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Operation Giving Back

Notes from Dr. Steve Shackford

January 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).  

I hope that you all find the following helpful information about Haiti and things that we might supply (hopefully, our SMRT team will be going there soon):

1. Haitians are incredibly resilient--they are strong, stoic, and appreciative of anything that we can do for them.

 

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.

If anything else comes to mind I will share---keep Haiti in your thoughts and prayers.

Steven R. Shackford MD FACS
Director, Graduate Medical Education and Quality Improvement
Trauma Services
Scripps Mercy Medical Center