March 2010 Volume 7

Dr Ken Vaughan's Haiti Report

Dr. Kenneth Vaughan
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I had the opportunity to give some needed medical assistance in Haiti after the recent earthquake. As part of the Ministry of Health's emergency response team I arrived in Haiti a week after the event. Things were pretty chaotic with a lot of septic patients needing limb ablation surgery for their survival. We had to function under very trying circumstances with limited resources. Nonetheless we were able to do a good job. Some wounds had to be left open because of sepsis, whereas others were closed. We had to function during the daylight hours as there was no guarantee of light at nights as the hospital's generator was turned off at nights. Needless to say we were not allowed to stay overnight for our own safety as we were provided with Jamaica Defense Force Escort and UN vehicle for transportation. At nights there was also a curfew. This meant that the patients we operated on during the day had to be well enough to be left at nights where there were no personnel to look after them. It was very difficult but we were under military instructions. As the week passed, we were able to have a few night-nurses to care for patients who were in tents all over the hospital compounds and some just under the elements. Fortunately, it did not rain otherwise it would have been disastrous for the patients.

Having adequately dealt with the cases of gangrene we were able to attend to those cases that had closed fractures, placed casts on them where appropriate or set up skin tractions. All this was done without any knowledge of the type of fractures as we had no x-ray facilities. That was to come later. In the midst of all of this there were cases of malaria, gastroenteritis, births etc. In any one day I had to wear several caps including that of porter, midwife, paediatrician, physician, etc. We had a great team and fortunately despite the lack of lab facilities, (we did not have blood count or electrolytes on any patient) we did not have any mortality. Our anaesthetists were superb as were our surgeons I might add!

This was truly a once in a life time experience. It was very rewarding and I am happy I was able to make a contribution despite the challenges. It has however taught me a few things which I will share, namely:

1. Not everyone who comes to your country in a disaster is there to help you

2. There are different levels of staff that come in any situation of a disaster, some are more of a nuisance than anything else and would create havoc rather than being of any help. We had several run-in with some of those who would want to amputate a woman's leg for example because she had a fever and to his mind that meant gangrene while not taking the time to examine the whole patient to find out that the woman had a pneumonia hence her fever, which was not due to the laceration on her thigh!!

3. The media often have no regard for the privacy of patients and would want to disregard the dignity of the native people for the sake of a footage!

I have bored you all enough. If ever any of us in the region should experience any such disaster we have to come together to help each other. Our collective skills will be needed.

For those who are not aware there is still a team in Haiti which is there on a rotating basis helping to provide care. They are now in the stage of public health and fixation of fractures.

Keep them in your prayers.

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