Brigitte Smith– OR Nurse

We started the trip being  flown via the Coast Guard into Port of Prince, Haiti. We stayed overnight in tents on concrete in the middle of an already condemned compound that we made into a tent city.  It was chaos after that.

The next morning we thought we were going to Pignon, but nothing was confirmed, and the on-site director of Partners in Health said that she may split the teams depending on  what hospitals needed what specialties and staffing.

It was decided that that 5 people would fly into Pignon and start assessing: Myself, Dr. Johnson, Dr. Hogarth, Sue and Frank (ER physician) .

We left for the airport to board  a  very, very small plane.  When we arrived to the chaotic airport,  as we were about to board the 5 passenger plane, a missionary asked us if we knew any orthopedic surgeons. He was escorting a 9 year old girl  who had been found under the rubble and dug out by her mother. She had crush wounds , open fractures in both feet , that were  both were partially amputated.

We  immediately  transported the child “Meika”, her mother  with  us to Pignon.

She became our mascot of the mission; and everyone fell in love with  Meika.

We arrived in  Pignon  and we were greeted by Stacy and her husband,  missionaries in town.  We went directly to the hospital, toured and then went right to  work.  This facility’s operating room was very sufficient. We worked straight thru until 6am in the morning.  We rounded up the floor and immediately made a surgical schedule.

We thought our first patient  would be Meika, but instead we performed a revision amputation on a young female who was septic and dying.  She was brought back several times during the week for additional surgeries.  We did a hip disarticulation on her; she had necratizing fasciitis, but with multiple wash-outs, debridements, de-bulking and the disarticulation, we think she will live.

That night we did several more wash-outs on patients with open fractures, so that the next day we could go in, explore the wounds and determine if we could salvage the limb by reducing the fracture and not having to perform amputations.

The next day the rest of the team arrived.  We worked until 3 am the next morning.

Surgeries performed:

Hip disarticulation

Multiple extremity wash-outs and debridements

Hand, arm, foot amputations

Open reduction, internal fixations of several femur fractures

Open reduction, internal fixations of several humeral fractures

Application of external fixator of tibial/fibula fracture

At the hospital patients  lined up in the halls.  Patients’ families actually lived underneath the patients stretchers and beds.   Each family is expected to bring the meals to the patient, but as this was a disaster, the missionaries were  supplying 2 meals per day.

In Pignon,  the medical team was housed in the missionary compound, which was owned by Dr. Guy, who is actually running for the next president of Haiti.  The house was very nice and in each room there were 3-4 beds, with a toilet and shower on each floor, something we weren’t expecting.

The staff in the compound supplied our meals, with a main stay of rice and beans.  Had refrigeration with bottled water and cola (nice, huh)

Each day we walked back and forth to the hospital  in groups, stayed together and were safe.

We did all the patients in Pignon and some that were flown into us, and   were able to get word out from the pilots who  brought  us to fly in anyone who needed surgery.

Flights were provided by Missionary Flights International (a christian volunteer network).

We did about  30 cases, which doesn’t sound  much, but these cases were difficult &  some taking 4-5 hours.

Brigitte Smith, RN, CNOR of the Grand Strand Regional Medical Center in South Carolina

“How was my trip to Haiti?” by Timothy S. Johnson, MD

“How was my trip to Haiti?” everyone asks.   Whoa! …That’s a tough question to sum up in a single word.  Fast?  Good?  Chaotic? Sad?  Happy? Tiring? Productive?  Successful?  Yes, all are true but none alone fully capture the voyage.   Allow me to digest that question while I recount the ride.

My Orthopaedic Mission to Haiti began on Wednesday 1/20 and I returned home safely on 1/29/2010.  As you might imagine, the experience was physically, mentally and emotionally stressful.  The chaos and agony reported by the media does little justice to the suffering on the ground.  Nonetheless, we managed to overcome many of the obstacles that had limited the effective delivery of surgical services by other well intentioned missionary teams in Haiti. I think our success was due to a variety of factors including our personnel, our supporting organizations, a little luck and mostly  the resiliency of the Haitian people.

