Winston Price, MD, FAAP, FACPE Past President-NMA
I returned on January 29th from an eight-day stint in Haiti to assist in the medical relief efforts following the devastating earthquakes that besieged their island nation.
I traveled to Port-Au-Prince as part of a third wave of first responders organized by The Association of Haitian Physicians Abroad (AMHE) who had partnered with a missionary group to secure the direct flight from Miami to Haiti on which departed on the 21st of January. Drs. Auguste, Nacier and Angus along with the feverishly working staff at the NY Chapter of AMHE were my points of contact prior to my departure. Earlier attempts to leave on the 14th and 18th of January from NYC and NJ were cancelled at the last minute because of the lack of landing clearance from either the Domincan Republic or Port-Au-Prince, Haiti. The AMHE sponsored group included physicians, nurses, EMT’s and a handful of reporters. There were additional medical and missionary aids that joined us at the Miami airport for the late night flight to Haiti.
We arrived in the dark of night so other than the deserted airport, heavy military presence and the occasional structural cracks in the main airport building we were not able to witness the major effects of the quake. Our eyes were met with a different reality during the daylight hours when we traveled into the heart of the city of Port-Au-Prince. The magnitude of the destruction and the unprecedented human toll was unimaginable to say the least. Neither words nor pictures can fully describe what has transpired in the affected areas or adequately sensitize everyone to the urgent complex needs to help bring this country to a status of stability with a solid infrastructure for the future.
I am still decompressing from the experience and the constant preoccupation of trying to determine how best to assist in the future. While there were certainly several NMA members participating in the medical relief efforts the NMA could and should be there during this crucial first wave of medical support.
I am aware that the NMA has as of this date compiled a list of more than 53 medical volunteers, the majority of them physicians. They plan to work through the White House to structure the teams to go to Haiti in the coming weeks and months but I strongly feel that the NMA should be on the ground in force NOW. I am, however, pleased to learn that the International Affairs Council of the NMA is continuing to reinforce the list currently available and is planning to deploy medical teams from our Association on weekly assignments for at least the next six months. This planned commitment on behalf of the NMA embodies the undying resolve of our Association and the unwavering dedication of our member physicians.
The medical expertise embodied by the NMA and its affiliate members could have and should still immediately strengthen the Haitian medical workforce. The main hospital in Port-au-Prince, Hôpital Universitaire de l’État d’Haïti (HUEH), is under the able leadership of the Medical Director, Dr. Alix Lassègue; the Chief of Surgery, Dr. Louis Frank Telemachus; the Chief of Pediatrics, Dr. Dodley Severe, and the Chief of OB-GYN. They have been assisted by the many volunteer organizations from around the world as well as the individual physicians, nurses and EMT’s who found their way down to Haiti by partnering with local secular organizations and NGO’s. Several of the local Haitian medical doctors along with the hospital’s support staff have resumed working but many more are still dealing with their own personal post-quake crisis. Many of them have lost homes, family members, colleagues and vehicles to get to work.
The medical staff that is still missing in action will hopefully be returning to the hospitals and surrounding clinics over the next few days. During my stay working at HUEH I primarily focused on the pediatric post surgical ward that was being managed by the Swiss Team of surgeons. The 18 beds which made up that area expanded to more than 60 pediatric beds before I departed on the 29th. At that point I coordinated the care for the expanded service that now included several chronic medical cases and premature deliveries were expanding the makeshift neonatal unit. The Mt. Sinai group that I met on my arrival had departed 4 days before I left relegating me to handle the administration of the growing influx of pediatric cases. I was certain to interface with Dr. Severe on all of the managerial decisions, however, since this was indeed the pediatric unit that he was responsible for prior to the quake and it was his to rebuild over the ensuing weeks.
During my last communication with representatives from Partners in Health on February 2nd I learned that the situation has been improving daily and gradually PIH hopes to be able to pull back on their deployment of physicians allowing the local Haitian medical teams to assume more of the medical care themselves.
The massive influx of trauma cases during the first couple of days was and is overwhelming and as things progressed into the second week the usual chronic conditions inherent in a developing country added to the already overextended medical infrastructure as a result of the quakes. Fracture after fracture, burn after burn, laceration after laceration permeated the crisis triage centers set up at the HUEH and at the outlying medical clinics in the surrounding towns. Without adequate medical staff (doctors, nurses, EMT’s, social workers, physical therapists, wound care specialists, dietitians, lab technicians, etc) the walking wounded have and will have their much needed care delayed or not given leading to unnecessary morbidity and often times mortality. Additionally the long term effects of this tragedy on the survivors in terms of PTSD, domestic disruption, social demise and post-amputee rehabilitation can be significantly ameliorated by early and effective intervention during this critical first phase. Waiting for the “right time” or “when things are stable” will be too little too late for many citizens of Haiti who need the NMA’s help now.
The expertise embodied by the physicians of the NMA will allow the 2nd phase of medical problems facing the injured in Haiti to be better addressed. Similarly the implementation of an electronic medical documentation system and public health tracking system will allow for better coordination of the resources and preventive health measures that must be put in place as time moves forward. It’s interesting to recognize how critical an effective telemedicine program would be to the people of Haiti right now and over the many years of rebuilding their health status to respectability. The talents and potential of the many young people in Haiti can only be realized if we give them the resources, the mechanism to achieve healthy outcomes and the secure infrastructure they so desperately need. The NMA can and must lend a hand in that process and it is comforting to know that we are on a path toward that end.
The International Affairs Council under your leadership should continue to work closely with outside US agencies to enhance the NMA’s immediate and on-going process to send NMA medical relief teams to assist the Minister of Health and his medical team in Haiti. This team should be continue to be inclusive of all specialties and health professionals as outlined above and you should re-evaluate the feasibility of extending that rotating basis for at least a year or to such time that the MOH determines that Haiti’s medical workforce can cope with the on-going problems. During my stay in Haiti I felt comfortable with the heavy US military presence and did not feel threatened any more than working in an inner city US hospital. In fact, I found the people we served to be extremely resilient and grateful for our presence.
I look forward to my continued service with the NMA in this humanitarian effort. Thanks for addressing this matter as expeditiously as possible and assuring that the NMA is able to document that it is accountable for some of the medical successes during this current catastrophe in Haiti.
We must always maintain this posture for future tragedies that are inevitable in our people’s homelands.
Winston Price, MD, FAAP, FACPE Past President-NMA