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Team 1 (Team Bad Idea Dinosaur) :

Thank you statement from Team 1 - February 11, 2010

After seven earthquakes, fourteen days, several new friendships and countless butt-jarring hours in trucks, Team Bad Idea Dinosaur is back in the States.  At the time of this writing, Daniel is back at home in Providence, and the remaining members of the team are driving to Atlanta to travel home.  (At the time of publishing, we've all parted ways.)

First and foremost we would like to offer our deepest thanks to MADR for the opportunity, support, and awesomeness y'all have provided to us.  As our organization, MADR helped us to give of ourselves and our skills, which in turn allowed us to receive.  We believe that it is this relationship that forms the bedrock of the idea of mutual aid.  We would especially like to thank Kyla, our emergency contact, support, and confidant.  Dude you rock so hard.  You were our link to sanity and the outside world.  Secondly we'd like to thank our families and friends who supported us with kind words, monetary contributions and prayers and good wishes.  We would also like to thank the people who flew us in and out of Haiti; MFI and Priority Flights, and New Life Children's Home who sheltered and sometimes fed us.  Gratitude must also go to all the people we worked with and met along the way for their friendship, advice and companionship.  Mad love and respect go out to our MADR comrades in Ekip Bon Fwa for the amazing work they did and will continue to do.  It was an honor to work with y'all. 

We would also like to express our deepest respect for the Haitian people and the amazing strength, courage, and resilience they have within themselves.  You are and will continue to be an inspiration we will never forget.  We stand in solidarity with the Haitian people as they struggle to rebuild in the face of neocolonialism, flawed trade policies and lack of infrastructure.

Our experience illustrated the need for people and groups willing to travel into areas not usually visited by other aid workers- in short, to work where the scene is not safe.  Many of us on the team and in MADR became involved with the group through the street medic movement, a movement focused on providing medical support where others fear to tread.  This experience gave us as much preparation as any could have.  Those of us from the street medic community would like to thank that community for all the love, information, trainings and late night beers of commiseration that made it possible for us to be in the places we have been today.

 It took a devastating disaster for the world to notice Haiti and it will take only  a few weeks for it to forget it again.   We refuse to be a part of this, and will strive to use our experience to take an active stand against this ignorance. We offer our sincere wishes for a safe, productive, and amazing journey to present and future MADR teams and hope that they are able to learn and experience as much as we did from the Haitian land and people.  Our phone lines and emails are open all day every day for information, support, or anything else we can offer.

With love, solidarity, and sincere thanks.
Team 1/Bad Idea Dinosaur

Tuesday, January 19, 11 PM:
Team 1 is safe and sound, and are now in World Harvest's well established compound in a neighborhood that was not damaged very badly by the earthquake.  Our team has running water, electricity, personal beds with clean sheets and pillows, meals, and even a borrowed car!  They have spotty internet service which means we will have pictures soon.  They are tired. Thomas drove 12 hours and then stayed up all night and day for the flight and busride in Haiti.

Our team has been joined by an ER doctor, two additional WEMTs, a media person, and a local translator. They are already packed with gauze, tape, and sutures to begin scouting Delmas and Carfoure, the
earthquake's epicenter, at 6am tomorrow morning.  They have several leads on hospitals and field clinics that need reinforcements.  When they identify an area that needs their help, they'll return to the compound and come back with a convoy of supplies.

As of yet, they haven't seen too much: some hurt limbs, broken bones. They haven't treated anyone yet, but tomorrow begin the "real world situations."

RETURN TRIP: Team 1 plans to return February 2nd.  They have booked a return flight to Miami and can stay at the compound the entire time, but may move depending on where they end up working.

SECURITY:  The compound has security guards, but more importantly, has good relationships with their community.  There are no operations at night.  The team with leave with sunup at 6am and return at 4pm each day, to be back inside by sundown at 6pm.

COMMUNICATION: The team communicated to the US via satellite phone, txt messages, cell phones, and even a couple of e-mails today.  Communication is solid, at least for now, but they are very busy, and worry about being overwhelmed by communications from the States. We'll continue to limit updates to them to 1-2 per day.

Chris ended his reportback by saying, as he looks around, life continues.  People are at markets.  For those travelers who felt unprepared, there are enough supplies for everybody at the current time and they feel well surrounded.  To y'all back home: “You guys are gonna do fine.  Rack up money and get supplies for us.”

They feel close as a team and are ready to be there together for two weeks.



Wednesday, January 20, 12:45 PM:
From Chris: "We just looked at an abandoned hospital that we could set up on the way to Leogane. It was hit really hard but we are also heading to Leogane right now for an assessment."

Wednesday, January 20, 11:30 AM:
Chris reports that they were not affected by the aftershock:Chris: "Nah, we are great. We are traveling across to find where our team could be of use. Smells like death and it's really hot. We've been to a few hospitals but we are in the works of setting up a new hospital."

Wednesday, January 20, 7 AM:
Team 1 did not suffer any damage in the aftershock and is actively involved in treating wounded Haitians.
Chris from Team 1 reports: "Yea. We're good. Just got to the city. Ran up on a baby with broken femur."

Wednesday, January 20 Daily Summary Report:
The MADRIH team consists of Thomas, Hexe, Jeff, Chris, and Daniel, and is teamed up with an extremely enthusiastic doctor specializing in emergency medicine. Overall, they feel pretty good; they sounded tired but in high spirits. I asked how they're doing emotionally, and they said, pretty ok.  They saw some things that were pretty shocking, but overall are holding up.

