A Lesson in Resilience

HAITI - Earthquake 2010

February 7, 2010

A Lesson in Resilience Maurica Orgill MSN, RN It has been one full day since I have been back from Hai7. As I look around my surroundings, it becomes so obvious all the things I take for granted. The superficial things that consume us and mask our mortality are not apparent in another country where I have taken care of vic7ms of an unforeseen tragedy. In Hai7, I have taken care of people who are s7ll hopeful about the future. Despite the human toll of an earthquake that has ravaged their country, it has not dampened their spirit.

While working at the Good Samaritan Hospital (GSH) and orphanage in Jimani, Dominican Republic, (now turned refugee camp and hospital for the thousands of displaced Hai7ans), I witnessed an outpouring of love and humanity at an overwhelming level towards the vic7ms. As you can see from our pictures, we were health care professionals working with very limited resources. I cannot even imagine how cramped the orphanage must have been days prior when hundreds were evacuated to other refugee camps in Hai7.

Most of the remaining pa7ents suffered mul7ple fractures and were in need of sustained orthopedic care. It appears that the previous health care teams fixed every single fracture with either an external fixator or an amputa7on. Our team had to take several new x‐rays and reposi7on many of these casts and external fixators. Many of the pa7ents worried that they would have these metal

contrap7ons in their legs forever. Some were anxious about their physical recovery and their ability to work and provide for their families, more so than the psychological loss of a limb. As health care professionals, we had to reassure some of them that

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these external fixators and casts were not permanent. For others, we had to be sensi7ve in being the bearer of bad news, and tell them the possibility of systemic infec7on if they refused to amputate the limb.

The pa7ents had no call bells so my only recourse was to make frequent rounds with my flashlight. There were many nights I had to walk over family members, who slept on the floor next to each pa7ent, only to find someone in the corner crying from the pain that awoke him or her out of their sleep. I had to comfort and medicate the pa7ents with the limited pain medica7on on hand. I thought about the United States and how pa7ents like these would have a pain management consult, or at the very least, be on prescrip7on pain medica7ons that were tailored to the severity of their pain. In this instance, the concept of pain being subjec7ve for each pa7ent could not be addressed.

At the Good Samaritan Hospital and orphanage, I worked among health care teams from many countries and organiza7ons like Spain, the United States, Brazil, the United Arab Emirates as well as the Founda7on for Peace and the Peace Corps. The teams consisted of doctors, nurses, interpreters and various logis7cal volunteers. It was difficult to explain to the pa7ents that I was not a physician, but a nurse, as they insisted on calling non‐physicians doctors in their na7ve tongue (pronounced doc‐to).

I must say though, that most of the hands‐on nursing care was provided by the families who would not leave their loved ones for any reason.

Every pa7ent had a family or a friend disposing the contents of their bedpans, bathing them and tending to all their daily care. Many of the families were even learning how to do wound care with the nurse’s instruc7ons. The pa7ents and families were ever so thankful and grateful for any level of kindness bestowed upon them.

On most nights I had more than 40 pa7ents to myself, which is in stark contrast to the average pa7ent to nurse ra7o in the United States. I had to u7lize my nursing judgment and experience to improvise pa7ent care, which included deciphering a char7ng system that was being used by nurses and doctors with different char7ng disciplines. In fact, we were the first team to enact any form of order to the charts.

One observa7on that stands out in my mind when I think about these file folders we created into pa7ent charts, was how each pa7ent guarded their charts by placing it under their maYresses or pillows. I cannot blame them because the charts were what we depended on to read what the previous health care teams did.

Can you imagine how lost we would have been if those charts were misplaced?

I experienced a thought‐provoking moment during an interac7on with the psychologists and the pa7ents. The psychologists were trying to evaluate the pa7ents and assess their need for an7depressant medica7ons. The pa7ents began to preach the word of God to these psychologists, and told them in Creole that while it is true that they have experienced great loss, they look toward God for comfort. None of these pa7ents were interested in taking mood‐altering medica7ons. While working on the night shi^, I also observed them praying and singing as they prepared for bed. It was apparent that Chris7anity was not just a Sunday ritual, but a way of life for these ardent people.