Our base of operation was “Hopital Bienfaisance de Pignon” in Pignon Haiti.  Pignon is located approximately 55 miles north of  Port au Prince.   The hospital was undamaged by the earthquake.  It is equipped with 2 functioning operating rooms, an adequate compliment of trained Haitian staff and a reasonably well stocked inventory of basic medical supplies.  Because it was far enough away from the disaster zone the hospital had ample diesel generated electricity, running water and an extremely secure environment in which to treat patients.  We were the first medical team to set-up there.  Upon arrival we found an overcrowded inpatient ward filled with the injured from Port au Prince and their homeless families.  During our stay in Pignon we frequently operated 10-16 hours a day, several times operating through the night until daybreak.  .  There were many open fractures (broken bones that came out through the skin), crushed extremities and infected, gangrenous, traumatic wounds.  Due to our excellent pre-trip planning we came prepared and successfully saved lives and salvaged more limbs than anticipated. The surgical cases were challenging and truly tested my limits as a surgeon.  I did perform 4 amputations and although they were medically necessary, these decisions were still the most haunting tasks of my stay.

Despite the misery and despair I have fond memories of this journey.  One in particular, occurred on the afternoon of our arrival.  We had just completed rounds on the ward for the first time and I was at the nursing station reviewing x-rays, trying to decide who needed to go to surgery that first night.  My senses were overwhelmed.  The mangled limbs and gangrenous wounds were the worst I had ever encountered.  Most had been literally covered in dirt and gravel for over a week.  My nose was so saturated with the nauseating scent of pus that I could practically taste the stench.  My ears were ringing with the moans of pain from the ward.  I was hot, sweating from a long day of travel in the Caribbean sun and very much in need of a shower and some deodorant.   I was tired and a bit sore from sleeping on the trembling Port au Prince concrete the night before.  I knew I was in for another long night.  And it was at that moment that I was struck by a spiritual melody echoing down the dark hallway.  It grew softly as voice after voice joined the chorus.  The patients in their beds and their families strewn about on the floor, well over 70 voices in total, had broken out into song.  I found my senses calmed and my soul being nourished.  The lyrics were Kreyol so I could not make out the words well but the sentiment was clear.  We had brought “hope” to a “hopeless” situation.

So, “How was my trip to Haiti?” Fast?  Good? Chaotic?  Sad?  Happy? Tiring? Productive?  Successful?  Yes, all are true but none alone fully capture the voyage.   Fulfilling?….yes, unequivocally fulfilling.   And, I write to tell you that you should feel fulfilled too. Know that your kindness has answered the prayers of the people of Haiti.  Know that my hands were simply instruments guided by your love. Yet above all, know that I am grateful that you found me worthy to bring the miracle of “you “to those who , as one victim said ,“felt that they were left all alone in this world”.  The recovery from this calamity is only beginning and the road for Haiti is sure to be long.  So I leave you with this Haitian proverb as food for thought:

Men anpil chay pa lou………. Many hands make the load lighter.

Most humbly,

Tim

Timothy S. Johnson, MD – National Sports Medicine Institute

19455 Deerfield Ave, Suite 312 Lansdowne, VA 20176

Tel: 703 729-5010 Fax: 703 729-5833  http://www.NationalSportsMed.com/

Academic Appointment:

Assistant Professor, Johns Hopkins School of Medicine

Department of Orthopaedic Surgery-Sports Medicine, Shoulder & Elbow Surgery

Port-au-Prince

We left Port-au-Prince on Friday morning.
On the runway, as we were about to board the 5 passenger plane, a missionary asked us if we knew any orthopedic surgeons. He was escorting a 9 year old girl (with her mother ) who had been found under the rubble after 3 days. Her father and two siblings were killed by the quake. Also, she had open fractures in both feet and both were partially amputated.

So we took her along with us to Pinion. The first day we derided her feet in attempts to save her feet but we knew we would need to eventually amputate possibly BKA.

Children with amputation lead tough lives in Haiti and we really trying to save her limb. But today we had to perform a transmetatarsal amputation of her left foot and excision of bone on her right. Thankfully, a plastic surgeon arrived today and stated he thinks he could perform skin grafts on both feet so we decided not to perform bilateral below the knee amputations. Also our American colleagues have told us that they can get her prosthetics in the future.

She is a beautiful loving child that has grabbed the hearts of everyone in the hospital. God Bless her. I will NEVER forget her. Never

Unfortunately, she is one of MANY. The emergency workers have ended their search and rescue missions.

What remains is a nation in great need of long term help. God Bless my beloved Haiti.

No pictures. Too graphic.

Jean-Max
Sent from my Verizon Wireless BlackBerry

Dr. Jean Hogarth’s email

Sorry I haven’t been communicating well the last 2 days, but we’ve been extremely busy and working until the early morning. Try to fill you in later. Lots going on.

Satellite phones not working because we’ve been indoors the whole time. Also, my blackberry battery died

Jean-Max

HAITI UPDATE

We have been collaborating closely with Partners in Health (www.PIH.org), The Community Coalition for Haiti (www.cchaiti.org), NGO Liaison for the USNS Comfort and Operation Smile to bring much needed vital medical assistance as quickly and effectively as possible.

