee Camp Delmas 40-B." Yet on the same sidewalk, street vendors are spearheading a rebound in the economy. At a brisk pace they sell burgundy red sugar cane sticks, fried bananas, button-down shirts, and an expansive collection of oil paintings. The paintings are perhaps the most ironic among the goods for sale, illustrating scenes of a serene, pastoral and verdant Haiti. There's no hint of the nation's spiral to the near-bottom of the Human Development Index. There's no evidence of the 1.2 million people who are now out of their homes, struggling to cope with the lack of clean water, food, and shelter--or the new misery the approaching rainy season will bring.
When we get to the field hospital, the medical team fans out to various ward tents for morning rounds. The facility is fully equipped with one operating theater--housing two tables allowing the team to operate on up to two people at a time-- four ward tents with beds for 40 in-patients, and a separate area for out-patient treatment services providing basic health care for as many as 300 people a day.
The specialized surgical team, an orthopedic and plastic surgeon, have the combined skills to better treat the grave but common injuries that result from earthquake disasters: complex bone fractures, severe crush injuries and extensive tissue loss. Each of these injuries can lead to secondary, life-threatening infections, so the aim is to save lives and limbs. It's a nascent approach for medical emergency response sector, but has clearly led to better outcomes. With restored function and mobility in their limbs or hands, patients will have a better quality of life once they fully recover.
While trying to avoid unnecessary amputations, the surgical team is also working with a number of amputees who need ongoing follow-up care so their wounds can heal properly and in such a way that it works well with a prosthetic limb. Upon opening, the Delmas 33 field hospital filled rapidly with patients transferred from city hospitals that were damaged, overwhelmed and under-resourced. Many patients had already undergone amputation surgeries under extreme emergency conditions, as did the mother of one of our staff. Trapped in the rubble and unable to get out, her husband was forced to cut off her leg with a machete to save her life. She is just one of thousands of people who were teetering between life and death in the immediate aftermath of the earthquake. While Haiti's government estimates that there are 4,000 new amputees in this country, other organizations working here put it higher.
At the field hospital, we have amputee patients ranging in age from 2 years old to 52 years old. Emmanuel Etienne, 21, was transferred after he lost his right leg just below the knee. Plastic surgeons have performed a skin graft to make sure the wound closes and heals nicely in order to fit well into a prosthetic leg. Emmanuel understands that having prosthesis will be key to living something closer to a normal life without his right leg.
"I just got into high school (secondary school) and I have two more years to go before I can go onto university," he said, adding that he'd like to study medicine. But he worries that the earthquake tragedy has stolen these hopes.
We've been working closely with partner organizations to help each patient rebuild their lives amidst great uncertainty. For each patient like Emmanuel, there is a considerable coordination effort to ensure they have a plan for follow-up treatment, physical therapy, rehabilitation and the prosthetic limb they need. In Haiti, already the poorest country in the Western Hemisphere and grappling with high unemployment, young men like Emmanuel will be vulnerable in the scramble for a job and resources.
