Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Haiti, January 23

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We saw a lot of progress today at the hospital. The surgeons are seeing a decrease in the number of patients that need emergency surgery for crush injuries and fractures, but that doesn't mean that we are anywhere near a point where less-than-massive resources are needed. There are countless broken bones, deformities, facial injuries, burns and so forth, and we are encountering the sequelae of the initial surgeries that were performed in difficult settings. These mostly include infections that requires wash-outs of wounds and revisions of the prior surgeries. This is to be expected in our situation. The U.S. military has given the hospital tremendous report in facilitating the transfers necessary to the USNS Comfort, which is thankfully still involved in this relief effort.

The hospital campus is evolving with some decent structure. We now have a central pharmacy, three operating rooms for adults, one operating theatre (within a tent, as are most facilities) for children, and arrangements for childbirth, children, postoperative patients, triage and emergency assessment, and so forth. These are crowded and extremely busy areas, staffed by dedicated physician, nurse and technician volunteers. We are moving toward 24 hour coverage. We have decent drinking water and food distributions. Phone lines will hopefully begin to come in tomorrow. We may soon have some reliable laboratory testing and do have a small blood bank.

There was great sadness and an unsettling moment as a body was recovered within our compound from under the wreckage of the nursing school. I have a fairly strong stomach, but had to walk away. There are perhaps many more bodies in that location. We lose an occasional patient now, and we are particularly saddened by the deaths of those we have come to know, and have tried unsuccessfully to save.

I spoke with a young woman today, a dancer in Haiti who lost part of one of her legs. She was brave and doing her best to cope. I told her that she will dance again, and that she will be a much better dancer on one leg than I could ever be on two. She smiled and squeezed my hand. These are such special people. I have not seen one seriously injured victim complain.

We're preparing for the wave of patients that may arise as the word of our capabilities spreads and the injured who fled the area begin to return. So we are scaling up and beginning to fill in more services.

I have been officially promoted to coordinate the medical activities of all the non-governmental agencies within the compound, so am working on medicine, essential services (water, food, sanitation), integration between services, creation of satellite pharmacies, placement of physicians and other volunteers, and many other activities. I have never worked so hard, but have also never been more focused. My job is to make the situation improve every day for these people and for this country. The Stanford team has performed in the way that I knew it would - tirelessly and without a whimper, and has set an example of what can be done when you are on a mission and go after it with all of your heart and soul.
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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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