January 19, 2010 Evening

My father turned 87 years old today.

Many this last week have commented that “anpil moun ap soufri anpil anpil. Se la viv an." Many people are suffering very very much. This is life.

This is usually followed by “Bon dje pral ede nou.” God will help us.

The recognition of suffering as part of life is not said with condemnation – or resignation. It is an acknowledgment of the situation in which they now find themselves.

Faith here is powerful. I remain deeply moved each time I hear expressions of faith in the midst of this.

The hospital halls and outside courtyard areas remain occupied.

More steam in. We continue to get the very severe cases.

Today there was a reassessment and discharge of those who were ready. Or in some cases not ready, but nothing more could be done.

This is a difficult reality. “Bon dje pral ede yo.” God will help them.

Our staff has worked, and continues to work, non-stop to provide care and they are, along with many supplies, stretched to the limit.

On surgical rounds this morning we methodically moved from patient to patient. Our docs making decisions about how to handle each situation.

They were greeted with relief and questions.

During what is mostly a very serious process we found laughter. A gift from a very special patient. In the midst of an outdoor area sat a woman. One of those incredibly beautiful elders whose faces defy description. She is blind. On her bed sat her young grandson.

I’m not 100% certain of what she was saying, but it was heartfelt and insistent and not to be ignored. She was giving us all what I believe was a piece of her mind. And her assessment of the situation.

With every attempt to move on came another commentary. Our quiet surgeons soon found themselves stopping for affectionate banter.

The entire ward was drawn in.

A new team of surgeons arrived this morning. They went immediately to the operating room. Rumor has it that they are very energetic and determined.

With this increased capacity to provide surgical intervention comes the increased need for post-operative nursing.

If I could wish for something else to arrive today it would be more nurses and pain medications.

And Dad, I’m wishing you a happy birthday.

MASH - Tuesday, January 19, 2010

The following reflections were written this morning by Denise English, physical therapist, and director of our Rehabilitation Technician Training Program, who has been working at HAS since before the earthquake.

Today I wake to the sound of helicopters overhead.

Our doctors and nurses who were stranded in PAP returned on Sunday.

A team of surgeons arrived. The US Coast Guard brought them in from Ft Lauderdale.

Much needed back-up for our staff. Also a sign to those waiting that indeed the rumors were true. Help was coming.

Dr. Maibach [HAS boardmember and former medical director of the hospital] was in Port Au Prince when the quake happened. He spoke at morning medical meeting yesterday. He expressed his deeply felt sense of having returned home – home here to HAS.

The team from Ft. Lauderdale was to work through last evening and into the early morning – we heard the 3:00 am beep of the vehicle taking them to Cap Haitien. They will be exchanged for an arriving team.

It took them 48 hours to get here. Long circuitous route. They are hoping for a more direct trip home.

Aircraft continue to pass above us. Dawn is breaking. Soon they’ll be visible.

I’m remembering Radar O’Reilly.

Update from HAS, Monday 1/18/10

The following is an update from the managing director of HAS, Ian Rawson.

The flow of urgent cases from Port au Prince continues as before except that they are more serious cases. It has been possible to treat and release many of the patients, so slowly the ones who remain are taken off the floor and put on cots, and then to beds.

A surgical team from Miami arrived yesterday evening on a military flight, started to work immediately, and had done a dozen cases by midnight. There is still a long row of surgical candidates in the hallway by the operating suite. The team has provided a welcome relief to the Haitian surgeons, and they are prepared to continue their work through today. They had been stalled in Miami for two days due to the confusion surrounding flights into the Port Au Prince airport.

We are learning every day about disaster medicine; we are a microcosm of what is happening throughout the country, especially in Port au Prince. The clinical demand is astounding; thousands of injured people are seeking care in Port au Prince, and for many it is a race against infection and systemic damages.

