Sunday, January 31, 2010
We followed the docs on grand rounds. There are people everywhere but that said everyone is being treated well. The pih philosophy is to not turn anyone away and no one is charged. What's more amazing is that almost all of the staff is Haitian with a handful of American docs here because there are so many patients and they are just slammed. The patients range with problems all over the map and sadly many amputees. The peds ward is the toughest yet all the kids smile and wave as do the parents. It's horrible to think what some of their lives will be like when they leave here. Life is hard enough with four limbs here.
We followed a few of the docs after rounds and watched them adjust a few casts and reset a young boy's leg. The care they give is completely wonderful and it's great to watch them hug and play with the kids even though there is a language barrier.
We also sat in on a beautiful church service run in one of the clinics because the church is being used for the wounded. It was quite moving and beautiful and odd to hear a sermon in Creole where I recognized the word Israel so much.
We then gowned up and headed into the two ERs to watch a biopsy and a broken arm. It was pretty wild. I asked the surgeon about the biopsy and he told me that there was some debate as to whether or not to do it. If they find he has cancer there is very little that can be done so some of the docs questioned whether knowing was a good thing. Hard to say.
The broken arm was interesting as when they started they noticed healed gun shot wounds and when they opened his arm realized this was an old wound and the guy probably hadn't been able to use his arm for years. He came in saying it happened in the quake. This is happening a lot since people see the opportunity for good health care. The irony is that pih would have helped him when it happened.
We finished the day doing some interviews with the staff including an imaging tech who lost her husband and son. Everyone here has lost someone and some even their entire families yet they are here working to make people better. It's humbling to witness.
The pih facility here in cange is sort of like the citadel. A huge compound with the hospital a school a nutrition center a church and a host of other services. They started by trying to treat tb and HIV and then realized that treatment was no good if they didn't have water, shelter and food. So they started working on clean water and nutrition as well as home fixing/building. Then they moved into nutrition as well. It's really incredible. And when you think that everyone who walks through the door gets whatever they need for free- surgery, aftercare, hospital care, medicines- sounds sort of cool doesn't it? And this is Haiti. I think the greatest thing that I've heard since I've been here has been talking with Konji, one of the pih crew. He summed up their philosophy like this. Pih is not necessarily about saving lives, although that is what we aim to do here. Pih is about assuring dignity and letting everyone know that regardless of who they are or where they are from, the utmost possible was done to give them the best care possible because that is the right of every human being. These guys rock.
We traveled to Cange today where we are staying for a few days. Cange is about 3 hours from the Dominican border and is on what is one of the two roads that lead to Port au Prince from the dm. Half of it is paved and half not so I can see why getting supplies in is rough.
It's extremely rural and along the way there are a tremendous number of people living by the roadside in tin shacks. Most are subsistance farmers by the look of it and as such were largely unaffected by the quake. I have to admit it's nice to be somewhere where you don't see destruction and smell the smells of death for a change.
Cange is where Dr. Farmer started pih and the hospital here is absolutely huge and spread out over many acres. It's the first of 10 hospitals that they built in Haiti and understandably the flagship. It's a bit surreal to be staying in this oasis, sleeping on a real bed with clean sheets, and looking out on a gorgeous vista when so many people are suffering such a short distance away.
Having just written that, it occurs to me that minus the earthquake and the sheer numbers of the displaced, Los Angeles is no different as we will go to dinner and a movie while people up the street look for a place to spend the night. Much can be learned from all of this as there are troubles and need everywhere. But I digress.
We spent the day touring the hospital and checking out the town which is essentially one dirt road. Imagine a sophisticated hospital in one of the most rural poor areas one can think of and you understand what the pih mission is. Free healthcare for those who need it most and what's most important is that the majority of the hospital is staffed and run by Haitians. That's the key.
