Built in 1984, the Haitian Community Hospital is managed by the Haitian Health and Education Foundation (FHASE), a non-government and non-profit foundation created in 1972. Through its public health programs, outpatient clinics, and 75-bed inpatient hospital, HCH has provided quality care to upwards of 80,000 people annually. It is committed to and accessible to the most disadvantaged sections of the area. Given its geographic position and services, Haitian Community Hospital aims to serve a population of 250,000 people, mainly from the communes of Pétion-ville (283,052 inhabitants) and Delmas (679,650 inhabitants).

By Gilou Hudicourt

On January 12, 2010, Julienne was a young second-year Accounting Student at University Lumiere on Ave O in Port-au-Prince.  Her classroom was on the top floor of a four story concrete building.  She was sitting in the front row.  Her class contained about 40 students and there were several hundred other students in other classes.  Those that had not paid up their tuition fees were not allowed in and many of those congregated in the University yard, hoping to get in.

Then the whole building began to shake and Julienne rushed in panic, first to the front where the exit was and then to the back of the class.  She wanted to get away from the exit and the four story drop to the ground level.  Then she fell forward as the concrete roof collapsed on her, her fall was broken by the steel framed chairs in the classroom. A large concrete block fell on her lower back as the whole building collapsed.  As she lay in pain, in total darkness, she found herself trapped in a space only one foot high, between the floor and the level of the chairs’ seats.  As the dust settled, she saw someone crawl towards a hole of light at the back of the classroom.  When the person exited, she could see the street.  She was at street level.  Someone behind her told her to crawl towards the hole.  She was preventing that person from geting out.  She pushed the piece of concrete off her back and crawled forward, in great pain. She noticed the crushed bodies of several of her classmates.  All those still in their chairs when the roof collapsed were dead. She managed to get her torso through the hole but stayed stuck between the feet of two chairs.  She screamed at students outside to come and help her, but do one dared.  Those who were inclined to come were warned by others not to get near the Unviversity.  Until then, Julienne was unaware of any earthquake, she just thought her university had collapsed.  That is why she did not understand her schoolmate’s terror, when they were safely outside, in the street. Finally a man who just happened to pass by yelled “I will save you if I have to die trying” and he began to run forward. Meanwhile, the the person stuck behind her was frantically pushing at her legs, causing her horrible pain.  The savior wrestled with the chairs, stuck between the ceiling and the floor and succeeded in freeing one of them.  He then carried her out and laid her on the ground across the street.  Her legs could not move and she had numerous cuts and bruises.

By then it was dark.  A lady, a total stranger, spent the whole night with her taking care of her, giving her water, getting her socks for her freezing feet, a pillow for her head.  But, no help was coming.  In the morning, Julienne’s mother showed up.   Julienne had been spending the week at a friends house and was not expected home the previous night.  In the morning her mom found out the University had collapsed and rushed down the hill looking for her daughter.  On her way down, she encountered another mother who told her “Julienne is alive, she is on the street across from the University”.  At that point, Mrs Prequis added that had she found that lady’s daughter in such a state in the street, she would not have walked away as that lady had done.  “Mom, she was crazy looking for her own daughter” Julienne interrupted her.

When her mom found her, Julienne could not move or sit up.  Her legs hurt.  They were unable to move her.  Then four men went by carrying a corpse on a door. ” What are you doing carrying corpses when there are live people to be carried” someone screamed.  They agreed, dumped the corpse and came for Julienne.  She was reluctant to be laid where a corpse had just been laid a few seconds earlier, so they turned the door around and laid her on the other side, and carried her until a pickup truck was found.  After vainly searching for a hospital for hours, the pickup went as close as it could to her home and then she was carried home the rest of the distance, up the hill to her home in Carrefour Feuille, near the Sanatorium, still lying on the door taken from a wrecked home across from her school.  Her mom spent three days scouring the city looking for a hospital to take her daughter to, all the while Julienne laid at home in pain.  She soon realized she could no longer urinate and was bloated.  On the third day, Geskio hospital on Boulevard Marie Jeanne told the mom to bring her in.  There, on Friday, she received her first first-aid from a foreign medical team.  They put in a catheter which allowed her to urinate and gave her medicine.  Her first X-Rays revealed the seriousness of her injuries.  Her pelvis was broken in several places.  After a couple days at that hospital, they put her in a vehicle and took her to the Haitian Community Hospital where teams of well equiped othopedist surgeons had arrived.  That is where I met her shortly after her arrival.  She went to surgery several times.  I did what I could in my non-medical capacity to help her while she was there.  I brought clean sheets, diapers, soap, baby wipes, toilet paper, anything I coould find to give this young woman a little dignity and comfort.  She thought she was going to be a cripple.  I told her she would dance again and that I would visit her when she got out.  At that remark her mother exclaimed out loud “where is that blanc going to find us once we leave this hospital”.