Originally, our team was expected to work from a hospital we identified in Pignon, however we were requested to divert to St. Damien’s Hospital in Port-au-Prince.

With limited communications, we are still waiting to hear details from our team on the ground.
As soon as we hear from Dr. Jean Hogarth , we will update information.

MIAMI

We landed in Miami tonight with all our supplies tonight. It was tough. We have about 80 boxes and bags to take along with us. We are READY to operate.

We are scheduled to be airlifted by the Coast Guard at 4pm tomorrow. Unfortunately, we may not be going to the hospital we had initially planned to go to in Pignon. We may be headed to St. Damien’s Hospital in Port-au-Prince.

In the attachment are some members of our team Dr. Timothy Johnson- Orthopedic Surgeon (National Sports Medicine Institute), Dr. Mark Seymour- Anesthesiologist (Frederick Memorial Hospital- First Colonies Anesthesia Associates), Brigitte Smith and Susan Cook (Myrtle Beach, SC), Toni Chotikul and Cheryl Clayborne (St. Joseph Medical Center). Not pictured are Greg Bennett, PT (Excel Rehabilitation), Joshua Lamb,MD (Chief Orthopedics Resident- Inova Fairfax) and Frank Duggan,MD (Emergency Medicine- Inova Fairfax). And I of course am taking the picture.

GOODNIGHT

Jean-Max Hogarth

HAITI Medical Team – Pignon, Haiti

Here’s the PCCHF team on their way to Haiti tomorrow, but leaving for Miami today.
Tim Johnson, MD Orthopedic
Jean-Max Hogarth, MD Anesthesiologist
Mark Seymour– Anesthesiologist
Thon (Toni) Chotikul– Orthopedic Tech/Surgical Tech
Brigitte Smith– OR Nurse
Sue Cook, PACU RN
The team will be with the Coast Guard flying into Port au Prince, then helicopter to Pignon, Haiti.
Pignon, Haiti is located in the Central Plateau of Haiti about 40 miles south to Cap-haitien and 30 miles north to Hinche.

HAITI

Last week Haiti experienced an earthquake of 7.0 magnitude, the worst in 2 centuries , leaving its people in total devastation. The global community immediately began relief efforts – sending rescue & medical teams by plane and sea. We are grateful to be able to assist in these medical efforts.

Headed by Dr. Jean Hogarth , an anesthesiologist with First Colonies Anesthesia based in Maryland, PCCHF is mobilizing a team of surgeons & nurses that will be leaving on Wednesday to Haiti.We are collaborating with Partners in Health, and Community Coalition for Haiti for logistical support.PIH is providing transportation from Miami to Haiti’s capital Port-au-Prince, and then to the hospital in need of surgical team. Details are unfolding, and changing by the hour.

The medical team consists of anesthesiologists Dr. Hogarth, Dr. Seymor & Dr. Johnson, orthopedics surgeon, Sue -PACU nurse, & Nurse Brigitte Smith. Brigitte Smith, RN, CNOR of the Grand Strand Regional Medical Center in South Carolina, has received many pharmaceutical donations from the hospital prioritizing her supplies to limit to the surgical instruments and much needed supplies.

Check back for more updates.

JUNE 1st, 2009 – Benefit at The Core Club in New York City

PCCHF Benefit at Core Club
When: Monday , June 1, 2009 – 7 pm
Where: Core Club - 66 East 55th St
The Paul Chester Children’s Hope Foundation invites you to our
4th annual benefit supporting our ongoing medical programs in Kenya, & Colombia.
Please join us for drinks, food, and Silent Auction, and screening.
Tickets : $200 
http://store.pcchf.org/servlet/Categories?category=Tickets+to+Upcoming+Fundraiser

Welcome from Tumaco

From student Benjamin Plotsky:

After a long, tiring day of travel we have arrived in Tumaco, Columbia.

The hotel is outstanding, but I kind of feel guilty with the way people live in the surrounding areas.
We got in at 10, but, and probably because we got up at 5, it felt like 3. We are going to lunch soon at a place Claudia (our native contact) knows about.

Military Debriefing after lunch, more to come later.”

Our student volunters serve an enormous role, particularly on this mission.  From sorting and transporting our huge shipment of medical and diagnostic equipment to serving as a compassionate liason with patients and their families, they take on the essential, often thankless tasks with courage and grace.  Thank you to Ben, Deborah, Alina and all of our student team members from missions past!