Since I've returned, a lot of folks have asked me how they can help. If you text the word "HOPE" to 25383 it will send $10 to the folks at Medical Teams International (you can do it more than once if you like). If you would like to donate a larger amount, please visit their site at www.medicalteams.org. Thank you to all of you that have supported the work in Haiti. My biggest fear is that we will move on and forget. There is such a tremendous need. I'm still having dreams every night.

During my senior year at Washington State University I did research on chickens at the Veterinary school. You know, it was just one of those things. In the process of it, I learned how to hypnotize (mesmorize) chickens. It really is something that everyone should know how to do. After all, you never know when it might come in handy. At WSU we did it so we could put them on their side and give them medication to relax them before we operated on them. So I just couldn't resist teaching my Haitian friends how to do. Besides, the team was eager to learn as well.

(Photo: Pastor Devariste's wife in route to Miami aboard a donated Learjet about 2 weeks ago.)

I was able to speak to Pastor Devariste in Miami and he told me that his wife is doing well. Not only is she going to live but it looks like she is going to be able to keep her vary own foot as well. Please keep her in your prayers. She is having surgery this Wednesday.

For nearly the past two weeks I've been working as hard as I know how to get King's Hospital up and running with two functioning ORs that could simultaneously do surgery on three patients. We met that goal about 48 hours after we started it. After reaching that goal,  we then began to focus our attention on the tent cities and other places where we might extend our work to reach more people. We began to partner with the Baptist Mission, Grace Tabernacle and Haiti One as we sought to understand the needs of the tent cities. Our plan was to use those places as outreach "clinics" to meet the needs of the patients there and, if needed, transfer patients via Haiti One's ambulance to King's Hospital for surgery or more advanced care. Today, Dr. Junie informed us that she wanted to return to business as usual at her hospital. In other words, now that her hospital was running again, she wanted to use her staff to manage the hospital and take care of the patients. This could turn out to be a great thing. It will free us up to meet more needs elsewhere. Therefore, today we did a 3D-Evaluation and decided that we should pack up and move from a hospital focus to a field focus. It only took us about 2 hours to gather our supplies and load the large cage truck.

We are still seeing a lot of wounded people that have not yet been evaluated by anyone. Unbelievable!

Today was an interesting one. Once again, for me it was a day of networking and coordination. We received word today that the anesthesia machine that we had been anxiously waiting for was finally in Haiti. Now, the challenge was going to be getting it from the airport to the hospital. The roads are dirt moguls and potholes. They could easily destroy sensitive medical equipment. It turns out that the machine was delivered to Haiti by the US Air Force. The folks at Hope Force worked it out. After even more behind the scenes work by them, they were able to arrange to have it delivered to the hospital by helicopter! The Canadian Air Force agreed to deliver it by sling.

It was awesome to see it come in and I couldn't resist being up on the roof to get some great pictures. Well, that was a big mistake. The roof used to be covered with concrete dust and gravel. Now, all of that is under my eyelids, in my ears and down my pants. But, we have our anesthesia machine! Nice! The US Army 82nd Airborne were with us and they coordinated with the helicopter to land in a nearby field while they provided security. That way the Canadians were able to retrieve their harness and hook and drop off two of the guys from Hope Force to help uncrate the machine and transport it down stairs to the OR. Great teamwork!

 

As the medical director for this team I know full well that our effectiveness is dependant on several things.

1) I need to be sure that our team is safe.
2) I need to sure that we have the resources that we need to do our job or I need to work with the team to help them come up with creative ways to use the resources we have.
3) I need to be sure that we have adequate communications both internally and externally.
4) I need to be sure that I understand how we fit into the bigger picture.
5) I need to constantly assess how we are doing and look to the future with a willingness to adjust the plan based on feedback from the team and others.

The last point actually impacts the other three significantly. Networking is key during disasters. The strength of a disaster response in general has to do with how well the various resources cooperate. During this trip I introduced mind-mapping software called Mindmiester. This software allows us to track relationships in a visual format that will help our team get things done more effectively and more efficiently. We have found that the iPhone has been a very powerful and dependable communications tool her in Haiti. The folks at Mindmeister have an app that allows us to edit our map on the fly. All of us on the team can share the same map. The team back in the US can also see how the network is expanding. I anticipate that this type of technology will become more and more important as we respond to disasters in the future.

(The above video was originally streamed live from my iPhone!)

