Saturday, January 30, 2010

First Day Realities in Haiti

By Alicia Hernandez
Johns Hopkins Go Team disaster medicine team member

Expectations have so drastically changed every hour along the way here that I can't even compare the reality to expectations.

We had heard earthquake-related medical needs are over and yet one of the patients we received today was a little girl who had bricks fall on her legs during the earthquake and only came in today for it. She had bilateral femur fractures. I'm not sure how things will turn out for her.

The day was filled with the questions 'What can we really do for this patient?' and 'How many resources should we really use?' Considering every bag of saline and every glucose meter strip when we were down to 4 of each for the day by noon.

So much of this care involves deciding who to let die. The hard part means watching them die and watching their loved ones deal with their deaths. In these places, you'll see a brother, who's 40-something previously healthy sister just died, say "Ok" with a nonchalant shrug when informed that she's gone. Like, "just thought I'd ask." And it seems like they are so hardened to this because they are dealing with it regularly, and dealing with so much worse.

But with this particular individual, we had the privileige of treating his father in the same day and keeping his company throughout the majority of the day. Even after his sister died, and worrying about his father's treatment in the same place, he was cheerful and thankful.

There was a moment, however, where the hardening softened, and he collapsed down onto the stretcher next to his father that was finally briefly freed of another patient, and sobbed, when he thought no one was looking, for a brief moment.

Each death was different, each patient was different; from gun shot wounds from a riot setting to chronic illnesses sent from other hospitals also drowning in the situation, to Jane Does with nothing left we could do - no family, no identity, and who still hung on for hours. There is so much need, and so many people who want to provide, and so many obstacles.

And this is just our day One. We will make a difference. I am determined. I don't know how. I know even less so how than I thought I did three days ago. But with the good will and determination I sensed today, it will happen, no matter how slowly.

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