LEAP Foundation

First Days in Zimbabwe

2010-09-21T21:59:00.000-07:00

Word of the life changing surgeries performed by LEAP last year in Zimbabwe has spread. "People are coming out of the woodwork," says Dr. Hobar while holding a beautiful baby cleft patient, "our operating schedule is filling up and we will do as many as we can." Holding true to their promise, the LEAP team evaluated over 100 patients Sunday and already 20 patients have undergone corrective surgery. Most surgeries are complex clefts and many are infants. Dr. Hobar and his team will continue to work around the clock to provide hope for the parents and new beginnings for the patients.

2010-09-17T16:50:00.000-07:00

Just days after four American relief doctors and nurses were jailed in Zimbabwe, the Leap foundation will soon be touching down in Harare, the capital of Zimbabwe, to administer medical aid for their second year in a row. Dr. Hobar leads a team of 2 surgeons, 4 anesthesiologists, 2 circulators, 2 scrub techs, 2 PACU nurses, 1 respiratory therapist, 1 photographer, and 2 support aids to "show the love of Christ through their surgical talents." This 16-member team will perform over 50 surgeries in 5 days, targeting children with cleft lip and palette deformities. Though these life-altering surgeries come at a time of uncertainty, they undoubtedly provide a new hope for these children and others in need. Dr. Hobar asks for your prayers, citing the encouragement he and the team receive from the support of their many prayer warriors. So watch these two video blogs of Dr. Hobar, setting the stage for what promises to be a display of Christian love and caring compassion for this beautiful country:

Mariline’s Journey

2010-04-17T21:19:00.000-07:00

Her name is Mariline and she has made her way to a hospital room in Dallas through the most miraculous and heartbreaking of circumstances. Three months ago, when the walls of her University classroom came crashing down in the catastrophic Haitian earthquake – so did her entire world. She lost one arm and suffered nerve damage in the other. In an instant, this bright and vital 23-year-old, so close to achieving her dreams was fighting for her life. Within weeks, it would take an even darker turn.

One Patient

“I am so scared, so very scared for Mariline and I feel so helpless. She will die if we don’t get her back to the states.” And so began

the email sent from Linnea Trageser to Dr. Craig Hobar. Trageser is a nurse practitioner now working full time with the LEAP Foundation in Haiti. Dr. Craig Hobar, Founder and Medical director of LEAP says this about Trageser: “this incredible ‘gift from God’ is giving up everything else in her life to live in Haiti and help coordinate our efforts with patient care, communication and team transitions, and she won’t take a penny for it.” Dr. Hobar and Dr. Ale Mitchell have led LEAP’s efforts on the island nation since the first relief planes were allowed to land following the 7.0 earthquake that struck on January 12, 2010. Since that day, there have been hundreds of thousands of injured patients in Haiti.

The fact is, by the time Mariline and her sister sought the help of LEAP’s doctors, she was in a race against time. She wanted doctors to save her leg; they knew they were fighting to save her life. With a drug resistant bacteria moving through her bloodstream, LEAP’s doctors were forced to amputate her leg below the knee. But Mariline was still fighting the bacteria and critical anemia and slipping away day by day. Getting her to Dallas was imperative. She needed medicine to save her life and to save what was left of her leg. Doctors knew any further amputation would make it nearly impossible for Mariline to ever walk again.Trageser says it is hard to understand why, of the hundreds of thousands of injured patients in Haiti, she felt Mariline needed something more: “she’s this incredible young lady who everyone immediately falls in love and she represents the personal essence of what our medical relief effort has been all about.” Mariline came to LEAP’s doctors when she was told by others an infection spreading through her body would force the loss of her leg. For the once vibrant 23 year old, it was simply too much. She told LEAP’s doctors if she had to lose a leg too, she no longer wanted to live. She told them she didn’t want to be a burden on her family and she felt it better is she died. For Trageser, who had already witnessed such enormous tragedy in the ravaged land, it was also too much. She decided it was time for extraordinary measures. She hoped Dr. Hobar and his staff in Dallas might feel the same way and she sat down to write an email. The subject line read simply: One Patient. Mariline’s story unfolded, and touched the hearts of everyone who read it. What followed was an Easter weekend flurry of activity unlike anything anyone had witnessed. The LEAP team was ready for another miracle.

The Fight

Trageser describes the efforts between Haiti, Dallas, and Washington DC which cleared the way for the first ever medical evacuation from Haiti to Dallas since the earthquake. “There were late night phone calls, driving from one side of Port au Prince to the other, knocking on doors, facing callous bureaucracy, tracking down senators, calling in favors, coming up with money, changing airline reservations,” and she says, “Most of all, praying.”

Dr. Hobar adds, “It was an incredible weekend. With the help of another heaven sent volunteer, Suzanne Appel, who manages my pediatric practice, we had people going into their offices in Washington D.C. and their counterparts in Haiti moving bureaucratic mountains to get this young lady here. While we were fighting this battle, Dr. Mitchell and our Haitian Field Coordinator, Cliff Estera were driving around to the Haitian Embassy’s and U.S. Embassy’s with Mariline’s family to get this necessary part done.”

On Wednesday April 7, 2010 Mariline and her sister arrived at DFW airport. It was against all odds she survived the earthquake, against all odds she survived the bacterial infection, and against all odds she survived the bureaucracy that could have denied her lifesaving medical care.

There is still a long road ahead, an uncertain future with months of rehabilitation, prosthetic fittings and therapy. Through it all there is triumph, for this one patient and the LEAP team who brought her to Dallas.

Against all odds, Mariline is facing her future with a smile.

A Few Thoughts on Haiti from the eyes of Dr. Kayser

2010-04-17T21:12:00.000-07:00

This blog does not necessarily represent the opinions and views of the LEAP Foundation.

Here are a few thoughts on my trip to Haiti:

Simply put, my week in Haiti was a journey that involved so many facets of sight, sound and emotion. The most obvious dealt with the sheer poverty of the country and its people. Even before the earthquake, people were living in tents scattered throughout the city and surrounding areas. Trash and filth were ubiquitous with rumblings of a corrupt government that virtually enslaves its people to an island unable to sustain them - there is basically no financial way for most Haitians to leave and, even if they could, the government would not let them. Combine that with the geographical demographics, which essentially confine its people to a few hundred square miles, and you have a state of perpetual captivity.

The earthquake has only compounded the problem, but I truly wonder if its impact is only a blip on the screen of what already is a devastating situation. Although the acute phase of the injuries is over, patients continue to need treatment of amputations, chronic wounds and daily medical care that has always been necessary in spite of the earthquake. With health care virtually non-existent to the poor, the services provided by teams of volunteers are essential but the futility of what we provided was, in some respects, so overwhelming that I sometimes questioned the point of it all; so many people to treat and so little help to sustain their ongoing care. Yet, I was also encouraged by the number of various medical and and church volunteers willing to take a few days out of their lives to be of service in any capacity they could and found it important to remember that if somehow even one person was helped from our presence then the trip was well worth the effort.

Yet the people of Haiti survive and continue to thrive. Although stories of violence were heard of, I was not a witness to any of them; indeed I found myself surrounded by a people of faith and determination that allowed the physical devastation to remain bearable. In a place that would garner nothing but futility, there was hope; and in their survival, I too, found myself encouraged. Yes, God does live. And when one can question how God can allow these things to happen, I was reminded that in the midst of the tragedy, His people still believe and shine through.

With regard to my team, I was honored and privileged to be surrounded by such a talented and enthusiastic group of medical volunteers. All of us, unknown to each other before we assembled in Miami, came together to become a unified team as the week in Haiti progressed. I was encouraged each day to be part of a team of such diverse individuals (in both training and personal attributes) exceeding the sum of our parts to provide care in so many different ways. This will be a bond that I will always value.

Now one week home, I have found my return back in the United States sobering. I have been somewhat subdued - more intent on listening to others and hearing their concerns and less quick to jump to conclusions and, perhaps, make myself heard. The sheer disparity between the endless bounty we have been given in this country with that of the people of Haiti reminds me, once again, to thank God for all that He does provide and be so very grateful for my life here at home. I believe that my week in Haiti will have contibuted to an ongoing change in me that is part of a desire to improve myself for the rest of my life - a continued growth that sets the tone to embrace the value of the life God has given me and the lives of those around me just a little bit more and, in the end, isn't that what living is all about?

Mariline Arrives!

2010-04-07T13:16:00.000-07:00

Mariline beams an electric smile as she arrives into DFW today.

Update on Mariline

2010-04-02T15:52:00.000-07:00

Mariline and LEAP doctors have been fighting to recover her leg ever since it was severely wounded in the earthquake. They did everything they could to save her leg, trying their hardest to nurse it to wellness, but infection has spread into her bloodstream. Wednesday, Dr. Ale Mitchell was forced to do an emergency below-the-knee amputation on Mariline. She is now in stable condition. More than ever, she needs intensive care and rehabilitation as well as rest to heal from the operation. Baylor Hospital is coordinating with LEAP to try to bring Mariline to Dallas so she can have the best medical care available. Before Mariline can travel to the United States, LEAP needs to gain authorization from the Haitian Government. Suzanne Appell is working closely with Texas Senator Cornyn to gain approval for Mariline’s travels. Please pray for Mariline and all fears she is facing right now. Pray that her hope will be restored and that she and her family will find encouragement in the midst of this drastic change in her life. Also, pray that she will be granted travel privileges to the U.S. and for her continued healing.

Ongoing Prayer Requests

2010-03-30T20:50:00.000-07:00

Pray:

For Mariline.

Mariline is a 23-year-old who was studying at the University when it was suddenly shaken by the earthquake. The building around her collapsed into a pile of rubble. She required amputation of one of her arms and sustained only partial function in the other. She has a severe wound on one of her legs that may require amputation. When the LEAP team first encountered her she was depressed and devastated, claiming she would commit suicide if her leg was amputated. Her spirits have been lifted tremendously, and she is encouraged by the loving care the LEAP teams have provided her with. She now has hope that she can go on. Please pray for her ongoing spiritual and emotional strength. Please pray for her physical healing: for her leg to be saved and for peace amidst the struggles she experiences due to the physical losses she has already faced.

