Hello everyone: This Sunday is the first day the hospital has closed the clinic since the earthquake. While driving in to perform hospital rounds I see families walking on the side of the roads wearing their Sunday church clothes. Little girls in white and yellow dresses and little boys in clean white shirts and black pants. Their older siblings and parents are dressed in similar fashion. The clean and colorful clothing stands in stark contrast to the dusty dirty broken cityscape.

The patients in the hospital are doing well. Most are close to going home, but they have no home to go to. Older children from the orphanage brought the daily meal to the patients and their families in the hospital. A plate of brown rice with a few beans mixed in. The meal is bland tasting with a hint of smokiness. Yet it is simply satisfying. During hospital rounds I hear about the limb deformities found yesterday by the medical teams that performed outreach clinics at schools and tent cities. One example is a 7 year old boy with a bent forearm which in most likely an angulated radial and ulnar fracture. These people are expected to come to the hospital clinic Monday. As I finish the paperwork summarizing the past week and describing the week ahead, the orthopedic replacement team makes a surprising entrance. The orthopedic surgeon and 2 ortho physician assistants have arrived from Santa Domingo via overland route. They are tired but anxious to start. After taking them on the hospital tour and meeting the patients, I transferred the service to the new team. I feel relieved, but also a sense guilt that my time at Kings Hospital is coming to an end.

It is decided to take me to the Port-au-Prince airport tonight instead of tomorrow at 0400. This way the morning rush hour traffic can be avoided. Once dropped off at the airport I go through a series of checkpoints manned by US police and Customs officials. My passport is checked numerous times. I filled out all the paperwork, then I am thumbprinted with bright neon red ink. I am no longer a trauma surgeon. I am an US citizen evacuee. As I write this I am sitting in the evacuation holding area. We are mixture of health care providers, rescue workers, and US citizens that live in Haiti. All appear tired and weary. I have been trading stories with another physician whose experiences sound identical to mine. We are told that we will be leaving for Orlando later tonight on an Air Force C-17. When does the plane leave? As they say in Haiti,”we will leave when we leave.”

I will email this when I reach the US. After I get home we will place pictures on the web site over the next few days. As you finish this take a moment to pray for Haiti and her people. It will take years to recover, but Haiti needs more than to recover back to its pre-earthquake state. Haiti and her people need to become self-sustaining for food, housing, and jobs that provide a just wage. If you wish to volunteer in Haiti, there are plenty of ways. They range from delivering food to helping in the orphanages. Search your heart, and act upon what you find.

Albert D Olszewski

Hello everyone:

We arrived at clinic before 8 am this morning but the patients came about 9. It was a busy day for the rest of the morning. I got to see some of my own patients in follow up for dressing changes and wound checks. In addition, there are patients showing up from other trauma hospitals that have already returned back to their home country. One young boy had a hanging cast for a humeral fracture. His father was worried because he wouldn’t walk. As usual the mechanism of injury was that his house fell on him. After a careful examination, I discovered he had a mid shaft tibial fracture that was stabilized by the intact fibula. I placed him in a cast. He will return next week with x-rays taken at an X-ray shop close by. My two year old girl that had the open distal fibular fracture came back for a wound check. Her rotation skin flap is still viable. She did scream and cry as we cut off her cast. After bribing her with some Gummi bears, the screams went silent. Shortly thereafter I met a woman who had a crushed foot injury. It has been cleaned, but still is contaminated with tendons on the top of the foot exposed. She is scheduled for surgery for a washout and attempt to cover the tendons on monday.

I was introduced to Dr Benjamin Nau, a local orthopedic surgeon, today. He described how chaotic his office was immediately after the earthquake. People came directly to his office with severe orthopedic injuries and he did his best to care for the people of Haiti. Today was the first day he could round on his patients that were in the hospital prior to the earthquake. He has a patient that we have scheduled for a washout of his infected open segmental tibial fracture with placement of an external fixator later this week.