Today was a scouting day, with as much medical aid as they could provide along the way. They spent 5 hours in a 12-person van w/ 17 people & trauma equipment with no air circulation in a scorching, hot environment. Many of the organizations the team visited today seemed unorganized.  At the Central Hospital, for example, they were told they could set up a tarp, but after a little while someone else told them to take it away. Much of Port-au-Prince seemed well staffed, though, so the team listened for reports of understaffed places and went looking for them.

PLACES THEY SCOUTED:

  • Port au Prince Downtown General Hospital : They helped for a few hours—the hospital seems well staffed
  • Médecins Sans Frontiéres (Doctors Without Borders) : MSF is seeing 400 people/day and doing basic surgery, but NOT abdominal surgery.  While the team was there, MSF did not have many patients to treat.
  • Field hospital set up in a church, 100s of yards from MSF - Many patients needing help, but no room for more help
  • Leogane (a city west of Port au Prince):
    Some news reports say Leogane was totally leveled. Those reports are incorrect. "Everything that's on news is way overhyped," Thomas said.  There's a Canadian hospital there that is only seeing Canadian nationals.   There are lots of people around but not a lot of people seeking medical care.

The team is currently bunked at the World Harvest compound. The scouting mission revealed that the places where hospitals are being set up are not where most of the patients seem to be. There is a possibility the team will set up a field hospital in the compound; if so,  they will need help to transport patients in, possibly asking the UN for assistance.

Medical problems seen and handled by the team were of an "emergency", but not trauma nature. According to Thomas, "People who need immediate trauma care needed it a week ago and they've either died or found care." There are rampant infections - "Pus comes out of everything." Many fractures needed to be set, and bandages changed from prior medical care from other groups. Third-degree burns are prevalent as well.


Thursday, January 21, 12:45 PM:
The team split up into two groups, one working at a clinic by the dock, the other setting up a clinic at a tent city. The tent city group has been seeing "crazy lacerations, this and that, everything, really... little scrapes to abrasions to wounds that have to be.... really severe infections." It's their first treatment day, and they are very busy.

Thursday, January 21 Daily Summary Report:
The group split into two teams this morning, and gave separate updates.

Report from Daniel, Team 1A:
Team 1A included Hexe, Fidget, Daniel, the Emergency doctor they're working with, and 7-8 more people. This morning they went to the big tent city in a park by the National Palace to set up a clinic. They worked for 6 hours and felt somewhat overwhelmed. There was a good perimeter and the area was moderately organized, but there were a lot of people and it was very busy. They met 3-4 Haitians there who spoke
English and volunteered with them to help translate.

Starting out in the morning was frustrating for Team 1A because of problems in being heard by other groups. Some groups do not use consensus process and this brought on a feeling of disorganization.

They treated at least 50 patients, with each person seeing at least 10 people, sometimes working in teams. Almost everyone they saw had been treated before, most about 1-4 days ago. The injuries they saw were
all "continuing care." They included:

  • Almost all injuries involved taking off a dressing from pre-existing wound, cleaning, and rebandaging
  • Infections
  • Open wounds, like deep scrapes, or huge chunks of flesh missing
  • Prescription medicines being dispensed by the Emergency Doctor
  • Jeff said he saw the worst injury he’s ever seen, a gash about two inches deep, which in turn covered a chunk of flesh approximately the size of an adult hand. They had to rip off a lot of flesh when they took
    the bandage off to adminster further treatment to prevent an infection from taking root.

The doctor was able to arrange it so they could bring 2 patients back to the orphanage where they're staying for longer care. One was a little boy with a 2 inch deep cut to the bone on his leg and 6-7 lacerations on his arms and legs, and a twisted ankle. The second was a girl who has a break in her pelvis, and had been misdiagnosed (by other people) with lower back pain and just sent away with drugs.

Thomas noted that this doctor is great. He's high energy, enthusiastic, very practical, great at improvising, and experienced in third world medicine (11 years travel in Third World Countries). He said, "I know a lot of doctors and I can’t think of one that I’d be more comfortable working with then him."

Report from Chris, Team 1B:
Team 1B included Chris, Thomas, and 3 volunteers who they'd met on the plane to Haiti. They drove around to find a place needing medical help. The team was basically wound care (Chris), medications (Thomas), a pharmacist and two street nurses. By request from the World Harvest orphanage where they're staying, they checked out another orphanage. All 135 kids were ok, and getting a ride to US embassy tomorrow, already adopted.

Team 1B settled in Delmas tent city, where they were told there was one patient who needed attending to. Four hours later, they had treated over 100 people. It was primarily wound management, changing bandages (Chris handled most of the wound care) and dispensing medications and antibiotics (from the Doctor at the compound-- Thomas handled meds as prescribed.) They cut up gloves to hold meds they dispensed in the fingertips.

One girl's finger was mostly falling off, and was attached by a chunk of skin. It was infected. Her finger needed amputation and it hurt so much she would barely allow Chris to touch it. Chris explained that he could have treated this injury, but because Chris did not have the right syringes and needles and because there are not enough anesthetics, he couldn’t treat her properly and had to refer her on.

