In Haiti, he Finds Another Scourge, but the Strength Remains

Alexi Matousek, M.D. (M '09), who is completing his first year as a general surgery resident at Brigham and Women's Hospital in Boston, took part in a relief trip to L’Hôpital Université d’État d’Haiti, the largest public hospital in Port-au-Prince. He was a member of a surgical team from the Brigham and Women's Hospital, volunteering with Partners In Health (PIH). His trip took place five weeks after the Jan. 12 earthquake. He reports on the mission, which was focused on wound care.

In many ways the earthquake was an acute trauma that occurred on top of the chronic disaster of extreme poverty that exists in Haiti. For L’Hôpital Université d’État d’Haiti, it was no different: a 700-bed hospital, which hadn't been able to pay its 1,800 employees for the four months preceding the earthquake, was now tasked with caring for hundreds of severely injured patients in damaged buildings and with a hastily constructed emergency supply chain and several international groups, all trying to coordinate their efforts.

The situation was dire. We had no oral pain medication, intermittent conventional radiography, and the only lab test available was a hematocrit. Some more basic elements were also missing. We had very few diapers for adult patients and resorted to using sterile surgical gowns as sheets to maintain some dignity for the patients. On the surface, the hospital was chaos. A few volunteers were so paralyzed by the lack of resources that they were unable to function and left. The more stoic, ingenuitive and resourceful providers (qualities that are essential for living in Haiti, and which the Haitian people provided the lion's share during the current crisis) were able to look past the shortages and found some remarkable resources.

In one corner of the damaged medical ward was a clean, air-conditioned dialysis unit run by Médecines Sans Frontièrs (Doctors Without Borders) with eight functioning HD machines. The patients all had charts, beds were numbered, and there was a system of hospital flow from a three-tent emergency department to four functioning operating rooms, to post-operative tents. Among the various volunteers, we had specialists trained in emergency medicine, trauma/burn surgery, orthopedics, plastic surgery, anesthesia, infectious disease, critical care nursing, physical therapy and no shortage of Haitian students who came to translate.

"The situation was dire. We had no oral pain medication, intermittent conventional radiography, and the only lab test available was a hematocrit."

Most impressive were the families of the patients, some of whom cleaned stool from nearby patients who had no family. Our team saw more than 200 patients, cared for 45 patients with chronic wounds on a daily basis, and performed 20 operative cases in 10 days. We also deployed a prototype simplified negative pressure wound therapy device that worked well on selected wounds, and which we hope will become a useful tool in resource-poor settings. Many of our patients had granulating wounds and were successfully signed out to various other teams upon our departure.

I have been traveling to Haiti for 20 years, and I know the Haitian people are well acquainted with suffering. The earthquake ruined so much that I expected that their spirit may have broken, and that the faith of those who remained would be shaken. What I found is that the earthquake is another blow, perhaps the most severe in Haiti's history, but like the many scourges of Haiti's past, it has not beaten her people into submission. The strength of their faith remains, and the earthquake will be another mountain in this land of mountains.

My hope is that the international community, and especially the United States, will this time be a true partner in Haiti's recovery. For my part, I remain personally and professionally committed to stand in solidarity with an amazing people who have taught me everything I know about dignity, faith and service.

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