hospital courtyard on a day immediately following the January 12th earthquake

As we approach the anniversary of the January 12^th earthquake, the board members of the Haitian Health and Education Foundation would like to share the ways in which the Haitian Community Hospital (HCH) experienced and survived many of this year’s events.

The year 2009 was a fairly good year for the nation – most people were feeling hopeful about social and economic improvements; the country had suffered no hurricanes; agricultural products were plentiful; and there were no political or social crises.

On Tuesday, January 12, 2010, these positive feelings came abruptly to an end.  Several cities, including the capital, experienced the destruction of at least half of their structures and, horrifically, the deaths of more than a hundred thousand citizens.  The largest buildings were the most affected: churches, schools, multiple-story apartment homes, hospitals, and government buildings, including the national palace.  Large buildings collapsed while many schools were still in session and while people were working.  In many instances, hundreds of people, including children, died all at once.

Life will never be the same in Port-au-Prince.

The Haitian Community Hospital is located three kilometers from the Pétion-Ville center.  Pétion-Ville, a suburb of Port-au-prince, is approximately six kilometers away from the capital.  Years ago, Pétion-Ville was primarily a residential area, but in the past twenty years it has developed a sizable business district.  Fortunately, Pétion-Ville was not affected as much as other areas by the earthquake, and the hospital itself was not damaged.

Tuesday, January 12, 2010: Fifteen minutes after the earthquake, patients started to be rushed to the emergency room at the HCH.  Neighbors and family members rushed the injured in their arms or in wheelbarrows; cars transporting the wounded started speeding dangerously in the yard.  At one point, hundreds of people were crowded in the hospital yard.  The emergency room personnel were overwhelmed.  Several doctors living or working in the neighborhood came to help, including two orthopedist employed at HCH.  Others with no medical qualifications also appeared to help with the transport of patients, general logistics, as well as the identification of the most urgent cases.  The HCH’s General Director, the Medical Director and a few board members were in a meeting at HCH when the earthquake occurred, so they were immediately available to help manage the multitude of unexpected situations.  The doctors who were present the night of the earthquake worked non-stop until the arrival of Dr. Scott Nelson, an American surgeon who left his service in the Dominican Republic, to arrive at HCH on January 14^th late at night.  The next day Dr. Pereira and Dr. Jocelyne David, two Haitian-American physicians, arrived by a special flight from Miami, accompanied by an American colleague.  A team from the US Virgin Islands arrived in Haïti with supplies, and met up with individuals heading to HCH.  Friday morning, January 15^th, our stock of disinfectant was desperately depleting when the first truck of supplies from the Dominican Republic arrived with Betadine!

After these four critical days, help from all over the world arrived daily in the form of goods and human resources, as unpredictably as the patients – those suffering from earthquake traumas, women in labor, stroke victims, etc…

In the following days, we learned that a relative of a board member had created a Website for HCH.  Medication, supplies and money were being collected in Florida through the aid of the website.

At one point, we had six operating rooms working day and night. Our hospital normally has two operating rooms, so space was converted to operate. No space had a definitive designation, and most of the hospital was becoming post-op, including the nursery.

For three months after January 12th, emergency situations of all kinds were occurring because the country’s basic facilities were destroyed, for instance the seaport and the airport.  Our usual avenues for acquiring supplies were shut down at a time of intense consumption.  Our routines, and our daily plans, could never adequately address the rapidly developing needs that presented themselves.  Although we attempted to plan for the day’s activities each morning, we could never fully anticipate all the crises and scenarios that would eventually unfold.

Often, donated supplies would appear almost out of nowhere by truck, and our volunteer teams would rush them to the storage rooms, and there were no documents indicating the supplies’ origins.

Because of medical volunteers and donations from around the world, we were able to provide care to more than 10,000 individuals at the hospital.  For a three-month span, all fees at the hospital were suspended, and regardless of the ailment or type of consultation received, patients were not charged.

It was a time of crisis and everyone was doing his or her best.  So many people came to offer their services.  To see so many come to our assistance was what soothed the pain we were experiencing and witnessing.

We have so many people to thank, individuals and organizations, and we do not have a complete list of these generous donors!