On the evening of the Jan 26th I found out I had a free ride home on the morning of the 27th with Air Transat, the company that employs me.  They were flying to Haiti with aid workers and supplies.  I had to be back at work on the 31st, so I decided to leave Haiti.  I wanted to say goodbye but Julienne was out of surgery and fast asleep.  I left a note to her mother. It said : “While I jokingly called you my little girlfriend, at 48 I am way too old for you and already have a girlfriend. But I really want to hear from you in the future.  He is my number.  Call me when you get out.”  She finally called me around in March.  She told me she left the hospital around Feb 15th and had since been seing a Cuban doctor every day for rehab.  At first she used a walker with a walker, then with crutches.  I told her I would keep my promise come and say hello to her at home.

I went to see her this afternoon after my flight.  She met me at the street corner, with a limp but no crutches.  She told me it was her first time with no crutches.  We (I was with my son Ian) only stayed 30 minutes, long enough to hear her story and take a few pictures.

In the name of all the Juliennes in Haiti, thank you for all of you that made this possible. Here is Julienne today.  She thinks she looks ugly after all she’s been through.  I’ll let you be the judge.

]]> http://haitihosp.org/a-story-about-julienne/feed/ 0 http://haitihosp.org/march-2010-update/ http://haitihosp.org/march-2010-update/#comments Mon, 15 Mar 2010 01:42:10 +0000 admin http://haitihosp.org/?p=58

By Josiane Hudicourt-Barnes

It’s been two months since the earthquake now, two months since I’ve been hanging out at HCH every day. I am not a doctor. What could possibly have kept me busy at a hospital.

The beginning of the crisis was completely crazy. My sister, Brigitte, had gone to the hospital minutes after the earthquake because she is a doctor. I, and most of the people close to me, were too shocked the first day to realize that we could be of help to anyone. Our neighborhood, Fréres was not heavily damaged. It took a day or two to realize the extent of the catastrophe. For me it was when Brigitte came home from the hospital on January 13th to shower and lunch, and talked about the crowds of wounded that I realized what was happening. We had no telephone, no television and most radio stations were not functioning. In fact we are still trying to take in the dimensions of the consequences of the earthquake. My home is intact and I often forget that many people I see working at the hospital have no safe place to go to. Tents and tarps are the most precious commodities. Hopes of safe housing are remote. How should we rebuild? What does “safe” mean?

What was good about the beginning was that once people realized that there was so much human suffering, they just offered themselves, the things they had that could help, their supplies, their skills, their money, themselves. They just did it, whatever they could do. And thank God, many lives were saved. The support was outstanding. At first, it was just local, then came the world, more skilled, more tooled, and we supported each other in our self-defined tasks.

One of the people who represents compassion to me is a young man whose name I don’t know but whose face I know very well. He was living with a cousin who had two children. He came home from work on January 12th, to find that the house had collapsed. He combed through the rubble to get them out. He could not save the young mother, but got the two children. Both of the children were hospitalized at HCH. I know only one of them well. She is the cutest two year old girl, with a very serious injury in her left arm. She has had several surgeries and Cousin is always there, holding her. The most recent surgery was to try to reestablish some function in the fingers. That was done by LEAP, Dr. Hobar’s group of volunteer plastic surgeons from Dallas. Little girl Euclide has grown and put on some weight in the last two months and she has learned who might be coming to do things that hurt. When she is an outpatient, she always seems worried in the waiting room. When she has just had surgery she is sad, and doesn’t like visitors. When the pain goes away, she is friendly and might even offer the visitor a piece of her cereal. When I saw her this week, I thought that her arm looked really good and that I might never see her again. I am regretting not taking the cousin’s contact information. There will be relationships formed in the last two months that will be forever, and other that were just circumstantial.

