Haiti Journal

Haiti Journal

Paula J Pearlman, MD

Winter 2011 - Volume 15 Number 1

I’m still not completely sure how I connected to the woman in LA who got me onto a relief flight out of Miami into Port-au-Prince on January 24, 12 days after the earthquake. What I am sure about is that I was lucky to be able to get down there as an individual, as opposed to a member of a sponsored team, and to have a destination once I landed: a hospital in Port-au-Prince for women and children, Hôpital Espoir: Hope Hospital.

I spent the first two days at Hôpital Espoir seeing a few patients who, by this point, presented with minor traumatic injuries but mostly people were coming for primary care. And they came. In droves. I saw people with headaches, chest pain, insomnia, colds, cough, vaginal infections, anorexia, rashes, abdominal and back pain. I decided early on not to let anyone leave without some kind of medication, even if it was only multivitamins and even if they were going to turn around and sell it.

The next few days I spent at a "mobile clinic" that we established in an area on the outskirts of town. My experience as Chief of the Emergency Department at the Kaiser Permanente West Los Angeles Medical Center where I endured tedious meetings developing patient flow plans actually paid off! I was the de facto "administrator" at our little clinic and was able to organize the process swiftly. We set up shop in an open-air church. There were three physicians, three nurses, translators, a few volunteers, medications, supplies and water to distribute. Word spread that the physicians were in town and we saw around 300 patients over those 2 days. Every adult brought 2 to 3 kids with them, most of whom had vague complaints, almost none of whom were really sick. Again, everybody got something: Children’s Tylenol, creams, pills, Vicks Vaporub (good for the whole family!).

The practice of medicine in these settings was a shocking experience. All the "luxuries" of modern medical care as I know it were either scarce or nonexistent (there are virtually no ventilators or computed tomography scanners available in Haiti, no monitors, no electrocardiogram machine at my hospital). And the therapeutic options, too, were so limited. What do I do with a child with tinea capitus over his entire scalp? Even if I had the pills to give him that would cure this, do I take the risk of treating him without follow-up to monitor potential dangerous side effects of the medication? Will a two-week supply of antihypertensive medications really affect the long-term health of a patient? Is the chest pain musculoskeletal or cardiac related? Well, the kid with the fungus got a bit of Metronidazole cream that we had on hand to treat vaginal infections, the hypertensive lady got Enalapril with fingers crossed that her kidneys could cope with it, the patient with chest pain got aspirin. Band-aids to stop a hemorrhage. It was unsettling.

While I was there, I kept wishing that I were a surgeon. These were the physicians who were doing the heroic deeds and truly saving life and limb. But I realize that just using whatever skills I have to help a few people through this terrible calamity was a lesson in what it means to be a physician. It was a rich and rewarding experience.

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