Stories about: Global Surgical Team

Returning from Haiti-one week later

Last week, Children’s Global Surgical team returned from a trip to Cange, Haiti, where they performed surgeries, wound care, general pediatrics and occupational and physical therapy. Here, John Meara, MD, DMD, MBA, the hospital’s plastic-surgeon-in-chief, reflects on what was accomplished and what is still left to be done.

While we were in Cange, we witnessed a lot of improvement in the patients. Many of the wounds are either closed or much better. Our orthopedic surgeons were able to do a lot of procedures, fracture reductions, removing some old external fixators and generally getting people out of the hospital.

The nurses did a great job at integrating with the Haitian nursing team. This was the first time I’ve had physical and occupational therapists on a surgical trip, and they were invaluable, spending all day helping patients who would just have been in bed for most of the day. They also made all sorts of prosthetic devices and helped us evaluate patients to see whether they’re able to leave the hospital.

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Orthopedic care after a catastrophe

This boy was able to hobble out of the clinic without the cast he had been wearing for almost two months.
This boy was able to hobble out of the clinic without the cast he wore for two months.

Although there’s long been a need for improved orthopedic care in Haiti, the nature of the trauma injuries caused by the earthquake has exacerbated the problem into a dire one. Currently, there are only 15 Haitian orthopedists working in the country. “Because of all the associated bone injuries,  which require x-rays, cast changes and ongoing surgeries, it’s clear there’s a chronic need for orthopedic care here,” says George Dyer, staff orthopedic surgeon at Children’s. “That one earthquake created work for a generation of orthopedic surgeons.”

Walking around the hospital, there’s no end to the number of people in casts and external fixation devices–metal rods or pins attached outside of the body to keep a bone in place. “After the earthquake there were so many people with broken femurs that the only thing that could be done was place external fixators on their legs, which can be done quickly and without x-ray,” says Paul Appleton, orthopaedic trauma surgeon at BIDMC. “Some people got casts, but if they had a severe injury to the skin over the bone, the wounds couldn’t be covered due to the need for daily dressing changes.”

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Connecting kids over an ocean

Haitian children drew messages and pictures to bring back to the United States.
Haitian children drew messages and pictures to bring back to the United States.

When Judie Jackson, operating room nurse at Children’s, found out she would be coming to Haiti, she asked her 8 year old niece, Isabella, if she wanted to send a greeting to the school children in Cange. “I thought it would be nice to have a connection between the kids in America and the kids here,” she says. Jackson bought a big blank banner over 10 feet long, and gave it to her niece, who had the idea to bring it to her class at Medway Elementary School. There, her classmates joined in, drawing pictures, greetings and telling the children all about their life in America. “They all knew that Haiti had experienced an earthquake, and they were sad for the children,” says Jackson. “All the messages were very helpful and uplifting.”

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Kim Wilson: improving pediatric care in Haiti

haitidayone_03202010_0113Kim Wilson, a pediatrician at Martha Eliot Health Center, was originally on the Global Surgical team in Cange. But the day after arriving, she was rerouted back to Port-au-Prince, where the University hospital (HUEH) was desperately in need of clinicians to staff the pediatrics tents.

I initially came with the team to work on developing collaborations between Partners In Health’s (PIH) child health program and Children’s, as PIH is planning an expansion of their child health services. However, PIH is also helping to coordinate staffing for the pediatric tents at the general hospital in Port-au-Prince. Ideally, the pediatric tents are staffed by three pediatricians and 12 nurses, but as of this week, there were no pediatricians slated to be there. So Dr. Sophie Allende and I went down to help.

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