Dr. Paley and his team return to Haiti one year later March 12, 2011

We took the short flight from FL to PauP at 6:10 AM. By 11AM we were already in the hospital. The one hour car ride from the airport to Carrefour revealed many remaining tent cities but far fewer than a year ago. A year ago there were even tents in the median strip dividing the highway while this year they are gone. The presence of the UN is much more noticeable. Armed UN soldiers are seen at the market, the stadium, and along the roads. The hustle and bustle of business, markets, and every day life is seen now but was absent a year ago. The wreckage of houses is still very evident, although the rubble is off the streets. The government buildings remain collapsed. Despite this there is evidence of reconstruction of some houses, but much less than I expected. The hospital grounds were devoid of tents and the hospital seemed much more organized. It was difficult to assess because today is the Adventist Sabbath so little but prayer was going on.

We were met by Amy and Nathan the administrative couple running the hospital. Dr. Terry Deitrich is the orthopedic surgeon in charge. He has been here since November. He is an orthopedic surgeon previously practicing in Wisconsin with a long background of missionary medical work. Previously working in the Dominican Republic, Terry is the surgeon who inspired Scott Nelson (my former fellow and our last year’s host) to volunteer and work there for the past 5 years. Terry and his wife Jeannie are planning to be here till November. Under the concept that we brought an expertise there that was not usually available, the Adventist doctors felt justified for us to start operating today (just as it is justified to pull an ox out of the mud on the Sabbath).

We reviewed 5 patients with a variety of complex pathology before lunch in order to plan for which surgeries to do today. One girl had an untreated severe bowlegged deformity (see pictures) from Blount’s disease. Another had an untreated clubfoot deformity at the age of 17.  Another girl had an untreated complex deformity called posteromedial bowing of the tibia with a lot of shortening of the leg. Another boy had a chronic bone infection. One girl had a residual deformity from a crush injury from last years earthquake and finally one girl had nutritional rickets with bone deformities. Terry told me that about 1 in 5 patients currently being treated has residual of earthquake trauma.

We began operating around 2PM. We completed the bone infection case. There were two areas of infection and I had to remove a huge amount of the tibia to get them out. I believe we cured him. The untreated clubfoot was treated by applying a TSF device. We used a double level device for this very complex correction. Our Smith and Nephew rep brought a lot of the supplies we used and the rest was already here. Dr. Ann Marie James did all the anesthesia today. She did an amazing job. Servando, John, Mark and our fellow Chris Fougere all participated in various parts of these surgeries today. We were assisted also by Ben a resident from Loma Linda and by Dr. Nelson who arrived this afternoon. Finally in addition to our own Smith and Nephew rep Tom,  Jeff an Orthofix rep from California was also here to help us. Great team and great teamwork. We were also assisted by two Dominican staff that had helped Dr. Nelson when he worked there. One in anesthesia and one a scrub nurse.

One challenge was that the C-arm (the image intensifier was broken; Dr. Nelson hopes to have it fixed by tomorrow; he brought special parts and was soddering them in place during the surgery). The two surgeries we did today were done without help from xray. Real third world surgery.

Overall a rewarding day full of teamwork and camaraderie. Great pathology to see and treat and a sense of doing something worthwhile. Amazing that these peaceful undemanding people live with these horrible debilitating deformities and never complain. What a reward to be able to help a few of them.

Dror Paley, MD

 

 

 

 

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