CRNA Volunteer Nelson Aquino, CRNA, MS

Staff Nurse Anesthetist for the
CHMC Anesthesia Foundation, Inc. at
Children's Hospital Boston

Member, Public Relations Committee FY 2009-2010

Nelson Aquino

Wednesday, January 20, 2010
Hi All,
We are scheduled to be at Hanscom Base at 11:30 a.m. and fly to Haiti sometime today. We will be taking a 14 seat Falcon jet! Our team will be deployed for 10-14 days. It is uncertain where at this point. It seems the needs down there are changing every moment. Right now, there are teams in Port-au-Prince (PAP) at two locations...University Hospital and another area outside of PAP. As I may have mentioned, my Children's Hospital Boston (CHB) team consists of two surgeons, two anesthesiologists, one CRNA, five nurses, and a scrub tech.
I am confident about the Partners in Health (PIH) team. This organization is excellent. Maybe you could post their link on the AANA website? They also have a FaceBook page if you are a FB member. Check out their website and links. 
They have set up ten ORs already and we will find out today, when we arrive, where my team "Children's Hospital Boston" will be deployed...either in PAP at the University Hospital or elsewhere. If you read the PIH site, they need nurses and Certified Registered Nurse Anesthetists (CRNAs)!! Now that they want to set up more operating rooms (ORs), they need people to do anesthesia right! The director mentioned this quite a bit. He told the physicians (MDs) and ground people who go back or communicate to spread the word, "We need nurses." He also mentioned CRNAs, but it seems like they want teams. It seems that Medical-Surgical Nurses and Intensive Care Unit (ICU) RNs can join and fill in anywhere.
I am extremely excited, scared and ready to do great things there.
Thank you again for all your thoughts and support!
Nelson and Jay Boarding Falcon Jet
Nelson Aquino, CRNA, MS, and Jay Hartford, RN, BSN, SNI, about to board the 14-seat Falcon jet.


Haiti Update

Thursday, January 21, 2010
Hi Everyone,
We arrived in Haiti last night around 6:45 p.m. after a five hour flight in a Falcon jet which was kindly donated to Partners in Health (PIH) to use.
When we reached the airport we were able to quickly unload and were greeted by PIH members and military. We loaded all our equipment and belongings. The airport was set up with the military and several planes were there including Air Force planes.
I met some L.A. rescue guys who said they rescued one guy from rubble but that he probably wouldn't make it due to renal (kidney) failure. They have been here for a week and were exhausted.
We left the airport and were escorted to the compound where we are staying. Our lugage was lost in transport but arrived intact a few hours later.
We had a team meeting with the PIH medical director and were updated on what was going on here. Too much to share it all, but basically PIH wants to set up many ORs here. Our mission is to help and utilize the Haitian doctors, nurses and other medical staff and to help them rebuild. It seems that larger organizations just want to do their work by themselves, so we are taking steps for long-term outcomes and to work with the Haitian people.
They are short of nurses here big time and are recruiting RNs. The director did mention another CRNA was here helping her set up the anethseia machines!! I was so proud. I will ask who later.
Right now we are waiting for a truck to bring us to General Hospital in Port-au-Prince.
We're getting an update, so I'll write more later. We are all safe.
Please thank everyone for me,
Nelson J. Aquino, CRNA, MS
Member, Public Relations Committee FY 2009-2010


