Dr Paley Visits HAH

The following post was authored by Scott Nelson, MD and was originally posted on the Cure Caribe Blog.

It has been truly a privilege to have Dr. Dror Paley and his team visit our hospital this week. The Haiti relief efforts have been a constantly evolving process. Doctors and nurses have come and gone, injuries have continued to evolve in various ways, and supplies have waxed and waned. Dr. Paley's visit came at a key time in the chronology of the relief efforts. We are now 9 weeks after the earthquake and the evolution of the injured victims is becoming increasingly complex. There are still people with untreated injuries and many others that were operated on who require secondary procedures. This week we were able to take advantage of Dr. Paley's expertise in limb reconstruction and trauma surgery in the treatment of these extremely challenging cases.

Dr. Paley wrote the authoritative reference on limb deformity correction and is recognized worldwide for his pioneering in these concepts. I have been to his course on limb deformity many times and was also able to spend one summer with him and his partners in Baltimore doing a mini fellowship. The concepts learned have revolutionized my thinking and abilities to treat some of the challenging and exotic problems faced in the developing world. His work here this week not only benefited the patients operated but the many that will continue to be treated with the new principles that I always learn from him.

This week we did more than 30 orthopaedic cases at Adventist Hospital. Maybe not that impressive until one realizes that we were also seeing 30-50 patients a day in our clinic, rounding on all of our post op cases, organizing and refilling all of our instrument trays, transporting patients, cleaning operating rooms and participating in other aspects of the overall hospital management which goes far beyond orthopaedics. The credit for all this work must be given to his entire team as well as the other volunteers at the hospital who are working day and night to make this all possible. The Paley team consisted of:

• Servando - Ortho PA
• Jennifer - Ortho PA
• Mark - Ortho Technician
• Terry - Operating Rm RN
• Keith Dowell - General Surgery MD
• Aviva - Instrumentation Coordinator
• Jonathan - Public Relations

I have been threatening to hire a few local hit men to kidnap various members of this team, and I can assure you that the ransom will be very high. Their expertise, hard work and caring attitude has enabled us to provide the loving and quality care that we strive for at Adventist Hospital.

Some of the difficult cases we treated this week included:

• R hip traumatic dislocation (Injury 12 Jan)
• Comminuted L subtrochanteric femur fracture
• R radius and ulna fracture (Injury 12 Jan)
• L femur fracture (Injury 12 Jan)
• Revision external fixation and bone grafting tibia fracture
• Reduction and fixation of ankle malunions (Injury 12 Jan)

When I saw a mother bring her infant child to the clinic with a congenital short femur it was inspiring to see Dr. Paley talk to this mother. She ironically had no idea that she was talking to a world expert who has innovated the most advanced lengthening techniques for treating this rare disorder. Ultimately Dr. Paley had to ask me what we should do about this problem since the normal infrastructure for providing limb lengthening does not exist in Port au Prince. Without letting the logistical challenges limit our thinking we recorded her contact information, made her a follow up appointment and will make future plans to give her the appropriate treatment.

Dr. Paley's Jewish heritage convened well with the Adventist observation of a Sabbath rest. After a busy and rigorous week of work it was much welcomed by all. Dr. Paley and his children Jonathan and Aviva led out in a ceremonial Sabbath blessing on Friday night to remind us of this special time. Because restoration of life is always a priority in the work God has given us we still have some urgent operations to do today, but feel refreshed and blessed as we conclude another week at Hopital Adventiste d'Haiti.

Special thank you to CURE International for providing the logistics and support for these surgical teams and other volunteers helping at the Adventist Hospital that enable top quality reconstructive surgery options for victims of the Haiti earthquake.

For more information on this past week's events please view Dr Paley's blog.