Newswise — The challenges were almost countless. Most were deadly serious, including life-threatening injuries, amputations and pervasive infection.
Some were a bit less serious, including a rogue rooster that insisted on providing 4 a.m. wakeup calls.
Through it all, a medical team organized by a physician assistant at The University of Texas Health Science Center at Houston (UTHealth) labored under grim conditions to treat hundreds of victims of the earthquake in Haiti. And throughout their weeklong stay in that devastated country, orthopaedic surgeon Milan Sen, M.D., kept his followers on Twitter updated. Sen is an assistant professor of orthopedic surgery at The University of Texas Medical School at Houston, part of UTHealth.
“Haitian people have a tremendous spirit and they are going to need support for many years to come. Please don’t forget them,” wrote Sen in his final “tweet” after the team returned to the United States on March 7.
“I can’t say enough about what the University of Texas team did for us,” said Carol Fipp, who has been coordinating a complex schedule of medical teams since an earthquake smashed the Haitian capital of Port-au-Prince on Jan. 12. In addition to the estimated 230,000 people killed, many thousands were severely injured by collapsing buildings and falling debris.
Fipp has worked long hours contacting individual doctors, nurses, physical therapists and others as she assembles teams to come to Haiti. When she received a call in February from Jerry Buchert, UTHealth orthopedic surgery physician assistant and instructor, she couldn’t believe her good fortune.
“When I have someone call me and say, ‘We’d like to bring a team of 15 or 20 or 25 people’ and I have to talk to only one person to get it all set up, that’s a tremendous help,” Fipp said. “It’s a huge job to build a team. It was a tremendous gift to us and to Haiti.”
Buchert and others in the 27-member group say the gift went both ways. He said he will always remember the experience and the people he worked with, and he believes they would gladly go back if called upon.
“The people of Haiti had a need and we were all blessed with the ability to help people in this type of situation,” said Buchert, who works with Rex Marco, M.D., associate professor, orthopaedic oncologist and spine surgeon at the UTHealth Medical School. “It was a gift that we had the opportunity to go down there and help.”
In some of his tweets as the group prepared to return home, Sen wrote about the Haitians’ gratitude.
“Said our goodbyes. Translators were so grateful,” he tweeted on March 6. “Said that without our help, they would have to watch their people suffer, unable to help them.”
A short time later, he wrote about the patients’ expressions of thanks. “Pts very grateful, sad to see us leave,” Sen tweeted. “I think it is hard for them also. They get attached, learn to trust you, and then you leave.”
“I have never received so much gratitude just for doing my job,” Sen added. “God blesses me and will protect me, they say.”
The team worked at Sacred Heart Hospital in the town of Milot, about 90 miles from Port-au-Prince. Fipp, a resident of Jacksonville, Fla., who is preparing to start nursing school, is a board member for CRUDEM, the American nonprofit foundation created to support the hospital.
More than 500 patients injured in the quake have been treated surgically at Sacred Heart, a 23-year-old hospital. While Sacred Heart typically had 10 to 12 volunteers at work during normal times, Fipp said the volunteer base has stayed at about 90 since the earthquake. New orthopaedic surgical teams are being brought in every Saturday and volunteers are asked to stay for at least a week so that a level of continuity can be maintained.
The Texas Medical Center team was organized after Buchert heard from a friend who went to Haiti with a group in late January. Buchert said he was trying to think of how he could help after the earthquake, and his wife, Jennifer, urged him to aim high.
“I was thinking pretty much about what I could do myself, but she challenged my effort level and helped push me to figure out what to do,” he said. “I figured out that we could accomplish a lot more if a whole team went.”
Sen, an attending physician at Memorial Hermann-Texas Medical Center, said the team realized quickly that, in addition to the severe injuries that needed treatment, infection was a major problem. With the hospital at its capacity (300 patients in a space designed for 73 beds), victims were housed in a small school across the street and in six tents, each of which held about 40 patients on cots.
“These cots were better than being on the ground, but it still was not a good situation,” Sen said in an interview after returning. “There were a lot of pressure sores, a lot of flies and the bedpans were being kept under the cots.”During their week in Milot, the surgeons performed 94 operations or procedures. Buchert said they worked hard to prevent infection, installing mosquito netting to keep flies out of the operating rooms and helping people understand the importance of such measures as keeping doors closed and digging latrines.
The surgeons decided that, except for spinal cases, they would rarely use internal hardware in orthopaedic surgery because at least half of the patients developed infections, Sen said. Doctors also had to make difficult decisions in prioritizing patients because of the scarcity of some equipment. The pediatric cases were hard to deal with, he said, noting that many injuries that might be treated routinely in the United States could be fatal for Haitian children because of the high infection risk and their malnourished condition.
Among those was 3-month-old Faina, who was rescued after five days in the rubble under the bodies of her parents. Faina’s broken leg had become septic and she had no intravenous access, raising fears that she would die if she were not taken to the United States. The Houston medical team finally had to head home with the issue still unresolved, but Peter Kelly, M.D., president of the CRUDEM Foundation, reported on March 15 that doctors had managed to treat her with antibiotics and she had recovered without losing her leg.
The team members focused on getting the job done, Sen said, and even surgeons sometimes carried patients on stretchers. “We understood from Day 1 that there was no hierarchy,” he said.
In addition to Sen, Marco and Buchert, volunteers from UTHealth’s orthopaedic surgery department were Timothy Achor, M.D., assistant professor; and residents Matt Camarillo, M.D.; John Wesley Munz, M.D.; and Michael J. Connally, M.D.
Didier Sciard, M.D., associate professor of anesthesiology at the UTHealth Medical School, also joined the team. Nurses who participated were from Shriners Hospitals for Children Houston, The Methodist Hospital and Memorial Hermann-TMC.
“We couldn’t have done it without the residents,” Sen said. “Those guys ran a tight ship. Everybody worked hard, but they were particularly impressive.”
Despite long hours treating patients, Sen kept up a steady stream of reports on Twitter and displayed his humor amid chaos. After arriving in Haiti on Feb. 27 and triaging patients, he tweeted: “Dinner of champions! Macaroni, Hamburger Helper and Guinness!”
Fipp said the Haitian people are extremely grateful for the help that has poured in from the United States and other countries. And a lot of medical professionals have expressed gratitude that they got the opportunity to help, Fipp said.
“I hear from many, many people who go down there and then, afterward, they tell me, ‘It changed my life.’ ”
Buchert said that, since recruiting the team, he has received at least 2,000 e-mail and Facebook messages from medical professionals and others asking how they can help. He said people can contact him at [email protected] or go to the CRUDEM Foundation Web site at www.crudem.org.
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