Haiti: Amputations with no anesthetic

By Ann Ballard
In 2004 I began traveling to Haiti, briefly as a Peace Corps volunteer and later with Healing Hands for Haiti International. HHHI is dedicated to providing rehabilitation training, treatment, education and equipment to the physically disabled in Haiti.
During the January 12 earthquake, HHHI lost all seven buildings on their property. Among thousands of Haitians lost were three residents on campus, including Annia St. Louis, the wife of a staff member, a proud medical school graduate and an even prouder mother of two children, a 4 year old and a seven-month old baby.
The organization reeled with shock and quickly took action. High level meetings were held and a group was sent to treat emergencies, including Emergency Room doctors, family practice doctors, orthopedic and trauma surgeons, nurses and a rehabilitation doctor. Bandages, needles, syringes, surgical kits, IV fluids and as much medication as they could fit into their bags were loaded for travel.
The reality was daunting. On day two, a trauma surgeon and orthopedist left in the morning on helicopter for Leogane, a hard-hit small town south of Port-au-Prince. They heard that one of the surgeons was doing amputations without anesthetic. The other surgeons and a trauma nurse went to the Sacre Coeur hospital. After a long hard day, they ran out of pins, screws and sterile gowns.
A homeless, parentless 13-year-old boy’s tibia fracture was treated and a plan set to treat his crushed femur. The next morning he was out on the lawn waiting with the other patients for the sun to come up and the doctors to return. In these circumstances the doctors work tirelessly and will do a good job for him. It’s what they are trained to do. The worry is: After the medical care, what will happen to him then?
That evening HHHI transported a girl to a French clinic and set her down in the street under an awning. Because she was frightened, they drove back to the chapel and brought her grandfather to stay with her.
A French team was using a private plastic surgery center as a makeshift trauma unit with their triage on the street and sidewalks. The cooperation was amazing, everyone sharing what they had, helping when they could, and working to ease suffering.
Noel, an HHHI driver, spoke to the founder of HHHI about the quake. The driver’s two daughters, age 18 and 8, were at the market when it hit. He ran to the area to find it demolished. Frantically, he crawled over the rubble calling his daughters’ names until finally he heard, “Papa, papa, help me!” He got as close as he could and spent the next three days and nights comforting them, urging them to feel around for food and water. They were rescued on the fourth day, both seriously injured, but alive. The anguish in his eyes as he described sleeping next to his daughters was indescribable.
Prosthetic organizations and charities worldwide have warned of the huge task facing Haiti as it struggles to rehabilitate hundreds of thousands of amputees. Doctors say they are already struggling to cope with the sheer numbers of people needing amputations after being trapped in the rubble.
Some surgeons estimate that as many as 200,000 Haitians will end up losing one or more limbs – in a country where the few rehabilitation facilities that existed before the earthquake have largely been destroyed.
In Haiti, where an estimated 800,000 people were already living with disabilities before the disaster struck, meeting the needs of the amputees will require years of international commitment.

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