My First Trip to Haiti: Day 2

30 01 2010

[Sun. Jan. 17, 2010]

Once I had cleared all the bodies I thought I’d close my eyes for an hour or two. The rest of the team was up and about. It was early and the air was still relatively cool. All the cots were in use so I fashioned a couple empty crates into position. I padded them with some cushioning and curled up in a fetal position.

My “nap” only lasted for 15 minutes. It seemed as soon as I had gotten to sleep someone was claiming that we had to move our operation. I don’t know who they were or even if they were “official,” and I didn’t care. There was no way we were moving anything. We had too many patients and too much equipment. They said they would gather a crew of people and move everything for us.

The discussion went on for about a half hour and almost everyone on our crew got in on it. One of the locals who was there with her son took me aside. She spoke English and overheard parts of the conversation that was going on in private. It seemed that the intent was to get us to move to a place that was more convenient for them. The main thing they wanted was our supplies.

Medicine, painkillers, antibiotics, first aid supplies were like gold. There simply wasn’t enough and I could understand their desperation. But instead of asking they came in under false pretenses and that pissed me off. At one point they said, “we have a truck and we can load up those crates now and come back for the rest.”

That was obviously a give away because no truck could get to the area they were talking about. All the roads were closed due to the rubble. The conversation kept going back and forth and I it seemed their story kept changing as it went along.

I finally stood up on the crate that was my bed and shouted at the top of my lungs, “If you really do have a truck then you can bring your injured to us and I’ll make sure they are taken care of, but we are not moving and that is final. Now get out of here.”

Complete silence. Everyone stopped and stared at me. I was kind of surprised that I said it and hoped that I hadn’t overstepped my boundary. I was hoping to get a nod of approval from my brother and/or the other doctors, but then decided I didn’t need it. They put me in charge of operations and it was my decision. I just looked around at them and said “Back to work.”

It was a pivotal moment for me. Until that point I thought of myself as a helper, an assistant to whomever. Now I realized the best assistance I could give it is to take charge so the medical team could be free to do their thing. If the incident we just witnessed was any indication of what was to come, someone had to be vigilant so it might as well be me.

The next few hours were relatively peaceful. It gave everyone an opportunity to develop a routine and finish getting ourselves set up. But the quiet time was just a lull before the storm. By noon there were lines of people bringing in the injured. Someone used the term mangled masses and that is exactly what it was. A sea of crushed bodies.

I don’t want to go into details about the injuries I saw. It upsets me just to think about them and there isn’t anything I can report that you haven’t already seen on CNN. But what I can say is that you learn to dissociate yourself in such a situation. It is a constant balance to not get lost in who you are and what your purpose is. I found myself showing empathy when needed, to comfort the injured or their family, but not to allow the emotions to get the best of me.

Showing empathy was like dispensing medicine. You can give too much. You want people to know you care, but that you are not lost in all you feel. Trained medical professionals learn to balance emotions early in their training. For me, keeping my emotions in check for any sustained amount of time was all new and more difficult than I thought.

And it was becoming overwhelming. By mid afternoon I found myself going down the line of people waiting to get in and telling them that if they can find any other place it would be better. The reality was that we wouldn’t be able to treat them for many hours and probably not even till the next day. All the while I knew that many of them wouldn’t live that long.

But how do you turn people away? It was like issuing a death sentence. That was the real lesson of the day. I was sobered up to the fact that we would have to let people die and refuse treatment to many. There were many cases that were so bad no amount of medical care would save them. All you can do is comfort them in their passing.

So many of them had no one. Most were in some degree of shock. Some had traumatic shock, others were just shocked into a state of confusion. You could tell by looking in their eyes they did not fully comprehend what was going on around them. They were filled with so much fear and so little hope. The uncertainty of not knowing if any of your family is alive or if you will ever see a familiar face again is unimaginable.

