Debbie Orre, National Nurse Supporter, On The Ground in Haiti

Debbie Orre MSN, RN and National Nurse supporter traveled to Haiti to volunteer as a nurse last month. Debbie provides us with this personal and firsthand report including these pictures.On January 19th I was given the privilege and opportunity to travel with a medical group to Haiti. We arrived eight days after the earthquake from Santiago in the Dominican Republic via charter plane, ultimately landing on the road-become-airstrip in Leogane. The group I was associated with is part of an organization called Forward in Health, founded by our local Pediatrician, John Mulqueen and his wife, Paula (a nurse). They have been in existence for about six years now and are currently building a clinic in the northern part of Haiti. Fortunately for them, this area was not badly damaged in the quake. They soon began to receive urgent emails, however, from a mission they work with while down there called Mission of Hope, pleading for their help. John and Paula mobilized the people and gathered the supplies in 5 short days. In turn the pastor of the mission and his wife, Lex and Renee, agreed to host us and provide the necessary vehicles and drivers.Thus, once we arrived in Leogane, we were ready to roll. Lex took us immediately to a village in the mountains called St. Etienne for our first clinic and we went to work treating an assortment of fractures, dislocations and infected wounds. Later that afternoon, once we had seen everyone there, we were brought to the mission house of our hosts, where we feasted on a wonderful meal of spaghetti and slept on our choice of either the concrete ground, the bus we used for travel, or in the case of our obstetrician, a long, folding table.Over the next few days, we ran clinics in Gran Goave, where Lex and Renee's mission is located, or traveled to a variety of tent cities treating people out of the back of our box truck. Our last day was the most difficult for us. A medical group from Doctor's Without Borders asked us to relieve them so we traveled to a town called Petit Goave on the other side of the mountain. There was a hospital there but it was too badly damaged to use so the group had erected a clinic/tent and, in their absence, we were able to take it over. It was still early but there were already many patients lined up for us to see. The day became hot and busy, and we had a hard time keeping up. We saved the two most difficult cases for last. The OR at this hospital was in a separate building that had not been too badly damaged to use. With the help of several Cuban doctors and nurses we were able to debride a badly burned boy and do a below the knee amputation on a 10 year-old under more sterile conditions. Packing up to leave that evening we found we had many conflicting feelings. While we knew that many of the people we treated may not otherwise have received care at all, we also knew that we were delivering a sort of 'hit and run' medicine, leaving us worried about follow up and survivability of patients once we left. We were creative and able to adapt treatment methods to fit our circumstances, adlibbing as we went, but were not use to the harsh circumstances we found ourselves in. There were four doctors with us: a pediatrician, obstetrician, family practitioner and orthopedic surgeon. There were also 7 nurses, a lawyer who functioned as our pharmacist and an EMT. None of us practiced within our traditional roles, performing what needed to be done, when and how best we could. It soon became clear that our orthopedic surgeon was the person on our team most in demand. After our day in Petit Goave he was exhausted and pensive on the return bus trip. However, we soon met up with the doctor who ran the clinic that day at the Mission of Hope church who needed a patient to be evaluated by our orthopedic surgeon if possible. Though I know it must have taken his last bit of energy, he got off the bus, along with our equally tired obstetrician, and they saw the patient before walking four or so miles back to the mission house. When I questioned him about this later he said simply "You have to do what you have to do. That's all." Our evenings were mostly unpredictable and involved at least some of us working at any given point in time. One night, our obstetrician was approached to assist in a breach-birth delivery. Unfortunately, the baby didn't make it. Another night found five of us walking to a nearby clinic to see several patients we had previously agreed to see, and even brought along one of our own because they had a room that was more conducive to the use of light anesthesia (Ketamine) and joint manipulation. As we were leaving, we were asked to go into a tent city that had sprung up just outside the clinic to see a patient who was ill. Its interior presented us with unique difficulties made worse by the fact that most people were already asleep. Because they were so close together we had to step over them and onto their blankets in order to even get to the patient. The rooms were sectioned off with blankets in a disconcerting and haphazard maze. We soon found ourselves mumbling over fears of being unable to find our way out or, worse yet, tripping and falling on someone, especially in the dim to nonexistent light. On another evening, the family practice doc was asked to see a local 36 year-old woman whom he diagnosed as being in a severe Sickle Cell Crisis. He worried about her throughout the night and first thing in the morning hopped onto a motorcycle with a visiting pastor to drive the mile or two down the road in order to approach a group of US Navy men recently stationed there. He asked them to assist him in getting both she and another young man onto the medical ship, Comfort, in the Port-O-Prince harbor. They readily agreed and were very helpful in gathering up the patients then transporting them via helicopter onto the ship. The doctor cradled the woman in his lap the whole way hopeful that she would pull through but unfortunately we recently found out that she had died.On our last evening there, we were all invited to dinner at the United Nations (UN) Compound near where we were staying. The UN also provided us with food and water during our busy day in Petit Gaove. They patrolled the streets where we stayed each night, since the walls surrounding the mission house had fallen during the quake, and we often saw them in the process of handing out food and other supplies.I believe that I speak for each of us in saying that we returned home awestruck, exhausted and grateful for the opportunity to serve the people of Haiti during a time of such great need. More information concerning our trip and other information concerning Forward in Health is available on their website at http://forwardinhealth.org. Donations would be greatly appreciated.Experiencing Haiti After the QuakeIt was a rare opportunity, both exciting and frightening,And one that would move me beyond my ordinary 'self'.It brought me to a disorientating place,Allowing me to step out of time and space,And produced in me a sense of awe and humility.Here, there was nothing that needed doing,Except to follow the flow of energy, Commitment and connection.But when I returned to the 'present',I had become someone more than the person I once was.Debbie Orre, National Nurse Supporter, On The Ground in Haiti

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