April 12, 2010: Three months after the earthquake, the hospital began to reinstate many of its normal administrative policies and routines.  For thirty years, HCH has provided medical care to the general Haitian population at fees that are a fraction of the cost of other private institutions.  These fees were reinstated; however, earthquake victims, whatever the duration of their hospital stays did not pay.  During the acute crisis, a few doctors started a non-trauma, outpatient clinic outside of the main building.  Consultation in the outpatient clinic continues to be free-of-charge.  With funds collected for the purpose of running this free-clinic, many patients have been able to obtain free medical tests and drugs, and some women have given birth at no cost.

After the massive influx of people and activity following the earthquake, the hospital was in disarray.  Gradually, evidence of the clean-up efforts could be seen.  By the end of the summer, most of the facility was restored to its original condition.

End of October 2010: Cholera was detected in the central part of Haïti.  This outbreak is not directly related to the January earthquake.  The epidemic extended to northern and southern regions of Haïti in one month.  By mid-November, cases were identified near Port-au-Prince.

HCH became the main Pétion-Ville care center for cholera in a network put in place by the Public Health Department and its partner organizations.  A tent hospital, a significant distance from the main building, has been receiving cholera patients since November 17th.  We noticed, sadly, that the occupied hospital beds as well as the numbers served in the outpatient clinic has decreased significantly since it has been publicly announced that HCH is a cholera care center…

Some individuals who helped during the acute crisis have maintained contact to assist patients within the institution or to assist in the hospital’s development.

In October, a Swedish organization named Star of Hope donated quality, modern operating room equipment.   A surgeon, who had volunteered at the hospital during the crisis, along with three technicians came to install the equipment.  They left spare parts for the equipment, and they brought specialized wheelchairs, hospital beds, and a stock of cholera vaccines to protect the hospital staff.

The Global Therapy Group, a group organized by two American physiotherapists, has recruited volunteer physiotherapists from April 5, 2010 to the end of this year to provide rehabilitative services.  Under a temporary cover, the therapists provide care daily to outpatients and hospitalized patients. Their work is a real blessing; we have been able to witness the positive impact on the patients’ functioning and morale!

Our hope is to offer better working conditions for the Global Therapy Group’s dedicated caregivers.  Star of Hope has promised to replace the temporary cover under which Global Therapy works with one of exceptional quality.  We need an architect to integrate this structure in the hospital’s existing construction.  We are in the process of making plans to permanently incorporate rehabilitation services at HCH.  Some steps towards that goal will be made in the near future and others involve long range planning.  Sherbrooke University (Quebec, Canada), Quisqueya University (Port-au-Prince, Haïti), Star of Hope, and Global Therapy Group are planning to contribute to the plans to bring permanent rehabilitation services to HCH.

We want you to know that our hearts are warm with gratitude for those who helped HCH when the national situation was so critical and for those who are continuing to help HCH to recover and to progress.

The Foundation aims to offer quality medical care to all levels of our society.  For many years, the fund raising was mostly local.  After Gonaïves was flooded in the 2006, the Southern Command of the US Navy desired to create emergency rooms in Haïti.  After visiting several hospitals, HCH was their first choice.  The Foundation agreed to offer an unfinished new section measuring 2,160 square feet for the operating room.  In the end, the Southern Command of the US Navy, converted the space into an emergency room, intensive care unity, x-ray facility, and blood bank, all connected to a functioning surgical block. The Pétion-Ville Rotary Club also collected money to equip this new section.  The Dr. Michel Carvonis Foundation gave $15,000 US as well.  The Haitian Resource Foundation trained our personnel in the use of the equipment.  This new section of the hospital was inaugurated in May 2009.  God knows, and we recognize, how crucial the development of this space was to our ability to respond to the catastrophic period following the earthquake.

We are deeply happy to send our thanks and our good wishes, and we offer our prayers to all the men and women of goodwill who assisted us in ways that permitted us to help so many others and save lives.

