CIR Haiti Watch: Day 5

A team of CIR physicians is volunteering in Haiti this week and CIR Communications Coordinator Erin Malone will be reporting back, sharing photos and reflections. Check here daily through August 24 for updates. Day 1  Day 2  Day 3  Day 4  Day 5 

I wake up to the news that a hurricane is heading toward Port-Au-Prince. Meterologists are unable to predict exactly when it will hit or how strong it will be, but Haiti will be the first place it touches land. With no further details, volunteers have no choice but to go about their days as usual.

In the morning, Michael, a pathologist volunteer, invites me to join him and Peter, a Haitian medical student, on a trip to the city’s general hospital to observe how the blood bank operates. We pull up to the hospital and see vendors’ tables similar to Bernard Mevs Hospital but no gates separating the hospital facilities from the streets. The complex is significantly larger than HBMPM as well.

We’re here to meet a prominent physician, Dr. Gideon, who will answer some of Michael’s questions about how transfusion medicine is practiced in Haiti. Dr. Gideon graciously receives us and later introduces us to the staff at the Haitian Red Cross.

As we enter, there are two lines of people—one side waiting to donate blood, the other side waiting to receive it. We learn from the laboratory manager that whole blood transfusions are practiced in Haiti. Michael later tells me that practice has largely been abandoned in the United States, and that one would only find it in extreme crisis situations–on a battlefield for instance.

After speaking with the blood bank staff, Dr. Gideon takes us on a tour of the hospital in an attempt to witness a live blood transfusion. As we walk from service to service, I can see the  vast differences between Bernard Mevs and this institution. This hospital is an entire complex of buildings housing a medical school and a residency program. It was scorching out with little shade yet I hadn’t noticed because all of Bernard Mevs treatment areas are air conditioned.

The Pediatric unit is housed in wooden trailers. The original unit was destroyed in the earthquake. The heat inside is as overwhelming as the heat outside. The trailer is crowded with listless bodies of the babies and child patients with their families and the crush of doctors and nurses trying to attend to them.

No transfusions are happening in that area so we continue to the labor and delivery wings. We visit a few other units to no avail before we find ourselves in the ER. At the entrance, we have to push through a large crowd of people trying to get in and the security guards trying to hold them back.

On the other side of the large door I see rows and rows of ill patients on cots. We move to the other side of the room where an intern is preparing a patient for a transfusion. The family arrives with bags of blood in a grocery bag. I learn that in order for a patient to receive blood, the patient’s family must donate (twice as much blood must be donated as the patient will need to receive) and then return to the hospital with the blood. After watching the family talk with the intern, we learn that the patient can’t be transfused because the family hadn’t brought the needles and tubing needed to perform the procedure. These materials are too expensive for the hospitals to keep in stock so each patient (or their families) must somehow secure them on their own.

We return to the blood bank to talk more with the laboratory manager and wait for our transportation back to Bernard Mevs.

When we return, I learn that I missed a big case that drew in a number of volunteers. A patient came in complaining of abdominal pain. The doctors found that he had a twisted bowel and needed to be operated on. After the operation he was stable but later in the day had started to experience swelling in his abdomen. The patient went back on the operating table and the surgical them found fluid on his lungs and other vitals organ. It was a harrowing four hour procedure but he’s now in the ICU in stable condition.

After a late lunch, I head to the lab to interview Michael about his experience at the general hospital. As we end, Patty enters with a vial of blood. She is getting her blood typed. After my experience at the general hospital, I’m interested in donated too so I head to the ER to find someone to draw my blood.

Upon enter the ER, I see all of the volunteers on duty head into the ICU. The OR patient from earlier has coded. The nurse didn’t find a pulse when she went to check on him. Each of the volunteers and EMT/translators are taking turns performing chest compressions to try to resuscitate him. For 15 minutes each person in the room does all they can to try to save his life. Soon it’s clear that there’s nothing more that can be done and a nurse covers him with a sheet.

Quietly each volunteer leaves the ICU, somberly returning to their other duties in the hospital.

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