Podcast: Desperation, Destruction and Getting to Work

March 11, 2010 by

In this podcast, Andy Davidson, president and CEO of the Oregon Association of Hospitals and Health Systems, describes the heart-wrenching effort to get a Haitian hospital up and running after the tragic earthquake. Listen >>

Courtesy of Hospitals & Health Networks Magazine
www.hhnmag.com

Why Me….and not him?

February 3, 2010 by

I left Haiti this weekend with an incredible sense of pride for the work done by so many caring individuals and an overwhelming sense of being, well…..overwhelmed. As I’ve shared with you through this blog, the sheer magnitude of the destruction, the misery and the hopelessness will drag you down instantly. Yet at the same time, when you focus on one story at a time and one life touched, it begins to feel manageable in some way.

I realize there are so many personal lessons learned, personal perspectives changed and that there are many stories yet to tell about my brief time in Haiti. As such, I intend to use this blog to continue to share the many vignettes and personal snapshots collected since arriving in Port Au Prince. Doing this is both therapy for me and a way to keep all of us focused on how to help this incredibly resilient culture and its people.

I hope you will continue to look for updates here. At last count there have been almost 4000 hits to this blog in the last two weeks. If each of us collectively find a way to contribute our time, talent and treasure that’s a lot of time, talent and treasure we can provide toward the recovery. I will be working with many of the incredible professionals and organizations I had the privilege to interface with, including MTI, to formulate a longer term strategy. The Haitian people will need us for years to come. I intend to help lead the formulation of some meaningful next steps and will look to all 4000 of you to consider your role in those plans. Stand by.

In the meantime, let me share how it was I found my way home….because getting out of Haiti at this point is not business as usual:

The only way out at this stage is A) An 18 hour drive over the mountains to Santo Domingo, Dominican Republic or B) One of 2 small daily United Nations Charters out of Port Au Prince to Santo Domingo. From there it’s catch-as-catch-can on a commercial flight to the States. The third way is most akin to spinning the roulette wheel – going to the airport and standing by for a military cargo flight out of Port Au Prince to an unknown point in the United States. Being a gambler, this is the route I choose. It was really very simple…show your passport to US Military personnel in front of the airport, walk up to a makeshift immigration table on the tarmac manned by the State Department, fill out a US Citizen refugee evacuation form and wait for the next flight to come in, off load cargo and be taken to points unknown. I went to the airport around 9:30 pm. Was woken up from a fitful nap by an Army Captain at 12:30. Got on a C 17 by 1:00 am and landed in Orlando by 4:00. Of the 26 passengers on my flight, 17 were orphaned children on their way to their new adoptive parents in the US. The kids were escorted by two Americans. Looking onto their eyes through my own haze of 10 days on the ground, I saw fear, elation and confusion. But I also saw that under almost any circumstance, kids will be kids — as one of the Air Force crew members passed out Blow-Pops and chips to 17 excited hands.

When we landed in Orlando, the back of the plane dropped down to the tarmac and we were met by a horde of customs officials and border patrol folks. It was a bit surrealistic walking down that ramp alone and past throngs of expectant adoptive parents waiting to meet their kids, some for the first time. As with many things on this trip, a wave of emotion swept over me thinking about what the kids and parents have gone through to get them to this point. Lives forever changed.

It was that emotion that lead me into the terminal at 4:15 am and up to the Dollar rental car counter where I got a car on the spot and drove 3 hours to visit my own parents who are on Anna Maria Island, south of Tampa. It was a poignant visit for me, fueled with the knowledge of just how lucky some of us truly are. Why me, instead of that kid sitting across the plane from me? Why me, instead of that guy whose leg we just took below the knee? Why me instead of the girl whose baby we delivered while her husband was having his maggot infected big toe amputated? Why me, instead of the woman who died in the car on the way to our hospital? Why me? I don’t know…..But man do I feel both burdened and empowered by my good fortune and driven to make a difference.

More to come.

Will Work for Medical Supplies

January 31, 2010 by

In the week after the earthquake, those of us there to provide urgent care for injured citizens found ourselves short of everything….antibiotics, anesthesia, sterilizing equipment, crutches, plaster…you name it. Many of us honed our skills at barter and trade in order to acquire the minimum necessary equipment and supplies to treat the critically injured.

