Vol. 12 No. 8 - March, 2010

Notes from Haiti

Janet Fraser Hale reports on her recent experience as a member of a medical relief team

haiti hale
Janet Fraser Hale PhD, RN, FNP, associate dean for academic affairs and director of interprofessional partnerships for the GSN, and Michael Kneeland, MD, associate dean for allied health and interprofessional education for the School of Medicine and DNP faculty member in the GSN, living out their interprofessional titles in the administration of parasite medicine.

I was honored to be asked by Dean Paulette Seymour-Route to go with the interprofessional team of physicians from UMMS and UMass Memorial Health Care that was put together by Terry Flotte, MD, dean of the School of Medicine, provost and executive deputy chancellor, with assistance from Associate Dean for Allied Health and Interprofessional Education Michael Kneeland, MD. The purpose of the trip was to provide primary care services to small camps (1,000 tents or fewer) of displaced Haitian families in the Delmas section of Port-Au-Prince.

The people of Haiti
We all fell in love with the people of Haiti. Those for whom we cared had little before the earthquake and now have even less, and are coping with the loss of family members and friends. We were inspired by the human spirit and the resilience of the people we cared for. They were appreciative of anything we provided—care, vitamins, antibiotics, immunization (tetanus) and parasite medicine as well as food and water when it was available. We were saddened that people’s desperate need for food and water was sometimes interpreted by others as violence. We were impressed by their gentleness, their faith, their smiles and their continued hope in the face of the devastation and loss surrounding them.

Nursing
Two nurses, including myself, accompanied the team of 13 physicians from the departments of family medicine & community health, emergency medicine, orthopedics, internal medicine and pediatrics. The other nurse, Debrale Murphy, wife of Peter Murphy, MD, assistant professor of pediatrics, who was also part of our team, was a terrific resource for us all. She is a very experienced, compassionate nurse who demonstrated every day the essence of all that is good about nurses. She and Peter had previous experience with providing post-disaster care, including  the Asian tsunami of 2004, and had been on a number of previous medical relief trips to Haiti and other locations.

Upon arrival in the Dominican Republic, we were joined by other professionals from the Good Samaritan Hospital in La Romana. We traveled together to Haiti the night we arrived. The team was led by another remarkable nurse, Kristy Engle, RN, a pediatric nurse practitioner who has dedicated her life to caring for people in Haiti as well as to the Haitians who work in the sugar cane fields in the Dominican Republic. Kristy ensured our protection as she guided us to what she had been told were small tent camps (some had grown to more than 2,500 people) that had not received care since the earthquake occurred.

The first day in Haiti, Kristy essentially told us that we would all go by first names, that we didn’t need to know titles or other roles, other than profession and expertise, and that she was in charge. She explained that this is the only way she could assure our safety and ensure the best utilization of our collective talents. She received no arguments from us, particularly after we saw her ability to get our trucks escorted to the camps by the local chief of police of our area, her fluency in multiple languages and her knowledge of the politics and the culture of Haiti. We marveled at how she negotiated a replacement for our broken-down bus in the middle of the night while we were en route to Haiti; how she managed the reconstruction of the retreat house where we were housed; and how she fed and transported us as a team wherever we went.

Kristy had relationships with the field hospitals and the limited Haitian hospitals in case we needed to refer one of our patients (for instance, a baby with a fractured skull), or needed some additional supplies or medications. She was a master negotiator and knew how to barter with supplies and medical talent to get what we needed, and to provide return services and extra supplies to others in need of them. Without her connections, political clout, expertise and other numerous talents, we would never have been able to provide all of the health care that we did in an efficient and effective manner. She ensured that we did the greatest good to the greatest number possible.

Working together

The group bonded quickly and no task was too menial. The doctorss, nurses and EMTs would jump in to an area of need, be it providing primary care, orthopedic care or wound care; acting as pharmacy techs, care givers, counselors, laborers, ultrasound techs, x-ray techs; participating in immunization clinics or administering medications to more than 1,000 displaced Haitians living in the four tent camps we served.

We were blessed to have a Haitian pediatrician from UMMS with us. Onesky Aupont, MD, MPH, PhD, assistant professor of pediatrics, shared information about the Haitian people and culture and supported us in our disbelief at the expansiveness and depth of the destruction, devastation and lack of food, water and health care. He helped us provide the best care we could with limited resources, equipment and other than basic supplies and medications. He never let us forget why we were there and the value of what we were doing for the people of Haiti. Whenever he would speak to us as a group to express his appreciation, there was never a dry eye. He was an incredible inspiration for us and we all felt, not only our own pain, but his in terms of the losses and challenges he faces personally, professionally and nationally for his country.

A note of thanks

Dean Flotte and Dr. Kneeland put together an amazing team for this trip. They provided us with leadership and monitored our health and safety throughout the trip. We all agreed that we would welcome the opportunity to go back to Haiti, or to any other area in need of medical relief, with this team of dedicated professionals. Other members of the team who selflessly contributed expertise, friendship and support were John Broach, MD, MPH; Matthew Collins, MD; Joseph DiFranza, MD; Jeremy Golding, MD; Katherine Harrison, MD; Mariah McNamara, MD, MPH; Christine Purington, MD; Alexandra Schultes, MD; and John Wixted, MD. Our families, our colleagues, our students and our patients are to be applauded for supporting our participation in this medical relief experience.

Bob Beck and his wonderful team of volunteers from First Church in Sterling, Mass., including GSN faculty member Sandy Leiby and Graduate Entry Pathway nursing students, also worked quickly and tirelessly to package the drugs and supplies donated by UMass Memorial Health Care and other area facilities into our 30 duffle bags.

We sincerely appreciated the behind-the-scenes work of Michele Pugnaire, MD, professor of family medicine & community health, Dr. Flotte’s chief of staff, Lisa Beittel, as well as Kiger Lau , administrative coordinator in the Office of Global Health and the many others who made sure the trip came together so perfectly with little notice and time for preparation.