"We lose one staff a day..."

Tom Kirsch, M.D. (pictured right) with Rocky Cagle, RN

Tom Kirsch, M.D.
Johns Hopkins Emergency Physician and Go Team Leader

The day starts about 5:30 a.m. when the hotel turns back on the power. The fans come back on at least. People begin stirring, snores fade away,
backpacks rustle and feet pad around.
The lights usually burst on at six and then the activity intensifies except for a few trying to squeeze out a few more minutes of sleep. People dress, food and supplies are gathered.
The bus leaves at 7 a.m., driving less than a mile past normal buildings and lives and crumbled ones and tent camps. Vendors have already lined the streets
past the ramshackle tents in the city’s main plaza- food stalls, haircuts, a Gno Kozes (snow cones), but most interestingly the guy with the truck. It is well lit
by fluorescent lights and has a rack of blenders in the back making smoothies.
At the gate of the hospital there is already a half-block long line of patients waiting to get in.
By 7:15 a.m. we have completed out briefing and are pulling supplies.
The little triage tent is bursting with people.
A report is given by the night team- there are always leftovers – usually very sick. They bring the sick ones from the rest of the compound back to the ED if they go bad at night, and only the really sick come in after midnight.
Patients start pouring in.
Our tents are hot, probably 10-20 F hotter that the ambient 95 F air outside. They have few windows and the power only runs occasionally to run the
fans.
We loose at least one staff a day to heat exhaustion.
Yesterday it was the 6’2” nurse from Utah. Dizzy and pale, then down and vomiting.
We run IV fluids and bring them to a cooler area. We have started mandatory fluid requirements, and push people to take breaks and now will have a
mandatory ½ day off every 5 days minimum.
The army guys might hook us up to one of their generators so we can at least run the fans. I got pizzas and cold Cokes delivered from the outside yesterday. A strange comforting little piece of normality.
The buses head back between 5:30 and 6 and it is always a scramble to tuck things away, restock and sign out to the night people. We usually miss the
bus and bet the late one.Debriefing 6-6:30 or 6:45 (although I usually miss the first few minutes, preferring to sit with my sore feet dangling in the cold pool water and drinking a
beer). Dinner cafeteria style is at 8. Most people start fading out around 9. The few hardy (stupid? gregarious? Insomniacs?) sit on the patio late
talking and drinking $4 beers or soda until late surrounded by the reporters furiously working on stories and hogging all the wireless bandwidth).Finally sleep in the dark conference room with 40-50 people scattered around in various odd sleeping arrangements- bed mattresses, inflatable ones,
cots, even tents pitched indoors. The stirring, rustling backpack and padding feet gradually fade away and a low-grade background hum of stores rise up
and the day ends.