Disaster Response B #4

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Disaster Response B #4           

 I was talking to one of my male patients today about his experience during and after the hurricane.  He said that leading up to the hurricane they had no idea that the storm would turn out the way it did.   He’s an electrician by trade, and worked up till the storm hit.  They’d been through many storms and were not concerned.  This storm had high winds, sustained at 180mph with gusts to 200mph.  it went over the island at about 1 mph.  so essentially lingered for 2 days.  And the storm hit at the time of a king tide and the storm surge across the island was devastating.   He was at home when the storm hit.  And after a few hours he discovered there was water flowing in under the door.  The water slowly rose, and he realized that the water was flowing brown with septic system contents.  He decided to drive his family to higher ground.  On the way there the water got to deep and killed the engine of the car.  He took his child and niece in his arms and waded to a near by house.  He said the water was flowing constantly from East to West.  The family let him in their house and he said the water was getting higher and higher and was up to his waist.  He put the three children on top of the refrigerator to keep them out of the water.  He said on his way to the house he stumbled over something hitting his lower leg and hurting his toe.  He estimates he stood in water for about 16 hours.  His house is still standing but everything in it is ruined.  He had a cut and dead area on his toe that I debreeded and found a piece of glass in it. 

People are very traumatized after the storm.  They’ve lost everything in 2 days.  A team went out to help with tarps and water to the other end of the island and the damage was as if a “bomb had gone off.”  

A woman said she came back after the storm and this is what she found- it was a cement pad of her home.  No walls, no roof, no stuff laying around or near by, NOTHING- just a cement pad.  

Another man described the water coming in his house and he was hanging on to the AC unit in the wall when the water broke through his front door and swept him to the back door and nearly through it.  He said he hung on to the doors of the fridge for about 12 hours as the water swept though his house, and he struggled to not let go and get swept out.

In another small village a grandma described that she lived on a “high” spot on the island and her daughter brought her niece to be with her and then went back to the village to get other people.  They begged her to stay but she left, and was never seen again.  Of the 25 people in that little village the niece is the only one who anyone has seen.  The village is gone, and they were likely swept out to sea with the current flowing across the island.  

Another family describes, how they were in the house when the water started coming in, and they got up on chairs.  They have a disabled teenage daughter.  As the water rose the family of 4 got up on higher furniture and eventually climbed up in the rafters.  The water in their house was 10 feet deep and they only survived by being in the rafters for >10 hours, before being rescued.

            A number of churches at that end were even concrete and were destroyed.  A few houses remained standing but their roofs were heavily damaged or gone.  Businesses were flattened.  Cars swept out to the ocean.  Boats turned upside down on top of trees.  Containers on their sides, or swept away.  Rows of houses- are now rows of barren cement pads with very little debris around them.  

            Lord God, help us to show your love to these hurting people.  Help me to see each one as a person who not only needs physical help, but also emotional and spiritual help.  Give me your words for each that I see tomorrow and every day there after!

Disaster response B#3

administrator Greg No Comments

Disaster response B#3
Second full day here, and another two storms on the way.  one is suppose to be tonight and should have 60mph winds and lots of rain, and the other may come this way in a week and be  stronger (Tropical depression 9).  We will wait and see.  I made rounds with two surgeons from the RAND hospital that came over here to see what patients we had and to contribute what they know about them.  Some of the patients came from their hospital which is closed because it sat in water for two days.  We saw and looked at a lot of the patients with cellulitis and debridements. The man that I operated on last night is doing better and more conscious all the time.  There were three patients that came in last night and a constant stream in the ER today.  
 I saw another woman that had a leg infection from standing in water that had sewage in it.  The dressing needed changing, and I was told she may need sedation.  So I arranged with the OR for sedation.  They set up monitoring and everything near her bed in the womens ward.  I unwrapped a lot of surrounding dressings.  Then I saw patches fo necrotic (dead) tissue.  I was able to push off some of the with my finger and rub them away with gauze.  Then I realized it was deeper and needed a formal debridement in the OR.  The orthopedist came in and saw what I was up to, and agreed.  He has a lot of war wound experience and I think his thoughts are important.   Transferring this person was challenging as she was very heavy.  Lifting her on and off the OR table and stretcher took 7 of us. The orthopod and I scrubbed it the OR and cleaned out all the dead areas we could.  Then we wrapped her legs and willl wait to see what happens.  Later in the afternoon I went and helped tie down the windows of the tents, so that when the winds start tonight, we will have less rain inside.
I was able to take a shower early, in the outdoor showers-looking at the sky.  Then off to supper, with was a vegitable curry with rice- and was good!  now off to bed, before the storm hits and I get woken up.  
Greg

