AMHE News
 
Dr Paul Nacier  who is overseeing the Haitian Doctors (AMHE) deployment to the Mother land declares at the Mount Sinai reception on Thursday the 25 th of February 2010 that the total medical personnel sent so far to Haiti  has risen to 410 , including nurses, EMT etc. He will travel to Port-au-Prince via Santo Domingo as a Team leader of the Nigerian medical squad under the banner of AMHE. Paul is assisted in his huge task by pasts Presidents: Yves Manigat, Eric Jerome, the
AMHE Medical Relief Mission  members and the AMHE chapters presidents.
 
 
Report of Alain Bertoni ,MD MPH ,
 
Dr. Jerome,
 
I wanted to submit a few words upon my return from Haiti. I went through Project Medishare/ University of Miami.  I spent 5 days working at their field hospital adjacent to the airport.  As an internist, I saw thea vast medical need of the people, beyond immediate injuries sustained as a result of the earthquake.   Decompensated heart failure. Diabetic leg infections. Asthma exacerbation. Stroke. Acute renal failure.  Malaria. Tuberculosis. HIV.  Sickle cell chest crisis.  Less immediately life threatening issues were common- it seems all of our patients were anemic.  New injuries, indirectly related to the earthquake- many motor vehicle related injuries, people being hit by cars, because they are living in the streets.   Mental health needs- likely schizophrenia, along with depression/ grief reaction.  A teenager refusing an amputation because he wants to join his parents in death- he feels he has no one, no reason to live.  Some of these problems are not new, and the resources for these patients before the earthquake were not often there.  As an epidemiologist, I saw the potential for much more suffering. The malaria and TB issues are only going to get worse, as people are living crowded together in tent cities/ on the streets.  Even within the hospital/tent city, vast open wards are concerning for infection control.  Diarrheal illnesses. Tetanus.   The need for shelter, sanitation,  and preventive efforts is vast.
 
My political science background also affected my observations.  Two different patients independently told me that they were better off during the Duvalier years. One of them told me this after I asked him to stop calling me “Baby Doc”- he insisted I looked a lot like him (OK, maybe I am light skinned and heavy set.. but still!). One of the transporter guys told him now was not the time for politics, and not to insult the visiting doctor.  I overheard conversations about Aristide too.   I recalled my grandmother talking about how things worked better during the Occupation.  My political side thought simply this- Haitians need a government that works, and need to stop recalling fondly the past, simply because the present and future continue to be so bleak.
 
It was perhaps as a Haitian American that I felt I contributed most.  My ability to speak French, English, and even Spanish, served me well in communicating with the staff, volunteers, doctors, and patients. I realized I understood more Creole than I had appreciated, once I was hearing it again all the time. I leaned a few key phrases to start people talking- “Sa kap fe ou mal?”  and listened to the response.  The patients seemed quite pleased that I was trying to speak with them, even if they were a bit skeptical that I was really Haitian.  I was fortunate to have worked with several Haitian-American nurses who were volunteering, along with Haitian nurses and doctors, who had come to the Field Hospital to serve.  I do believe that the case of malaria I diagnosed was because I of my ability to communicate well.  The Haitian nurse told me a patient, already being treated for 2 days, was not doing well, and asked me to evaluate her further. I took a careful history with the assistance of a translator, but French to Creole, rather than English to Creole; and I could understand most of the patient’s and her husband’s replies.   My clinical impression was that malaria was a possibility, and indeed the smear revealed that to be the case.  I spent a lot of my time out of the hospital wards on the grounds of the hospital, speaking with the guards, translators, children.  Many have no homes to go to when they leave the complex at the end of the day.  They sleep under a tarp, or just on a bed roll.   I will not easily forget one conversation- a translator wanted to see if he could get an official badge like mine.  He had his name and role on a piece of tape attached to his shirt.  I asked him why he wanted one- and he said “Dignity”. 
 
Haiti, you have suffered an incomprehensible tragedy.   I admit to having been afraid about what I would encounter.  I know that there is not great security.  I know the history, the problems of corruption, distrust.  And yet I see that others, from all over the US, Canada, and indeed beyond, are donating money, and even traveling to Haiti to try to help.   To your sons and daughters abroad, now is the time to help.   Doctors, nurses, physical therapists,  rehab specialist. You will be appreciated.   If your specialty is public health, engineering, construction, organization- you can help too.   Don’t speak Creole--- Pas de pwoblem.  It seems Haiti is full of young people who can serve as translators.   The challenge is ENORMOUS.  I wish, that 25 years from now Haiti is on a different level, and that this earthquake was the pivot.  That is the only thing that keeps me from being terribly sad for what has transpired so far in 2010.
 
Respectfully,
 
Alain Bertoni MD, MPH.