Crudem Update: Dr Fleming - March 11th-12th

Thursday, March 11

The weather turned hot and the dust and insects increased. Preventive care with mosquito netting and closed doors in the ICU and OR improved what was a bad problem when we arrived last Friday.

Jean Baptiste, the hydrocephalic child, has not had a fever in 24 hours and appears to be improving.

I assisted Tim OConnell with a skin graft to a left forearm amputation stump on an 18 y/o lady who is four months pregnant. I had to go to pediatrics after that and was greeted by a smiling five y/o who used his left hand to take me to the nursing station so that he could get a treat. I then noticed that he had a right forearm amputation. This is one of the few times when I almost lost it. The kids are amazingly resilient. The hospital has made the decision to keep them there until they no longer need prosthetics and have a place to go to. Several of them lost their entire families but it will take many months to find any relatives.

The excitement for the day was a young pregnant mother who walked 40 kilometers with her 11 y/o son who had lacerated his radial artery and median nerve. He had a tourniquet on for the over six hours it took her to get the child to Crudem. One of the ortho hand surgeons took care of the child and expects a good result.

The under 45 crowd went to the local disco last night. I decided that it would be better not to find out which of the younger nurses was tattooed. Tim and I had a Heineken on the porch, packed and called it a night.

Friday, the 12th

Eight of us left today with 16 suit cases tied to the top of the Toyota van. Wild third world seen as various men tried to unload the bags for a tip when we got to the airport.

No good deed goes unpunished or we should bear the crosses God has given us. Florida and Atlanta had bad storms. wee were diverted to Miami for two hours and finally arrived in Lauderdale to find that Delta was backed up four hours. Finally home at 1 am.

Thoughts: 
I was glad that I was there to help. It was a combination of the worst of an inner city hospital and a bad summer camp but egos were checked at  the door, people got taken care of and we had a few laughs and the satisfaction of doing a good job under desperate circumstances.

The overall conditions of the hospital have improved with 35 people discharged and another 30 pending discharge. One of the tents has been removed. Jeff Sabin, the spinal surgeon from Colorado, was going to stabilize the last two paraplegics from the Baptist center on Friday after getting more equipment. The bad wounds we saw on Friday last week are much more manageable. The doctors and nurses on the tent wards made extensive notes for the new teams so there will not be many gaps in care. An oxygen concentration facility is being built and will be running in a week. There are supplies and heroic efforts were made to distribute and organize them. Supply is going to be a continuing difficulty with no local infrastructure and the continuing use in the hospital. 

Ultimately, Hospital Crudem belongs to the Haitian staff. They have had to go the background as US trained doctors and nurses did the heavy lifting for the mass trauma. There has been an ongoing effort to teach  but it is difficult with the language and cultural barrier. Dr Previl, the hospital director, and Dr Bernard, a general surgeon are excellent. Many of the nurses have great potential now that the pressure is lessening. Many other folks such as Pierre, the transport director, have come to shine. A special mention must be made of the kitchen staf under the direction of Fifi who fed the volunteers three good meals a day. I have learned to love rice, beans and spicy Haitian peanut butter.

It was a great privilege to be involved in this effort. Will send pictures when I find where I packed the camera.

Mike