Disaster response B #2

administrator Greg No Comments

Disaster response B #2

            I made it to the disaster area hospital today.  At 9AM we took the Caravan plane to the other island that was more effected by the hurricane where the emergency tent hospital was set up.  As soon as we land and unload our stuffff into a mobile cart- it downpours!!! We head for the one tent that is the only shelter.  There are so many people waiting under it that our stuff sits out in the downpour fo r 30 minutes till it passes.  All my cloths are wet, but I had my electronics with me, so they are OK.  Samaritans Purse has a very nice set up, with tents that make up a full 40 bed hospital.  Generators run non-stop, large oxygen concentrators are hissing, a container with a huge water tank on top gravity feeds all the running water.  A tent  with cots for the men staff, and another for the women.  A male ward, female ward, OB ward, a connected tent that has ER, ICU, step-down, and OR all under one connected roof of 4 tents.  The equipment is state of the art, monitors, suction, anesthesia machine, surgical packs, gauze, medicine, ultrasound machine, mobile x-ray machine.  A mess tent.  Tarp lined showers, porta-pottys.  I found a cot that appeared mostly empty and put my stuff down.  The tent is air-conditioned, and that will help with sleeping!  Amazing.  The wards are not, the OR is.  After lying down my stuff, I headed into the hospital to find someone who knew what I was to do.  I found the clinical coordinator and she showed me all around the hospital, and introduced me to the staff.  We have 1 OB/GYN, 3 FP docs, me, and 4 ER docs.  The local RAND hospital is right across the street.  But most things were destroyed in it, when the whole island sat under about 4 feet of water for 2 days.  In fact the first 4 feet of any metal building was destroyed, leaving higher walls, and a roof intact on some.  Trash is piles out of all the houses.  Anything that sits less than 4 feet in a house was destroyed!  Imagine how little is left in the homes that are standing?  There is gradually local power coming back, no water yet.  Power lines lay across the road in places on our way in.

            After being shown around the hospital, I was asked to see a few patients with one doctor.  On the male ward and female wards- there are many people who are overweight, have diabetes, and walked around in the 4 feet of water for 2 days.  This has led to many of them having cellulites with I’m sure a variety of bacteria.  I evaluate a guy with a bowel obstruction and another couple patients.  Then there is not much to do but wait.  Right before supper I’m asked to see another patient.

            This guy was found unconscious yesterday and brought in.  A white blood cell count shows 7 yesterday and 23 today.  Very high.  I touch is abdomen and he winces in pain.  I let go and he is much worse.  He has peritonitis.  A slew of labs were ordered yesterday, but the RAND hospital across the road isn’t able to get them to us quickly so we have very little.  No liver numbers, no pancreas numbers, only a few electrolytes.  So I decide he needs to be explored.

            Supper tonight is a lot of beef with a little broccoli and potatoes.  So I pick out the broccoli and potatoes and eat that. (I’m a vegetarian).  After supper I ask where the family is, and no one has seen them, and he apparently was living alone.  I ask whether I should go ahead?  They decided we should contact the RAND hospital and see if they had a way of finding out. About an hour and a half later, the medical director from over there, comes and evaluates the patient with me, and he agrees with the need for exploration.

            We head to the OR.  After the anesthesiologist puts him to sleep, I open along the mid line.  I encounter what appears to be cloudy fluid.  I find the appendix- normal. I search the large bowel for diverticulitis- normal.  I look at all the small bowel- normal.  I look at the stomach front and back- normal.  I mobilize the duodenum- normal, but the pancreas is inflamed!  Pancreatitis!  So we close him back up and he goes back to the step-down unit.

            I take a shower under the stars- and now think I’ve wound down enough to finally ready to sleep.

Greg

Disaster response B #1

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Dear family and friends,

About 2 years ago Audrey and I discovered Samaritans Purse DART program (disaster response).  We joined the organization and are excited about serving people effected by disasters.  About two weeks ago I realized I had time off when they were having one of their training weeks.  So I contacted the DART team and signed up for the training session.  About a week later hurricane Dorian was headed to the Bahamas.  They called up a non-medical response.  I offered to go, and they thought it best to do the training.  Then they decided to deploy their Emergency Field Hospital.  This is a 40 bed hospital in tents, with an operating room and delivery room.  I again offered my help.  They already had a surgeon and orthopedic surgeon and didn’t need me.

            Two days ago, in the afternoon, I got a call.  They were asking me to join the existing surgeon to help in the Bahamas.  I am very excited to be able to go and serve during this disaster response.  As you likely know, hurricane Dorian had sustained winds of 180 mph and from the pictures online, leveled much of the Bahamas.  A hospital in one of the large towns was destroyed and this is where DART decided to deploy the emergency field hospital.

            So this morning, I signed out to my partner and drove a couple hours to the airport.  I am currently on my flights going towards the Bahamas.  I am unsure of what awaits me.  Humid heat, I’m sure!  Many people, 75,000, in need.  I imagine that the worst things surgically have already been dealt with or the person succumbed to their injuries.  So I imagine that the hospital will be dealing with traumas from the clean up and possibly cholera and waterborne diseases from the island being half under water.

            I hope to be giving you updates as I go along, but I suspect that there isn’t any communication at this point.  I figure that a cell tower is one of the first things to be blown over.  Either way, I will write.  Then send them when I can.  I hope that you are able to join in either coming to help or in your support of Samaritans Purse or other organizations that help provide disaster relief.  Please pray for me, that God give me wisdom to treat each person I come in contact with, with compassion and love.  Hope to communicate again soon.