Fort Bragg, Calif. — April 6, 2010 – Earlier this year, over the period of several months, a number of Mendocino Coast District Hospital physicians and nurses volunteered to help provide desperately needed healthcare services, under extremely challenging circumstances, to earthquake victims in Haiti. Individuals who volunteered were: Larry Burchett, MD, Vivian Daniel, RN, Tricia Ferguson, RN, Jason Haefeli, EMT, Jane Jenab, MD, Cauckwell, RN, Jennifer Surber, MD, Anita West, RN, and Cyndee Wuoltee, RN.
A number of the volunteers posted blogs and took pictures, some of which we’ve shared as part of this article.
As part of the relief effort, the Mendocino Rotary Club donated $1,000 for medical supplies.
In the Q&A below, Jennifer Surber, MD, MCDH Emergency Room physician, shares her experience.
What was your role in organizing the MCDH team? Was it a team, or was it a number of individuals who went at different times, and worked with different groups in Haiti?
I have to say that my role was defined for me as I went along. In the beginning, it was just me
going down to Haiti to help out after I heard about the earthquake. I asked the hospital to donate some supplies, and as a consequence more and more people knew that a local doc was going down there, and word got around. As I talked about it with coworkers and friends, I think people began to realize that they too could help. So, by virtue of having been the first to go of many people in my little world, I became the source point for those who also wanted to go.
MCDH did not have a formal team going; rather it just happened that after my trip, another two docs (Jane Jenab and Larry Burchett) decided to go and coordinated their time with a few other nurses and an EMT from MCDH, so most of them traveled together. Then, when I went again myself in March, I knew three nurses who were interested in going, and who wanted to go while I was there, so we all coordinated our trips to coincide.
As such, we docs kind of became de facto leaders of our little informal groups, but once there, we were assigned to work in various clinics/towns and didn’t necessarily all work on the same team all the time, which was good because it gave us an opportunity to work with people from other places also!
So I suppose my “role” has turned out to be an instigator of sorts! Or, rather I’d like to think an “inspirer.”
Who were the other members?
My travel companions in March were: Vivian Daniel, RN, Tricia Ferguson, RN, and
Cyndee Wuoltee, RN. Just before my second trip and overlapping with the group below, was Anita West, RN, who went on her own (and I am very proud of her for doing that!) to work with Heart to Heart as well.
The group that went in February were: Jane Jenab, MD, Larry Burchett, MD, Jason Haefeli, EMT, and Jeanna Cauckwell, RN.
Why did you get involved?
I just had to. I remember hearing about the quake on USGS updates, then seeing the news that night and thinking how bad it looked and that they would need lots of help. And then, oddly, I went to a show (Anthony Bourdain) in Santa Rosa the next day — just going on with life — until I just started to realize that hey…what am I doing sitting here? I could go, and I should go.
I was finally in a position in life to do just that after the years of being obligated to my training in med school and residency — but now, I was free. I couldn’t reconcile having the skills and means to go, but just sitting at home shopping, being entertained and enjoying life when there was something tragic going on out there that needed attention I could give. So that night I contacted Heart to Heart to see if I could go with them. I actually spent a long time trying to research any possible organization to work with in order to be sure to go as soon as possible, but Heart to Heart called me back first. I was in the middle of moving from one house to another here, and I so wanted to just drop it all and go that very next day. But I had to finish the move. I literally drove to SFO to catch my plane the afternoon that my furniture and boxes were delivered to my new house. It was a whirlwind, but I still wish I could have gotten down there sooner.
Disaster relief work is something I have long felt I should be doing. I have believed that I have the right personality and traits for it, and I love traveling, even on short notice. This was essentially my first opportunity to try out my theory.
When did you go, and how long did you stay?
My first trip was in January, about a week after the actual earthquake. I stayed for a week. Really wished I could have stayed longer, but I was scheduled to work here and needed to come back for that. As soon as I got back I was planning my next trip, which then materialized this March 10-21st.
What did you do once you got there? What group/agency were you working with (government, Red Cross, other), and where did you do your work?
All of us from MCDH did go to Haiti to work with a specific non-governmental organization (NGO), Heart to Heart International (www.hearttoheart.org). I have had some affiliation with them since Oct 2009 when I did a medical teaching trip in China. They were the first group I contacted when the earthquake happened, to see if they were organizing a relief effort.
Once on the ground, what were your initial impressions? What was a typical day like? What were some of the biggest challenges you faced?
We had a base of operations in Port au Prince. In January, we were working at a soccer stadium turned tent city in the heart of town, side by side under tarps on the grass with other NGOs from all over the world. It was primitive, and such a sight to see. I was impressed not only by the obvious devastation and displacement of so many people, but by the way that so many great people came from all over the world to the aid of this disaster. There were groups offering help from countries that I thought could not spare a nickel to help! (eg; Sri Lanka, Nepal). And they all worked so smoothly together, everyone with the interest of patients in mind, and no egos, no turf battles…just working to make things happen. Really incredible and makes you realize how good things can be with a spirit of cooperation and unified goals.
I worked in Port au Prince for only one day on that trip, and then was dispatched on a mobile team to Leogane, where the epicenter was. We spent about four or five days there, camping out and seeing patients in a similar tent city ‘clinic’. There were only a handful of field hospitals, and fewer resources out there, but it was a terrific experience.
