My first medical mission trip: In the following pages I will talk about my experiences on my first trip to Haiti following the devastating earthquake in January 2010.
The biggest “first” is it was my first medical trip outside the United States. I had done disaster relief for Hurricane Katrina, but when the Earthquake in Haiti happened in January of 2010, I was given the opportunity to go and help with the disaster relief efforts. I remember it all happened very quickly. A friend and co-worker had gone on a medical mission to Haiti in late 2009, and were asked by the organization she went with, if she could come down and help. She said yes, but didn’t want to travel alone, so she asked if I would go. I said yes before checking with work, or family to see if it was possible. In the next week we made our arrangements, got our shots, packed our bags, and collected supplies from local hospitals. As the scope of the disaster was becoming apparent to the world, it was obvious that more people would be needed. Within a few days twelve local doctors, nurses, and medics were selected and we all rushed to get ready. Our team arrived on the twelfth day after the quake. Most of us had never been to a third world country, done medical care outside the U.S., or spoke Creole, the native language of Haiti. None of us had been exposed to a disaster of this magnitude, and that made all of us nervous about what we would find and do. We left St. Louis, MO with snow flurries and nine degree temps. Four hours later we stepped off of the jet onto the tarmac of a small airport in Northern Haiti with high temps (90 degrees) and high humidity. We were driven about 10 miles away and due to the horrible road conditions it took over 45 minutes. As we pulled into the compound of the organization we were working for, we were met by a nurse from the U.S. who said “put your stuff on the porch, get your scrubs on, and go to work”. Our orientation consisted of a briefing as we walked up the street to the hospital. Once we got there the O.R. team went one way, and the E.R. team the other. We barely saw each other the rest of the week. The most powerful image I have in my head to this day is the stack of medical waste and body parts outside the O.R. suites that needed to be hauled off and burned. The conservative estimate is 300,000 died in the quake that hit Port-au-Prince, Haiti. Thousands were injured, and millions were displaced and homeless. The hospital we were staffing was the receiving point for the U.S. Navy and international agencies that were evacuating injured out of PaP (Port-au-Prince). We would receive anywhere from 30-50 patients a day by helicopter, or pick-up truck. The hospital we were at was a 70 bed hospital with very limited capabilities. In the space of several days the school across the street became the new hospital. The basketball court became the receiving area. We triaged and began treatments here. Pts. were then moved to one of sixteen classrooms and treated there. These rooms had no power or lighting, our patient count was so high that the benches had to be removed so we could make more space on the floor. We shared translators between rooms; we did patient care after 4 pm by headlamp, and were responsible for finding our supplies in the boxes of completely random materials arriving from the states. As American medical workers we were freaked out at the lack of equipment, trained staff, supplies, documentation, etc. You name it, and it didn’t resemble what we knew. So we set out to create order, as much for us, as for a smoother flow to patient care. We moved patients so men, women, and children weren’t in the same room. We cohorted ortho, trauma, wound care, and contagious patients together. There were entire rooms of patients identified by their injuries i.e. pelvic fracture patients, or the Ex-fixes, or the amputations. We worked around the clock to set ourselves up for success, and to make the learning curve shorter for those who followed us. By first world standards the care we gave was horrible. We as providers were constantly asking for things we would use normally and were being told that those things don’t exist in Haiti. We spent our entire time behind the curve, and by that I mean many of our patients who had BKA’s for example had to go back and become AKA’s due to infection and no antibiotic therapy after their initial care. One of the most frustrating things for me that week was losing patients there that we would never have lost here. A little girl with pneumonia died for a lack of oxygen and a peep valve, or a man became septic and died because he never spoke up and told anyone he felt worse. We are so used to patients screaming and yelling as their pain got worse, not so in Haiti… the patient that was quiet, sweating, and clicking their teeth were the ones in the worst shape. We had to quickly learn that this culture and their ways were different than our own. A phrase I began using, and still use when introducing new folks to medical mission work is “Looking at third world problems through first world eyes”. We cannot make the same moral, ethical, and medical decisions there that we can here. Once you learn that, then you begin to work within the confines of the hospital or area that you are in.
When I was asked to write this about my first time, I was flooded with memories and feelings. Most of which I don’t have time to go into. I will share that when I came home the first time I was messed up. In my job as a Flight Medic here in the states, I see the worst of the worst, but only one or two at a time. In Haiti I saw no end to the patients, and felt like I wasn’t doing any good. At one point my first week our e.r. staffing ratio was 92:1. Can you even imagine that?! We worked 20 hr days, in tropical conditions, with little food or water. My departure for home was as abrupt as my orientation was at the beginning of the week. We literally got yanked from the hospital and put in the truck that the new folks were getting out of. Our hand-off was “umm, the hospital is there, the patients are there, there, there, and over there…supplies are there…good luck!” So six hours after I was knee-deep in patients, I was home alone. I slept for 24 hrs, and when I woke up I hurt. I had more physical pain throughout my entire body than I have ever had. I had not even to begun to process what I had seen and felt. The PTSD manifested itself for me in crying for no particular reason. It wasn’t that I was thinking about it, talking about it, seeing news reports, or anything I could put my finger on. I am enough of an emotional control freak due to the work I do here, that it pissed me off I couldn’t control the trigger for my emotions. I can honestly say that once I let the tears come, I began to heal. The best thing for me personally, was going right back a week later. When I left I felt like we were abandoning these people, there was so much work and care to be done. Going back I got to continue my work, I got to see patients I had cared for getting better, and while I didn’t slow down, I could see things beginning to get better. Since my first trip I have made nine more. I will continue to return to Haiti, even as I begin to go other places in the world to help. I still don’t speak much Creole, but I now have friends and coworkers there that I keep in touch with. I have bonded with one little boy and have helped him and his family. Watching him grow and succeed has been one of my greatest joys. I now help out in a trauma hospital in PaP. This facility sees the worst of the worst in Haiti, and is very well suited for my job and skill set. Everyone who goes will get something different from the experience. All I ask is that you try. It may or may not be for you, but I can promise you that you will be forever changed by sharing your heart and talents with the underserved in a third world country. You will be humbled, will look at your own life and work differently, and that kind of infection is good for us all.