For us, the workers, in January there was no time to cry. We could not dwell because there was too much suffering, action was more important. Now I find myself tearing up about small things. This week, my sixteen year old friend Ridky came back from his grandmother’s hometown of Port-de-Paix to get fitted for a prosthesis. When he arrived at the hospital, I realized that his remaining leg was not fully functional. He had a very hard time with the crutches. A nurse told me that he has nerve damage in the foot of the remaining leg. We got him a wheel chair and he spent five days back at the hospital. There was a cheery atmosphere in the back hall of the hospital. He had brought a laptop and some movies. Someone had a radio. He moved around in his wheel chair visiting people and hanging out with other young ones. Twice I ask where his grandmother was, and he told me she was asleep on the floor of the room. I asked why she was sleeping so much in the daytime. At night she cries, he said. He probably cries too, but he is a charmer, he smiles a lot, and speaks to me about my family, about meeting my mother and my son, Max. I asked whether he had news of his old school, Centre d’Etudes Secondaires. It’s damaged, he’s not going back, he is going to school in Port-de-Paix now. On Wednesday, Dr. Kemal’s team from Connecticut worked with him and made him a prosthesis overnight. The effort to stand up immediately brought beads of sweat to his forehead. But he tried, and he will practice, he says, and he will be back in a few months for a better prosthesis. He kissed me goodbye and told me to give his best wishes to my family. He left on his wheelchair with his prosthetic leg and his laptop on his lap. Tears came to my eyes. I hope that he will be as wonderful a man as he is a child.

Among us adults there is now time for discord. In January, the mission and the tasks were so overwhelming that we had to respond, do something, anything we could do. We were effective. If we stepped on each other’s toes, we might say sorry and just keep going because the work was urgent. Now we have time to reflect about next steps and we have expectations of appropriate adult behavior. Some of us expect something in return for what we do and when we don’t get it we give up. Is it OK to give up because Ridky and Euclide are going to be alright? The task continues to be humongous. Everyday about 200 patients come to the hospital for care: obgyn patients, pediatrics patients, orthopedic patients. Instead of being covered with dirt with open wounds the way people were on January 12th, 13th, 14th, 15th, in March the patients are clean and well-dressed. Babies wear colorful barrettes and cute little shoes. Dr. Valerie Rice, a volunteer OBGYN from Tennessee asked, how could these people living in tent cities be so clean? I think they come here in their best clothing because a hospital is an important place. It’s a gesture of respect for you doctors, for the service you are offering. It may be free of charge but it is very valuable. So, let us adults keep concentrating on the mission, a mission that is a bit changed two months later but no less important: saving lives. The method may be different, the urgency is less predominant but the threats to life continue to be insidious.

Thursday, February 18, 2010

There was a long steady rain during the night in Frères. We needed the rain but as I keep telling my son Max, in Haiti people are not ready. We are almost never ready for the situations that we know are going to happen. We only react after the problem. All week I saw workers cleaning out sand and trash from the ditch next to Route Frères. Since we had two light rains prior to this big one, someone in the government must have thought that it was time to get ready, to clean the ditch for the rain water. But the sand was pilled up on the street next to the ditch last night. They did not have time to load it up and take it away. This morning it must all be back in the ditch.

There is so much to worry about with the rain. We can worry about the foreign doctors sleeping in tents on the roof of the hospital. I wondered if their tents protected them. I asked how they did. “We got hammered,” said Paul, the volunteer pharmacy organizer from St. Thomas.

I am worried about the Lalue orphanage. It is a place on a main street of Port-au-Prince where 43 children sleep in 2 little rooms. Some of the HCH hospital volunteers who wanted to help orphans were taken there 2 weeks ago by their Haitian driver. The orphanage’s main building was damaged by the earthquake. The children are crowded in 2 dark rooms with leaky roofs. The babies are left in cribs all day in a humid room. Most of the children have symptoms of malnutrition: large bellies, skinny limbs, skin rashes, lethargy. An American volunteers got the person in charge of the orphanage to release to the hospital 3 very unhealthy babies. The babies are still with us. There is a small room at the hospital which has become an intensive care pediatric ward . There are 5 children. In addition to the 3 orphans we have 2 others of uncertain status. Manuelie looks like those children from the original “We are the World” campaign to help Africa: skeletal. She might be a year and a half. She sits up straight and hardly moves, she whimpers sometimes. She has pneumonia in addition to starvation. The fifth child is a preemie. Someone dropped him off last Friday. It’s a 3 pound baby boy. The doctors from Aruba improvised an incubator. They wanted to take the baby with them. We could not complete the legal steps for to let them travel with him, and then someone showed up to say he was an uncle. I was told that yesterday someone said to be the mother came. The name David was added to the incubator. We hope David will make it and mommy will come back again. There are 3 young Canadian nurses in the baby room. They hold them and feed them. Manuelie looks like she has cheeks today and they told me that she smiled yesterday. She loves Plumpeanut, the therapeutic food for children suffering from malnutrition.

The children of Haiti are having a rough life these days.

I went to UNICEF’s child protection office 2 days ago because we feel that as the 3 orphanage children get better, we cannot return them to the same place. UNICEF gave me the name of someone in the government. UNICEF says that they know about the bad orphanage but that it is up to the government to do something about it. I called the appropriate office “Bureau du Bien-Etre Social”. They told me that they would send someone to see the orphanage and to the hospital see our orphans. The situation made me think about the UN trucks in the movie “Sometimes in April.” The Tutsi’s and the Hutu’s were at war, and only Whites were evacuated. We have to follow chains of command and legal steps. It’s hard.

