Haiti Photos
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A patient in the "ICU" of the University of Miami
tent hospital at the Port au Prince airport is
evacuated by helicopter to Miami for care of a
suspected subdermal hematoma. Imaging is not
available on site for verification the first and
second week after the quake.
Local store in downtown Port au Prince en route to
refugee camps of Petionville. More than 1/3 of the
buildings on this street were destroyed.
Tents where many of us stayed 200 meters from the
University of Miami tent hospital at the airport,
approximately 25 min drive from General Hospital.
Dermatological disorder of undetermined origin on
upper extremity found on various parts of body of
majority of children and adolescents in refugee
camps.
Similar vesicles to previous photo, also on upper
extremity, more linear in appearance, pt denies
itching or pain associated with vesicles.
Makeshift clinic outside for refugee camp at Delmas
38, Haitian translator (Teresita) on left, Yanori RN,
CRNA, in background, Mateo RN in middle with
local children curious to see medical attention at
their camp for the first time.
Sunset of a long day at the refugee camps, now
overlooking the capital from the site of the Hotel
Montana. Pictured: Teresita, Mateo, Bonny, Dr.
Smith, and Yanori.

                  A Small Piece of Haiti
                          as seen by
                      Mateo Gennette RN

      Having arrived to Port au Prince
approximately 10 days after the quake through
Santo Domingo by bus, I was never prepared
for the lack of organization found on the
ground. Walking to the airport looked like an
old Vietnam War movie where helicopters and
military planes landed and took off moments
apart. Meanwhile thousands of people formed
throngs in the streets attempting to enter both
the airport and the industrial center where the
Red Cross was setup.  Entrance was fast and
easy for those with foreign passports, quite
challenging for what the military called the
native population.
      Once inside the airport, I immediately
found the University of Miami tent hospital and
got straight to work.  Even MacGyver would
sweat in this place. No electricity, no
supplemental oxygen, very few medications
initially, no dialysis, very limited equipment in
every way. The first few days I saw many
trauma patients just having found medical
care, by the end of my two weeks the
transition was being made to more chronic
care conditions. What did not change was the
lack of nurses. Doctors, doctors everywhere,
but not enough nurses for medication
administration, non-existent vital sign
documentation, severe lack of specialized
nurses in the areas of critical care/emergency
/community health.  Many of the surgeons
brought their own nurses from overseas, but
their were more than enough hands in the
OR's.
       Most of the critical patients were flown
out to Miami for care that could not be
provided in the capital, including our pediatric
patients with tetanus and C-spine fracture
patients.  Many more received amputations,
often of multiple limbs where we discharged
them home with directions to follow up at a
clinic we hope one day would exist and
without the crutches or wheelchairs they
needed, but we did not have.
      Even having lost homes, family, jobs, and
health, the people celebrated hope at every
opportunity. My first night one of my patients
delivered her first child, a boy, to the applause
and singing of the hundreds of patients in the
tent.  After having helped deliver babies in
elevators, cars, sidewalks, and parking lots
here in the states, I still remain overwhelmingly
impressed with the delivery of that child,
Jefferson.  
      Many people ask if the experience was
traumatic for me, seeing the amputations and
injuries, dead bodies, etc.  Honestly, it was
not.  No worse than what is found in Brasil, El
Salvador, or many of the urban areas high in
trauma in the U.S. The acuity was not
impressive so much as the quantity of sick and
injured was.  The patients in the hospitals I
attended to seemed to have at least some
small hope in the way they spoke to you.
      In the refugee camps it was often a
different story. Fighting broke out frequently in
front of us over water or food (though all were
orderly about receiving medical attention). As
each day went on the situation became more
desperate as the few strong men hoarded the
hastily-dropped food and water supplies,
leaving most of the refugees to search
elsewhere.  Combine this with pre-earthquake
stockpiles having run out and the military
halting many supply drops until the security
could first be established and you get a people
who do not know how or if they will survive.
      There was of course a minority who lost
less in the earthquake and those fortunate
enough to be sent to the Dominican Republic
or Miami for medical care.  The stories of thos
fortunate few I only glimpsed briefly at the
national hospital in Santo Domingo.
      The international community did an
impressive job at coordinating
multi-disciplinary care at the General Hospital
in Port au Prince, as the Swiss ran the
pediatric units, the Norweigans ran the skin
graft unit, and the French an OR for
amputations and sterile dressing changes
QOD.  The Americans ran the ER, several
OR's, the pre and post-op units, as well as the
critical care unit.  During my time there this
was overseen by the International Medical
Corp, and I was told Johns Hopkins was
coming in to take over shortly thereafter.  
      Aside from the care we provided, I would
have to say one of my favorite things about
the teams I worked with was the humility.
Everyone, including doctors, were on a first
name basis and whether you were a
translator, transporter, CNA, RN, or
self-proclaimed deity, you looked all in the eye
with the same level of respect and
appreciation.  VIVE LA HAITI!!!!