February 10, 2010

Three Updates: Reflections and Reports

We continue to receive reports from friends and acquaintances and partners who are still in the field in Haiti. We want to share three of those stories today.

A Surgeon's Reflections, Written on a Plane Returning from Haiti

Dick Furman, M.D. -- Samaritan's Purse

            ...I don't know how their memories will affect me as time goes on.  But now it is difficult not to compare them with life, as we know it.  They will not sleep in their homes because of the after quakes.  At night they still cry out and moan and wail.  The stench remains in the air as you drive by building that collapsed.  And then there are the patients that survived and we operated on who are in despair with nowhere to go and loved ones dead.  We had our surgical team meeting this morning after which I made my last walk through the hospital and left patients I will remember for the rest of my life.  I am on the plane flying home as I think back over what was the most horrific time I have ever experienced in my life.  I have never seen such suffering.  I have never seen so many people go through so much sorrow. 

            It surely looked different on TV.  Watching it, you could get the feeling of what the earthquake was like.  You could get a feel of the destruction of buildings and houses and stores.  You could even get some insight into the terrible devastating feeling the people are going through.  But until you have examined a patient who was in the kitchen while her husband and four children were in the next room, who felt her third floor apartment begin to shake and sway and less than sixty seconds later; her family was dead and she had a slab of concrete roof lying on her legs and pelvis  -  until you are a part of that, you can't really understand what it was all about.  We operated on her and for the next week, every time I examined her at her bedside she would begin shaking her head and begin weeping.  Last night, my last night in Haiti, I left our quarters and slipped down to the hospital just before going to bed and prayed at her bedside, gently placing my hand on her head.  I didn't know how to pray, what to ask.  I realized we had done everything medically which could be done and only God's love for this woman could give her any comfort.  Our surgery was going to be successful.  The physical part of her problem would be healed but that part of her desperation was minimal to her over-all suffering.  So I prayed a verse, which came to mind.  I prayed that God would give her a peace that surpasses all human understanding that would guard her heart and her mind through Jesus Christ during this terrible time in her life.  I finished my prayer and stood by her bed and just looked at her hardened face and thought of what she has been through and wondered how long she would suffer before she realized the peace of God.

            I walked through the other wards.  Most of the patients were asleep.  I could not speak Creole nor understand it.  I would stop at the foot of certain beds and give a nod at a particular patient I had gotten to know in a very unusual way.  They didn't try to speak.  I would stand a few minutes looking at them and ask God to give them that same peace that only he could give.  I would just touch their foot or pat their leg and stand with them a moment just to let them know that even though I wouldn't see them again here on earth, I cared. 

            I stopped at the first ber in the second ward.  He had pulled his sheet up over his face.  I wanted him to see me but didn't want to awaken him even though he was one of my favorite patients.  He was a large man; a policeman, in his mid thirties.  We had put some metal pins through his broken bones on his right leg and then stabilized it with an external brace.  He had a wife and two young daughters.  His wife was giving the girls a bath when the quake hit.  For two days, the he was trapped, not knowing whether his wife and children were alive or not.  Even when some men found him and pounded the concrete off his body to free him, he did not know.  He didn't know for sure they had died until he looked back at the rest of the house and realized the slab of roof had completely crushed the bathroom portion of his home.  He had been with us three days in the hospital but didn't speak much to anybody.  I can only imagine what keeps going through his mind.  I can't imagine how I would react if my wife and all my children were suddenly taken away from me. 

            And a few beds down were the man with the little three-year-old boy who had lost part of his arm.  The man's wife and two children had died in the quake.  He kept telling me through the interrupter that his wife was thirty-two years old.  Thirty-two he kept saying. I remember him sitting and holding his boy all day in his lap as if he wanted to make certain he didn't loose him.  We had tried to discharge him earlier in the day but he had no money and nowhere to go.  At least at the hospital they received one meal a day.  We needed his bed for other patients but yet couldn't make him leave for some reason...

(Dick has a longer reflection of multiple patients. These were just some stories that remind you of the families torn apart in a moment's time.)

