Haiti: Emergency surgeries after the earthquake

Where were you when the earthquake struck?

I was returning home from MSF's Tabarre hospital and I felt the shaking on the road. At first I didn't think it was a very powerful earthquake. It was afterward that I started to receive photos and images of what happened. I saw an informal discussion in an MSF chat group that we could send a team, and I told our medical activity manager that if MSF needed an orthopedic surgeon, I was available, and he said we would leave at 2pm.

Everything was ready then and we left on the road for Les Cayes. The most stressful point was to pass through the Martissant neighbourhood to reach the road to the southern region affected by the earthquake. There are armed clashes in the area, and we heard worrying reports that raised our stress—for our safety, and not because of the earthquake.

What was the situation you found on arriving in the south?

The first place we arrived was the town of Les Cayes. It was very impressive. It brought me back to the earthquake in 2010, because it was practically the same kind of destruction—houses completely collapsed, rubble in the streets. There were places where we could not pass at all, where we had to find another way. We spent our first night in Les Cayes, before moving on; a colleague of ours was already supporting the operating theater at the hospital there.

The next morning we left for Jérémie. Before we reached the Riviere Glace, we saw that the road was blocked by a landslide. We already knew that the road was blocked, but no one could tell us whether a car could squeeze through the rocks there. We exited the vehicle and took photos of how rocks blocked the road for at least a kilometer. Then we had a little scare because we were close to the cliff, and then there was an aftershock, and a few stones came down. We turned back to Les Cayes, and finally we took a helicopter to reach Jérémie.

How did you begin your work in the area?

The first difficulty we had was to make contact, to know who we should see, because no one knew who we were and what we were here to do. It took a day and a half before we could really work. The personnel at Saint Antoine Hospital did extraordinary work with the few staff and resources they had. Many patients were already cleaned and their wounds were debrided when we arrived. Some had external fixators to set broken bones, and some patients had already been referred to Port-au-Prince by air. A number of doctors who were originally from this region also returned from their jobs elsewhere to support the hospital. 

So when we arrived, we asked, "What can we do for you?" We picked up where they started. And so we operated on many patients. Sunday we had four patients, Monday we had nine patients, then 10 to 12 patients per day. Generally we left the hospital between 11pm and midnight, in order to see the maximum number of patients. So we are shrinking the pool of patients waiting for treatment, waiting for surgery.

Are you seeing patients for follow-up surgeries?

Yes, we are starting follow-ups. The majority of our patients are now ones that we have already seen, coming back for a debridement, a new surgery or a cast. But there are still people from the back-country, where there is no help, who are coming to Jérémie for emergency care.

As of 20 August, the MSF surgical team in Jérémie had treated 54 patients for injuries suffered during the earthquake. Thirty-six of these patients underwent surgery, while others received casts or splints.

MSF also provides surgical care at its Tabarre hospital in Port-au-Prince, where more than 45 patients have been admitted with injuries from the earthquake to date, in addition to patients being treated in the emergency room and discharged or referred elsewhere.