Full capacity

We have been at full capacity at our hospital in Port au Prince for a day or two now but there is no shortage of patients here who need hospital care.

We have been at full capacity at our hospital in Port au Prince for a day or two now but there is no shortage of patients here who need hospital care.

We are waiting to hear if we can use a large location not far from here which we could turn into a large hospital (perhaps with a capacity for 400 beds)  so I am looking forward to see if we can get the go ahead to start.

We are all still packed into the one large house which doubles as a base for MSF Swiss in Port au Prince.  It is on a hill with great views over the city, but for the 50 or so expats we have here it is quite squashed. Most of us are still sleeping on the roof (partly out of fear of another quake, but also because the roof is a large terrace and we can put many beds on it!  We all get tangled up in the web of makeshift washing lines, with mosquito nets and clothes drying which zig zag across all of our mattresses.  The very few bathrooms we have are barely functional, with an unreliable water supply and toilets that don?t flush well.  Yesterday evening for the first time it started to rain, and we all quickly had to take our beds into the indoor passageway until it passed. Luckily it did not rain while we were trying to sleep.  I enjoy sleeping on the roof; the sunlight wakes me up naturally in time for work. Very soon many of us will be moving into another house which should make things more hospitable.  But when you compare our lifestyle with the tens comfortable complaining about.

The recently orphaned girl called Jenna who i was talking about in my last blog is still an unhappy looking little thing, and yesterday had one of her screaming fits again because the plaster was making her leg itch.  We managed to wheel her around the hospital in a wheelchair to give her a change of scenery from inside her tent.  When I look at her I try to imagine what it would be like for her, one month now without her mother or anyone familiar, her leg in a cast and stuck in a hospital tent with construction happening all around her.  How quickly her life changed.  We have not been able to make her smile much yet, she is not very interactive.  But we have alerted her to the psychologists who will encourage her to start playing again when she is ready.  I can see small improvements in her sense of security.

My staff have been asking me if I can provide them tents as they are also living under 'la belle étoile' (the beautiful stars) as they call them in the typically positive Haitian way.  It is difficult to imagine that nearly all of our staff is also living without water, sanitation and protection from the rain, in camps around the city.  It rained last night quite heavily for the first time... when we arrived at the hospital this morning we had to remove all our damaged stock that got wet accidentally when the makeshift roof let the rain in.  The patients tents needed a good mopping but all in all the hospital survived ok. It is the beginning of a huge crisis here now the rains are starting and tens of thousands of people are living on the streets.

We have had heavy machinery and earth moving trucks operating next door to our hospital.  The noise of crumbling buildings reverberates all day around our hospital which is disconcerting for many.  We even feel the earth tremor because of them which is not conducive for a therapeutic environment but I guess this will be the norm in Haiti for a long time. We have had a few mini earthquakes and tremors over the last few days that have caused things to shake occasionally, but not severely.  So many buildings are about to topple that it won?t take much.  Things feel very precarious.

However despite all this, the ambience at our hospital gets better and better each day as people settle in.  We have a team of physiotherapists that are getting people up to walk, whether they have legs amputated or external fixation still in place.  We have parallel bars, wheelchairs, crutches etc. and it is great to see people smiling as they can learn to move around again.  To see a man smiling with pride as he negotiates going up a ramp on crutches, just one month after losing his leg gives me a sense of purpose and motivation all day to do all I can for these people.

Our psychologists are doing a great job with consultations, and especially with the children who are all starting to play with balls, teddy bears and draw with crayons.  Every day there is laughter and games and more and more interaction between staff and patients as things are coming together and settling into a nice rhythm.  It is starting to have a homely feel. We are also providing great quality food which makes a big difference to the lives of our patients.

But it feels like a bubble.  As soon as we leave the gates we are confronted by a desperate situation that seems mammoth.  The living conditions in some other hospitals are terrible, yet sometimes the patients in these places are too afraid to leave where they are to come to our hospital because it is unknown to them and they don?t want to give up their beds and risk being stranded.

Today there were some men in a car who called out to us to ask if there was hope for Haiti... we replied that there was certainly hope, but they responded that they didn?t think so as they drove on by. Time will tell.

Plans are being made to relocate large patches of the population who are living in camps in town.  It is interesting where the strategies are going in terms of deciding to either rebuild Port au Prince, or re-establish another capital city entirely.  I have been here almost two weeks and the magnitude of all this still hasn't really sunk in because I have been so pre-occupied with the task at hand.  In terms of loss of human lives, it has surpassed the Asian Tsunami which effected a huge stretch of land in many countries.  This was one city.  Destroyed in 30 seconds, and the aftermath is still barely manageable.

We have no idea how we will ever be able to discharge most of our patients, as we can?t send someone out to the streets with one leg and no house, job or family.  At the moment though, we are focussing on just providing the post operative care so many need.