Cracking the medical supply code – Wednesday – 1/27/10

Today we made our first real crack in the supply code and got our first real access to medical supplies. We found the USAID warehouse where all the ‘unclaimed’ pallets and pallets of medical aid that were off-loaded from planes (but the recipients didn’t happen to have trucks standing by to take them away at the time the flight landed…funny how sometimes a flight will come in 5 hours earlier than one has been told, and you get to the airport with you trucks and the plane is long gone…and you never find your medical supplies!) were taken to. We scored 3 generators, miscellaneous medical supplies, fans, and 6 beds. This was a small part of the list we had gone there with for tents and the equipment we need to set up 3 field hospitals.

One of the orthopedic surgeons said last night “There is going to be a tsunami of implants (rods, plates, and screws) necessary in this country in order to fix all the broken bones”. Not to mention the need for a lot more truly sterile operating rooms to put them all in without getting them infected. It boggles my mind. I suppose if shiploads of supplies eventually start hitting the docks it will be more realistic. But those implants are expensive! And the companies that make them have been telling surgeons who call and ask to bring more down with them that they have already donated all that they’re going to donate.

CDTI (Center for Diagnosis, Treatment, and Imaging), the hospital where I did amputations for my first week here, contains 4 of the very few sterile operating rooms in this city capable of doing surgery to place implants. The rest of the patients with broken legs (femur fractures) and other fractures have been shipped out to the Navy hospital ship “Comfort”, which has been overloaded to the point that the waiting list to transfer patients to it is now 3 weeks.

Speaking of CDTI, my good friend and colleague Ben Massey (and Debbie Valdez too I am told) has been doing very good work there since I dropped them off there 2 days ago. (Was it only 2 days ago?!) They now have the following teams all working together there as one big team: Melbourne FL, Colorado Springs CO, Frisco CO, Pueblo CO, 2 other teams from other states, and a French team. Ben says that they have all completely synched with one another and are working as one big team, asking each other what help they can give, getting excited about each other’s cases, etc. Tonight the young obstetrician (OB-GYN Camille Boon) with here husband John, a urologist, whom I took over there this morning did a c-section and brought a new baby into the world. That really excited everyone there and gave them an extra charge too. Bob Penkus from Colorado Springs is the one who really made that hospital’s operating rooms “sing” for the first time since the disaster. He has been flying his private plane down here since last Sunday bringing in two very high-powered trauma/orthopedic surgical teams and nurses from Memorial Hospital in Colorado Springs with lots of ‘hardware’ (the implants I was talking about) for them to operate for a few days. Then, I just found out that he turned around today and flew in a whole cargo load of more equipment for them for which they all pitched in and rented their own truck to go down to the airport to pick up, bringing it directly back to the CDTI hospital to keep them operating. My hat is truly off to Bob Penkus. I need to drive up to the Springs and meet him sometime.

There is a bigger problem brewing for the CDTI state of the art facility here in Port-au-Prince, though. It has been keeping its doors open (diesel for the generators, xray film for the thousands of x-rays needed to fix broken bones, etc, etc.) with no income (all charity work) since the disaster, and the owner (a wonderfully humanitarian Haitian radiologist by the name of Reynold Savain) is running out of money. He has been paying for all of this from his own pocket, because it is “the right thing to do”. Ben astutely observed that this is THE hospital that has been doing the surgeries to permanently repair fractures (as opposed to putting on external fixators,( which is only a temporary solution and has a higher risk of getting infected), and is a huge resource for the country. It would stand to reason, then, that some of the aid money pouring in for the disaster should go to sustaining this highly valuable resource. No one has noticed this, however, outside of the doctors and nurses working inside the hospital. Ben called me last night to tell me that he really wanted to get Dr. Jean-Charles over to meet Reynold to see for himself the nature of the problem so that he could communicate this to the Minister of Health of Haiti. Tonight the meeting took place at one of the few remaining restraunts in town, a place called the Pizza Garden which is evidently known all over the city. Ben called to report that it had gone VERY well. They came up with some good ideas for suggestions to solve the problem.