In this video, I made my way to the US Military Medical Command at the airport with a couple of colleagues in search of some specialized equipment for the operating room at King’s Hospital in Port Au Prince. If you want to know what we had to trade for the equipment we got, shoot me a note….it’s not for the feint of heart.

The airport was a free for all. Noise and activity from all directions. But we succeeded and saved numerous lives as a result. My thanks to the men and women of the US Military who found the compassion to help us help others on numerous occasions….

Andrew S. Davidson

President and CEO

Oregon Association of Hospitals and Health Systems

503.636.2204 (ofc)

503.705.7068 (mobile)

www.oahhs.org

Little Victim of a Food Fight

January 31, 2010 by

We were just finishing a 12 hour shift last week at the hospital we were running in Port Au Prince, when a man ran up the driveway carrying a limp and bloody young boy. He was bleeding from the head, just above his left ear and his shirt was soaked wet with blood.

There had been a food drop. Hungry people pushed and shoved. Fists and rocks flew, one connecting with this little guy’s skull.

Things looked far worse than they were. A few stitches and a song with his family and he was on his way back home. A little banged up…..and without the food they so desperately needed.

Did You Ever Wonder????

January 31, 2010 by

At any time while driving through earthquake ravaged areas, whether downtown or in the outlying areas, you see things that make you cry or want to puke….and you see things that make you wonder.

This photo falls into the latter realm of wonder…. The crucifix stands amongst the ruin of the church and surrounding buildings.

What do you think?

30 January, 2010 09:05

January 30, 2010 by

Today we began our second phase of Haitian medical relief by heading out of Port Au Prince and into the surrounding countryside in search of communities that are in need of medical clinics and triage. Today we went southwest about 30 kilometers to Gressier and Leogane, the reported epicenter of the January 12 quake. The destruction in Leogane was nothing short of mind-blowing. We’d conservatively estimate that at least 80-90% of all buildings, houses and other structures in Leogane were destroyed. In the attached video, you will see some of the destruction of downtown, including a huge pile of pulverized concrete. This huge pile was in fact the historic Catholic Church built sometime on the 18th century. It is nothing more than rock and dust today. Dr. Joe Markee of Vancouver, WA who was leading our outreach is a former resident of Leogane. He was shocked and saddened.

When you travel 30-40 kilometers seeing destroyed building after destroyed building, you begin to realize how the current death toll estimates are so high. Thousands of structures pancaked. Forever tombs for the unsuspecting. I found myself trying not to look too hard for signs of death. But that didn’t work too well. They were everywhere. I’ve attached a picture of a school that collapsed. I climbed through the rubble to look into what was the ground floor. A classroom for sure as I saw the remnants of chalkboards and desks. The good news is that the quake hit at just before 5 pm so the kids were out, but they suspect some staff were still inside at that time.

We went to the Notre Dame School of Nursing in Leogane and found our way to their hospital. It was being run by the Japanese army and had a line out front like we had not seen at kings for a few days. Next to the hospital was a very nice compound. Learned it was built by the Bill and Melinda Gates Foundation to support the work of the school. I took the attached picture of a painting I found on the wall in the hallway of the guesthouse which was done by a Leogane artist named Dubic. It depicts the town with two well marked graves marking the “death” of two common lymphatic ailments (types of elephantitus) in this part of Haiti – Gwopye (swollen feet) and Maklouklou (swollen scrotums). Look at how Bill and Melinda are depicted in this painting. Black tie in this Haitian village…

By 3:00 we had made arrangements to provide medical support at the Lepertorium, an actual leper colony that has become the base of medical relief operations between Leogane and Gressier. We will send a team there for a few days tomorrow to provide on site care. Today a consortium of German, Cuban and American medical personnel saw over 700 patients. We expect the numbers to be high tomorrow and will look forward to the Canadian Army opening a full service mobile hospital in the morning.

We currently have two teams out in the field through the weekend. I’ll be calling them later tonight to hear how things are going. I know one thing for sure…..they won’t be sitting on their hands. The medical needs of the Haitian people resulting form the earthquake will be acute for several months. Their overall health status dire for decades.

