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On the Ground in Haiti: The First Day

Editor's Note: Healthline blogger Dr. Anil Menon is in Haiti to help with the global effort to provide medical care in the wake of the January 12 earthquake. Because communication outlets are limited, he has been sending updates to his mother via text message. She has been transcribing those messages for us so we can pass them along to you. Please know, these updates are being relayed directly from Dr. Menon, and some of the information is graphic and might be emotionally difficult for some people to read. We will be posting new updates as we receive them in the days ahead.

"How was your day?"

I've had to answer that question throughout the day. At first I would reply, "Good," my standard rote response. But then I just had to tell the truth because it wasn't good—it was horrible. After 48 hours of traveling, very little sleep, not much food, I had no desire for food or sleep. The rubble of Port Au Prince was strewn with injured people, in even worse condition on day five. I wasn't the only one who felt that way. Everyone did, and no one expected to sleep—surely not peacefully.

On the first day, I sent a woman home who lost her right leg, sent her home with several vicodin because her leg did not show signs of infection yet, and hoped that keflex would be sufficient. A translator, Manny, wanted to help. His entire family was dead and he had nothing left. He was very helpful.

I was asked about the saddest cases, and it had to be the kids. One girl, with an open pelvic fracture, was urinating blood. Somehow, like many others, she didn't even cry, though the pain must have been excrutiating, and a wait for an operating room, an overnight event. Now I'm hoping she'll still be with us tomorrow.

At this point, most of the fractures and lacerations are days old, the maggots and bacteria have set in, and the bone looks dark. Our hope is that by losing a limb we can prevent losing a life, and our emergency room is backing up with post-operative amputations. Of course, this makes it harder to see new patients, and we often discharge them on their first post-operative day. An ER physician might do a fasciotomy or Steinman pin. But here, you’re constrained by resource and logistic issues. The saying that you would treat every single patient as if you were in the US is difficult. Here you can only treat a few. This is what makes this situation unbearable. Being trained to help someone but having so many people tug at your arm, needing an immediate response, and only be able to answer a few.

Anil Menon

Follow all of Healthline's Haiti Coverage:
Anil's First Dispatch: My Journey to Haiti
The World Rushes to Haiti
Celebrities and Schoolkids: Money for Haiti Coming from All Directions
Haitian Health Concerns Grow Due to Devastating Quake
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About the Author

The Stanford Emergency Room is the center of emergency care at Stanford University.