We had, and still have, a desperate need for clinical personnel; the surgical team which arrived yesterday has helped a great deal. Our OR nurses have worked as hard as the physicians, and are also in need of a break. More surgeons represent more demand for their services. The Surgery post-operative ward has spilled out into other spaces, but with only a few additional nurses, who are stretched thin.

I hope this comes across not as complaints, but as a description of what life is like on the ground here at Hôpital Albert Schweitzer, where the vast majority of our services have been provided by an exclusively local Haitian staff, and are only now getting support from international specialists.

Many of our patients have been in our hallways now for days, patiently waiting for help. We have become good friends and I appreciate their forbearance when I explain why they have not yet had their much-needed surgeries. Their pain is becoming more intense, and they must be frustrated, but they always respond with a smile and an assurance that they are doing all right, when it is obvious that they are not.

Several patients have brought radios. One of the early morning broadcasts play hymns. The patients turn up the volume a bit, and many people quietly join the songs, from both wards, the halls, the pediatric clinic, which is filled with beds, and the old horse parking lot, which is also filled. Many Haitians have lovely singing voices and the sound is angelic. For many, it is an inspiration that their faith will help them to endure the pain.

Your collective concern and support has helped to sustain us all in the face of an incomprehensible demand. I, and all of us here ion Deschapelles, send our sincere thanks.

Ian Rawson

News from Deschapelles and Rehabilitation at HAS

The following is an account sent by email to us from Denise English, the director of the Rehabilitation Technician Training Program. Denise is currently in Deschapelles, Haiti, at HAS.

I find my telling of this new beginning far differently than I imagined. It will remain an account of hope and reaffirmation.

We arrived, Chuck Gulas and I, on January 4, 2010. Chuck flew in from St. Louis. Ian Rawson and I flew in from Pittsburgh. Chuck was waving from the curb outside the airport, having arrived ahead of us.

The trip up from Port au Prince to Deschapelles went smoothly. The vistas spectacular. Haiti never disappoints.

Chuck Gulas, PT PhD, is the Dean of the School of Health Professions at Maryville University in St. Louis, Missouri. This is his third trip to Haiti as volunteer faculty for Health Volunteers Overseas www.hvousa.org.

Beginning the second Rehabilitation Technician Training Program at Hopital Albert Schweitzer (HAS), brought us back. We’re a team. Class started on January 6, 2010.

We find ourselves sharing knowledge and laughter with our six delightful students – each one different – each one engaging – each one expressing their desire to become part of the health care community here assisting the disabled.

They are pioneers. Rehabilitation in this country is in its infancy. Chuck has a way with students. Knowledge delivered with humor. Yesterday class finished with laughter.

The last several days have been quite somber. The students each know someone who has been affected by the earthquake in Port au Prince. Most have family there. Yesterday phone service began to return with news of family and friends. Some good. Some devastating.

Patients began arriving at HAS before dawn on Wednesday. We’d felt the quake here late in the afternoon Tuesday, and the after shocks continued into the next day. We’re not certain, but we think that we felt some slight ones yesterday.

Most medical facilities in Port au Prince were rendered inoperable. Hôpital Albert Schweitzer is one of the few operating without interruption, having been spared the damage of the earthquake. It is now a key rescue facility.

Wednesday continued to see the arrival of vehicle after vehicle of the injured from Port au Prince. Many have been identified as from this area, or having family here. We are 70 miles by road from the capitol.

Our classroom at the hospital has been turned over for patient care. The Physiotherapi room is cleared out and functions as a ward.

Yesterday, we had class here at the house. The day began with discussion of news the students had received. The day ended, as noted above, with laughter. A good decision to spend the day together yesterday. A sense of purpose in a situation that is full of uncertainty.

Chuck and I were privileged to witness the initial mobilization of the hospital staff and community members in response to the arrival of the injured. A sense of calm – in the midst of suffering – prevailed. Patients were carried in the doors – often in the arms of security staff and other hospital employees called into action. Community members came to assist. We began to fill up fast. A search began for additional beds and mattresses. The staff began evaluating and then designating people for radiology and surgery. The nurses moving quietly between patients. Soon it appeared that every possible place was filled.