The Dancing Orphans

January 28, 2010 by

Greetings from Port Au Prince. It’s a very hot and sticky night. I’ve been sleeping outside and thank god I’m there tonight. We’ve been working 18 hour days so when sleep comes, it’s critical to maximize the opportunity. Today we were able to take the late afternoon off and decompress a bit. First time since arriving. Took a nap. Now I’ll probably be up all night. But man is the Sudoku app on my i phone going to get a good workout.

Amidst all the chaos and misery here in Haiti, we’ve managed to find some moments of comic relief. Next to the hospital where we’ve been working there is an orphanage. We’ve all tried to spend some time with the kids. Here’s a video of some of the boys dancing to their own music….cause there sure wasn’t any playing ;-)

I’ll try to post a better situation report and reflection later tonight or in the morning. In the meantime I want to thank all of you who are following the situation via this blog. Most importantly I want to again thank all of the hospital leaders and their staffs in Oregon and Washington who so quickly stepped up to aid the Haitian people. I am seeing the direct impact of your financial contributions and have watched the medications and supplies you so graciously donated being administered every hour of every day.

Enjoy this video. There is hope for a better tomorrow in these kids.

Day 4: Just When You Think It’s Getting Better

January 24, 2010 by

Hard day. I fought like hell today to get two particular patients transferred out to military hospitals. They were on the verge of death. I got them out after a shitload of heavy work.

One was a very small and very sick 7 year old boy. I took a personal interest in him and helped to load him into the truck which we arranged to evacuate him. He was so scared. The fear was emanating from his eyes. All i wanted to do was tell him we were doing all we could to make him better. I held his tiny hand and as my translator was helping load another patient, all I could do was use non verbal communications to ease him. As the truck drove off, I lost it. It’s only the second time I broke down, but it was a big one. I felt better afterward, but emotionally drained. Transferred another 4 very sick patients out, including 3 to the USS Comfort. Everyone pitched in to work the system to make it happen. What a team effort to pull the right strings. Things were stabilized as we ended our day, despite the strong aftershock

Then as we were leaving, a father came running into the hospital carrying his 4 year old nephew. His head was bandaged, his shirt soaked wet with blood. Turns out that there was a food distribution near the hospital and a riot broke out. Rocks and bricks were thrown and one hit him in the side of his head. Again, I held his hand and asked my translator to tell him we were going to help him. We also did the same with his family, all of whom hovered around the bed and cried as the little boy wailed. The sounds were hard to handle. His wound not so bad. The docs sewed him up and they went away happy, the entire family thanking and hugging the team as they left.

I do believe that life’s priorities are shifting for me. I am running a surgical hospital in the midst of a war zone. Ive never run a hospital or been in a war. SO why not check both off at the same time? I reflected last night that I am NOT sweating the small stuff. If I did I would not make it or the people around me would be really miserable. I hope I can carry this part of Haiti home with me.

Day 3: A Glimmer of Hope Amidst the Chaos

January 24, 2010 by

I am ragged, dirty and having a blast. While I have not slept much for the last 5 nights, I am energized not exhausted. Despite the majority of experiences being absolutely heartbreaking, I am mentally focused on the moments of greatness rather than the moments of despair.and there are many.

We made a lot of headway today in organizing hospital operations. As their administrator, this is my measure of making a difference. Im on my way implementing our org structure and policies. The medical team was not threatened by this structure. They embraced it, supported it and supported me. As Dr. Dan Diamond says, they were lovin on the scene.

In general, the city seems to be stabilizing. I was at the United Nations compound yesterday, which is by the airport, and got to see all of the various US search and rescue trucks and equipment heading to the tarmac to be loaded onto C 130s. NY, LA County, Dade County..They drive through the city with lights and sirens ablaze. It was a bittersweet send off as it meant that search and rescue had officially turned to recovery. I was glad to have the chance to see it and reflect. And then it was back to hospital.

We are continuing to see a very large influx of patients. A few really just need clinic or primary care. But most have major trauma ranging from burns to infected leg fractures with a little rotting flesh thrown in. Last night we had a patient die. Today we delivered a healthy baby and it lifted the entire hospitals spirits Haitian patients, families staff and our ex-pat team. The crying and screaming stopped for a while. That baby made a difference in morale that was really needed. Yesterday we had to amputate the babys fathers big toe. It was infected and had maggots visibly crawling in the flesh. Yet today, you would never know what that guy went through thanks again.to the baby.