Day 2: Haiti Mission

Friday, January 22, 2010
Hi All,
This evening we headed back to the University Hospital. We had three operating rooms (ORs) going. Earlier today, two other groups joined our team to enable the hospital to run night cases for the first time since the earthquake. We had surgeons, doctors, and nurses from Michigan and California helping us. We spent most of the morning organizing the night ORs. We had several aftershocks and people were scrambling.
Driving through the city is surreal: camps of people, lines of people, military everywhere, and homeless people. We saw the ruined palace and a chopper transferring a patient from the Military Sealift Command hospital ship, USNS Comfort. It was eerie at night with no electricity, seeing ruined buildings, and the smell of corpses everywhere.
I basically did pain management and sedation for the post-op patients during the day. We used morphine and started many patients on PO narcotics. For the many wound changes, I used ketamine and my portable finger pulse oximeter! The ICU nurses and intensivists were great and we all utilized each specialty. Everyone loved that I had the narcotics and could do sedation!
The patients were so thankful,… you could see in their eyes, the grief, pain, and acceptance of what had happened. Both the children and adults were inspiring.
Challenges for me were dealing with the pain management of a woman -- 8 months pregnant -- with tibia-fibula ("tib-fib") fractures. Also, trying to get IVs into a trauma renal (kidney) failure dialysis patient post-op... But we all did it!!! Dave Waisel was awesome. Both he and Craig did amazing work today with the ORs.
At the end of the night a three-hour labor baby was born Cesarean-section, but was born with rectal bleeding. We all worked together... intraosseous infusions were used. A physician assistant (PA) donated his own blood so the neonate could survive tonight. Amazing what people do in these conditions and circumstances! John Meara and Craig McClain stayed overnight to watch the baby.
Now I’m back at the compound; more volunteers are arriving. The surge of help is coming now. A week late but not too late. So many people need surgery and wound care and have nowhere to go. It’s going to take months for the injured to be cared for.
NBC news taped us during the day, following the Partners in Health (PIH) volunteers... I’ve included a link to the video: Saving Lives in a World of Ruin. In it, you can see the Children's Group along with the PIH staff.
I know I’m missing more but I’m beat.
Thanks to everyone for your kind thoughts and support!
Nelson Aquino, CRNA
Haitian Palace After the 

The Presidential Palace in Port-au-Prince after the earthquake.

Day 3: Haiti Mission

Saturday, January 23, 2010
Hi Everyone!
After a couple of nights, our group has figured out the dynamics of how to get operating room (OR) time; this morning, we took the first bus in to Port-au-Prince, to the hospital.
When we arrived, we jumped into action to find out what our plan was today. Stella took charge and got our team going, minus John and Craig. In the meantime, the military commander was looking for the baby we took care of last night. We all searched and searched, and later learned he had been brought to another Disaster Medical Assistance Team (DMAT) unit headed by Dr. Mooney and the Federal Emergency Management Agency (FEMA).
In the morning, Gary and the orthopedic guys did some rounds to gather patients for the night OR. Everyone got busy doing their own thing, while waiting for John and Craig to return.
Some of us did pain management and sedation for the many wound and amputee dressings. Jay, Lisa, and Terri were awesome, inserting IVs and helping the Mt. Sinai and Dartmouth Hitchcock team.
The OR group gathered furniture and equipment to make a new OR. Stella, Pam, Trish, and Joann were working to make the OR night happen. Joann has been so vital translating and making sure all the locals are in tune with our plan.
We headed home to camp at 2 p.m. and rested till the night shift started at 7 p.m. At camp, more teams started to arrive. We noticed their uncertainty, just like we felt when we came. As the first group to arrive at camp, we all helped to make their transition smooth. But let me say, there are way too many personalities here.
At night, we had many drop-offs, meaning military men would walk up with patients and say, "Here you go." Some were lucky to get a triage, some a bed, some directly to the OR, and some... not so lucky. The people are desperate for any kind of help. You will be working and ten people are pulling you in every direction but you can’t understand what they are saying. The tents need nurses so badly, to give meds, pain meds, antibiotics, dressings and basic care. If you are lucky, you may have a local Haitian nurse, but last night it was me, Jay, and Teri Manding in five tents (more than 100 patients) and a post-op area. There were a few doctors helping and we even had the director/founder of Partners in Health (PIH), Paul Farmer, helping us.
Some of the things we saw were a young man who had a wall fall on him last week. Tonight he arrived from the Israeli field hospital, with family and chest x-rays (CXRs), looking for intensive care and hoping to get on the Comfort Ship. Unfortunately, it was too late to transport him, so we did the best we could. I put my pulse oximeter on him and it measured 48. He was in respiratory distress, pain, and borderline obtunded. Doctors Meara and Farmer managed to assess and determine this was not surgical. We administered antibiotics, morphine, and heparin, and watched him overnight.
Thank goodness we met and befriended this team of New York Fire Department  (FDNY) paramedics, firefighters, doctors, physician assistants who all mended the patients at night. They willingly found beds and accepted our post-ops late at night. These guys were amazing!
Last night, we also did five surgeries: one triage trauma patient, a manual vacuum aspiration (MVA), an orthopedic trauma, and a massive orbit degloving. The teams were busy until 11 p.m. when we stopped surgeries.
Jay and I befriended a father who spoke English and whose son needed septum surgery. He had lost his entire family. It was just him and his boy. He said his boy was a "diamond," the most valuable thing he had now. Despite his losses, the father was there helping other families and I saw him later unloading a warehouse for the paramedics. That is pure humanity to see in these conditions.
I can’t describe the hundreds of other patients we’ve seen, or the experience in the OR, but I hope this has given you all a tiny glimpse of the difference we are making!
Just to follow up, the neonate that was handed off to Dr. Mooney at DMAT, is alive and stable although there is still a question of whether there is volvulus or intussusception present. The mom is in good condition.
Thank you all!