As for me and Roger (Jean-Charles) and Dave (Rivard of Airline Ambassadors…the person in charge of their disaster relief team (which now includes me as medical coordinator as well)) , we got to go to the USAID warehouse, as I said, and dig through what medical equipment they had, then attended the 4 o’clock medical briefing of all the NGO’s (non-governmental organizations) at the United Nations tent at the airport. Then Dave and I (and Greg, our wonderful ‘Army guy”…on leave after two tours in Iraq…and Haitian…and an incredibly effective mover and shaker for getting done whatever we need to be able to do what we’re doing here in haiti went up to a school called Quiskeye (sp?) Christian School for their nightly 8 pm briefing where doctors from all the hospitals get together and share information about who needs surgeons, etc.

Another thing that is happening is that the California Nurses Association sent two of their R.N.s (John Pickles and Gerard Brogan (both englishmen with wonderful british accents)) on the flight of 32 that I picked up 2 days ago and brought here to our house/command center. They have been going all over the city scouring the neighborhoods and hospitals and getting to know all the NGO’s at the airport in preparation for a report to their organization about possibly sending thousands of the nurse volunteers from their large database here on a continuing basis to help train nurses (the “train the trainer” concept) to rebuild the healthcare system of the country. This could be a good partnership with Airline Ambassadors, since we are providing the same type of pipeline and distribution network for doctors (and nurses) coming into the country, both bringing them here and distribution them to hospitals and clinics where they are needed.

The other thing that I and others with Airline Ambassadors are doing is forming our Medical Outreach Teams to go out into the neighborhoods, inside and outside of the city, bringing healthcare directly to the people. Julie Manly, MD – Emergency Physician and veteran of the Hurricane Katrina relief effort who is from North Carolina (and came with me into the country 2 weeks ago on the same small jet provided by the American Ambassador to Finland, Honorable Earl Mack) will be coming back again tomorrow and will lead our next team. This team will be comprised of 11 firefighters from Denver headed by Shane Murphy, who have been trying to move heaven and earth to get down here, and will indeed make it here with tomorrow morning’s airline ambassador group, courtesy of United Airlines.

Tomorrow there is another flight coming in. Luckily we now have another house rented.

Time for me to go to bed.

Jim

4 Responses to “Cracking the medical supply code – Wednesday – 1/27/10”

  1. lynne wagner Says:

    Dear Jim, your work is so inspirational, I am grateful for your updates as I have wondered what has happened since I left CDTI last Thursday. If you run into Louissant Gregory, our law student translator at CDTI, please give him my cell # in US: 303-809-9272. I have been trying to reach him. thanks, Lynne Wagner

    • jimsmithmd Says:

      Hi Lynn, I am sending 5 nurses over there in the morning so will have one of them deliver york message. Things really haven’t changed much around there, just listening to the nurses talk this evening. I remember how hard you worked! Take care. Jim

  2. katia Chenet Says:

    Jim,
    Thank you for all the work and compassion. Thank you for raising the awareness of the problems brewing for the CDTI. I personally know Dr Reynold Savain and I do hope that with so many volunteering at the CDTI the word will spread and funds will come back to help him rebuild his hospital and pay his debt to the banks. Here in Melbourne, we have been collecting and sending supplies however we all knwo that they will also need cash to keep the hospital running and ultimately help Dr Savain rebuild his hospital. Please spread the word around you. They have a contact in Miami for donation:

    HSBC Pivate Bank,1441 Brickell Avenue Miami Florida, 33131 Acct Number: 0330473746 ABA Routing: 066010445 Account Name: CDTI c/o Dr. Reynold Savain

    Thank you for helping th epeople of Haiti…

    • health4haiti Says:

      I am so very glad to be able to help Dr. Savain. The fact that Haiti had such a resource as this modern state-of-the-art CDTI hospital when the earthquake hit has saved and is continuing to save many lives. For those readers who don’t know, Dr Savain has kept his hospital running since the quake at his own expense with no income, because his country needs it. It was partially damaged in the quake, but since it was built to such new, first world building standards we doctors and nurses who arrived in Port-au-Prince from the outside world to do surgery right afterwards were able to use the modern operating rooms and x-ray facilities, the likes of which did not exist anywhere else in the city prior to the quake. (We reinforced the local surgeons/medical professionals who worked at this hospital prior to the disaster, who had been working tirelessly since the event when we arrived on the scene.)

      Dr Jim Smith

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