NICK – “Being a nurse in the aftermath of the Hatian earthquake”

My name is Nick Baker and in 2010 I was a recently graduated nurse who traveled to Haiti as a medical volunteer two weeks after the earthquake. The following is a letter written to friends and family who donated money to fund the trip. 

Getting There
My story begins in the Dominican Republic. It’s dawn and we are ten doctors and nurses driving toward Haiti at 75 miles per hour. Our driver is José, a gold-necklaced Dominican native who has the radio meringue at full volume and is passing buses with white-knuckle, middle-of-the-road, we’re-all-going-to-die maneuvering. Jose gets excited when he sees women with big butts. He points at them with wide eyes like he’s just spotted a pile of money on the side of the road. We swerve and narrowly miss a goat. Scooters putt-putt along the margins, the obligatory third-world chicken pecks at the highway trash, and a woman in high heels stands with crossed arms as her boyfriend rushes to fix a steaming radiator. There’s an effervescent spirit to the beginning of this trip as Jose encourages the car full of doctors to sing along and an orange sun peaks above the sugarcane. So far, this feels like travel as I know it. It will be seven hours before we reach Haiti where the mood will shift perceptibly with our first glimpses of the damage done by the earthquake and the overwhelming poverty of Port au Prince.
We reach the border. The dusty kaleidoscope of vendors and motorcycles and uniformed men with guns quiets the celebratory start to our trip. We pass easily into Haiti and, for the next hour, we approach Port au Prince in almost complete silence. We all wonder how bad the damage is going to be. We arrive. Those of us who imagined a completely flattened city, limbs visible from the rubble, and palpable chaos, are relieved. Not every building has fallen. The city roads are mostly cleared of rubble. There are street vendors selling mangoes and clothes. People go about their day.
 
Homebase
We arrive at the gate to the makeshift clinic where we will work, sleep, and eat for the next week. It is an open-air compound with high concrete walls that once served as a children’s amusement park. To enter, we drive through the legs of an enormous cartoon character and into a relative oasis. The amusement-park-turned-clinic has two open-air, thatched roof structures. One serves as a primary care area (belly aches, fevers) and the other as an urgent care center and pharmacy (trauma, wound care, pregnancies). There are about 15 camping tents where myself and the other nurses, doctors and paramedics sleep comfortably on cots. There’s plenty of bottled water and we’re served rice and beans for lunch each afternoon. For breakfast and dinner, we are on our own. I’ve packed energy bars with peanut butter for the morning and beef jerky, tuna fish and tortillas for dinner.
 
The Team

A Haitian aid group—Aimer Haiti—has secured the clinic location and a non-profit called Comprehensive Disaster Response Services  (CDRS) provides the logistical support under the leadership of a bust-through-red-tape workaholic and logistical mastermind named Todd. With his beer gut and half-beard, Todd looks like he belongs on a La-Z-boy in front of Monday night football, but the man is the hardest working person in Haiti and an absolute genius at making contacts, getting things done, and working the kind of magic that larger relief organizations are too cumbersome to accomplish. At our home base clinic, the group is comprised of 20 doctors and nurses from LA; 5 paramedics from Tacoma, Washington; and the 10 in my group from an organization called IMANA (Islamic Medical Association of North America). Despite being the only non-Muslim from IMANA, I’m graciously accepted. (Long story how we linked up.)

A drive around town
As soon as we arrive, Todd gathers three trucks and sends us on a twilight tour of Port au Prince. I bring my camera, but after snapping a few photos of fallen buildings that are now mass graves I find myself conflicted between documentary and respect.
If there is a stench of death in the air, as so many news people seemed to report, I can’t smell it over the throat-singeing smell of exhaust and burning garbage. I develop a cough. Dust fills my eyes.
Many of us are surprised to see that not every building has fallen. (It seems the ones left standing are not front-page material.) Even at the epicenter, unaffected structures stand next to completely flattened buildings. About every third building on each city block is still erect. There are tent villages everywhere. Acres of blue tarps, corrugated tin, and wood scraps blanket the landscape. Some of these villages were constructed out of necessity after the quake but many existed before. We see people digging trenches for bathrooms and playing soccer in vacant lots. People dress in clean clothes and present themselves with dignity. While my white t-shirt is soiled in minutes from wiping dusty sweat from my forehead, Haitians have a miraculous knack for keeping sharp. Beautiful women wear impeccably bright whites and colorful skirts and tops. As the week goes on I come to understand that the dignity evident in their wardrobe also extends to their personality. I tell them I’m sorry for what happened to their city. They thank me, but shrug their shoulders. With alarming optimism, they say something like “Well, we can’t change these things, but we can move on.” Everyone attributes this optimism to conditioned acceptance—Haiti having already experienced so much tragedy. I don’t buy it. Tragedy also breeds bitterness, to which Haitians seem to have a special immunity. Something greater than simple conditioning is at work here.
We get out of the truck at the fallen Parliament building that you have seen on TV.  I expect to be swarmed by people begging for food or money. Not a single person. Two teenagers approach me and we talk for 15 minutes—me attempting French, them practicing English. Their families have died in the earthquake. They have every reason to solicit my charity but never ask for anything and give me a hug when we say goodbye. My eyes fill with tears. It’s at this point that my overwhelming respect for the victims of the quake is solidified and this already purpose-driven trip takes on heightened sense of determination to be as helpful as I can while I’m here.
 