Day 4: Haiti Mission

Sunday, January 24, 2010
Today we all made huge progress with our new operating room (OR). Our Children's Hospital Boston (CHB) team now has teamed up with the Brigham and Women’s and New York University (NYU) teams to do surgery. Early this morning, our first group headed out to set up the OR and seek out our potential patients.
At the general hospital, we opened a pre-op area, four OR tables, and a post-anesthesia care unit (PACU). Our team leaders worked hard today with the IMC (International Medical Corp) to make this happen.
While searching for extra beds and the right Red Cross tent, Jay Hartford (a 7 South RN) and I stumbled upon some chaos. A two day-old baby had been seizing on and off since birth. A team of paramedics were screaming for intubation but only had a large endotracheal tube (ETT). So, being a pediatric CRNA, I naturally rushed over and told them. Immediately, they moved everyone aside and said, “Let him intubate!” As the paramedic removed the Ambu bag off the neonate, I used a large blade and intubated this 3 kg baby. As they listened for breathing sounds and confirmed placement, everyone was clapping. The U.S. military arrived and helped us transport this neonate in a Hummer. With no monitors, no meds and an unstable IV, the military guys shut the doors. It was pitch black and 100 degrees.
Both Jay and I looked at each other and really couldn't believe this was happening. This small baby's life was in our hands. During the ten minute ride to the Disaster Medical Assistance Team (DMAT) unit, I manually ventilated the baby as Jay held the ETT. We were both praying and hoping this baby would make it there. We felt no pulse at one time and started CPR. When the doors on the Hummer opened, we rushed the baby to the disaster tent.
When we arrived, we were greeted by Dr. Mooney and pharmacist Shanninir Sharon from CHB! We couldn't believe it! Also, I was greeted by a fellow nurse anesthetist, Mike Storey, CRNA (who trained me). We handed off the baby to Dr. Mooney and his team. The baby was alive and stabilized. What a miracle!
As we rode back in the Hummer, we were wondering if our team knew we had been gone?
When we arrived our first post-op patient arrived. Our teams did seven to eight cases today. Our anesthesiologists, Craig McClain, MD, and David Wiesel, MD, teamed up with us and did some amazing work. Dr. John Meara and Dr. Gary Rogers worked the entire day repairing broken bones and optimizing wound healing.
Lisa Pixley (7 south RN) and a team of MGH and Brigham and Women's nurses treated wounds, changed dressings and provided pain relief in many tents. Everyone pitched in and at one point I scrubbed in, handing over surgical equipment. Joann, our scrub tech, did amazing work translating and working at the same time.
One challenge we had was making sure all our post-ops had beds and would be cared for tonight. We found a group of paramedics and Emergency Medical Technicians (EMTs) to look over everyone!
By the end of the day, everyone was exhausted. We tried to keep up on water and food but several of us needed IVs for hydration.
We headed home early, around 6:30 p.m., and were welcomed home to mattresses in our tents, dinner, snack room and showers!
What an unbelievable day! Tomorrow is another adventure. Everyone here misses all of our families and friends!
Thank you for all your support!
General Hospital, Port-au-Prince
General Hospital in Port-au-Prince, Haiti

