January 22, 2010

To Haiti and back

Humanitarian crisis spurs Johns Hopkins community into action

More than a week after a devastating 7.0 earthquake struck Haiti, the tiny Caribbean nation remains caught in a major medical crisis that only promises to worsen unless international aid groups and health professionals can meet the growing need for supplies and medical assistance for the countless injured and suffering there.

Moments after the earthquake hit, many Johns Hopkins men and women went into action to help with the massive humanitarian effort.

Volunteers—who include emergency physicians, pediatricians and a pulmonary specialist—are currently on the ground to provide care and relief to the people of Haiti. Some have already returned from short-term medical missions, and more are expected to depart soon. In addition, fund-raising efforts have been launched at a number of university divisions.

Michael Millin, a disaster medicine expert in the School of Medicine’s Department of Emergency Medicine, has been deployed as part of the New Jersey Disaster Medical Assistance Team. He serves as medical officer for the team, which is trained and equipped to be self-sufficient in disaster zones. Millin was last reported preparing to deploy from the U.S. Embassy in Port-au-Prince to a U.S. Coast Guard vessel offshore. The team will assist with trauma patients flown onboard by helicopter.

E. Lee Daugherty, a critical care specialist in the School of Medicine’s Department of Pulmonary and Critical Care Medicine, arrived in Haiti as a volunteer with a charitable organization. She is working at a hospital near the Port-au-Prince airport.

Karen Schneider, a Catholic nun with the Sisters of Mercy and a pediatric emergency specialist at Johns Hopkins, made her way into Haiti from Baltimore last week and is now caring for earthquake victims in a U.N. medical tent at the Port-au-Prince airport. Traveling with Schneider, an assistant professor in the School of Medicine, were six residents from the Department of Pediatrics.

One of those with Schneider was Delphine Robotham, who returned on Wednesday from a five-day mission. She and her colleagues had been scheduled for six months to leave for Haiti on Wednesday, the day after the earthquake hit, to provide medical care to children. Their flight was obviously canceled.

Undeterred, the group found flights to Miami and there, through the University of Miami, found a group called Medishare that had a makeshift hospital set up in the U.N. compound next to the Port-au-Prince airport. At midnight the next day, they boarded a private Learjet with as many medical supplies and as much food and water as the plane could handle.

Once on the ground, Robotham and three other doctors immediately staffed a tent where roughly 150 patients were lined up on cots. The majority of patients had multiple fractures and crush injuries. The doctors worked up and down the aisles changing dressings, placing IVs and administering antibiotics and pain medication.

“When I got there, I was overwhelmed by the amount there was to do,” Robotham said in telephone interview with The Gazette on the morning after she returned.

The volunteers spent the remainder of their time in these tents, as new patients arrived around the clock. Fifty to 60 children under the age of 16 were there each day, Robotham said. The doctors barely had time for sleep, and when they could find the time, had to rest on the ground as there were no beds for doctors or nurses.

Robotham said that each day brought a pendulum swing of emotions. Moments of despair would be followed by triumphs. She recalls one girl who had a severe injury and could not speak or stand up. “But on the last day when I was rounding, she just stood up and went to her mom. Then she threw her arms around me,” she said. “I wasn’t sure if she would recover, so that was just amazing.”

Robotham, who, when she returned, chronicled her time in Haiti on a blog, said that many of the children currently receiving care require immediate surgeries, which they cannot receive under current conditions.

“We can only keep them alive for so long; they need to get to hospitals,” she said. “So I’m trying to get the word out.”

She’s also helping raise money for supplies, such as crutches, and to transport patients to hospitals. A Johns Hopkins pediatric group started a PayPal account where people can donate. The account is now up to $16,000.

Jean Ford, a native of Haiti and a faculty member at the Bloomberg School of Public Health, reached Port-au-Prince on Tuesday with a team from the University of Miami and immediately went to work with adult patients at the same field hospital where the Johns Hopkins Medicine pediatricians were treating children. Ford, an associate professor of epidemiology at the Bloomberg School and director of the Public Health Grant and Cancer Disparities Program at the Johns Hopkins Kimmel Cancer Center, said in a message back to Baltimore that the psychological trauma “may be more profound” for his patients than their physical injuries.

Four master’s degree students in the Bloomberg School were working on a UNICEF project in the villages of Anse Rouge and Pont Sonde when the earthquake hit. The students, who were unharmed, traveled to Port-au-Prince and volunteered at a school for 200 children, worked at a makeshift hospital and conducted a survey to try to determine death and injury rates in one of the hardest-hit sections of the city. They have since returned to Baltimore.

Jhpiego, the Johns Hopkins–affiliated organization that works around the globe to build infrastructure for maternal and child health, sent a three-member team to augment its six-person Haiti staff, all of whom survived the earthquake. The team is headed to Port-au-Prince to work with the Haitian staff to ensure the health care needs of pregnant women and newborns.

The team, all Creole and French speakers, is also charged with assisting the Jhpiego Haitian team of doctors and nurse midwives to review the long-term health needs of women and children and with using its experience working in low-resource settings to help rebuild the health care system in Haiti. The team will be working with other local health care experts, government agencies and nongovernmental agencies.