The doctors had to prioritize who they would treat and who they would set aside. Who they would attend to first and who they would walk away from. And I had to learn to do the same. In many incidents there were children who the doctors could have saved if only they had a parent or guardian there to look after them for the weeks to come.

Surgery is more than just what goes on in the operating room. It is the post care that has to be provided 24/7. For the orphaned child that is badly injured there is no hope. Even for an orphan with minor injuries the long term prognosis is grim at best. And if they are an infant there is no milk, no formula, no place for them to go.

The line continued to deepen. Many had been turned away from other facilities and I would have to either ignore them or turn them away again. It is probably the hardest thing I ever did.

At one point my brother said to me, “Saying ‘no’ to someone who will die is saying ‘yes’ to someone who will live.”

[As many of you know I am preparing to go back down in a few days. I hope to get Days 3 & 4 posted before I go so please check back. If you haven’t read Day 1 I recommend it.]


My First Trip to Haiti: Day 1

29 01 2010

[Fri. Jan. 15, 2010]

Originally I hadn’t planned to go to Haiti. It was a last minute decision.

As many of you know, my brother is a doctor. He organized a team of physicians, nurses, anesthesiologists and support staff to go down. I helped with coordinating efforts; getting medical supplies together, arranging for tents, cots, generators, etc.

Once everything was set to go there was a personnel shortage. A couple people would have to come later leaving set up and logistics (i.e. schlepping and grunt work) to the medical staff. My brother insisted that I go along and act as coordinator. I insisted that I could do more by staying in NYC and coordinating resupply efforts from home. Then he promised I would be relieved as soon as the rest of the crew arrived. But the clincher was when my brother said, “Deep inside I know you really want to do this, you’re just afraid.”

He was right. I did want to go and I was scared shitless. The tragedy in Haiti was beyond comprehension to me. My tendency in situations like this was to send a check to the Red Cross and help out behind the scenes in whatever capacity I could. I give good phone.

My bother on the other hand, is one of those people who is always on the front line. He worked with Doctors Without Borders for years. He was there for Katrina and the Tsunami. He forges into remote jungle villages and fights disease outbreaks in places I’ve never heard of. Needless to say, I’m very proud of him, but I’m not him and I had never been in the front lines of any disaster.

I grabbed my backpack and quickly stuffed some clean clothes in it. An hour later I was on the plane and hoping I had remembered to pack a toothbrush in my haste. I was excited to be going and scared to death at the same time. The entire flight was surreal. I was intoxicated with fear and self doubt. “What if I fucked up?” “What if I couldn’t pull my weight?” “What if I couldn’t handle the blood, the smells, the horror?” “What if I made things worse, not better?”

[Sat. Jan. 16, 2010]

As soon as I landed the fears went away. There is nothing more sobering than stepping out of the plane at Port-au-Prince. There were dozens of relief organizations already there. Some large, some small. Some well organized and well structured. Some make shift and very impromptu. We were obviously among the latter.

Being small had its advantages. First was that we were able to keep all our equipment and supplies together. Many groups weren’t operational for a day or two because their equipment and/or supplies had been lost, rerouted or hijacked.

Luckily my brother took care of finding a staging area and coordinating things with what local officials there were. I would never have known where to start. But once we got positioned the medical staff focused on their thing and the rest was left to me. Or so it seemed.

In an ideal world we would have had the tents set up, the generators working, the cots laid out in neat rows, and all the supplies in place for easy access. In the real world we had broken bodies coming to us before the first rib of our tent was erected. The medical staff took on what they could as fast as they could. I was left to coordinate the rest.

The first two days were complete chaos. It seems like a blur as I try to remember everything that happened and in what order. My first task was to get the tent together. We had ladder to help with assembling the ribs and stretching the roof and walls, but we gave it to a search and rescue crew who needed it more.

I continued working on the tent by stacking up supply crates and climbing up make shift arrangements of boxes and luggage. I found I was good at improvising as was everyone else.