One of the many tents run by volunteers.

Nelson Aquino, CRNA, MS, primes a patient's IV line in a
provisional postanesthesia care unit.
Makeshift Operating Room
Makeshift operating room


Nelson, Craig, and Dave in Haiti 
Left to right: Nelson Aquino, CRNA, MS, Craig McClain, MD, and David Wiesel, MD.
"By the end of the day, everyone was exhausted. We tried to keep up on water and food but
several of us needed IVs for hydration."

Day 5: Haiti

Monday, January 25, 2009
In the post-anesthesia care unit (PACU) today, we had a young boy screaming words in Haitian.  We asked the interpreter, ask him if he is having pain and where? The interpreter said “He is not having pain. He’s calling out the names of all his dead family members; and asking them to help him.” My heart just dropped and I just looked at him and rubbed his forehead, I didn’t know what else to do.
PACU, January 25th, JPG 
For every tragedy there is a miracle. Today I learned about a man I had cared for yesterday in a tent. This man was emaciated and rumor was he was found 10 days later in the rubble. I remember seeing him transported in when we arrived. I was giving him sedation for his dressing changes.
Here is the story Dr. Mitch told one of our nurses: The man was actually found in the morgue. What had happened was he had been without a pulse, thought to be dead, and placed with the other deceased. When workers opened the morgue doors ten days later they saw this man was moving his hands! So he was immediately resuscitated, placed on a fentanyl patch for hospice care. Well, today he is alive and sitting up and drinking! The Haitians have now named him "Black Jesus." What an amazing story.
In the operating room (OR) today, our teams completed 15 operative cases and several same day procedures. It was nonstop from the moment we walked in at 7 a.m., until we left at 6 p.m. We had more than 10 surgeons specializing in ortho trauma, plastics, general and vascular surgery. Our team had four working ORs and is the main center for surgery. At one point, our pre-op area was jammed packed. We had to ask the U.S. military to guard the door and do some crowd control.
Overall, it was very busy and many patients were seen and cared for. We managed to have a team of doctors and nurses monitoring the tents and to find teams to care for our patients overnight. One of teams was from Dartmouth Hitchcock in N.H. This group consisted of an ER doctor and all nurses. These people are amazing. They accepted all our patients and have the best reputation in the hospital grounds.
We had an 82nd Airborne medic who asked to come and watch surgeries. We actually had him scrub in with his machine gun on his back! In fact, these medics were really helpful putting in IVs, transporting, and caring for all these injured people.
Lastly, I need to share how unbelievable the Haitian people are. We have many volunteers translating for us, feeding us, driving us, protecting us, cleaning for us, shopping for us, and just making us feel at home. Some of these volunteers have lost many family members, their homes, and everything they own. But they have not lost their spirit or pride. It amazes me how resilient people can be in the midst of devastation.
We have had so many experiences, many I have not been able to share. But all in all, our entire group is safe, healthy, grateful and humbled being here.

