Tackling a mountain of suffering

January 19, 2010

PORT-AU-PRINCE, Haiti - Patient number 4, swaddled in a baby blue blanket and pink cap, entered a disaster field hospital yesterday morning cradled in the arms of a young Boston doctor.

The dehydrated baby was met by an exultant and determined Massachusetts medical team that, after three days of bureaucratic fumbling, was eager to do what it came to do: save lives.

It was the first US government medical mission to treat patients in Haiti after last Tuesday’s massive earthquake.

The baby had arrived in the world 19 hours and 17 minutes before, born in a hospital amid the chaos that gripped Haiti’s capital.

But by yesterday morning, the infant had become listless. He and his mother, Priessiele Nathabi, lay outside a school where the Massachusetts disaster medical team had worked through the night to erect the mobile hospital. The boy’s life was ebbing away.

“The baby probably would have died within 24 hours,’’ said Dr. Gary Fleisher, pediatrician in chief at Children’s Hospital Boston and a veteran of disaster response teams. But with special fluid pumped through his nose and into his stomach - and 150 milligrams of antibiotics - the infant had rebounded by late yesterday afternoon, snuggling on a green canvas cot.On the Massachusetts-1 Disaster Medical Assistance Team’s first day of operation, the collection of three taupe government-issue tents welcomed a steady stream of patients. The team found a queue of 28 people seeking treatment, some of whom had been waiting for days. Some moaned or writhed in pain; others were covered with flies.

The doctors began the day evaluating the ailing, assisted by translators hired off the streets. The team decided to focus on patients with the most urgent needs and most amenable to treatment. That meant those with wounds, fractures, diarrhea, burns, pneumonia, fevers, abdominal pain.

“We want to be able to do things we can do and not advertise things we can’t,’’ said Jack Twomey, a registered nurse at Boston Medical Center.

The doctors treated a woman with a fractured pelvis and another whose big toe was partially sheared off.

There were patients uninjured in the quake but victims nonetheless: A mother forced from her home delivered her baby in a field, then severed the umbilical cord and tied off what remained with athletic tape.

“It’s just heartbreaking that there’s been no help for them,’’ said Courtney Shores, a physician assistant, “until now.’’

By 7 p.m., the three dozen medical workers from Massachusetts had treated 41 patients.

Their efforts culminated a Kafkaesque odyssey that was a maddening coda to days of frustration. And it was an illustration of the challenge medical workers confront in trying to provide care in a country in disarray.

After flying in Friday, they waited for their supplies to arrive. Saturday, the cache landed at the city’s overwhelmed airport, but there was no security escort available to guarantee safe passage of the supplies - and the disaster team - to its site.

Finally, late Sunday, the security escort arrived. Thirty members of the 82nd Airborne, guns slung over their shoulders, descended. The convoy of supplies and medical workers lumbered through Port-au-Prince, past a tableau of devastation, medical workers ducking to avoid low-hanging wires and tree limbs. Next to one collapsed building, a prayer service rang out, the faithful with outstretched arms.

Shortly before 10 p.m., the Massachusetts medical team eased up to a soccer field converted into a tent city by the displaced. Dozens gathered, watching the trucks, faces weary.

The crisis medical team learned its field hospital would be built in a leafy school courtyard next to the encampment. In deep darkness, the squad hoisted themselves from the trucks and staked out the courtyard.

“Everyone is hungry, tired, and thirsty,’’ said Keith Lindsay, a Chelmsford firefighter-paramedic who is the unit’s commander, “and probably needs to use the bathroom.’’ But there would be no time for rest.

Instead, the doctors, nurses, and other medical workers strapped on headlamps, resembling miners. They formed a fire bucket-style line to unload supplies. “Hi-ho!’’ bellowed team member Michael Vojak, a Boston emergency medical technician who sports flowing gray hair.

At 11:25 p.m., lights glowed in the courtyard, powered by humming generators. A rooster crowed, mistaking the infusion of light for dawn.

Crates, some weighing 454 pounds, were lugged in, their contents unpacked to build tents. The work continued through the night, as half of the team - the ones who would start treating patients in the morning - found a few hours of sleep on nearly 20 cots arranged in one tent.

They arose early, washing themselves as best they could, improvising with bottled water because there was none in the tap.

The team expected that it would see mainly cases of trauma and infectious disease. Although there were plenty of injuries, there was also an unexpected break from the misery.

Late in the morning, the team encountered a woman with a swollen belly. Walkenline World, whose house was ruined in the quake, was in labor. At 12:25 p.m., Fleisher, who figured he hadn’t delivered a baby in a decade, joined forces with a Haitian doctor to deliver her healthy baby boy. After a nurse suctioned mucus from his mouth, the infant let out a joyous squall.

Source: Boston News