For the Prosthetic Program.

Please pray for vision for the prosthetic program currently in the works. God has put the right leaders for the program in our midst.

Over a decade ago, Lou Newman watched her daughter Libby come within a breath of losing her life. Then, when her life was spared, she lost her legs. Below is her story, told by her mother.

Libby is 31 now. She was 17 and a high school senior when she nearly lost her life. Libby was in the Parkland Hospital burn unit for a month due to excessive tissue damage. Parkland is a county hospital renowned for trauma and burn care. The visiting hours are 4 times a day for 15 minutes only. I spent a great deal of time waiting for those visits. After a while your situation becomes the norm and friends don't visit quite as much. With so much time and not much to do I became a student of life. It is fascinating to watch interactions of families during a time of distress. Whenever possible, I availed myself of the child psychologist. I learned about the stages of grief. I learned patience.

When you have something you know will be wonderfully helpful you want to share it as much and as soon as possible. But you have to be careful. You may overwhelm people and they may not be receptive at that particular stage.

Lou Newman is making phone calls and gathering professionals and spearheading the effort to develop what LEAP believes will be one of Haiti's premier prosthetic programs. Please pray for this essential component of the LEAP effort in Haiti. Libby, the program’s professional advisor, is temporarily in an advisorial role only because she and her husband just welcomed their first child into the world. Libby’s profession is fashioning world class prosthetic limbs for other amputees. After hearing Mariline’s story, Lou said she knows Libby would be willing to contact Mariline and her family.

For Linnea, a Nurse Practitioner who has given up her life to be a constant presence in Haiti and is helping coordinate LEAP teams for at least the next 6 months as a volunteer. For her strength, courage, wisdom and rest. God, thank you for this child of yours.

For each one of you who continue to pray and support the efforts when this is no longer front page news, but when the need is just beginning.

For the current LEAP team in Haiti from Philadelphia. The plastic surgeon leader, Carl "Happy" Manstein, headed directly to the American embassy and asked for an audience from Bush and Clinton. He didn't get it, but you have to love his initiative. Doesn’t Laura Bush live in Dallas?

For the one-week-old baby that was the miracle of Haitian Community Hospital last week. The Haitian Ob-Gyn physician asked the LEAP team to help him perform an emergency C-Section last week, as there was no Haitian staff around to help. The Haitian surgeon worked frantically to save the mother's life. The LEAP anesthetist administered anesthesia, and instruments were handed to him by the LEAP scrub tech. The plastic surgeon from Pittsburgh described it: "You would not have believed what happened today. I was just standing there watching this incredible dedication and professional support by the LEAP team. The surgeon delivered the baby, pronounced it dead and continued to work frantically to save the mother's life. The LEAP nurses (2 from Dallas and one from Alabama) wouldn't accept it. They took the baby away, immediately huddled in the corner, suctioned the baby, performed CPR, and the next thing I knew their was this incredibly loud cry and a beautiful, healthy baby." The mother did well in the procedure. Pray for this baby to be a part of positive change in the new Haiti and for him to comprehend the miracle that God orchestrated to begin his life.

For the Haitian hospital staff, who has gone without pay since shortly after the earthquake.

An Update on a Patient in Haiti

2010-03-20T09:16:00.000-07:00

We were recently sent an email from one our teams detailing a unique follow-up opportunity with a particular young patient:

In February, a team from Atlanta was facilitated by LEAP to work at HCH in Haiti. Ironically, one of their younger patients is now recovering in Atlanta and the team has been able to follow-up with the young boy! The LEAP facilitated team reset his boken femur and helped deal with an infection. A team member was able to see the patient in Atlanta and reports that his Xfix (an external device made for broken bones) is off and the patient is walking with a walker! God is good.

LEAP's Latest Trip to Haiti detailed by Dr. Michael Howard

2010-03-02T18:03:00.000-08:00

This blog does not necessarily represent the opinions and views of the LEAP Foundation.

SATURDAY 2.20.2010:

The craziness began after landing. Our plane made a u turn on the tarmac...

The main airport is still in ruins. Shuttle buses took us to the makeshift terminal in an old hanger at the end of the field.

Customs reminded me of Macys, day after thanksgiving. People going everywhich way in and out. I think my passport got stamped... Maybe not.

Our group (12 strong) collected our 30+ boxes and bags and ran smack into a wall of humanity clinging to the gates outside. We spent an hour waiting for our contact and ride, named "Jackson". When we asked "where's jackson?", 3 guys appeared. 1 won out. Wendy (a nurse back for a second tour) bluntly quiped "last trip our Jackson was tall, and thin.". This guy was short and only had 1 arm.

Ultimately we settled on a guy named Cliff. He assured us that "it was jackson's day off". Winslow and I agreed that it was an "I'll call you in the morning" line. But we applauded his effort. Turns out that Cliff was our guy. He is quite friendly, great English and kept telling me how much he loved his time in Chicago.
An hour later we were on our way to The Hatian Community Hospital in Petione-Vile (sp?) - a community a few miles south of PAP.

People everywhere. With no place to go. Destruction everywhere. In places its a bombed out cinder block city. Yet there are pockets of pristine structures. Down the hill from the hospital is a gas station, market and pub/resturaunt that are quite busy.

We are headed to our homes .

SUNDAY 2.21.2010:

So, Jackson does exist.

A good nights sleep on the tile floor of an an open air house with an incessant dog barking outside and an early rising rooster. Haitian coffee for breakfast - an espresso, but smoother.

Jackson rolled in at about 0730 and stuffed the 7 of us in an Izuzu trooper for a quick trip to HCH (Hatian Community Hospital).

We made rounds with the various teams there and spent time getting to know the patients and staff.

Amazing volunteers from all over.

We found 4 pts who needed surgery. Spent a few hours getting the OR ready and then did the cases. 4 debridements. Hand, 2 legs (open fractures) and a butt.
Lots of medical aftermath to pick up from. The bangledeshi ortho team seems to have wrought substantial destruction. The Germans fixed one lady's Bangledishi-repaired femur... but it was still off by 25 degrees. The Iranians were here and did some good. No ortho teams are left at our hospital. Looks like 2 other hospitals will have the longterm ortho teams. We will spend the next couple days building relationships w/ them for refering our pts there and getting their wounds here.

After wrapping up, the entire group went to our little town for dinner. Jackson pulled some driving manuvers that were absolutely amazing to avoid a trafic jam from a jack knifed tractor trailer. He got a round af applause.

We all will sleep well.

Love to all.

MONDAY 2.22.2010:

I was wide awake at 0430 today, lying in bed listening to the dog bark next door and planning Wednesdays surgery on Idoxy's arm.

The ground shook.

It only lasted 2 seconds. Cliff later said it was a 4.2. But it was enough to wake the rest of the team, set off all the car alarms in the neighborhood, and start every dog barking for the next hour. Which then set off the rooster. No one had much to say, but everyone was eyeing the best route to the front door.

An incredibly busy day. Highlights:
- All our patients survived the night.
- Chris Winslow's (my colleague from Evanston) ICU census continued to increase. The people hear there is a critical care doc and they come. He is amazing. He took a single 18x25 room with 8 sick patients in it and converted it to a reasonable unit. He labored most of today on a 3 month old girl having a severe asthma attack. Without him, there's no way...
- We rounded on our patients, did dressing changes, and planned for the OR today. Phil, a plastic surgeon in Dallas took 2 of them to the OR while Tim, Craig and I went to Adventist Hospital to connect with the teams there.
We went thru downtown Port au Prince on the way - destruction everywhere. The capital building was down and supreme court was completely destroyed. People in the streets. Miles of tent cities. Not sure where to begin fixing the issues here.

We walked into Adventist Hospital, introduced ourselves to the staff. After a handshake, they immediately handed us IDs and pointed us to the OR. (The easiest hospital professional staff application I've ever filled out). On the way to the OR, we were met by the AZ ortho team who pointed to a kid with a crushed hand and asked if I could take care of it. 5 min later I was putting in a wrist block and away we went. Best guess, time from entering the hospital to PACU = 65 minutes.

The kid's hand was a mess. He had rings on all the fingers which had acted as tourniquettes for who knows how long. The 5th finger was dead which I amputated. The 3rd was partly dead and was amputated midfinger. The other fingers were cleaned out. Tim and I debated on whether to leave Gods "little wound cleaning crew" in place or not. Ultimately we elected to remove the maggots too. We coordinated with the ortho team to come back on Thursday to operate with them again. They will collect cases for us over the next 3 days - good collaboration is key.

Leaving the hospital turned into a challenge. As I finished the case, word came that the hospital was on lockdown and UN troops were outside. Turns out that the hospital admin had tried to clear the people from the hospital yard tent city to make room for more patients. This turned into a minor riot. Things settled and soon Jackson had us on our way back.

Back at HCH things were highlighted by 2 ortho patients - 1 quake tib/fib fx had been casted 3 weeks ago in poor allignment and a second bus v. pedestrian w/ a crushed lower leg and an ob/gyn pt (pill-induced abortion) who needed a d&c. Both the ortho patients got transfered to St. Damien - a peds hospital next door to the US embassy doing. They are staffed by a big team from Seattle and we've been looking forward to connecting with them. So I hopped in the ambulance w them. The hospital is very well run with a lot of italian military support. After a quick 30 min tour and introductions, I headed back out. My ambulance ride and the Estonian driver were no where to be found... After a few laughs, "arrangements" were made.

Back to HCH for evening rounds where we irrigated the thigh/femur wound patient using my home made, implanted irrigation system. (CT, you'd love this one). It looks clean - may try closing it on wedneday.

Another 30 min conversation with some other volunteer groups re: our hospital administration and how to plan for the future as more groups start pulling out.

Got a great call from Melissa - she talked to AT&T - through a very broken connection I understood that they have a "disaster responder plan" that will make phone and texts reasonably affordable. Good to hear as text, email and cell are imperative to relief efforts here.

Back home for a quick dinner w host family.

At dinner Jim suggested we eat the rooster. No one disagreed.

