Bittersweet goodbyes -- a parting report from Haiti

Some of you may not know me; I'm an RN (on the left) who lives in Lincoln and works at Fletcher Allen. I wanted to share a little about the experience I and my colleagues have had assisting with disaster relief for the Haitian people. We have teams lined up to continue the effort through March. Please consider supporting the continuation of the wonderful work our Vermont team has been doing by donating to the Vermont Haiti Project (please designate as for Vermont Haiti Relief - union).  Thanks in advance.......

I’m writing to you on my last night in Jimani; feebly attempting to discover a metaphor that would describe any part of this slice of time in this spot on our planet.  It’s an impossible task; I can only share what in the telling seems like brief episodes of a two dimensional mini- series compared to actuality.  And I’m feeling very sad.

I’m not sure exactly how long I’ve been down here. I believe it’s been between 2 and 3 weeks. Down here = on a hot dusty piece of real estate owned by folks from Tennessee who set up a hospital, clinic and orphanage called “Good Samaritan” or “Buen Samaritano” in Spanish, in the border town of Jimani, Dominican Republic.  We can see Haiti from our “home”.  After the earthquake, Haitians began crossing the border into Jimani any way they could, looking for emergent medical assistance.  At first it was completely disorganized, however they could get a ride, and some of them walked. Eventually earthquake victims were sent here by helicopter and ambulance as well.

Buen Samaritano was inactive at the time of the earthquake. The systems and supplies sprang up almost immediately, and were ever-evolving as more patients and volunteers arrived.  As I write, we have 2 highly functioning, though primitive, operating rooms with PACU, 2 pharmacies, digital xray at the orphanage and fluoroscopy at the main building; we’ve been staffed with ortho and trauma providers, nurses, EMTs and paramedics; infectious disease, ob-gyn, plastics, physical therapy, psychology, and more.

As soon as we arrived, our prayers were answered: we were able to do what we came here to do - work really hard (and, serendipitously, fall in love with these amazing people).  Initially, we worked 7 twelve hour shifts in a row (both day and night crews did – I would not recommend it, but it mostly worked).

The heat and the sweat were incidental.  The aching feet eventually became so as well.  The 12 hour day shifts passed very quickly for the staff because there was so much to be done. For the patients I think the days must have been endless, like a nightmarish Groundhog Day.  The nights dragged on for some as well, who couldn’t stop thinking about how their family members died, how they tried to get their children and parents and siblings out of the rubble, but couldn’t. 

At the beginning, the Vermont team was caring for 40-55 patients in the post-surgical ward A (other Vermonters were in PACU or ICU), sometimes with only 2 RNs or EMTs or med students, and if we were fortunate, 3 or 4.  We begin every shift rounding on every patient, managing pain, doing assessments, and taking notes for that day’s plan of care.  Rounds typically took up to 3 hours when the census was high, because patients always had immediate needs.  Family members would also come get us when their loved ones needed something.  After rounds, we would start doing dressing changes on the major abrasions, avulsions, amputations, and pin care on the external fixation devices. We had no xray for at least 10 days: external fixation was performed by landmark and physical assessment.  When we finally got the digital xray, every patient had films taken, and many had fixation adjustments or revisions.  Some had undiscovered fractures.  And then we planned for and assisted with mobility, bowel management, and chronic medical problems.  And get up and do it again - Amen.

The family members with each patient are as heroic as the patients.  We could not have done our work without them. We were able to leave supplies of medications, even opiate analgesics, with instructions at the bedside – because the patients and the families were incredibly responsible.  The families bathed the patients, and assisted with toileting.

Three weeks ago, most patients were afraid to move.  Many were afraid to be taken to the operating room because they might find a part of their body missing when they awoke.  Yesterday and today, I witnessed two sights (among many the past few weeks) that were a holy balm for the accumulated ache moving through my heart for all of this suffering.

The first – I was with a patient on the front porch of the orphanage when I heard someone call my name. I looked up to see, waving at me, twenty something year old Wilfred with his new above the knee amputation, beautiful twenty something year old Chantel with her new complete arm amputation, and feisty twenty something year old Emmanuel with her new below the knee amputation all walking together outside of their cardboard/bedsheet ‘shantytown’.  I hadn’t seen them out of  their cots together since I’d been there.  They’d overcome their fear of mobilizing, and were so excited to be walking about together, like they were all going out on the town. Indescribable joy.

The second – I visited a similar disaster relief clinic in Haiti today called Love a Child, about an hours drive away (depending on the traffic).  We have gradually been discharging patients from Buen Samaritano to Love a Child (previously a well established orphanage). Amos Hare and I rode on a school bus there today with more of our discharged patients there, including 14 year old Lorentia, and her mother Saintenise. Saintenise also has a 3 month old baby who she hasn’t seen since the earthquake; both Lorentia and her mother have left fractured femurs with external fixators and were sent to Buen Samaritano while the father and the baby had to stay in Haiti.  Today – Saintenise and her baby were reunited – as was the whole family. Indescribable joy.

For most of them, the future beyond physical rehabilitation in Love a Child or any other clinic is a colossal unknown. And still, they gave us such grand affection and love, and grew to trust us immensely.  This alone was a magnificent gift and honor, one that I will treasure for the rest of my life.  Though I’m using first person narrative, it is not my story - it is theirs.  I will probably never see these people again.  I remind myself that this great beauty in this great tragedy is a collection of moments that continue to pass all of us by, and that grasping to the feelings or to our new friends will only diminish the power of the love and insight that has passed between us.

Mari Cordes

Here is some music from emergency room patients.   Click to download.