Other injuries and conditions included:

  • Someone with sutures on the front and back of their head, with infection
  • Some broken bones
  • Wounds (lots): abrasions, wounds already treated with infections,
    amputations. The largest wound was 3 inches x 1.5 inches wide, 1-1.5
    inches deep w/ bones showing. Lots of flesh wounds but some to bone.
  • Hypertension
  • Diabetes
  • Dehydration
  • Early signs of hunger
  • UTIs

Thomas handed out 1000-1500 oral medications today. A lot of people didn't have anything medically wrong (50+ women claimed to have UTIs, only 4-5 actually did), but needed something to make them feel better. Thomas handed out a lot of vitamins as placebos.

They found people there were very receptive to them and calling them “doc”-- no one would listen to Chris tell them they aren't doctors. They treated people until there were no more people seeking medical help despite the team's exhaustion. On the way home they saw a sign calling for “doctors and medical help.” They checked it out and found about 5 patients.

Chris treated a man who was "really banged up." He'd been stuck under two floors of concrete. He had infected abrasions and wounds on his legs, arms, behind the knees, chest, and back. The man had abdominal pain, was vomiting and dizzy. Chris treated his wounds, and they gave him antibiotics for 6 days, which would be enough to get the guy to be able to stand and get to a hospital. Chris felt there wasn't much he could do for this person: there is a desperate need for rehydration IV fluids.

When they came back to the compound, they saw the doctor had set up a hospital at the church there (with Daniel’s two patients). The doctor said Chris could bring his last patient there, but it was too late
today and they will try to get him tomorrow.


Friday, January 22 Daily Summary Report:

SUMMARY:
Today was an effective, efficient, and useful day, and included the first beers they were able to crack open when finally relaxing together at the end of the day.


LOGISTICS:
  • Work/Housing:
    The team found the University of Miami Hospital (also referred to as "the UN hospital", the one near the airport you keep hearing about on TV) was organized and understaffed. They were told outright that their help would be "welcome and useful"-- the hospital needed people. Best news: the team can camp out in the compound which is in a protected area.

  • Longer term possibility work/housing:
    Yesterday the team met a trauma nurse who is the lone international medical help set up in a 3-story school/hospital, complete with operating rooms, security guard, and no earthquake damage. 200 Haitian people are living nearby in a tent city. This lady is one of those awesome, independent, crazy dedicated people, on the "loony awesome end of liberation theology" . Daniel described her as "really cool, someone we'd get along with really well." He shared a choice quote from her: "It's funny how the earthquake mostly destroyed all the rich people's stuff... karma's a bitch!"

    She invited this team and more to stay with her: "everyone's totally welcome but only if they're ok with my extremely foul mouth." The building is structurally sound and located in Delmas 24.

  • Supplies:
    The Emergency doctor with whom they're working went to a UN meeting and registered as an NGO relief agency, which means they are on a list to get any medical equipment they want, which includes the possibility of ambulances in the near future.

  • Logistics for future teams:
    Although Team 1 has found possible places for Team 2 and other teams to stay, the lack of transportation in-country makes it nearly impossible to bring more people in at this time. They're trying to find a way to be more mobile—ambulances would help. If they organize well, they might soon have a place to put another team.

GENERAL UPDATES:

Hexe said today was a pretty good day. In the morning they went out to the tent city by the National Palace. Again, it was frustrating in the beginning to work with people who don't respect or use consensus at all. Eventually they moved on to a different tent city where they got to use their EMS skills, which was "really cool." Jeff agreed, saying "We finally got to do stuff we're trained for… without the equipment we're trained to use to do it." Hexe agreed but added that "so much of what we've been doing is simple wound management, so it's not beyond our scope at all." Basically, it felt good to be able to apply their higher level training to actually save lives.

At the second tent city, the team found two patients. One had head trauma with a possible c-spine injury and the other was presenting medically as a cardiac patient, though later they found out was not. The team transferred them to Miami U's hospital in the back of a modified pickup truck. Hexe said, "It was invaluable to have a place to transport to-- because as EMTs what we do is transport and the hospital was so welcoming and inviting us to come back and help out or stay there." Thomas said, "One, if not both of the people who got transported wouldn't have gotten medical attention if it hadn't been for us. I'm gonna go to bed with sweet dreams of actually helping people tonight because of that."

Hexe summed up the day saying her first beer in Haiti "is lovely. It really really is." She's doing really good right now because they have the possibility of being more autonomous and being able to work closely with the hospital. The possibility of her and Jeff driving ambulances was generally agreed to be wonderful. Hexe is hoping trends continue and they keep getting handed cool opportunities to do stuff. Even if they do nothing more then treat people in tent cities and hand them to a hospital, she said, that's completely amazing, good work. She's seen no change in major injuries: most are wound care and secondary care of wounds that were poorly dealt with in the beginning, and that will continue to need treatment.

Her highlight of the day was asking the doctors at the hospital if they needed extra help and them being welcoming, telling her “of course you can come and help, we always need more people. Everyone's doing every job, you'll get moved around a lot,” but they are welcomed, useful, and they can camp there. The hospital opportunity is really good too because, since it's not safe to walk around after dark, the hospital would allow them a place to work after dark, instead of traveling back outside town to the compound where they're currently staying. Of course, being in at 6 or 7pm forces them take time to relax, and that's really important.

Jeff said it's gonna be difficult to go back to Boston because he's having so much fun-- he kind of hesitated at his words, and then went on slowly, "Shit's bad, it's really bad here. But it's a good crew. The days are insane and then the nights we have wonderful times together. We want to try to go to Thomas's farm in Alabama to decompress" when they come back. They are working incredibly hard during the days, to the point of exhaustion for some, but they feel they are being effective, and they are taking care of each other.

