Group Health News

The following is a powerful message from Group Health Urgent Care Dr. Ken Elam, who just returned  from volunteering in Haiti. He shares his experience, sadness, joy and advice.

Dr. Elam with nurse, and proud father

Before on trips to Haiti, we often had trouble nailing down with patients when exactly symptoms started, probably a point of little relevance to those seeking treatment. Now, however,the tremblement de terre or earthquake is the starting point of all misery, injuries of course, but headaches, back pain and acid stomach too. With few new additional injuries, our focus in  an area of Port au Prince away from the worst destruction was on care of the scores with wounds often hastily covered the first days, and post op care for the many people with bones fixed in place surgically with metal rods and with amputations. The heart freezes, the breath gasps at the sight of every amputated child.

As multitudes are living outside, the bandages were usually filthy and we dreaded what would be uncovered. Deep though they were, many losses of flesh and muscle were surprisingly free of infection, perhaps due to good wound healing genes possessed by the Haitians. All types of pain meds were in ready supply but narcotics were very rarely needed; so different than our North American culture. People bearing casts thrown on during those first days turned out not to have fractures, determined by the very basic process of palpating the bones.

What to do with the patients waiting for the 4-6  weeks to pass so the ortho hardware could be removed loomed as a giant obstacle. In L’Hopital de la Communate Haitienne, HCH, where we found the most need, there was constant pressure for more beds or mattresses on the floor to be freed for the new post op folks, those getting delayed fixes or revisions, or having conditions such as appendicitis that never go away.  A “discharge” from the hospital is to where?!?  when you have no house or fear to re-enter the structure left standing. We were able to transfer some patients needing full service to the hospital ship Comfort and the tent hospital of the Univ. of Miami which wisely is scheduled to remain there a year.

Supplies were everywhere in Port au Prince but were not always getting out to rural clinics. Boxes and boxes had to be sorted through and the arrival of more with each new team of helpers added to the crunch. Dave Fluitt, pharmacist and great friend from Carson City, easily burned off 1 million calories each day ripping boxes open and restocking overflowing shelves. “I know I saw Pepcid somewhere but lord oh lord which shelf?” Cartons of tracheostomy kits , even boxes of omega fish oils littered precious space as it seemed US medical institutions had packed anything remotely useful without regard to the ripple at the other end. Kelly, Dave’s wife, with whom I had worked in the ER at Carson Tahoe Hospital, was 6 energizer bunnies rolled into one. Now a nurse practitioner, she threw herself into whatever was needed: scrub nurse in the OR (where at one hospital, orthopedists were surgically fixing fractures without benefit of xrays), ICU nurse, compassionate clinician in the wound care trenches.

The 3 of us did a small clinic in a neighborhood school run by an amazing lady, Dottie, who runs a nearby intact B&B. Near the time we were ready to stop, there was still a line of about 60 who mostly had minor cold symptoms. We searched the group for serious problems and dealt with those, and then I thought I had a brilliant idea. Through the translator I asked, “how many have cold symptoms?” Most hands were raised to which we responded, “We have run out of cold medicines.” Would there be mutinous surges? There was an outburst of laughter that any comedian might relish.  Whatever cultural disconnect (mine) elicited that response I’ll never know but our activities dwindled without apparent rancor.

The streets seemed safe in our neck of Port au Prince with Haitian police and US troops roaming the neighborhoods in an unthreatening mode, stopping at the hospitals and even Dottie’s school to ask what was needed.  I was desperate to donate blood, as you cannot do it in the US after traveling to Haiti for at least a year, but was told the only place to go was the downtown general hospital where gangs were thought to lurk. On the streets of our zone of PAP, the sidewalks were filled with the usual vendors of everything including some handsome looking fruits and vegetables. Smashed alternated with intact buildings in patterns bereft of rhyme or reason as construction seemed mostly the same, concrete and rebar.

Joy was not absent down there as I had the pleasure of delivering a healthy baby girl; the dad’s exuberant glow felt like a warm blanket around my heart. Of course I thought of our new granddaughter, Elle.  In the realm of small world, a military doctor transported to our hospital a man who had passed out and perhaps seized. She gave me that I-know-you-from-somewhere stare and she was exactly right. She had rotated through St Joseph’s ER while a resident at Madigan Army Hospital 13 years ago.

How best to help is a tough question. Will the billions donated actually get to the exigencies of new structures, limb prostheses, lasting sanitation and water access? The de-rubbling will take years of course so simply not forgetting is part of the task. If you hear of someone reliable going down for a specific task, re-building or healthcare, that’s where I would make my donation. I solicited money for 200 doses of a 24 hr. antibiotic and saw hundreds of patients on that exact drug. If you want to go down, align yourself with a purposeful team, but even then there may be uncertainty.  For health care types, I personally witnessed the amazing efficiency of Medical Teams International based in Portland, an outfit I will try and join for future relief quests. Check out the HCH web site and you can help a 50 bed hospital which is accommodating 3 times that many within.

I feel very fortunate to have had a chance to give action to the gut-squeeze we all felt with the calamitous news as we asked ourselves,  ”What can I do?”, “How can I help?” Without the organizational and loving support of my wife, Shannon, on the home front, and docs filling in my shifts, the trip would have been impossible.

Sad images fill my mind naturally. I see a sign tacked to a telephone pole in Seattle about a lost cat and I recollect photocopies of the missing people pasted to the hospital walls. I’ll try and remember the notions of fortitude and decency the Haitians imparted to me. As Edwidge Danticat, the premiere Haitian- American author said in her New Yorker commentary, no one said “Why me?” or “We’re cursed.” The media barrage will ebb and our own well wishes will understandably flag. But what we can do is patiently and creatively scheme ways to help.