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| Midcoast Doctors Operate at Quake's Epicenter | | 1/28/2010 8:14:00 AM | Email this article • Print this article |
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| Dr. Kevin Olehnik prepares to operate on an earthquake victim Tuesday morning at the field clinic set up in a classroom in Leogane, Haiti. PhotoS by Douglas Cole |
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| Dr. Olehnik talks with a woman before bringing her in for surgery. |
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by Christine Parrish
A small medical team, including three midcoast doctors, boarded a prop plane in the Dominican Republic last week and flew to a small city located at the epicenter of the earthquake that ravaged Haiti two weeks ago. They had been waiting for a military helicopter flight to take them to Haiti. It never came. Instead, they picked up a ride on a Cessna Caravan sent by other aid groups. The small plane landed on a stretch of road outside of Leogane, Haiti, that had been cleared of fallen trees and debris by United Nations staff. A truck was waiting.
Dr. Douglas Cole, a general surgeon, and two of his Pen Bay Healthcare colleagues, Dr. Lars Ellison, a urologist, and Dr. Kevin Olehnik, an orthopedist, had been to Leogane to provide medical care before. Haiti was poor. They knew that. On previous visits, including one in 2008, they had treated diseases and medical conditions rarely found in the United States. Now, they were in a disaster situation.
After landing, the doctors and crew transferred over a ton of medical supplies, water and food to the truck and drove to the nursing-school compound that is home to the University of Notre Dame Haiti Program - an international health care effort to eliminate lymphatic filariasis, a mosquito-borne illness prevalent in Haiti. The school has two buildings, a residence and a classroom, and they were among the few buildings that remained standing in Leogane.
The city was at the epicenter and damage exceeds that of Port-au-Prince
Located 18 miles west of Port-au-Prince, the port city of Leogane had been hit dead center. The city's 300,000 residents had either died, fled to the sugarcane fields, or had begun constructing squatter camps from whatever they could find, according to the United Nations. Access to the capital was cut off and the United Nations estimates that up to 90 percent of the buildings in Leogane were destroyed. Estimates of the dead range from 10,000 to 30,000 people.
When the doctors arrived at the nursing-school compound on Thursday, January 21, there was a Japanese disaster team and a small medical team working out of the classroom building.
"But there was only one orthopedic surgeon and no anesthesiologists," said Cole, who is acting as a spokesman for the midcoast medical team. The Free Press reached Cole in Leogane on a satellite telephone connection Monday night.
The clinic has neither running water nor electricity and there was no oxygen for anesthesia.
"The operating rooms are in empty classrooms. We're using wooden tables covered with sheets for operations and there is no electricity. We're using generators borrowed from the Japanese disaster team and running extension cords through the windows."
"There is an effort to wash instruments with bleach and to keep it clean, but no, it's just not sterile. This is nothing like what you might be used to."
The midcoast physicians are staying in the residence building, which Cole described as being structurally sound. Some health care workers refuse to sleep in the enclosed building. Outside, a tarp in the courtyard serves as shelter for recovering patients, though space is limited.
Patients are still arriving with open wounds and fractures, but the number of those coming in with infection is on the rise, according to Cole. The medical team treated a woman who had an infection in the stump of her arm, which had been amputated a week ago. They have also delivered a baby and done their share of amputations.
The midcoast doctors are volunteering their services through InterVol, a humanitarian nonprofit started by Dr. Ralph Pennino, a surgeon at Rochester General Hospital in Rochester, New York. InterVol coordinates volunteer medical teams and supplies medical equipment for health care efforts in poor areas of the world. InterVol volunteers have been working in Haiti for years in cooperation with nursing-school staff and other humanitarian organizations, including the Children's Nutrition Program, World Wide Vision, and Save the Children. These groups are also currently on the ground in Leogane.
InterVol volunteers, including Dr. Cole, Dr. Ellison and Dr. Olehnik, flew from Rochester, New York, on a Constellation Brands corporate plane to Haiti's neighbor, the Dominican Republic, last week. Constellation Brands is an international wine producer and beer importer that is providing free flight service to InterVol for its relief efforts.
Cole said the clinic became increasingly efficient over the weekend. On Monday morning, just four days after arriving, a team of 20 doctors and emergency medical technicians had a meeting to iron out how to effectively work together.
Patients walk in for surgery and walk out. There is no recovery room.
"We are very organized, now. The first day we were in each other's way a lot. Now we are divided into an anesthesia team, a triage team, and a surgery team. And there are more teams coming."
On Monday, Cole was part of a medical team that went into the countryside in search of victims unable to reach the clinic. The recovery truck team found a man with a severe thigh fracture in a poor outlying village. Cole said the man hadn't had any medical care since he was injured in the earthquake two weeks ago. The team brought him back to the clinic for an X-ray and planned to evacuate him to Port-au-Prince on Tuesday. In the meantime, they had no bed for him. The patient, who had managed to find crutches somewhere, hobbled away into the night, leaning on his wife for support.
Those who are unable to leave the compound after an operation sleep for a night or two beneath an awning set up in the courtyard, but most walk out again.
"I don't know where they went. I don't know where they slept.... Most of the operations we do are in and out. People come with family members and we don't even have any crutches to hand out," said Cole.
"There seems to be a cultural difference in the perception of pain. If you or I had a femur fracture, we would be howling in pain. The people I have seen have a remarkable tolerance for pain. They don't even grit their teeth. They accept it."
A tent city made of blue tarps, bed sheets and pieces of corrugated metal has grown outside the clinic gates.
"They have cooking fires going right now," Cole said, during the Monday-night telephone call. "It's not a coordinated effort. There is no sanitation. They do their business out around the edges, I guess. There's no latrine."
Cole estimates that 500 people are currently at the tent camp outside the nursing-school gates, but conditions and numbers are changing daily. Few supplies appeared to have reached Leogane early this week, he said, but international news reports indicate aid is finally reaching Leogane.
Tempers flare as disaster relief is slow to come
Cole said Haitians that were already employed at the nursing school are working with the international clinic teams. They also brought their families inside the nursing-school compound. They were camped in the courtyard. In all, Cole estimated that about a hundred people are living and working inside the gated compound. The Haitians inside the compound are better off than those in the tent camp outside the gates, he said, and it appeared to be creating tension.
Early in the week, the ad hoc clinic was being guarded by three Sri Lankan soldiers, according to Cole, when unrest started at the compound gates. A group of people had gathered and started shouting.
"It was an angry group asking to be let in," said Cole. "They wanted jobs."
Cole said the disruption was minimal and
didn't fear it would grow stronger.
"It's a very fluid situation," said Cole, noting that conditions change daily, as new medical teams come in and others leave, as refugees move into the area, and aid efforts step up. The midcoast physicians plan to be in Haiti for another week.
To see a video of InterVol medical teams, including Dr. Cole, Dr. Ellison and Dr. Olehnik, arriving and working in Leogane, see www.intervol.org/index.php.
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Reader Comments
Posted: Friday, January 29, 2010
Article comment by:
Jane Lafleur
Thank you Free Press for this informative, well written and important article about the good work being done by Pen Bay area physicians in Haiti. We are fortunate to have these people to help.
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