Children's Hospital Boston's pediatric health blog
On January 12, news of the catastrophic earthquake that hit outside Port-au-Prince, the capital of Haiti, reverberated around the world. Here at Children’s Hospital Boston, many surgeons, nurses, anesthesiologists and other health care providers promptly mobilized to assist with relief efforts. Check out these blog posts and photos from our various missions to Haiti since the disaster.
Last week, Children’s Global Surgical team returned from a trip to Cange, Haiti, where they performed surgeries, wound care, general pediatrics and occupational and physical therapy. Here,John Meara, MD, DMD, MBA, the hospital’s plastic-surgeon-in-chief, reflects on what was accomplished and what is still left to be done.
While we were in Cange, we witnessed a lot of improvement in the patients. Many of the wounds are either closed or much better. Our orthopedic surgeons were able to do a lot of procedures, fracture reductions, removing some old external fixators and generally getting people out of the hospital.
The nurses did a great job at integrating with the Haitian nursing team. This was the first time I’ve had physical and occupational therapists on a surgical trip, and they were invaluable, spending all day helping patients who would just have been in bed for most of the day. They also made all sorts of prosthetic devices and helped us evaluate patients to see whether they’re able to leave the hospital. [click to continue…]
This boy was able to hobble out of the clinic without the cast he wore for two months.
Although there’s long been a need for improved orthopedic care in Haiti, the nature of the trauma injuries caused by the earthquake has exacerbated the problem into a dire one. Currently, there are only 15 Haitian orthopedists working in the country. “Because of all the associated bone injuries, which require x-rays, cast changes and ongoing surgeries, it’s clear there’s a chronic need for orthopedic care here,” says George Dyer, staff orthopedic surgeon at Children’s. “That one earthquake created work for a generation of orthopedic surgeons.”
Walking around the hospital, there’s no end to the number of people in casts and external fixation devices–metal rods or pins attached outside of the body to keep a bone in place. “After the earthquake there were so many people with broken femurs that the only thing that could be done was place external fixators on their legs, which can be done quickly and without x-ray,” says Paul Appleton, orthopaedic trauma surgeon at BIDMC. “Some people got casts, but if they had a severe injury to the skin over the bone, the wounds couldn’t be covered due to the need for daily dressing changes.” [click to continue…]
Haitian children drew messages and pictures to bring back to the United States.
When Judie Jackson, operating room nurse at Children’s, found out she would be coming to Haiti, she asked her 8 year old niece, Isabella, if she wanted to send a greeting to the school children in Cange. “I thought it would be nice to have a connection between the kids in America and the kids here,” she says. Jackson bought a big blank banner over 10 feet long, and gave it to her niece, who had the idea to bring it to her class at Medway Elementary School. There, her classmates joined in, drawing pictures, greetings and telling the children all about their life in America. “They all knew that Haiti had experienced an earthquake, and they were sad for the children,” says Jackson. “All the messages were very helpful and uplifting.” [click to continue…]
Kim Wilson, a pediatrician at Martha Eliot Health Center, was originally on the Global Surgical team in Cange. But the day after arriving, she was rerouted back to Port-au-Prince, where the University hospital (HUEH) was desperately in need of clinicians to staff the pediatrics tents.
I initially came with the team to work on developing collaborations between Partners In Health’s (PIH) child health program and Children’s, as PIH is planning an expansion of their child health services. However, PIH is also helping to coordinate staffing for the pediatric tents at the general hospital in Port-au-Prince. Ideally, the pediatric tents are staffed by three pediatricians and 12 nurses, but as of this week, there were no pediatricians slated to be there. So Dr. Sophie Allende and I went down to help. [click to continue…]
With their brilliant smiles and frequent bouts of laughter, Carmene Guerrier, 16, and Julmiste Shelove, 25, light up the medical ward. Their friends come to visit often, sitting on the edges of their beds. They gossip, tease each other and teach simple Haitian Creole phrases to the English speaking clinicians. Although both girls have lived in the hospital for the past two months, where there’s few forms of entertainment, the near constant hair maintenance they partake in—braiding, corn rows, combing knots out and complaining about the lack of shampoo—never ceases to absorb them. When the physical and occupational therapists arrive to interrupt their fun, just like typical teens, they try distraction techniques to avoid what they know is coming. “Pa mal, pa mal,” says Shelove, as she points to her leg. Guerrier grabs the hologram stickers she received earlier and mimics that she wants more. [click to continue…]
by Childrens Hospital Boston staff on March 24, 2010
Michael Felber, RN, and Kathryn Barrett, RN, take care of a patient in Haiti.
