AMHENY.org

Report from the Field by Daniel Laroche, MD

The Empire State Medical Association is working with the Association of Haitian Physicians Abroad (AMHE,) to deploy physicians, nurses and medical personnel to provide medical relief to Haiti. AMHE has deployed nearly 410 physicians and nurses to Haiti thus far. The current updated needs are as follows: (updated 3-1-10)

1)Currently AMHE Medical relief missions are 1-2 week rotations from Saturday to Saturday. Flights are now available directly into Port au Prince. Lodging is at an orphanage at Delmas 75 called The village. Another lodging location will be at the Quisqueya secondary school in Delmas. There will be a minimal fee for accommodation $75.00 US for the week. If you decide to go please register with the state department at . Specifics are given via conference call two days before departure. To register please go to www.amhe.org.
We are compiling photos of our physicians affiliated with ESMA/NMA whom have gone to Haiti with AMHE. If you have photos of yourself delivering care in Haiti please email to myself at
dlarochemd@aol.com.
2) Report of Alain Bertoni ,MD MPH , to Dr. Eric Jerome,
I wanted to submit a few words upon my return from Haiti. I went through Project Medishare/ University of Miami. I spent 5 days working at their field hospital adjacent to the airport. As an internist, I saw the vast medical need of the people, beyond immediate injuries sustained as a result of the earthquake. Decompensated heart failure. Diabetic leg infections. Asthma exacerbation. Stroke. Acute renal failure. Malaria. Tuberculosis. HIV. Sickle cell chest crisis. Less immediately life threatening issues were common- it seems all of our patients were anemic. New injuries, indirectly related to the earthquake- many motor vehicle related injuries, people being hit by cars, because they are living in the streets. Mental health needs- likely schizophrenia, along with depression/ grief reaction. A teenager refusing an amputation because he wants to join his parents in death- he feels he has no one, no reason to live. Some of these problems are not new, and the resources for these patients before the earthquake were not often there. As an epidemiologist, I saw the potential for much more suffering. The malaria and TB issues are only going to get worse, as people are living crowded together in tent cities/ on the streets. Even within the hospital/tent city, vast open wards are concerning for infection control. Diarrheal illnesses. Tetanus. The need for shelter, sanitation, and preventive efforts is vast.
My political science background also affected my observations. Two different patients independently told me that they were better off during the Duvalier years. One of them told me this after I asked him to stop calling me “Baby Doc”- he insisted I looked a lot like him (OK, maybe I am light skinned and heavy set.. but still!). One of the transporter guys told him now was not the time for politics, and not to insult the visiting doctor. I overheard conversations about Aristide too. I recalled my grandmother talking about how things worked better during the Occupation. My political side thought simply this- Haitians need a government that works, and need to stop recalling fondly the past, simply because the present and future continue to be so bleak.

It was perhaps as a Haitian American that I felt I contributed most. My ability to speak French, English, and even Spanish, served me well in communicating with the staff, volunteers, doctors, and patients. I realized I understood more Creole than I had appreciated, once I was hearing it again all the time. I leaned a few key phrases to start people talking- “Sa kap fe ou mal?” and listened to the response. The patients seemed quite pleased that I was trying to speak with them, even if they were a bit skeptical that I was really Haitian. I was fortunate to have worked with several Haitian-American nurses who were volunteering, along with Haitian nurses and doctors, who had come to the Field Hospital to serve. I do believe that the case of malaria I diagnosed was because I of my ability to communicate well. The Haitian nurse told me a patient, already being treated for 2 days, was not doing well, and asked me to evaluate her further. I took a careful history with the assistance of a translator, but French to Creole, rather than English to Creole; and I could understand most of the patient’s and her husband’s replies. My clinical impression was that malaria was a possibility, and indeed the smear revealed that to be the case. I spent a lot of my time out of the hospital wards on the grounds of the hospital, speaking with the guards, translators, children. Many have no homes to go to when they leave the complex at the end of the day. They sleep under a tarp, or just on a bed roll. I will not easily forget one conversation- a translator wanted to see if he could get an official badge like mine. He had his name and role on a piece of tape attached to his shirt. I asked him why he wanted one- and he said “Dignity”.

Haiti, you have suffered an incomprehensible tragedy. I admit to having been afraid about what I would encounter. I know that there is not great security. I know the history, the problems of corruption, distrust. And yet I see that others, from all over the US, Canada, and indeed beyond, are donating money, and even traveling to Haiti to try to help. To your sons and daughters abroad, now is the time to help. Doctors, nurses, physical therapists, rehab specialist. You will be appreciated. If your specialty is public health, engineering, construction, organization- you can help too. Don’t speak Creole--- Pas de pwoblem. It seems Haiti is full of young people who can serve as translators. The challenge is ENORMOUS. I wish, that 25 years from now Haiti is on a different level, and that this earthquake was the pivot. That is the only thing that keeps me from being terribly sad for what has transpired so far in 2010.