Later I hired a couple local guys to help me set things up. Luckily they spoke enough English for us to communicate the basics. They were wonderful but they couldn’t stay for very long. Other locals pitched in. People would bring us their injured family members and help in whatever way they could while they waited. Most of it was done without a single word being spoken.

In middle of trying to run power cords where needed I was handed a dead body. It was a young girl. I’m guessing she was six or seven. A teenage boy just handed her to me and ran away before I could ask any questions. I took the body to one of our nurses who quickly reminded me that the medical staff only had time to deal with people who had the possibility of survival. The words I remember her saying is, “Get used to it. There will be lots more before the day is through.”

She was right.

People started bringing us their dead. Some people were alive when they started but died before they could reach help. Others had been dead from the beginning and people just brought them to us because they didn’t know where is to take them.

I found a shaded area outside of the tent to place the bodies. It was among the rubble but out of the path of traffic. I tried to lay each both out properly with respect. I covered the first three or four of them in sheets, but soon realized the effort was futile. The sick and wounded needed the sheets more.

By evening there were dozens of bodies and I was stacking them two and three deep. I kept hoping someone would come by to claim the dead, but no one did. Most of the bodies were without identification of any kind. I put toe tags on the few that had ID.

I collected their valuables; wallets, jewelry, etc., and put them in individual zip lock bags. I listed their names on a clip board and used an empty crate to file everything. I tried to be a meticulous as possible hoping that it would make a difference to someone at some point in the future.

In between the mounting corpses I was running around trying to assist in whatever way I could. Moping, cleaning, etc. I found the more mundane and mindless the job was, the more relaxing. It gave me a break from the nightmare going on around me.

But as the night went on, the nightmare continued. The crying screams echoed from every direction. I hadn’t notice it as much in the day, but the later it got the more the sounds intensified.

Around midnight it occurred to me that I would have to move the bodies. It was hot and humid. When the sun came up in the morning the bodies would be another day older, a little more decayed. I headed out with a flashlight to find a more appropriate place.

I started moving the bodies one by one. The children were manageable to move. The adults were much more difficult to carry. Sometimes I’d get some help, but most of the crew was exhausted and by 3 am they were all trying to get a catnap.

People tried to get me to stop what I was doing and get some rest too, but I couldn’t stop. I knew that if I stopped for even a minute I would break down in tears. My brother tried to get me to at least sit down and take a breather. He said something about how a rested body could help so much more than an exhausted person. He was right in a physical sense, but I needed to purge all the emotions that had built up inside. Physical exercise was my way of doing it. I was sweating and I stunk and felt like I was detoxifying every impurity from the pit of my soul.

Maybe I was just insane. Besides the bodies there was so much more going on that I can’t possibly recount here. Every moment was filled with something more shocking than the moment before.

Around 5 a. m. I was still moving the last of the bodies. My brother had slept for a while and was attending to patients. He was upset to find that I was still trudging away. Again he tried to get me to stop, but I couldn’t. It wasn’t a matter of not wanting to, I just couldn’t.

There was an impending feeling of urgency. Time mattered. I couldn’t help thinking that if just one of the many bodies had been brought to us sooner, they might have lived. Maybe. Maybe not. I had no way of knowing but I was driven by the thought that I wanted to be on top of the situation before the new day began. And I certainly didn’t want new patients seeing those who had expired.

Doing an all-nighter wasn’t new to me. I had done it many times in college and more times than I care to remember as a business owner. But those were times when I was doing it for me, for my own benefit, for my own personal reward. Now I was doing it for something greater than me, something more important than my self-centered little world.

By sunrise the bodies had all been moved. All of the patients on cots had made it through the night. The screaming had subsided. The terror in the pit of my stomach had gone away.

I sat outside the tent and watched the sun come up. It was a new day and I was a new person.

[I wanted to write this for the people who asked. There is so much more to recount and I hope to have the time to do justice to all I witnessed. I did take some photos but it will probably be a while before I get them posted. I’m getting ready to go back down so if I don’t get them uploaded this time I’ll do it when I get back.]