Late Saturday 1/30

I spoke with Budge late last night.

He sounded both physically and emotionally exhausted. I asked if it will be difficult to leave at the end of the week, given how many more people are in need of serious care. He said it would be harder to leave if he didn't know there was another team coming to continue the work they have started. The long days are beginning to wear on him. Sleeping in tents in the Haitian heat means they wake as soon as the sun rises, around 6am, and begin work almost immediately, rarely finishing before 10pm with brief breaks to eat.

He remarked he is amazed they are able to do as many cases as they have, given that the organization of a hospital does not exist there. With no electronic medical records, let alone past medical records, they rely on written information that is only so thorough. Issues as simple as 'where is the patient located?' can become a sad game of hide-and-seek as patients are moved from tent to tent.

Today, possibly as I write this, they are working on a pelvis in an older woman. She cannot walk, which is almost a death sentence in Haiti where there are no resources for those with handicapping injuries. She currently drags herself in a sort of 'crawl' to ambulate, which will not allow her to support herself enough to live long. Thus, they are taking this chance in operating on her today.

While they will be in a 'real' OR, approximately 2 miles away from the encampment, which will allow for sterile conditions, they do not have blood for transfusion. Further, there is no ICU facility for this patient undergoing a procedure that typically requires ICU stays. After lengthy discussion, the team felt they had to take the chance.

Budge says everything is so far from what we know about and have come to expect from medicine in the US. Informing and obtaining consent for this life-threatening/life-saving procedure was almost surreal. They found the patient in a tent, shared of course with 5 other patients. In front of these five other patients, they explained to the woman the significant risks - a "50-50 chance of survival" - but acknowledged that her chances for survival without the ability to ambulate are even lower. The patient, the single family member allowed in with her, and the 5 fellow patients, complete strangers to this woman, told the team they would "pray on it overnight" and let them know the decision in the morning.

He is hoping for the best and asks that everyone send their positive thoughts and prayers for their work, especially today.