We met some lovely people on the street. It's sad but in la these are people I might never meet or interact with for many reasons and here it's different. Everyone smiles. Scott our sound guy and I were watching these kids pound what looked like corn meal in this old rounded in wooden stump that looked like it had been used for thirty years all smoothed out and beautiful. The kids were smiling at us so I pointed at myself and then at what they were doing and they offered us a chance. It was pretty funny because with two people you need a rhythm and we didn't have much. It was a nice connection though.
Scott and I are pretty much attached at the hip as he needs to be getting sound be out of my shot and yet we have no idea what will happen next. He's very good and has done Survivor and Amazing Race for years so he knows how to move. Cool stories from those shows too.
Off to bed in a few but I'll leave you with this. Pih had worked out a deal with several hospitals in the states to take the most seriously wounded patients for free health care and the military had offered free transport. Quite a feat. Andrew our pih contact tells us that the state department will not grant visas because the cost of the patients care will be too great. Amazing.
We started out by following some of the pih docs to one of the medical tents in the tent cities. These cities are really not to be believed. Very mad max after civilization has fallen feeling at least visually. That said everyone is amazingly friendly and smiling as long as you nod to them first. I'm assuming that is because I have a camera and they are tired of cameramen as there seem to be two or three per Haitian.
To give you an idea of the tent cities imagine central park filled with tents. Not tents that you would buy by the way but tents made out of anything they can find. There is a saying here that everything goes to the dump but the only things that end up there are rocks and dirt. I watched as one man was pulling nails from a piece of old wood, straightened them, and then used a rock to hammer that wood on the top of his lean to.
The other thing is that there are kids everywhere and they are constantly asking for food and more specifically water. They don't look malnourished but to have a 5 year old come up and speak creole to you until you realize he wants water is completely heartbreaking.
The problem is that if you give something to one of them you soon have a swarm of people and there is potential for a problem. It's tough to figure out what to do. I've taken to giving things out as we leave an area and handing things to anyone who asks while we are at a light. I don't know. It's very hard.
One of the really weird things is that most of the out of towners - the docs and journalists - are white so you have a situation where the lighter skinned people have water and food and the darker skinned folks are looking everywhere for it. It's truly disturbing. One of the emt guys we met from NYC told me he'd been eating at the military tent. I asked him why they didn't mind and he responded oh they'll let anyone white in. Disturbing.
We left the tent city and sadly I realized on the way the I had lost my still camera. The cam I could care less about but it means all my movies and stills are gone. Again nothing compared to what surrounds me.
We then boarded a military boat and headed out to the US Comfort a floating navy hospital ship that holds a thousand patients. The Comfort is where the more serious patients are sent and one of the docs wanted to do follow up.
You may have heard about the port being shut down to ships and we saw why. Huge cranes on their sides in the water and a roadway the size of the 405 now completely submerged. Mind you this wasn't a bridge but a road that just cracked off and sunk. It's hard to imagine that kind of force.
We spent about two hours on the comfort following the pih doc as he checked on patients he sent ahead. I won't go into the particulars as it was really tough to see. These are the worse off patients and a lot of them are kids. It's heartwrenching. They were taking info to get in touch with family and let them know they were ok. In some instances there is no one.
As we move around I am overwhelmed by what is going to happen next. The emergency of the quake is slowly fading. People are getting fixed up and others are even starting to rebuild. But what happens when someone is done with the hospital and is sent home but has no one. Where do they go? As we drive at night there are no lights so it's really dark and our driver needs to slow down at corners because people are sleeping outside And in some places even in the street. They are afraid of going back in buildings and that's not really going to change. Where will these people go? There is talk of real tent cities being built but no one seems to know where. And what will happen when the rainy season starts. The people here have already been hit hard and this will only make that worse. Wish I had answers.
Since i got here I've been thinking about what the future of Haiti will be. Why not offer people here solar - free hot water free electricity. We were interviewing one of the pih docs yesterday and at one pint he said do you know what killed more people after the earthquake than anything else? I expected him to say infection but instead he said lack of electricity. Apparently the days after without electricity they had to stop working on patients after dark with few exceptions. How incredible would it be if there were solar panels charging batteries to light the areas they needed to work. I know it's a pipe dream but is that bad?