Hallways were impassable at times.

The patients continued to arrive through the night Wednesday and were still coming last night, Thursday, when I returned to the house around 11:00.

There was not as much heart-wrenching wailing this evening. Hymns could be heard being sung in the wards

Earlier last evening, Tomasz Skowronski, our HVO onsite contact and my partner in coordinating the HAS end of the training program needs for our teachers, was helping to coordinate and effort to secure more beds and mattresses. Now we were spilling out into the courtyards. The halls had long ago been filled to capacity – and then some.

The decision was easily made to press into service a bed and two mattresses that we were not using. Why we didn’t think of it sooner I don’t know. Tomasz arrived shortly with his team and whisked them off. We slept better knowing that someone else did as well. It was touching to watch Tomasz work along side of the others here.

David Charles, PT - the Director of Rehabilitation Services here at HAS – has been a leader in the efforts here – moving amongst the patients and assisting the physicians and nurses. Today we hope to be able to begin to work with him as patients are identified as ready for rehabilitation services.

The injuries are sobering – fractures, spinal cord and head injuries, amputations.

The families are remarkable – caring for and comforting, supporting one another.

Last night we were remarking that when we are in the midst of this we feel hopeful.

We are certain, more than ever, that the training of rehabilitation workers here will impact the lives of many that they touch. It already has. A reaffirmation.

Those who provide that service – our HVO Volunteers – and the sponsor organizations, Hôpital Albert Schweitzer and The Friends of HAS, are key.

In times like this, heroes are mentioned. They are indeed here in Deschapelles. We’ve seen them.

To make a donation to the Hôpital Albert Schweitzer earthquake relief fund, click HERE.

We need your support!

In order to continue to administer care to Haitians affected by this tragedy, we need your help! Please show your support through donations made online here:

www.hashaiti.org

Hôpital Albert Schweitzer Haiti (HAS), located 40 miles NW of Port Au Prince, was able to withstand the recent devastating earthquake and is currently operating with full staff helping victims. With mass casualty protocols in place, the medical staff is evaluating each patient, performing diagnostic tests and delivering life saving care.

Due to the expertise developed over its 54 year history, Hôpital Albert Schweitzer Haiti (HAS) is one of the few institutions positioned to provide timely hospital care for the injured. As the flow of people urgently seeking care increases over the next few days and weeks, our resources will be pushed to the breaking point. It is critical that we receive support to help us continue with our mission!

Pittsburgh Office
Hôpital Albert Schweitzer
P. O. Box 81046
Pittsburgh, PA 15217 USA
412.361.5200 phone
412.361.5400 fax

Afternoon Report Wednesday, 13 Jan 2009

As we have all heard many reports of the terrible disaster---a 7.0 earthquake in Haiti, the worst in 200 years. Up to 3 million people may have been affected. So far, tens of thousands of people have died.

Hôpital Albert Schweitzer Haiti, located 40 miles NW of Port-Au-Prince was able to withstand the recent devastating earthquake and is currently operating with full staff helping victims. With mass casualty protocols in place, the medical staff is evaluating each patient, performing diagnostic tests and delivering life saving care. Due to the expertise developed over its 54 year history, Hôpital Albert Schweitzer Haiti (HAS) is one of the few institutions positioned to provide timely hospital care for the injured. As the flow of people urgently seeking care increases over the next few days and weeks, our resources will be pushed to the breaking point. It is critical that we receive support to help us continue with our mission.

Ever since early this morning, a steady stream of vehicles, mainly the open-back pickups which serve as public taxis on Haiti's roads, has come to the front of the hospital. In the back are one or two people, their legs or arms covered in bandages or clothes. HAS security staff rush out to the truck with a backboard or gurney, and bring the patient inside to be triaged by the emergency team.