Day 6: Haiti

Tuesday, January 26, 2010
As we almost reach the end of our first week here in Haiti, I wanted to share that Port au Prince is slowly making some improvement. Each day seems like the people here are trying their best to move on and go on with living. Despite the devastation and tragedy, we have seen the Haitian people looking for work, selling food on the street, cleaning what's left of their homes, dressing up for Sunday's best, attending services, and children smiling and playing.
The city is full of dust, has poor air quality, remains in shambles, and is piled with trash. The people are eating, sleeping and living in these conditions. Crowds gather daily to look for work, see the envoy of volunteers and fill roads with traffic.
It amazes me that it took a major disaster for us to finally get over here and help this very poor country. I hope we continue to realize that we need to support Haiti and countries like Haiti. I am amazed how the less fortunate are so happy despite having nothing.
Today in the operating room (OR) we worked extremely hard to complete about 20-plus cases. Dr. Meara and Dr. Rogers cared for many wounds and even had the opportunity to meet Wyclef Jean and his entourage. Jay Hartford, RN, was in charge of the PACU and worked hard with our colleagues at Mt. Sinai to make sure every patient had a home. Lisa Pixley, RN, and Terri MacDonald, RN, continued to follow each tent amd make sure the postop patients were cared for. Our physicians from Partners In Health (PIH) also worked so hard to make sure the tents were staffed day in and at night.
Nelson assisting Haitian anesthesia resident with Occupation
Education Diagnostic Sonogram (OEDS)
In the OR, Stella Harrington, RN; Pam Gorgone, RN; Trish Powers, RN; Liz Sampson, RN; and Johanne Jocelyn, SST; did their magic.
Today, I stepped out of running the post-anesthesia care unit (PACU) and joined my colleages Craig MacClain, MD, and David Waisel, MD, in providing anesthesia care for the surgeries. I teamed up with a fellow nurse anesthetist, Brian Birner, CRNA, and had a great time doing what I love! Oh, and a Happy Nurse Anesthetist Week to all my friends and colleagues!!!
Nelson and Brian 

Prepare for Mandible Surgery, JPG
Brian Birner, CRNA (green scrubs) and Nelson Aquino, CRNA, putting
a patient to sleep for mandible surgery with Dr. Meara.
One of the patients I anesthetized today, woke up screaming in joy that we did not amputate her legs. She proceeded to place her hand on my head and said a prayer for me. The interpreter said it was some really heavy stuff she was saying. For me, I feel so blessed to be able give all I can as an RN, CRNA, and human being.

Nelson's patient who was so thankful they didn't have to amputate. 
In the OR, everyone is working so hard; we often try and take breaks to drink and eat what we can find. It is so tough sometimes because all the Haitian volunteers, workers and familes have no food or water and stare. Some beg and some just starve. Nurse Trish found a drinking station provided by the Spaniards and had the workers fill their bottles with clean water! The U.S. Army 82nd Airborne Division found us boxes of donated food to eat. We were able to give families the food that needed to be cooked.
View of Haiti, JPG 
Today one of the nurses walked by this building on campus that was demolished. It was the nursing school, and everyone in the building had died in the quake. The doors were not locked until today and the bodies still lie there.
I have recived many emails from people asking where to donate. I would have to recommend Partners in Health. Every bit goes to the Haitian people and even to the people caring for them. I cannot tell you how much PIH makes a difference in their lives. They have been working in Haiti for the last 20 years and are invested in its future. Check out Paul Farmer's book Mountains Beyond Mountains. Check out Partners in Health's Facebook page and website. Thank you in advance for donating!


Day 7: Haiti

Gates of the Nursing School
  Gates of the Nursing School 
Day 6: "Today one of the nurses walked by this building on campus that was demolished. It was the nursing school, and everyone in the building had died in the quake. The doors were not locked until today and the bodies still lie there. 


