Restraint Urged for Clinicians Seeking to Volunteer in Haiti - page 2

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    For those nurses who are in the Boston area, Partners in Health (Harvard affiliated) already has (had?) hospitals and clinics in PAP. Go the the PIH website, they are looking for nurses who can volunteer 2 weeks and are offering to pay the flight down to Dominican. You're warned that you might have to pay for flight home. I agree with previous posters- be prepared for suffering that can't be described. I went to N. Haiti 2 years ago and am still traumatized by the suffering- and we hadn't had earthquakes! To me it's almost unimaginable that just a few hundred miles from our shores that so many are still a full week later suffering. We will never know the accurate death toll. Tragic.
    momology, rph3664, and Elvish like this.

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    Quote from oramar
    If you read between the lines of this article, it sounds like some people are going down there unprepared and running about willie-nillie. It would never occur to me to something like that. Think about it, you could get kidnapped, murdered for the clothes on your back or just disappear.
    I REALLY DON"T LIKE THIS COMMENT .... The people of Haiti have been devastated and all you can think about, is how savage they maybe. The horrendous things you speak of, can happen anywhere!!
    marquelle, momology, Luscious41, and 1 other like this.
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    Quote from midnite nurse
    I REALLY DON"T LIKE THIS COMMENT .... The people of Haiti have been devastated and all you can think about, is how savage they maybe. The horrendous things you speak of, can happen anywhere!!
    I took it a bit differently. The reality is that when chaos reigns, bad things tend to happen more often. I can't speak for the poster of that comment, but I know from living on the coast during hurricane season that more people out and about makes for more work - and more risk - for rescuers.
    MandaTaye, areawoman, nurse441, and 4 others like this.
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    I agree with other posters. Volunteering to go down should be thoughtful. This isn't the yearly county fair looking for volunteers for the 4-H booth. This is tragedy to the fullest extent. If I WERE in that situation, I think it's entirely possible that I would do anything it took, EVEN BEING SAVAGE, to do what I could for my daughter's survival. This is beyond etiquette and social inhibitions, and I think it's important to acknowledge it.
    oncnursemsn and Luscious41 like this.
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    Quote from buddiage
    I agree with other posters. Volunteering to go down should be thoughtful. This isn't the yearly county fair looking for volunteers for the 4-H booth. This is tragedy to the fullest extent. If I WERE in that situation, I think it's entirely possible that I would do anything it took, EVEN BEING SAVAGE, to do what I could for my daughter's survival. This is beyond etiquette and social inhibitions, and I think it's important to acknowledge it.
    Quote from midnite nurse
    I REALLY DON"T LIKE THIS COMMENT .... The people of Haiti have been devastated and all you can think about, is how savage they maybe. The horrendous things you speak of, can happen anywhere!!
    hate to burst anyones bubble but haiti is a 3rd world country, always has and will be. and like life in other places of a similair economic/social make-up life is cheap and easily overlooked. now you throw in a natural disaster...you best beware of your surroundings...as a old army sgt. of mine always said "stay alert & stay alive".
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    [QUOTE=C-DIFF PHIL RN;4082086]hate to burst anyones bubble but haiti is a 3rd world country, always has and will be. and like life in other places of a similair economic/social make-up life is cheap and easily overlooked. now you throw in a natural disaster...you best beware of your surroundings...as a old army sgt. of mine always said "stay alert & stay alive".[/QUOTE

    I'll tell you that calling any country 3rd world is offensive to those from that country. It also smacks of hubris. Also, historically the murder rate of Haiti, per capita, is exactly the same as that for the USA -- so the idea that life is cheap there would probably be offensive to them too and inaccurate. Poor populations don't think life is cheap . Neither do black populations -- although I am hoping that wasn't what you were intimating.

