 Notes from Dr. Steve ShackfordJanuary 18, 2010 I have been going to Haiti every year to operate since 2002. I
was last there in November, 2009. I go to a place called
Milot--Hopital Sacre Coeur (HSC), near Cap Haitein on the northeastern
peninsula--over the mountains east of Port Au Prince(PAP).
2. Malnitrition is rampant and malaria is very common--I am always
surprised to see a hemoglobin over 10. Nevertheless, they heal well.
3. In Milot we have limited blood, limited lab, and post op
ventilation does not exist. Transfer to other hospitals is even more
difficult now since the major hospital at PAP is down, the hospital at
Gonneives was destroyed in the 2005/2006 hurricane and is not yet
completely rebuilt. HSC is a referral hospital for the northeast (and
Gonnieves) and you now now what we have there.
4. The local Haitian surgeons that I have worked with are
compulsive and hard working, but their experience, particularly with
trauma is extremely limited.
5. Security is an issue because of the conditions and the
frustrations, not because Haitians are unruly. Haitians are incredibly
long-suffering, but seeing their children with injuries and dying may
push them to acts of violence. Please be advised that the Haitian
National Police (HNP) may provide limited protection but the primary
source of security normally is the UN.
6. Generally, malarial prophylaxis starts with chloroquin 2 weeks
before departure--we do not have that luxury now, but if you know you
are going start now. Also, take plenty of bismuth with you and take it
BID to avoid the GI complications associated with chloroquin.
7. On the best of days Haiti, in the rural provinces, has less
than adequate communication with the outside world. I am sure now that
communication is poor. My e-com with Milot has been sporadic but their
cell tower was not toppled so that is good. They are actually awaiting
casualties from PAP, but none have been transferred--and 2 walked over
the mountains to get there.
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