Today was another hectic day in our makeshift operating room (OR). To make it worse, we did not have any electricity the entire morning. However, we continued on safely using our portable monitors, homemade suction and no electrocauteries (bovies). You would be amazed at how much work we got done without light or electricty. Things are starting to get better each day. As old teams leave and new ones arrive, we continue to get our work done. We all feel like we hit the wall today. The fatigue is starting to get to us even though we are hydrating and trying to eat as much as we can.
With our help, the mission of  Partners in Health (PIH) is to eventually have the Haitians running their own hospital again. Today, we were able to work toward that goal by having the Haitian doctors, surgeons, anesthesia providers, and nurses work with us in the OR, post-anesthesia care unit (PACU) and outside tents.
Some of the Haitian workers seem really receptive to us, while others are still traumatized by the loss of their family members and loss of their homes. I can't imagine what they are all experiencing but as I have said before, it amazes me how strong-willed these people are... going on with life.
During this whole experience, we have met some wonderful people. The U.S. 82nd Airborne has been helping us throughout our journey. The medics are awesome with crowd control, inserting IVs, helping with anything and just being there for all of us. These guys were supposed to be in Afghanistan but got rerouted to Haiti for the time being. The OR folks allowed these medics to scrub in and help with surgeries. The medics were so enthusiastic and willing to learn!
We have also started to notice the prevalence of human immunodeficiency virus (HIV) within the Haitian community. We cared for several confirmed cases, including children.
One of the other things we are noticing is that many of the people are so afraid of losing their limbs. When the patients return to their tents from the ORs, everyone would sing praises and songs for not having a limb amputated. Tonight we dropped off one lady who returned from the OR and the entire tent was singing praises. They all kept thanking us in prayer. But the part that really sucks is that in the morning we have to tell her that she will die if we don't amputate her leg.
Every day we experience special moments that we will always remember and we are so grateful for all of them. We hope to share more when we all return. As of right now, we are hoping to complete our mission by the end of the weekend.
A week later, and many volunteers are starting to go home. I wonder who will come to replace them? Will it be surgeons, doctors, nurses, or all of them, who will roll up their sleeves to take care of the sick? We need many people to rehab the amputees, remove hardware, provide nursing care and antibiotics, and provide for the patients' long term needs. It will take a long time for this country to get back to where it was prior to the earthquake.
But it must be better than that. We must provide homes, a clean water supply and some revenue for this country. What concerns me is that people may forget the devastation this country has experienced. Yet I know, I will never forget the images burned upon my memory. There are no words to describe the devastation here. People are sleeping in the rubble of their homes to protect their property and unbury their dead.
The Streets of Port-au-Prince
 Streets of Port au Prince
Day 6: The city is full of dust, has poor air quality, remains in shambles, and is piled with trash. The people are eating, sleeping and living in these conditions. Crowds gather daily to look for work, see the envoy of volunteers and fill roads with traffic.
The infrastructure of the country has been almost annihilated. I am unsure how the hospital will function after other volunteer groups start to return home. The ultimate goal is to enable the Haitian people to function independently at a higher standard of care. This will require an unconditional commitment from the international community.
Despite what you may hear, Haiti is in dire need of volunteers with expertise and versatility. These volunteers need to teach and empower the Haitian people who remain proud and dignified.
Today, we cared for about 30 patients in the OR. One of the patients cared for by Dr. Meara, was the Bishop's wife. Three of our sickest patients have been transferred to the United States Naval Ship (USNS) Comfort today. The USNS Comfort is off the coast of Haiti. This 1,000 bed (hospital) ship is staffed collaboratively by the U.S. Navy and Project HOPE (Health Opportunities for People Everywhere).
Besides doing anesthesia in the OR, my colleagues and I have been useful in providing anesthesia in the tents for the many extensive dressing changes done each day. I even was able to perform an ankle block for one of the patients in the PACU for a metacarpal removal.
 Nelson Performing 

an Ankle Block for Metacarpal Removal.
Nelson Aquino, CRNA, MS, performs an ankle block for one of the patients in the PACU.
One of the nurses met a two-year-old who was pulled from the rubble after seven days. He is doing well and is heading to the U.S. to live with his aunt.
Amidst all of the tragedy, the earthquake will hopefully be a catalyst for progress. Let us hope and be part of the change.
A special thank you to Liz, Lisa and Jay for their help with this entry. A special hello to Owen, Luke, Will and Wyatt Hartford from Uncle Nelson.
Thanks to all of you for following our blog and for all your messages and thoughts. We all appreciate it!!!!
Nelson J. Aquino, CRNA, MS

Day 8: Haiti

Nelson Aquino, CRNA, MS, administers a spinal block.