    I do agree that in a natural disaster one better have a grip and excellent situational awareness. However, that would be equally the case if this disaster had been in the USA -- and has been the case.
    oncnursemsn, marquelle, momology, and 3 others like this.
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    Quote from midnite nurse
    I REALLY DON"T LIKE THIS COMMENT .... The people of Haiti have been devastated and all you can think about, is how savage they maybe. The horrendous things you speak of, can happen anywhere!!
    To be honest, I think the quote from Oramer comes from the articles I've seen about gangs looting and killing people off the streets, or piling up dead bodies to block everyone from getting down a particular street, etc. Yes, while it was a tragedy and everyone's been devastated, it's also a free ticket to the surviving gangs to "pillage and plunder" while no one's keeping them in check.
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    Guys, I have been in Haiti...granted, not post-disaster, but been there nonetheless. I'm telling you, I walked down the streets at night by myself all the time. Never had one bad thing happen, and never even had any close calls.

    Can things happen? Yes. Could something have happened? Of course, but the same is true for Podunkville, USA where I live right now were a terrible natural disaster to occur. I don't think it's very accurate to paint the folks of Haiti as bloodthirsty savages who will murder and pillage the first person they come across because they value life so little. My friends on the ground in Port-au-Prince say they don't know where the reports/rumors of looting and rioting and mayhem are coming from because it's not happening where they are.

    All the same, it's not fair to burden an already burdened relief system with another random person to house, feed, and put to work. If you're not with an organization and/or don't have plans for someone to meet you on the ground there, going is a stupid idea.
    ese1212, oncnursemsn, marquelle, and 3 others like this.
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    I just received an email forwarded by a trauma surgeon at WVU Med Center, from another trauma surgeon explaining his group's attempt to help. I hope this isn't too long to post- it was very interesting to me:

    "I believe we went in with a reasonably comprehensive service; we wanted to provide acute trauma care in an orthopedic disaster. Our plan was to be at a hospital where we could utilize our abilities as trauma surgeons treat the acute injuries involved in an orthopaedic disaster. We expected many amputations however came with a philosophy that would reasonably start limb salvage in what we thought was a salvageable limb.

    David Helfet put a team together which included:
    2 orthopaedic trauma surgeons
    3 orthopaedic trauma fellows
    2 highly skilled anesthiologists
    1 general surgery trauma surgeon
    2 synthes reps who were also scrub techs
    1 trauma nurse practioner to do triage
    2 OR nurses

    Our equipment including a huge amount of anesth medications and equipment, ability to construct 150 ex fix both small and large, OR equipment including scalpels etc, OR soft goods, splint material, OR prep material.

    We also had a plan of physician and equipment replacemnt that was dynamic where w/i 24hrs we could bring in what was necessary on the Synthes private jet.

    We thought the plan was a good one.

    We were incredibly na´ve.

    Disaster management on the ground was nonexistent. The difficulties in getting in despite the intelligence we had from people on the ground and david helfet's high political connections with Partner's in Health as well as the Clintons only portended the difficulties we would have once we arrived.

    We started out friday morning, got a slot to get in friday that was eventually cancelled when we were on the runway to be rescheduled the next day. We diverted to the DR and planned on arriving in P OP saturday.

    Once on the ground the hospital we had intelligence that was up and running with 2 OR's General Hospital was included severely in the earthquake and not capable of running functioning OR's as there was no running water and only a limited electrical supply on generator.

    We quickly took our second option
    Community Hospital of Haiti. We found approx 750 pt in the hospital upon our initial eval, the hospital had running water, electricity and 2 functional OR's Our naivette did not expect that the 2 anesth machines would not work, there would be 1 cautery for the hospital, autoclave that fit instruments the size of a cigar box, no sterile saline, no functioning fluoro and no local staff only a ragtag group of voluntary health providers who like us had made it there on there own.

    To summarize we had no clue the medical infrastructure of the country was so poor.

    As we got up and running in the OR and organized the patients for surgery we communicated our new needs back to Synthes and more supplies were loaded for a second trip - these included battery operated pulse lavage, a huge supply of saline, soft goods in the OR. This plane landed as planned sunday pm, equipment was loaded on a truck and subsequent hijacked between the airport and the hospital.

    At the hospital we had zero security despite promises form NYPD and NYFD to provide that to us.

