Day 7 - bon jour Katty!

A new team from Chicago arrived with more MD's and a few nurses. There are also MD's coming from Port-au-Prince. I have to say there are too many cooks in the kitchen - we definitely don't need any more doctors (with the possible exception of surgeons) but have an unending need for nurses. Some physical therapists and one occupational therapist arrived, and they have their work cut out for them.
Some local Haitian nurses have been coming over and we're trying to train them in wound management. I spent the day with Lusien and taught her about wound care and dressing changes. She was very helpful, but it's difficult to teach through a translator, plus the Haitians tend to take everything so literally, that it's sometimes hard to get them to critically think through things. But she did great and I'm encouraged. I hope she shows again tomorrow.
Many patients are now post-op almost a month (at least the ones who arrived from Port-au-Prince) and are now having complications like bed sores and DVT's (deep vein thrombosis for those non-medical folks - it's a clot in an extremity that has the potential to break loose and end up in the lungs which can be fatal). We have a small ultrasound machine and 2 of my non-ambulatory patients were found to have DVT's. There are so many people with bilateral femur fractures, or other injuries that make them totally immobile. We've tried to teach family members to turn patients, (I cut up 2 camping mattress pads to make turning wedges) but it's so difficult when everyone is essentially camping.
We also have limited x-ray capability. The orphanage here has a small clinic attached (we're not using it - otherwise it would be trashed) and has allowed us to use their hand held x-ray machine. It's apparently for veterinary use (and has not been approved for human use in the U.S.- go figure), but we have found it very handy to verify pin placement or missed fractures on patients.
Today, the plastic surgeon and I had to tell another patient that there was no way we could save her foot and would have to amputate in the morning. It's impossible to describe how heartbreaking it is to see so many people going through this. It truly is mind boggling to see how many people's lives have been changed forever because of this earthquake.
Now that the local community knows that there's a medical facility at this site, we're seeing more and more patients who are chronically ill. Today a 4yr old boy was brought in by his mother. He was in liver and kidney failure. The docs were guessing it was caused by a parasitic biliary obstruction, but no way to tell for sure. After many phone calls, we found a place that in Port-au-Prince that has dialysis capability. He was flown by helicopter there, but there's serious doubts whether or
not he'll even survive the night.
We're also seeing a 2nd round of failed fasciotomies. So that will keep surgery busy with more amputations.
I enjoy my patients more and more each day. When I unzip the tents to go in, they call out "bon jour Katty" - since they can't really say the "th". Most of their wounds are slowly healing and they're making progress. I passed out clothes, sheets, soap, flip flops and toothbrush/toothpaste (thanks Alice Bigelow and her girls who gave those supplies to me - they're much appreciated by the Haitians!) Also, it wasn't quite so brutally hot today - or am I just getting used to the heat? I can't even remember what a hot shower feels like. I had licorice for breakfast this morning - and actually really enjoyed it.