TUESDAY 2.23.2010:

The morning started at 0130 with another quake that knocked me off my air mattress. Internet said it was a 4.7. Definitely felt stronger than yesterday. 15 min later, a second minor shock lasting 5 seconds, had most standing in the living room eyeing the front door.

Beautiful sunny morning here. Everyone was up and out early due to the quake. Prior to our ride to the hospital, I took a walk thru the neighbohood and talked with a few of the neighbors. One is a Palestinian, born here in Haiti and educated in the US. He owns a construction company. Ironic. Spent a while talking w him re the construction techniques that led to the disaster. Many of the houses just pancacked down. Basically, he summed it up as "cheap construction". The engineer in me was intrigued by his further explanation: The re-bar in the pillars between floors was scant, only 4 pieces or so. That rebar was wired, not welded, to the rebar in the floor. Within 3 months, the fresh concrete dissolves the wire, leaving virtually no support to the structure and rendering the builing a house of cards. During the quake, the top and bottom of the pillars crumbled and the floors crushed down one on another. There are hundreds of homes and apts like this. Who knows how many victims are still in them.

When we arrived at the hospital, the place was in chaos. People everywhere. The entire grounds covered with beds, stretchers, IV poles, patients, and family. It was as if everyone in the hospital, patient, family member and staff, had moved outside. In fact, they had.

The staff said that the mid night quake had sent every one running for the doors, carrying their family member/patient on their mattress. It proved what I had suspected since landing - there is immense psychologic trauma here. Most everyone has a hollow look, deep in their eyes. Most people still prefer to sleep outside.

We spent the next 2 hours coordinating the return of the patients back inside. Our team spearheaded the ICU pt location, eval, and transport. I had to laugh when I found our entire ICU census in the driveway... We got them back in and tucked away. All except for the 3 month old asthmatic that Chris Winslow had saved yesterday. She and mom were nowhere to be found. We all feared the worse.

Early this am, Chris left with Craig Hobar (a plastic surgeon in Dallas, LEAP founder and our team leader) for a remote hospital 5 hours away that has not had a doctor in weeks. We texted them updates. 2 hrs later we were happy to let him know that the baby and mother had reappeared in quite good shape. Chris' replacement was Susan, a nurse on our team. She was amazing. An ICU nurse at Childrens in Dallas, she picked right up where Chris left off and didn't look back. She was the only one in the unit for the next 12 hrs. She tuned up the baby and discharged her (at the mothers request) with some steroids, amoxicillin and instructions to return "imediamont!" If the wheezing resumed. She later admitted an 83 yo lady with a fever of 103, blood glucose 600, BP 200/130 who had siezed in the triage. No CT scan to confirm our neuro exam, but Susan was pretty sure she'd had a big stroke. Between cases I checked on one of our postops and took a look at her as well. Through the translator we talked with the family, asuring them we'd keep her comfortable. They were satisfied. "She has Jesus in her heart. Her heart is strong," they said. The family gave Susan 6 tangerines as she left tonight. There were no dry eyes on the way home.

Tim and I tag teamed the surgical cases today. Mainly debridements and skin grafts. Last night, Chris had given us the ok to operate on the large 3rd degree burn pt in the ICU (make that "driveway" this am). It took him 8 hours to figure out how to get a CBC, but his efforts paid off, his hgb was 11. Tim and I skin grafted his entire left back, flank and hip. Thanks to 2 liters of tumescence, an otherwise very bloody procedure was quite manageable. (We were also told yesterday, "there is a way to get a blood transfusion", they just forgot to mention, exactly what "that way" was...). The only hitch was that the hospitals power went out about 1/3rd of the way through the case. Our skin graft harvesting machine is electric. Tim and I just looked at each other and laughed. We finished what we could, but before deciding about Plan B, the lights flickered back on and we were back in business.

While Tim did the next couple cases, I went on wound rounds in the hospital, which means seeing just about every patient in the place, less the nursery and the OB wards. I use the term "ward" loosely. Its actually a larger room that houses more than 3 patients. And all their family. And all their earthly possessions. And a cell phone charging in every available electric socket.

Each patient has 2 or 3 family members caring for him or her in the room. Their bed and sheets from home are spotless. The patients hygiene is perfect. When you go into a room to see a patient, at least 15 people are watching the dressing change. HIPPA does not play well here. In fact, the onlookers are great to have - they erupt in cheers when you and the translator pronounce "the graft has taken"; they also give great support when the news is not so good. Privacy is sometimes not a good thing.

A Baptist group out of North Carolina, affiliated with Samaritans Purse, wearing red team shirts, known collectively as "The Red Shirts", is providing a substantial amount of the hospital's daily infrastructure. Several Red Shirt guys are the construction detail- they have built an entire hospital wing of shelving, including a wall full in our OR stockroom. (Their Dewalt Power tool chargers trump the patient cellphone chargers in the HCH electrical heirarchy. 2 days ago they made a Home Depot run. Seriously.). At lunch the same guys pull out massive kettles and cook a meal for the entire hospital. The Red Shirts have a team led by an EMT and a retired physical therapist that do daily wound dressing changes. They are trying to train a Haitian team to take over for the long term, but that has not gone so well... Late last week, the wounds started looking much worse after 3 days of Haitian Team changes, so the Red Shirts stepped back in. The Red Shirts also staff the ER/Triage in front of the hospital. If anyone in the US knows a Samaritan-Purse-Sponsored-Red- Shirt-Wearing-Baptist-in-North Carolina, tell them "thank you".

I mentioned the nursery. Here at HCH, for security purposes, its located in the back of the hospital on the second floor in an unfinished section of the hospital. 4 cinder block walls and a tarp roof house 2 saintly nusres from Basque region Spain and 10 pack & plays. Each has at least 3 or 4 toddlers in it, peering over the edge and bouncing happy as can be. It is the cutest damn thing you'll ever see. Most of this dehydrated and malnurished group were rescued last week from an orphanage that was in deplorable condition. Through a US Virgin Island volunteer's local Hatian contacts, a team "visited" the orphanage, found one of the infants who coughed once, declared "a suspected tuberculosis outbreak" and rounded up all the kids. The orphanage is calling to get the kids back. Not sure how this will sort itself out.

Back home for dinner - supposedly turkey, but birds don't have that big of bones or solid of marrow, and a bite of tangerine.

Jim found an seismograph app for his iphone and set it up in our room. He spent 30 minutes calibrating the alarm sensitivity. Its currently set at 2.0 on the Richter scale. He's wearing his shoes to bed. "If this baby goes off, the house will have one less anesthesiologist in it."

Wonder if Idoxy will show tomorrow?

WEDNESDAY 2.24.2010:

Part One:

Jim's iphone seismograph was quiet last night. But, at 0515 it unfortunately was again clear that we had not eaten the rooster for dinner. Yet.

Last night as we were leaving the hospital, so were the patients and families for a second night in the courtyard. Quite strange to see an entire hospital evacuate as the sun set. The only 2 patients in the whole place was our postop burn/graft patient and the stroke patient. By the time we got to the hospital this am, most everyone had already returned to their rooms with no issue. With several hundred people coming and going like that, there is substantial concern for looting, theft and mysterious dissapearance. Fortunately, this doesn't seem to have been a problem. In fact, a day ago, I noticed a large basin of medication boxes sitting on a shelf in a hallway. On close inspection, it turned out to be at least a hundred vials of morphine and many more dilaudid and lorazepam to boot. Patients and family had no interest. The water bottles and our Power Bars, on the other hand, did not fare as well this week and have been classified as "mysterious dissapearnce". Linnea and I had a long discussion on this today while recovering our first patient. We agreed that there is a moral distinction between stealing food for survival in Haiti and stealing drugs in America.

Linnea is a nurse practicioner from San Diego. She joined the team as she is between jobs. Her last job was as the single healthcare provider for the US contingent of Stark Treaty observers of a nuclear warhead factory in Siberia. Technically it was still Russia, but 500 miles east of Moscow counts as Siberia in my book. She and 20 Americans counted railcars coming out of the factory as a proxy for warhead production volume. Evidently, the Stark treaty expired and no one got arround to renewing it. Who knew. The expiration occured at the same time as Michael Jacksons death. So, while the world became obsessed with propofol, Russia became free to churn out railcars at will.

With all the US-Russian nuke observers now unemployed, Linnea is contemplating staying for a few weeks to bridge future LEAP teams as they cycle through. This consistent presence and patient care is key. Her second week here will qualify her as the default hospital medical director.

She, Tim and I went to hospital morning report, currently organized by Cord, a future psychiatry resident from Kansas City. He introduced 2 new teams, a couple of orthopods from Akron, Ohio and a group of 4 high school guys and their dads. Cord put the 8 of them in charge of sorting thru and organizing the hundreds of yet-unopend boxes of donated supplies. He sent the rest of us off to our respective posts.

We spent the morning doing wound rounds, seeing patients with the new ortho team and several cases. They consisted of a few skin grafts, amputation stump revisions and a foot avulsion flap revision. Jessica, our team's scrub, also from Dallas Childrens, had her A game on. We've only worked together for a few days, but she had me and and the system figured out. (Better: she has us on her system). The instruments were scrubbed and soaking in Cidex, room cleaned, and tables ready for the next patient in 7 minutes flat. I bet our room might even pass a JCHO inspection!

Looking at the historical course of cases here has been quite interesting. The quake occured on 12 January. Most amputees relate their first operation was not until 19, 20 or 21 January. Most ex-fixes went on between 22 Jan and 3 Feb. There will be a huge need here in 3-4 weeks just taking off exfixes. The scene is bad now 6 weeks out; I cant imagine the traumatic, mangled extremity scene the first week post quake. Thousands of crushes untreated for days.

Many of our current surgical cases are dealing with complications of prior surgeries. It is at first tempting to say "what were they thinking, doing that?" But, stepping back, imagining the scene and realizing that there was no way of knowing if they or the patient would ever get another chance. It was essentially 4 weeks of damage control surgery. It is amazing that the first groups in, did so much, so well. For the most part.

Case in point: one of my wound patients was admitted, seizing, 4 weeks ago (about 14 days post quake). In the ER, Dr. Ken was about to give him some ativan when a nurse injected the contents of another syringe into the patient. Penicillin. The guy survived his full blown tetnus episode and looks great.