I'm babbling. I think that psychologically what we are seeing is beginning to effect me. At first I could close my eyes and disconnect if I needed to but now it's not possible. We've see too much and while most is not as bad as I thought it would be it's extremely tough nonetheless. One of the things I cant seem to shake is the smell of the bodies. It's not everywhere like I expected it would be but you can generally tell which buildings buried a number of people by the sweet sickly smell coming from them. It's something i'd like to think I'll forget but doubt I ever will.
Thursday, January 28, 2010
We started the day early today by filming a meeting of a group of Partners in Health docs who were heading out to set up a mobile field clinic in an area that had seen little help so far. Most of them were Haitian and fairly young and have tremendous pride in knowing that they will be helping their countrymen. It's quite wonderful to see. I rode with them in a bus to the location. They mostly speak French and some Creole and both are lacking for me so we smiled a lot. I did speak a little to one guy who spoke Spanish but I can't quite say what we talked about.
Driving out to the outskirts of the city you can really start to see not only the devastation, but also the poverty. It's like nothing I've seen. There are buildings down everywhere with 4 stories crushed to a couple of feet. The buildings are built so poorly, a symptom of bad poverty and corruption, that they came down in no time. The earthquake lasted 30 seconds according to most people we talked to, and for anyone who has been in one, that's a long time.
The mobile med center was amazing. By the time we got there, they had set up some shelter tents and word was spreading. Slowly people started appearing and began forming huge lines. Each patient is seen by a doc given a care booklet where info is recorded and then sent to the hospital or given mess. The hospital sets back up in a week for follow-up.
At this point most medical stuff is second wave. Wave one was hardcore emergency stuff. This wave is fixing rush jobs from wave one and dealing with the lesser emergencies. Now that they have stopped looking for bodies, things have gone to a more normal pace. We did see a 5-year-old girl who had cut her finger off which was tough, but they took her immediately and sent her to the hospital.
While I have not seen the level of trauma I expected (thankfully), the thing that has amazed me the most is the Haitians. Haiti has this bad voodoo crime aids rap that seems undeserved. The people that we have met have been truly amazing and we've been in what were some pretty rough areas. But of course these are odd times and I've been here for two days. However, the expats who live down here say the same thing. Two examples come to mind. The first was a screw up that could have gone bad. Due to sheer exhaustion one of our cameras was left in a public area where people are living for about an hour. The only reason we found it was because I walked by and saw it. That's a ten thousand dollar piece of equipment left unattended for an hour in a group of people who are homeless and hungry and it wasn't even touched.
The second thing is those tent cities. Thousands of people camping together, no police in sight, and no problems to be seen. And we went to many of them and they were all the same.
As far as food, commerce has picked back up and there are roadside stands everywhere. Now, can you imagine this happening in an American city and there not being violence?
We are bedding down with the journalists tonight, which is kind of funny as many of them are really obnoxious. They view this as just a story and treat the people like props. Very sad. The surgeons we first met were not happy to see us until they realized what we were doing and saw that we were not walking into triage and getting into docs’ ways. Mention Sanjay Gupta to them or Anderson Cooper and they lose their minds. One of them said that Gupta walked into an OR he was operating in with cams and started talking to the surgeons on camera. They told him to get out and apparently he was shocked they didn't want him there. This whole event, like many I'm sure, has been overly dramatized for the sake of who knows what. I don't mean to minimize what happened because it's horrible, but the aftermath has been inspiring. It's an incredible place and the Haitian people are incredible.
One of the things that everyone agrees on is that they hate The UN. They are nowhere to be seen.
The surgeons we met headed home tonight, as the Haitians have taken back control of the general hospital. It's sad because it took an earthquake to destroy the place to get the kind of healthcare that people should have and the equipment to do it.
