The structure across the courtyard from my bedroom stands incomplete. Rebar sticks out from the top of the wall, supporting the rising sun. The new construction is a reminder of the rubble that once lay here following the earthquake six years ago. To my right is a dorm where 30 girls, ages 10-20, are sleeping. To my left is the boy’s dorm that sleeps five. The 15 babies are asleep in the back building. There are three new babies here from Les Cayes, all of them left without family after the hurricane. Three more are coming this week.
I always end my trips to Haiti with a visit to the orphanage where we found our daughter Anabelle. It is the highlight of my trip, and last night we sat around with the older kids talking about their dreams and school. We were late getting here as a man, stabbed by his wife, was brought into the hospital just as we were leaving. He had stab wounds to his chest and upper arm. We spent the next two hours sewing up his brachial artery and median nerve, a repair that would not have occurred in our absence. His wife brought him to the hospital. I guess she still loves him!
This trip to Haiti, after Hurricane Matthew, was a short one intended only to care for patients with upper extremity injuries, who made it to Port-au-Prince from the southern peninsula. More than 500 people died and tens of thousands have been left homeless by that storm. Dr. Jean Hippolyte, who spent two months with us in Flagstaff during his orthopedic surgery training, called and asked for support to treat patients after this disaster.
Roseline suffered a forearm laceration when the roof of her house flew into the air and came crashing down on her. We repaired her median nerve and multiple flexor tendons, another injury that would have gone untreated had a hand team not been in town.
Louis-Jean was also struck by a flying roof and sustained a hip fracture. It was 10 days after her injury when we arrived. We tackled this without an x-ray to assist us, and during the procedure we discovered we had no power drills. I was able to find two hand drills and with the Haitian orthopedic residents providing the strength, we were able to fix the hip with three screws.
We also treated Genese, who lost her children, her husband, and all of her possessions in the storm. She suffered a left femur fracture and right forearm fracture repaired by Dr. Hippolyte the day after the hurricane. Her right wrist was fractured in multiple pieces with one boney fragment flipped 180 degrees into her forearm and pushing on her the median nerve. Without an X-ray machine in the operating room, and with limited supplies, we were still able to improve the position of the fracture and maintain it with a couple small screws, wires, and an external fixator. It was not perfect, but in a better position than before. She has the chance for a functional arm.
The most difficult case for me was a 10-year-old boy who had lay on the ground for several days after being hit by debris. It severed his spinal cord through a thoracic spine fracture dislocation. He arrived with the worst decubitus ulcer over his right buttock that I have ever seen. We debrided this and watched his fevers go away. He also has tetanus and is being kept alive with a ventilator. He will likely not survive.
Next week, the American Society for Surgery of the Hand is sending a team to Haiti through their volunteer program “Touching Hands.” They will care for patients with upper extremity injuries and teach the Haitian orthopedic residents. These residents are bright, talented, and eager to learn. Touching Hands will also help train these future orthopedic surgeons in techniques that will allow them to care for these patients who do not get treatment unless a volunteer hand surgeon is in Haiti. Our team returns in December.
Many people in the cities of Jeremie and Les Cayes are sleeping tonight on a sheet on the ground including the families of our two Haitian exchange students. My trips to Haiti are always humbling experiences, and I return feeling so lucky for what I have: a roof, four walls, a bed, food, and my healthy family.
Give your family members all a big hug tonight.