Between cases, Wendy had time to unpack the box that I brought down with me. Wendy is an OR nurse from Childrens in Dallas and has our little OR wing fairly well organized. She was ecstatic with the "trash" from my hospital! It will be well used. Will have to thank all the OR nurses back home.

Our cases were set to finish on the early side and we made the fatal mistake of saying we're done early, when the ER called us over for a pediatric case. Tim took the boy to the OR and extracted a rather large black bean from his ear while I tended to yet another young boy from the ER with a deep buttock laceration. By the time we had finished, everyone was gone from the ER, except for the boy, his mother and I. I left them there, ran upstairs to pharmacy and found the tetnus toxoid for him. No lie, just as I finished the injection and pulled the syringe out, a mother ran arround the corner with her 2 yo daughter in her arms. She looked at me and yelled "are you the ER dr?". I looked over my left and right shoulders. Nada. "Yes" was all I could say.

The girl had fallen off the stairs at home, onto the stove, where mom was cooking dinner. We took her to the OR, cleaned her burns up and got her back to the ICU. Chris was just back from his 2 day adventure, tending to yet another pediatric asthmatic. His iphone churned out the Parkland formula for her IV fluid rate. Haven't seen a scale here, in my arms, she weighed about the same as Nolan, so we went with that.

All the patients and their families had left the hospital for the parking lot hours ago. I was leaving the front door when Susan found me and dragged me back to the icu. "We can't find your postop orders.". I swore I'd done them, but they were nowhere to be found. Some things are still the same as the US!

Hats off to Jesse and Jim, our team's anesthesiologists. Between the ICU, our full surgical load and the ER, they were incredible. Given the sick patients, the communication barriers and the sketchy histories, I do think their job is the toughest of all. Our hospital is situated at the top of a very long, steep hill. Driving up it, Jim and I joked that the only 2 preop questions we really need answered is "when did you eat last" and did you walk to the hospital?". The walk up the hill is the definitive cardiac stress test.

On our way back, Chris told us about his past 48 hour adventure, which is great subject matter for another email. Not sure which name is most appropriate: MacGyver, House or Jack Bauer.

Hard to believe the week is half over.

Part Two:

Got an email last pm from a friend saying, "wow, it must be depressing."

Quite the opposite.

Yes, there is an amazing amt of destruction. The death toll is staggering. The poverty is everywhere. People living in the streets with nowhere to go or tents in front of their houses, afraid to go back inside. Corruption rivaling that of Chicago - maybe worse. The trauma fresh on the peoples faces and bodies. A generation of amputees in a country with zero handicap accessibility.

But, in the midst of all that, the sun is shining beautifully, the orphans at our hospital are truely smiling. The Haitian people are so friendly and appreciative. The volunteers are coming from everywhere, some alone, some by the bus load.

Currently our hospital is effectively being run by a photographer from Arizona (he used to work materials mangement in a hospital) and a PM&R doc from Dallas. Each just dropped everything and came for a month, fortuitously ending up at HCH. Add to that cooks from NC, a 30yo contractor from MA and a 29 yo leading a team from the USVI, who also just found themselves here. I've mentioned the Basque nurses and the Tyler, TX surgical team. The Red Shirts. LEAP team. Ortho from Seattle. Its amazing. Crazy. But beautifully so.

Two other recent emails asked what can I do there in Haiti? And, What can I do here at home?

To #1, in short, I now firmly believe that everyone in the US has some talent, gift or skill they can use here. Whether it be doing surgery, building shelves, nursing, opening boxes, changing dressings, cooking rice, organizing patient transfers/politically working with the local administration, counseling, making coffee or changing a diaper - everyone could do something. Find an organization and sign up. Even if its a year from now, the need will be there.

To #2, even those who can't go can do something back home. Will spend some time thinking about/sorting out specifics to this over the next days and weeks.

Stay tuned.

THURSDAY 2.25.2010:

When God talks to you, I suggest that you listen. I also recommend that you do what He says...

I had a dream 4 days before this trip that I needed to learn how to do a c-section. I blew Him off, thinking it was my overactive immagination and pending trip excitement. At 6 this evening, I was convinced that I had made a poor decision.

Our day started as planned- Tim did several cases while I did wound rounds with Vicki, an oncology nurse, and Meredith, a Med/surg nurse. Both are Red Shirts from NC and have been doing wound rounds and working triage for the past week. It took 4 hours to round (18 rooms, peds, and ICU - each with 3-10 patients per room); we are seeing 90% of the hospital census for dressing changes, suture removal, and discussion with the ortho team re: future plans for the patients. We have the service in pretty good shape.

Our minor victory for the day was the successful application of our second and third VACs in the hospital. Not sure how or who, but Craig had someone donate 3 of them for the trip. We could use 15 more. We've been slow to apply them tho, as most of the wounds were rather infected when we got here, requiring multiple debridements. We were also a bit concerned for the functionality and patient acceptance of the device. Our first VAC survived the past 2 nights in the parking lot, so today was full speed ahead!

By 2:30 or 3, Susan was spotted on multiple occasions between the ICU and Labor and Delivery ward. This was not a good sign, as she had a pre-eclamptic patient yesterday and a 28 week premie the day before, both with a bad outcome. She didn't look too worried, tho, as the Hatian Ob/Gyn was coming.

Nina and Scott, the Akron orthopods joined us in our little OR where we took ex fix off of a 4yo boy's tibia. Our last case was a second exfix removal from a 7 yo girl, but we had to cancel as the mom had fed her lunch an hour before. ("But she was hungry..." the interpreter said.) Again, some things here are identical to the US. In the US, we'd look for an intern to blame, but, as I am effectively the intern as well, I just smiled and moved her name to tomorrow's schedule.

Susan was glad that Jim was not doing any more cases and dragged him over to OB. Her patient was bleeding. She was worried.

I spent a bit talking with our team's interpreters/transporters. One, Jersey Joe, has particularly good English. He spent several years in NJ and graduated high school there. He's been back in Haiti for 8 months and is currently working at HCH. He's taken an interest to the wound care. Will have to see if Diversified has a Wound Center in NJ that could "employ" him for a few weeks so he could learn wound care. He's a potential answer to the ongoing HCH wound service needs.

Jim returned. "Michael, she's bleeding. A lot. No Haitian should be that white." By now it was 600pm and the other surgical team's bus had come and gone. We were it. We walked over to OB. For a split second, I thought my dream was going to be a nightmare. Fortunately, as I got to the ward, so did the Haitian OB...

Still, it seemed like an eternity getting her back to the OR. Lots of hand waving and excited conversations in Creole. A couple trips to the lab. I could make out "AB plues" in the conversation. By now, Jim and Jesse had found a 3rd set of anaesthsia hands in the form of a CRNA from the Red Shirts, who were still here. (Their bus was still a couple hours a way. It had been used earlier in the day to transport the orphans from our nursery upstairs to a different orphanage and was caught in the rain on the way back.)

She was still bleeding. I assisted the Hatian OB; Tim, Susan and Jessica assisted the Haitian OR circulating team; Craig and Liz (our new team addition, a Hatian born nurse, currently living in Atlanta, that Craig recruited to join us from the camp he visited earlier this week) ran to the lab for blood. More than 1 phone call was made to the hospital medical director and hospital president to ask for permission to give her a blood transfusion. (JP, how would you like that added to your job description?!). We enetually got approval for 4 units. Somehow 6 showed up.

Chris had a very sick patient with pneumonia show up in the ICU earlier today. While I was changing the dressing on our burn patients, I personally watched him mask ventilate the guy for at least 30 minutes. Sue and another Red Shirt nurse took over for a while as he fiddled with the ventilator he had found somewhere. The "vent" was a medium sized plastic box that more closely resembled the old hair dryer at my grandmas house. It now has a large piece of tape on it that said, "THIS WORKS". Fortunately the guy did not ultimately need it and it was available for our OB patient later. In fact he was sitting up, watching us this evening when we brought her in.

The case was very rocky. The baby did not make it. Her placental abruption led to A LOT of bleeding. At one point her BP was 40/20. Kudos to the Hatian OB as he was quite profficient. Hats off again to the anesthesia team for even getting her through the operation. None of the 3 of them had ever stepped foot in that OR room before that case. None of them normally do OB. They had no idea where the drugs and fluids were kept. Wow.

Everybody got the patient to the ICU. I went with the OB and Liz to meet the family. Selfishly, I wanted to hear how the OB would explain things. Still the outsiders, we are trying to make sure we are not intruding or overbearing, rather, making every effort to be welcomed additional support to their system. To be perfectly honest, I did have a small concern that somehow blame for a bad outcome could be slightly shifted our way. Fortunately, it was absolutely not the case.

We prayed with the husband and then took him back to the ICU to see his wife.

Chris and Susan will spend the night at the icu. There are 2 more pre-eclamptic pts in there as well. I did see the Haitian OB examining them, then later, leaving the hospital in his street clothes. Not sure what to make of that.

The rest of us gathered up our stuff and headed out. At the front door, the Haitian Dr on call tonight flagged me down to consult on a possible bowel obstruction.

In the parking lot, I noticed that fewer patients are spending the night outside. The threat of rain is now outways the memory of the quake 3 nights ago.

Tomorrow, half of our team will go back to adventist to do some cases they have lined up for us. Will look for my hand patient.

FRIDAY 2.26.2010:

Part One:

She made it through the night.

Chris and Susan were amazing.

Heading to Adventist to do a few a few cases. No idea what they are.

Part Two:

During our drive across PAP to Adventist - it was again obvious that the downtown was harder hit; more destruction in the more densly pop areas; or was it the poorer construction? Unconsciously found myself holding my breath as we drove by flattened buildings. The stench of death is still everywhere.

Our route to took us by the harbor. The US Comfort is out there. Pretty cool looking. Rumor has it that the only functional CT scanner in PAP is on the ship. Rumor also has it that they are pulling out soon.

In fact, there are lots of rumors here in Port au Prince. We hear Aristid (sp?) Is coming back. Others swear they will kill him if he does. (That is fact, not rumor). One rumor, broadcast on major radio, blames the French for the quake. ("They got us again." and "It may have been a nuclear bomb from France").