Children’s nurse Michael Felber came to Haiti on March 15, where he’s been working in the town of Fond Parisian. On Monday, he joined the Global Surgical team in Cange. Here, he reflects on his experience so far.
Being in Haiti is a little like the fable of the three blind men and the elephant – each of them had different experiences based on what they encountered. In someways things look a lot like most Latin American countries- it’s hot, the cities are crowded, the people are wonderful. Port au Prince looked mostly ok from the air, but then when you look closer you can see that some areas are rubble, and there are tents everywhere, even where the buildings are standing. The tents here at the field hospital are easily over 100 degrees, but many people are still afraid to go inside buildings. The kids here are wonderful – big friendly smiles, love to play soccer, make kites. Still pretty much everyone has lost family members. Many don’t have homes to go to, and rainy season is coming soon. Its hard to imagine that possible a quarter of a million people died in the earthquake and the days after. Where do you go from there? One of the patients said to me, “I’ll see you tomorrow, if god is willing”. The hospital is well run, especially considering how many people are coming and going. The pharmacy is as organised as I have seen anywhere. There are electronic medical records, although much simpler and more user friendly than ours. You have to be comfortable stepping out of your comfort zone. Tonight I am covering the night shift in Triage. It’s like an ER in a tent, hopefully more quiet now that everyone has gone to sleep.
Bev Small, RN, works with Haitian nurse Yanick Michel.
Before the earthquake, the hospital in Cange did eight, maybe nine operations a day, recalls Yanick Michel, a 26 year old OR nurse who’s worked here for a year. Almost immediately after the earthquake, the surgical caseload doubled. At the same time, donated equipment poured in to furnish the two operating rooms, including a new anesthesia machine.
To handle the influx of patients requiring surgery, visiting surgical groups, like this group from Children’s, are rotating through the hospital. As well as helping ease the patient load, the specialized surgical teams (orthopedics, plastic surgery and urology, for example) educate the local staff how to handle difficult cases they may never have seen before. “Although it’s been busier, it doesn’t feel hectic,” says Michel. “We adapt. I feel very comfortable because we have such a good entourage and we’re all trying to do the same thing. It’s all about the teamwork.” [click to continue…]
Joceyln Guerrier, shown receiving a dressing change, was injured when her house collapsed during the earthquake.
After the earthquake, the hospital complex in Cange was inundated with people suffering from fractures, crushed limbs, spine and pelvic injuries and deep cuts and abrasions. Now, almost two months later, the wards are still home to patients with wounds that are slowly healing—and require attentive care so they don’t turn more serious.
Monday morning began with wound care rounds. Nurses Cassandra Mombrun and Pat Lisle assisted Dr. John Meara as they took off old bandages, cleaned and dressed wounds, and looked for signs of infection. One dressing change was for Jocelyn Guerrier, a 28-year-old woman with a fractured leg and a deep gash wound on her calf, who’s lived here since the day after the earthquake. She was washing clothes on her balcony when she felt the house shake. She tried to run outside but didn’t make it in time, and the house collapsed on top of her. A car transported her to Cange, where she’s been ever since. Although her house was completely destroyed, her family stayed safe during the disaster. [click to continue…]
Kim Wilson, a pediatrician at 
With their brilliant smiles and frequent bouts of laughter, Carmene Guerrier, 16, and Julmiste Shelove, 25, light up the medical ward. Their friends come to visit often, sitting on the edges of their beds. They gossip, tease each other and teach simple Haitian Creole phrases to the English speaking clinicians. Although both girls have lived in the hospital for the past two months, where there’s few forms of entertainment, the near constant hair maintenance they partake in—braiding, corn rows, combing knots out and complaining about the lack of shampoo—never ceases to absorb them. When the physical and occupational therapists arrive to interrupt their fun, just like typical teens, they try distraction techniques to avoid what they know is coming. “Pa mal, pa mal,” says Shelove, as she points to her leg. Guerrier grabs the hologram stickers she received earlier and mimics that she wants more. 