Day 9: Last Night in Haiti

Today was our last day in the operating room (OR). The Haitian surgical team will be taking over the OR tomorrow with the few leftover volunteers. Tomorrow the Haitians will be administering their own anesthesia and providing nursing care. This is great that they are ready to become independent again. We all hope they will be able to do so.
We started our day just like we ended our first night - resuscitating a newborn baby. Dr. McClain, Dr. Waisel and the OR team were able to resuscitate the infant and transfer him to the Disaster Medical Assistance Team (DMAT). In the OR, our team managed two rooms and the Haitians took over the other two. Dr. Meara and Dr. Rogers finished their last surgeries today. I was able to finish my cases with spinal anesthesia and sedation. Overall, we estimated about 70 surgeries total, not including the sedation in the post-anesthesia care unit (PACU) and in the tents.
Our nurses did amazing work this week, making sure all the tents and patients were well cared for despite the lack of resources. Day in and day out, the OR nurses, scrub tech and field nurses cared for hundreds of victims and their families. They were able to teach and empower the Haitian nurses to provide the highest standard of care for their patients.
Terri and Lisa devoted their time in the pediatric tent on their own. Sadly, they lost an infant who presented with dehydration and febrile seizures. The nurses say the emergency medical technicians (EMTs) were giving mouth-to-mouth resuscitation while they were doing CPR. There was no oxygen or ambu bag available. When I stopped by to visit, the child had just passed and you could hear the mother wailing in the streets. It was terrible to hear and so sad, because in the states, this baby would be alive.
Follow-up care for the patients will be provided by the Haitians and volunteers left at the General Hospital. One patient that Dr. Meara stitched up yesterday was from Brockton and will actually see Dr. Meara on Monday in Waltham!!! The man was visiting Haiti, fell, and needed stitches on his upper lip. Now that is continuity of care!
As I sit here tonight, thinking about our trip here, I am extremely humbled by this experience. It is bittersweet, knowing we have helped hundreds, but sad to say there are hundreds of thousands more that need our help.
Tomorrow we head to the airport on standby, and we are guaranteed on another flight. Some of us may end up in Chicago or Miami. If possible, some of us may get flights into Boston late Friday night or during the day on Saturday. Cross your fingers!
What we choose to leave behind are the huge Air Force cargo planes flying over our heads all night long, every 30 minutes. It will be so nice to be home to see all our family and friends and get a good night's sleep!
One last request is that no one should ever forget the devastation that took place here only 12 days ago. We have left behind all that we brought: medical supplies, clothes, sleeping bags, money and even our shoes for the people.
May we hope the infrastructure will change, and remember the good will that the world has shown. It may take a while, but we all need to stay vigilant. We heard a story from one of our volunteers whose friend was heading home to the U.S. Upon coming to customs, the Haitian officials were charging people (missionaries and medical volunteers) money in order to receive donated supplies to the country.
We need to encourage our government to promote change in Haiti. If this is not done, the people will continue to suffer and die.
Thanks to all of you for following this blog. Thank you to our Children's Hospital Boston (CHB) team, Partners in Health (PIH), and to all the people in Haiti for your inspiration and continued faith in the world.
Yours, Nelson J. Aquino, CRNA, MS
Staff Nurse Anesthetist
Children's Hospital Boston
Last Night at Camp: Johanne Jocelyn, SST, Nelson 

Aquino, CRNA, Jay Hartford, RN, and Liz Sampson, RN 
Last night at camp (from left): Johanne Jocelyn, SST;
Nelson Aquino, CRNA, MS;
Jay Hartford, RN;
and Liz Sampson, RN

and Anderson 
Nelson Aquino and Anderson Cooper of CNN.
"Our C17 U.S. Air Force plane home"
U.S. Air Force Cargo Plane, JPG 
Entering cargo plane home

Two Weeks Later....  

