Notes on Haiti - CEO Journal Part 3

Chris Van Gorder, FACHE, President and Chief Executive Officer

Note: While serving a medical mission to Haiti, Scripps CEO Chris Van Gorder is writing dispatches about medical aid in progress, conditions on the ground and what can be done to help earthquake victims. For other journal entries, see the Haiti news page.

This morning (Monday) we started our day early with a trip to the Mission Baptiste Hospital, which is up in the mountain above Port-au-Prince. On the way to the hospital in the Papal Nuncio’s diplomatic car, the police officer driver asked us to stop to see his cousin, who had injured her foot in the earthquake. Dr. Edward Gamboa made a quick check, cleaned the wound and sent her on her way.

Our driver was a very interesting man. As we were driving, he told us he was a policeman during the week and, on the weekends he played and sang in a piano-bar. He actually studied music for three years in Germany. When he was told I was a former police officer, he jumped in his seat, and yelled, “Sallud, you’re fine now, I like you” — and we continued to the hospital.

The Haitian mountain above Port-au-Prince was beautiful, with small farms across the valley. Along the entire length of road we saw more people just walking up or down the road, or selling food or other mostly-used products — anything to make a living or survive.

We finally arrived at the Baptiste Hospital. It had approximately 80-100 patients and the hospital was in much better shape than the hospital we had been working in. All patients were indoors. Surgery was conducted in two operating rooms with full general anesthesia and there were many volunteers: chaplains, physicians and nurses from the Billy Graham organization. We were given a tour and we discussed patient cases with the medical staff, but it was clear that they did not require any additional support.

So we drove back to the Papal Nuncio’s compound to pick up supplies that Dr. Gamboa had arranged to have delivered, and we loaded up to return to Hospital Saint Francis de Sales, in the most heavily damaged part of the city.

On arrival at the hospital, we found it much busier than on Sunday. The outside triage area was full and it appeared as if there were even more patients than the day before.

Dr. Eastman was pulled immediately to triage/pre-op to check three patients: a boy who had a crush injury to his foot, a woman who had an old injury to both of her lower legs, and another woman with a leg injury. This last woman had been eight months pregnant, but she lost the baby when she was trapped for eight hours under the rubble of her house.

We also learned that the young boy we had cared for yesterday had lost the battle to save his foot and it had ultimately been amputated. But he was going to survive.

So we started our work. Dr. Eastman began with the boy with the foot injury. His wounds were surgically cleaned and two toes removed that were not salvageable. I was able to assist on these cases. We were also fortunate to meet a surgical tech who had just arrived from Boston. She agreed to work with us and, frankly, that was a big relief for me. But I did get to be the “circulating nurse” (in name only), pulling supplies and assisting wherever I could.

Our next case was the woman who had sustained injuries to both legs. Dr. Eastman opened and cleaned both wounds and we packed them with material that will aid in healing over time.

The Belgian physicians and most of the German physicians were leaving. What we did not know is that they were taking their anesthesiologist with them, along with all of their surgical instruments. After some negotiations, we convinced them to leave their instruments. Dr. Eastman also went into one area of the hospital not being used anymore due to earthquake damage and found more surgical instruments. So we were still in business.

We also had a patient with Tetanus (rarely seen in the United States). Unfortunately, this boy will probably not survive.

At the end of a busy day, we met with the Papal Nuncio who had come to pick us up, as well as the leadership of the hospital. They met and then approached me to ask if we could come back — with a few more Scripps doctors and staff. Apparently they liked our style, quality, and work ethic, and despite the fact that some other physicians are coming to work at the hospital on Wednesday, they also wanted a Scripps team to return as soon as possible. They told me it was their hospital and they could invite who they wanted to help, and when they wanted the help. (This reminded us of Houston after Hurricane Katrina. At that time, Mayor Bill White invited us back after Hurricane Rita.) The Papal Nuncio also said he would help our team with lodging and transportation when we are there — all within their capabilities, of course.

After our shift today, we returned to the Papal Nuncio’s home and had dinner with the Nuncio and Father Rick, a priest with a D.O. degree who operates an orphanage and a children’s hospital.

During dinner, he told us what it was like in the days right after the earthquake. He said there were so many dead outside the National Hospital that the line of dead was more than a half mile long. He said people would bring their family members who had died to the National Hospital, but the hospital would not take the responsibility to bury them. So, in this case, several front-end loaders picked them up and put them into trucks for mass burials. He told us that he and several volunteers came to pray for the souls of the departed when they were being removed in the trucks.

During the dinner, Father Rick told us how difficult it was to operate a hospital and orphanage in Haiti. He said that to operate in Haiti, you had to be able to provide your own power, water, and electricity. He also said you needed to make sure your medications were pure and from a reputable dealer. He told us some horror stories and said you even had to be careful with labs because some used poor equipment, etc. Father Rick told us that they would sometimes send lab work to two outside labs, only to receive “wildly different results” due to bad equipment and expired reagents used in the testing.

So, in summary: in just a couple of days, Dr. Eastman and I came to Haiti on an information gathering mission, and found ourselves caring for patients for two days in addition to our information gathering. And based on the request to come back to help the Haitians recover, we might be back relatively soon.

As to my story of the day — well, I found out that the number of dead under the collapsed part of the hospital is much larger than previously thought. It is now estimated to be somewhere between 50 and 200 – 25 babies and more children, parents and staff members. Very sad and a constant reminder of the tragedy. In addition, we found flies — lots of flies. I found it interesting to care for patients while flies were constantly in your operating room and all around. I wondered many times today that if we were in California, would the State DHS licensing people let us continue taking care of patients? But this was not California, and these patients needed our help — even if there were flies all around. We did what we had to do, and what we could do.

So we will soon end a short stay in Haiti, but it appears as if we will be back with other Scripps doctors, nurses and support people… because they want us &#8212 and they need us.

See you soon.

Chris and Brent

See the Haiti news page for other journal entries.