November 21st, 2011
This may well be the last installment of Melissa’s CP11 blog – as I have been home for 2 ½ months now and my motivation to write about the final parts of the mission – and my memory of the details – are lacking at this point. But the chronicle wouldn’t be complete without at least trying to describe our last-but-definitely-not-least stop, Port-au-Prince, Haiti.
The COMFORT had been to Haiti before, on previous CP missions and more recently, after the earthquake in Jan/ Feb 2010. Several of the crew on our mission had been aboard the ship during the earthquake/ disaster response (DR) mission. These crew members had been telling stories for months about the devastation and ruin that had overtaken Port-au-Prince – but everyone who had been there said the same thing: you have to see it to believe it.
I don’t know what I was expecting, but when we anchored offshore on the 17th of August, PAP looked much like any other town we had seen. In fact, from a distance, the landscape was very pretty – green hills in the background and of course, that gorgeous Caribbean blue water surrounding the island, which makes everyplace picturesque.
I was the site leader at the surgical site on the first day (the 18th), so was one of the first people to take the hospitality boat to land. Unfortunately (or fortunately, depending on how you look at it), there was no bus ride to the clinic site – we were set up within walking distance – about 200 yards – from the BLZ. Because of this, I didn’t really get to appreciate the local area, as we were set up essentially on a military base. However, as site leader, I was immediately introduced to some of our local help – several NGO (non-governmental organization) personnel who helped facilitate patient referrals to the ship. Many of these NGOs were from the States, and had permanently relocated to Haiti, to run orphanages or work in medical clinics or provide any assistance possible. Several of them had been in Haiti for 2 or 3 previous CP missions, and most had been there during and in the aftermath of the earthquake. We had not been lucky enough to work with similar individuals in other countries – probably because their assistance wasn’t particularly necessary elsewhere. In Haiti, I cannot imagine how we would have accomplished anything without these ever-present NGOs – if for no other reason than the fact that most of them spoke Creole! After 4+ months of immersing myself in medical Spanish, I was surprised how little French I could come up with (despite years of classes in high school and college – don’t tell mom and dad). And anyway, as it turns out, French and Creole are similar, but NOT the same. The NGOs were invaluable in many ways, not the least of which was bridging the language barrier.
The surgical site ran similar to other countries, except that instead of patients being referred by the local ministry of health, they were referred by NGOs. I was responsible (again) for ensuring smooth patient flow and maximizing the number of patients that could be screened on our first day at the site. The front gate was where I got my first taste of Haiti. The first 2 children to enter the gate were some of the sickest patients I had seen over the entire mission. The first looked to be about 9 (but was actually 19, I learned later), and had severe ascites and anasarca. It turned out that she had severe liver failure. The second patient was a 7-year old boy, and he wasn’t necessarily sick per se, but his right eye was completely protruding from its socket – he desperately needed surgery for a trauma that he had suffered years before, but couldn’t afford it. I cannot imagine the effect that this cosmetic deformity had had on his confidence and ability to socialize with other kids. The remaining 150 or so patients that we saw that day were equally critical. The common theme was that all the patients had desperate medical needs – there were no oh-by-the-way requests for vitamins or the incidental “my knee hurts” – these were all major medical or surgical cases – but any help we could provide would be far too little, and invariably too late. Really heartbreaking.
On the second day, I was a “worker bee” at the medical site – also located at a BLZ so no local travel. Whereas in most other countries we set up our MEDCAP sites in pre-existing buildings (schools, gymnasiums, auditoriums, etc.), there was no freestanding building at the Port-au-Prince MEDCAP. The site leader and setup team had been out the day before, and had set up several tents, tables, and hundreds of chairs, all in a dirt field directly next to the water. There was no breeze, and no electricity (except that provided by one generator – which was used to power the X-ray machine). It was hot - in the high-120s on average.
The patients came by the many hundreds. I saw my personal record number of patients that day – 42. Way too many to be effective. Pretty much every one though had a huge impact on me. Most of them had horror stories about losing multiple family members in the earthquake – one man (boy, really, he was 21) described hearing his father call for help under the rubble but was unable to get to him, so eventually, 3 days later, he heard his father die. One of my translators volunteered to translate in the hope that somehow, he would make it onto the ship, where his brother had supposedly been taken after the earthquake for medical care – and no one in the family had heard from the patient since that time. It was absolutely heartbreaking. As was the trend during the mission, I saw many patients who were suspected to have cancer, and most of these suspected patients turned out to, of course, have cancer. Cancer that, in the States, would be very treatable and often curable, but in Haiti, I was told, “you can make some recommendations for pain medications, but otherwise they won’t get any treatment.” The near-complete lack of resources got to be very frustrating and again, heartbreaking. That was one of my longest and hardest days.
I spent the next two days caring for pre- and post-operative patients on the ship – no less heart-wrenching, unfortunately. The day after that, we were told of Hurricane Irene’s approach toward Haiti. Because of certain Navy docking concepts that aren’t entirely clear to me, it was going to be necessary to pull up anchor, sail back out to sea, and wait out the storm. This was obviously NOT in our original SOM (scheme of maneuver). This meant lots of hurried patient discharges, late night surgeries, and cancelled procedures. Ultimately, the COMFORT pulled back out to see on the 22nd, and remained floating/ sailing aimlessly for just over 2 days. We headed back to Haiti on the 24th, and weren’t sure what we would find. In our 2 days at sea, we had prepared ourselves to convert from an HA (humanitarian assistance) mission to a DR (disaster response) mission. As it turns out, the areas in which we were working were not too terribly damaged, although our dirt-field MEDCAP site was converted to a huge mud pit. The MEDCAP was moved to the previous surgical site, and opened back up for business the next day. Because of our detour at sea, my hospital tour had been cancelled, then rescheduled. I was also scheduled to attend a tour of the Brazilian attaché to MINUSTAH (la Mission de Nations Unités of something something Stabilisation in Haiti – the UN, basically), and of a local cholera clinic. The descriptions of those tours, though, will have to wait, as my fingers are out of typographical practice and I need to take a break. Apparently this was NOT my last blog entry. And you thought I’d be done when I got back!
