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Meeting inside a makeshift office at the field hospital are, from left, Michael VanRooyen and Hilarie Cranmer of BWH, Jennifer Chan and Christian Theodosis of the University of Chicago, and Emille Calvello of Johns Hopkins. Photo by Justin Ide/Harvard University News Office.
At a field hospital set up by BWH’s Hilarie Cranmer, MD, MPH, and Stephanie Rosborough, MD, MPH, more than 500 patients are receiving surgical and medical care, including measles vaccinations.
The two Emergency Medicine physicians flew to Haiti two days after the earthquake to assist in relief efforts and led the establishment of the hospital on the Love a Child orphanage compound in Fond Parisien, which is close to the border of the Dominican Republic and 40 minutes from Port-au-Prince.
“This was my first time setting up a field hospital,” said Rosborough, director of the BWH International Emergency Medicine Fellowship, who, like Cranmer, has assisted in disaster relief efforts all over the world. None, though, compare to Haiti in the scale of the disaster and the proportion of need.
But their clinical and leadership skills and experience in relief work helped them establish a well-run hospital and coordinate volunteer medical staff from 13 countries to care for the many patients in need, housed in rows upon rows of tents. “There have been no deaths or disease outbreaks in our hospital,” said Rosborough, who returned to BWH Feb. 4 while Cranmer remained in Haiti.
Staff at the hospital perform surgeries, wound care and recovery, and they also set up a measles vaccination campaign and vaccinated everyone between 6 months and 15 years old.
“The measles vaccination rate in Haiti is very low, which is fine for every day, but when people are in close quarters, one case of measles will spread rapidly and become life-threatening,” she said, adding that special coordination was required to refrigerate the vaccines.
The surgical wards of the hospital performed up to 23 surgeries per day, mostly for amputation revisions and wound cleaning. From there, patients were sent to recovery beds within the hospital.
“In setting up the hospital, one of our main areas to focus on was ensuring there are enough post-operative beds,” Rosborough said. “Without enough recovery beds, patients have nowhere to go after their surgery, and surgeons cannot proceed to the next cases.”
New tents are frequently added, and the hospital, which had the capacity for 300 patients as of Feb. 3, was expected to expand to accommodate between 700 and 1,000 patients.
Most patients were sent there from a hospital in Jimani in the Dominican Republic, and the USS Comfort ship also began taking patients there. Most of these patients had amputations and complex fractures that can become infected without proper care. Rosborough and Cranmer also asked that unaccompanied minors be sent to the hospital.
“We partnered with another nearby orphanage to ensure these children were kept safe, given medical care and registered with UNICEF so that no one can take them from the country illegally,” Rosborough said.
After patients are discharged from the hospital, they have a safe place to go at a camp set up by the American Refugee Committee a little ways down the road.
“The camp has become the discharge facility for the hospital,” Rosborough said. “We send patients there, and they receive a tent, water, household items and other things they need to begin to get their lives back on track.”
The field hospital, which Rosborough estimates will continue to operate for at least four to six more months, will be led by Harvard and BWH-trained physicians who have volunteered their time and skills. Rosborough is calling on residents, physicians and other professionals who have taken the two-week Humanitarian Studies Course, which trains people in relief work, humanitarian crises and international disaster response.
Christian Arbelaez, MD, MPH, of Emergency Medicine, writes a daily blog chronicling his experiences in Haiti. Visit BWHPikeNotes.org/Haiti to read the full entries.