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Health Center Today, April 23, 2010

Health Center Team Back from Haiti

By Chris DeFrancesco

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A team of three physicians and six nurses from the Health Center is back from Haiti after spending two weeks assisting with the medial relief effort there.

  • Katherine Anderson, general medicine nurse
  • Mary Beth Barry, cardiology nurse practitioner
  • Dr. Michael Fischer, internal medicine
  • Laura Glynn, general medicine nurse
  • Dr. Lynn Kosowicz, internal medicine
  • Dr. Susan Levine, a community physician on the clinical faculty
  • Mitch McGrath, general medicine nurse
  • Christy Meyer, cardiac catheterization lab nurse
  • Dawn Smith, cardiology nurse

It was a volunteer mission with the global humanitarian group International Medical Corps. Dr. Robert Fuller, head of emergency medicine at the Health Center, traveled with IMC to Haiti shortly after the earthquake and inspired many of the team members to follow in his footsteps. They returned home April 3. Some offered an account of their experience.

Kosowicz and Levine ran an intensive care unit tent in Port au Prince.

"I was inspired by the resiliency of the people and how families come together and care for each other," Kosowicz says. "I was also impressed by the number and variety of volunteers from all over the world – not just health care workers but also engineers, dock workers, and security workers. There was also a good amount of donated supplies. However, one of the challenges to providing good care was the inconsistency in the availability of providers, supplies and particularly diagnostic services and the difficulty with coordinating independent volunteer efforts."

"Virtually the entire country, not just Port au Prince, is a tent village. The hospital was a tent city as well," Levine says. "We had ventilators and portable ultrasound but would occasionally run out of oxygen or regulators. I would say that was the biggest challenge. You also had to be very resourceful and improvise a lot. If the right kind of wound drain wasn’t available you made one… We all had to work beyond our comfort zone. I found this also to be very rewarding."

About an hour’s drive from Port au Prince, Barry and Smith set up a primary care clinic in a tented camp in Leogone, the site of the epicenter of the January 12 earthquake.

"Days were long, hot and rewarding; it was quite a challenge," Barry says. "We particularly enjoyed the children and the opportunity to teach not only the patients, but the Haitian medical team as well. Education was shared. We saw very unique cases."

For McGrath, the primary task was triaging patients under tents that served as the emergency department in Port au Prince.

"I remember the TV show M*A*S*H. There were days we had less than them and still managed," McGrath says. "The first week we were seeing over 250 per day. By the last few days we were seeing over 100."

Inspired by Gratitude

"We admitted a gentleman who had had a terrible accident and suffered extensive burns over much of his body," Kosowicz says. "We provided the best care that we could with the resources available, but unfortunately after many days in the ICU he ultimately died. Throughout his time with us he was never alone – several family members were always at his side. When he died, we were all deeply affected. His family gathered all of us together, and said a prayer. They thanked us for our efforts and attention to their loved one. They wanted us all to know how much it meant that people from around the world are there to help, that the people of Haiti are not forgotten, that their loved one had been attended to. It was gratitude like this that kept us going – knowing that our efforts and the compassion we felt were helpful and appreciated even with the challenges we experienced in trying to provide good care with limited resources."

Lost in Translation

"A doctor asked a translator to ask the patient what was wrong, why he was in the emergency room today," McGrath says. "The conversation went on and on for minutes between the patient and translator. The translator then looked at the doctor and replied, simply, ‘He’s had a hard life.’"

Small Victories

"Toward the end of my stay, we intubated and empirically treated a young paralyzed patient with high-dose steroids," Levine says. "Before I left he was moving his extremities, following commands and likely to recover. We had in the ICU post-op patients with bowel resections from typhoid who recovered and went home. We had hypertensives with pulmonary edema who recovered. The most amazing thing about Haiti is its people – incredibly strong, graceful, compassionate and family oriented."

Good Friday

"Working in the ICU on Good Friday, a volunteer priest from Argentina came to pray with patients and families," Kosowicz says. "Visitors came to read the Bible and sing. The ICU is one big tent, no private rooms or privacy at all. But this allowed for a feeling of community. All of the staff, family members, and patients who were able sang along. An 81-year-old grandmother who was recovering from a recent MI sang and swayed to the music – a new form of cardiac rehab! It was a beautiful service."

Healing by Faith

"While on several occasions death was inevitable, I was always taken aback by the religiously grounded grace and gratitude of the family," Levine says. "I remember being told by the brother of a young man who had suffered a 60 percent burn, ‘God tells us when we are born and when we will die and blesses you for all you are doing for our people!’ He then gave me a big hug. Though I knew only a few words of Creole, we had bonded in a deeply meaningful way. For me Haiti has been a life altering experience."