Team Haiti Returns to Port-au-Prince: Week One

A team of UC Health physicians, nurses and pharmacists is back home after traveling to Port-au-Prince, Haiti last week for their third annual medical mission trip.

UC Health’s "Team Haiti” began annual trips to the country after the January 2010 earthquake that devastated portions of the small island of Hispaniola, which Haiti shares with the Dominican Republic. Last week, the first group of 23 volunteers traveled to Haiti’s only trauma hospital to begin Team Haiti’s three-week rotation.

The first week’s team included physicians and nurses from emergency medicine, surgery, anesthesiology, cardiology and pediatrics. Working day and night, they staffed Bernard Mevs Hospital, run by a small cadre of Haitian health care providers and supported by Florida nonprofit organization Project Medishare.

Bernard Mevs, with three operating rooms, an ICU, ED and pediatric unit, also houses the country’s only ventilators and one of its only two CAT scanners.

UC Health emergency medicine physician Stewart Wright, MD, says the ED, med/surgery ward and ICU combined were still smaller than one of the pods in the University of Cincinnati Medical Center ED.

"We maxed out at four ICU patients, nine in-patients and four ER patients,” he says. 

Wright and others had to work outside the hospital gates to triage waiting patients. 

"We had to turn away some away,” he says. "We assessed them outside the gates and once we realized what we could do and what we couldn’t do, we would see if there was another hospital that could provide the same care.”

That care, he saw, was very different than what he’s used to providing in Cincinnati.

"Treating a heart attack in Haiti is very different,” says Wright. "There are no cardiologists, no cath labs, no thrombolytics. You give the patient an aspirin and all the medications you can think of to support them through the disease, and you hope they get better.”

He says the team also worked to improve the conditions and care at Bernard Mevs. They trained the staff on operating donated medical devices from Sonosite ultrasound machine and Cheetah NICOM monitors, and trauma surgeon Christina Williams, MD, assisted Haitian surgeons in refining their techniques.

Nicole Harger, PharmD, an emergency medicine clinical pharmacy specialist at UCMC, had traveled with Team Haiti in 2011, and said she was "pleasantly surprised” at the progress made since her last trip. 

No longer a collection of jumbled medications, the Bernard Mev pharmacy was better organized and the pharmacists more proactive and independent.

"They are much farther along,” she says. "The staff was very engaged and the pharmacy was better staffed.”

Harger spent some of the week training the pharmacists in calculations and sterile preparations—and says she had to spent some of learning as well.

"There’s definitely a lot of thinking outside of the box and being creative with our resources there,” says Harger. "We had to figure out different regimens for some of the bugs that we weren’t used to and even everyday things based on the medications we had available to us.”

Wright says Haitian physicians could diagnose tropical diseases like malaria, cholera and typhoid with a glance and a patient history. "Things you would never see here, they saw all the time—they would look at a patient and figure it out,” he says.

The team even saw two cases of miliary TB, a severe form of tuberculosis, during the week.

"It was very rare,” says Wright. "Both patients were critically ill, both on ventilators and so young. One even made it through and was discharged.”

Back in Cincinnati, Wright says he returned to the UCMC ED with a renewed appreciation for the teamwork among UC Health’s providers and "for what we have, who we have and the help that we provide each other.” 

"You have to give back,” he says. "We’re so blessed here, both at the hospital as well as personally—you have to give something back if you’re in such a good place.”