SAFETY: EARTHQUAKES CONTINUE DAILY

Jeff reported that there's been 6 earthquakes since they arrived Tuesday night; they haven't gone a day without 1-2 aftershocks. The one last night was big enough that everyone left the room and went outside. Jeff just heard a noise, but some of them felt it. It was a bigger one-- out of the 6, they've only really felt 2-3, the others they just heard about having happened. When the big one happened Wednesday morning, everyone was just like "holy shit."

They are all sleeping outdoors, and avoid going into buildings if they can. When they have to go into a building, they walk around it first and look for cracks. Jeff said, "we're not engineers but you can kind of tell from outside of some of the damage. We're trying to be careful about it. There's a million buildings flattened but a lot are leaning over so that even small aftershocks can dump one. Hopefully they'll taper off."

The man they treated for c-spine today had a building fall on him in an aftershock. Today was the first time since they've been there that they heard of someone getting hurt by a building falling from an aftershock.



Saturday, January 23 Daily Summary Report:
Hexe, Jeff, and Daniel spent the day navigating bureaucracy at the UN. Thanks to them, "Mutual Aid Disaster Relief" is now an officially registered UN NGO (non-governmental organization), and will probably be getting badges tomorrow. This means MADRiH teams on the ground have access to meetings with WHO (World Health Organization) and other health NGOs. They should get access to the UN's warehouse of medical supplies: pallets of stuff sitting unused in a warehouse. This means our teams can get whatever med supplies they need, including drugs and possibly even an ambulance. For other supplies, they are still researching the best way for getting shipments.

The team spent all day hitching rides between the UN and the U of Miami hospital. "We're an NGO, for legit", Fidget said. The team felt uneasy about registering as a UN NGO without waiting for a consensus meeting, but realized it was necessary to obtain resources - supplies, possibly reliable transportation, and even a possible operational location. Fidget said designation as a UN NGO has "no evident downsides. The process was filling out an index card with a contact person and a group name. It doesn't mean anything—it just has meaning on the ground—but there are no obligations, rules, or restrictions. It's set up so we can get supplies and info, maps of Port-au-Prince (a godsend, to know where the hell we are), and we will try to hook up supplies and meds and transport." Although the terminology used has "organization" in its title, "NGO" status does not compromise our identity as simply a network of resources. Another plus with the NGO status is that the team can now attend the daily meeting with all the health orgs operating in Haiti right now.

The UN estimates that there are approximately 500 "spontaneous encampments" - tent cities - in Port au Prince, but the UN only knows the location of 100. Almost no one has gone to these tent cities, and officials are just coordinating that now. Most tent cities have had no medical care so far - which, Fidget said, "is what our team knew and why we formed the group… This is still mind boggling."

It appears that some medical care done immediately after the earthquake, before the team arrived, was not done up to our standards. The team is doing a lot of follow-up on these cases. Fidget says they included "sutures that don't fully close wounds and a serious open tib-fib fractures that was sutured but not splinted. A lot of really serious fractures, femurs, tibfib, open fractures that weren't splinted almost two weeks after the earthquake."

Also, the UN said there are mass population movements in the 100,000s out of Port-au-Prince, north, south, and east. The government is encouraging and offering free transport for people to leave. 50% of the city has relatives in the countryside, so they're expecting lots of people to move there… but many haven't seen any medical care at all.

There have been no infectious disease outbreaks yet (cholera, malaria, typhoid), which is a "miracle but they could still develop," said Jeff. The Israeli hospital, though, has had 3 cases of meningitis, 1 typhoid, and 1 malaria. Typhoid and malaria are common and, while serious especially if untreated, are comparable to a bad case of influenza if treatment is initiated promptly.

There are now a ton of international hospitals and field hospitals in Port au Prince doing "fairly good work in terms of EMS care and operations, but everyone is in hospitals so no one is going out into the tent cities, triaging and transporting to hospitals." So this has become our team's niche: treating in the field and transporting to hospitals. Now that they have a reliable map, they know where the hospitals are no matter where in the city they are. The roads are getting more congested as access to fuel increases. It's harder to move in a timely fashion because of traffic, "but not terrible," Jeff added.

Team 1 communications with team 2 are non-existent at this point. Both teams can communicate to the US, but they are unable to use texts, email, or phones to communicate with each other.

The cost for housing at the orphanage has dropped to $10/night/person. There's free housing at U of Miami by the airport or with friends in Delmas 24, but the team continues to stay at the orphanage because that is their only source of transporation at this time that does not need to be hired. 

If the UN is unable to supply one or more ambulances, there are two helicopters at the orphanage that may be able to fly our team outside of Port-au-Prince to where all the people are moving. They may need to hire a car for transportation if these don't pan out. Due to the NGO status, the team has a good amount of supplies available to them, but transportation is still costly. Gasoline is running at $10/gallon. In order to get to the patients to treat them, the team will need more cash soon.  

Jeff said, "It felt hotter here today. Walking in the sun, at tops a couple miles, was extremely draining compared to standing in the shade and treating."

When asked how he's doing, Fidge said he's "Good. Tired. Rough day spent doing bureaucratic stuff, which was important but you feel like, compared to us going out and treating and directly helping people, bureaucratic crap doesn't feel effective but it had to be done." He reiterated that it's hard not being on an autonomous team, which is "difficult for people not used to following orders."