Now, in early afternoon, a crowd of over 200 people are outside the hospital, friends or neighbors of injured patients. They rush to the arriving trucks and try to help to carry the new patients inside. Occasionally, the combination of the person's injuries and the truck ride are more than can be sustained by the patient, and the family members, with great wailing, adapt to the shock of the loss of a loved one. A sound system has been set up outside, so that family members may be called into the hospital to meet with doctors.

Each patient is brought into the Observation Unit and quickly evaluated. Some are sent to for an X-Ray or lab test while others are taken immediately to the holding area outside surgery, where both operating rooms are being used full time.

All beds have been pressed into use, and still there are patients on benches. Gradually, some of the early arrivals and less injured are prepared for discharge.

Systems at HAS are working well; preparation and practice have paid off. The greatest resource, however, is the dignity and grace of people who have suffered a great shock and sometimes tragedy, and remain calm and show concern not just for the people with whom they have come here, but for others as well.

This is the most serious challenge ever faced by HAS in its 54-year history, and while we are currently coping with the onslaught of the injured, we urgently need support.

At this moment, we don't have the capability to accept material goods or personnel. Our greatest and most urgent need is for funds to pay overtime wages to our dedicated staff, and to buy replacement medicines and supplies.

We will update the www.hashaiti.org website with news of relief efforts. To make a donation that will have immediate impact, please go to www.hashaiti.org.

Thank you again for the many expressions of help and caring that are coming from around the globe.

HAS Haiti 1/13/09

These are images taken today outside of Hôpital Albert Schweitzer Haiti. Please, if you are able to dig deeply into your hearts and help us, please do so immediately through making direct contributions to our hospital.


Click HERE for a statement from the Friends' president, Lucy Rawson.

Earthquake in Haiti - Morning Report for Wednesday, 13 January 2010

Please donate to the HAS Haiti Earthquake Relief Fund by clicking HERE.

The following is the report we received this morning from Haiti:

The halls are filled with people who have come in overnight; all nurses and residents were called in to handle a large number of new patients - traumatic injuries, mostly. Hard to get a social history, but several reports of collapses of multi-story buildings in Petite Riviere.

The influx has been handled professionally by the all-Haitian medical staff and nurses - although all available gurneys and benches are occupied, patients are triaged and staged along the corridor to the operating suite and lab/radiology. Families and friends wait anxiously outside, while the necessary care is provided calmly and quietly.

Among the most serious impacts has been the loss of communications as the cell phone towers collapsed; everyone in this area has family in Port-au-Prince, with no contact. Several people left last night for PauP, taking public transport as far as possible, and then prepared to walk several miles into town to check on family members and to report back to anxious relatives.

Out here in the valley, we experienced only minor tremors, but people poured out of their houses onto the roads. As I write this, I am feeling a very small aftershock. Major cell towers are out and only Haitel has a signal. Only a few calls are getting through to PauP, where the radio says that many large buildings have been affected. Our twelve new residents and all physicians all have families in PauP, but can't find out how they are.

You may be getting better news from CNN or Fox than we are; we will continue to monitor as best we can, but we are afraid that the daylight will bring sad information from Port au Prince. Earthquakes are rare here - only the older people realized what was going on. Since the hospital has lights and electric current, the front is crowded with people listening to radios and sharing rumors.

Unfortunately, Haiti has a long experience with natural disasters, including floods, hurricanes and mudslides; each one reinforces our awareness of the fragility of the formal social service system, and the strength of the informal systems, where communities and families come together to care for victims and to ensure that the most seriously injured come to HAS and other facilities.

We are grateful for the many messages of support; time and demands don't allow for personal answers, but be assured of our appreciation. As is usual in disasters, we have sufficient doctors and nurses, a full stock of medications for the most part, and we are fortunate to have not lost power or water. We appreciate your concern, and will continue to offer updates as time allows.

Ian Rawson and the HAS staff

Please donate to the HAS Haiti Earthquake Relief Fund by clicking HERE.