CRNA Volunteer Jean M. LeFevre, CRNA, MSN

Association des Médecins Haïtiens à l'Étranger
(Association of Haitian Physicians Abroad)

Port-au-Prince, Haiti
January 16-24, 2010

I wanted to go to Haiti because I knew I could help by providing anesthesia. I was a little apprehensive about my safety, but also about my ability to offer comfort and reassurance, to offer hope.
I was shocked by what I saw – many times worse than it appeared on television. We arrived at night, but we could see the destruction. People were scattered, roaming the streets. It was like a movie, but you were in it. It was profound.
When we got off the bus from the airport, people rushed us, asking for food and water. They all needed the basics – food, water and shelter. It was sad to see, and reminded me how fortunate I am. I told them to pray, that we were there to help them rebuild, and that there would be others after we left. I wanted to save them all, but I couldn’t. What I could do was help as much as possible, while we were there.
We slept outside on the ground, and the first night was a little rough because of the noise. I was out of my comfort zone, but that was the least of our problems. The hospital was in the capital city, Port-au-Prince, where the earthquake took place. On our way there, we could see the rubble, dead bodies, and people making their homes in the streets.
Jean LeFevre, CRNA, MSN
 Jean M. LeFevre, CRNA, MSN

We ultimately saw hundreds of patients with open wounds, bleeding, multiple injuries and fractures, all seeking some medical help.
Inside the building there was no electricity, so we saw many of our patients outside. We did improvise an OR inside the building and set up for surgery, the team consisting of a surgeon, an OR nurse, and me.
We were fortunate to have propofol, a sedative that puts patients to sleep, but we had no oxygen, no anesthesia machine, and no monitor for vital signs. We had to rely on monitoring respirations by watching the chest rise and checking the pulse with a stethoscope. It was definitely not the luxury we are accustomed to in a hospital.
Table with Medications
 "It was definitely not the luxury we are accustomed to in a hospital."

We tried to get as early a start as possible because we depended on daylight to see. We wanted to do as much as we could each day, so we worked from 6:00 a.m. until 6:00 p.m. We did 40-45 operations while we were there.
Our patients ranged in age from about four to 70. All needed amputations because of crush injuries and compound fractures. We had to use a hack saw – just take the saw and cut off the limb. Otherwise, it would get infected and the patient would eventually die.
Our anesthesia was adequate, but the patients experienced extreme post-operative pain because there was no analgesia. One thing I found especially disheartening was that there were no charts and no follow-through, even to change a dressing. Follow-up is extremely important.
I was especially touched by one patient who asked why this was happening – essentially, ‘why me?’ I explained that if he didn’t have the amputation he could die, and that prosthetics could help him walk again and go to school. He was only five.
As I left, I wondered what else I could do? I didn’t want this to be a one-time gesture to feel good. I feel totally dedicated to Haiti now. I want to go back; this was not the end for me.