ISHI organized a surgical team of six to provide critical care in Haiti in response to the horrible aftermath of the recent earthquake. We are also in the process of prepping a second team to take over once the first team returns. We will be posting updates from our team as they come in from the field, so please check back frequently or sign-up to be automatically notified of new posts.

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Day 8 (January 30)
Departure day. The team has been at the airport since 9a.m., and their flight, which they were told would arrive around noon, has not arrived and it is already early afternoon. With the airport occupied by the US military, the team has nowhere else to wait but out on the tarmac in the sun. The team is getting very tired with no shade, dust, and the constant loud noises from the runway.

Day 7 (January 29)
The team was very happy because the new team from the Philippines who was going to take over the hospital managed to make it to Haiti. They took them to the stadium to show them around and introduce them.

A US military team came to assess the hospital (what they are doing what suplies they have, etc.). The day before, they did twelve surgeries and today they plan on doing ten.

They are still seeing many cases of fractures that have not been treated since the earthquake. They had a case of a child with an intestinal perforation that Dr. Sifri suspected might be typhoid. The pediatric team is working in the stadium and becoming more independent. There are a lot of pediatric cases. The team is very tired, and the work is very hard, but everything is going well.

Day 6 (January 26)
Yesterday the team performed thirteen operations and they now have about thirty in-patients. The doctor who joined the group yesterday is a plastic surgeon, but he wasn’t able to bring his skin-grafting machine. However, two blocks away is another hospital where there is another plastic surgeon. That facility does have the skin-grafting machine, but they refused to lend it to the team. So the team was forced to transport their patients the two blocks to the other hospital so that they could use the machine on site there.

Today the team has fourteen surgeries scheduled, so they are very busy. They returned to the stadium and took a physician’s assistant with them who is the wife of Dr. Benton, the hand surgeon. They sent back one ambulance with an eleven-year-old with a femur fracture, who had not been treated since the earthquake and whose leg was clearly broken, back to the hospital, as well as a very dehydrated baby. The second ambulance was sent back to the hospital with a patient who had a tibia fracture, another dehydrated baby, and a baby with an injured finger (since there is a hand surgeon there).

There are many children in need of medical care in the stadium, but Heart to Heart does not have much experience in pediatrics. However, as mentioned yesterday, the team changed houses and the new team that moved into the house they left is actually a pediatric team, so Dr. Sifri contacted them and asked them to head to the stadium. They sent one pediatrician and a pediatric nurse. This has helped Heart to Heart and the children in the stadium immensely. There is a triage tent and children are being given oral hydration therapy there.

Yesterday a Russian team sent two patients to ISHI, as they are getting a reputation for dealing well with orthopedic issues. They are also getting walk-ins for things like redressing wounds.

There is a possibility that a team from the Philippines might come in once ISHI leaves (the team that was supposed to replace them cannot get a flight). Regardless, ISHI is trying to discharge as many patients that can be discharged, and transfer the patients that need more care to other hospitals before leaving the country.

The team is getting tired. They are working very hard; sleeping on the floor. To exacerbate matters, there was a car accident in the evening near the home where the team is staying. Two men suffered broken legs (one with an open wound), so Dr. Reino and another doctor took them to the hospital and took care of them for two hours before returning home.

The patients have no food. The World Health Organization has not honored its promise to deliver meals for fifty patients per day, and so the team is giving them their lunches and eating protein bars instead. The team is still managing to eat well, but obviously food is quickly becoming scarce. Supplies are also dwindling, but the team is receiving donation of supplies, antibiotics etc. from other teams that are leaving.

The desperation of the Haitian people is growing day by day. Someone abandoned a one-month-old baby on a chair in the hospital, presumably because they could not care of the baby.  One of the nurses from Florida is working on the adoption papers so that she can bring the baby back to the States with her when she leaves in two days.

Day 5 (January 25)
The team has moved to another house with running water and electricity, so they are much happier. They went again to the stadium and most of the cases are now infections, coughs, diarrhea. Almost half of these cases are pediatric. Dr. Sifri will be asking the pediatrician from the hospital to go to the stadium tomorrow. In the meantime, they got called back to the hospital as the caseloads there had increased. People are hearing that this hospital is now up and running and they are starting to head there.

The nine-month-old infant with dysentery is doing better and is still in the hospital. There is a patient with the broken spine, who will be taken to a hospital in the US. Two nurses and one doctor have arrived at the hospital, which is making things easier for the team.