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Some signs of the pa7ents suffering from post‐ trauma7c stress from the earthquake and the various a^ershocks that followed while we were there did become evident. Just one week before we had arrived, two pa7ents jumped out of the orphanage from the second floor balcony when they felt one of the a^ershocks that was graded a five on the Richter scale. One of them is now a paraplegic and the other succumbed to his injuries. Some pa7ents now prefer to sleep in makeshi^ tents than stay in buildings of any sort.

There were remnants of buildings and some people were s7ll searching for loved ones that may February 8, 2010 Volume VII s7ll be trapped in the rubbles, but there was no stench in this hot and arid region. In fact, people seen with masks were only wearing them to protect themselves from the dust. On the street corners you can see the street vendors selling

The fear of the exis7ng buildings is no7ceable in some Hai7ans and was evident when I went to the hometown of an accompanying relief volunteer.

Although the earthquake did not affect her family’s house, located on the outskirts of Port‐au‐Prince, her rela7ve was s7ll afraid to park his car near any buildings on the road, including structures that were visibly intact.

produce and markets selling meat, fish, and various food items – more evidence that life s7ll goes on for the Hai7an people. Across the street from the Presiden7al Palace are hundreds of makeshi^ tents, made from sheets, plas7c, tree limbs, and whatever else that can be found to serve as a form of refuge for thousands who are now homeless. I wondered how these people would manage during the rainy season that was imminent.

One of her rela7ves told us the story of the Senegalese president that wanted to give land to any Hai7an that was interested in migra7ng to Senegal. He stated, “Whereas the language barrier would not pose a problem, it is inconceivable for any Hai7an to migrate to Senegal, because Hai7 is s7ll our home, our culture, our way of life, and we will con7nue to love our country no maYer what.”

I soon realized that most Hai7ans were ready to rebuild their country, instead of abandon it.

There is also a growing fear in displaced Hai7ans who are being treated in refugee camps on the border of Dominican Republic.

Surprisingly, as I drove through Port‐au‐ Prince, I saw no corpses on the road as expected from watching media coverage prior to my journey here.

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Volunteers and myself were given instruc7ons to get a head count of the pa7ents and their families, so that they can be bussed out to Hai7 the following day. Follow‐up care for these pa7ents will be lacking, and with the frequent migra7on to various camps, uni7ng families will be a challenge.

have developed an affinity for these people and their culture. So many nights my pa7ents had me laughing with the jokes that they told me via the interpreter. They are truly a strong people, who have overcome oppression on many levels. My hopes are that the relief efforts will be invested in the long‐term ongoing concerns of the country. I hope that Dr. Pinard’s ambi7ons will mo7vate both Hai7ans and non‐Hai7ans to rebuild the country, and show the world that the overall living condi7ons can be improved over 7me.

Dr. Marc Pinard, a Hai7an physician, founded the Good Samaritan Hospital and orphanage.

Although he dedicated his efforts to providing care to the Hai7an children who lived on the border of the Dominican Republic, his dream never came to frui7on. The orphanage was closed for two years prior to the earthquake.

The Dominican government has since reluctantly sanc7oned the use of the space for the earthquake relief efforts. I wondered if the Dominican government would now allow Dr. Pinard to open up his orphanage a^er this natural disaster has given so much exposure to the orphanage and its original mission.

I feel fortunate to have the health and strength to extend my nursing care experience and educa7on to care for people who were in desperate need of medical aYen7on. I le^ wishing that I could have done more. I hope that my story will influence others to volunteer, and share in the human spirit of giving to a country like Hai7, that has so much poten7al and life.

My overall thoughts a^er this trip cannot be expressed fully in words, but I will say that I

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