7pm Thursday January 28, 2010

I just got off the phone with Jay:

Just as Cynthia shared, the team realized that the other three "quadrants" of the injured refugee camp were perhaps receiving less than fantastic care. They are all doing their best, but the Dominican-run quadruant has the equivalent of a first-year trained general practitioner who is doing much more than his training. It's a sensitive issue-- how to help others improve their care of patients without taking away their dignity or their ownership of the medical care. So, Jay set up a "wound care team" including a Haitian nurse with wound care experience. They approached the Dominican team, offering to work together and share their expertise in wound care. The approach was received well, and the team had a great oppportunity to assist the Dominican team with their care-- and have a better idea of what help the Dominican team needs. They saw about 120 patients in the course of the mornings hours on wound rounds. They encountered an adult woman in a spika cast (which is known to result in about 100% complication rate)-- and indeed she had ischial pressure wounds that were un-noticed. The team also found a closed pelvic fracture that was originally believed to be a spine injury. All in all, it was a good experience. Tiring, but effective. Jay spent the afternoon taking xrays with the handheld digital xray machine on patients in their own quadrant-- on the patients that Matt Budge had noted as needing films. He did get into the OR for one case-- and the teams had done about 16 cases over the day.

The team was previously showering near the thorn trees inside tarps hung for privacy and using port-a-potties. But today they were able to establish staff toilets with running water-- a great morale booster. Now they also have privacy to take a spit-bath from the sink in those bathrooms. The team tries to use soap and water to wash their clothes as well as they can, but the effect is far from perfect. They continue to sleep on the hard ground in tents. The temperatures are 90+ with high humidity, but they do feel sea breezes that are somewhat relieving. However, the heat is nearly unbearable inside the Red Cross tents as they do their rounds. Jay says that it is definitely rough living-- like an Outward Bound course for two weeks.

The team is very grateful for the three Operation Smile staff accompanying them that take care of all the team logisitics. While the team cares for the medical/surgical needs of the patients, the three OS folks spend their day making sure there is clean water, food, and supplies. Today they were even able to get the team music for the OR. A small luxury, but an appreciated one! Jay says that each day gets a little better in some way.

As stated before, the team is in desperate need for adult crutches. And Jay says they REALLY need a C-arm. Someone saw a perfectly packed C-arm heading out of town on a flatbed truck...

Lots of people have asked how they can go. If you are a part of HMC, you need to contact Dr. Ben Frederick who will also put you in touch with Operation Smile. If you are outside our institution, you can contact Operation Smile yourself... or even come by yourself. Jay recommends that any team considering coming NEEDS to bring the following: their own answer to anesthesia, surgeons, primary care cods, a therapist, and at least 2x as many "floor nurses" as OR staff. You should also strongly consider logistics folks. There continues to be a tremendous need-- so anyone who can come would be helpful-- especially as word about the camp spreads and more people come in search of good care.

The camp is quickly becoming known as one of the best staffed surgical facilities-- but that means that other places can "dump" difficult patients on them.

Thanks to everyone for their support-- we are grateful for our "Penn State" family and our own families for being so very much a part of everything we are doing in Haiti-- either by holding down the homefront, the clinic, the ORs-- or just by thinking of and praying for us. We couldn't do it without you.

New photos on the Operation Smile site today-- click on the link on the sidebar.
(Thanks to my sister Olivia for helping me make the blog look a bit better today.)