I have at least 10 other examples of moments of greatness. Im just too tired tonight to reflect.

Tomorrows wish is for the US Army 82nd Airborne to return to the hospital, following their offer to assist today. We are in need of so many critical supplies and they are our ticket to staying just . rely ahead of the curve. In addition to securing the hospitals perimeter, we need their help in evacuating 4 patients that need immediate orthopedic surgery to save their broken limbs. We need shipping containers to stor supplies and equipment. We need very specific medications which are in short supply city-wide, most importantly IV based antibiotics. And we need them to work with the Spanish Army who have been on site working to sure up the hospital itself. We are earthquake damaged and each successive tremor threatens the safety of our building and the people inside. It will be repaired tomorrow.

Ill close tonight with what I view as a small but really import sign of progress. At about 5 tonight we discharged a patient who had his leg amputated below the knee a few days ago. What enabled us to even consider this discharge was one simple but impossible to find item — crutches. We can NOT find crutches anywhere in Haiti or the Dominican Republic. This guy really wanted to go home. And we had said not possible all day. Then at about 4:30 a pair of crutches literally appeared out of nowhere.

Call it what you want.Ill call it a poignant example of serendipity. And those serendipitous events are what keep all of us forging ahead under extreme circumstances.
Below are a few pictures including one of the amputee we discharged tonight.

Day 1: A World Forever Changed

January 21, 2010 by

We arrived in Port-au-Prince (PAP) this morning on schedule aboard a Lear Jet donated by a prominent Portland Business owner.  On approach, we could see the USS Carl Vincent in the harbor along with the USS Comfort.  It was clear we were entering the zone immediately upon arrival.  Helicopters, C 130s from several militaries, CNN, NBC, refugees, US Department of State and an airport building which is uninhabitable.  We exited our supple leather seats and hand polished rosewood tray tables and walked into the theatre of pandemonium.  The sheer magnitude of the effort at the airport was frankly overwhelming.  The sound, the sea of people and heat.  We off loaded our cargo which ranged from anesthesia medications and bandages, to bleach and underwater cable.  Ran into Sanjay Gupta and told him that he and Anderson Cooper are the reason that I am here.  What an even keel guy.  We hope to get him out to Kings in the next couple of days w/ Anderson.

As we drove through the streets of PAP so many Haitians were still stuck with the blank stare of utter shock and desperation.  Shanty towns, tent cities, trash, rubble, goats, more rubble and an occasional roadside stand selling water and coke.  We were taken immediately to Kings Hospital, where there was a line of patients out the door.  MTI nurses were triaging and prioritizing, keeping order on both the outpatient and inpatient sectors…only for the apple cart to be upset when an emergent patient arrived.  That happened at least 10 times today. 

We were briefed and put to work.  Clinical teams deployed to outpatient and inpatient sectors a nurse and anesthesiologist deployed to the OR and me playing jack of all trades.   I unloaded supplies, helped Nurse Ann triage and keep order with the patients and their families, and found a little girl who’s sister was brought in unconscious and who herself had not eaten in 8 days.  I made her a peanut butter sandwich and then another and then another.  Her smile got bigger each time.  It was one of the highlights of my days.

Attached are a couple of pictures showing team members and patients from today.

I saw things I never imagined.  Injuries beyond belief.  I even helped a young girl who vomited several times, only to find a 6 inch tapeworm in her bed pan.  Everyone wanted to see that.  She was quite proud.  A 500 mg dose of mebendazole and we hopefully killed the sucker.

I was drafted this evening to serve as the administrator of Kings Hospital.  I was honored to be asked.  Working with Dan Diamond, emergency doc extraordinaire from Bremerton, WA, we’ve developed an org chart and tomorrow I will brief staff and develop job descriptions.  Our goal is to develop an org structure that will transcend the eventual departure of MTI in a few months.  The Haitian doc who owns the hospital is like no one I’ve ever met.  She is so thankful for thinking about how to integrate our needs today while leaving a legacy for her organization long term.

Tomorrow I will share more about the working conditions and give you a sense of our living conditions.  They are quite plush by relief standards.

As I will say many times over, I have never and I mean never, worked with a group of more dedicated and caring people than I did today.


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