Haiti Mission Project

Puder the Tall Checking In

Today I woke up feverish in a sweat to the shaking of the earth. I am on doxy malaria prophylaxis but added chloroquine today. The residual fatigue is getting to me, but as the day went on I felt stronger. I had a new doctor who worked ER triage so I slowly made my rounds making sure things in the ER were moving forward and people getting meds, improving, etc. One of my big projects today was using a translator to make sure the Haitian nurses knew how we were writting orders. Dr. Nelson arrived today.  Good to see the doc that got me excited about Haiti!

News from Dr. Patton

This afternoon I made rounds through the tents with a general surgeon from Martinique. He is an angel! His goal is to help motivate the patients to return to there homes and begin to rebuild rather than remain in a tent on the hospital lawn. Every family and widow responded, “we need a tent to set up on the street outside our house”. They have nowhere to go. Dozens of families. I heard the exact story repeatedly.

The mobile dressing and casting cases I made were wheeled through the camp today to care fore those in the tents.

The surgeon amputated an infected foot.

The Ortho team rode to the hotel where CNN reporters and other VIPs stay in a “top-top”. It’s a pick up with a topper raised by metal bars to allow the passengers to ride in the bed of the pickup, sitting on parallel facing benches yet covered with truck bed topper: top-top. We survived.

I had a wonderful conversation with Andrew Hagland about the story of the first few days of establishing this hospital as the premier medical faciltiy in Haiti post quake.

Scott Nelson arrives tomorrow.

Tough Day

Today’s events:

• ER triage;
• a cardiologist helped me diagnose a girl who looks pregnant with (per echo) biventricular heart failure with a 20% ef;
• called a code as a woman came in vomiting up blood;
• worked with Haitians on organizing the er pharmacy;
• packed a gun shot wound;
• took a pregnancy test to make sure it works (I’m not pregnant);
• made difficult decisions;
• prayed to God for help;
• worked dirrectly in consults with surgeons and ortho;
• treated a severe asthma exacerbation;
• drained some abscesses;
• delt with stress related psychosomatic issues;
• worked with some excellent nurses;
• got to know some translators;
• and loving it!

Out of the Rubble – Blog

Organizing the ER

Another 7 am to 845 pm day in the Er. Today I woke up on a mission, and got to work organizing the er. We have 4 areas, and I put a doctor and a nurse in each area. Luckily we had enough people mid day to do this from 9 to five. I then worked with a retired ob doc on planning out the pharmacy. Before it was endlessly frustrating to find anything, but now we have a plan of attack, and a map at the doorway. I also ran around doing things which others could not like interact with the lab, ob ward, ect, things I have learned in the past week. An er doc and I made assessments on post op patients, one with pneumonia, another not as anemic as the lab thinks (clinical opinion is best). Then a team of doctors and nurses, 6 total, left at 4pm, and all of a sudden several very sick patients showed up. A pneumonia with double pneumothorax took up a considerable amount of time, even finding all the supplies! No time to organize when people are crashing! Alfonso has been doing the night shifts in the er, and feels a little sick.

Many of the diseases I am seeing are the result of the Haitians living in close proximity in the streets, psychological stress, infectious diseases, broken bones or musculoskeletal pain from the event, and long term issues that have never been addressed.

Pray for us!

The morning

Full attention to a crashing patient. One general surgeon, one icu doctor, one anesthisiologist...

"Directly observed antimalarial therapy"

Last Night

Night Shift

Organizations Impressed

Update from Daniel Patton – Day #4

Today I broadened my horizons. I climbed up on the roof of the hospital during the day. I could see the ocean, the Adventist college with it auditorium about to fall, and the thousands of tents of “tent city”. All set againts the back drop of the green mountains with fingers of the city crawling up with gnarled broken fingers.

I went exploring the camp and clinics outside the main hospital. I found a pediatric, AIDS, and obstetric clinics. I found newly constructed outhouses and the trash burning pit. Venturing behind the hospital I saw a sight the reminded me of when I was a child. I recall seeing cows that had died laying motionless behind my familys barn waiting for pick up by the smelly truck with a winch that would pull the lifeless mass into it’s bowels. There behind the hospital was a ghostly white man-sized bag labeled with label, “biohazard”. There was no one but me and the lifeless man in sight. I felt numb. I feel numb. I want to save life but… I wanted that man to have a family by him… He was alone in a baggy waiting for pick up, alone.

I went and learned a swear word from the Haitians. We all laughed. They laughed at me because I was swearing in a funny accent and I laughed because their reaction was so different from the idea I intended. Language is funny like that.

I saved a life with a knife. A little girl had a huge pimple on her leg. The fancy word for “pimple you can fit your whole finger in” is abcess. Those big pimples will kill more than your chances of kissing a girl. So I popped (lanced) it.

I finished the day by cleaning my room. The cast room was a mess. Now it’s not. I am proud. My back is killing me.

Update from David Puder – Day #4

Today we started at 730 am and finished around 10 pm. Alfonso and I worked on the er/short term ward.  There are many different groups, all bringing expertise to the hospital.  We really have become an essential part of the team, in terms of working up patients, making sure their care is moving forward, and sometimes giving meds, replacing IVs, getting creative… Like how do you treat someone with somewhat limited supplies… At times it is frustrating, at times extremely rewarding! Rounding is done at 12 hour shift changes, attendings are present when needed, and food and water are not an issue. It is hot, but it now feels normal, and the showers are a great end to the day! The key is the history and physical, there are many translators!

Things I’ve seen:

• Malaria
• Typhoid
• Scabes
• Worms
• Trauma
• Seizures
• Stroke
• Hyptertensive emergency
• Sepsis
• Acute abdomen
• Cholecystitis
• Post op issues
• Leptospirosis
• STD not treated
• Tb (pots, extrapulmonary, ect)
• Diarrhea

Continue to pray!