From Terry Dietrich, MD 8/24/10 7AM CDT
Aug 20 The Thedacare Orthopedics Plus Haiti Relief team from Appleton Wisconsin is locked and loaded. The team:
1. Todd Smith orthopedic surgeon
2. Terry Dietrich Orthopedic surgeon
3. Jeannie Dietrich RN Trip coordinator
4. Jodi Zimmerman RN
5. Becky Czechanski RPT
6. Kristen Daniels RTRM
7. Hannan RTRM
8. Trent Jerzinski Health Care engineering/construction specialist
9. Ed Mueller Linvatec representative arthroscopy equipment specialist
We have included a wound specialist, JanKlass, from San Diego as well as an anesthesiologist, Karl Eckhardt, from Walla Walla, Washington. Both are high priority for the types of patients that are cared for at the Hopitale Adventiste d’Haiti.
This team was formed to respond to the orthopedic needs of the people of Haiti in the aftermath of the devastating earthquake of January 12. The site for our work will be the HAH. This small mission hospital in a suburb of Port as Prince was developed in the weeks following the earthquake to care for the many patients with fractures and other orthopedic injuries. Dr Scott Nelson was the first orthopedic surgeon to arrive in the city just 24 hours after the earthquake. He decided after assessing the medical facilities to focus on HAH as the best site to provide orthopedic care. No orthopedic surgery had ever been done at HAH before the earthquake. In the past 7 months, he has done a remarkable job of developing the orthopedic capabilities of HAH. It is now regarded as THE referral hospital for orthopedics in the entire country. Many of the patients that are cared for there are victims of the earthquake with residual infections and/or deformities that were unable to be treated in the chaos following the disaster. Many patients with orthopedic injuries that have occurred since the earthquake are now also treated at HAH.
The goals of the team are:
1. Provide orthopedic care for Haitians
2. Develop an arthroscopy capability for HAH (the first such program in the country)
3. Assess the physical needs of the hospital.
4. Develop strategies for raising funds to support costs of providing orthopedic care for indigents.
Dr Nelson and other volunteer orthopedists have been inundated with orthopedic cases especially in the indigent population. There is a huge ongoing need for volunteers to continue to provide this care. The government orthopedic hospital is largely limited to treating the patients with acute trauma. Their resources are limited. Arthroscopy will increase the range of orthopedic services and bring a modern orthopedic capability to the country. The Hospital physical plant has major needs. The operating rooms are very small making it difficult to accommodate the equipment necessary for modern orthopedics. Storage space is hopelessly inadequate.
All team members plan to spend the night near the airport in Chicago. We leave at 9:20 tomorrow.
Aug 21 The trip to Haiti had some anxious moments. We arrived at the airport before 7 am. We were informed that the maximum number of checked bags per person is 2. The Website indicated 3. We were able to repack and use the overweight allowance of 70# for 3 of our bags. We had a very helpful AA desk agent named Eli Ortega. Jan met us in Miami. Karl arrived in Port au Prince yesterday. There were 3 other AA planes on the tarmac when we touched down. Baggage claim was near total chaos. All of our luggage made it in good condition. The hospital contact got us to the vehicles and secured the luggage. It was a fairly long walk. On our trip through the city, it appeared as if there has been virtually no work done to remove the rubble or rebuild. It really leaves an impact to see the incredible amount of destruction in the city and the piles of rubbish and the tens of thousands of tents. We met with Nathan and Amy at the hospital and gave the group an orientation. We are anxious to start seeing patients and putting our new equipment together and start using it.
Aug 22 The forecast was for a light day. We started with morning report at 7:30. We just finished our last case n the OR and it is 10 pm. We have 6 cases on the schedule tomorrow including a man who came in to the ER with fractures of the tibia, femur and proximal humerus. The C-arm gave us grief today and wouldn’t boot up. We are hoping we can get it figured out by tomorrow. Ed got all of the arthroscopy equipment unpacked and is anxious to start using it. Ben scrubbed in on some cases and was a big help. The whole team has jumped in with both feet. It is a great team to be a part of.
Aug 23 As expected, the ortho clinic was huge. Scott managed it pretty much by himself while Todd started the first case in the OR. I made rounds with the rest of the team. Our patients are doing well except for the patient with the multiple fractures. His hemoglobin was 6.0. We asked for blood and are still waiting. Meanwhile, his Hgb has dropped to 4.7.Since malunions and nonunions are treatable, we have decided to not operate until blood is available. We did a lot of cases today and finished by 8:30. They all went well even though we don’t have a C-arm to check our reductions. We might have to make some adjustments to some of the fractures. We ran 2 rooms a good share of the day. It is great to have 2 anesthesiologists. Jeannie has been spending a lot of time with Lucia learning how to set up the OR and how everything is organized. We used the new drill/pin driver on 2 cases today and it works great. Ed scrubbed in and assisted Todd on an ORIF of an elbow fracture. Ben helped me on several cases. It is really fun working with these guys. Trent made contact today with the Haitian student. I don’t know what happened with that yet. I am sure that tomorrow will bring more new challenges.