Disaster relief organizations and workers have always had my complete respect.  They frequently put themselves at risk physically and emotionally, working in hazardous conditions and entering unknown situations. It is not my forte, but I have worked disaster relief before - New Orleans hurricane, Midwest floods in the United States, and our own earthquake response in Peru’s Ica region. 

Each one has always been different, depending on response teams, how well funded and organized they are, and very importantly, the political situation at the time of disaster and the one arising during response. This is my story with the Haitian response.

On February 17 I flew from Lima to Santo Domingo, Dominican Republic. After a long seven hour bus ride, I arrived at a medical camp in Jimani, at the border of Haiti, run by International Medical Alliance.

The accommodations were adequate in a large building completely empty of furnishings and I was assigned to a room with 12 beds.  I registered, showing my nursing license and telling them that I had administrative experience.  They assigned me to 12 hour nights as a nurse, 8 p.m. – 8 a.m.  My heart sagged since I really didn’t know if I could work all night.  At 7 p.m., everyone gathered as a doctor conducted a small briefing of the day’s events.  Then I reported to my tent, set up outside the building along with three other tents housing patients.

Two large glaring lights in the tent ceiling lit up a big semicircle of patients in cots of every design and shape, with families on cots or cardboard on the dirt floor between them. The nurse’s station was a few cinder blocks with cardboard placed on top and a couple of plastic chairs.  There was a row of shelving which held supplies and medicines to the side.  Bottles of water were sitting in the dirt, along with larger supplies and a garbage can.

The entire extent of my job was to give medications, manage IV’s, and change dressings.  The families took entire care of the patients, giving and emptying bedpans, bathing the patients, changing sheets, washing clothing and sheets, turning, assisting them with eating, etc. I was amazed at how families cared for patients – there were no decubitus ulcers or bad smells, patients were clean.

After my four hours of orientation, I was left alone in my tent with 21 patients, most of them having had complicated orthopedic surgeries.  Since we were five weeks out from the earthquake, most of the more minor and simpler surgery patients had healed enough to leave the camp, so we were left with long bone fractures of legs, and crushing injuries needing plates and rods.

All patients were Haitian and spoke Creole, a form of French.  My interpreter spoke Spanish and Creole.  I spoke Spanish with him and he translated into Creole and back to me in Spanish.  It worked and that is how we got by.

At approximately 10 p.m. each night, a preacher would conduct a service of prayers and sermon for about an hour. The Haitian service was Baptist in content, and every single patient participated in singing and chanting and raising their arms in praise.  Their faith seemed quite important and probably sustained them in these most trying times.  Many patients had their entire belongings in a bundle on the dirt floor beside their cot.

I wondered at these patients, who were from every walk of life, some well-educated with jobs and nice homes, as well as very poor people – each in the wrong place at the wrong time.  All were thrown together in these tents, men and women, young and old, all bathing and using bedpans with no privacy – their entire lives and emotional ups and down just out in the open, for weeks and weeks.  And there was little continuity of the people that they depended on to help them, all of us coming and going through their lives at different times. The Haitian patients and families in general seemed happy and smiling, which must have shown something of their culture and their outlook and way of living their lives.

We were lucky in that the nurses felt needed at the camp.  We knew what our role was and what we were there to do.  Unfortunately for many people there, very little direction was given.  We felt the leadership falling apart, with communications back to us sporadic, and daily briefings eventually stopped.  As days went by, leadership became less visible, new people were arriving without people to greet them and tell them what to do or where to stay.  There was both underlying and overt anger from these volunteers.  Food became less and less available, so most of us depended on snacks and what we had brought with us.  Tensions between the Haitians and Dominicans increased and we found supplies being stolen, including our entire bottled water supply, and our food being eaten by Dominicans.  Security was sporadic and at night we provided our own security, alert for strangers and unauthorized vehicles, even chasing cows, goats, dogs, and pigs away from the tents.

There were no psychologists or counselors in the camp, which was quite unfortunate.  Nightmares were common after this traumatic disaster.  Not only was this a concern for patients and families, but for staff as well.  One of the neediest volunteers that I encountered was a young woman doctor assigned to my tent.  She was tearful on and off all the time as she cared for patients, seeking reassurance from the patients that things would be OK, sitting on their beds crying, which, of course, no one could know. 

About 30% of the patients had homes or families to go to, which meant the other 70% were being discharged to refugee camps.  Other NGOs were issuing a small tent and set of pots and pans to get them started in the camps, and we were rounding up any extra luggage or garbage bags for them to place their meager belongings in for the trip.  Since some of the patients could barely get around on crutches or walkers, straighten or bend their legs, we could not imagine how they would be able to get from mattresses on the floor of a tent to sitting and walking positions.  As the time got closer to closing the camp, more patients were sent out in compromised conditions.

Although I was hungry most of the time and felt sleep-deprived as I couldn’t sleep more than 4 hours per day, I was very happy that I made the trip. I felt quite needed, providing continuity of care for 21 patients during my 11-day stay.  It is a situation where you do it because it is the right thing to do.  No one is going to tell you that you did a good job, or say thank you.  An underlying element of unrest was present the entire time with lack of leadership, lack of security, and tensions within the countries of Haiti and Dominican.  But the memory of seeing the faces of those Haitian patients was enough for me.