After an uneventful drive to the hospital in Saintard, Haiti, Kathy and I dismounted our usually trusty vehicle, opened the squeaky gate, and entered the hospital yard. Before we ascended the stairs to our shared office, the ER doctor approached me. His bloodshot eyes told me it had been a tough night in the emergency department. “I need to talk to you when you are available,” he slowly muttered. I quickly made my way back to the ER after a brief stop in the office and knew something was out-of-the-ordinary, as this experienced physician rarely asks for help. We walked together into the ER, where nearly every bed was filled and family members were worriedly surrounding their loved ones. The story of the night unfolded as we visited each bed, revealing each chapter of the long, involved story.
We stopped by Bed 1, where we gazed upon a sleeping 7-year-old child with a heavily bandaged head. “She has a skull fracture,” the weary physician said. “I closed [stapled] the superficial wounds but I really need to transfer her to a center with a neurologist.” I wholeheartedly agreed, and he asked me to work out the details.
Bed 2 was filled with a gentleman who had a severe femur fracture, as well as some fractured ribs and multiple lacerations. “We need to get him transferred as well”, the ER doc muttered, “but since the gangs are shooting, we have been forced to keep these people here.”
We continued the journey around the emergency department, and the details of the previous night came into view. It appeared there had been a Voodoo ceremony of some type, and a vehicle had plowed into the crowd. Add to that two other motorcycle accidents and the normal disease entities, and the night had been a whirlwind of activity. The final tally was that we had three who should be transferred, but the child with the skull fracture and the gentleman with the femur fracture were definitely number one and number two.
“Can you help me find supplies to rig up traction of the femur” the doctor asked, “and then I can work on that while you work on the transfers.” I found some gallon jugs and strips of cloth for the makeshift traction, and then made my way to the office to get busy on getting the transfers done.
Port au Prince holds the bulk of the hospitals with specialty services such as neurology, and a Doctors without Borders facility that could handle the femur fracture patient. Unfortunately, all roads between our hospital and Port au Prince were impassable due to gang violence. The press was calling it “gang warfare”, which was probably more accurate. There is a medical helicopter service still active in Port au Prince, and with the roads unavailable to us, a call to them seemed appropriate.
“We cannot get to our helicopter currently [due to the violence] and are afraid they would shoot at the helicopter upon take-off. We’ll get back to you.” I contacted another larger hospital in the opposite direction of the gang warfare to check if they could treat our patients. They informed us that they believed one of their specialists could handle the femur fracture and potential hemothorax, but that they were out of oxygen. If we could lend them an oxygen tank, they could help us out. Once the patient was prepared for transport, complete with an extra oxygen tank, our ambulance headed their direction.
Meanwhile, the hospital with the neurologist in Port au Prince contacted us and said their neurologist was unable to get to the hospital due to the “situation” on the roads. We continued to work on possibilities, and called the pilot of a small plane. If the ambulance could transport the patient three hours north (the opposite direction from the hospital in Port au Prince) to his location, he could fly over the gang area and get an ambulance to transport from the airport in Port au Prince to the hospital. All of that could have worked, but the hospital there still did not have the specialists who were needed.
The day turned into night and the patients were still stable. The possibility of transfer was zero at this point, and we would need to prayerfully hope that the patients would remain stable to try to make the transfer on day 2.
Day 2 found us loading up the patient in our ambulance, followed by our truck full of empty oxygen tanks to fill in Port au Prince. The 2-vehicle caravan traveled toward Port au Prince, only to find the gangs turning them away once again. We were back to dependence upon our oxygen concentrators and what we could manage at our little hospital in the country.
Fortunately, the chapters of the story as of today are more hopeful. The patients eventually were transferred. The appropriate specialists were found and the injured persons continue to improve. We are thankful. We are blessed, and we continue to write the final chapter of the story of this one night in the ER.
Each day we go to the hospital and open the squeaky gate, another story begins. We have no idea of the adventure, heartache, victories, or laughter that the next chapter holds. We are however, thankful to serve the One who is the author of life.