Respectfully,

Alain Bertoni MD, MPH.
3) There continues to be large nursing needs. Please see comments from:
Nurse Maggie Lazarre RN states:My observations which I have already shared with the group on the bus:

be sensitive to the staff working there…they need the help but need to be approached with great care..we can’t come in and take over
we need to be open to assist wherever the needs may be ( the ER is almost always short…I only saw 2 Haitian doctors there and one Haitian nurse)
bring supplies i.e stethoscope, BP cuffs, thermometers, glucometers, pain meds (IV), Tylenol suppositories, malaria testing kits, gloves, wound dressing supplies or whatever supplies you identified for your area4)We recommend at all subspecialties of medicine and surgery, etc. work with Association of Haitian Physicians In Haiti, Association of Haitian Physicians abroad www.amhe.org , the National Medical Association Subspecialty sections www.nmanet.org, and National Subspecialty Academies. This collaboration will help provide the manpower to assist Haiti in its recovery and will all the private business community to assist with much need supplies and equipment. The above collaborations will hopefully help direct the efficient flow of supplies and manpower to the needed areas.

5) If you plan to travel to Haiti Please visit the CDC link below to prepare for your trip. MUST READ
http://wwwnc.cdc.gov/travel/content/news-announcements/relief-workers-haiti.aspx
6) The ESMA continues to collect financial donations for shipping medical supplies for healthcare in Haiti working with Please continue to give contributions to: Empire State Medical Association, Haiti medical relief, 49 West 127th Street, NY, NY 10027
All contributions go directly to earthquake relief with no administrative fees
deducted from your contribution. All of the officers and members and supporters
are Physicians, nurses and supporting medical personnel and supporters whom are not compensated and volunteer their time to improve the health of the Haitian people.
7) Medical Supplies Needed
Manual OR Tables
Exam Table
IV Poles
Wheelchairs
Sterile as well as regular gloves
Antibiotics (cephalosporins, cillins, cleocin, etc.)
Skin-graft equipment (dermatome, blades, mesh.)
Oxygen
Surgical packs
Surgical drapes
Surgical blades
Iodine
Alcohol antiseptic
Hand sanitizer
Respiratory masks
Iv starter kits
Ringers
Topical antiseptic
Casting materials
Cotton
Betadine
Gauze
Bandage
Tape
Topical wound care (Silvadene, bactitracin, or Neosporin, ointments, xeroform, etc.)
Sterilizing equipments
Cauterizing equipment
Staples
Staple removers
Sutures (all sizes and types… nylon (ethicon) 2-0 3-0 4-0…
Vicryl 2-0 3-0 4-0…. Chromic 3-0 4-0 2-0; Prolene 6-0 4-0 3-0 2-0 , 8-0, 9-0, 10-0,etc
Instruments
Trays
Plastic trays
Pain meds
Local anesthetics
Syringes
Needles
Fiberglass splint materials
Cast materials
Cast cutter tools
IV fluids
IV lines/starter kits
Tapes
Chest tubes
Tents, bedding, pillow, cidex, garbage bags
Our Contact in Haiti is:
Attn Bridgette Hudicourt MD, Caritas Haiti: 31, Delmas 65, Port-au-Prince, Haïti
Tél(s) : (509) 22461690 / 28131690
You may also ship items directly to Port au Prince with A and S Transport Cargo Inc.
96-09 Springfield Blvd, Suite 210a, Queens Village NY 11429. They will come to your office to pick up boxes to bring to Haiti door to door. There telephone numbers are 718-217-1618.646-296-0882, 917-586-8244. Ask for Alix and Smith. Depending on the size and weight they will give your cost of shipment.
8) To purchase medical supplies at a lower price you can use doctodock.org website. DoctoDock Address: 300 Douglass Street, Brooklyn, NY 11217, phone 718-852-0655. Dr. Brenda Aiken is coordinating this effort and can be reached at: ba220@columbia.edu
Antibiotics can also be purchased at Map International MAP INTERNATIONAL
Telephone: 800-225-8550 / Fax: 912-280-6638
4700 Glynco Parkway, Brunswick, GA 31525.
The Empire State Medical Association has been registered with MAP.
Web link is: http://www.map.org/site/PageServer?pagename=travel_Map_Travel_Pack
9) Please encourage community groups and churches to collect,
bottled water and clothing, and first aid supplies and SEND relief in BARRELS to:
Tents, Water, Rubbing Alcohol, shoes,
PERSONAL HYGIENE GOODS:
• Toothpaste and tooth brushes
• soap and deodorant
• sanitary napkins
• brand new underwear - adult (small & med.) and children sizes
DRY FOODS & OTHER ITEMS:
• Nutritional bars, fruit & nut bars, cereal bars • Tea Light candles & quality batteries (AA & D) Paying for the shipping will ensure it gets there. Try to avoid canned food due to increased weight and disposal difficulties, and difficulty opening cans in the current environment (this is a change from our previous recommendation.
All donated material can be mailed to :
Attn Bridgette Hudicourt MD
Caritas Haiti: 31, Delmas 65, Port-au-Prince, Haïti
Tél(s) : (509) 22461690 / 28131690
You may also ship items directly to Port au Prince with A and S Transport Cargo Inc.
96-09 Springfield Blvd, Suite 210a, Queens Village NY 11429. They will come to your office to pick up boxes.
Thanks in advance for all whom have supported and continue to support. Please forward
to other supporter and enablers.
Daniel Laroche MD
President, Empire State Medical Association www.nyesma.org,
NYS affiliate of the National Medical Association www.nmanet.org
Member, AMHE www.amhe.org
Director, Glaucoma Section, National Medical Association
Member, American Academy of Ophthalmology
Member, American Glaucoma Society