Dr. Edith Dreyfuss-Hudicourt

Below is a letter written by Dr. Edith Dreyfuss-Hudicourt, who is one of the founders of the Haitian Community Hospital.  Recently she travelled to Illinois to attend the wedding of her granddaughter.  This was her first trip out of Haiti since the earthquake six months ago, and her first break from working long hours at HCH.  Being surrounded by family, she felt moved to write to those who have supported the hospital and saved the hospital from bankruptcy, which is the current fate of many Haitian medical institutions.

Hello All,

From Willowbrook, Illinois, I think of all the people who generously helped our hospital provide care to so many earthquake victims after January 12th!

The assistance came so spontaneously from those who already knew the hospital (HCH) and the foundation (FHASE).  They started collecting supplies and money, created the website, and developed paths for donations.  It was the beginning of a long solidarity chain: close relatives, old friends, friends of relatives, friends of friends, work colleagues, school children, religious congregations, pharmaceutical companies, and so on.  All this saved us from bankruptcy.

Every day, medical volunteers treated hundreds of earthquake victims. Volunteers also helped handle and store water bottles and other emergency medical supplies that arrived daily in trucks.  Sometimes we did not know who sent these supplies, and there was no time to count and register everything.  Every inch of space was being used inside and outside the hospital.  Some unfinished rooms of the second floor with no doors or windows became storage rooms.

I must confess that seeing so many people coming to our assistance was the most comforting feeling in the midst of all the suffering we had to witness.

I feel so grateful to all of you!

I wish I could hug each of you!

Sincerely,

Dr. Edith Dreyfuss-Hudicourt

By Josiane Hudicourt-Barnes
May 1, 2010

Here we are at the beginning of May and it will soon be 4 months since the Earthquake happened. The frantic pace of emergency care has abated and the hospital is quiet after 2 pm every day. In the morning the outpatient clinics are crowded but there are few hospitalized patients, few mothers giving birth. I haven’t seen a baby in the neonatal room for more than 2 weeks. The ICU is empty and the emergency room is often very quiet. People have to pay for care at HCH and people don’t have money. Only 2 patients are left from the Earthquake: 15 year-old Judeline with her multiple traumas, and Anese, the first time mom and amputee.Anese’s baby boy is two weeks old now and she is just waiting for a spot in a tent camp that the Organization for International Migration promised to find for her. Judeline is likely to travel to the US for further treatment.

Djimmy , the boy with the external fixator in the photos on our website, finally had his fixator removed by Dr. Bernard this week. The wound care area in the first courtyard is no longer in use, and La Pepinniére replanted flowers and plants in the two courtyards. We had a painting crew two weekends ago freshening up the staircase walls and the coffee area walls, and we had a mural painted on the far wall of the main courtyard. Three weeks ago, Rainmaker guys built a wood and tarp structure over the concrete platform next to the ER entrance for the Global Therapy Group to have their own workspace. Judeline is their main patient with 2 one-hour sessions every day. Judeline has been transformed by the therapist. She no longer has to be begged to get out of bed, and she smiles all the time. Most other physical therapy clients are outpatients who walk in for help or in-patient stroke victims. Global Therapy is in for the long haul and is making connections with other providers, and referring patients to Handicap International for prostheses, until we get our own lab. The Swedish and Colombian delegation that will help us with the prosthesis workshop arrives next week. Meanwhile HCH will be featured for a few moments at the end of this Sunday’s (May 2) Extreme Makeover Home Edition. The family who is getting the new home has a double amputee girl who donated two of her old prostheses to Renane, our poster child from the thank you note, and to another little girl named Louisemil.

Since the last week’s news spotlighted the bankruptcy of Haitian private hospitals, HCH feels lucky. We have had no lay-offs and we are still working. You, our great friends and relatives in the United States, Canada, Haiti, and the world have sent us contributions. Thanks to all of you, we made our payrolls and began to pay our bills without charging patients for 3 full months. We even bought a tiny box van to do errands because the hospital truck can no longer be repaired. We also continued to feed a meal of rice and beans every day to patients and staff. The administration wants to stop feeding the staff as of May 1.

