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Reflections From UM Doctor in Haiti: ''I Felt Invisible''

Anthony Amoroso, MD, an assistant professor of medicine in the School of Medicine, was part of the first University of Maryland team to go to Haiti to provide medical care to earthquake survivors. Below are his reflections, written while en route back to Baltimore.

Feb. 8:
I'm now in Boston awaiting my connection to BWI, my extraction provided by a UN cargo plan. I'm sitting here watching the Rachael Ray Show; the altered sense of reality is intense.

Watching CNN with the horrific pictures of bodies and destruction compelled us all to do something. I am grateful for Dr. [Robert] Redfield, Dr. [Thomas] Scalea and all the others for giving me the opportunity to put away the TV remote and help.

I had been to Haiti 5 other times. I knew things would be difficult, but words and a few photos from a moving car cannot capture the utter destruction, impromptu camps, dust, smells and filth. There are certainly thousands upon thousands of people entombed in the rubble and still thousands suffering from untreated wounds and fractures. And I fear the next wave of misery from unsanitary living conditions is around the corner.

For the first time in Haiti I felt invisible, and I was stuck by the fact that people were getting back to the daily hard work necessary to survive in Port-au-Prince.

The Haitian people are hard as nails, but I simply cannot image any rosy future for Port-au-Prince. The international response, though large, is perplexing, and I think the poverty, destruction, and trauma is a staggering challenge.

I believe we did something meaningful. I believe we made a indelible connection not only to the patients but the staff and students of the hospital. I am proud to have been part of the Maryland team - tough, focused, careful and caring and never self important or touristic. I am thankful for the vision, professionalism, respect and humor of the "team."

The terms "block crush injury" will be with me for life.

Feb. 11:
I'm going to try to get out tomorrow. A bit torn, patients have gotten word of our departure and getting a bit upset. Every day we make some improvements and it becomes a bit addictive. We worked late tonight doing what we can to make transition to incoming group. There are about 5 people staying on and another 10-15 coming tomorrow. We know every patient in the hospital and have a medical and surgical records on all of them. We only have a few backlog cases waiting the new team.

We leave with 5 functioning operating rooms, an organized stock room, almost automated lab, an admissions and discharge system, medical records, ambulatory appointment system, 6-bed trauma bay for wound care and fractures, community triage teams, some capacity for patient transport, beginnings of sanitation with port-a-pots finally arriving and medical waste and sharps disposal. We continue to struggle for beds, linens, crutches, flys, lack of misquito nets, human waste disposal and basic hygiene like toothpaste, soap, and shampoo.

From a medical standpoint the nature of the injuries - fractured legs, very large wounds, bone infections, kidney failure from crush, paralysis, dead limbs, and amputations - makes for long-term complicated problems.

My biggest frustration and anger lies in the entrenched backward and uncaring health system that permeates the hospital despite the fact that it is destroyed. It's a real feat that it is running, and this only through the force of several external personalities. As these people leave I fear for the patients and know the volunteers will walk away frustrated.

The bigger picture remains far from over. There are hundreds of thousands of homeless people living in squalid improvised camps throughout the city and region. Dysentery is picking up, and we saw the first cases of hepatitis A today. A cholera outbreak is easily feasible and would be devastating. How on earth the cleanup will commence and even come close to succeeding remains a mystery to me.

I've hit my wall, fatigued, with muscle and back pain. Chronic dehydration. Now with mouth sores. I have no more socks, underwear, or food. I guess it's time to go home. It's been an incredible experience. I'll be back to see how this turns out.

Posting Date: 02/19/2010
Contact Name: Karen Buckelew
Contact Phone: 410-706-7590
Contact Email: kbuckelew@som.umaryland.edu