{"id":218656,"date":"2010-01-19T16:37:27","date_gmt":"2010-01-19T21:37:27","guid":{"rendered":"http:\/\/news.harvard.edu\/gazette\/?p=35250"},"modified":"2010-01-19T16:37:27","modified_gmt":"2010-01-19T21:37:27","slug":"medical-workers-gain-momentum","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/218656","title":{"rendered":"Medical workers gain momentum"},"content":{"rendered":"

A week after an earthquake devastated Haiti, Harvard University<\/a> affiliates have ramped up a combined medical and surgical aid effort in the battered island nation that is larger than that of any nongovernmental organization.<\/p>\n

The logistics required to coordinate medical assistance that broadly and quickly is likely to provide a helpful template in the future for harnessing the power of academic medicine to meet the demands of major disasters, officials believe.<\/p>\n

Fifty medical and surgical personnel have been deployed in Haiti in the last week from Harvard-affiliated hospitals. Harvard teaching hospitals have sent planeloads of medical supplies, including surgical and anesthesia equipment. More surgical teams are lined up to depart for Haiti Wednesday (Jan. 20).<\/p>\n

Partners In Health<\/a> (PIH), a not-for-profit Harvard affiliate, has taken the lead in University-related medical aid. The group, co-founded by Paul Farmer<\/a>, the Maude and Lillian Presley Professor of Social Medicine at Harvard Medical School<\/a>, operates nine medical sites in Haiti and has had a presence there since 1985.<\/p>\n

PIH has seven operating rooms at the University Hospital in Port-au-Prince, where 1,000 patients await surgery. The agency has been shuttling patients to other medical facilities in the rugged Central Plateau, two hours away, and has just opened a treatment center outside Port-au-Prince, the Haitian capital, with three more operating rooms.<\/p>\n

The Harvard School of Public Health<\/a> (HSPH) and the Harvard Humanitarian Initiative <\/a>(HHI) are providing leadership for the United Nations \u201chealth cluster\u201d and a U.N. field hospital. Such U.N. health clusters coordinate government, nongovernment, academic, and private organizations during medical emergencies.<\/p>\n

For the next week or two, \u201csurgical needs will dominate,\u201d said HHI\u2019s co-director Michael J. VanRooyen<\/a>, who is helping to coordinate Harvard\u2019s medical resources bound for Haiti.<\/p>\n

Amputations and wound debridements are common, and crush injuries and infections are a major cause of mortality.<\/p>\n

Among the Harvard affiliates helping to send medical and surgical teams are Brigham and Women\u2019s Hospital<\/a>, Children\u2019s Hospital Boston<\/a>, and Massachusetts General Hospital<\/a>.<\/p>\n

After the initial response, VanRooyen said, the challenge will be to create temporary housing for the displaced, nurse the injured, and provide post-operative care.<\/p>\n

Large numbers of those who were displaced in Port-au-Prince, he said, \u201care living in the rubble.\u201d<\/p>\n

The Haitian carnage is different from most earthquake disasters, said VanRooyen. It happened in a large city, where crushing injuries are a huge factor, but where surgical facilities are close by.<\/p>\n

Harvard\u2019s medical authorities on the ground have begun to get word out on the conditions they have found in Haiti, despite spotty cell phone service and limited access to e-mail. Some physicians already have rotated through the country.<\/p>\n

Stephanie Rosborough<\/a>, an emergency physician and disaster relief expert at Brigham and Women\u2019s, was in Miami today (Jan. 19) after five days at a U.N. compound medical clinic in Port-au-Prince. Later today, she will be on a plane to the Dominican Republic, and will travel overland to Jiman\u00ed, a town on Haiti\u2019s eastern border. There, Rosborough will help set up a post-operative medical camp.<\/p>\n

She had arrived in Port-au-Prince last Thursday (Jan. 14) from Santo Domingo by helicopter, a vantage that revealed the enormity of the destruction in the capital, where structures collapsed \u201clike stacks of pancakes.\u201d In the city, water was scarce even for doctors and other medical staff, said Rosborough. Everyone slept in or outside the same two vast plastic tents housing 150 patients at the U.N. compound.<\/p>\n

