I always end my trips to Haiti with this visit to the orphanage where we found our daughter Anabelle. It is the highlight of my trip and last night we sat around with the older kids talking about their dreams and school. We were late getting here as a man stabbed by his wife was brought into the hospital as we were departing. He had stab wounds to his chest and upper arm. The ensuing 2 hours we spent sewing up his brachial artery and median nerve, a repair that would not have occurred in our absence. His wife brought him to the hospital. I guess she still loves him!
This trip to Haiti after Hurricane Matthew was a short one and scheduled only to care for some upper extremity injuries that made it to Port-au-Prince from the southern peninsula where over 500 people died and tens of thousands have been left homeless. Dr Jean Hippolyte who spend two months with us in Flagstaff during his orthopedic surgery training called and asked for support treating patients after this disaster. Roseline suffered a forearm laceration when the roof of her house flew into the air and came crashing down on her. We repaired her Median nerve and multiple flexor tendons, another injury that would have gone untreated had a hand team not been in town. Louis-Jean was also struck by a flying roof and sustained a hip fracture. It was 10 days after injury when we arrived. We tackled this without X-ray to assist us and during the procedure discovered we had no power drills. I was able to find two hand drills and with the Haitian Orthopedic Residents providing the strength, we were able to fix the hip with three screws.
We also treated Genese who lost her children, her husband and all her possessions. She suffered a left femur fracture and right forearm fracture repaired by Dr Hippolyte the day after the hurricane. Her right wrist was fractured in multiple pieces with one boney fragment flipped 180 degrees into her forearm and pushing on her the median nerve. Without xray in the operating room and with limited supplies we were able to improve the position of the fracture and maintain it with a couple small screws, wires and an External fixator. Not perfect but in a better position than before. She has the chance for a functional arm.
The most difficult case for me was a 10 year old boy who lay on the ground for several days after he was hit by debris which severed his spinal chord through a thoracic spine fracture dislocation. He arrived with the worst decubitus ulcer over his right buttock that I have ever seen, we debrided this and watched his fevers go away. He also has tetanus and is being kept alive with a ventilator. He will not likely survive.
Next week the American Society for Surgery of the Hand is sending a team to Haiti through their volunteer program “Touching Hands”. They will care for patients with upper extremity injuries and teach the Haitian Orthopedic Residents. These residents are bright, talented and eager to learn. Touching Hands will also help train these future orthopedic surgeons in techniques that will allow them to care for these patients who do not get treatment unless a volunteer hand surgeon is in Haiti. Our team returns in December.
Many in the cities of Jeremie and Les Cayes are sleeping tonight on a sheet on the ground including the families of our two Haitian exchange students. My trips to Haiti are always humbling experiences and I return feeling so lucky for what I have, a roof, four walls, a bed, food and my healthy family.
Give your family members all a big hug tonight.
With Love, Bull Durham
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