They came to the hospital gate, and no one was turned away because they couldn't pay. Some people had traveled many hours, days even, seeking help. They had wounds of all kinds—gunshot wounds, burns, head traumas from car accidents— plus other critical conditions, ectopic pregnancies, infected diabetic feet, limbs requiring amputations, neglected or undiagnosed cancers, severe GI distress, and others.
Hospital Bernard Mevs, in Port-au-Prince, is the only trauma and critical care hospital in Haiti, a country of 10 million people and one of the poorest in the Western Hemisphere. The hospital offers the country's only NICU and PICU.
Outside, it was 90 degrees with 75 percent humidity. Inside, the ER's air conditioner didn't work. Supplies, diagnostics and labs came in limited quantities, and with intermittent electricity, the CT scanner was available only part of the day. Families did their own nursing: bringing the sick food, keeping them clean, changing their linens, helping them to the bathroom. People died there, but many more were saved. Babies were born, and people were treated and went home to their families.
For seven days from March 31 to April 7, a 15-member team from OHSU worked side by side with Haitian staff and translators to provide care, each teaching and learning from the other. The OHSU members were there as volunteers on a medical mission run by Project Medishare, a nonprofit health care organization started by the University of Miami School of Medicine in partnership with Hospital Bernard Mevs's Haitian surgeons.
The OHSU team came together via word of mouth, colleagues asking colleagues. They represented a variety of units: John Mayberry, MD '86, R 92, Trauma/General Surgeon, Professor of Surgery, who was the trip organizer, Tiffany Reinke, RN- 8C, Cardiac and Surgical ICU, Jenna Dullanty, RN- 8C, Cardiac and Surgical ICU, Becca Cooper, RN- 8C, Cardiac and Surgical ICU, Kit Bowden, RN- 8C, Cardiac and Surgical ICU, Casey Hursh, RN- 8C, Cardiac and Surgical ICU, Bethany Denison, RN- 8C, Cardiac and Surgical ICU, Jerusha Taylor, PharmD- Pharmacist, Carolyn Lynnes, RN- 7A, Trauma ICU, Kathy Conway, RN- 7A, Trauma ICU,Kim Dody, RN- Pediatric ICU, Diana Scolaro-Cook, RN- Pediatric ICU, Helen Thomas, EMT- Paramedic, ED, Rebecca Harrison, MD R'98, Hospitalist and Associate Professor of Medicine, and Deb Freysiner, CRNA- Anesthesia.
The OHSU team worked in 12- to 14-hour shifts and slept in a compound right next to the hospital. They filled in wherever they were needed, even if it was outside their skill set. Dr. Harrison, a hospitalist, helped out in the ICU, doing post-op surgical care. She also cared for babies in the NICU and pitched in with physical therapy. It was her first medical mission abroad.
"I wanted to go for several reasons," said Dr. Harrison. "I wanted to help, to serve, to see medicine in a different environment and to broaden my horizons. Working with limited resources really pushed the envelope in that regard."
Because of limited supplies and diagnostics, the team was pressed into finding innovative solutions. "We called it MacGyvering," said Tiffany Reinke, RN, who worked in the hospital's ER, though she's an ICU nurse. "It was making do with what we had. For restraints, we MacGyvered with stretchy gauze. Sometimes for foleys, we'd hook up a foley bag to a garbage bag. For the little babies, we sometimes used a specimen cup for a urine container. All these little tricks made it work. I found it fun and different, and it gives you perspective. What little we could do made such a big difference."
The new, challenging environment pulled the group together as a solid working unit. "We were a team of people working together and consulting with one another to figure out a problem," said Dr. Harrison. "It was awesome. We came together in a really powerful way. OHSU should be really proud of the group that went."
During her time there, Dr. Harrison discovered how different Haitians are when it comes to pain relief and pain management. Despite the availability of narcotics, most Haitians preferred minor pain relief or none at all. "In about 100-plus hours on duty, I wrote three orders for IV narcotics. Their resilience was incredible," said Dr. Harrison.
She also observed how realistic people were when it came to death and dying. "Haitians view death as very much a part of life," said Dr. Harrison. "There is acceptance of the limits of medical intervention. It was so different from the U.S., where we use all these health care dollars to desperately hold onto life. That was a big lesson."
For Dr. Mayberry, who tries to volunteer in medical missions once or twice a year, the trip was his second to Haiti. "It's personally very gratifying to do it," he said. "And it's a challenge. You are the one at that moment. You have to do it. You just dive in. And you can give good care without all this fancy equipment. It gives you perspective on what is good care."
"It changed me, very much," adds Dr. Harrison. "I realized that by doing this, you can be that change you want to see. One way is giving money and resources. And the other way is seeing it with your own eyes. Now I understand something I didn't before. The experience and the people there taught me a lot. I got a global picture of health care that is very different from our own. And I feel very, very grateful. I'll be back!"