One day, she said, doctors performed 14 amputations using ketamine, a common drug for field surgeries, to anesthetize the patients. Crushing injuries, broken bones, and infections \u2014\u00a0even gangrene \u2014 were common, said Rosborough, a Cambridge resident who is director of the International Emergency Medicine Fellowship at the Brigham.<\/p>\n

Many Haitians \u201chave lost everything they have,\u201d she said, and now many face life without limbs, or without family. \u201cIt\u2019s heartbreaking.\u201d<\/p>\n

Evan Lyon, a resident in internal medicine at the Brigham, spent his first 12 hours in the capital city last weekend assessing the need for emergency medical care.<\/p>\n

\u201cBeyond the horror,\u201d he wrote of his drive through Port-au-Prince Sunday, \u201cone striking reality is that things are totally peaceful. We circulated \u2026 \u00a0in the middle of everything until just now. Everywhere. No U.N. No police. No U.S. Marines and no violence or chaos or anything. Just people helping each other.\u201d<\/p>\n

Lyon, once a teacher in Port-au-Prince, split his time for the last year between Boston and Haiti\u2019s Central Plateau, where PIH has eight community-run clinics collectively called Zanmi Lasante.<\/p>\n

Jonathan Crocker, an internist at Beth Israel Deaconess Medical Center in Boston, another Harvard affiliate, arrived at Zanmi Lasante\u2019s flagship clinic in Cange on Sunday, and posted his impressions the next day.
\n\u201cPatients are dazed,\u201d he wrote of the growing flood of wounded arriving from the capital. \u201cThe disruption to their families and lives is beyond description. Many of our injured patients are not mobile, have few resources, have no home to return to, and many have lost their entire families. We care for their wounds. We listen. We grieve with them.\u201d<\/p>\n

\u201cAll Harvard hospitals continue to communicate closely with each other around
\nissues relating to supplies and material support for PIH and other efforts,\u201d according to the HHI Web site. \u201cThe level of coordination is a strong testimony to the solidarity of the Harvard system in support of Haiti and our partnering organizations providing relief.\u201d<\/p>\n

PIH surgical teams are working in Cange as well as at the University Hospital in Port-au-Prince. PIH has become one of the largest medical and surgical nongovernmental organizations and one of the lead agencies for civilian humanitarian assistance in Haiti.<\/p>\n

Security and safety remain key concerns, but so far Harvard-affiliated medical personnel in the field report that Port-au-Prince has been generally peaceful, that logistics are improving, and that health workers are safe and well.<\/p>\n

As Lyon drove through Port-au-Prince in search of urgent emergency cases, he passed the city\u2019s main central park, where almost 50,000 people were sleeping at night.<\/p>\n

\u201cIt was almost silent,\u201d he wrote. \u201cPeople cooking, talking, some singing and crying.\u201d<\/p>\n

Despite hundreds of injured people lying on the ground, with \u201copen fractures, massive injuries of all kinds,\u201d he wrote, \u201cpeople are kind, calm, generous to us and others.\u201d<\/p>\n

But the stench of death was everywhere, wrote Lyon. \u201cThe city is changed forever.\u201d<\/p>\n

Lyon oversaw the evacuation of four patients to U.S. hospitals, who may be the first Haitian nationals to leave for care in the United States, he said.<\/p>\n

Crocker wrote that the Cange operation is \u201cincredibly busy,\u201d especially as the wounded have begun to develop complications, especially sepsis and venous blood clots from immobility and trauma.<\/p>\n

\u201cThe Haitian medical staff of Partners In Health\/Zanmi Lasante and survivors of the quake are working with unimaginable valor and dedication, as many of them have lost several or most members of their family,\u201d he wrote. \u201cAnd yet they remain here, working tirelessly to provide care for others. They are the true heroes.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

A week after an earthquake devastated Haiti, Harvard University affiliates have ramped up a combined medical and surgical aid effort in the battered island nation that is larger than that of any nongovernmental organization. The logistics required to coordinate medical assistance that broadly and quickly is likely to provide a helpful template in the future […]<\/p>\n","protected":false},"author":4175,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-218656","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/218656","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/4175"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=218656"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/218656\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=218656"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=218656"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=218656"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}