We walked in to Adventist and found a line of patients down the hall waiting to see the plastic surgeon, having been told that they may need surgery. And in fact, most did.

The consistent presence there is by Scott Nelson, an orthopedic surgeon from CURE/loma linda, who's been in Santo Domingo for the several years. He's been doing some monthly work in Cape Haitian, a town a few hours from PaP. They moved their whole operation to PaP shortly after the quake. Having been at Adventist for a few weeks, he is the default International Medical Director there. Overhearing conversations between cases, it appears he too is doing a lot of good, building relations and supporting the existing Haitian admin. The pre-quake relationship between Loma Linda and Adventist has helped tons. They have med students and residents rotating here! Impressive.

A 4th year medical student named Matt took me down the hallway for post-op clinic/wound rounds/pre-op clinic. In a matter of minutes he had my day's OR schedule filled. Matt is awaiting match day, going in to ortho. Here, he has been functioning at much higher of a level than a student. We joked about the 80 hour work week concept here... Internship will be a chip shot for him. Maybe even a buzzkill.

A Canadian fireman then grabbed me and took me out to the hospital's tent city - site of the minor uprising earlier this week. There he had several more surgical cases for me, including a cleft lip and several more wounds for flaps or grafting. We put one more wound on our schedule for the day and gave the rest the name and number of our clinic at HCH. Scott and I coordinated another day of OR time next week for the LEAP team. Easiest OR block time ever negotiated with the OR committee:
Scott, "You guys want a room on Tuesday or Wednesday?"
Mike, " Sure."
Scott: "See you then"

The tents are crazy. There must be over a hundred ranging in size from a Coleman pup tent to a giant white one with a huge red Canadian maple leaf on it. It is almost as magestic looking as the Comfort in the harbor. The tents are packed with cots and matresses. And patients. And family members.

Out in the Canadian tent, between cases, I found my hand patient from earlier this week. I changed his dressing. Several more members of God's Little Cleaning Crew had shown up and been busy over the past 3-4 days. The wound was quite clean. I didn't have time to close him today; hopefully next weeks LEAP team or the ortho guys will be able to do so.

The cases went well. Wendy and Jim did a great job of showing up to a hospital they've never stepped foot in and putting toether an OR room and anaesthsia. Uneventful is good.

All of the patients, save 2, will spend the night in the PACU and then tomorrow get sent outside to the tents.

2 patients with rather complex wounds of an amputation stump and a wrist got VAC'd. Scott had "acquired" 2 VAC machines that were brand new. These were the first VACs placed on patients in this hospital. When they showed up in PACU, the machines created quite a stir. Lots of excited Creole. I told them to trust me, we do this all the time over at HCH (3 times does count as 'all the time', right?). More excited Creole. Then smiles and hugs. Then pictures of Scott, me, a machine and an amp wound vac.

One patient I operated on today really has captured the heart of the Adventist volunteer staff. Scott's wife has written it up in detail and I will forward it when he sends it to me. In short, Rochelle is a 26yo law student who was in class when the quake struck. Her brother, Eddy, dug her out of the school building a day later. Her left arm had to ultimately be amputated below the elbow. Another plastic surgeon had covered the stump with tissue from her groin 3 weeks ago. It had healed well and today she was ready to divide the pedicle connection between her arm and groin. When I get home, I am going to google the surgeon who did her flap to give him some followup on how well she's doing. Tomorrow or Sunday, Matt will discharge her to the tents. Her brother kept hugging everyone.

This case, among many others, really get me thinking about DVT prophylaxis. There is none. All we have is early ambulation and prayer. Have several physical therapy teams here helping with the first. But, as with everything, they need more of both.

A lot of Rochelles story came from a nurse named Brooke. After the quake, she felt a calling to go, so she sold her house and furniture and jumped on Loma Linda train heading south. She's an ER nurse and will be here until May. Maybe longer. She and several others were heading out to a local club tonight for some r&r. "Not everything was destroyed...". Brooke's remaining US possession is a 2009 Subaru outback. Its for sale too. Anyone interested?

The cases went a little longer than we had planned, so our trip back was after dark. I could sense that Jackson wasn't too pleased. I thought it was a security/safety thing, but midway home realized that probably was not it. Rather, with no streetlights, the driving juju was a bit more tense. Same number, if not more pedestrians and motorcycles. Same agressive Jackson driving.

In fact, driving back through downtown felt very big-city comfortable. In the dark, without street lights, all you could see were the people and tent fronts, illuminated by candles and small lights powered by small generators. Rows and rows of port-a-potties. Plenty of little metal grill carts with delicious smelling barbeque. People everywhere, milling about, smiling and laughing. Tents. We all agreed that it felt like camping out for superbowl tickets in NYC. Or Mardi Gras, minus the beads and parades. Until we passed another illuminated pancacked building front and I found myself holding my breath.

We got back to HCH. They had had a good day. The OB pt was extubated in the ICU. Her skin color looked much more appropriate for a Haitian. Chris was very happy.

We collected the rest of the crew, less Jesse and Liz, who were still in the OR w the Haitian OB doing yet another c-section. Not sure how the case would have gotten done without our anesthesia team here...

Over pizza at a nearby resturaunt, we all swapped stories from the day and began processing the past week.

Liz and Jesse joined us late. Spent an hour talking to Liz. She passed on a very big "thank you" to the rest of the team from the Haitian OB doc for the help last night. "She is alive thanks to your team". Quite interesting to get the Hatian-American perspective and hear about her and her husbands interest in returning to live in Haiti. With her nursing skills, the opportunity is endless. I think her eyes were opened as much, if not more, than mine by the the trip.

As we were getting ready to leave, another American team from 2 tables over came over and asked if there was a general/trauma surgeon in our group? They had just been called about 2 gunshot wound patients brought to their hospital. They don't have a general surgeon there. While we made some calls to help locate a general surgeon, I spoke with a nurse on their team, Julie, who quit her job as a news anchor in Duluth to come down. When she goes back, she is headed to NP school.

The stories from this place are amazing and the craziness just does not stop...

SATURDAY 2.26.2010:

I woke up feeling more than a bit off. My first thought was that I couldn't believe I was going to come down with "Hatian Happiness" during my last 6 hours in Haiti.

I took my first dose of cipro, a couple pepto pills and started drinking. Jim had a few gatorade powder packs to add. By the time we got to HCH, I was sure it was just dehydration. The OR at Adventist yesterday was particlarly warm, in part due to the facilities and in part due to the need to keep patients warm during surgery. There are no patient warming machines. There are no blankets. Their street clothes are it.

3 large bottles of water later and I was feeling much better. The med student from KU with the One Five group out of Kansas City was not faring quite as well. After morning report, I convinced him that an IV was in his best interest (personal experience, too). A liter of fluid perked him right up.

Its easy to get behind on fluids here. You're busy, its warm and humid. You give your water away to a patient. Your water bottle experiences a "mysterious dissapearance." And there's a subtle fear of "is this water ok?", even if it comes from an unopened bottle or packet.

Rounds this morning were quick. 2 VAC changes and a trip through the wards and ICU. Everyone was stable. A plan was in place for everyone with Linnea for the next team. They don't know it yet, but they have several cases tomorrow...

We said our goodbyes to the patients, translator staff, and other volunteers. Lots of pictures. Traded email addresses. Unlike summer camp goodbyes, I have a feeling that we will stay in touch.

We then literally bolted for the car past the ER and triage zones before one of the Red Shirts could see us and ask, "Hey Mike, can you look at this patient...?"

Cliff was moving us along. "We should have left 30 minutes ago." He always said that.

The ride to the airport was along a different route, but with similar scenery: Huge fields covered with tent cities. People living on the sidewalks. Flattened and crumbled buildings next to ones that appeared completly untouched.

To me, the most mind-boggling sites of all are the pristine looking buildings, sitting all askew, 5 to 10 feet off its foundation.

Jim said his iphone reports an 8.2 quake in Chile this am. He says he will keep his seismograph ap on for the next few nights; he is as yet undecided about the shoes.

The airpot was hot and humid with no breeze. But, rather effiicient. We were at the gate with plenty of time to spare.

We ran into the St Damien Hospital ortho group from Virginia Mason/Seattle. They've had a great month.

The terminal was filled with lots of other tired-looking-in-need-of-a-shower-and-shave volunteers. Many Haitian families were waiting for the flight to Miami as well.

The incoming AA flight landed and made its u-turn at the end of the runway. Mark Peters, a plastic surgeon from Louisiana, and the rest of the next LEAP team was on that plane. Cliff and Linnea were outside waiting for them. It was Jackson's day off.

I thought I'd be sad to leave. I wasn't. It was actually just feelings of unfinished business.

From 20 feet away, through a glass wall, our team watched the passengers deplane - mostly relief workers. Clean. Well-rested. Wide-eyed with anticipation. We held up a LEAP team sign. A group of 6 recognized it and waved at us excitedly before heading in the opposite direction towards the customs hanger.

The feelings of unfinished business immediately vanished.

Our shoes were filled.

HAITI Postscript

Back home to Chicago. There is snow on the ground. I am in need of a shave, shower and a good nights sleep.

Everyone in our group who had been on previous medical mission trips agreed that this was MUCH different than any others they'd taken. What set this one apart was the unpredictability of what we encountered on a daily basis, the extreme disorganization that still remains and the huge gaps in the availability of basic healthcare providers. (Any time a plastic surgeon even thinks about doing a c-section, you know you have a problem...)

I do see "shoots of green", however. People like Craig Hobar and Scott Nelson who have a heart for Haiti and vision for how things can work are where it all begins. They, and others like them, need our support.

The stories behind the volunteers I met this past week are inspiring. Countless numbers of individuals from around the world who dropped everything at home to respond to a need.

For the victims, much care is still needed. It is 7 weeks post quake and there is still an abundance of acute medical needs: wounds, infections, etc. Long term medical needs such as rehab and prosthetics are coming.

Time to plan the next trip!

