Helping in Haiti
Was this your first mission as a Red Cross volunteer?
It was my first mission, and a really big one, too. I was there as part of an ERU team. That means Emergency Response Unit. I completed that Red Cross training in 2007. One of the things you learn, among others, is how to set up a field hospital, divide into teams, identify needs, patient care, and, above all, deal with the many unknowns because, when you are in the field, there are lots of those.
Were you in Port-au-Prince?
Yes, we were on the campus of the Haiti State University Hospital (HUEH), which had been badly damaged and several departments had collapsed. Many NGOs were there; for example Médecins Sans Frontières, Médecins du Monde, UNICEF, Swiss hospitals. There were a lot of us and we worked in collaboration.
Were you actually camping?
Yes, outdoors in tents. Due to lack of space, we were the only ones who were on location 24 hours a day. The others left at 5:00 p.m. and came back at 9:00 a.m. the next day. We set up an operating block tent and outside of the regular working hours, we handled the emergencies, such as Cæsareans. I assisted on all the Cæsareans.
Did you fly straight to Port-au-Prince?
No, we flew to the Dominican Republic and took a shuttle bus to get to Haiti–eight hours in a minibus on bumpy and chaotic roads. There was a lot of traffic in both directions. After driving around Port-au-Prince for a while, we finally met up with our group.
I imagine that you were all a bit shocked when you got into the city?
It was horrible–there was just silence in the minibus. The further we got into the city, the more we saw collapsed buildings and debris. But there were people living there; even amongst the bodies and the rubble, daily life was continued. They had no choice. They had to live in the streets among the debris and the bodies.
Once you were there, did you have any time to adapt and take it all in? Or did you have to start work right away?
When I arrived I was sure that I would see a lot of births, given my assignment and work experience. But then I was told that another organisation had already set up a field hospital for obstetrics and pædiatrics so I was assigned to the "operating room." So I took charge of perioperative and patient care through the gardens and alleys that served as wards during our first days there. The hardest part was finding patients in this maze–especially after the first aftershock; everyone came out of the buildings and onto the streets, beds and all. They set themselves up as best as they could using cardboard and tarps as shelter. Gradually, we setup our tents and equipment and became better at working under these conditions. I was fortunate to work with very dedicated and creative people. Our team was made up of paramedics from the Israeli Red Crystal, surgeons from Norway and Haitian support staff. I was also lucky to get the chance to work with two Haitian nurses.
So you didn't get much rest I imagine?
No, we had two half-days off. Our days started around 7:00 a.m. and ended around 7:30 p.m. because we were mainly working with the daylight.
What sort of injuries were there?
There was a lot of traumatology. We started operating the day after we arrived but that was already six days after the earthquake, so there were a lot of compound fractures that were infected. Inevitably, in the first days we did a lot of amputations. Afterwards, we did a lot of external fixers and skin grafts.
Beyond serious injuries, patients must have been in shock?
Yes, at the beginning, it was difficult to establish communication beyond "Hi, how are you?" and "Where does it hurt?" The fact that they had serious injuries which would mean a long recovery or permanent disabilities – and loss of autonomy – weighed heavily on many. As time went by, we learned more about their personal catastrophes. But after about one week, once a climate of trust had been established and they felt that we were there to help them in the long term, I found them to be very warm. They seemed very patient and resigned but they are also very strong people!
What do you mean?
Resigned in the sense that they have suffered so many dramatic events and catastrophic events but seemed to still have the strength to continue.
Do you mean a kind of fatalism?
No, I wouldn't say fatalism. They continue to believe in God, they continue to pray to God, they still believe in all that. But the earthquake was not a punishment, it was just what happened. They are resigned in the sense that they are going to rebuild from where they are now–they are starting over yet again.
Coming back to the care–you didn't just do amputations and skin grafts. Did you also assist with births?
Yes, but I only did Cæsareans because we took in the emergencies. I assisted with five Cæsareans during my mission. Forty-five minutes after the second 6.1 quake, we had two mothers who came in for Cæsareans at the same time–a boy and a girl!
Do you know whether midwives play a role in Haiti?
No, I don't. I think so but everything was so chaotic. What I saw was that the women went to the maternity ward at the end of the little road where we were. All through their labour, they walked past us; they could spend the whole day walking. Based on what I observed, they don't stay in the hospital long before returning home. I assisted in a natural delivery and the mother left two hours later. She didn't have a house so she went back to her tent or her little corner.
Did your work with Aboriginal communities better prepare you to work with the Haitians?
Yes, definitely.
How?
In that it taught me to make do, to listen and observe before acting. You have to respect customs and traditions, you have to learn to recognize them, respect them and work that way if you want the people to participate. The holistic approach is far more important when you work in isolated regions because the people there, a bit like in Haiti, learn how to manage with what they have around them. Haiti is a really poor country. Here in Canada, in the Far North, we aren't disadvantaged financially, but rather because of lack of services, the temperature, the long distances and the fact that care takes so long to arrive. So I found that there were many similarities from that point of view and also in this type of acceptance. Haitians have that acceptance; not fatalism, but, like I said earlier, a resignation which makes them strong. They are capable of getting by with almost nothing at all. It is this adaptability that I find similar to the Aboriginal people in the Far North.
Did you notice the Christian influence among your Haitian patients?
What I noticed was that when people woke up after an anæsthetic, they would often pray or sing.
Do they like to sing?
Yes, they love it. But it's because the drug we use to anæsthetize them brings out what they have deep inside, so when they woke up, they sang hymns, religious prayers, or they thanked Jesus. I would say that 90% of the time, it was a reference to "le bon Dieu," even children eight or nine years old. Also, we were on the site of the small faculty of medicine church, so every morning there was a public mass at 7:00 a.m. They would assemble in the road so they could listen and they would sing. Every two or three days they would come and sing at the door of the post-op ward as a kind of gift to the patients.
Was it a challenge to be working on a multicultural team?
It was very interesting. I think that Canadians were incorporated into the ERU teams because we are bilingual, French and English, and we are also pretty versatile. The Norwegians speak Norwegian and English, the Israelis speak Hebrew and English, so we were the link between all those people–it was really interesting. I think we were appreciated for our teamwork, friendliness and professionalism. We received a lot of commendations.
You went back to work just a few days after getting back from this trip, so you didn't have a lot of time to digest the experience. Was it hard to go back to work?
Yes. What I found hard about returning to work was that I felt like I had nothing to do here anymore. I worked so hard while I was there that when I got back here I got bored, so I found extra things to do.
Were your colleagues interested in your experience?
Yes, but it was a bit exceptional in my case. We were the first Canadian medical team to be deployed to Haiti, so Radio-Canada, CTV and the CBC were all following us. All of my colleagues saw me on TV. Chibougamau is just a small village, so when I came back, people felt like they knew me. My colleagues were pleased that I went for them and I felt supported by them, thanks to the magic of satellite communications!!
Would you have any advice for people thinking of taking part in a mission like yours?
Before going, you absolutely must feel good about yourself.
How do you mean?
I would say being open to everything that could happen, having a positive attitude and keeping an open mind because you could miss so much. You need to be very adaptable and really flexible too. You need to keep an open mind at all times, even if things seem strange or incoherent. There is a reason for everything. So, the first reaction has to be acceptance, and understanding will come later. It is not my place to judge anything.