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The last couple of days have been a blur for me.  Ended the trip on a low point with a patient who underwent IM rodding Sunday evening then probably threw a pulmonary embolus postop.  Unfortunately, despite the best efforts of our anesthesiologist shackled with limited resources, the young man expired early in the morning a couple of hours before we left for the airport.

Travelled to the terminal uneventfully in the hospital ambulance with red light flashing.  Stood in line for over 4 hours waiting for our boarding pass then embarked on the journey back to Los Angeles via New York.  The circuitous itinerary was courtesy of Delta Airlines as American Airlines still was not flying in and out of Port au Prince.

Had my initial bout of GI distress in LAX, an hour later in Redlands all hell broke loose...I couldn't keep any fluids down.  Thankfully, our surgery center anesthesiologist, Jeanie Sprengel, stopped by the house, started an IV on me and pumped in 3L of fluid before I started to feel better.  I'm currently back in the office seeing patients and am almost good as new.  I'm most grateful for her intervention and even more thankful that I survived the majority of the trip without illness.

Hopital Adventiste's parent NGO, Adventist Health International,  recommended this past weekend that all expat volunteers vacate the premises by today (read more from Jessica Scott) due to escalating civil unrest. Scott, Terry and Jeannie were planning to leave by this coming weekend although I'm waiting to here more of their updated plans.

I didn't get much of chance to post a more detailed summary of our trip with case highlights but will try to due so with a couple of "retroactive" posts over the next few days.

Good to be home but I'm filled with mixed emotion as so much has been accomplished from an orthopaedic surgical standpoint at HAH since the Big Quake and the potential was great.  My fear is now that with Haiti's deepening election crisis after two leading presidential candidates rejected a proposed recount of last month's disputed vote that enthusiasm for volunteer involvement will begin to wane.  I hope and pray that my concerns will not come to fruition.

C-arm Is Now Functional!

As many are aware, the image intensifier (C-arm) at Hopital Adventiste has been nonfunctional for at least 6 weeks.  For an orthopaedist, that's a major functional impediment and significantly narrows the types of cases that we can operate on.  

There have been numerous attempts by many individuals to bring this radiographic patient back to life all of which have proved fruitless...until Greg Bonner came on the scene.  Greg is a Certified Biomedical Electronics Engineer from Portland, Oregon and travelled to HAH a few days ago with his wife to tackle several pressing projects.  To make a long story short, Greg work diligently, even pulling a couple of all nighters, and finally got the beast up and running again.  Greg is a modest fellow and gave all credit to the Great Physician for solving the problem.  

The first case with the "new" C-arm was a young man with a T3 burst fracture that underwent pedicle screw fixation.  Although not technically impossible, it is much safer to perform this type of surgery under x-ray guidance.

Scott Nelson organizing instruments for the first case with revitalized C-arm

Terry and Scott instrumenting the spine

Image intensifier documenting pedicle screws in place

With respect to other imaging issues, we've also been blessed to have Jere Chrispens, an Information Technology Consultant from Yucaipa, California here for the past week.  He has been working diligently to solve the virus issues plaguing the portable digital x-ray unit we use in the clinic.

Jere on the phone with Fuji tech support

Helping Hands

Got word early this morning that my upcoming Sunday AM flight back home was cancelled so I scrambled to find a flight midweek.  Late for worship, I was met at the front door to the chapel by one of the nurses shouting that a newborn was coding over in the pediatric ward.  I hollered to Tim and Scott inside and we all ran over to help.

The photo above says it all, many hands pitched in attempting to save the little fella's life.  Our efforts were initially successful but he passed on a few hours later.  But the image remains symbolic of Hopital Adventiste's "team effort" volunteer mentality.  I would like to introduce you to a small sample of some of the "helping hands" who have pitched in to get the job done during the past week.

Tim Downey (Appleton, WI) - Nurse Anesthetist

Brent Scully  (Walla Walla, WA) - General Contractor

Sebastian Nicora (Walla Walla, WA) - Electrician


Erin Scott (Washington, DC) - Photographer


Jere Chrispens (Yucaipa, CA) - Information Technology


Randy Tall (Goldendale, WA) - Electrician

C-Arm Down And Out

The biggest negative to the trip so far has been the fact that the image intensifier has been down for the count since we've been here.   The C-arm is a critical piece of equipment for an orthopaedic service and its absence sorely missed.

Scott on the phone with Puerto Rican tech support

Actually, it has been nonfunctional for the past few weeks in spite of the fact that there have multiple technicians attempting to resurrect it.  There are several patients on the ward and from the clinic awaiting surgical intervention that would be best served with intraoperative imaging.

Terry, Ray, and Jessica rounding on femur fracture patient in traction

The restoration of the C-arm has been the object of a special prayer request in worship over the past two days so your thoughts and prayers would be greatly appreciated as well.

Hopital Adventiste On Lockdown

Last night the Haitian presidential election results were posted and the citizens reacted negatively.  In the image below by Damon Winter, Haitians burned tires, trash and earthquake rubble and blocked streets in the capital, Port su Prince.

This morning we met for a group photo before a couple of the volunteers were to leave for the airport.  Shortly after the image below was taken, we were informed that all flights in and out of Port au Prince have been cancelled and the hospital is on lockdown due to the unrest in the streets.  Fortunately, one man's misfortune is our gain as anesthetist par excellence Tim Downey is forced to spend more time with us.

L to R: Terry Dietrich, Jere Chrispens, Tim Downey, Scott Nelson, Jim Matiko, Ray Grijalva

Nathan Lindsey receives word in morning worship that another volunteer missed flight

Hopital Adventiste Redux, Part 1

I had good intentions of posting at least a couple of progress reports by now but a combination of a busy schedule, tiredness and a little laziness have foiled my efforts so far.  Scott Nelson and I took the red eye out of LA this past Friday night and flew to Miami by jet then hopped on a small prop plane for the 2 hour flight to Port au Prince.

Scott checking out familiar landmarks as we flew over the DR

We were aware that American Airlines currently had an embargo on boxes (contrary to what has been previously recommended) so we packed everything into bags.  Prior to leaving home, we checked on the AA website and noted that we could pay $100 for an extra bag each so we decided to avail ourselves of that option.  When we checked into the ticket counter, we were informed that only Business Class patrons were afforded that luxury.  Finally, after a little sweet talk, and with the aid of the Excess Baggage Waiver provided to us by Amy Lindsay, the agent gave us the OK and even waived the excess fees.

 Suitcases purchased from a thrift store are an excellent option to transport supplies

Immigration and Customs in Port au Prince were a breeze.  When we exited the terminal, we were accosted with the usual hord of "red hats" wanting to assist us with our baggage, each one who touched our gear for even second expected compensation.  

Scott managed to escape the throngs of "red hats" with only one assistant

Fortunately, Nathan was waiting with the trusted Montero and we had an uneventful trip to the hospital.  It was great to see Terry and Jeanie again and toured the hospital which gave us the opportunity to view the changes (or lack thereof) that had transpired since our last visit.

Scott and Terry reviewing cases for the upcoming week