Wednesday, January 27, 2010
A long day has finally ended. We got her at about 7 am and went straight to the central hospital. When I say hospital, I don't mean it like anything you've ever seen in Los Angeles. The guys who have been here since Day One told us that the hospital was overrun with rats. The poverty here is not to be believed. There was a tragedy in Haiti but the earthquake is only the latest chapter. Doctors from all across the world have been thrown together and are making it work at the hospital. In a short amoung of time, we have gotten to know some of them and hear their stories.
I'm exhausted and about to go to sleep in a tent on concrete, so I'm just going to list some things that maybe I can expound on later:
In spite of what you've seen on CNN, things are not crazy down here. In fact, everyone is working together and being extremely patient. I sat and hung out with 3 surgeons tonight who have been here a week and they told me they've performed 200 operations and haven't had to amputate a single limb. I mentioned that the impression on TV is that everyone has lost a limb. Apparently, when things first happened there were aid organizations doing the best they could, but they were in over their heads, so they amputated rather than risking surgery. That spread like wildfire and now people with fractures are afraid to come in, and instead wait until the last minute and end up with gangrene. Insanity.
I was talking with an ENT from Brooklyn who told me that he went out on a search and rescue mission last week and had to make the choice between saving a mother in one part of the house or the father and son in another. He decided to save the father and son, and the mother was gone by the time he got to her. It seems like everyone has a story like this.
The roughtest part of the day was walking through the Swiss pediatrics tent. Babies and infants in the kind of shape no one would ever want to see. Many worn parents there too, but many kids are alone. It's horrible. We checked out an operating room as well, while they were operating. When I say 'room' I mean just that. I can't believe what they pull off with what they have. The toughtest cases get sent to the USS Compassion out in the harbor that has 1000 beds and a crack surgical team. Oddly enough, there are tons of Scientologists here. They are extremely helpful and wear there yellow Scientology shirts.
We are camped near the airport and about every ten minutes, an army transport takes off or lands. It's really loud and almost drowns out the noise of all the generators.
For those of you who asked, I have no yet visited the Israeli camp yet, but the first person I saw on the ground was an IDF soldier with a yarmulka. Odd context. When you mention them here, everyone pretty much agrees that they are the best at what they are doing. The first place rheu (?) try when they need equipment is the IDF hospital and I was told that in general, "an dray" (?) takes 3 to 4 hours and maybe you hear back the next day. At the IDF hospital it takes 15 minutes and within another 15 minutes you get results back from a team in Israel who has checked it over.
No one is sleeping inside but everyone is very cool about it. People are on the sidewalks and even rooftops. I'm sure there is more, but I'm too spent to write. Tomorrow, I'll follow a team into some remote villages that have not been "rexhwd" (sorry, having trouble decifering this... any ideas?) since the event as it is known.
Tuesday, January 26, 2010
40 food bars
a water purifier squeeze bottle that takes out viruses and organisms
a back up water prifying system
candles and matches
a solar/crankable radio,flashlight,usb charger
medical and wilderness survival apps fro my iphone
Touching down gotta run. Next up HAiti
So here's what happened. The day after the earthquake, i woke up feeling helpless like most of us, watchingt he news and surfing the web, wishing i could do something, anything to help. I decided I'd start a donation collection going at the school i work at part time and by the end of the day, with the help of one of the students who was already collecting on her own, and some faculty matching funds, we had collected $1000 and purcahsed a shelter box which has already been donated in Haiti. It was really quite amazing how many people stepped up to help.
Now it just so happens that I had a lunch meeting with a friend of mine, Dannielle, and actress I have known for a while and an all aorund good person. Danielle mentioned in passing that she had a friend who was flying a chartered jet down to miami to ferry people and supplies back and forth to Haiti as was needed. She said that another friend was working with a childrens hospital called St Damiens. I asked her for their numbers and she sent them as soon as she got on her computer.
I called Eric, the guy with the jet first, and he told me that he works for a charter company (he may own it, i;m not sure) and that they were going to be flying down. i then called Danielles friend Alex and asked how i could help with St Damiens. He put me in touch with their office on the ground in miami and one of their advocates in washington who was coming back from PA with a her newly adopted haitian son who she had just picked up. All of this happened in the scope of two hours.
