8:30pm Tuesday January 26, 2010

Jus got off the phone with Jay: He is so impressed. This "camp" went from nothing to what they have now in only three days. It's incredibly well run and well organized-- considering the circumstances. He is so glad that they chose this site. There was some original question about whether to split their team between Jimani and Fond Parisien, but as soon as they drove over the border, it was apparent that they could not effectively work as a split team divided by a national border. He said he cannot imagine a better place to be. Very secure. About 1/2 mile off main road, wall all around the compound with locked gate, and security that patrols. The team has their own water supply, but there is even well water from a spigot that people have been using for days without illness. The operation is being run by 2 ed docs who are disaster trained and have public health backgrounds.

The team had their first hot meal tonight of Campbell's chicken noodle soup with crackers. Yesterday it was tuna fish out of can with crackers and trail mix and water.

The team all have tents and were even able to take a shower tonight. Weather is okay. Overcast with breezes at times. Not too many mosquitos. But hot and humid at other times-- though not as hot as Honduras.

OR will be ready for tomorrow. Today Spence did one case. Shane did an eyelid lac. Jay used a handheld digitial xray that sends the images directly to a laptop. He took a ton of radiographs today-- and they will have xray rounds tomorrow morning. Matt Budge has been doing rounds as best he can in the circumstances. And he will train to do the xrays as well so that everyone can rotate jobs as needed.

They are the "second wave" of surgical relief. The first wave was there to do "urgent" care-- docs came through Port-au-Prince and the DR to take over national hospitals where the national staff had been killed or left to look for family. The did fx casting and ex fixes and whatever else they could. Now the needs continue for those patients with ex fixes infected, would pus-ing out under casts, wounds closed that should have been left open. Lots of infections being seen. The needs are overwhelming. Needs for amputations, re-amputations, closed and open fractures, skin grafts, wash outs, flaps. They have no ICU-- but the seriously ill patients are either dead soon or get taken elsewhere. The plan for tomorrow is to take as many open fx back to the OR-- and then re-evaluate the most urgent needs.

They are next to a refugee camp which is a tent city with no organization. Not even everyone has tents. One quarter of the tent city is now designated as "ex-fix city" which has been "given" to the team to do dressing changes and round on. But they are coming to the realization that there are MANY more ortho issues than simply in the ex-fix corner. Two buses brought 20 patients each tonight around dinner time-- requiring the team to triage. They expect a large influx of patients at some point-- possibly not until this team has been relieved, but there is space and potential for a lot of surgical work to be done. More empty buildings and warehouses. But the team is trying to be sensitive to and balance the needs of the orphanage who is sharing their land with them. However, the orphanage which normally operates with 60 full-time staff has lost most of the their staff who has gone to look for family.

Jay was able to dash off one e-mail earlier on the compound wifi-- but the connection was just made secure tonight, so emails may be difficult after this.

Jay says this is the poorest country he has ever been to... utter desperation.
But everyone on the team is in good spirits and appreciates the support of everyone back home.