Stanford Hospital sends eight to aid a broken nation

For Dr. Bob Norris and his team, the term “call of duty” took on new meaning the morning of Jan. 13. Less than 24 hours after a 7.0 magnitude earthquake rocked Haiti, Norris, the chief of the Division of Emergency Medicine at Stanford, was leading a departmental meeting when he received a phone call. It was a colleague from the Washington, D.C.-based International Medical Core (IMC).

Dr. Paul Auerbach, Stanford physician and the former chief of the ER Division, saw Norris on the phone and immediately knew what the call would be about.

“We looked at each other,” Auerbach said. “I asked him, ‘We’re going someplace, right?’”

IMC had requested that Norris put together a medical team to assist in the relief efforts in Haiti. Dr. Ian Brown and Dr. Anil Menon, two emergency medicine physicians present at the meeting, volunteered immediately. Norris then sent out an e-mail asking for nurses. Three Stanford Hospital nurses, Gaby McAdoo, Heather Tilson and Julie Rachioppi, as well as one traveling nurse, Jonathan Gardner, answered the request.

In the two days between the call and their Friday departure, the eight-person team could only imagine the devastation that awaited them. News reports estimated that over 200,000 had perished from the natural disaster, with another 300,000 injured. Over a quarter of a million homes had been leveled by the quake, which had its epicenter about 16 miles from the Haitian capital of Port-au-Prince.

“I don’t think any of us really knew what we were going to face,” said Menon, who had also worked in the field in Afghanistan. “It’s one thing to watch the news and it’s another thing to see bodies and smell infection.”

With $18,000 worth of medical supplies in tow, the team traveled for three days, departing from San Francisco International Airport and stopping in Santo Domingo in the Dominican Republic. They waited in Santo Domingo for a half a day for a scheduled flight that never materialized—with planes working overtime to ship in needed aid.

Rightfully impatient, the team soon realized their utility was dwindling with each passing minute.

“Every moment we weren’t there, we knew there was somebody we could have saved,” said Gardner, who been on vacation in Lake Tahoe when he received Norris’ e-mail.

By late Saturday evening, the physicians and nurses, unable to wait any longer, piled their supplies into rented vans. After a 10-hour ride, the group arrived at the Haitian border Sunday morning. With the sun rising, after making their way through the Haitian mainland to the coast, team members finally laid eyes on the devastated capital, the streets filled with debris and human bodies.

“Hands were reaching up everywhere,” Norris said. “Everyone was trying to get help for their loved ones.”

With the aid of Haitian police, the convoy arrived safely at the University Hospital compound in Port-au-Prince. Auerbach estimated that upon their arrival, the compound was holding between 750 and 800 patients and their families. Due to the structural instability of the building, which made it vulnerable to aftershocks, and the sheer crowding of the complex, workers began setting up tents outside.

Splitting up to assess the severity of victims’ injuries, the team began an arduous task of treating what seemed like an endless amount of patients. Auerbach and Gardner worked in an area known as “The Forest,” a central courtyard where hundreds of patients lay beneath tarps and trees waiting for care.

The first two days on-site, the team practiced nonstop clinical medicine, treating amputations, fractures, facial injuries and burns alongside teams from Canada, Nicaragua and Switzerland. Physicians operated on cots and gurneys, while nurses and other staff circulated outside, dispensing medication and narcotics from fanny packs.

Because medical staff were required to leave the compound at nightfall because of “security reasons,” the Stanford physicians and nurses slept in a conference room at a nearby hotel, averaging three to four hours of sleep nightly and having little time for nourishment. Auerbach recalled a point where he was so dehydrated he had to receive nine liters of fluid through an IV before he could continue working.

“We started a marathon at a sprinting pace,” said Menon, who survived on two Power Bars for his first three days in Haiti.

Although a 6.0 earthquake the morning of Jan. 20 caused some disorganization, medical staff transitioned relatively smoothly from critical to primary care over the next week and a half, with Auerbach appointed lead physician at the compound. Over that time period, each member of the team forged connections with the people that they worked with. Stanford nurse Gaby McAdoo formed an especially strong bond with a five-year-old Haitian boy named Monley, who had been trapped under rubble next to his deceased father for eight days before he was rescued. Monley also lost his mother and his brothers in the disaster, making him the only survivor of the quake from his immediate family.

Though McAdoo was technically Monley’s nurse for only a few days, she continued to visit and interact with him through a French translator. When it came time for the team to leave, IMC psychologists gave Monley a family of four mice, hoping they would help him cope with the loss of his family and nurse.

“Monley grabbed the tail of the mom mouse and the tail of the boy mouse and tied them together,” McAdoo said. “Even though we couldn’t communicate with each other, that was his way of saying he didn’t want me to go.”

Gardner echoed McAdoo’s respect for the Haitian people, saying they demonstrated a strength and resilience uncommon in these types of disasters.

“[The Haitians] had no unreal expectations of people doing anything for them,” he said. “They were extremely grateful for any care they received instead of feeling like it was owed to them.”

The Stanford team remained in Haiti for approximately two weeks, flying out on the morning of Jan. 29 after handing over the reins to Haitian physicians. Though they accomplished much during their stay, the team members realized the work has only begun.

“We wanted to do what was right and empower other people,” Auerbach said. “The earthquake created an entire generation of amputees, people who will need prosthetics, therapy, plastic surgery. There’s infectious disease and homelessness. We weren’t so much rebuilding a medical infrastructure as creating one.”