A Heart for Haiti
Judy F. Minkove
Date: February 4, 2010
Four times a year, Hopkins Children’s emergency medicine physician Karen Schneider takes a group of residents to developing countries as part of a tropical medicine elective in the pediatric residency program. Schneider and six residents were on their way to the airport Jan. 12 for a regularly scheduled medical mission to Haiti when the 7.0 earthquake disrupted those plans. Still determined to get there, they piggybacked with a University of Miami medical team and boarded a private Learjet with food and as many medical supplies as the plane could hold. This is Karen Schneider’s story.
We made our way to a makeshift hospital in the U.N. compound next to the Port-au-Prince airport. The medical team we relieved had worked for 48 consecutive hours.
The victims in the hospital had open fractures—their bones were sticking out. There was no anesthesia, no morphine before we got there. All we could do was clean the wounds as best we could and give the children antibiotics. The first kid I saw was 11 and needed his leg cut off. He had a crushed infected leg and had developed a fever and was becoming septic. He died an hour after surgery. But he was the only child we lost. Once the other docs got there, we handled hundreds of kids 16 or younger and made sure they got IVs, antibiotics and pain medicine.
She Cried Out To Me, “My father’s dead, my mother’s dead and my body’s broken. What’s going to happen to me?” No one claimed her. I felt so guilty about leaving her.
The residents were fantastic. We took turns napping. They would say to me, You go to sleep now; I’ll take over. We worked 22 to 24 hours a day.
The residents were there for five to six days. I was there for eight days. We were running on adrenalin.Thirty-six hours after we arrived, I collapsed on a floor mat. I managed to sleep about an hour and a half when I felt a tug and one of the nurses was yelling, “Karen, Karen, can you get up? They just pulled a baby from the rubble!”
It was a 2-month old baby girl and she was covered in white concrete dust. She’d been buried for four days. Her chest was completely pushed in, her skull had a deformity, and she was so dehydrated that her heart was slowing down.
She was very close to dying. There was no oxygen, no X-rays. We couldn’t find a vein, but we finally got a line into her bone marrow so she could get some dextrose and fluids.
Suddenly someone came running in to inform us that a plane was flying to a Miami hospital. So we packaged the baby up. As I laid her down on the seat, she gave me this big, crooked smile. It was the first time this baby had responded. And then she peed! That meant that we had gotten enough fluid in her. It was really uplifting. That baby was later shown on national TV and is now doing well.
Seeing so many devastating injuries and orphaned children was beginning to take an emotional toll and it was hard not to cry. Yet the Haitian people are incredibly resilient and giving. They always look out for one another—and they’re so grateful for our help.
At one point, I got sick of eating granola bars and peanut butter and went searching in my bag for a nut mix with chocolate chips. A badly injured 20-year-old was guarding my bag, which was loaded with expensive medical supplies. He just took it upon himself to keep an eye on it and was leaning against it. I gave him a handful of the nut mix. He thanked me profusely. Then he took a tiny portion of the mix and passed it on to the person next to him, who passed it on to the next person, and so on, until it was gone.
Many of the children we saw had compartment syndrome, a crushing injury. The muscle is enveloped in fascia, like a plastic case. When a muscle is crushed, it swells and needs to be let out of the fascia. Here in the United States, after such a trauma, we would do a fasciotomy to release the muscle.
Otherwise, the muscle occludes—cuts off blood flow to the veins and arteries. Initially, it’s unbelievably painful, but then there’s no pain because the limb dies. By the time we got to Haiti, we were forced to amputate many limbs because it was too late to do fasciotomies.
On day three, a 12- or 13-year-old girl who was found sandwiched between her parents’ decomposing bodies arrived at the hospital. She cried out to me, “My father’s dead, my mother’s dead and my body’s broken. What’s going to happen to me?” She had two femur fractures, and elbow and wrist fractures. No one claimed her. She had unbelievable strength. I felt so guilty about leaving her.
There was another 12-year-old boy—Mistell—who came in with his father. His mother and three siblings had died, and he needed to have his leg amputated. He asked me, “How can I go to church or school? I don’t want to beg on the street. My daddy needs me.” He was shaking with fear.
One of the surgery residents took him to surgery and we took care of his pain. After the amputation, I sat down next to him. He wanted to see his leg, but I had to tell him it wasn’t there. The boy’s eyes filled with tears; then he heard kids screaming. He said to me, “You go because the children are crying. The children need you. I’m not in pain. They are.”
And you ask me why I go back to Haiti? It’s because of people like this. The media talk about voodoo and looting. But the Haitian people are amazing. When they get a bag of rice and boil it, it’s not just for one family. It’s for whoever comes near that pot.
—as told to Judy F. Minkove
For more on Hopkins’ efforts in Haiti, click here