Day 4 (January 24)
There was an aftershock this morning at 5am and a bit of panic, but everyone is fine.
Today the hospital was rather quiet and the patients were doing well, so the ISHI team went to the stadium to help Heart to Heart. They found a 9-month-old baby with dysentery and they couldn’t wake her so they sent her by ambulance to the hospital. They are seeing a lot more infections with coughing and dysentery, and have to do a lot of wound care. ISHI is donating IV tubing to Heart to Heart as they are running low in the stadium.

ISHI has made a deal with an ambulance driver to take patients back and forth from the stadium to the hospital and bring back patients who are no longer need to be in the hospital back to the stadium. ISHI pays for the fuel. Today they already sent two ambulances to the hospital from the stadium with a total of nine patients (including the infant).

A Syrian storeowner visited the hospital and donated some food and drinks to the team. They asked the storeowners for some prune juice (for patients) and some mops (to clean the OR). Sadly, two boxes of food that the hospital had were stolen. ISHI will be making a donation to the people who are lodging them and feeding them. One of the challenges is that there is no electricity at night, so they’re having difficulty charging their phones and cameras.

The team received the three units of blood (whole) at the hospital for the anemic man, and there is also an anemic girl who is also in need of blood. Another patient has a serious foot condition and infection that requires an amputation, but she is refusing it for now.

The French team visited the hospital to do some occupational therapy. They evaluated the patients and distributed about twelve pairs of crutches. There is another hospital two blocks away from Hopital Eleazar Germain that is doing plastic surgery, so patients who need plastic surgery are being moved there once they are stable. This hospital needed some extra help so they asked to “borrow” the team’s orthopedic surgeon.

Day 3 (Saturday, January 23)
There are currently long patient lines at the stadium and the team is helping the Heart to Heart nurses (who are not specialized in emergencies, but rather in cardiac care) to do the triage. The stadium cases were initially being cared for by an Israeli team, then Doctors Without Borders, and now Heart to Heart. A new Israeli team just arrived to help.

One new case in the stadium is a man who was bleeding from his calf. An ER doctor in the triage center made a small incision and he bled profusely. The bleeding couldn’t be controlled. The team put a tourniquet on his leg and paid an ambulance $20 (the cost of the fuel) to take him immediately to the hospital. Dr. Sifri suspects a vascular injury in the calf.

There are many infections, especially in cases where emergency surgeries were performed early on in less-than-ideal conditions.

ISHI has four emergency operations today. Yesterday they had nine urgent operations. Nurses are being stretched thin. At one point, there was one nurse tending to thirty patients, so they shut down one of the ORs for two hours and the doctors did rounds on all the patients and took care of all their needs. Two local nurses stayed with the patients overnight, and everyone did well.

Today they shut down one of the ORs because there were too many patients in recovery and the nurses were not able to care for them all. Sue Walsh, our cRNA volunteer, is now helping the nurses.

One bit of good news was that the team found a large supply of medicine, which was a much-needed supplement to the medications they brought along with them from the States.

Dr. Sifri is trying to contact one of the US ships to see if they can take a patient with a spinal cord injury who had a high fever (which has now improved) as he needs a CT scan, and has to be stabilized.

Watch video of ISHI in Haiti The French team sent another six patients to ISHI, but they were only able to accept four as the other two were highly unstable and they didn’t have all that was needed for their care. Of the four that were accepted, one had an infection from an amputation; one had an intestinal obstruction; one had a crushed ankle; and one had an amputation that needed revision. The first patient with the infected amputation needed blood before the team could operate, so they contacted the Red Cross to try and get him three units of blood.

The French team is working at another hospital and is having major issues because none of the local nurses are staying with the patients during the night. In many cases, when they come back the next morning, patients have died from complications overnight. One such case happened last night.

The team still has not received food for patients from World Health Organization and they are trying to get some more fuel for the generator. Yesterday the team was in the dark at night. They still have food but the quantities are decreasing.

More nurses will be arriving from Florida on Monday. In the meantime, the doctors are doing their jobs, plus the jobs of the orderlies and the nurses.

The team will be finishing their work on Friday, January 29, and leaving on Saturday on the same plane that brought them in from Florida. The cost of their flight to and from Florida was a donation from NASCAR.