Reflections from a Clinical Research Nurse Trainer, Vanderbilt University -- at GHESKIO Clinic: Port au Prince

by Janet Nicotera, RN BSN

I want to let you know I am alive and well at GHESKIO. The main building the one built more than 20 yrs ago when our collaboration began is not safe but that has not stopped the work. Administration moved, research trial patients are seen outside under the trees and every inch is utilized. Two field hospitals are also on the university side so it sounds a lot like the TV show MASH all day. We have almost 6000 refugees, 1000 under 5 yrs old. I had not put my bags away and Dr. Pape had given me three new tasks..I love that about him. We are currently preparing for two post op sites and another research site so patients can have more access to care. Life goes on here. I am so grateful to be with these amazing people and learn from their tenacity.
Best, Jan

From Save the Children, a HTHH Beneficiary of Haiti Disaster Relief Funding (as of 2/10/2010)

Reading Material: SC produced this prior to the earthquake assessing the needs of Haiti last Fall, October 2009 -- Modernizing Foreign Assistance, Insights from the Field: Haiti

Our efforts in Haiti continue to make a big difference for families and children. The mass food distribution which we are managing with the World Food Program at 2 of the 19 locations in Port au Prince continues to go well (target 280.000 beneficiaries). The Family Tracing and Reunification (FTR) center and helpline was set up over the weekend at the UN logs base and is now operational as child separation and protection remain key concerns. Community registration workers were trained and began registering children in Port-au-Prince on Sunday in coordination with UNICEF, IRC and ICRC. Fully operational sub-offices in Leagone and Jacmel have been established to support our growing response in those areas. Further sub-offices in Petit Goave and Port au Prince are being established. With rains imminent, the distribution of shelter material and the establishment of planned settlements still remain among the main priorities for assistance, with sanitation and control of vector-borne diseases becoming a major concern at many temporary sites.

General Updates:

* The Government of Haiti reports that the death toll may be as high as 200,000 people, with an additional 300,000 people injured by the quake.

* To date, seven organized settlements have been established for 42,000 displaced people, with an additional 460,000 in spontaneous settlements throughout PAP.

* The Ministry of Education is in the process of assessing 6,000 schools and estimates that over 400,000 children are displaced.

Our most recent activities are as follows:

Total number of beneficiaries reached so far: 297,591

Total number of beneficiaries we intend to reach: 800,000

Non Food Items (NFIs)/Shelter:

* SC has reached a total of 9,611 families with NFIs to date. 500 families in Leogane and 511 families in Jacmel were provided with blankets, hygiene kits and other NFIs in the last three days.

* SC shelter activities will be scaled up in the coming weeks, with an interagency assessment to identify tent sites in Jacmel already underway.

Water, Sanitation and Hygiene (WASH):

* To date, SC WASH interventions have reached more than 60,000 people. This includes the construction of 156 emergency latrines, 90 bathing areas, and hand washing facilities at 20 latrines.

* Additionally, the first of an expected 150 WASH facilities was installed at a Child Friendly Space on Monday.

* SC is leading an inter-agency WASH assessment in 5 districts in Leogane and conducted training for mass hygiene promotion activities set to begin this week in Port-au-Prince.

Health and Nutrition:

* 14 SC mobile health teams have seen a total of 10,630 patients at 45 locations to date. This includes 2,760 people in Port-au-Prince, 1,143 people in Leogane and 6,727 people in Jacmel. Additionally, SC health agents are equipped with oral rehydration solution to treat cases of diarrhea.

* SC health teams completed MUAC screening for 125 children, of which 7 were found to have severe acute malnutrition and 13 had moderate malnutrition. Additionally, SC, in collaboration with Ministry of Health, completed a measles vaccination campaign along with MUAC screening in Jacmel.

*SC is leading the infant and child feeding program at the national level and is supplying safer breast milk substitutes (BMS) for infants who cannot be breastfed.

Child Protection:

* The Family Tracing and Reunification (FTR) center and helpline was set up over the weekend at the UN logs base. Community registration workers were trained and began registering children in Port-au-Prince on Sunday in coordination with UNICEF, IRC and ICRC.

* The sector specific in-depth assessment is being conducted this week in Port-au-Prince and Jacmel by SC trained volunteers. 10 additional staff will be trained for an upcoming assessment in Leogane.

* SC also held a two day workshop for CFS trainers, with 70 participants from 25 organizations.


* So far, SC food distributions have reached over 120,000 beneficiaries, including 72,000 children. This number will continue to increase as distributions in Port-au-Prince continue over the next week.

* SC distributed 25kg bags of rice to 1,700 families daily over the weekend in each of the two locations, Martissant and Tabarre, as part of the 14-day World Food Program collaboration.

* The cash programming learning group led by SC is being officially recognized by the Early Recovery cluster and Cash for Work programming is expected to begin this week.


*Of the 29 schools that were a part of SC's Rewrite the Future Campaign, 5 were totally destroyed, 14 were partially affected with varying levels of damage, 8 were not structurally affected and information was unavailable for 2. Only one of these schools has started to function.

* SC will conduct assessments in 4 zones in Leogane to identify sites for temporary learning spaces.


* Wellness sessions with staff members continue and a long-term strategy will be issued soon.

* Additionally, 70 tents, 300 sleeping bags and 300 sleeping mats for national staff arrived in Port-au-Prince on Friday, providing some much-needed relief.