The Jhpiego group—a doctor specializing in gynecology and obstetrics and two staff members experienced in working in Haiti—was bringing with it basic medical supplies and equipment, including antiseptic creams, sterile gloves, gauze and other items. Lucito Jeannis, Jhpiego’s country director in Haiti, has asked for such materials to help equip a fledgling medical clinic.

As reported in a blog on Jhpiego’s Web site, team director Rich Lamporte, along with Willy Shasha and program manager Anne Pfitzer, arrived in the Dominican Republic on Wednesday afternoon, amid sweltering humidity and heat. The team was expected to cross into Haiti on Friday.

Lamporte, in a telephone call from Santo Domingo to Jhpiego staff in Baltimore, said that his team is glad to be there and anxious to meet with its in-country colleagues. “We want to get down to work, get to the local team and make sure they are in good shape so we can all participate in the recovery,” he said.

Ron Magarick, Jhpiego’s director of global programs, said that Lamporte and other team members will help meet the urgent health needs for pregnant women. “The hospitals and clinics where they would have gone to deliver are wiped out,” Magarick said. “We are helping to establish a referral center so that these women know where to go, and also looking to identify a core group of midwives and birth attendants. Jhpiego has been working with Haiti since the late 1970s; we have a network of more than 1,200 health professionals that we have trained.”

For his part, Jeannis has opened his property to neighbors in need. At last count, 17 people were sharing water and food in a makeshift compound outside his house.

Back stateside, Johns Hopkins affiliates are looking to help with their time and money.

A coalition of Homewood campus student organizations is forming to build awareness of Haiti’s needs and to help raise funds to meet them. More than a dozen and a half student groups are already involved, and more are expected to join. A meeting is scheduled for 7 p.m. on Tuesday, Jan. 26, in the Glass Pavilion.

Michael Rogers, a junior in the School of Arts and Sciences and co-chair of Students for Environmental Action, said that he hopes many students and other members of the university community will come out to offer ideas.

“Above all, we’re looking to expand the coalition of student groups committed to relief efforts and to plan a larger collaborative campuswide relief effort for later in the semester,” Rogers said. “As students, we feel that one of the most effective ways that we can contribute to efforts on the ground in Haiti is to work together to raise funds for groups with the expertise, experience and skills to make use of them.”

Rogers said that the groups hope to leverage all their connections and resources in order to support both acute-phase and long-term relief efforts.

“While many of us would like to be lending a hand on the ground, we’re committed to doing what we can here while in Baltimore,” Rogers said. “We’re committed to pragmatic solidarity with the Haitian people, and there’s a lot we can do here.”

As soon as the earthquake hit Haiti, a number of students at SAIS’ Bologna Center put together a plan for how the school could respond to the human suffering and structural devastation that has occurred in and surrounding Port-au-Prince. Students started an online donation campaign, the SAIS-BC Haiti Relief Fund, and two separate fund-raising events.

On Friday, the SAIS-BC Haiti Relief Fund had reached its final goal of 2,000 euros.

“We’ve been very impressed and touched by the generosity of the SAIS-BC students, faculty and staff toward this cause and the Bologna community as a whole for standing in solidarity with the people of Haiti,” said Ian Warthin, a Bologna Center student and SAIS-BC Haiti Fund-Raising Committee member. “In my experience, after Haiti was struck by four hurricanes in 2008, it was the emergency relief received within this first week which was the most important.”

University personnel preparing to go to Haiti in the near future include members of the Johns Hopkins Go Team, a trained group of disaster medical experts and support staff.

Before sending a contingent to the country, Christina Catlett, an emergency physician and director of the team, and Gabe Kelen, director of the Johns Hopkins Office of Critical Event Preparedness and Response and chair of the Department of Emergency Medicine at the School of Medicine, are assessing how the team can best serve in the short and the long term. Team members have already been briefed and given necessary vaccinations.

Catlett, who has cared for victims of hurricanes Katrina, Ivan and Rita, is familiar with Haiti’s public health infrastructure, having co-led three medical missions to the Central Plateau region of the island for Project Medishare for Haiti, a nonprofit dedicated to helping that country develop and improve public health services.

Go Team member Beth Sloand, an assistant professor at the School of Nursing and coordinator of the pediatric nurse practioner track, estimates that she’s been to Haiti nearly 30 times in the past 10 years. Sloand, who was asked by Nursing Dean Martha Hill to coordinate the school’s Haiti efforts, said that she’s eager to depart on the mission.

“I have a great love for the Haitian people,” said Sloand, who speaks Haitian Creole. “What has happened to that country is the most devastating thing that I can imagine. I feel a great urgency to get there and help any way I can.”

Sloand said that the team is currently in a “holding pattern” and could leave as soon as this week or sometime next month. “The logistical challenges are huge,” she said. “This is not a short-term fix. We plan to be there for an extended period.”

As for the School of Nursing’s efforts to date, Sloand said that she has received a tremendous number of calls, e-mails and knocks on the door from students and faculty who want to volunteer. “Nurses are action people,” she said. “Everyone wants to volunteer to go.”

Sloand said fund raising is under way at the school and that she and SoN leadership have asked students, faculty and staff to make financial contributions to well-organized agencies already working in the field.

For a list of such organizations, and for up-to-date details on JHU’s efforts in and for Haiti, go here.