Haiti, Day Four

Walking around the outside of the U of Miami Satellite tent hospital. First you see the ER (some cots below a tarp), then a random dude carrying a full bedpan, then the adult tent, and at the end, the radiology department, er, I mean, cot.

The biggest problem in Haiti is logistics. There are facilities, supplies, service-workers, and injured people, but you only get at most three of these in any given place at once. It’s kind of like the engineer’s saying: “Good, fast, cheap: Pick any two.” Therefore, one thing I realized was that we had to get the patients where the appropriate facilities and supplies were.

Many of the patients in our cots at U of Miami Hospital were either so seriously injured that we couldn’t even begin to fix their problems (pelvic and spine fractures) or those that were closed injuries that we didn’t want to open up to put plates and screws into (because then it’s just asking to get infected). So I started gathering and making lists from all of the different ortho and neuro surgeons.

However, only a small number of patients could go to these other facilities for higher levels of care, such as the USS Comfort, a Navy surgical ship sitting out in the port, and other smaller surgery centers run by Americans with clean ORs. Gathering the lists and deciding which patients got to leave our humble tents to go to cleaner, air-conditioned, well-provisioned facilities, I couldn’t help but thinking about that scene from Schindler’s List where they say “The list is good, the list is life!”

You can see the USS Comfort Navy Hospital Ship way off in the harbor to the right. If they could just get their pier and port up and running again, this country would have a chance, since it is the main vein of all commerce in Haiti.

One of the pediatric surgeons saw me making my list and started begging me to put a certain girl on it that she had become attached to. I went ahead and put her on, but to do it, I had to take someone else off. Looking through my carefully selected, short list of those who needed to go the most, I couldn’t see anyone who obviously didn’t need to go. For me, it was going to be random to take someone off the list, but for that person, it may have been the difference between life and death, or at least the difference between a good quality of life and chronic pain and limitations until the day they die.