Children's and Project Medishare: reflections from the Operating Room

Maggie Pierre, RN, Organ Transplant, Unit 10S
Maggie Pierre, RN, Organ Transplant, Unit 10S

Maggie Pierre, RN, Organ Transplant, Unit 10S

Stepping on the grounds of my birthplace after 23 years was a shocking experience. The images of poverty, destruction and desperation around me was quite different from the images of my childhood memories. Immediately, I begin to have mixed feelings of guilt for being more fortunate than others in this country as a child, at the same time blessed for the opportunities I have as a United States citizen. Within hours of arrival at the tent hospital, we had two emergent cesarean cases rushed though the operating room doors. As a post-operative nurse, the operating room seems like a foreign and confusing place. I was willing to learn and play the role of the operating nurse for a week. What I soon learned, there was no orientation to the operating room or a preceptor around. This is it, I was the OR nurse.

he first case was a woman that was given birth to her eighth child in labor. She was taken to a local hospital near her home and was turned away due to lack of financial ability to pay for healthcare services. Friends an family drove for three hours to the tent hospital managed by Project Medishare. She screams in pain and begged us to save her baby. With limited resources and lack diagnostic equipment, it was challenging to monitor the fetus’ health. Someone found a Doppler and we were able to get the baby’s heart rate. Manual assessment determined that the fetus was breech. With all these challenges in place we knew we had to work fast and work as a team. We searched around for safety equipments, open boxes hoping to find everything on time to save mom and baby. With the help of everyone involved including two CRNAs from CHB, plastic surgeons and general surgeon, we delivered a health baby boy. Dad was the happiest father I’ve ever seen, as if this was his first born. We transferred mom over to the medical surgical tent and baby boy Peterson was transferred to the NICU tent. Although we had limited supplies and was unfamiliar with our surrounds and partake in roles outside of around comfort zone, we saved so many lives.

There was days that it seemed as if every patient was dying. I spent time crying and question my own faith. Towards the end of our mission I felt grateful to have been part of this mission group. And sad that more women and children will be dying. As we take off for Miami, I couldn’t help but think about the babies in the NICU that are now orphans. They need nutrition and nurture to survive. The work that needs to be done is no where near being completed. We need to continue to care for the children of Haiti. It will take the international community to rebuild this country.

There were two ORs; Sarah Zack and Anne Marie Rich were the only anesthesia staff.

Sarah Zack, MS, CRNA, Department of Anesthesiology

I am writing from an experienced background in Anesthesiology as well as with other medical missions. I do have to say, this specific mission with Medishare/University of Miami/ CHB, to Port-au-Prince, Haiti was one that was very well run. Aside from the group of us from Children’s, (25 or so), there were other medical professionals we came in contact with, from all part s of the U.S. and the world. Together, without knowing one another, we gave everything we had, to work together and help those in need. It was tiring, yes, but the experiences we had professionally and personally from this trip make it one I will never forget.

From my personal level, this mission helped me grow as a practitioner. Being one of two CRNA’s, we had to make some difficult decisions and prioritize the care we were able to give. At times of exhaustion, we kept moving and looked out for one another. The patients’ (and family’s) smiles were enough to know any amount of our time was making a difference.

With such poverty and helplessness, the Haitian people were and are so grateful for everything we do. That in mind makes it easy to give up things that come so easy to us. I saw patience, collaboration, frustration, laughter, tears, teamwork and fatigue. Together, we all made a difference to those people and should be proud of ourselves. I feel very privileged to have been a part of this mission.

Anne Marie Rich, CRNA, and Sarah Zack, CRNA
Anne Marie Rich, CRNA, and Sarah Zack, CRNA

Ann Marie Rich, MS, CRNA, Department of Anesthesia

It is very hard to articulate the experience I had in Haiti. It seems that every time that I try to sit, gather my thoughts, and write about it, I feel the words can’t possibly convey the intensity of emotion that I’m sure all of us experienced on this trip. What I can say, is that it was not what I expected. Having been on a previous mission in Haiti, I thought I had a sense of what it would be like to go again. Shortly after arriving, I realized that was not the case.

Every day brought a busy case load of operative procedures that needed anesthesia. Sarah and I were the only two anesthesia providers during the entire week, so we relied on each other and other members of the team from Children’s to make things run as smoothly as possible. Some cases were urgent, some not; some patients were extremely sick, and others were maintaining some semblance of stability. My emotions followed suit ranging from happy moments knowing I made a positive impact in a person’s life to pure dread knowing that I couldn’t help someone because we lacked basic equipment that I take for granted at Children’s.

Despite this range of emotion, certain moments stood out in the chaos. Those moments grounded me and made me realize how lucky I am to have shared in this experience with such talented, giving, and lovely people. The memory of one such moment will stay with me a lifetime. After a long, busy day in the OR, a patient came in with a broken femur. We did the best we could as a team, but were unable to help him. I was frustrated and overwhelmed with the knowledge that if he were at home he likely would have survived. I stepped outside where a young orphan girl with an amputated leg approached me in her makeshift wheelchair. She held my face in her hands. In spite of the language barrier, she helped me more than anyone else could have at that time. She simply repeated “it’s OK Miss, it’s OK Miss” over and over again. Even during that momentary breakdown into tears, I realized how unbelievable this little girl’s spirit (and those of the Haitian people) was. She has suffered so much devastation and loss in her own life, and yet somehow found the time and compassion to help me. I later thanked her through an interpreter and the smile I received in return made my day.

I thought going to Haiti would make me feel that I had made a positive impact in other’s lives. What I didn’t realize is how much this experience would impact my own.