    Our philosophy was to work like this was a marathon run the OR's around the clock with the idea that we would have a defined extraction time of 11pm tues. The plane that extracted us would come in with a new medical staff compliment to replace us. Equipment included urgent things to maximize issues that were nonexistent in the hospital that would enable us to provide better and more efficient care:
    2 portable anesth machines
    2electrocautery
    2 portable monitors for the pacu
    2autoclaves
    Replacement exfix
    Things that didn't arive with the previous flight

    That planes slot was cancelled by the military at 6am tues.
    We also previously had seen daylight in the remaining patients monday night haviving completed approx 100 surgeries. However on tues morning we found a huge # of new patients. The hospital was forced to undergo lockdown closing its gates to the outside and outside crowd becoming angry.

    We also noted tues morning that many of the patients we were operating on were becoming septic.
    We finished operating at noon tues, the last surgery our group assisting an obstetrician on a caesarian and resuscitating a baby that was not breathing.

    We decided as a group the situation for us at the hospital was untenable supplies were running out, team was exhauted, safety a huge concern, and no extraction plan with resupply. We decided to make our way to airport thru the help of a hospital benefactor. Jamaican soldiers with M-16 were necessary to escort us out with our luggage as the crowd outside saw us abandoning the hospital.

    We made it to airport on back of a pickup track, got onto the tarmac, hailed a commercial plane that carried cargo to montreal and had private jet pick us up there.

    The issues we were unprepared for and witnessed were 1. The amount of human devastation 2. The complete lack of a medical infrastructure in the country 3. The lack of support of the haitian medical community 4. The complete lack of any organization on the ground. Noone was in charge, we had the first functional up and running hospital in the P OP area yet noone and I me NOONE came to the hospital to assess what we were doing, what we were capable of doing and what we would need, to be more efficient. The fact that the military could not or would not protect the resupply equipment on sunday or let the tues flight come in says it all.
    5. Lack of any security at all at the hospital

    I would take away that disasters like this need organization on a much higher level than we had with the clear involvement and approval of the military from the beginning.

    Currently there is Noone obviously running the show and care is in chaotic at best. MD's are coming in country with no plan of what the are going to do. Surgeons that expect to just show up and operate are delusional as to what there role would be as without a complement of support staff and supplies they would be of limited or no value.

    I hope this helps. We all felt as though we abandoned these patients and that country and feel terrible. Our role now being back in NY is to expose the inadequacies of the system to the media in the hopes of effecting a change in this system immediatly. We feel that the only way to really help now is an urgent programtic change and organization in the support of the medical staff on the ground and what is critically needed to expeditiosly bring in.

    Cherrios on the tarmac are not getting it done on these patients which clearly would be savable if good care could urgently be provided.

    Please share this email with everyone and anyone you find might help.

    Good luck
    Dean
    tewdles, ese1212, allthaticanbe, and 10 others like this.
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    [quote=DolceVita;4082522]
    Quote from C-DIFF PHIL RN
    hate to burst anyones bubble but haiti is a 3rd world country, always has and will be. and like life in other places of a similair economic/social make-up life is cheap and easily overlooked. now you throw in a natural disaster...you best beware of your surroundings...as a old army sgt. of mine always said "stay alert & stay alive".[/QUOTE

    I'll tell you that calling any country 3rd world is offensive to those from that country. It also smacks of hubris. Also, historically the murder rate of Haiti, per capita, is exactly the same as that for the USA -- so the idea that life is cheap there would probably be offensive to them too and inaccurate. Poor populations don't think life is cheap . Neither do black populations -- although I am hoping that wasn't what you were intimating.

    I do agree that in a natural disaster one better have a grip and excellent situational awareness. However, that would be equally the case if this disaster had been in the USA -- and has been the case.
    please..i havent even began to to smack you with my arrogance. nationsonline.org list has haiti listed thirdworld country in subcatogory as least developed country or LDC. put the race card back in yo pocket.
    ese1212, momology, Luscious41, and 1 other like this.


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