They're happy that Team 2 is on its way. They talked a little about Mutual Aid Disaster Relief the network and our goals, and the team has ideas they want to voice, but in Jeff's words, "It's damn near impossible to think about anything but the small picture when you're beside people who need medical care and we can provide it in a manner that is dignified and respectful, we can provide it in a way that is consistent with mutual aid, not charity or jock doctors."

Thomas has got a “golden” video for when he comes back home. He's trying to shoot more video and has a friend with a video editing school who will make a documentary and wants lots and lots of video from them. Today, he treated a 96 year old lady with a femur fracture. He held the fracture while J2 (the Emergency doctor's son, a premed student) provided traction and the Doctor made an improvised traction splint.

As the woman laid on the cot with Thomas holding her broken leg in his hands, she began singing, "half singing, half chanting. It sounded ancient and moving." A pastor nearby translated; the woman was singing, "Lord have mercy, you know that we're going through misery right now, you know that we're going through suffering right now," while she had an open femur fracture for 12 days and they are the first medical people she is seeing. It was a diverse group, a pastor, an herbalist, a doctor, and a pre-med student all helping while this women sang "Lord have mercy" not for herself but for her people. They were all moved to tears as they sent her to the hospital in a "taptap", a pickup truck cab.

The cab that brought this woman to the hospital for surgery to have a pin put in her leg sent back a boy for the orphanage. The boy, about 12 years old, had a head wound and had been in 3-4 different hospitals since the earthquake. The orphanage director asked where his mother and father are, and he says “They're at home.” "He's 12 years old and nobody had thought to ask if he had their phone number," Thomas said. "The boy rattles off his phone number and they called their phone number AND HIS PARENTS COME TO PICK HIM UP. They had not seen him in 12 days. It's one thing to save a life and we've saved several here-- but its quite another thing to save a family."
Sunday, January 24 Daily Summary Report:
Today Thomas went to the UN to network with people and organizations there, while the rest of the team went out into city. They didn't find many patients today because between yesterday's update and today's there has been "a huge flood of medical personnel" into Port au Prince, which, based on meetings with the UN, they anticipate to "continue for the next week or so." The influx of medical personnel means that all 500 tent cities which the UN is aware of have medical teams patrolling and checking for people needing medical care.

With Port au Prince "saturated" with medical personnel, Team 1 is working to get out of the city. Thousands of Haitians are leaving Port au Prince because the government is providing free transportation to anyone who will leave. Many of these people are leaving having had only basic primary medical care, or none at all. Worse, much of that care is, Hexe explained, substandard. "Very, very badly done wound care, sutures that are only making things worse, putting casts over open fractures that are then getting infected so then people have to lose legs.” The team believes the priority on future teams should be surgeons and doctors, and have filled out a UN requisition form for medications and other supplies.

UN food distribution is still a problem. Hexe said "No one is rioting for food, but you have very very hungry people and distributing food is difficult because people are so hungry. It's difficult for us because we cannot give people our food and water because it might start a riot." When asked to clarify, Hexe said that she "hasn't seen anyone actually riot but the situation has been when people try to give people things, there's suddenly a group of 10-15 people who think the people [handing out food] have more than they do."

Hexe went on, saying she can't give an accurate, total picture because "we've been sheltered, driven around everywhere, and babysat—it's not safe to be walking around and we don't have a whole lot of information and don't have a strong enough connection with people here as if, say we [all] spoke Creole. This is nothing like New Orleans after Katrina: we are playing ball with the UN, we don't speak the language and we're horribly hampered by that."

She continued, "Today was a day we sat back and looked at the situation and realized we're becoming less effective and less useful. We're figuring out logistics. We've been having a hard time finding patients. Our team is very trauma heavy, our expertise is treating trauma patients, and since there is now so many medical personnel, there's little use for us. We've been doing secondary care on wounds and broken bones and transporting to hospitals for surgery. Now we're trying to find more ways to do that and branch into other avenues, but we're not sure what those are yet." Jeff added, "We need to get the hell out of the capital."

Tomorrow they plan to spend the latter half of the day debriefing and coordinating with Ekip Bon Fwa (Team 2), which will include extra time to relax and collect so they aren't too exhausted to move out into the suburbs. Jeff also said that since after 6 or 7pm they are inside and can't treat people, from "then on is hanging out. We spend good hours sitting on our gravel pile" in front of the orphanage compound.


Monday, January 25 Daily Summary Report:
The doctor with whom they've been working was called out of the country; he left on a helicopter this morning.

The team spent the day scouting and doing basic hygiene and healthcare. They handed out multivitamins and supplements, vitamin C, ibuprofen, rehydration salts for diarrhea, and deworming meds. Most importantly, they recorded the GPS coordinates of each tent city they came across, and plan to hit every tent city in the Delmas over the next day or so. This is very important, because once the coordinates are recorded, our team will be able to report the tent city's location, needs, and the number of people there to the UN, who can direct further resources towards them. During the day, the team came across a US Army vehicle that was handing out food and were able to direct them to tent cities where people hadn't gotten any food aid yet.

Tomorrow, they get their supplies from the WHO (World Health Organization, part of the UN) and will continue to map out the Delmas, doing basic & preventative care; as Chris said, "picking up GPS coordinates of places that need help and dropping them at some of the good friends we’ve made." Our stateside contact for Team 1 has sent them a list of locations outside Port au Prince that have been requesting aid, and they will either try to go there themselves and also pass this information on to the UN.

