University of Chicago medical teams return from Haitian relief efforts

After a Jan. 12 earthquake devastated much of Haiti, more than 40 health care providers from the University of Chicago Medical Center were selected from hundreds of volunteers to spend one to six weeks working hot, dusty, 18-hour days contributing to medical relief efforts there or across the border in the Dominican Republic. Another team is preparing to fly into Port-au-Prince on April 8.

Since the first team left for Haiti on Jan. 25, the Medical Center has donated more than $250,000 worth of resources to the ongoing effort, including medical supplies, medications, X-ray and ultrasound devices. They persuaded several vendors to collect and transport additional medical supplies. These range from about 500 pairs of crutches to two "C-arms," large diagnostic-imaging devices. The Medical Center also is matching donations, which now exceed $40,000, to Haitian relief by faculty, staff and students.

"We should all be enormously proud of the contributions we were able to make and the help and comfort we brought to a nation where the level of need is almost incomprehensible," said Funmi Olopade, Professor of Medicine and Director of the Global Health Initiative at the University of Chicago, which helped coordinate the relief efforts. "We made a significant and meaningful difference in a landscape that initially appeared hopeless. And, in the process, we impressed our international colleagues with the talent, commitment and consistency of the people we sent."

Most of the Medical Center's volunteers have been involved in patient care and rehabilitation roles at a field hospital outside Fond Parisien, Haiti, a small town about 30 miles east of Port-au-Prince. This medical relief camp, the largest such facility in the country, has provided medical care, food and shelter for more than 1,000 patients injured by the earthquake, plus their families. Based at the 60-acre site of the Love A Child Orphanage, the walled-off camp houses about 250 to 300 patients.

Physicians and nurses from the camp also helped staff a clinic on the edge of Port-au-Prince and organized vaccine campaigns for the children at both settings.

"The ongoing role of this camp will be our primary legacy in this humanitarian effort," said Carolyn Wilson, Chief Operating Officer for the Medical Center, who supported the effort and helped collect the resources.

Immediately after the earthquake, the governments of Haiti and the Dominican Republic began working with the Love A Child orphanage to establish the field hospital at Fond Parisien. The camp would be led and staffed by disaster-response teams from governmental institutions, NGOs such as Partners in Health, and academic medical centers. In January, University of Chicago emergency medicine physicians Christian Theodosis and Chrissy Babcock took on leadership roles for this field hospital.

The Medical Center also played a lead role in organizing a collaborative effort by the University of Chicago, Northwestern University, Rush University and the University of Illinois at Chicago to send teams of health care workers to Port-au-Prince, where they helped staff a large hospital and mobile clinics run by the International Medical Corps. This unprecedented coordination across the city of Chicago has provided 64 doctors and nurses, one-fourth of all volunteers to Haiti for the International Medical Corps. Deployments will continue until the end of June.

The University's Fond Parisien team brought depth and diversity to the field hospital. Pharmacist Dima Awad, for example, built and organized the camp pharmacy, an effort that brought a standing ovation from the rest of the camp's caregivers. Physical therapists, led by Diane Davis, educated patients about wound care, got them up and moving and somehow acquired the necessary equipment -- often as simple as a pair of crutches. Information technologist Mike Sorenson, with donated networking gear from Cisco, built the on-site wireless network that connected the camp staff with each other and to the outside world.

"We had the best pharmacy, first-rate physical therapy, and the most extensive IT and data-management system ever seen in such an acute setting," said Theodosis. "We were registering people into the hospital on iPhones-completely novel, and all built onsite."

Such resources soon made Fond Parisien the primary center for follow-up care for patients released from the U.S. Navy's hospital ship, the USNS Comfort, stationed off the coast of Port-au-Prince.

"We've been told we're one of the better, if not the best, field hospitals in Haiti," said Babcock. "Our transfer network, involving both the USNS Comfort and nearby hospitals, allowed us to provide definitive care for complicated orthopedic problems. In addition, we facilitated readmission of these patients. We developed a reputation as a field hospital that follows and takes care of patients ensuring no one gets lost in the system, which is essential with the current migration problem."

"This camp is on the frontlines of the next phase of health care in Haiti," said Theodosis. "Most of the injured who survived needed immediate surgical attention, complex orthopedic procedures or amputations. But those have been done." A nearby temporary hospital in the Dominican Republic closed in late February, and the Navy's Comfort pulled out in early March. "The next step is to manage wounds, begin rehabilitation and help patients return to their communities."

"I can't tell you," Theodosis added, "how difficult it is to discharge a patient in this setting. What do you do, how do you follow up, with a patient who is not only homeless, but legless in a context of complete devastation? There is no place for the well, no place for the able-bodied, much less those who have been profoundly damaged. And the rains are coming."

About half of the discharged patients now live in a displaced persons camp about a mile away. The rest have headed back toward Port-au-Prince.

Despite the mountains of supplies that the teams brought with them, providing care in this setting called for imagination and creativity. Even at the Love A Child camp - among the most secure, best organized, staffed and supplied in the country - shortages were common. At first, there were no crutches for children. There weren't enough tents. There were no X-rays, forcing surgeon Rex Haydon, who ran the initial triage tent, to practice what he called "psychic orthopedics" until proper diagnostic tools arrived. There was only one drill; the surgeons used it during the day, and the carpenters borrowed it at night.

In addition to the academic outposts in Fond Parisien and Port-au-Prince, several other University of Chicago teams and a few individuals free-lanced their way to Hispaniola through other NGOs. One ER nurse worked with a well-connected religious charity that flew them into Port-au-Prince six days after the quake. Four plastic and reconstructive surgeons repurposed a pre-arranged visit to Santo Domingo to perform reconstructive surgery for patients from Haiti. Five doctors and nurses from the pediatric intensive care unit helped care for children brought to Santo Domingo for complex heart surgery.

The Medical Center is negotiating with potential funding sources, including the United Nations, the U.S. Department of Health and Human Services, and the Haitian Ministry of Health, to establish a long-term connection at the Fond Parisien camp.

"We have already made an impact," said Theodosis, who returned to Haiti this week, "and we are trying to find ways to extend our presence. This project provides extraordinary exposure to an approach to medicine that people who train entirely in the U.S. never see. And there's no question about the need."

Despite the hardships -- dust storms every time a helicopter lands in camp, a diet of beans and rice (mostly rice) with well water, sleeping in tents, semi-public bucket showers and a ubiquitous cough dubbed the "Haiti Hack" - the volunteers found the experience entirely unforgettable and mostly rewarding.

The team's efforts impressed the Haitians, who awed team members with their resiliency. "I realized that, despite every good reason, patients weren't crying at night in their tents," said Melanie Plumley, a University of Chicago nurse. "Back home, they would be on Prozac, on Ativan. Here they seem to fight off depression by laughing or singing. There's a lot of singing."