In the yard of the hospital there are usually half a dozen boys under 12 years hanging out. Sometimes they slide down the outdoor staircase ramp, some times they play soccer with empty plastic bottles. Yesterday I saw an American female volunteer from the Rescue 24 Baptist group teaching them to bat with a tree branch and an empty water bottle. Mostly the kids hang out because they might get the chance of being fed by someone or being given something. I saw them hanging around a US military Humvee and eating MRE’s two days ago. It is very unlikely that school will start any time soon. Many schools have collapsed. Since 80% of schools are private and uninsured, some will never reopen even when they have minor damage. The government is grandiosely speaking about the end of the public/private binary but at the same time says that there is no money to rebuild schools. Children are afraid of staying under cement roofs and in two-story buildings. If we had enough trees we could just have school in the shade of the trees when there is no rain.

We need the rain. After a full dry month, the city was engulfed in a cloud of dust and smoke. It looked foggy but it was sand from all the destruction and smoke from many small fires put by people who are trying to clean up the trash that the government does not pick up, by burning it. Today the air is clear and cool. I just don’t know about the ground in the hundreds of camps all over the city. I can just imagine little children’s muddy feet kicking around whatever they find to use as soccer balls. The government says that they are afraid that the mud will be spreading germs and we’ll have epidemics of infectious diseases. Are we ready for that?

I had gone with Dr. Yvonne Ankrah, a volunteer OBGYN from illinois who is staying with our family and who wanted to check on 2 of her patients. Babies are born every day now but there are no real rooms for the moms. They stay behind screens in a large open space near the delivery room.

Today the Rescue 24 Baptist guys from North Carolina undertook a project to improve the hospital kitchen. The kitchen space was built before the event but it had not been functional. Patient families had to bring food. A couple of weeks ago, we received donations of bulk food. The Boulos family brought some gas stove tops and the hospital began serving one meal a day.

We have 4 Haitian volunteers in the Kitchen: Alex was a Montana hotel cook, Marie Carme is Ecole Acacia’s cook, and 2 other people. On Sunday, only Alex came to cook and the Rescue 24 guys came to help feed the patients and staff. Today they told us that they wanted to improve the kitchen. They found a sink on the roof of the hospital and went to the hardware store to get what they needed to install it. They asked for a table, and Max went to pick up Edith’s old wooden examination table from home.

The Rescue 24 guys wanted plywood to make shelves, and we found some old doors and scrap plywood. (A German team of volunteers had just built a door to look up their supplies.) So for now, the patients are getting some donated nutritious cookies in the morning and a meal of mostly rice and beans in the afternoon. Most often there is a small amount of animal protein with the beans, like canned fish or canned meat. Today was special because the USVI team donated 2 hams. The rescue 24 guys would like to feed 3 times a day and Edith, my mother, has suggested that most Haitians like “labouyi” or porridge in the evening. We do have some powdered milk and oatmeal in storage. So quality of life is improving quite a bit for those who are still in the hospital. In fact, all the patients are on beds or cots now. There was a time 20 days ago when a good piece of cardboard was all patients and families were asking for so that they wouldn’t sleep on the hard cold floor.

Many have been discharged. I miss and worry about the ones I got to know. I worry most about 16 year old Ricky, an amputee, who left for Port-de-Paix with his grandmother. Apparently I should not worry because his grandmother called the hospital roommate to say that they’d made it safely, and there is a descent hospital in Port-de-Paix.

The patients who have not gone too far will come back for wound care, cast removal, external fixator removals. Patients do keep coming. The waiting room in the lobby was reconstituted and it was quite full this morning. There were many mothers with sick babies. Now that broken bodies are on the mend, we need to worry about spirits. A young girl came last week seemingly lifeless. Her heartrate was normal, her pulse was normal, her blood sugar was normal, but she was limp and her open eyes did not blink when the doctor moved his hand close to her face. Someone called that hysteria, someone called it transfer but what the mother said was that she had been in church and the pastor was talking about the possibility of even worse Catastrophe, maybe all of the land would go under water. And the girl collapsed. She could not move for 24 hours, she was unresponsive, except for the tears in her eyes. Who will heal the spirits? What will heal the spirits? The government has declared that next weekend, the weekend that was to be Mardi-Gras weekend, is officially a time for prayer and renewal.

