The patient had a number of wounds to her battered body, but her most pressing question was how to stanch the flow of milk from her breasts, recalls Lisa Luly-Rivera, MD. The woman was in an endless line of people Dr. Luly-Rivera, a hospitalist at the University of Miami (Fla.) Hospital, cared for during a five-day medical volunteer mission to Haiti in the aftermath of the January earthquake that devastated much of the country.
“She had lost everything, including her seven-month-old baby, who she watched die in the earthquake. She was still lactating and wanted to know how to get the milk to stop,” Dr. Luly-Rivera says. “I heard story after story after story like this. For me, it was emotionally jarring.”
A Haitian-American who has extended-family members in Haiti who survived the Jan. 12 earthquake, Dr. Luly-Rivera leaped at the chance to participate in the medical relief effort organized by the university’s Miller School of Medicine in conjunction with Project Medishare and Jackson Memorial Hospital in Miami. But soon after arriving in the Haitian capital of Port-au-Prince on Jan. 20 and witnessing the magnitude of human suffering there, she second-guessed her decision, wondering if she was emotionally strong enough to deal with such tragedy.
She wasn’t the only one with reservations. Some at the University of Miami Hospital were skeptical that hospitalists could help the situation in Haiti. They questioned why she and her colleagues were included on the volunteer team, Dr. Luly-Rivera says. Ultimately, she proved herself—and the doubters—wrong.
“As internists, we were very valuable there,” says Dr. Luly-Rivera, who logged long hours treating patients and listening to their stories.
Determined to do their part to help survivors of the earthquake, hospitalists across the country joined a surge of American medical personnel in Haiti. Once there, they faced a severely traumatized populace (the Haitian government estimates more than 215,000 were killed and 300,000 injured in the quake), a crippled hospital infrastructure, and a debilitated public health system that had failed even before the earthquake to provide adequate sanitation, vaccinations, infectious-disease control, and basic primary care.
“If Haiti wasn’t chronically poor, if it hadn’t suffered for so long outside of the eye of the world community, then the devastation would have never been so great,” says Sriram Shamasunder, MD, a hospitalist and assistant clinical professor at the University of California at San Francisco’s Department of Medicine who volunteered in the relief effort with the Boston-based nonprofit group Partners in Health. “The house that crumbled is the one chronic poverty built.”
The Jan. 12 quake killed more than 200,000 and toppled buildings in Port-au-Prince. Building instability has kept civilians out of their homes for more than three months.
Dr. Luly-Rivera checks the chart of a patient at the tent hospital in Port-au-Prince.
Dr. Reyes (left) and Dr. Jaffer (right), with Barth Green, MD, chair of neurological surgery at the Miller School of Medicine, after a long day at the tent hospital.
Dr. Crocker uses a portable ultrasound machine to check out a patient at Clinique Bon Saveur, a hospital in the town of Cange, about two hours northeast of Port-au-Prince.
Dr. Shamasunder was stationed at St. Marc’s Hospital, 60 miles west of the capital.
Worthy Cause, Unimaginable Conditions
Mario A. Reyes, MD, FHM, director of the Division of Pediatric Hospital Medicine at Miami Children’s Hospital, shakes his head when he thinks of the conditions in Haiti, one of the poorest nations in the Western Hemisphere. “This is how unfair the world is, that you can fly one and a half hours from a country of such plenty to a country with so much poverty,” says Dr. Reyes, who made his third trip to the island nation in as many years. “Once you go the first time, you feel a connection to the country and the people. It’s a sense of duty to help a very poor neighbor.”