Day 2 (Friday, January 22)
When the team landed in Port-au-Prince, they were a bit nervous because they had heard about other teams being attacked by groups of looters. After an eventful ride, they arrived at the sleeping compound, which seems to safe. The house next door has been destroyed. There is rubble everywhere and the entrance to compound is gone, so the team has to walk over rubbles to get in. They could not confirm whether or not they have any internet connection. They are keeping an audio log on Dr. Sifri’s iPhone to share with us.

The team is working with Cellule de Crise du Ministère des Affaires Etrangère Française, and today Dr. Sifri was talking to the medical chief of MAF; they are sending the team twenty patients. Dr. Sifri indicated that they are receiving twelve patients by helicopter from another hospital closer to the capital.

The team now has seventeen patients admitted in the hospital. Today they went to the stadium to evaluate the wounded and they found five people in a critical state and classified them as the highest priority. They gave those patients an orange tag. Of the five in a critical state, one has a pulmonary contusion with rib fracture (coughing up blood), one has a fracture with an open wound on the right foot, one has an infection on the back with an open wound of 10-15 cm with puss, and one has a hand infection with a very swollen hand. In addition, three of the injured were classified as “priority 2″. One of those is a woman with a broken pelvis, who is stable; she has two daughters.

The younger daughter is a six month old infant who is severely dehydrated, probably malnourished and Dr. Sifri was unable to wake her. They agreed to take the baby with them to the hospital (at the mother’s request; she wasn’t managing to take care of her) and on the way to the hospital Dr. Sifri, who was carrying her, gave her about ten drops of water, which already made her responsive.

There is an organization called Heart to Heart that is taking care of the injured in the stadium and the team is working with them. As the General Hospital is overwhelmed, Heart to Heart agreed to send the team any new patients from the stadium. Dr. Sifri is trying to organize transport for the patients.

Clearing crews are starting to take the rubble away but this is creating traffic jams and blocking the streets for long periods of time. Medical supplies are starting to be depleted at the hospital so the team is asking the World Health Organization for more. The hospital itself is without an elevator, so when a patient needs to be transported between floors, the team is forced to carry the gurney by themselves up and down the stairs. They did not get the French nurses they were expecting and are noticing a shortage of nurses as well. The team is doing well nonetheless. They are getting two meals a day plus one protein bar. No one is sick and their spirits are good.

Day 1 (Thursday, January 21)
We left New Jersey on two separate planes to Florida, three of us at noon and three of us in the afternoon. Mae Eloy, cRNA, anesthesiologist Daniel Eloy, and RN Mae Tingson left first. Unfortunately, Continental Airlines would not cut us a break with our baggage, which was almost entirely medical supplies. I would hope that in times like this, the airlines would put aside their bottom line and do their part to help in the relief effort. The plane was full and packed. Michele picked us up from airport—we had three vans for us and our nine bags of supplies.

When we got to Michele’s house, it was nice to see that the others were relaxed. Her house was very comfortable, with lots of rooms and bathrooms. And a crazy dog. We met one of the orthopedic surgeons from Texas. He does a lot of volunteer work in South America and has also gone to Guatemala several times on missions.

We had an hour presentation by a drug rep about some patches that relieve pain that we can use in Haiti. He tried it on the ortho surgeon, Brian, who has had shoulder pain for years, but it did not work very well.  He later tried it on Michele’s mom, who is about eighty years old and suffers from chronic back pain, and it worked. She almost started dancing!

We had pizza for dinner that Michele got…That is our last meal; we ate it while working tonight. Mostly packing up instruments collected in Florida.

We got a truck load of new boxes delivered to us at 9 p.m. It was like Christmas day when you open the gifts. Every time we found something we could use there was a big loud “Yes!”

We went to Walgreen’s at 10 p.m. and got more supplies—water, Off bug spray, duct tape, peanut butter for May (she said she can survive on only peanut butter for a week!), and big garbage bags.

Got home at 11:30 dead tired and quickly crashed. Some slept on beds, others on couches all over the house.

Wake up call was at 4:30 a.m. Water was hot. Everyone is tired but excited. Three cabs are waiting outside. Somehow the cab drivers get into a fight and one storms out on the road and breaks a security fence. Michele is furious and wants the driver to pay for the damage .

On the way to the airport now. . . .

—Dr. Ziad Sifri, ISHI President, from the field in Haiti