We worry about Spring. Last night it almost rained. We are in the dry season and there hasn’t been any real rain since the quake. Yesterday it drizzled for about 5 minutes. There was a lot of conversation about rain today among the staff an volunteers who still sleep outdoors because they are afraid of their cement roofs or because their home is not livable. Yes people realize that the rain will come. I have very mixed feelings about the rain. Most plants look terrible these days. The hospital lawns have taken a beating with all the people who lived there and if there is no rain soon the grass will be dead. It might already be dead. Medical staff talk about the spread of infectious disease being a scary thought in tent cities when rain comes. Right now pneumonia is a fairly common diagnosis. Too much dust.

There is a lot of talk about the financial burden of the earthquake. Many families have lost everything, many business will never recover. At the hospital there is also talk of money. Before January 12 the hospital charged fees for services (US $3 for consult, US $20 for X-ray). All fees were dropped after the quake. We decided to worry about money later; “the money will come somehow.” Many people have contributed and raised funds for the HCH. Many people have collected, brought, shipped supplies. We are still worried though and we have been meeting with other hospitals about what to do. HCH is a cheap hospital, but even the most expensive hospitals dropped all fees. The question to ask is , when every foreign doctor and nurse is gone, will Haitian private and semi-private hospital still exist? Will they have paid their creditors for the fuel for generators, for the cleaning supplies, for the X-ray films? Will the Haitian government really act on its promise to pay staff salaries? The foreign volunteers are coming and giving a week or two for free but the Haitian doctors are staying and will need to pay their bills. At HCH the current compromise is that Earthquake victims continue to be gratis, but new patients with other problems need to pay. Not a perfect solution.

There is a French group and an American group outdoors. Indoors we have many American medical staff, some Swedish, Japanese, Korean, Jamaicans, a very special group for the US Virgin Islands, and Haitian Diaspora folks. The hospital’s permanent staff is also trying to figure out how to transition to “normal.” At some point we had 200 foreign volunteers and about 100 Haitian volunteers. The hospital staff is 200. Yesterday there were 2 major accidents that brought people for emergencies, one was a motorcycle versus a pedestrian, and the other was a landslide in the Laboule sand mines. Two brothers were brought in from having been pulled out from under the sand. A third brother brought them in and said he didn’t think he could take this because he had just had buried his wife from the earthquake. I did not see these patients, John saw them; one was in the ICU in critical condition.

John arrived Tuesday night with Dr. John Moses and Dr. Peter Moses, and he has been a translator in the ICU for the last two days. I took most of today off from the hospital. I had been spending all of my days there since the day after the Earthquake. I was constantly running around solving minor things for people. I was taking questions and request from both Haitians and non-Haitians, and finding people as that were needed or finding things like: Do you know where I could find clean scrubs? Batteries? Trash bags? Blood? Someone to distribute water? Have you seen my son named Peterson? I haven’t seen him since the earthquake and I heard he was in a hospital with an amputated leg. Peterson was not at HCH. I also did some delicate translations, like having to tell people that their parent was not going to pull through. It’s been busy with very little time to think about it. Yesterday I got upset. I did not get upset by the situation of the pain and suffering. I got upset about human relations. For the last week, leaders of foreign volunteer teams have been meeting with the Hospital’s permanent leadership to talk about how things were going, strategies, systems, etc… All along there were issues of what the permanent staff of the hospital should be doing.

There were communication issues as the Haitian nurses don’t speak English and the Hospital became an English-speaking place. Anyhow, for the last few days, there was an issue of having too many young adults, mostly males having signed up to volunteer as translators and transporters, and some of them were being thought of as imposters. We agreed that the hospital was simply too crowded by patient relatives and volunteers. For quite a while now we’ve been trying to enforce a policy of one relative at a time per patient. We tried to decide how many volunteer translators and transporters were actually needed. Two days ago, I tried to weed out volunteers by telling everyone that to come back the next day they needed to ask someone to come to tell me that they were useful and wanted. It turned out that just about everyone found someone to recommend them. Yesterday the job of deciding who the volunteers would be was taken over by an American security specialist. It got to a point that his method of weeding out was offensive to me. Around mid-morning I left for the day. Tomorrow morning, I will go to the strategy meeting and try to discuss human relations and Haitian respect. Many lives have been saved thanks financial, service, and in-kind donations from all over the world. There are now longer -erm issues to think about. For example the doctors would like to discharge my 16 year-old amputee friend Ricky. His grandmother says that if he is discharged she has to take him to Port-de-Paix because the family no longer has a place in the Port-au-Prince area. Getting to Port-de-Paix is a very uncomfortable dusty trip for anyone. How will he get a prosthesis if he goes far away? The Swedish group said that they may be able to bring trainers to teach Haitians how to make prostheses. How will we find Ricky then? Many lives have been cut short or changed by this earthquake. Miraculously most houses in our neighborhood are in good shape. People are going about their daily pre-earthquake activities as much as possible. Of all my siblings, I am the only one regularly hanging out at the hospital now. All the teenagers in my extended family are being sent to relatives in the US and Canada so that they can finish the school year. Right now only Jessica (11 yo) and Anais (13 y)) have no plans for travel. In the hospital yard large groups of children are roaming around looking for something to do. Sometimes they play catch with a blown up hospital glove.

