Haiti Response: First-Person Accounts

NYC Medics, an international relief organization, mobilized and within five days had placed two teams on the ground in the country. Over the next eight weeks, NYC Medics deployed a total of seven teams--nearly 60 paramedics, nurses, physician assistants and doctors. During this initial response to the earthquake, NYC Medics treated roughly 20,000 patients. Here are some first-person accounts from rescue personnel deployed to Haiti.

Individuals Come Together for a Common Goal by Betsy Fine, MD

In October 2005, I responded to an email from the Society of Adolescent Medicine requesting a doctor to go to Kashmir after a massive earthquake. Within a week or so, I flew to New York City and then on to Pakistan with a group of complete strangers--a fairly close-knit but somewhat ragtag group of veteran NYC paramedics, off on their own with no organizational backing. It was a crazy thing to do, but it was the start of some of the most rewarding experiences of my career and my life. How a family doc with a specialty in adolescent medicine fit in with a group of seasoned New York paramedics was and remains a little unclear. Somehow, even though our skills sets are very different, our basic belief that anyone can do something to help ties us together.

Though each trip with NYC Medics was very different--the first to remote Kashmir, Pakistan, a second to refugee camps for displaced mountain people in Garhi Habibullah, Pakistan, and most recently to one of the poorest and most densely populated cities on earth in Port-au Prince, Haiti, my friends and colleagues work with the same energy, compassion and utmost respect. I marvel at how folks whose work is in tiny fragments of lives in emergencies were as connected to the patients as those of us who spend years in practice getting to know them. Not only patients, but the local staff, translators and community completely bond with this group. Four and a half years later, we still get emails from our friends in Pakistan.

Personally, I found Haiti the most emotionally difficult of our missions. Our work, though meaningful, felt like a drop in the ocean compared with the homelessness, poverty, and a lack of food and water heaped on top of illness and injury and unimaginable loss. It has really stayed with me daily when I turn on the tap, walk in my home or open my full refrigerator. I am constantly reminded how the people of Haiti are living. We had the amazing fortune to be welcomed by the people we came to help and by the activist community people who would be there after we left.

In the end, it really is all about connections--something my friends from NYC Medics are extraordinarily good at. As one patient said to our gentle friend Chris in Kashmir, "You have two hands, I have two hands...we are the same." Ultimately, this is the reward of our work, to share our humanity and to stand with each other in the face of sorrow and loss. I am ever so grateful to have been a part of that.

"Entry into Haiti" by John McGlade, EMT-P

Six members of NYC Medics 'Team 3' met with Ruben Flores for coffee, ID cards and a briefing at John F. Kennedy Airport in New York City around 3:30 a.m. Eight hours later, we were on the ground in Santo Domingo waiting for the rest of our team from California. A few short hours into the afternoon, we were on the way to the Haiti border, several hours to the west.

The roads were a maze of potholes and broken asphalt, and an inevitable flat tire held us up for over an hour while it was repaired. In the Dominican Republic (DR), a flat tire isn't a problem. However, having two flats is a big deal, so we had to get it repaired just in case it happened again.

The flat tire and hour delay put us at the border after 9 p.m.; it had closed at 7. After a discussion with the immigrations officer who was responsible for the border, she approved our crossing, since we were "diplomats," and they opened the border gates for us, but it was too soon to celebrate. We hadn't figured on the animosity between the Dominicans and Haitians.

As our van drove into the border crossing, the guard said something to our driver that caused him to stop and back up into the DR. It was obvious that he was very shaken. She had told him that he would be murdered by Haitian bandits if he proceeded to Port au Prince in the dark. He wasn't going any further that night.

Once we returned to the DR, we were stuck. They told us we would have to stay the night in the "no man's land" at the border crossing. After several hours of cajoling the DR border guards, they agreed to let the team proceed, but then told us they were unable to reopen the gate because the key went home with the immigrations official. Our only option was to leave our van and climb the gate between the DR and Haiti. After the sergeant of the guard rolled back the barbed wire, we scaled the eight-foot fence with our bags. There we stood in the pitch black of the Haitian side, with our ride from Port au Prince about 200 yards away at the Haitian check point.

After a brief skirmish with a pack of barking dogs, we met our drivers and were off to Port au Prince. We finally arrived at the Delmas Gate camp of the 82nd Airborne, the place where we would be stationed for our mission, around 2 a.m.--23 hours after meeting in New York. In another 5 hours, we would begin seeing our first patients.

NYC Medics: An EMS Approach to Disaster Response by Eric Holden, PA-C, MPA, EMT-P

In January of this year, I was fortunate to be invited to join the first response team sent by NYC Medics to Haiti following the earthquake there. Many public and private organizations, both from the U.S. and abroad, sent teams as well. Most of these teams were composed of physicians, surgeons and nurses seeking to replicate a field version of the hospital environment--what they knew best. The vast majority of field hospitals were centered at the airport, with fewer throughout the communities of Port au Prince.

Some volunteers with these organizations never left their field hospitals or saw anything other than the area immediately surrounding the international airport. Unfortunately, many patients were unable to arrange transportation to these facilities and stayed in their home communities without receiving the care they so desperately needed. Patients with femur fractures, significant dehydration or a crushed pelvis can’t walk to their nearest hospital to obtain care. A link in the chain was missing.

NYC Medics took another approach to this problem. As a team founded and led by EMS professionals, it is not surprising that their model was based on doing what EMS does best: finding patients where they are, regardless of their circumstances, and providing care where they live. To the best of my knowledge, the teams from NYC Medics were the only ones to walk through the tent cities, finding and stabilizing patients in the field and treating or transferring them as their needs required. Our teams certainly needed the services of surgeons at the field hospitals for some of our critical patients, but without the services we provided, these patients would never have reached definitive care.

We also ran a series of mobile clinics at several locations throughout the city in areas with the most damage that one to two weeks after the quake had yet to see their first medical provider. These were the "slums" of Port au Prince--areas like Citie Militaire and Citie Soleil that were considered "too dangerous to travel through." We traveled to these areas alone as a team and later with transportation assistance from the Army 82nd airborne, and it was where we found some of the most critically injured victims. Our clinics were set up in such a way that we could arrive at a location and be ready to see patients within a very short time. Most days we saw 400 or more patients using this model. As soon as we had seen everyone in a neighborhood, we packed up and moved on to other sites that we had scouted and discovered to be in need.

In future disasters, we need to remember one lesson: Disaster zones need skilled providers and support staff and all the skills they can provide in field hospitals, but they also need rapid response teams like those fielded by NYC Medics who can get to patients quickly where they live to provide care in the out-of-hospital environment and transportation for those with issues requiring more significant interventions.

For more on NYC Medics, visit www.nycmedics.org.