The second trip in March was similar but I worked about half the time in Leogane as a Medical Director/team leader there, and the second half as a doctor in Port au Prince at a new clinic site in an old church building in the Bel Air district — so I got the best of both experiences, rural and urban. In Leogane, we worked at impromptu ‘clinics’ set up in the rubble of an old church, or would travel at someone’s request to scout an outlying area that reported needing medical care. We packed up meds and things we thought we might need in boxes and suitcases, hired trucks and drivers and just drove out and set up. It was challenging in that we had more austere conditions, had limited supplies and medicines and had to wait for more to be delivered from Port au Prince if we ran out, which could take days — often if you didn’t have it there, it was scarce in Port au Prince also.
We worked outdoors almost all the time, and had to travel a lot to serve the people. But this was also extremely rewarding. Especially when you did find a handful of people who truly needed help and hadn’t been seen by anyone else yet, or who had been seen and treated once but never had any good follow-up care. In Port au Prince, we were in a fixed clinic site and had more structure and definitely more equipment and a larger, though still limited, pharmaceutical supply at our disposal.
Also being closer to the larger functioning referral hospitals was useful there, although transportation of sick patients was an issue in either locale: no ambulances, no formal transfer processes. You simply loaded really sick people in the back of a truck you hired and took them to hospitals and tried to talk to a physician to help get them in the door for treatment. Otherwise they might be turned away or have to wait hours and hours–which some people just couldn’t afford due to severity of illness.
What is the long-term picture there? How long will outside medical care be needed?
Long term is just that. Long. The medical infrastructure there was pretty much reduced to rubble along with the rest of the cities affected by the earthquake, and the truth is it wasn’t that sophisticated to begin with. But now, you find that many of the outside agencies that came and set up field hospitals and provide services like x-ray, surgery, and inpatient care, have pulled out and there is a constant turnover of these sorts of assistances. However, some agencies have gone on to develop sustainable field hospitals and clinics with a long view to staying around for six months and more, and further, to recruit and train/assist local Haitian personnel to become the long term purveyors and stewards of this care. This is where we can have such a great impact.
And this is going to be crucial to keeping the ground that has been gained in medical care there since the earthquake.
You can argue that because the country was so limited in its resources even before the earthquake and now it has been taxed beyond those limits, and add to that the thousands and thousands of displaced people living in less than ideal conditions for the long term (tent cities, though making improvements, still foster disease and public health risks of many kinds) — that there will be a need for medical care assistance there for years to come.
Do you think you’ll go back?
I will. Again and again. The people there are just…different. So nice, so strong. They take care of one another. They don’t complain and lament their misfortunes (which are tremendous). They clear the streets, they rebuild, they say thanks for what they do have and they get to work. They want to move forward, and they are so happy to see you and are gracious and thankful for whatever you give. It inspires you to want to do more and more.
Others Share Their Stories
Tricia Ferguson, RN
Going to Haiti was something that I knew I would be doing, not just wanted to. It was a life changing adventure in so many ways. There are so many different things that I would like to share. Each day we would open clinic and see anywhere from 50 to 150 patients in Leogane between the three of us there: Jennifer Surber, Matthew Cushman (a paramedic from Kansas City, MO.), and myself. We saw many sick children with fevers and upper respiratory infections, adults with high blood pressure, PTSD, or general aches and pains from working so hard to return things to normal or injuries from the quake itself.
My most vivid memory was going to the “market”. When you first arrive the smell was overwhelming, like going to the dump. There were makeshift tables, with products (partially rotten vegetables, unidentifiable chunks of cut up meat covered with flies, clothing, and random supplies). If you greeted the Haitians in Creole, they would smile and greet you back. There was a large hole dug in the ground where the meat and produce stands were, this is where they would throw their trash. The stream that ran through the market was there sewage. To the Haitians this was the norm and nothing appeared to be wrong with it.
Jane Jenab, MD
“Thank you for continuing to shine a light on the Haiti tragedy. They still desperately need our help,” says Dr. Jenab. Read her story posted on her university alumni website at: http://www2.binghamton.edu/alumni/news/alumni-connect/mar-2010/haiti-relief.html
Anita West, RN
When people ask me, “How was it?” I answer, “It was life changing… I don’t ever want to forget”.
I was humbled by the thousands of Haitians who woke every day to the never ending despair of their situation, yet maintained their activities of daily living with dignity and resilience; peace. They returned to their churches and gave praise and thanks to the Lord with total ruins and loss surrounding them on all sides. I felt like an intruder bearing witness to their powerful return of faith as I questioned my own on some levels.
You greet strangers with a smile and wave that was always returned. The trust that was placed in our work was unyielding, and yet I/we could offer so little in comparison to the modern technologies of the 21st century United States. Frustrated? Yes! Every second of every day, I was frustrated. Frustrated that we could not offer patients proper surgical and medical attention that was a basic standard of care in my country. I was embarrassed at my ignorance to this crisis that was clearly present long before the devastating quake.
The comfort comes in knowing that I am a proud member of this wonderful society of humanitarianism. Many will follow after me fresh with energy, skills, and ideas to make a change/difference in human lives.
On that same note, I could not be more proud of my community and hospital. Yes, one person did make a difference. Mendocino Coast District Hospital did make a difference. The community of Fort Bragg, California did make a difference. Thank you for your love, prayers, and support. Thank you for making my world smaller.
Photo left to right: Jason Haefeli, EMT, Jeana Cauckwell,RN, Jane Jenab, MD
Anita West, RN, Larry Burchett, MD
Tricia Ferguson with kids after clinic one day in Leogane.
Anita West, RN and Haitian child