Yesterday, I sat down most of the day, and that is a measure of progress. I was at the door, making sure all employees and volunteers were tagged. Many volunteers had been doing diverse tasks, and we felt the need to specialize them. We have to keep a firm person at the door with the regular security man because we want to slow the flow of visitors, family members, and lookers.

The hospital is poor and has always relied on family members to feed and wash the patients. Family members do more than that, they advocate, they offer moral support, and they try to grab a medical person when necessary. Most of the day we allow only one relative next to the patient and we accompany anyone who says they are there to take over care for the family member or to bring something to the family member. The hospital kitchen is still under construction, so the families have to find a way to get food for their patient. We have been trying to scrounge for bottled water and distribute that a couple of times a day. We received a donation of 3 cases of 300 eggs and a volunteer has been boiling some of those at home every morning. Today might be the last batch of eggs. Max Edouard brought us a case of peanut butter and a breakfast porridge mix yesterday. The Selecto Coffee company has been providing us with ground coffee and sugar and my sister Dominique has been taking care of a snack, coffee and water desk in the administrative office for the staff and volunteers. Occasionally someone brings in a batch of spaghetti or rice for that table. But most supermarkets remain closed so that even disposable utensils and paper goods are in short supply.

In addition to the Hudicourts, there has been a Boulos family whose help has been constant and invaluable. They have trucks, contacts, and staff. Johnny Boulos has been going to the airport where volunteers and supplies come and intercepting them for us. Yesterday there was a threat of rain and they brought in a roll of awning material. Tents were built in the yard with blue and white striped awning material for the patients and families who still live outside.

Of the people living outside, we are now finding that some of them are coming in too late for care. One family brought in a 13 year old boy the night before last because they were realizing that they were loosing him. He had no cuts, just that he couldn’t move. They had him lying on the ground outside and only brought him in when they realized that he was slipping away. The doctors realized he had a spine injury and tried what they could during the night but he died. A thirteen year old girl came in, brought in by a parent of one of the inside patients. The girl was very small for her age, with a cut in her chin and a swollen jaw, and no family. When I interviewed her she said that she was at school when the earthquake hit and that someone helped her get here. As I questioned her I realized that she was a restavek in a family, in Nazon, a neighborhood that has been practically destroyed. Her real mother lived in Karis, inthe mountains near the DR border and Cap Haitian. I put a nametag on her with “Orphan”. Within the next couple of hours a group of volunteers from an American religious mission took her to their headquarters. Last night, the little Miracle baby, Angel came back. The cousin taking care of him said that he cried all the time and was not eating. The doctors think that maybe he has a fractured skull since he had a cut on the head. Victor Boulos is working on getting the baby to a foreign hospital where he could get appropriate care.

We really have no adequate care for people with back injuries. We don’t even have backboards as Stewart, a Jamaican volunteer pointed out to me last night. We just tell people to stay on stiff board. I got angry at two young women because I saw them moving around a man, probably their father, who had been told to stay still on an old door. The girls said they just wanted to clean him and make him comfortable. Another time I saw the same man turned on his stomach. I’ve been told my one of the medical staff that we now have people who are paraplegic who were not paraplegic when they came in.

This whole thing is so sad that we have yet to cry. The dimensions of the drama have yet to hit us, those who are living it. My sister Chantal went to the funeral of Guito Blanchet and his wife Colette yesterday. Georges Celcis, the president of the Hospital Board went to burry his son-in-law, Roland Rocourt, yesterday. Those who can afford it have proper funerals. Last night Chantal made a deal with the mayor of Petion-Ville that the hospital would give diesel fuel to the city truck if they came to pick up our bodies. Father Rick Frechette’s crew had come to pick up the first group of 18 bodies but they have not come back since he left for Massachusetts to see his dying mother. What is ironic is that I usually look at the Obituary page of the Haitian newspaper, Le Nouvelliste on-line, even when I am in the US, but this week for the first time, there is nothing under the Deuil tab, Le Nouvelliste had no obituaries.

