We found our driver, loaded up the truck and left for the house that had been arranged for us. We thought we were prepared to see shocking images. We were so wrong. Buildings laying on their sides. Cars crushed by rubble. Empty lots we thought were vacant land but in reality were piles of compressed rubble from a collapsed building. While waiting at a stop sign we would stare at the devastation. Our expressions of shock must have been plainly obvious because, with our windows down and in those narrow streets people on the sidewalk would lean toward our car and quietly say, “This was a hospital”, or “This was a school.” As if asking us to mourn with them. Hundreds of buildings collapsed, ruined, destroyed. And what of the people? We would soon find out.
When we arrived at the hospital we were greeted by total chaos. People crowding the front door and hallways trying to be seen, or visit, or be attended to in triage. We wanted to find the office to report to the person in charge for duty. But what office? What person in charge? We wanted to say, “Here we are. What do you want us to do? Put us to work.” But there was no order, no authority, no hierarchy. No-one to say “This is Mr. Soandso what do you think? What can be done for him?”. No, nothing like that. Just injured people laying in crowded rooms or in the hallway hoping some passing doctor or nurse would take an interest in them and do something. What happened to this person? What has been done for them? What is the plan? No one knew. There was no plan. There was no one in charge.
One soon realizes that modern societies are not defined by knowledge or technological advances, but rather by a chain of command, by central authority. We were adrift without someone to tell us what to do. We were a few feet apart from the people we were there to help. Walking above them as they lay on the floor but really miles apart. Separated by their inability to ask for help and our inability to know where to start.
Never had we seen such devastating injuries. Rooms meant to hold 2 people filled with 5 or 6. Sometimes more than one per bed. Every patient missing limbs. Amputations everywhere. A country of amputees. An arm. A leg. Both legs. An arm and a leg. Men women adults children. How could this be?
Patients with horrible fractures and devastating wounds. We would walk into a room and see a massive soft tissue defect. How is this wound being dressed? Is this patient on antibiotics? What is the plan for this wound? There was no one to ask. No one knew anything. Chaos.
What was to be done? These patients needed surgery. Leslie picked up her clipboard and made notes. Zig and I and the nurses picked out patients. This patient needs a skin graft. This woman a stump revision. This child a wound debridement. We’ll operate on them in this order. The list is posted on the wall. Tammy, Sue and Lori hurry back to the OR to set up for the cases and Zig prepares his anesthetics.
On our first day in Haiti, fuzzy from lack of sleep , shocked by scenes of devastation, made numb by the sight of human suffering, we begin to operate. Taking skin grafts, meshing the skin, applying the graft. Next patient. Debriding the wound, shortening the bone, suturing the defect. Next patient. A rhythm of blood and pain. Seven surgeries between 2pm and 6pm. Finally we are forced to stop because the power fails and the OR is dark.
On the drive home no one speaks. At dinner we quietly discuss what happened. How did we do? What can we do better tomorrow? Who needs surgery the next day?
We roll into our sleeping bags early. Most of us sleep on the floor. I share a room with Zig. When I enter the room he looks up from his book and smiles.
“Frank”, he says. “Next time we go on holiday together, I think we’ll go someplace else.”