It has been two weeks since I have been back from our mission to Port-au-Prince, Haiti, and I would like to take this opportunity to personally thank each and every one of you who have followed this blog and shared it with family and friends. This blog was initially intended for the families of the Children's Hospital Boston (CHB) team only, to inform them of our progress during the mission, but I am happy that others have taken an interest in Haiti and what can be done to help so many of those in need.
Two days after returning, things really started to hit me emotionally and I began to have overwhelming feelings of anxiety and withdrawal. I had never experienced anything like the situation in Haiti before, and the feelings that followed this experience frightened me. I needed to talk with someone who could understand what I was feeling. I needed to know if the feelings were normal, or if it was a severe case of Post-Traumatic Stress Syndrome. I called a longtime colleague, and spoke with him about what I was experiencing. It was at that moment that it finally hit me: The mission in Haiti has forever changed my life.
After 10 days of running on adrenaline, despite physical and emotional exhaustion, I was only then starting to process what really happened in Port-au-Prince. I tried to "re-enter" my daily routines, but the tragedies and horrors of all those we left behind haunted me every day. I would start speaking to someone I hadn't seen in a while and I would get teary-eyed and all choked up. It didn’t really matter what I was talking about, it would just happen. I know many who went on the mission came back feeling the same way.
Now that I am here, all I want to do is go back there (Haiti). There, nothing is wasted. Everyone is real. There, it didn't matter what I was wearing; it didn’t matter what people were thinking; it didn’t matter what I owned. There, I was just one human being helping another.
"How was your trip?" "What was it like?" That's what most people ask, and usually I answer: "It was life-altering, unfathomable, indescribable.” Other times, I don’t know what to say or share. Should I just share the positive? Or do I talk about the corruption, describe the smell of death, explain how it feels to see people starving, homeless, and injured knowing they’ll all eventually die because of lack of resources? The questions are difficult.
Final Haiti Slides from Nelson
"Going to Haiti is not about you. Going to Haiti is about them. It’s about helping people who need help."
Nelson Aquino, CRNA, MS

As these past weeks have progressed, I’ve found myself crying at odd times. I’ll be in the supermarket or walking down the hallway, and suddenly tears begin to fall. Until now, I’m not sure what triggers these moments, but something inside of me is different. It has been one month now since the earthquake. This shocking news is now old news. The Winter Olympics will now be the main attraction. Many people who haven't been to Haiti probably aren’t interested in hearing about it as much anymore. I know it’s human nature to be this way, but after seeing all those people suffering in Port-au-Prince, it is hard for me to accept. The earthquake is not old news to the people in Port-au-Prince. They are living with the devastation every day—and they will be living with it for many months and years to come.
The other day, my friend John Kimbrough, RN, returned from Port-au-Prince after working at the General Hospital. I asked him if things had gotten any better. His said, "It is so disorganized and by any stretch of the imagination, people are still dying.”
I keep wondering how this is even possible with all the volunteers, donated supplies, and supposed financial aid? Still, the struggles the Haitians continue to face are so basic—getting water, food, medications. I hope after reading this some of my questions may inspire others. What do I do now? How do I not forget? What can I do to contribute if I can't be there?
Here is what I am doing: I have started to learn more about Haiti. I am trying to become more aware of their struggles and what challenges face them now. When I am feeling helpless, I remember the good things I witnessed: the love the patients in the hospital had for one another, their amazing faith, their resilience, and their laughter despite the fact that they lost family members, their home, their livelihood.
A group of us are also currently working on stories and pictures to share with colleagues, family, and friends. Some will be returning to Haiti this March with Dr. Meara and his team. Ultimately, we must not forget Haiti and continue to give Haiti some exposure and aid in whatever way we can. The people there need all the help they can get.