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“It’s devastating. Everything is affected. Everyone is affected.”
On Tuesday, that’s how Hilarie Cranmer, MD, MPH, of Emergency Medicine, described a dire situation in Haiti via telephone from Miami International Airport. Cranmer was in Port-au-Prince last week, just 48 hours after the earthquake struck where she spent five days caring for patients with broken bones, infections and other injuries. On Tuesday, she flew from Port-au-Prince to Miami en route back to Haiti.
“There was no power in Port-au-Prince,” said Cranmer, who was based at the field hospital on UN Headquarters in the capital city, along with Stephanie Rosborough MD, MPH, of Emergency Medicine, and Jennifer Furin, MD, PhD, of the Division of Global Health Equity and Partners In Health. “Many needed operations but it was difficult to get people where they needed to go for surgery.”
For the last five days, they treated UN employees, their families and local residents. “Survivors’ injuries include infected cuts, bruises, broken legs, collapsed lungs and other injuries,” said Cranmer, who has traveled extensively to care for patients in disasters, including Hurricane Katrina and the tsunami in Indonesia. The group organized hospital personnel, pharmacy and patient care, and helped get food and water for patients in the hospital.
“We admitted five to 10 patients each day, and on the day we left, there were 149 patients in the hospital altogether,” Cranmer said.
The three doctors left the UN hospital and boarded a plane for Miami. In Florida, they restocked their supplies as they awaited a flight back to the island. They arrived in Font Parisien on the morning of Jan. 20 and are supporting a clinic in Haiti treating patients operated on in the Dominican Republic.
Cranmer wrote this e-mail to her colleagues in BWH Emergency Medicine at 1:21 a.m. on Wednesday, Jan. 20:
All is well. Stephanie and I are safe and healthy. We travelled to Port au Prince last Thursday via helicopter. Our team that went to Port au Prince also included Dr. Jennifer Furin, an ID attending with lots of experience in Haiti with PIH, and we were able to support the impromptu field hospital by helping with coordination with the UN as well as helping to facilitate transfers to hospitals that could care for all the patients we had. Most of the injuries were orthopedic with infected open fractures and nearly every patient needed some sort of operative procedure. Words can’t describe the degree to which these people are suffering, and it’s hard to find a place in the city that has been unaffected. Logistically, there was huge need for food, water, transportation and security, so we decided we would be most helpful to be in an area that hasn’t received as much attention and wouldn’t require too heavy of logistics. So we travel to Jimani and Font Parisien in Haiti tomw [tomorrow/Wednesday] by helicopter to help support a clinic that is receiving patients that have been operated on in the Dominican Republic. This was facilitated by our own Alejandro Baez, [MD, MPH, formerly of Emergency Medicine Division of International Health and Humanitarian Program] now relocated in Dominican Republic, and we are excited to see it all tomorrow, again by helicopter.
Selwyn Rogers, MD, MPH, chief of the Division of Trauma, Burns and Surgical Critical Care, is caring for earthquake victims from the Partners In Health hospital in Saint Marc, Haiti. He’s providing periodic updates via Blackberry.
On Jan. 19, he writes:
There is a limitless list of patients. When we arrived and set up the OR, there were 20 people with open fractures (an emergency in the U.S.) that are 5 to 6 days old, 50 with closed fractures and multiple other injuries. We did 5 cases yesterday and 6 today.
We have a census of 100 but it grows daily as we started cases and the word has filtered out that we are doing surgery. The injuries are myriad. Lots of open fractures and severely infected wounds.
100+ still waiting.
A scene tonight: 15-year-old girl came to the ED today from PAP [Port-au-Prince]. She had nicely braided hair and clean clothes and a blackened dead lower extremity from a crush injury when rubble trapped her right leg for hours and could not get medical care until 6 days after the earthquake. I spent an hour talking with her aunt (an ED nurse), her father and the girl explaining that we will need to amputate her leg. Her father said in an anguished way “an amputation is like death.”
Don’t sleep much as we have long operative days.
Saint Marc is 90 minutes from PAP. All the pts are from the PAP quake. We have converted a district hospital that normally only does C-sections into a functioning hospital doing life saving operations.
On Jan. 17, he writes:
Just finished my first case: 33-year-old mother with her husband at her side with gangrene of the leg since the earthquake developing septic shock who needed an amputation. Working with PIH, we had to set up an OR, pre-op and post-op areas. We did an above knee amputation to save her life. We are prioritizing life threatening injuries over all else.
The wards are jam packed. We have over 50 people who need urgent operations. Focus is on life-sustaining surgery.
Visit bwhpikenotes.org/haiti for regular updates, employee resources and other information pertaining to the hospital’s response to Haiti.