Creativity

Port Au Prince Travel Blog

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Tyler, from the ICU, models one of the many forms of OR "hats"- it was a requirement to have a hat on in the OR and ICU, but we ran out so people got creative

The last week has gone by so fast.  Who would have thought it would be day 10? 

I'm still working at the Miami Field Hospital.  We leave the orphanage at 7am, work all day and get picked up at 6pm, after the sun has gone down.  Thank God for Stef, an ICU nurse from California, who has been here for a while now and took it upon herself to take care of us in the OR and ICU, by making us lunch in a crockpot using canned food that had been donated.  If it wasn't for her, we wouldn't have anything other than powerbars to eat.  You can always find time to eat lasanga or mac and cheese, but there never seems to be enough time to eat a protein bar, go figure :)  She also keeps the small fridge in the back stocked with bottle water, though drinking water is in short supply at this point, we don't have water to wash our hands, we use hand sanitizer to scrub with before surgery.

Making our own pulse lavage (used to irrigate and wash out wounds)

As I've mentioned before, the intial crisis is over, we are doing mostly follow up care now- wound care, skin grafts, stump revisions, casting, etc.  We've also become known as a trauma hospital in the area and have started getting more and more traumas- motor vechile accidents, gun shots, etc.  We will go from having some spare time on our hands to extremely busy in less than a minute with no warning.  It goes to show how talented the people working here are that we can shift gears and handle situations as they come.  Though, even when everything falls into place and everyone does their job, people do die.  Its a hard fact of life.  One day I started my day with a death and ended the day with a death.  But you move on, there are plenty of other people you can save.

Xray of the guy with a C5-6 fracture
 

Some of the more memorable cases:  a gentleman walked into the ER complaining of neck pain, he had fallen during the earthquake.  He was sent to xray and was immediantly put in an immobilizer when it was determined his neck pain was due to a C5-6 fracture!  It was a miracle he was still able to walk!  We brought him back to the OR and put him in traction to reduce the fracture.  Another patient with a C1-2 fracture, was a sweet 4 year old little girl.  She was in a C-collar, but it was too big for her and so she was still able to move her head.  In order for her to heal and prevent any spinal cord injury, we needed to immobilize her head completely, but we didn't have a halo for her.  It was decided to put her in a upper body cast, one that went from her chin, covering her shoulders and chest.

Improvising a halo out of casting material
  What a sweet little girl, she was all smiles, and soon the OR was filled with 4 american adults and 1 little haitian child singing Twinkle Twinkle Little Star.  Adorable!

We are reaching a supply crisis at this point.  We are running out of basic things, like lap sponges, anesthesia drugs, bovies (cautery), sheets, and even oxygen.  Yes, oxygen.  With 4 anesthesia machines, at least 5 vented patients in the ICUs, and any number of patients on the wards needing oxygen support, we are going through tanks like crazy.  We are also having issues finding regulators and keys to change tanks.  I've had to bag (breathe for them) patients on room air for a while because we couldn't find a new tank that had oxygen in it.

Central supply chaos
 

Oxygen is not our only problem.  During the intial weeks of the hospital, they were doing 30+ cases a day, trying to keep up with the increasing demands.  That being said, supplies were brought in and dumped around the OR.  Over the days, people have tried to put some order to the chaos, but inevidently, things were still hard to find.  With cases slowing down, we had more time to start going through the boxes and organizing.  Jade, a nurse from Nebraska, and I took it upon ourselves to weed through the mess and find everything a home, whether it be labeled on the shelf or sent back to the central supply tent- which  is worse off than our little supply area in the OR.  The military has stepped in to help us organize and I have complete faith that within a week it'll be completely transformed.

Jade lost in the supply tent
  Going through the boxes, we found some much needed supplies, some not so needed and some why on earth would anyone think we needed or could use this?  The saying "Junk For Jesus" comes up quite a bit- stuff that in all rights should have been thrown away, but instead was donated, all with good intentions, but totally worthless to us.  It took us the better part of 3 days to get the supplies in a workable order, but I would like to think we are leaving this place better than what we found it. 

aelder2259 says:
I just read your entire blog and I feel proud....proud that I live in a world with so many caring people like you. While I don't have the necessary skills (or the health) to help like you and others did/do, I'm there in spirit rooting you on and making donations so places like Haiti can get the much needed supplies. I applaud you for stepping up and taking action. Peace.
Posted on: Mar 06, 2010
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Tyler, from the ICU, models one of…
Tyler, from the ICU, models one o…
Making our own pulse lavage (used …
Making our own pulse lavage (used…
Xray of the guy with a C5-6 fractu…
Xray of the guy with a C5-6 fract…
Improvising a halo out of casting …
Improvising a halo out of casting…
Central supply chaos
Central supply chaos
Jade lost in the supply tent
Jade lost in the supply tent
The command center with the staff …
The command center with the staff…
Outpatient wound care tent
Outpatient wound care tent
Outside the adult tent
Outside the adult tent
Inside the adult tent
Inside the adult tent
The ER, yes its outside and gets v…
The ER, yes its outside and gets …
The ER and the peds tent
The ER and the peds tent
Removing an external fixator from …
Removing an external fixator from…
View of peds tent from the OR
View of peds tent from the OR
Jen, Dr Nathen, Jade, Sarah, Taylo…
Jen, Dr Nathen, Jade, Sarah, Tayl…
Our sterile instruments are under …
Our sterile instruments are under…
Port Au Prince
photo by: Bluenose