I talked to the St. Damiens folks and they explained how dire the situation was and what was needed. St Damines is a 120 bed hospiutal and they were treating 900 people a day with people on the lawn, the roof, the hallways. They said that the surgical teams were working 24/7 and mostly amputating, much of it without proper pain meds and antibiotics because things were so bad. I think it was that that really got to me, thinking of kids who's limbs were being amputated without anasthesia so that they wouldn't die of infection. It's incomprehensible.
So I got back on the phone with Eric and asked if we could send bags. He said yes, but didn't know when they were going. We sent out an email to the parents at the school and within a few hours had a pharmacist and several doctors offer supplies. Pretty cool.
I also was able to get a solar company to donate a bunch of solar chargers and send them to Haiti via Miami. ya never know what a call can do huh?
I went home and continued to email back and forth. At some point, my friend Laurie Webb, and amazing person all around, Facebooked that her producing partner was working with Partners in Health, a health org that runs a hospital in Haiti. I emailed Laurie and mentioned the flight going to Miami if it could be of help.
Laurie and I go back to my ER days where she was the DGA trainee and i was the steadicam operator. She must have emailed her friend Cary about me because in about 5 minutes I had an email from Cary asking me to call her.
So I called thinking that she was going to ask about sending gear, but instead she told me that she was producing a documentary about Partners in Health and it's founder Dr. Paul Farmer, one of the more respected health care proffesionals in the world fighting for health for the poor, and wanted to know if I would come along to shoot it. Crazy how things work huh?
I talked to Cary for a while and asked a ton of questions, talked with my wife (who I owe big time for being cool with all this) and decided to meet with the director, Kief Davidson. Kief is a very cool guy with two docs under his belt including Kassim The Dream, one of the more stylized and interesting documentaries I've seen. We hit it off, and before you know it I was getting ready to head to Haiti, instead of back east with my family for vacation, which I am still bummed about.
As for Eric and the charter, I was able to put two huge duffle bags together filled with medication, surgical supplies and a ton of other health related items and get them to him Sunday night. Emma, one of the students from school, helped coordinate a lot for that and I can't thank her enough.
Sunday night I drove out to van Nuys, a small private airport, and pulled into a dark parking lot with bags full of drugs, to meet a guy I had only spoken to on the phone. Very Miami Vice. Eric turned out to be very cool and had me pull out onto the tarmac. I assumed that he was taking one of the gulf streams I saw parked but he told me that their plane was around the corner.
It was actually a custom 737 that rents for $12000 an hour and only had four people on it. As the woman in front of me reclines and slams the laptop into my gut, i must say I am bummed I didn't go down with eric as the pullout beds and HD tvs did look nice. Crazy. What was more of a bummer was that he was only able to conatct me sunday morning and he could have taken a ton more stuff had i had more time. Such is life I guess and the stuff we did send was very well recieved, so that's good.
Also, sitting here on the flight, the stewardess asked if they could do anything else (as if they haven't done enough - see previous post). I mentioned having access to a lot of medical supplies in LA with no way to get them to Miami where they would go on to St Damiens in Port Au Prince. Within minutes she had gone up to the cockpit, asked the pilot who radioed the ground, and now it looks like Virgin is willing to take supplies for us from LA to fort lauderdale where they can be picked up and brought to miami. Amazing.
So there you have it. We hit the ground in NYC at 11:30 and then shuttle to Newark to grab a 1:30 charter flight which we shoulkd just make. The Virgin folks already know about it, have worked out letting us off the plane first and will be heloing us get baggage out quickly so we should be ok.
ONe final note. As I sit here it occurs to me how adaptable people are. I had a drink anf forgot to tell them I didn't need the little napkin before they gave me one. I generally do that to waste less. But then it occured to me that I have been told that toilet paper is at a premium down there right now so without hesitation, pocketed it and asked the woman next to me if she needed hers. That's two! But the amazing thing is until now, it didn't occur to me how odd that idea would have been otherwise (or that it woudn't have occured at all). Strange.