Our work
Every morning our beer-bellied logistical genius, Todd, delegates doctors and nurses to different workstations. Most remain at our clinic while others take turns rotating to tent villages, hospitals, and orphanages throughout Port au Prince.
On my first day, I am part of a team of four that is escorted by the US military to University Hospital in the city center. We get a briefing at the military base before leaving. I’m expecting coordinates, walky-talkies, maybe some special gear. Instead the briefing sounds like this: “Bring whatever supplies you have. Treat as many patients as you can. We’ll get you safely there and back.” While University Hospital still stands, the earthquake damage was enough to render the building unsafe. They believe that a small tremor could bring the building down. As a result, a tent village the size of a Super Walmart now houses the hospital’s patients in 20-bed tents.  My team consists of a fast-moving Syrian doctor from Texas with a huge heart; a tattooed, rock-star paramedic called Armadeus (not Amadeus); a photographer with the wide-eyed intensity of Jack Black; and myself.
We quickly learn that University Hospital is short-staffed and lacking leadership. There is no one to tell us where we are most needed. Haitian doctors and nurses are on strike. (On strike!) There are only a small handful of medical professionals to care for over a thousand patients. Instead of waiting for direction, we start at the first tent and get to work. We’ve come with rolling suitcases of pain medications, antibiotics, IV solution, and bandaging supplies for wound care. The tents are saunas. I soak through my scrubs instantly. Family members fan cardboard over their loved ones to keep them cool and to shoo away flies. Some patients are too sick for us to help. A 90-year-old woman lay stoically with her femur protruding from her thigh. Others have malaria. Many are wounded and have amputated limbs.
In nursing school I was fortunate enough to get a lot of practice with wound care—a skill that quickly proved useful in these tents. While many of the patients here received emergency care at the time of the earthquake (amputations, stitches, a bandage over a gaping wound) almost none of the injuries have been tended to since that time. We go down the line unwrapping two-week old, soiled dressings to discover infected, necrotic wounds in desperate need of care. For some, we only need to clean and redress the wound. Others are more complex, requiring us to cut away dead tissue in an attempt to save the limb. A pregnant woman who was trapped under rubble for three days has a gaping wound on her back that exposes her vertebrae. After losing the top part of his foot, a man’s bones and tendons are completely exposed. These aren’t exceptions.
Despite the severity of the situation, there is a calm about the scene. There is no wailing, no desperate pleas for help. Patients wait their turn and are openly grateful for our help. We’re able to make a few jokes and smiles are offered easily.
Though we work until the sun goes down, we feel like we haven’t done enough. We’ve only been through three of 25 tents.
Before coming to Haiti, I was one of the people who wondered if the only positive outcome of the earthquake might be a chance to start from scratch—a shot at a fresh start. But with this close-up view, it’s clear that this will not be the case. While the optimist in me is still willing to ponder the upside of this tragedy, I know that a fresh start is not it. The earthquake didn’t wipe the slate clean, it just complicated the mess.
 
At the home base clinic
The next day, I’m stationed at home base—the amusement park clinic.  The doors open to patients at 8am, but hundreds line up at the gates at dawn. Scanning the line, I’m impressed by how well-dressed everyone is. I learn that coming to the clinic is considered a formal affair and that people dress in their Sunday best for the occasion.
I help in the urgent care area, triaging patients, starting IVs, and getting patients ready for surgery. Haitian translators volunteer their time to help bridge the English-Creole language barrier. They work so hard and with such dedication—always smiling and making an effort to get to know us. Their only compensation is a midday plate of food and bottled water, and I suspect that they would do the job even without these benefits. Each of them has lost family in the earthquake but their loss has not affected their capacity for warmth. The translators are my favorite people to see in the morning.
Word spread fast about our clinic and people now arrive for problems that have gone untreated for years. Under consideration is the possibility of turning the park into a permanent clinic.
 
