Doctor in Haiti Tells of Makeshift Medical Care Amid Aftershocks

BOSTON--In Haiti, foreign forces have been dropping food and water from planes, and more medical supplies are coming in. The U.S. Navy hospital ship "Comfort"...arrived near Port Au Prince this morning.

That should be welcome news to medical workers who have been treating tens of thousands of quake victims with very limited resources.  One of those workers is Dr. Evan Lyon, who is volunteering in Haiti with the Boston-based aid organization Partners in Health.

The group has been in  Haiti for 20-plus years and runs ten hospitals there, with 4,0000 Haitian medical staff.  Dr. Lyon has been helping out for the past 13 years. We caught up with him via satellite phone yesterday and asked him to describe the scene.   You'll find his description, along with a transcript of the conversation below.

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We're working around the clock to come back to life.  We've been operating for 2 or 3 days now but in improvised operating rooms without proper anesthesia.  We've been forced to do amputations with a hack saw bought from the hardware store.

For the last few hours we've begun to have electricity.  Until then we've been operating by day light and by flash light.  I'm looking at a courtyard with more than a thousand people that need urgent surgery to potentially save their lives.

More than a thousand people?

In front of me, yes. People with broken bones, people with compound fractures. They're getting antibiotics they're getting wound care, but we don't have any pain medicines... Infection is starting to develop and we simply have not yet had the capacity to take care of these people.  The intensity of suffering ... is really staggering.
"We've been operating for 2 or 3 days now but in improvised operating rooms without proper anesthesia. We've been forced to do amputations with a hack saw bought from the hardware store."

--Dr. Evan LyonJust tell us a little more about these injuries.  Because we know many of them were crush injuries and you can't even see them from the outside sometimes, so how are you handling that?

Well the first thing we do when it's possible if there's a crushing injury that's swollen tissue. We're obligated to do a procedure called a fasciotomy where the skin and the muscle is opened to relieve pressure.  It's incredibly painful under the best of circumstances. And here with with a very small modicum of anesthesia and no post-op pain control, it's horrendous but it can be life-saving...

The people who are alive now, they have broken bones, they have these crushing injuries.  If they've been lucky enough to not die of infection or kidney failure because of the crushing injury, they're here with us now and we're working around the clock to provide them the surgical, the medical care that they need.

Can you describe how they are handling that.  I can't imagine being, you know, a mother with a child, 500 people back in a crowd of a thousand.  Patient.  How are they handling that wait?

I've lived in and out of Haiti for the last 13 years and and in many ways consider this my home.  This country and this community and this city is handling this disaster in a way that I think few places on earth would handle it.

We have these crowds.  Just today we're beginning to have some security from the U.S. army but up until now it was my Haitian colleagues the Haitian medical director, a few foreign volunteers and we've just been here on the ground and we've been here working around the clock.

People are very calm.  There's no insecurity.  It's been very painful to hear these rumors and lies about security problems when, in fact, I am here right at ground zero and have been around the clock without any security issues.

We've been circulating through the city in our own cars with our friends our Haitian colleagues. I'm staying at a friend's house and there's no insecurity.  At night there's no electricity, you can hear a pin drop in the city.  I don't know how people are surviving but they are.

And just what is it that you need the most?  I am sure that you are aware from your colleagues back here in Boston that there's tons of money being donated by Americans. Things are being boxed up but we know that there's a bottleneck at the airport. What are you starting to get that you're appreciating, but what do you really really need?

Right now we need the ability to do surgery. We need surgical supplies. We need medicines, surgical medicines, I.V. medicines and we need orthopedic materials- saws and tins, bolts and screws things to repair the bone.

We need materials to do this acute work. Very soon there's going to be now a generation of people with amputations and so we need crutches, we will need wheelchairs, we'll need other ways to help people move -if they survive- to help them get on with their lives.  Currently, many of our post-op patients are getting the best care we can possibly provide them.

They're now two and three days without food and they won't recover without food or water and so we're working to get that.  Right now, to be honest what we need most is money. With money we can move things very quickly.

In the next weeks and months, it'll become clear what material is needed.  But right now we need cash so that we can move things into the country and deal with this as a disaster and surgical emergency.  Soon there'll be other needs.
"I'm looking at a courtyard with more than a thousand people that need urgent surgery to potentially save their lives."

--Dr. Evan LyonAnother need long term and really why I am here personally.  Haiti needs to rebuild Haiti.  I am working as a volunteer directly for the medical director of this hospital.  All of my efforts are at his command.

This is a Haitian-led hospital, it always has been always will be.  We're providing assistance, but Haiti needs to be given the capacity to run itself.  The urgent needs, the materials and the food and the water and the medical assistance is urgent.

But in the coming weeks and months when people start to forget about this disaster, we need to understand that this country has been changed forever and it needs to be allowed to rebuild.

Is there any bright light that you want to share, anything after seven days of...you know just some hope?

I'll tell you the greatest hope I have right now is with my Haitian colleagues and friends.  They're unstoppable.  The work that has been done to this point has mostly been done by Haitians. We're all deeply appreciative of the assistance that's coming in from the outside world, there's hope in that.

And let me give you one one positive story to end this interview and then I've got to go.  We've talked about crushing injuries, one of the things that can happen is that with that muscle injury it can overstress the kidneys.  In these situations, people often need dialysis.

And you'd think in these conditions I'm describing, it would be impossible to do something as technical and and labor intensive as ...dialysis. There's a team from Medecins sans Frontieres in Beligum that is here on the campus and they've been doing dialysis now for 2 days.

I got an email around midnight from someone in .. one of our hospitals about 70 miles away who was in kidney failure.

They were moved here to Port Au Prince today and they'll receive dialysis And those success stories will start to come too.  They'll be very slow and they'll be very few, but there are some reasons to hope.