Figure 1 – Although the rubble had been mostly cleared from the main road from Port-au-Prince to Jacmel, rubble removal was still ongoing in Jacmel while we were there.
For 2 weeks this past March—2 months after the strongest earthquake to hit Haiti in more than 200 years had struck—I served as part of a physical medicine rehabilitation group sent by Team Canada Healing Hands (TCHH) (Box). The team worked in both Jacmel, a major city on the south coast of Haiti, and in Port-au-Prince. Portau-Prince, Jacmel, and the 80 km of mountainous land between these 2 cities suffered severe damage during the January earthquake.
My role was to provide medical support for the rehabilitation patients and otherwise support local pediatric services. As things turned out, more than 90% of my time was spent supporting local pediatric services. For the first 10 days, I was the pediatrician for the outpatient department at St Michel, a Jacmel hospital that partially survived the earthquake, and for the last 2 days, I served as pediatrician for the inpatients in the Project Medishare tent in Port-au-Prince.
When I arrived, the devastation wrought by the earthquake was immediately evident. Although just about all the rubble (Figure 1) had been cleared from the road that connects the capital to Jacmel (a 2-story–high boulder remained, blocking 1 lane near the top of the pass), there were wide cracks and upheavals in the paved road. The trip from Port-au-Prince to Jacmel took 3 or 4 hours, depending on the time of day and the weather. Almost everything but disaster and disease moves slowly in Haiti.
JACMEL: LONG LINES OF PATIENTS WAITING FOR CARE
During my time in Jacmel, there was usually a Haitian physician in the St Michel emergency room (ER) and a foreign disaster-relief physician in the outpatient area. In addition, Médecins Sans Frontières (MSF) ran an inpatient service in tents on the site. When I arrived, I took over the pediatric outpatient care, which we provided in a United Nations tent next to the ER (Figure 2).
Figure 2 – This is the United Nations tent in the city of Jacmel where we provided outpatient pediatric care.
Families and individuals in the Jacmel area who desired medical care turned up at the St Michel site soon after dawn each day and waited patiently to be seen by a physician. Some waited the entire day. Every morning by the time we arrived, there were several hundred people waiting to be assessed; about one-third were children (Figure 3). At first I was rusty and inefficient, and we did not manage to see all the children the same day they arrived. We gave out numbers to those we did not get to so that they would be seen first the next day. Within a few days, however, my history questions had become more focused, my notes had gotten much shorter, and we managed to see all the children who came to us.