Reflections from Dr. Frank Lista

2010-02-18T10:30:00.000-08:00

We found our driver, loaded up the truck and left for the house that had been arranged for us. We thought we were prepared to see shocking images. We were so wrong. Buildings laying on their sides. Cars crushed by rubble. Empty lots we thought were vacant land but in reality were piles of compressed rubble from a collapsed building. While waiting at a stop sign we would stare at the devastation. Our expressions of shock must have been plainly obvious because, with our windows down and in those narrow streets people on the sidewalk would lean toward our car and quietly say, "This was a hospital", or "This was a school." As if asking us to mourn with them. Hundreds of buildings collapsed, ruined, destroyed. And what of the people? We would soon find out.

When we arrived at the hospital we were greeted by total chaos. People crowding the front door and hallways trying to be seen, or visit, or be attended to in triage. We wanted to find the office to report to the person in charge for duty. But what office? What person in charge? We wanted to say, "Here we are. What do you want us to do? Put us to work." But there was no order, no authority, no hierarchy. No-one to say "This is Mr. Soandso what do you think? What can be done for him?". No, nothing like that. Just injured people laying in crowded rooms or in the hallway hoping some passing doctor or nurse would take an interest in them and do something. What happened to this person? What has been done for them? What is the plan? No one knew. There was no plan. There was no one in charge.

One soon realizes that modern societies are not defined by knowledge or technological advances, but rather by a chain of command, by central authority. We were adrift without someone to tell us what to do. We were a few feet apart from the people we were there to help. Walking above them as they lay on the floor but really miles apart. Separated by their inability to ask for help and our inability to know where to start.

Never had we seen such devastating injuries. Rooms meant to hold 2 people filled with 5 or 6. Sometimes more than one per bed. Every patient missing limbs. Amputations everywhere. A country of amputees. An arm. A leg. Both legs. An arm and a leg. Men women adults children. How could this be?

Patients with horrible fractures and devastating wounds. We would walk into a room and see a massive soft tissue defect. How is this wound being dressed? Is this patient on antibiotics? What is the plan for this wound? There was no one to ask. No one knew anything. Chaos.

What was to be done? These patients needed surgery. Leslie picked up her clipboard and made notes. Zig and I and the nurses picked out patients. This patient needs a skin graft. This woman a stump revision. This child a wound debridement. We'll operate on them in this order. The list is posted on the wall. Tammy, Sue and Lori hurry back to the OR to set up for the cases and Zig prepares his anesthetics.

On our first day in Haiti, fuzzy from lack of sleep , shocked by scenes of devastation, made numb by the sight of human suffering, we begin to operate. Taking skin grafts, meshing the skin, applying the graft. Next patient. Debriding the wound, shortening the bone, suturing the defect. Next patient. A rhythm of blood and pain. Seven surgeries between 2pm and 6pm. Finally we are forced to stop because the power fails and the OR is dark.

On the drive home no one speaks. At dinner we quietly discuss what happened. How did we do? What can we do better tomorrow? Who needs surgery the next day?

We roll into our sleeping bags early. Most of us sleep on the floor. I share a room with Zig. When I enter the room he looks up from his book and smiles.

"Frank", he says. "Next time we go on holiday together, I think we'll go someplace else."

For the six of us, this week, there is no place else

Thoughts from Claude-Jean Langevin, DMD, MD

2010-02-16T10:51:00.000-08:00

I have gone on several mission trips, however this was my first trip with the LEAP foundation and I am very grateful to have been given this opportunity to help in this relief effort. I was assigned to l'Hopital de la Communaute Haitienne, a small community hospital in Port-au-Prince. The gravity of the human devastation was easily palpable upon our arrival. There were tents set up all around the hospital filled with patients and their families, and among them doctors and nurses were tending to their wounds in this humid and slovenly environment. We then entered this small 2-story unfinished hospital which was again overcrowded with patients. Patients' rooms were used beyond their maximum capacity with 5 mattresses on the floor and additional patients lined up along the walls in these gloomy corridors. My ability to speak french allowed me to have a better understanding and insight into the plight of these people. They all lost something in this earthquake, a family member, a friend, a house... often much much more. I will never forget this one little girl we treated for a fasciotomy defect secondary to a crush injury to her left arm from the weight of her now dead mother. Despite all their troubling history and recent tragedy, the people of Haiti were extremely appreciative of our help. All medical personnels that I had the chance to interact with were entirely devoted to this cause. I just hope that we will all still remember that this country continues to need our help and prayers once the media attention dies out. Hopefully this earthquake will be an opportunity to help rebuilt this country with their amazing people and their once characteristic "joie de vivre"

9 Different Vantage Points on Haiti.

2010-02-02T15:35:00.000-08:00

Early Saturday, January 30th, 2 planes departed two different Dallas area airports—both bound for Haiti. Aboard were medical personnel (surgeons, nurses, and anesthesiologists) a journalist, and LEAP staff — all volunteers for LEAP's third trip to Haiti to work in two hospitals arranged by Dr. Ale Mitchell, who has been in Haiti since January 21. Upon arrival in Port-au-Prince, the teams split and head to two Hospitals HCH (Haiti Community Hospital) and CDTI. Below you can read each person's unique experience.

Thoughts from Sherry Colburn, Director of Missions, LEAP

Dr. Hobar has asked us to write a story or give our thoughts on our experience in Haiti this week. I wish I had a story or a thought—but not my own. I want their stories. Our team split into two teams when we arrived in Port Au Prince. Our group went to CDTI a hospital about a a half hour from the airport. We saw crushed buildings on the the drive to the hospital—and crushed bodies when we arrived. One of our patients was a young woman probably 25 years old and pregnant. We were asked to clean and and re-suture a large wound in her forehead. This woman had a crushed femur and had already undergone a massive surgery to repair her leg. Dr. Tim numbed her forehead and started to repair her wound. She started screaming and asking "why?". Over and over, unconsolable, just asking why. The repair of her head was not painful as she was numb, but she just kept screaming. Who of us can even imagine the horror this woman had experienced. Maybe she had lost her family, maybe she had lost her home. We fix people, but I want to know their stories. This woman who had endured so much pain and so much horror—looked up at us when we were finished and simply said, "Thank you. God sent you to me." She was transferred back down to the patient tents and we never saw her again. What was her story? I'll never really know—but I do know one thing—she was right—God sent us to Haiti and will send us back—to get their stories and to help heal their bodies.

Thoughts from Jackie Reed, RN

How can you begin to describe the devastation and chaos we saw in Port Au Prince? It's impossible to put in words, but I'll try. As we traveled from the airport, one saw lines of people waiting for food and water. Tempers were flaring, pushing and shoving, loud angry voices, mothers and crying children—the looks on their faces: shock, disbelief, uncertainty and fear. I'll never forget!! I was assigned to CDTI hospital. I've been involved with mission work since 1994, but nothing prepared me for what we encountered. Teams from all over the world coming together under one roof to help, not strangers, but human beings in whatever way we could. It was truly amazing. We shared everything from supplies and equipment to food, clothes, and lodging. The hours were long but the results were rewarding. I'm privileged to have been given this opportunity to make a difference in the lives of the injured. However healing their hearts and souls will take much longer.

A View from Gay Smith LVN's Journal Entry

It's amazing, we are flying over such beautiful skies, gorgeous clouds... when you look down awesome colors of the ocean. Then I think of what we are flying into....all on mission and have wonderful, faithful hearts—God's love is certainly felt. Praying for our strength, safety and compassion.

Driving through the city—totally unimaginable...buildings destroyed, in pieces or complete rubble. Tents & makeshift shelters everywhere, people everywhere...crazy busy!!! Port of Prince as the Haitians knew it has changed forever.

I'm overwhelmed by the outpouring of the world...supplies, workers, human kindness at its best!!

Felt really good about a hard days work... touched by one lady, Alvina. She was so traumatized it took all I had to keep her somewhat calm for a procedure. The soothing nature of the human touch and voice is incredible—I will not forget her face.

I feel we were all very privileged to be called to help.

Haiti trip 2/1/10: From the Perspective of Krishna (Bob) Rao, MD

I was very grateful for the opportunity to help in a tangible way after the terrible earthquake in Haiti. To show the love of Christ in a tangible way is a privilege and to serve with LEAP is an honor for me. I have several impressions of my trip to Haiti.

Firstly, I was impressed with the human tragedy of the earthquake. Haiti was already one of the poorest countries in the world. Despite its scenic beauty and lush vegetation, it is my understanding that the country has suffered from poverty and corruption. In addition to that sad situation, the horrible reality of a devastating earthquake occurred with the epicenter essentially at the country’s largest city. This has resulted in hundreds of thousands of dead, homeless, hurt, and hungry. We worked at a hospital which we simply called CDTI. When I first walked into the courtyard which is the entry of the hospital, I was ‘blown away’ by tent after tent of the injured and hurt waiting for help. It was hot and humid. Flies were everywhere. There was a bad smell in the air. You can not help but wonder why I am so blessed in so many ways while the people of Haiti suffer so much. I know that it is not deserved, and I have to imagine that severe suffering can affect any of us at anytime. The only way to face life for me is to rest on the hope found in Christ.

Secondly, I was impressed with the resulting chaos. As Haitians try to recover from the tragedy there is a large outpouring of aid from all over the world. The US, especially, has perhaps thousands of volunteers from various organizations in addition to US government and military help. The mixing of all of these people with the hundreds of thousands displaced and needy Haitians has created a chaotic situation. Who should be in charge, the possibly inept Haitian government, the French, the UN, the US? At one street corner, there was a UN force of Nepalese on one corner in an armored truck across the street from a US force in a Humvee. How does order occur? It leads me to think that the God of the Bible is a God of ‘order.’I would like to believe that when God is in charge, chaos dissipates and order occurs.

Thirdly, I was impressed by the generosity of the US. Now there are many positives of eastern cultures versus western cultures. However, as one who grew up with the influence of an eastern culture, it was amazing to see so many planes arriving with teams of people willing to give their time and energy to help. In the hospital I worked, there were teams from Colorado and Chicago in addition to our team from Dallas. I am blown away by the wonderful generosity of this country. I believe this is direct result of the Christian heritage of this country. I wonder as our country slowly transitions to a ‘post Christian’ environment if the generosity of individuals will continue (I hope so). As believers in Jesus, should we not show the love of Christ in a tangible manner? But should we also not neglect to share the love of Christ in the gospel of our Lord? We should seek a way to do both in a way that is respectful, not too pushy, not too offensive, that allows one to freely choose to believe or not believe.