April 12th was a very upsetting day because we began charging patients. Charges at HCH are usually 10-15% of the cost of a fully private hospital ($4 per visit, $6 per hospitalization bed) but it is still money that folks don’t have. The hospital emptied out and the emergency room became quiet. Today there are 20 hospitalized patients. The few earthquake victims left in hospital were allowed to remain for free. Outpatients from the earthquake will also continue receiving free services. Thankfully, this week we received a grant from Direct Relief International for $25000 to continue some free services for 3 months. We will continue to have an outdoor free clinic, and we will begin free consultations for women and children on Monday. By using the grant money to pay the Haitian doctors, we are hoping to actually double the value of the grant by also having guest medical staff to work in pediatrics and women’s care. We know that having fewer patients doesn’t mean that people are not sick. We know that women are having babies without skilled help in their tents or homes, and that every time a child is sick, the mother has to think about whether the child is sick enough to warrant borrowing the money for a medical visit or for transportation to a free clinic. That is an unbearable thought. We know, because too often the decision to go to the hospital is done so late that people die on the way, in the parking lot, or shortly after arrival. Meanwhile news of millions and billions being donated to Haiti keeps arriving but no large entity, not the Haitian government, not the US government, not the very large nonprofits have offered to help us serve the community.

Thankfully, Direct Relief has provided a grant of $25,000 to enable HCH to keep free services for pregnant mothers and the severely handicapped patients for three more months and hire three Haitian medical personnel to work in the clinic.

For more info, Click Here.

In the months following the earthquake, L’Hôpital de la Communauté Haïtienne provided great humanitarian service in a time of emergency and proved to be a great asset to the community. The earthquake highlighted the importance of a hospital in this community, thanks to our great support team, our doctors, our volunteers and our international supporters. However, we realize that we must lay the infrastructure to provide substantial growth and support to both the hospital and the community.

La Fondation Haïtienne de la Santé et de l’Education (FHASE) will be having a members’ meeting on May 25th, 2010. We invite you to join the members’ meeting as we discuss FHASE’s future plans and layout the blueprint to FHASE’s success. To attend the members’ meeting, please fill out a membership application and submit the annual fee; for more info click here.

FHASE Members’ Meeting

May 25th, 2010, 4:00 PM

L’Hôpital de la Communauté Haïtienne
Rue Audant, Rte de Frères
Frères, Haiti

Thanks to wonderful support locally and internationally, L’Hôpital de la Communauté Haïtienne provided care to thousands in the aftermath of the earthquake that destroyed much of Port-au-Prince and its surrounding areas.

In the weeks following the earthquake, up to 5,000 patients received care at HCH, including 541 surgeries. The number of injured immediately overwhelmed this 75-bed hospital. Hospital workers were victims of the earthquake themselves, so HCH was severely understaffed until medical volunteers arrived. Resources were improvised to create additional patient beds and operating rooms as well ensure proper sanitation. With donations, the hospital fed patients and hospital staff even before grocery stores and markets were re-opened. Prior to the earthquake, the hospital did not provide meals to patients, but within twelve days of the earthquake, a kitchen was donated and installed to serve warm meals.

Without the outpouring of support from donors and volunteers, the hospital would not have continued operating. Before the earthquake, the HCH collected small fees for services, but immediately following the earthquake all fees were suspended. Even though income is no longer collected, operating expenses must be paid. For instance, the running water consumption has increased beyond the well’s capacity, so the hospital must purchase truck loads of water, and diesel must be purchased to run generators 24 hours a day. The regular staff is being paid and many staff members were given assistance because they had lost their homes or relatives. HCH’s expenses from January 12th to February 12th are estimated to total 160,000 US dollars. This total does not include damaged equipment and equipment taken away by patients who had lost their homes (e.g., mattresses, sheets, etc).

Currently, the hospital is entering a new phase of care. Plastic surgeons have begun procedures to revise amputations and prepare limbs for prostheses. Medical teams are beginning to fit amputees for prosthetics. Further, the continued presence of foreign medical volunteers has increased the number of women delivering babies as well as the number of children receiving pediatric care at HCH.

Today, the Haitian Community Hospital’s Board of Directors decided to suspend all fees for medical care. HCH was committed to free care for earthquake victims for as long as services were needed, but was unclear about how to handle services not related to the quake.