This morning we had another tremor. I was on the porch with Jeff and the Journalists who have been staying with us. Chantal went hysterical. We thought it was over and everyone had started sleeping indoors again. I can’t imagine what it was like in the hospital. So many patients are amputee, terrible fractures with external fixators…

The situation is more stable at the Haitian Community Hospital, although the needs are still great. Doctors have arrived from all over the world and we have most of what we need to work. I just spent three days working for the Xray department night and day. This morning, I took a brake. I couldn’t think clearly anymore. My job was emotionally tough. I started on Friday and I had to convince suffering people, some of which were going to get amputated to wait up to 48 hours for Xrays and make sure that staff members from young volunteers to medical doctors would not sneak in people close to them by just bringing them in or sending them as emergencies. Sometimes I got angry and rude.

“I will not admit emergencies anymore! I yelled in desperation. Some people brought in here as emergencies look much better than others who have been waiting for more that 24 hours. Everybody here is an emergency, so only dying people should be considered as cases more urgent that others.”

My anger was a relief to those who were waiting. They felt that if I was defending their case with so much energy they didn’t have to get angry themselves.

For 36 hours we did not have large films for the Xrays so most people could not have their Xrays done. I ask some people who came to the hospital on Friday why they had arrived so late; I thought that maybe they had been caught under the rubbles. They answered that they spent several days trying to find a functioning hospital that would accept them. One of the patients, a boy of about twelve years old, had been amputated on his birthday; he was also the only surviving member of his immediate family of 4. On Saturday, a skinny ten year old who ended up getting a morphine shot was yelling non stop “Woy! Woy! Gooood! I’ve been dying since Tuesday!”

A very affectionate father gently holding his son whose arm was injured confessed: “The only thing that helps me keep my sanity is that everybody is homeless.” He also added that “Only the ten month old baby died.”

The earthquake is said to have struck in a very democratic way. The sizes of the houses didn’t matter.

The way the patients thanked me as they came out of the Xray was the most rewarding aspect of my task, although I truly felt that I was just doing what I was supposed to. This afternoon, my husband who was at the door of the Xray room told me with a smile at the end of the day that all he had eaten was a pack of salty cracker that an injured five year old gave him spontaneously. I think that part of the reason why people feel so grateful is that so many people in Haiti are not used to receiving any services at all.

Caroline Hudicourt

It is hard to actually describe what goes on at l’Hopital de la Communauté but we are feeling much better about patient care today. The first two days we had 2 Haitian orthopedists taking charge and seeing patients as fast as they could and 3 other doctors evaluating patients. There were no aftershocks today, and that was a blessing because every time there is a tremor the patients scream and their relatives try to carry them out of the building. Today, I looked around and felt like we were in a hospital and not a war zone.

The main thing that happened was that a team of mostly Haitian American doctors arrived 2 days ago and asked to take charge of sorting the patients by orders of priority. The volunteers have been great. There is a team of surgeon lead by an American who lives in the Dominican Republic in charge of the two operating room. In addition, every morning our family has an organizing meeting about needs and distribution of jobs. All day yesterday new volunteers of all types arrived and donated supplies arrived. One large truck and a bus came with a group of 28 young Haitian medical residents from the Dominican Republic. They opened a clinic under a tarp in the yard to screen new arrivals and send those who needed more than sutures and bandages inside the building. That helped those patients who are terrified of going indoors get some care. Ten of the Haitian doctors from the DR came inside and helped with post-op care and wound care. My job yesterday morning was to work around with the one non-Haitian from the Miami team, translate and put a piece of masking tape on each patient’s forehead labeling his level of emergency. Most of the patients were spread around an inner courtyard which is usually the main external clinic of the hospital. We set up a supply room in the dental clinic with a volunteer registration desk, a casting room in the regular consult area, a workers snack and coffee room in the administrative offices, and two major supply rooms, one for medical stuff in a meeting room and one for food stuff in an unfinished area on the second floor. Later yesterday, new teams arrived from St-Thomas (VI), and Jamaica. Many wealthier local Haitians were also there helping with translation, bringing donations, sorting of donations, and management of patient families. This hospital usually permits relatives to be there 24 hours, but the doctors from the US told us that the place was too crowded and that only children could have a parent present full-time. That was very rough. One young teenage boy who didn’t want to leave his mother and sick sister signed up as a volunteer. We had to have lots of policing at the gate.