I'm overwhelmed by the amount of injuries and the severity of the injuries! Everywhere that I look there are buildings that have been destroyed! Even banks! BANKS!? Good grief! Taking pictures of the destroyed buildings seems pointless after a while. They all just look like pictures of piles of rocks. I don't allow my brain to wonder what it could be like to be trapped alive. However, I must admit, my mind keeps burping the concept up since the aftershock scared the heck out of me. Last night I woke up about five times thinking we were having another earthquake only to realize, several heartbeats later, that it was only a US Air Force C130 transport plane taking off. Our guest house is somewhere just beyond the end of the runway. Those things are loud!

Today was a blur. The one thing that I do remember for sure is that I fell in love. No doubt. How can you not fall in love with a 12 year old 7th grader with huge brown eyes, a cute little sundress and a smile that could stop time itself?   When "The Thing" happened she was so frightened that she ran out into the street and was hit by a car. She was pinned under the car and sustained third degree burns on nearly the entire right side of her face and her right shoulder from the muffler! Her neighbors pulled her out and she ran in to help her mother get out of the house!

When I met her she was a patient at the UN - U of Miami hospital. I fell in love with her instantly. No way was I going I let her stay there.  I told them that we would be happy to take her to our hospital (where we could love on her and give her some personalized care). We loaded her and her mother into our car and took her to King's for some outstanding care (not that I'm biased but I really like our team). 

Jay Leno said calling it an aftershock is like calling the second twin an "after-birth". He is right. No matter how you look at it, we had an earthquake early this morning that was a 6.1.  It was scary! But there is more to the story. You see, at home I usually sleep naked (TMI?) but here I have been wearing shorts. Well, last night I was just too dang hot so I decided to sleep in my bun-huggers. When you were a kid did you ever have the same recurrent nightmare that I did—the one where you went to school and forgot to put your clothes on? When the quake hit, I was sleeping and the room started to heave and rock. There was an amazing rumbling roar that was a very deep sound/sensation. Bill jumped up and yelled "Earthquake! We gotta get out of here now!!!" I jumped up and asked myself a quick question, "Dan Diamond, would you rather look for your shorts and possibly die or experience a compound fracture or would you rather run outside in your underwear?"   I went for the underwear and ran outside. When I got outside I was the only one wearing briefs. Then a little girl passed out and I ran over to check on her. Now Nick, our video guy that is documenting the trip (eat your heart out Brittany Spears, he didn't film me in my underwear)--Nick said that the girl passed out BECAUSE she saw me in my underwear. Needless to say my staff and the Haitians at my new home spent the rest of the day laughing at me.

The tremor was really scary. When we arrived at the hospital we found our night crew outside with ALL of the patients. They evacuated all of them. They were amazing! They had them all organized with their names, medications, and their diagnosis.  They even drew out a grid of the hospital grounds and mapped their location so they could be located. Fabulous! I am working with first rate people.

Today it hit me. 

 Bill and I were up very early to take the pastor and his wife to the airport. It was very emotional putting her in a exclusive Leer Jet. Her husband was overwhelmed with joy. His smile went all the way around his head. Then to top it all, the pilot asked him if he wanted to go as well!!! He was blown away. He hugged me like I just saved his life. Hmmm. I can still see his smile. It's only a 90 min flight in a Leer Jet. It was a happy ending to an amazing story. She was picked up at the airport by an ambulance and, as you read this, she is already in the hospital getting the care she needs. 

At the hospital today I was able to define my departments and assign department heads. The departments are Triage, Intake, OR, Inpatient Floor B, Inpatient Floor C, Inpatient Floor D, Supply/Pharmacy, Operations, and Security. I have an outstanding team, they have rallied and made tremendous progress today. The OR looked like a real OR. We have had, however, significant troubles with the generator. It is too small and frequently the breaker trips. When that happens, the autoclave that sterilizes the instruments shuts down and has to be restarted. It has caused some frustrating delays. We ended up shutting down all of the breakers to the entire hospital except for the autoclave. We have big-boy huge generator on a palate but we don't have the cable to hook it up. There is only one forklift in town that can move it to the best location and it is at the US Embassy. All the UN lifts are being used to off load the supplies at the airport so we might be able to pull that one off soon. 

I spent a good amount of time scrambling trying to find supplies and have made some great finds at the UN. We also agreed to take up to 15 post-op patients from their tent if they would send us their cots. I've been trying to find some cots today with a goal of about 250 cots. Don't tell the staff, they aren't quite ready for that many patients yet but we are growing rapidly. We also started using a regular charting system today. All patients are formally checked in and have a chart. Orders, notes and meds are all recorded. We are nearly JCAH certified! We even have radios so the Dept Heads can communicate.