July 23, 2010

Earthquake in Haiti

Kellogg's Dr. Kaz Soong reports from the ground ten days after the quake and again three months later

Earthquake strikes

January 12th was a balmy workday with scattered clouds, typical of the dry season in Haiti. Downtown Port-au-Prince was bustling with traffic and pedestrians in the late afternoon when it was rocked by a 7.0-magnitude earthquake that lasted 35 seconds . . . an interminable half-minute of terror that would forever change the country. Several of my Haitian friends heard an eerie prelude of thumps and low-pitched rumbles before seeing the buildings sway and sidewalks move.

For me, that day started as another chilly January clinic day in Michigan. I first learned of the earthquake late that evening; the true impact of the disaster, however, did not become apparent until two days later when more horrifying details emerged. The extent of devastation was unprecedented. Unfathomable. More people perished from this catastrophe than from the 2004 Pacific tsunami or from the destruction of Hiroshima and Nagasaki.

The earthquake affected me on a very personal level, as I had come to know and love the country over the past decade. After many visits over 10 years it had come to feel like a second home. My dear Haiti was bleeding profusely; my friends were in trouble. In its time of greatest need, I knew that I had to go back to help. For an agonizing week I lost touch with my Haitian friends and could not find a way to get into the country. All commercial flights had been halted and my quest to find a wormhole through the rigid bureaucracy and Byzantine protocol went nowhere.

When my friend, Dr. Eduardo Alfonso, chairman of Bascom Palmer Eye Institute, learned of my plight, he promptly invited me to join the University of Miami medical team at the field hospital on the outskirts of the Port-au-Prince airport. With the help of Bascom Palmer's Dr. Richard Lee, I got a flight into Haiti ten days after the earthquake.

Situation on the ground

During my five days at the field hospital I saw eight eye cases, none of which required surgery with the exception of one patient who had facial and orbital fractures. He underwent surgical repair by the facial plastic surgeons. Otherwise, my work was non-ophthalmological. I helped orthopedic surgeons with amputations, insertion of external fixation rods, reduction of closed fractures, and creation of spica casts for pelvic fractures in children. I assisted the radiologist taking x-rays on the scores of patients waiting in stretchers. The queues were endless.

Dr. Soong in the tent hospital
Dr. Soong taking x-rays in the tent hospital.
Dr. Soong in the OR
Dr. Soong assisting orthopedic surgeon under flashlight illumination in the tent hospital.

When not doctoring, I emptied bedpans, fed patients, removed medical waste, and swept the floors. I felt privileged to be able to help in any way I could. One Creole interpreter joked that I was a bayakou (a go-getter or gofer in polite company, but something more colorful in Creole). My nickname became Dokte (Doctor) Jackie Chan for many of the Haitian workers and patients. I took that as a great compliment.

Dr. Soong with the Israeli medical team
Dr. Soong picking up orthopedic supplies at the Israeli military field hospital.

One afternoon I went to the Israeli military field hospital under escort to pick up needed orthopedic supplies. The Israelis had a CT scanner and fully electronic medical records. I was both surprised and amused to see a female medical officer dressed as a clown entertaining the pediatric patients. Their grounds were immaculate without a single cigarette butt or candy wrapper in sight. Needless to say, I was thoroughly impressed by the discipline, organization, preparedness, and ingenuity of the Israelis.

Qatari rescue team
Earthquake rescue team from Qatar cooking breakfast.

On the way back I was driven through the city and witnessed the extent of the devastation first-hand. Much of downtown Port-au-Prince was in ruins and was unrecognizable to me.

Each morning I took a brisk stroll around the perimeter of our field hospital, where I could see earthquake rescue crews and firefighters from more than 50 countries encamped. They displayed
a proud assortment of flags and spoke a polyglot of languages.

Poignant moments remain etched in my memory. A weeping father stood by watching anxiously, pleading to me “souple anmwe” (please help), as his nine-year-old daughter, in full cardiac arrest was being resuscitated by the pediatrics team. Having lost five other children on the day of the earthquake, she was his last surviving child. Embracing him, I tried my best to offer emotional support, one father to another. The last I heard, the child survived.

Equally unforgettable, a 21-year-old man with a C4-C5 fracture who continued to maintain a sense of optimism and humor despite being rendered quadriplegic. Fluent in French, Creole, English, and Spanish, this young man's once bright future was now very uncertain. We improvised a rigid neck brace using cardboard, an old T-shirt, and rolled towels to immobilize him securely to his stretcher with clothesline and duct-tape for the airlift to a Miami hospital.

On a happier note, the birth of healthy twins in the operating room gave us all an emotional high and temporary respite from the grim situation. Surgeons at the adjacent tables stopped briefly to applaud and whoop it up for this joyful occasion.

Both the adult and pediatric patients endured pain and suffering in stoic silence. Some sang hymns or repeated the Lord's Prayer in Creole to overcome their anguish. Over the years, I've learned that this bravery and dignity are typical of the proud Haitian culture.

Valentines Day decorations
Valentine decorations made by children in the inpatient unit of the tent hospital.
Dr. Soong with the Israeli medical team
Dr. Soong relaxing with University Hospital eye residents.
Dr. Jeevak Lal, Director, World Eye Mission
Dr. Jeevak Lal, Director of World Eye Mission, visiting a tent community.

Three months later

In April I returned for another visit, this time to offer specialty eye care and resident education, as well as perform fact-finding for the American Academy of Ophthalmology to help develop long-term strategic aid to Haitian ophthalmology. I was accompanied by Dr. Jeevak Lal, ophthalmologist and Director of the World Eye Mission based in Michigan and Trinidad.

Unsafe food
Food was kept outdoors at unsafe temperatures with fly-infestation in tent community.

Many of the injuries now were from traffic accidents and violent assaults. However, we also saw corneal ulcers, usually traumatic or infectious in origin, many with underlying xerophthalmia due to severe pre-existing vitamin-A deficiency. We also saw retinoblastomas, large verrucous lesions of the conjunctiva totally obscuring the cornea (presumably from out-of-control papilloma viral infection), and advanced malignant conjunctival neoplasms, all perhaps reflecting the combined effects of genetic predisposition, high prevalence of HIV infection, and lack of access to medical care. There were also several cases of earthquake-related injuries, pterygia, herpetic corneal infections, mature cataracts, and congenital pediatric eye diseases.

Port-au-Prince was crowded with warrens of tent communities without running water or sewage facilities. The tropical rainy season had just begun, bringing with it swarms of mosquitoes, flies, and rats. I am afraid the current situation may be a breeding ground for serious epidemic disease.

Not surprisingly, Haiti is fading into the distant memory of the world again. The interest of the press has waned to a trickle following the sensational media circus of the first two months after the earthquake. The international community is becoming jaded; just plain “Haitied out.” I sincerely hope that we can continue to sustain awareness and give support to Haïti Cherie, my dear Haiti.

Haїti Cherie (My Dear Haiti)*

Ayiti cheri pi bon peyi pase ou nanpwen
Fòk mwen te kite w pou mwen te kap konprann valè w
Haiti is my beloved land
Oh I never knew that I have to leave you to understand
Just how much I miss the gallant Citadel,
Where days long ago, brave men served this country well.

*Popular folksong written in 1920 by Louis Achille Othello Bayard de Cayes

Last Modified: Wednesday, 08-Feb-2012 10:23:26 EST