Is There Progress?

The departure lounge at CAP is busy at 7 am. Young men jostle to carry luggage to security (the x ray machine is still not in service) and the bags are searched by hand, slowing the process. There are 5 flights this am – 3 to the States, but unlike in March, there are no other medical volunteers. Although I have picked up a small bit of Creole, I feel like a true foreigner. In some ways, this is comforting – at times, when the relief effort was in full swing, the airport had the feel of an invasion, and I was part of the army. Today, the pace is one of relative normalcy, and the inefficiencies and delays are expected and shrugged off.

The past week has moments that I have felt a great deal of optimism, and other times, frustration. The infrastructure is clearly improving – roads are being paved, there are solar powered streetlights around the hospital and compound, and with potable water, we no longer have piles of empty plastic bottles that were being burned. But at the same time, I saw an unhelmeted motorcyclist hit from behind, thrown from the bike and knocked unconscious. He had an obvious ankle fracture. Peopled emptied out into the street from both the hospital and the compound, and grabbed him by the extremities, without supporting his neck. A stretcher in the back of a pickup arrived, and he was taken to the hospital, but directly to xray. I did what I could to evaluate him, as he had woken up, but there were no vital signs taken, no IVs, and obviously, no way to do a CT. I later learned that numerous ATLS type lectures had been given to the security staff and others, but they clearly had little effect. We took the time to reemphasize stabilizing the neck and running the ABCs before focusing on the obvious fracture. Shortly before that, a young man came in with burns from a homemade still. He was taken outside the ED and numerous buckets of water were poured over him, and he was placed in front of a fan. This is the local standard of care, and we became involved with him, on request, the next day. We debrided and dressed all the wounds. I had rescheduled him for another dressing change in two days. When we called for him, the local nurse told me there were no more dressings, and by the way, he had checked out and returned to Cap.
Once again I was reminded of my role. In Haiti, as well as in the rest of my life, there are things that I can and should change, and others that may be beyond my control. By setting an example that yields good results we can hope that more global improvements may occur.

I was concerned about leaving the patients that I had cared for, as I didn’t know what surgical backup would be available. Then I heard a familiar voice – it was Jerry Bernard, a proud father of a new baby girl, and back to take over the service. He updated me on Rudy, my patient with the pelvic abscess- his ostomy was closed and he is very happy. Several other big cases had made good recoveries, including my little girl with the ovarian tumor. I knew that things, if not perfect, would be OK.



I’m finishing this blog from the Fort Lauderdale crown room. The internet works, there are no mosquitoes, and I’m still smiling from everything, good and bad, that happened last week.