Day 4: L'Hopital Bernard Mevs, Port-au-Prince, Haiti
April/17/2012 10:00 PM
So much to report about today, we don't know where to get started. I'll go for chronological. Some of the stories I share today include tales from the nurses who are with us on this trip and doing an amazing job.
At 3:00 am, a patient was brought in to triage with a diagnosis of a stroke. The radiologist and Emergency Room RN were asked to do a CAT scan on him. So, the two of them and five medical students studying here accompanied the patient to the mobile CAT scan unit. The radiologist noticed that the patient was soaked when removed from the scanner and once the scan was read, it was evident that the patient would probably not survive very long and the decision was made to clean the patient up before the family came to spend time with him. In cleaning the patient up, a medical student casually asked if the patient might have cholera and within seconds, it became clear that this was the case.
To not go into too much detail, cholera is usually determined by white runny/liquid fluid coming out and that was what the staff was in to. With that the crew needed to do a full decontamination protocol, which essentially means stripping down to nothing and washing in bleach and then doing away with anything that came in to contact with the patient. This particular case would mean that the triage area, emergency room, CAT scanner and all the staff who worked with this patient needed to go through major clean up. Of course the first challenge being that it is Haiti, is where is the bleach? The second challenge was convincing the Haitian medical students that they needed to strip down with the two female nurses, modesty being what it is. So, with some convincing the bleach bath was completed, the CAT scanner was bathed, as was the triage and ER and everything was back to "normal" when we woke up to start our day.
Things got crazy pretty quickly with more trauma and gunshot wounds. What we are learning is that people no longer threaten you with a gun while robbing you. Instead they simply shoot the victim in the neck at close range and make off with whatever they get their hands on. This explains why we are seeing so many cervical spinal cord injuries/gunshot wounds.
So, enter trauma patient one, a 33-year old who was brought in by ambulance (they mistakingly dropped him on to the exam table), with a gun shot wound at close range and a completely shattered C5-C6 spinal cord injury. If life wasn't hard enough for this young man, he then tested positive for HIV and syphillis. As the doctors said, he hit the trifecta. Not trying to make light of the morbid situation, but some of the docs are getting a little punchy from the overwhelming cases that keep coming through the door.
The story which caught our hearts the most is a young boy named Jerry. He says he is 11 but looks more like 7. The police found him last night wandering the streets of Port-au-Prince. They noticed that his wrist looked to be in a funny position, so they brought him to the hospital. The orthopedist was able to reduce a wrist fracture and get him casted, but first he was treated to a full-on bed bath and washed from head-to-toe. This is a shocking thing to see in Haiti, as the nurses generally do not bath the patients (family is responsible for all food, washing and linens), but this boy was being given the royal treatment.
It turns out his clothes were filthy, that the boy is homeless, unclear how long he has been wandering the streets of Haiti, and probably lying about his age in fear of getting in trouble.
He was treated to a pair of sneakers (probably one of the Tight's we believe) and a soccer ball (thank you James Laura). A perfect fit. Small scrubs were rolled up to serve as pants which promptly fell to the floor when he stood up. It's amazing how many ways one can use the precut Thera-Band we brought down with us. They can serve as a quick belt when one's scrubs are sinking to the floor. So now the hospital has a little boy Jerry which every one of us wants to bring back to the States. He is spending the night tonight with the Radiologist Stacy. He has been showered with gifts and lots of attention but when all is said and done, this poor little boy has seen far too much devastation for his years and his story is too tender and it breaks our hearts.
The highlight of the day was Susanne's stretch class attended by Nick, General Surgeon Allysa, Anesthesiologist Dave, one of the OR RN's and myself. It is amazing how wonderful we all felt after taking 15 minutes to do something good for our bodies. Our minds appreciated it as well! And I think we provided some entertainment to the Haitians coming in and out of the room we were stretching in. We got lot's of strange looks.
A good time was had by all at the UN for dinner. Quite a collection of characters at the UN. More about this another time.
We are tired and ready to go to sleep. Hopefully the very large cockroaches found in our bathroom last night will have found another place to expose themselves, preferably far away from Bunk 1. Nick and Kenny (4th year resident from Highland Hospital in Oakland, CA), were given the job last night of getting rid of each one we found. They made such a big deal about it too. What is the point of sharing a bunk with these men if they can't promptly kill a few genetically enlarged tropical cock roaches the size of flaccid penis?
Good night to all.
Jen
At 3:00 am, a patient was brought in to triage with a diagnosis of a stroke. The radiologist and Emergency Room RN were asked to do a CAT scan on him. So, the two of them and five medical students studying here accompanied the patient to the mobile CAT scan unit. The radiologist noticed that the patient was soaked when removed from the scanner and once the scan was read, it was evident that the patient would probably not survive very long and the decision was made to clean the patient up before the family came to spend time with him. In cleaning the patient up, a medical student casually asked if the patient might have cholera and within seconds, it became clear that this was the case.
To not go into too much detail, cholera is usually determined by white runny/liquid fluid coming out and that was what the staff was in to. With that the crew needed to do a full decontamination protocol, which essentially means stripping down to nothing and washing in bleach and then doing away with anything that came in to contact with the patient. This particular case would mean that the triage area, emergency room, CAT scanner and all the staff who worked with this patient needed to go through major clean up. Of course the first challenge being that it is Haiti, is where is the bleach? The second challenge was convincing the Haitian medical students that they needed to strip down with the two female nurses, modesty being what it is. So, with some convincing the bleach bath was completed, the CAT scanner was bathed, as was the triage and ER and everything was back to "normal" when we woke up to start our day.
Things got crazy pretty quickly with more trauma and gunshot wounds. What we are learning is that people no longer threaten you with a gun while robbing you. Instead they simply shoot the victim in the neck at close range and make off with whatever they get their hands on. This explains why we are seeing so many cervical spinal cord injuries/gunshot wounds.
So, enter trauma patient one, a 33-year old who was brought in by ambulance (they mistakingly dropped him on to the exam table), with a gun shot wound at close range and a completely shattered C5-C6 spinal cord injury. If life wasn't hard enough for this young man, he then tested positive for HIV and syphillis. As the doctors said, he hit the trifecta. Not trying to make light of the morbid situation, but some of the docs are getting a little punchy from the overwhelming cases that keep coming through the door.
The story which caught our hearts the most is a young boy named Jerry. He says he is 11 but looks more like 7. The police found him last night wandering the streets of Port-au-Prince. They noticed that his wrist looked to be in a funny position, so they brought him to the hospital. The orthopedist was able to reduce a wrist fracture and get him casted, but first he was treated to a full-on bed bath and washed from head-to-toe. This is a shocking thing to see in Haiti, as the nurses generally do not bath the patients (family is responsible for all food, washing and linens), but this boy was being given the royal treatment.
It turns out his clothes were filthy, that the boy is homeless, unclear how long he has been wandering the streets of Haiti, and probably lying about his age in fear of getting in trouble.
The highlight of the day was Susanne's stretch class attended by Nick, General Surgeon Allysa, Anesthesiologist Dave, one of the OR RN's and myself. It is amazing how wonderful we all felt after taking 15 minutes to do something good for our bodies. Our minds appreciated it as well! And I think we provided some entertainment to the Haitians coming in and out of the room we were stretching in. We got lot's of strange looks.
A good time was had by all at the UN for dinner. Quite a collection of characters at the UN. More about this another time.
Good night to all.
Jen
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