John Thorne, MD 's take

I am honored to have been able to be a part of this medical relief effort in Haiti. I was part of the HCH team. I was expecting much worse hospital conditions than we encountered (not that they were great). Everyone did an awesome job getting the OR organized and set up to start doing cases that first evening. Unexpectedly, the last case Saturday night was an emergency surgery with the general surgeon from St. Thomas. Speaking of that first night, hats off to Robyn Fitzgerald who volunteered to work in the ICU all night. When all the excitement settled some of us set up cots on the roof of the hospital. We then managed to get some chow with a military delicacy, the MRE. I slept next to my new colleague and friend C-J. I didn't sleep too much with the dogs barking, roosters crowing, and the occasional gun shot. All in all, I feel we did an awesome job. We made some new friends from Mississippi who are there now continuing the mission we set to do. I am physically and emotionally drained. I hope to have an opportuniy to return to do whatever is needed. I despise typing so this is it. I give thanks to God, LEAP, and my familly for making it possible for me to have made this short but necessary trip.

A Reflection from Robyn Fitzgerald, RN

I am blessed to be a part of the LEAP relief in Haiti. Every time I go on a surgical mission with the LEAP team I feel as if I grow, emotionally and spiritually. It is difficult to describe the satisfaction that comes with being able to use my nursing skills to provide care, comfort and relief to those with medical needs.

My experience in Haiti was different from other LEAP missions, though. I had mixed emotions this time. I felt a sense of accomplishment in the care we were able to provide, but I also felt a sense of loss as I left the hospital. It was extremely difficult to leave the country when there are so many more desperate people who need immediate medical attention.

I also had mixed emotions as I went to the roof of the hospital to sleep Sunday night. I stood at the edge of the roof and looked down at the hundreds of people living in tents outside the walls of the hospital. I heard cries of pain and loss. As I stepped away from the edge I looked at the mountains in the distance, and then looked up at the sky. The stars and moon appeared close enough to touch. At that moment I realized the great pain and beauty that coexists in Haiti at this time.

A Reflection from Travis Hardy, Creative Communications for LEAP

It wasn’t long after I stepped off the plane in Port-au-Prince that the existentialist question that plagues me at home confronted me, offered to me by our unassuming Haitian guide: “So, what do you do?”

Perhaps my inferiority complex was exacerbated by the fact that I was traveling with highly trained medical personnel, but my own initial thoughts as breathed in the warm dust-filled Haitian air were nearly the same queries that were proposed to me, by not only this person, but by nearly everyone I met: what do I do and why am I here? I’m not a relief worker. I’m not a specialist in Search and Rescue. I’m not a doctor, a surgeon, a nurse, or an anesthesiologist. I don’t have food or water for the masses. I’m just a story-teller. I tell stories with words sometimes, but mostly images—some images I capture, others I create with Adobe or Final Cut or a pencil. So what good am I to the people of Haiti? What is it I do? And why am I here?

It did not take long, as we departed the airport swarming with military and aid groups from all over the world, to realize why we were all there—we were all there to stand next to a fellow human created in God’s image in a time of great hurt. While I can’t fix their wounds, I can join the many voices telling their story. Yet, the story of the Haitian people cannot be summed up in 250 words or 1000 images or 15 days of Anderson Cooper’s reporting. Each person has a valuable story and struggle that is ongoing—everyone I met had lost a limb, a family member, their home, or all of the aforementioned. There is tremendous loss everywhere. There is no quick fix to this place or to the hearts of these people. Yet there is hope. Hope that together we can connect our stories with their stories and walk through these trials together—something I know LEAP is already doing and planning to do for much longer.

A Reflection from Steven Garren, MD

In a world so full of violence and hate, instantly one sees the outpouring of compassion and generosity—planes from Brazil, Canada, Russia, USA—and then leaving the airport for the hospitals, the surreal scene of a once city of three million reduced to rubble. The technical college with bodies with outstretched limbs...not quite making it away from the collapsing floors above them. The little blind woman sitting perplexedly on the sidewalk. No family left. What will she do tonight? Tomorrow? At the hospital are people who are instant friends; Janine, Mark, Karl, Peggy...probably never to be seen again, yet what a gift to work with people that so graciously give and care. A translator, Big Mack, took me to his house—it wasn't there. ONly a scattered deck of playing cards, sitting on rubble, with aces and twos up.

"Where will you stay tonight?"

"On the street."

"And if it rains?"

"I have an umbrella."

And then Camille does a C-Section—a healthy baby. People applaud. People will continually help, and hope and faith will prevail.

A Glimpse of Haiti from Wendy Yeater, RN

LEAP has afforded me opportunities to practice nursing in developing countries across the world; but nothing could have prepared me for Haiti. Television and media provided a snap shot of the destruction of the physical landscapes and buildings impacted by the Mother Nature’s earthquake. Pictures of the people made the news but it did not identify the real tragedy due to the ‘graphic’ nature of the content. It was only in person that I witnessed the impact on the human body both physically and emotionally. Where buildings and structures can be rebuilt it is the human body that suffers the brunt and long term effects of this nightmare that may never get repaired.

Judeline is a 15 year old young lady that was studying at home when the earth shook and the roof collapsed in on her. She did not only lose her Father and Brother but she also lost her lower right leg. She suffered a crushing injury to her left arm and was having some difficulties with her right arm. When I met her, her spirit seemed broken…A young lady coming into her own had now to learn to not only overcome the devastating physical injuries but also the psychological body image of a missing leg, needing to be in a diaper, and now we were here to take skin grafts and help in the healing process. She asked ‘why me’… The anesthesiologist needed to place a central line for ongoing antibiotics and fluid maintenance. During this time I held her hand as she endured yet another procedure. At the end of it I told her (through translation from a Plastic Surgeon) that she was a very brave strong young lady…a small smile came at the corner of her mouth and she closed her eyes. My heart sunk. If I could only imagine what this ordeal will do to her and has already done to her…I pray that she gets the ongoing medical care for her physical challenges and emotional support for psychological challenges that lay before her. I am thankful for the talent I was give to have made a small difference in a person’s life and pray for the opportunity to continue to help others in a cause greater than my own.

Important Info from LEAP for medical relief workers in Haiti

2010-01-27T16:18:00.000-08:00

United Airlines has planes coming into Port-au-Prince Airport Thursday, Friday, Saturday and Sunday. There is limited space for people to return on the plane to Chicago, where you would be responsible for you transportation afterwards. Space is limited and you need to send the following information to McAleer[at]united.com:

Legal Name (as it appears on ID)

Gender:
DOB –
PP # -
EXP DATE -
Country of Residence -

Country of Citizenship -

Country and place of issuance –

Current Residence:

LEAP's Dr. Mitchell featured in Rice University News

2010-01-22T18:39:00.000-08:00

Reconstructing hope in Haiti
Alumni LEAP to aid earthquake victims

BY JESSICA STARK
Rice News staff

Though not much information was readily available when Gabriel Garcia '00 heard about the earthquake in Haiti, he knew one thing: His sister, Dr. Alejandra (Ale) Garcia Mitchell '98, would find a way to help the victims.

"A lot of people say they support a cause, and some people will donate, but she's the only person I know that will do something about it," Garcia said.

Within days of the earthquake, Mitchell and her husband, Ian, were on a plane to the devastated country to offer medical care and assistance to those who needed it most.

"The region is pulverized," Dr. Ian Mitchell said. "Everything has been crushed."

A plastic surgeon with the Life Enhancement Association for People (LEAP) Foundation, Ale Mitchell is no stranger to operating in the less-than-ideal conditions of developing and poor nations. The doctors in her organization routinely travel to India, Belize, Guatemala, Zimbabwe, Laos and the Dominican Republic to give specialized medical service to the people there.

"In Port-au-Prince, we've been dealing mostly with crush injuries," Ian Mitchell said. "The quake spared no one."

In Haiti, Ale Mitchell has taken on another role: head of operations for reconstructive services. She is charged with overseeing the efforts by plastic surgeons. Not only is she doing surgeries, she is in charge of all the logistics and on-site operational activities, like ensuring that medical volunteers for plastic surgery who arrive in Haiti know where they are assigned.

Dr. Craig Hobar, president of the LEAP Foundation, said that the organization would not have been able to carry out work in Haiti without Ale Mitchell. He said she is the key person coordinating all reconstructive surgery efforts and has traveled around from clinic to clinic finding ways to better organize and serve.

"Dr. Mitchell is a godsend," Hobar said. "She has been such a blessing to us. We wouldn't have been able to step up to the plate and do what we've been doing without Dr. Mitchell. I've never met a person quite like her, who balances all the qualities of being an outstanding doctor with being such a warm and compassionate person. She's fearless too. She always does whatever it takes."

Her brother isn't surprised to hear such praise.

"This is Ale," Garcia said. "She dives in. She is doing what she loves doing. Ale went into plastics because she wanted to put a knee back on or help a kid with a cleft palette or deformity. She helps those who would never have an opportunity to get medical attention. She pretty much goes to the worst places in the world to help people, mostly kids."

He said that in Haiti, his sister has been faced with many tough decisions. She has had to perform amputations on many people to prevent further infections and damage, even in cases that would require reconstructive surgery, because she didn't have the resources she needed.

"It hurts to see her not be able to help in all the ways she wants," he said. "What she doesn't see is that just her being there is helping. She has been instrumental in LEAP getting the manpower and supplies it has needed."

Despite the terrible conditions and the enormity of disaster, Ian Mitchell said, there is still hope. He has seen the international community come together.

"We've been working alongside the French, and the Brazilian Air Force flew patients in to see us," he said. "It's an international effort at this point. We're all in it together. The people in Haiti need that and sustained medical attention -- not just to save lives now, but to work on rebuilding for their future."

