January 26, 2010
PORT-AU-PRINCE, Haiti - Helicopters shuttle people and supplies on and off the USNS Comfort from sunrise to sunset, but the flight preparing to leave at 9 a.m. Monday was clearly different.
There was no line of Haitian patients waiting near the flight deck, clutching bags of medical supplies and an extra meal for the trip home. No crew members strapping on their earphones and helmets. And along a wall, looking quiet and serious like everyone else, was the conspicuous presence of Cmdr. Dave Oravec, the ship's chaplain.
Then a door swung open - the one marked "morgue." The crew carried out four Haitians in black bags, marked only with a tag and a number, and loaded them onto the helicopter for a last flight to the island.
"We're mindful of the fact that these are extraordinary circumstances and many of these people have large families and loved ones who aren't with them right now," said Oravec, a chaplain at National Naval Medical Center in Bethesda and one of three serving aboard the Comfort. "But we're a family and we're with them."
As of Monday, 10 patients had died on board the Comfort since its mission to help Haitian earthquake victims began -- about 2 percent of the people treated. Capt. Jim Ware, the hospital's commanding officer, said that ratio is a little lower than he expected.
Physicians on the ship consider it, in some ways, one of the mission's successes that so few have died, considering the shockingly severe injuries that are common throughout the hospital's treatment and recovery rooms. Still, Ware is trying to prepare his crew to confront more death in the coming weeks.
"It is one of the realities, and we're trying our best to deal with it in a dignified way," he said.
Among the many challenges of the mission is finding relatives of the deceased who can receive the bodies once the Comfort takes them to a staging facility on shore. The ship is trying to work with aid organizations on the ground but it's difficult, since many patients' family members are dead or living anonymously in one of the many tent cities around Port-au-Prince.
For at least one of the Comfort's dead, the staff isn't even sure of his name.
As the most capable medical facility in the region, the floating hospital also has one of the few functioning morgues. It has room for 22 bodies, and is serving as a collection center for the dead from other Navy ships in the area.
A reminder of the earthquake's deadly consequences is broadcast to the staff every few hours, in the form of a message summoning a chaplain to the ship's emergency room or intensive care unit. Oravec said the calls aren't all related to an impending death, but some are, and he responds to offer prayer, scripture readings or whatever the patient requests. No matter what the chaplain calls are for, each seems to be met with a pause from the ship's crew, then whispers and shaking heads.
As the Comfort's mission matures, the floating hospital is clearly taking on the role of caring for the region's most serious injuries. Orthopedic injuries have surfaced as one of the more vexing logistical and medical challenges. Of more than 400 patients taken onboard so far, 210 require orthopedic surgery. Most need two surgeries; many need three or more.
But even with two or three operating rooms running 24 hours a day, solely to address the broken bones, amputations and follow-up surgeries of the orthopedic patients, ship officials estimate it will take 60 days to clear the cases already onboard.
The ship's officers don't want to turn away orthopedic patients, who make up so many of Haiti's victims, but resources are running thin. The ship has struck an arrangement with a hospital in Miami to care for its seven patients with severe burns, and Ware hopes a similar transfer process can be coordinated for orthopedic patients.
On the helicopter deck, as aircraft land and depart throughout the day, the call eventually goes out for an "angel flight," a term familiar to anyone who has deployed to a war zone. For a brief moment the activity stops, the chaplain appears on deck, and crew members carry out the stretchers loaded with black bags.
"For most of these individuals we have names and we want to have an opportunity for the family to be there when they are brought to shore," said Ware. "We're trying our best to do the right thing."
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