Two UCSF anesthesiologists returned Feb. 6 from an inspirational medical mission in the Dominican Republic, where they treated hundreds of survivors of the deadly 7.0-magnitude earthquake that struck Haiti on Jan. 12.
T. Anthony “Tony” Anderson, MD, PhD, a fourth-year resident, and Seema Gandhi, MD, a faculty member, both in the Department of Anesthesia and Perioperative Care at UCSF Medical Center, are among members of the UCSF community who have responded in various ways since the devastating earthquake one month ago.
Anderson and Gandhi went to the Dominican Republic with Operation Rainbow, a San Francisco Bay Area-based nonprofit volunteer organization that provides free orthopedic surgery and medical care and equipment to children and adults in developing countries.
“It was amazing, overwhelming and very sad, but it was great to help out any way I could,” Anderson said. “We provided orthopedic surgery, anesthesia for all types of surgeries, intensive care, general medical care, and pediatric medical services, as well as pain management for the large number of patients who have had injuries and surgery.”
UCSF resident Tony Anderson stands with a boy who was glad to get pain relief from the injuries he sustained in the Jan. 12 earthquake in Haiti.
The team arrived in Santo Domingo, Dominican Republic, late the evening of Jan. 31. The following morning, they left on a six-hour bus trip to a Haitian refugee camp in Jimani, which is in the Dominican Republic approximately one mile from the Haitian border.
The camp, which had about 200 to 250 refugees when the group from Operation Rainbow arrived, has become a major makeshift pediatric and adult hospital, intensive care unit, and operating facility for Haitian earthquake survivors. Only a month ago, it was an ophthalmology clinic and an orphanage. The orphanage now houses a ward with more than 150 patients and the remaining patients are being cared for in tents close by.
“I have worked in India with limited resources, but the magnitude of this catastrophe was unimaginable and something I had never seen before,” Gandhi said. “I was humbled and encouraged by the strength and resilience of the Haitians. I spent long hours in the OR working on pediatric cases and knowing that most of them will walk again was very fulfilling. I felt like I made a difference.”
And while scores of international health care volunteers converged in Haiti in the days and weeks following the disastrous temblor, the number of volunteers appears to be decreasing while the demand continues.
“There is going to be an ongoing need for aid to Haiti, medical and otherwise,” Anderson said. “Medical emergencies are decreasing, but long-term, organized efforts will need to continue.”
Although the Haitians face many daunting challenges ahead, Anderson was struck by their sense of optimism. “The fact that the people are still smiling is amazing,” he said. “They’re very happy with the help they’re getting and very appreciative of the care they receive. They smile at the little things.”
Providing Pain Relief
For the first half of the week, Anderson and Gandhi provided anesthesia to patients undergoing surgery in operating rooms and during the second half, they ventured outside to give much-needed pain relief to those with acute care injuries.
The group from Operation Rainbow deployed to the Dominican Republic on Jan. 31 to volunteer their time treating earthquake survivors.
“I saw every patient in the camp and organized a pain management service to provide for their ongoing pain needs,” Anderson said. “There are a large number of patients with specific pain issues secondary to their injuries from the earthquake and subsequent surgeries.”
Anderson said there appeared to be sufficient supplies of medications and equipment, like crutches and walkers when he was at the camp, but cultural and linguistic barriers prevented some Haitians from asking for pain medication.
For many who suffered broken bones after buildings collapsed on them, the pain of their injuries deterred them from moving at all after they were treated. But as Anderson explains, lack of movement for prolonged periods of time can lead to additional complications, such as bedsores and stiffening of joints.
“There were too few nurses they were just overwhelmed to help explain the importance of getting them up and moving around,” he noted.
Anderson came across a young girl who hadn’t walked for three weeks after she was treated for a fracture in the days following the earthquake. Like many patients who received quick fixes in the rush to treat as many victims as possible, her fractured bone was held together with an external fixator, a device in which a rod on outside of the skin is used to hold pins to align the lower and upper bones together.
“Doctors had to do [the procedure] quickly without X-rays,” he said. “They had to go purely by feel and looking at the injury. The girl was afraid to walk, partly out of anxiety of the pain she thought she would feel.”
Seema Gandhi and Tony Anderson.
Even after Anderson gave her a Vicodin for the pain, the girl initially refused to get up. But once the girl did rise, she wanted to keep on walking, smiling along the way, happy to be back on her feet, he said.
Now that X-ray machines are available, physicians are going back to patients like the girl to realign bones that weren’t perfectly aligned the first time around. This manipulation will cause a lot of pain. The long-term goals are to insert rods and plates, which is the standard procedure for resetting broken bones, Anderson said.
Although they never stepped foot in Haiti, Anderson said those from Operation Rainbow who did go to Port-au-Prince, told him of a city in ruins with no evidence of debris removal or rebuilding. He said the Haitians there still need the basics for survival: food, water, shelter and clothing.
Asked what he would tell other health professionals who are considering going to Haiti, Anderson said, “Make sure you are going to the location where you and your specialty are needed the most. Consider bringing a group of physicians with varied expertise rather than a group with a single expertise. Ask beforehand what type of medical supplies is most needed at that location. Do not become too focused on what tasks you want to provide, but rather assess what help is needed and provide that service to the best of your ability.”
Both Anderson and Gandhi came away with an experience of a lifetime.
“This has been one of the most memorable weeks of my life,” she said. “I have been touched by these people, who with so little have profoundly enriched my life. I am also heartened to see how the international community has transcended cultures and borders to help others in need. I started off with despair, but I returned with a lot of hope. The human spirit prevailed and the journey to recovery has just begun!”
UCSF Community Joins Together in Relief Efforts for Haiti
UCSF Today, January 22, 2010