Tuesday, January 26 Daily Summary Report:
This morning Daniel, Fidget, Hexe, Thomas, and Chris hooked up with a large group of Christians from a ministry school in Redding, CA. [Daniel thinks they're fiscally sponsored by TDA, Transformational Development Agency, but wasn't sure of the name]. Their two doctors, two nurses, and a dozen or so organizational and security staff set up on a local soccerfield. Since this group only had four trained medical staff, Daniel said, "they were happy to have our help."

The team triaged over 75 people today, but only had to treat about 40--and only five of these had problems directly related to the earthquake. "We were treating normal things that a free medical clinic would be treating" in this region at any time, Daniel explained. "Chronic things, infections, internal stuff which I have very little training in [Daniel's a WEMT], so I was very interested to learn from the doctors and Thomas." They gave out a lot of vitamins for colds and Tums, sometimes as a placebo-- when one kid got Tums for a tummy ache, suddenly every kid within ear shot had curiously similar symptoms. One person had something wrong with his kidneys. The ibuprofen he was prescribed didn't work, but Thomas, a clinical herbalist, was able to find a specific plant and mash it with sour orange and that cleared it up.

One of the doctors they worked with was a 79 year old man who got his medical license in 1957 and has been practicing medicine for 53 years. Another was an Austalian doctor who worked for years at a rural clinic. The organization practices faith-based healing (prayer) in addition to standard Western medicine. The Australian doctor explained to Daniel that he was skeptical of faithbased healing but when he saw it in action he was convinced enough to quit his job and get involved. Daniel said, "it was interesting learning, tagging along with these doctors and nurses."

They also noted that there is still a problem with distribution of UN supplies: "so many supplies but comparatively little effort to distribute them."

Tomorrow the same group will probably go to another location—someplace with more urgent patients. They left late at 10:30am, finished at 3pm, then hung out while waiting for their ride until 5.

Wednesday, January 27 Daily Summary Report:
Today the team went to the WHO (World Health Organization) warehouse where they were able to stock up on supplies, including antibiotics. Hexe said they weren't able to get stethoscopes or multivitamins. Later they went to a pediatric clinic with Anne and Roger from Team 2. Hexe said it was "Really interesting because most of us have no background or training for working in a clinical setting with children." Hexe mostly gave out supplies, but "Anne and Thomas were really good with the children." They left when the doctors got there, spent a while in transit, and hung out with Team 2 later on.

Hexe said, "We're not responding to a disaster anymore, we're responding to the aftermath of a natural disaster exacerbated by pvoerty and people's underlying health issues." She also said that they did not want a relief team sent down specifically to take on the work that they've been doing, because they are a trauma team and their work is not long term work.Given the warning that seismologists still expect more aftershocks in the coming weeks. Hexe said that their team is still sleeping outside, "partly to save money, partly because it's nice outside, and partly because of the 6.0 earthquake" they lived through the morning they arrived in Haiti.

Thursday, January 28 Daily Summary Report:
Although Team 1's reports are getting shorter, at some time in the future this site will have more stories about their work - once they're back in the US and will be able to relay pictures, video, and personal notes more easily than they can now.

Today the team revisited several tent cities to which they'd been before, enabling them to maintain relationships from earlier in the week and check in on some people they'd had as patients before.  They passed out vitamin C, multivitamins, and deworming pills to kids and resupplied some tent city clinics.  They saw  "no traumas to speak of" but changed a few bandages.  Thomas was happy to report that "it seems like Haitian nurses have stepped in and are doing a great job with the tent cities and small clinics."

Tomorrow Team 1 will check Haiti-based logistics for future teams, possibly Team 3.  Jacmel seems flooded with medical personnel, so they will check into that and also get to use a helicopter for reconnaissance to check out rural parts with greater needs than Jacmel has.  These rural areas are places that often only received medical attention 1-2 times year even before the earthquake.  Thomas said that hopefully we could get a team out into the rural communities to provide "primary care for the underprivileged for Haiti… a place where everyone's underprivileged."

One member of the team, Chris, is especially good at making connections. A Haitian by birth, Chris, according to Thomas, has been "watching out for everyone, trying to provide what he can.  He took an entire semester off to come down and help his people.  Our compound is literally on the outskirts of City Soloeil, 'the worst spot in the world'—even in good times the UN doesn't go into City Soliel-- and Chris has been going out there all the time, talking to people, asking if they need help, delivering baby formula, keeping us safe and connected to the local community."

Chris has offered to come back for short periods of time with new teams to help them get oriented to the country.  Thomas "highly suggests other teams bring Chris to get them settled and into the swing."   Also, since Thomas has observed that it takes "a week to get acclimated before real work gets done" , Thomas suggests that all future teams plan to stay at least 2 weeks, like Team 1 has done, or longer.

Thomas also believes that MADRiH should "keep teams on the ground for the next 6 months.  Future teams should plan to come for a long time, be self sufficient, bring food, water purification tablets, and be prepared to wok in rural Haiti." He hopes that MADRiH can raise $20,000 to continue to treat the secondary, lasting injuries from the earthquake and the deaths from poverty that are becoming more visible as the urgency of the earthquake fades a little.

The team has tickets to fly out of Port-au-Prince on February 2nd. Some members will continue working Stateside, raising herbs, giving interviews, and doing local fundraising.

Friday, January 29 Daily Summary Report:
Tomorrow Team 1 leaves for Jacmel.  They are excited to get out of Port-au-Prince, to see the movement of people who have been migrating out of Port-au-Prince and to see rural Haiti.  They are going to "put in a few more days of hard work before heading back.  I'm glad to have the opportunity to learn a bunch more about the country and people."  They will stay overnight in Jacmel, maybe longer.  The tent cities outside the city of Jacmel need medical help. Fidge said, they're going to "work real hard for the next couple of days and then it'll be time to come home." The team is scheduled to return on February 2nd.

