Canceled civilian flights into Port au Prince resulted in a 24-hour delay in Los Angeles, and then a diversion through the Dominican Republic where the chaos began. Our orderly civilian travel ended in Santo Domingo, DR, where we had no clear way into Haiti, but heard about a possible UN flight for relief workers. So we hitched a ride with 250 lbs. of medical gear to a military airbase were we did indeed secure a ride on a US Coast Guard C-131 cargo plane to get to Port au Prince at midnight last night. The infrastructure is so badly broken in Haiti that there is NO immigration process anymore. It felt distinctly strange to just “walk into” a country with no official stopping us to at least look at a passport and without having to fill out some form.
We had to walk about 3-4 miles along the runways of the airport to get to the UN compound, where we found a very active emergency medical clinic run by no one in particular, but staffed by ortho surgeons from Miami and other doctors from Partners in Health (started by Paul Farmer) and other Brigham and Women’s Hospital staff. They were incredibly short staffed and have approximately 100 patients, many two to a bed. It was about 5 am before we got a few hours sleep, but not before a briefing, and some patient care. The excitement of the evening was a patient brought in by one of our US Urban Search and Rescue teams that had been rescued from inside a collapsed school. She was a 15-year old who required amputation of her left arm in the field to free her after her 3-day entrapment. Needless to say, she was in poor condition, and it took hours to get her stabilized. It’s safe to say that without the sophisticated search and rescue and medical care she received, she would have died.
Today did not involve clinical care, but more of us setting up a program that can hit the ground running with the additional 10 people arriving by Monday. We’ve registered with the Office of Coordination for Humanitarian Affairs (OCHA), and managed to rent a vehicle and driver (not a small feat in a country with few available cars). Still need to secure better accommodations, as we spent our few hours of sleep on banquet style tables under the stars. There are no houses for rent and all hotels are either full or damaged. We will likely end up in tents – and the safest place will likely be the UN compound. We still have leads on some possible houses for rent from friends/relatives of contacts.
The current logistical and medical problems are huge. The one hospital standing is full and is planned for evacuation. There are supposed to be five field hospitals established, but until that happens there is almost no advanced care capability. Fuel, food and water supplies are low – there was no breakfast or lunch today at the UN compound as there was no water for cooking. It is a country with little resources to begin with that now has literally nothing – no active banking, commerce, or ability to dig itself out, much less stand on its own.
Today has been quite busy with team selection as well. One of the administrative parts of my work has been to facilitate volunteer opportunities for others, and I’m happy to say that by Monday, 6 of the 13 team members will be Kaiser Permanente staff, with hopefully more coming later. We are expecting a lot of work, but putting together the right people with the best skills has been time consuming. In the end, I’m very optimistic that we will have an incredible team. Right now I’m just hoping for a decent night’s sleep.
Thank you, thank you to all who have helped support this work!
Update from Hernando Garzon, MD, January 16, 2010