As I approach my last year of residency at Loma Linda University Medical Center, I’ve realized that one of my most influential experiences occurred thousands of miles away.
While I have a varied travel experience including visits to a number of third-world countries, none have compared to the devastation I surveyed as my taxi traveled the streets of Port-au-Prince on the way to Hopital Adventiste d’Haiti in the Carrefour neighborhood.
Although I passed by more than a year after the earthquake, I noticed the countless tent villages, the collapsed presidential palace, ever-present rubble, and abandoned cars that made it feel like only a few months.
The trip was organized by Scott Nelson, MD, assistant professor of orthopedic surgery, Loma Linda University School of Medicine, who not only staffed the hospital in the days after the earthquake but also stayed for the next year. He frequently returns, bringing us residents with him.
One of the main reasons I chose Loma Linda for my residency was the opportunity to experience rotations abroad during my training—not only to provide a service that can change lives, but also to remind myself how lucky we all are and what I take for granted at home.
The first day and a half of our trip was spent reorganizing and sorting the hospital’s orthopedic equipment and supplies. Dr. Nelson’s trips are notorious for generating a whirlwind of cases, with many complicated cases saved for him. We had to know exactly where everything was.
I was surprised to see the mountain of plates, screws, implants, and tools that had all arrived after the earthquake and remained. For a facility to have such a diverse inventory and yet reside in one of the world’s poorest countries was amazing. The hospital was prepared for almost anyone who came through the door and was tested on a daily basis.
Our first day’s schedule in the operating room (OR) was busy, and we weren’t able to get through every case in one day. But that was pretty much the way it went for the 10 days we were there. We often worked to midnight, since we felt pressure to help as many as possible before we left, and some may have to wait months for another opportunity.
However, we had a great time keeping everything running and troubleshooting the occasional hiccup. The fluctuating power supply made things interesting, as did wearing our lead aprons in 100-degree heat. We put ice packs under our hats and down our shirts. Golf cart batteries in the back powered backup lights while we operated at night. Stretching our supplies and innovating when problems arose were great learning experiences.
My trip lasted four weeks, and I was able to work with several teams and experience a variety of different situations throughout my stay. Loma Linda University alumnus Dr. Gerald King, from North Carolina, and Dr. Ron Anderson, from Kaiser Permanente Los Angeles, were there for week two. Both had been to Haiti before and brought a wealth of experience. During week three, a group of general orthopedists from Appleton, Wisconson, arrived. Since this was their first international mission trip, I found that I was the most up-to-date pediatric orthhopedist on site, with a total of one month at Loma Linda and two weeks in Haiti.
The clinic never ceased to present rare and interesting cases, leaving all of us scratching our heads from time to time. Unfortunately, a number of cases were left for the next subspecialist to come. Our cases ranged from chronically dislocated hips to fungating foot masses, and even several cases of macrodactylyl—a fairly rare condition where toes or fingers are abnormally large due to the overgrowth of underlying bone and soft tissue.
Dr. Lee Zuckerman, tumor specialist at Loma Linda, arrived during week four to help with backlogged cases. Several tumor cases were waiting for him, including osteochondromas and fungating foot masses, and an enormous forearm tumor. We spent about six hours removing a tumor to save the hand, removing one of two bones and leaving only a wisp of the second.
I was also able to spend time with Dr. Terry Dietrich, a Loma Linda alumnus, who took over for a year following Dr. Nelson. Dr. Francel Alexis, from the medical school at Université d’Etat d’Haïti, is still working at the hospital along with an LLU School of Medicine alumnus, Dr. James Matiko from Arrowhead Orthopedics, and a group of residents, medical students, translators, and nurses.
My time spent outside of the operating room impacted me the most. Seeing the patience and efforts of the Haitians who traveled days to the clinic, often arriving at night and sleeping on the benches waiting to be seen the next day, was amazing. For a people who have suffered so much, it was astonishing to see how much they had endured. They had waited months for injuries to be treated, receiving only Tylenol after large surgeries (we didn’t have narcotics other than morphine). There were no complaints—just thanks for being treated.
I learned to think on my feet and improvise, which is vital to the survival of Hopital Adventiste d’Haiti as it continues to treat the people it serves with the highest level of care possible. It was a great and lasting experience, and I can’t adequately thank Dr. Nelson, Dr. Dietrich, all of the long-term volunteers, and the short-term volunteers I was able to work with, and who truly keep this much-needed facility alive.