Port-au-Prince is still devastated physically, but life is trying to return to normal faster than I expected. Although gasoline is still expensive ($8 US per gallon – down from $20 US/ gal 1 week ago) traffic has returned to having rush hour type congestion. I have watched commerce on the side of the street change from a few people trying to sell sugar cane, potatos, and carrots to whole street blocks of small vendors selling fruit, bread, hot sandwiches, cell phones, and clothing. Early this week children were quiet and sedate. Now they are laughing and playing in the streets. Today is the first day I have seen teenagers wearing their MP3 players and, yes, Sony Walkman CD players. Water is readily available at multiple sources, but hundreds of young people can be seen carrying 5 gallon buckets of water back to their broken homes or tents. Speaking of tents, I learned that the largest tent encampment close to where I am staying has over 50,000 people living there. I suspect that these tent encampments will not go away soon.

At the end of the day I had the opportunity to talk to a young man who was in the university. He described his future in a bleak way. There are no jobs available for the young people. There is no longer a college education system for him to attend. The university buildings has been destroyed. He has no future as an educated man. He sees no future trying to learn a trade. In his own words, he has no future.

Please pray for Haiti and especially for their young people – they need hope of a future.

Albert D Olszewski MD

Hello Everyone:

Different kind of day today. No surgery. There is surgery to be done but no anesthesia. We deferred some surgical cases to other surgical units. I transferred one patient to the U of Miami’s hospital. In order to get her there I was able to contact the 82nd Airborne Division, 2nd Brigade combat Team, Special Troops Battalion for transportation. They are camped out about a mile from the hospital. Capt Torres and 1stSGT Soto and team helped carry the young girl with a femur fracture to a 4WD, drove us to the airport where the U of Miami is located. On the way I noticed that there are tents going up in the Internally Displaced People (IDP) Camps. The 82nd has been delivering tents as well as food to the people in these tent cities, I mean, IDP camps. The IDP camp by the airport houses more people than Whitefish. Once we passed through all the military checkpoints, it was easy to find the U of M. They have a forty thousand square foot circus type tent that is snow white in color. The entrance is through a triage area which was hectic. The docs appeared exhausted. They directed me to the Orthopedic receiving tent. There I had to present my patient to a team of docs that had a stern appearance. I apologized for showing up with a rather simple case but explained our inability to operate, lack of x ray capability, and the fact that this patient has an enormous chance at returning to a normal life if her femur was fixed surgically. In addition, I mentioned my connection to Wilford Hall Medical Center in the Air Force when I introduced myself. The director of orthopedics is David Pitcher an orthopedic oncologist and is a good friend of Ted Parsons, my old partner and professor from my Air Force days. He seemed to lighten up once we had a mutual friend and accepted the patient we brought him and also one other that the 82nd Airborne had mentioned to me that they found in a distant IDP camp the day before. David told me that their C-Arm broke down last night and they were flying in a repairman ASAP. He pointed out the mini tent city they were forming adjacent to the hospital for patients with external fixators that could not go home and required daily care. In addition, I mentioned to him that I had some expensive Wound Vac dressings at King’s hospital. The orthopedic surgeons were interested in this because they had run out of the limited quantities they brought and could use our supplies NOW! This set about a new mission for the 82nd Airborne Hurricane Company. We raced back to King’s Hospital to retrieve mission critical supplies for the “Miami.” Upon returning to the “Miami” we took the supplies to the command center. The people in the command center were not as excited about the wound vac supplies as the surgeons. However, I got their attention when they found an 18 volt cordless drill and light in the supply box. Turns out they didn’t bring one.

Prior to going on my adventure, I did work in the clinic evaluating many wounds and dressing changes. I admitted a 14 yr old girl with a pelvis fracture from her house collapsing on her 2 weeks ago. I also admitted a 34 year old women who is a Haitian nurse from Leogane. She developed a hand infection after the earthquake. This infection became quite aggressive and resulted in an arm amputation above the elbow. Her surgery occurred in Leogone by the Cuban Surgical team. The wound was left open. We have put her on antibiotics and wound dressing changes daily and plan to operate on her to washout the wounds and try to close them on Monday when there is an nurse anesthetist scheduled to arrive.

I’m about to run out of battery power and need to send this now. Say prayers for Haiti – they are getting better.

Al Olszewski