Over the last few days the team has witnessed illnesses and deaths from dehydration, malnutrition, and hunger.  At this point, it's more day-to-day poverty and illness that are killing people, not the immediate traumatic effects of the earthquake. The team plans to discuss and create as clear a list as possible of what illnesses/injuries/etc. future teams should be prepared to treat (Editor's note: this list will be based on the current situation; a strong aftershock could change the priorities of personnel and treatment.)





Saturday, January 30 Daily Summary Report:
The University of Miami has a huge hospital and has been employing lots of Haitian workers there since the quake. Through some bureaucratic screwup, they haven't been paying their Haitian doctors, nurses, and staff, so there is a strike at the University of Miami hospital. Team 1 heard a rumor that there was a big ruckus about it. [Editor's note: although I cannot find any information in stateside news about the strike, an article at http://www.miamiherald.com/news/breaking-news/story/1454684.html indicates a snafu between the Department of Homeland Security and the Department of Health and Human Services is preventing any more patients in critical status from being flown to the US for treatment that the USS Carl Vinson and the USNS Comfort cannot handle. As a result, the whole healthcare system in Haiti may be getting backlogged because patients are not being flown to the US anymore. The US military says they are ready and able to transport more patients, but the hospitals in FL are full and DHS won't let them take the patients anywhere else.]

Team 1, aka Team Bad Idea Dinosaur, wants to publicly express solidarity with the striking workers.

Chris has said that he will need at least a month at home to process, recover, work a little to pay some bills, etc. before he'll be ready to go down with future teams and assist with orienting them to Port au Prince. [Transcriber's note: Team 1 will need some rest and recuperation before they're able to jump into more organizing-- they've been going non-stop since the earthquake struck!]

Thomas has a very large network within the herbal and naturopathic community, including a guild of naturopathic doctors, students who he has taught all over the country, and his herbal mentors. He has been communicating with various contacts since he's been in Haiti and has already secured enough supplies ot set up a permanent herbal clinic in Port au Prince. He looks forward to coordinating with MADR alternative care people as well: “I would love to see up an herb clinic in Port-au-Prince and have lots of supplies to set up in Port-au-Prince."

The main problem about setting up a clinic is building logistics:
  • It wouldn't make sense to take any standing building for obvious reasons (so many homeless families);
  • Because there are so few buildings, putting money and effort into building a building so that our people can use it seems selfish;.
  • With the expectation of more aftershocks, it would take some engineering skills to construct a safe building; and
  • Buildings in Port-au-Prince were not cheap before the quake, and now they are more expensive. Thomas estimates the pre-quake, space for an herbal clinic would have been $600-700/mo plus security-- so before the quake $1000/mo. As of now, he has no leads on buildings or price estimates "because of the chaos."

One possibility is to simply bring a 20' party tent from the States, but that would still require security and would need to be staffed daily, a concern, since Thomas doesn't "know how feasible it is to keep herbalists on the ground daily." He's "working on it in his head."

At this point the majority of Team 1 is "“totally out of our field of what we're trained to do.” This not a reason to say “don't come,” but don't come thinking you're going to be using trauma skills.

Daniel estimates that there was a 2-week time period from the disaster before the direct injuries from the earthquake are gone. They look around and still find some dressings to change, "but minor wounds are treated and major ones are in hospitals. You're not gonna wander around and stumble into a tent city with 100s of people who haven't been seen yet." At this point, their work is simply "doing healthcare in a country where there isn't a lot of it."

“We've been trying to find out where we can plug in. It's gonna be really hard. We don't have a skillset that is needed right now, but with that said, we don't know what Port-au-Prince will look like in a week and a half because lots of groups are leaving in the next few days; this is the timeframe people are getting out of here. So it's possible if you just go to Port-au-Prince and visit places you'll find work."

Daniel continued, “There has been a huge amount of medical personnel wanting to get into this country. I'm not sure how clear that is from media and reports, but there's a lot of people here. In the city of Port-au-Prince, there are 10-15 field hospitals (foreign military hospitals) in addition to the Haitian hospitals that survived the quake—[a meeting with the WHO showed there are] 45 operating hospitals total with 100,000s of doctors and nurses who came to deal with direct trauma casualties of the disaster. The problem is almost all those people are on 1-2 week trips (like us). What I've been thinking about is that everyone's living outside Port-au-Prince and there's sanitation and diseases related to that, which are not an issue yet (it's crazy! WHO is monitoring and infectious diseases haven't broken out yet but they might be a concern soon), and I've been thinking about what health issues come from living outside in close quarters without access to sanitation, food, water (access to which is getting better…), not so much medical care—medical care happens in hospitals and there's a lot of that.”

Thomas mentioned making up little leaflets in Creole with clear pictures explaining water treatment and basic sanitation, how diseases spread: “aftercare sheets.” There is a need for community health not trauma.

The team spent most of the day in transit, but were able to set up a brief clinic outside a high school in the countryside around Jacmel. Of the 40 people they saw, only about half needed more than a 5-minute once over and vitamins. Of those, only about 5-10 needed more treatment than de-worming meds, ibuprofen or painkillers, and vitamins (Vitamin C or multivitamins).“If you're coming down here, you're coming down to do the care that's always needed, stuff that was needed before the earthquake and stuff that'll be needed after we leave:” rural community healthcare.