Yesterday we had 2 very touching stories. A fifteen year old names Ricky was alone for the first two days and I was very worried about him because he seemed to be sleeping most of the time. Another teen next to him told me that we had to watch out for him because no relatives were around and all his siblings were dead. Yesterday, Ricky sort of woke up and his mother came. When I came to see him with the doctor, the doctor told him he would need surgery on his leg. He told the doctor that he thought his leg was dead. The doctor said that he was right and that it would probably be an amputation. Ricky, said it was OK, as long as he could survive because he didn’t want his mother to be alone. The second story was a miracle baby named Angel. He was pulled out of the rubble on the fourth day. He was about four months. His mother had been killed and his mother’s cousin brought him in. The doctors looked all over and found nothing but minor cuts and scrapes around Angel’s little body. We found him some Pedialyte and formula in the supply room and Angel turned into a charmer. Each one of us who went to look at the miracle baby and talked to him got a great smile. That was incredible.

I talked to a guy today who was waiting for a death certificate for his 24 year old daughter. She was in class at an engineering school when the earthquake happened. He said that he couldn’t understand how an engineering school of all places could be so poorly built that it collapsed. Yes, anarchy in construction is a common subject of conversation in Haiti and it usually refers to the shanty town, small improvised housing all around the capital. But now we say that all of it was improvised: the presidential palace, the tax building, the justice department, the Catholic cathedral, the Episcolian cathedral, the fanciest hotel, the fanciest supermarket…. Or maybe nothing could prevent the collapse of all those important building?

The hospital still struggles with shortages and lack of supplies. Most beds are divided into bed and mattress. One person gets the bed with some cardboard padding or matting brought in by the patient, and another person gets the mattress. Many patients are on stretchers. We’ve been told that the US government will bring us 50 cots. We will still be short of sheets. One of the things we hope to work on in the next couple of days is infection control measures. We have gloves but there is a lot going on that is not hygienic right now and bacterial contamination is scary. Parents bring sheets and bedding from home, too many people go in and out around the patients with no hand cleaning. Well, we will work on that tomorrow.

The stories outside the hospital are scary. I really don’t have time to listen to the news on the few Haitian radio stations still functioning. One TV station shows CNN all day but when you are living through this, CNN is a bit irritating. Among the many dead, there are many important people, like the bishop of the Catholic church, the head of the Tax office, the senate president. We are actually not sure about what’s the truth when we hear about who is dead, missing, or found alive because there is a lot of rumor and there have been no Haitian newspapers printed since the event. We hear that banks and US government offices will open tomorrow morning. We hope that some supermarkets will open too.

Our house is full of people. Max came in to help at the hospital, Jeff came in with two journalists and a driver from the DR, Chantal and Sabrina are with us because their apartment is cracked, Louideur moved back into our yard with his wife, mother-in-law, and baby, and Guerda is there with her two daughters and grandchild. Brigitte took in a family also, and Tigeorges has one person.

In our neighborhood the internet doesn’t work except at Brigitte’s house. Tomorrow the hospital might get some fancy internet equipment. Two guys from the US came and asked if the hospital needed a satellite communication unit. So, tomorrow we might have internet and international phone connections from the hospital. That will be very helpful. I might be able to bring some photos…

Josiane

This is an appeal letter. I know that many people read my account of my 12 hours from the time of the earthquake to the next morning when I felt the need to share with friends and family in the US.

What I have been doing since is not easy to talk about because I have never imagined myself in such a situation. As many people know, my mother is the founding member of a foundation which runs a hospital near where my family lives.

The hospital is not free because it doesn’t get enough external funding to sustain it. Everyday, gasoline powered generators run to keep electricity going and there are full-time employees who have to be paid.

The night of the earthquake, my sister, Brigitte, who is an opthamologist, spent the whole night with the regular hospital employees, receiving patients. When she came home to shower and eat the next day at noon, I decided to go back with her to help.

Many of the lower level staff had gone home and not come back for the day and I found that the most useful thing I could do was pick up trash, all kinds of stuff was on the ground inside and out. The doctors and volunteers where just attending to the emergencies with very little help, and patients where not even being registered.

Some hospital staff have died in the earthquake and some have lost family members. A young female assistant manager was killed with her preschool child.

Yesterday morning, Brigitte and I had a meeting with our extended family and we made a plan to improve services, with or without the hospital’s regular staff. We created a trillage system and decided which relative would be at the first trillage stop, which would be in charge of supplies for the doctors, which would sort donated clothing, which would photograph dead bodies, etc… Even the elderly and children in our extended families who were not going to the hospital had jobs of creating tags to be given out at the trillage station and making small packets of pain killers to be given away.

The hospital staff was more present and we all did an enormous amount of work with many more volunteers. It no longer feels like hell, it feels like there is order and that people are being helped. I spent my morning filling out admission forms with patients, new and old. Patients have no resources. Banks are not open, people have lost everything, these are not ordinary times. We decided tonight that we would do an appeal to friends in the US so that we can assure to insure continued operations of this facility.

-Josiane Hudicourt-Barnes