from Haiti, January 27, 2010

We've been here working at the University Hospital in Port au Prince for nearly two full weeks, and it is shaping up. The care being delivered is remarkable given the circumstances since the earthquake. There are two operating rooms running 4 beds each, a tented medical unit for our sickest patients, a fully stocked pharmacy, a satellite pharmacy, an increasing laboratory testing capability, and more tents. Still, this is not a hospital as we have become accustomed to in the U.S. It is a medical facility under tents, and the conditions are not sterile in the sense of sterility in "clean facilities." What I am trying to convey is that while the situation is improving, and we have optimism that it will continue to improve, for the patients who have suffered bad injuries, they are certainly not yet all out of the woods.

I find myself going back to visit a few patients, like the young woman professional dancer who lost her leg. She was returned to the O.R. today for a revision of her stump, so was postoperative and asleep when I saw her. In the crowded tent, she was covered with flies, so I sat by her for a while and fanned them away with a small notebook. In another tent, I watched a mother bathe an emaciated infant. The baby will not make it through the next two days. One tent over, a woman shouted out in pain during childbirth.

The garbage is being picked up and we should have upright portable bathrooms tomorrow. That is a triumph towards which I have struggled for days. Once again, the U.S. military showed its compassion and coordination when nearly 50 patients were evacuated to more advanced care. More will follow tomorrow. In our central wooded area, the crowd is thinning as some persons have found locations out of the hospital where they may live and rest while they recover. That all may change if it begins to rain or the ground shakes again.

Yesterday the generator went out for many hours, so we could not run the O.R., or so I thought. A team of resourceful surgeons wore their headlamps and made it through some of their cases.

We got word today that we may be going home soon. I have mixed feelings about that. It will be difficult to leave, but all signs point to it approaching the right time. Emotionally, I am OK, but my legs are a bit wobbly. I wake up as tired as I was when I went to sleep. The people here deserve fresh legs.

Tomorrow we will finalize coordination of sanitation, electrical, tent placement, number of physicians needed to carry us through the next two weeks, and how to accelerate the return of Haitian physicians and nurses. There is much work to be done.