February 3, 2010
Haiti 2010 © Ron Haviv/VII
Dr. Philippe Touchard, an anesthetist, is head of emergencies at the Pasteur Hospital in Langon, near Bordeaux. Forty-eight hours after the January 12 earthquake, he flew to Haiti to reinforce MSF’s surgical teams in Port-au-Prince. Here are exerpts of his journal of this short mission.
Day 1, Wednesday, January 13: Just a few hours to decide
We leave by foot, in the heat, picking our way through the rubble. I cross this familiar city, and I have the impression, six days after the disaster, that it seems strangely normal. Life has re-started, the streets are full of people, traffic jams. There is neither silence nor cries, just the hum of city life. Then I see the collapsed houses, crushed under the weight of their roofs. In the streets, passers-by ask us for masks. They say they are scared of epidemics, but probably they also want to escape from the corpses smell. They ask what we’ve brought, and they are disappointed to learn it is a hospital. They want food. On arrival at Trinité hospital, I see for myself why it was so urgent to get the inflatable hospital through.”
It’s complicated and frustrating not having all the equipment at hand. I saw a tetanus case, a child of 10 years old. She was convulsing on the first day, and stiff, with spasms, by the second. Tetanus is hard to treat if you're not properly equipped. You need to administer a sedative to relax the patient, and then monitor her really closely, as her breathing can stop. This patient was on oxygen, and we monitored her as best we could, but it was a hit-and-miss affair. We needed a properly equipped intensive care unit, where there weren’t so many risks. The worst, the most annoying thing, was that we had breathing apparatus in the cargo plane, but as we’d been delayed, it wasn't yet installed. I heard afterwards that the little girl had been transferred to another, better equipped facility, so she’s sure to still be alive”.
All the medical staff has the right reflexes, which is hugely precious in massive emergencies like this. For example, when a patient refuses an amputation, we leave the Haitian Trinité medical staff to explain why the procedure is necessary, to reassure him or her. They soon bring patients around to the idea, speaking to them in Creole. As Trinité was a trauma center, we'd already dealt with this type of situation. The staff is trained to take the patient’s consent into consideration and manage this sort of difficulty. We also set up systematic vaccination against tetanus in the casualty unit, integrating protocols into the care, which means that despite these horrendous conditions, we can maintain medical quality.
I’ll go back before the year is over. There’s so much work left to do. The trauma center was already busy before the earthquake, so just imagine it now. When I was crossing Port-au-Prince, on my way out, I noticed that nothing seemed to have changed compared to when I arrived. No tents, people were sleeping outside, in public parks, in the streets. No or few distributions, the inhabitants were still hunting around for food. And at the airport, 100 metres or so away from the town center, I saw row after row of aid supplies, still sitting on the tarmac. This aid had reached Port-au-Prince.”
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)