Patients included:
  • Lots of dehydration headaches
  • One burn patient (unrelated to earthquake)
  • worms (everyone has them and they're a major cause of malnutrition)
  • UTIs
  • abdominal pain
  • malnutrition
  • common colds (vit C)
  • multivitamins to kids
  • baby aspirin to someone with heart stuff ("shitty thing to be offering but the only thing we had")

There were so few patients that Chris, who speaks the language, ended up doing most of the treating with the rest helping out "and Thomas doing a lot."

Daniel, Hexe, Chris, Thomas, and Jeff Fidget spent 3 hours getting to Jacmel—"it was a long, long trip" that covered just 30 miles. They met up with Suncere's contact who had a car and was "a really awesome guy." First they went to MSF (Doctors Without Borders) hospital where they were told that “we have enough people here, we don't need anyone at this hospital.” Chris talked to the director of the hospital about where they could go and through that hooked up with a Haitian named Professor Rock who lived in a rural place 1-2 hours away to check out. They stayed a little over an hour and plan to come back tomorrow all day and to scout for the John Brown Brigade (Team 3.)

In Jeff's words: "It was so beautiful. Ridiculous beautiful. Driving up form Port au Prince, from the chaos and misery, we drove up this riverbed surrounded by mountains in this lush area surrounded by mountains." They rode with the driver, Sun's contact, a friend who spoke English, plus the 5 of them, all in a pickup. Daniel explained they took a "crazy road in and out of a river, following the riverbed, crossing the river every couple hundred meters (at deepest 1 foot deep, in big pickup truck) to the remote tiny town where the professor is from. We set up a clinic outside the high school – nice building.

There were no structures there that could have been knocked down—just wood or tin construction. It's amazingly beautiful—the first big trees I've seen in the country." Although Haiti is 99% deforested, Daniel said that they were in "part of the 1%." Jeff said they spent a lot of the day traveling but “I felt really good about the work we did with these folks cause they don't get a lot of medical care.” They're going back to Port-au-Prince tomorrow night.

Tonight, Chris says, "we're chilling on the breezy beach…"

Sunday, January 31 Daily Summary Report:
They are sunburnt and tired and will be preparing to return home to the United States tomorrow, Monday. They fly out on Tuesday (February 2nd) and will be collectively regrouping together in Alabama for a few days upon returning home. They are very appreciative of the Stateside support and anticipate continuing support of Haiti relief work upon their return to the States.

This evening they had a conference call with Teams 2 and 4 to go over lessons learned by Team 1. They emphasized that a working knowledge of Haiti, basic medicines, and Creole (at least a substantial amount of translators) is important for any future teams. Chris said specifically, "Just make sure that whatever team is coming is not coming for a specific trauma situation. You need to work on having a good understanding and education about primary nutrition and primary care. We are in the post disaster period. We treat people who are not seeing doctors for up to a year in a 3rd world country. We want people to understand that. Also malaria, typhoid, dengue, other infectious diseases that might be coming up in the next 4 weeks. Every team needs to be able to understand how to identify these things. When we got here, we had to create a role and rush into learning a lot of these things. Each team needs to be more prepared."

Monday, February 1 Daily Summary Report:
Tonight Daniel gave the last update from Haiti for Team 1.

It was a chill day overall. Jeff, Hexe, Chris, Thomas, and Daniel met up with Team 2 and Chris's older brother, who lives in Haiti. They all hung out for an hour and a half and had really productive discussions reflecting on their time in Haiti, accomplishments, and future goals.

From there, Team 1 and Roger went with Chris's older brother to his house, where they hung out for a few hours and walked around his neighborhood. An older man and Thomas played craps--the old guy totally beat Thomas. Neither spoke the other's language but they managed to communicate just fine. Finally, the Team drove back with a driver they've been with for the last few days, and have been packing and sorting stuff, preparing for departure tomorrow.

Soon after they were back at the orphanage where they've been staying the last two weeks, Chris got a call from someone (a Haitian) who said there was a shooting in a neighborhood they'd just been through. "Cops and commotion," said the caller, Daniel told me. “Whatever calm and peace there was in the city is gonna go back to the situation it was before the earthquake." Daniel continued with his own thoughts, "It's interesting for me because we've seen this city in a time when they'd suffered this catastrophe but it had also changed the character of the city,” with crime rates down, a safer, different Port au Prince.

Daniel told me a story that he'd been "castigated" for forgetting to tell a few days ago. When they'd been driving to a rural village outside of Jacmel, they had been "driving in and out of this river, at one point it got completely dark and we were completely lost, driving the wrong way in a river valley. Our truck got stuck in the river trying to cross where you're not supposed to cross it because we were 50 feet off the road… oh damn. Sun's contact in Jacmel hopped out of the car and flipped it into 4-wheel drive-- it hadn't been in 4-wheel drive yet but they'd been driving through a freakin river! He kicked some rocks out of the way and just drove out."

Thomas and Jeff said "hi" too, but Hexe, Roger, and Chris were off eating, I think. They all look forward to sharing stories, thoughts, analysis, photos, and videos once they get to Thomas' farm in Alabama.

Tuesday, February 2 Daily Summary Report:
Team 1 and Roger are safe, sound, and happily in Florida. They're spending the night in Miami. Roger heads home and Team 1 heads to Alabama tomorrow morning.

 

Page last updated: Sunday, February 28, 2010, 10:02 AM HT