The catacombs
When the clinic stops seeing patients at 5pm, a team that has volunteered for the night shift at University Hospital takes a one-hour nap, restocks the medical suitcases and drives one hour to the hospital. The hospital is only a few miles away, but the congested streets make the trip longer. Each time we make the trip, I feel like I’ve smoked a carton of cigarettes and I have to close my eyes to keep out the dust. Eventually I get smart and start wearing a surgical mask and goggles during the drive.
We arrive at University Hospital at dusk and meet up with “Doctor Colin” from Partners in Health. Every doctor I meet in Haiti is addressed by their first name—something I find really interesting. It’s like the quake leveled more than just buildings. It humbled people to a level of humanity where titles are less significant. Colin tells us that our help is most needed in an area adjacent to the tents, called the Catacombs.
Darkness has fallen and the Catacombs are as creepy as they sound. It’s a grid-like, one-story structure of cement walls, with no windows and an occasional bare bulb casting the perfect light for maximum spookiness. Rats dart across the floor. With headlamps blazing, we enter with our rolling suitcases and begin to greet people. Right away it becomes less spooky. Each of our bonsoirs (good evenings) is met with genuine warmth, even from people who are immobile and laying in their own urine. We get to work undressing bandages and redressing the wounds with a note in Sharpie instructing other medics when they should be changed again.
At one point I’m alone in one of the rooms and a shadowy figure waves me over. She is skin and bones, at least 90 years old. She doesn’t speak. I kneel, she takes my hand and locks her peaceful eyes with mine.  She begins to nod “yes” and it’s clear that she’s not asking for anything more than this. We stay here for at least five minutes and when I leave Haiti five days later this is one of my most powerful memories.
Later I find a patient with eyes half open who appears to have stopped breathing. His left arm is amputated and he is malnourished.  He’s pulse-less and unresponsive. I start CPR with his sister watching. My team comes to help and with each compression on his skeletal chest, I’m thinking to myself “I don’t want him to come back. We should let this man rest.” But his sister is there and we feel like we have to try. Thirty minutes later one of our doctors pronounces him dead. During those 30 minutes, a patient two beds away passes as well.
We get back to camp at 2am. I get naked and stand under an ingenious shower system that was recently built in camp (well water + pump + PVC). It’s been days since I’ve showered and I’m anxious to rinse off the pollution and pus and blood and CPR and sweat before going to bed. I stand under the shower and turn the knob. A single gush of water dumps on my greasy, tangled hair and drips down my shoulders. The pump is broken. As I’m toweling off my 12oz shower in the moonlight, I feel genuinely lucky that a failed attempt to bathe is my greatest hardship tonight.
 
The irony doesn’t escape me
I was SO close to not getting sick!
It’s my second-to-last night in Haiti when my stomach turns and bubbles and says “What the hell did you just feed me?” The belly rumble builds to a crescendo at about 10pm and I find a private place under a mango tree to throw up. For the rest of the night I’m a fountain of vomit. After each retched hurl, I convince myself that I’ve exorcised the thing that made me sick. This lapse of judgment prevents me from telling anyone about my condition. By the time morning comes, I’m still vomiting. At this point I stop thinking about how sick I am and move to a place of sheer amazement that my body continues to produce such impressive volumes. When Armadeus finds me at my mango tree at 6am. My mouth feels like it’s lined with dry paper and my mid-section feels like a towel that has been rung out. He sticks me with an IV and over the next few hours I get four liters of fluid and some just-in-case antibiotics. I spend my last day in Haiti recovering with a slight fever, feeling fortunate to be sick in a camp full of doctors, nurses, and paramedics.

 

Going home

I’m in the truck with Jose, driving back to the Dominican Republic. He’s sucking down energy drinks and singing along with the Salsa. I’m looking forward to shaving and am feeling tired and contemplative.

I’m thinking back to the days before I left—the days when I was asking you all to help pay for this trip. I’m remembering that I seriously wondered if the money spent on the plane ticket might be better utilized as a cash donation to an organization on the ground. And then I bring myself back to the present and realize how desperate places like University Hospital are for medical professionals—especially with Haitian doctors and nurses on strike. I think about the hundreds of wounds that we kept clean and the number of limbs that were likely saved. Even if it was just one limb saved, what an incredible return we received on our investment.
So, in closing, I’m saying this as much for myself as I am for you: Your money was well spent. We did good work.

 

2 thoughts on “NICK – “Being a nurse in the aftermath of the Hatian earthquake”

  1. Nick, this is a phenomenal story! What an amazing, difficult, challenging, lasting experience. Keep being you, and thanks for sharing ;)

  2. Middletown resident Maria Blon stated Wings over Haiti has actually likewise aided because
    the quake by purchasing land, piercing for water as well as constructing an institution.

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