After we pick up the meds, we negotiate our way to the tent city where we set up a clinic in an old schoolhouse. Immediately, kids come out of the woodwork. They are jumping and singing and trying to hold our hands. They are adorable! I’m tasked with playing God and figuring out who the sickest 50 patients are amongst the hundreds who have lined up – who we can treat and who we have to send away. We only have three hours until we have to be out of there, because once the sun goes down, the area becomes very dangerous.
I spend about 15 minutes talking to a 17-year-old boy in broken French (on both our parts). He wants my glasses because he has trouble seeing the board at school. Even living in incomprehensible poverty there is a real human element and joie de vivre .
Today, I got a real sense of the poorest of the poor and I think we did some good. It feels like a drop in the ocean over all. Still, hopefully, there are 50 or so Haitians that will be better off this evening than they were this morning.
We’re heading over to the UN now for the only real food I get each day.
This morning I started in the OR doing a revision femoral external fixator, usually the second-last option at home but routine here. It’s like metal scaffolding that runs from the ankle to the thigh. In Canada, we usually nail it or put in plates and screws. As I was finishing, Dr. Duffy burst through the door, told me to scrub out STAT and go over to the local general hospital.
We arrive at a three-storey building that’s missing its entire front facade. I thought it was closed but, no, this building is where the current orthopedic ward is. We walk inside, passing the hospital laundry drying in the sun on razor wire, to find row after row of ortho patients in all forms of traction or external fixation. It’s very, very rudimentary treatment. We could easily have added 50 cases to our slate based on the patients there.
The most heartbreaking was a 15-month-old boy who has a broken tibia that has been sticking out of his skin for three months because his family can’t afford to get treatment. We begged his mother to come over to our place to fix him, but she didn’t trust us that we would provide care free of charge.
Starts out as any other day here: Wake up, and down my Gatorade, malaria pill, Pop-Tart, Clif Bar, instant coffee. After breakfast, I’m taking a shortcut through the ER when I find Dr. Ian Wishart looking for help. We have an hours-old neonate brought in by her mother. When the triage nurse sticks the pulse oximeter on the little tyke, it’s not reading an O2 sat [oxygen saturation] or a heart rate. The kid is immediately taken from the mother’s arms. Dr. Wishart assesses the baby, confirming that she isn’t breathing and lacks a pulse. He immediately jumps into code blue mode. There’s hell breaking loose because the nurses can’t get an IV, the suction isn’t working, the cardiac monitor isn’t working and there’s no neonatal intubation equipment around.
Dr. Wishart gets the intraosseous gun, which basically sticks a needle in the tibia to give fluids and meds. I run into the OR and I find Dr. Geoff Hawboldt (one of our anesthetists) and ask him urgently if they have a neonatal laryngoscope. He and Dr. John Arraf (another of our anesthetists) perk up with quizzical looks when I tell them why we need it. Dr. Hawboldt comes running with me. I resume chest compressions because the nurse is getting tired and, finally, they manage to intubate the kid. A couple rounds of epinephrine and 15 minutes of compressions later, we stop. We have a pulse and the baby is saturating well!! Amazing team effort as we saved this little girl’s life.