By Anthony Amoroso, M.D.
Assistant Professor of Medicine
Editor’s Note: Dr. Amoroso was part of the first University of Maryland team to go to Haiti to provide medical care to earthquake survivors. The following is an excerpt of an e-mail he sent to his wife the day before leaving Haiti. Read Dr. Amoroso’s first Haiti blog post.
I’m going to try to get out tomorrow. A bit torn, patients have gotten word of our departure and getting a bit upset. Every day we make some improvements and it becomes a bit addictive. We worked late tonight doing what we can to make transition to incoming group. There are about 5 people staying on and another 10-15 coming tomorrow. We know every patient in the hospital and have a medical and surgical records on all of them. We only have a few backlog cases waiting the new team.
We leave with 5 functioning operating rooms, an organized stock room, almost automated lab, an admissions and discharge system, medical records, ambulatory appointment system, 6-bed trauma bay for wound care and fractures, community triage teams, some capacity for patient transport, beginnings of sanitation with port-a-pots finally arriving and medical waste and sharps disposal. We continue to struggle for beds, linens, crutches, flys, lack of misquito nets, human waste disposal and basic hygiene like toothpaste, soap, and shampoo.
From a medical standpoint the nature of the injuries — fractured legs, very large wounds, bone infections, kidney failure from crush, paralysis, dead limbs, and amputations — makes for long-term complicated problems.
My biggest frustration and anger lies in the entrenched backward and uncaring health system that permeates the hospital despite the fact that it is destroyed. It’s a real feat that it is running, and this only through the force of several external personalities. As these people leave I fear for the patients and know the volunteers will walk away frustrated.
The bigger picture remains far from over. There are hundreds of thousand homeless people living in squalid improvised camps throughout the city and region. Dysentery is picking up, and we saw the first cases of hepatitis A today. A cholera outbreak is easily feasible and would be devastating. How on earth the cleanup will commence and even come close to succeeding remains a mystery to me.
I’ve hit my wall, fatigued, with muscle and back pain. Chronic dehydration. Now with mouth sores. I have no more socks, underwear, or food. I guess it’s time to go home. It’s been an incredible experience. I’ll be back to see how this turns out.