Putting others first

Ian Mitchell said that when they first arrived to Haiti, people would surround them by the truckloads when they learned they are doctors. He and his wife had to treat people in the streets and were scared by the unsafe conditions but worked on through the nights.

"We operated from dawn until about 10 p.m. when they had to turn down the generators to conserve power," he said. "Even then, we didn't want to stop. Ale didn't want to stop helping."

"I'm pretty sure she hasn't slept," Garcia said. "She was there for about a week and came home for 48 hours to gather supplies and do some organizational things. And then she was on a plane back to Haiti. Maybe she slept then. All I know is my sister always puts others first."

Garcia said Mitchell's commitment to service inspired him to do what he could. His consulting, engineering and IT company, TechStudios LLC, donated hours and effort to design and launch the LEAP Web site. The company's programmers are installing databases to help process forms for volunteers to apply to LEAP.

Already Garcia has seen many Rice-affiliated doctors volunteer to help. Even before the site launched three days ago, his fellow alumni were contacting him to ask how they could help in Haiti when they read some of his Facebook postings about his sister's work.

"I didn't really have to reach to anyone -- they started reaching out to me," Garcia said. "I got a bunch of e-mails from Rice alumni saying, 'I'm a doctor. I'm ready to go. When do you need me?' We have a few Rice people who are on their way there right now."

Rice's international reach

Camille Boon '00, an obstetrician/gynecologist, is waiting for her assignment through LEAP. She made arrangements with the other partners in her practice and her patients so that she could contribute to a cause that is so dear to her heart.

"When I was a freshman at Rice, I went on a service trip to Haiti with Rice's Community Involvement Center," Boon recalled. "Ironically and sadly, that's how I first met Diane (Berry) Caves. We were on the same trip. I'm sure that trip is part of the reason she volunteered for her post in Haiti."

Caves '00 is an alumna who has been missing since the powerful earthquake severely damaged the Hotel Montana, where she was staying in Port-au-Prince. Caves is on temporary assignment in Haiti for the Centers for Disease Control and Prevention.

"As soon as I heard about the earthquake, I started figuring how I could go back to Haiti," Boon said. "I had been there before, and I'm a doctor who speaks fluent French. I wanted to help."

Boon said commitment to service was instilled in her during her time at Rice.

"Rice really has an international reach and encourages its students to think and act globally. It creates and emphasizes opportunities for students to travel, study and serve abroad," she said.

Garcia said that's a reason why he thinks he'll be seeing even more Rice names Haiti-bound in the near future.

"We need physician assistants, nurses, doctors and those trained in administering first aid," Garcia said. "We hope that by tapping into our Rice network that we can have many, many more volunteers. Money is great too; we need it to buy the supplies and equipment required for the surgical procedures. However you can help, help."

Hobar said that in addition to the ways currently listed on LEAP's Web site to volunteer and donate, the organization is developing a long-term plan for helping Haiti rebuild.

"Because of our unique relationship with the region -- we've been working in the Dominican Republic since 1991 -- we have a long-term plan and commitment," Hobar said. "We want to help build orphanages and missions. We want to find ways to take care of the nation's homeless. We want to develop a prosthetic program for the victims of the quake. There are and will be lots of opportunities for people to help."

Find ways to help on LEAP's Web site at http://www.leap-foundation.org/.

For information on what current Rice students are doing to provide relief efforts to Haiti, visit http://www.media.rice.edu/media/NewsBot.asp?MODE=VIEW&ID=13611.

LEAP BACK IN HAITI

2010-01-21T21:46:00.000-08:00

This note is a summary of a text from Dr. Ale Mitchell in the field in Haiti,

She is at HCH and doing ok (we're not quite sure where HCH is, but we know it is somewhere located outside of Port-au-Prince). She says things are going well and she met with Johnny Boulle and they talked a bit. She also met a local pediatrician who has many patients needing plastic surgery at a clinic that was turned into a temporary mash unit. She is meeting with this pediatrician at the clinic tomorrow and will discuss possible long term hospitals for LEAP since she knows the city very well. She is sleeping outside again—this time on the roof. She reports that things are much calmer and there are less patients than last week but Haiti is still very, very busy. HCH is outside the city so patients arrive by car.

She will check in tomorrow. When she does—We'll Post it!

FROM THE FIELD - Our Experience in Haiti

2010-01-20T23:28:00.000-08:00

Current estimates of the Haitian Earthquake disaster include 200,000 dead, 250,000 injured, and as many as 1.5 million homeless. Through an unusual set of circumstances, LEAP was able to travel to ground zero, Port Au Prince, Haiti. We were there from day 4 through day 6 of the disaster. It was a big question mark whether we would even be able to land. Plane after plane hovered over the small airport, awaiting clearance from the military. There was the chance that our plane, like there was for all the others, would be either turned away or circling indefinitely. A group of a half dozen military personnel were sitting in a grassy spot near the middle of the runway serving as traffic control. Suddenly, our plane stopped on a dime, spun around and sped off the runway and out of the path of another plane rapidly coming in behind us.

The airport was pure chaos. Thankfully we managed out of the chaos with the help of the mission organization that was expecting us. Our hospital location changed unexpectedly midstream and we were taken to CDTI Hospital. Our drive to the hospital brought the image created beforehand by the media to reality– building after building and house after house lie in ruins interspersed with relatively untouched houses and buildings. The two search-and-rescue professionals with us commented on how many collapsed buildings were left ghostly undisturbed. We were used to the universal standard of a collapsed building being searched. We arrived to find the hospital abandoned for fear that it lacked structural integrity in the wake of potential aftershocks.The parking lot replaced the physical hospital with hundreds patients and their families lying on blankets or mattresses on the concrete ground. There were open fractures, closed femur fractures and gangrenous limb after gangrenous limb after gangrenous limb. We didn’t have access to the O.R. so we began immediately setting up surgical facilities in 3 stalls of an ER area, to which we did have access. Spinal blocks, axillary blocks and Ketamine sedation allowed us to do most of the things we needed to do. Amputations occurred without cautery and required quick tying of vessels and bleeders. Children were showing up for medical care alone or with siblings having lost their parent or parents in the quake. We worked hand in hand with the French National Medical team who performed triage and stabilization. We worked through the night and grabbed a couple hours of rest on sleeping bags or blankets on the concrete floor on the side of the hospital. Our plans were to have been picked up by the mission group that received us at the airport, and transported to homes, but that never materialized and we lost communication with them. Our brief rest was interrupted by the sound of multiple gunshots. About 4:00 am, we were awoken with the sound of a car horn repeatedly honking and banging at the front gate of our (fortunately for everyone) enclosed compound.

After sleeping a little, we immediately began working again. The group that I had hitched a ride with had an extremely well-organized plan of sending the planes back after they unloaded us and restocked with supplies. In addition to what was already scheduled to be on the plane, we identified several things and informed them. Our partners back in the U.S., visited hospitals and our warehouse and packed necessary supplies including portable anesthesia machines, portable cautery machines and multiple gigli saws. Later, we heard the radio station announce there was a group of American and French doctors working at CDTI which directed people with severe injuries to come to our hospital. More and more patients showed up. We finally got structural clearance of the hospital and were able to begin using the operating rooms midday on our second day. It was necessary to make some tough decisions such as removing oxygen (which was at critically low levels in the hospital with no hope of replenishment) from a critically ill woman with severe neck cellulitis and a compromised airway. We amputated limbs that possibly could have been salvaged to save lives.

The search-and-rescue guys immediately headed out and found dead bodies in most collapsed buildings they searched. They came across a school, and after immersing in the rubble, found a classroom of children still sitting in their desk chairs with their back packs on, crushed by rubble. They were able to team with a search-and-rescue team from Russia and save a young man.

Our biggest dilemma was knowing we had to leave the hospital early Monday morning. To our great relief, teams seemed to come out of the woodwork Sunday night to carry on our work. When we headed back to the airport, there were thousands of people in various areas lined up, presumably waiting for some type of help. When we arrived at the airport gate, it was manned by the military displaying their lethal power who then swung open the gate which led directly to the tarmac. We heard loud pops from crowd controlling devices being deployed.

One can only imagine the social unrest challenges that will escalate with 1.5 million homeless people, hungry and not directly feeling the benefits of the mass effort going on from organizations around the world. It is a true world war, all of us finally on the same side fighting for one cause, but there is way too much disorganization and very little vision of how we can effectively win. The good news is that things progress every day as we learn how to work together better, for the good of everyone. There is nothing that unites like a common goal. While the long term plan has yet to unfold, the intense battle of the acute crisis must be fought in any way possible.

LEAP RELIEF - UPDATE

2010-01-20T23:05:00.000-08:00

Urgent Wish-List Leap & Partner Organizations have developed a "Wish List" of items that are needed to assist in the relief effort, such as: (4) Anesthesia Machines, (4-10) suction machines, (4) Cautery machines, and medical supplies such as x-ray film and developer, gauze, lidocaine and more. To view the full list on our website click here.

LEAP RELIEF EFFORTS

2010-01-19T12:43:00.000-08:00

Due to the overwhelming show of support and requests to partner with us in offering aid to the people of Haiti, we have set up several ways to give specifically to the Haiti relief effort. Join us today in helping those in Haiti.

Volunteer: We have an online form that will help us determine where you can best fit with our efforts. Click here.
Donate: We are in the process of setting up specific items that we are needing for our relief efforts. As of now we do have a specific Haiti fund set-up on our Donate page

LEAP GOES TO HAITI

2010-01-15T10:19:00.000-08:00

In response to the 7.0 magnitude earthquake, LEAP has sent several doctors to assess the situation and to determine where LEAP can best assist in aid. Dr. Ian Mitchell (general surgeon), Dr. Ale Mitchell (Cranio-facial plastic surgeon) and Dr. Craig Hobar (Cranio-facial plastic surgeon) will be in Port Au Prince, Haiti by Saturday, Jauary 16. We appreciate all of the calls from our LEAP family volunteering to go into Haiti for the relief effort. Dr's Mitchell and Hobar will be better informed as to what is needed and how LEAP will be coordinating volunteer efforts for trips in the near and distant future. Please keep our Dr's, all the aid relief workers and the people of Haiti in your prayers.