Linda Kovitch, CRNA, RRT, MSN

Mission Location: Fond Parisien, Haiti
 
Mission Organization: Operation Smile
 
Mission Purpose: To provide health care for 1200 displaced refugee families in a tent hospital on the grounds of an orphanage. 
 
After hearing about the Haitian earthquake I immediately signed up with aid relief organizations to help out.  I’m a long standing supporter of Partners in Health which has been developing community health based care for infectious diseases and had some knowledge of Haiti.  All of the organizations offered me the chance to go to Haiti as a care giver.  I  opted to travel with Operation Smile and arrived there in April 2010 on the third month anniversary of the earthquake.  The airport was pure madness. I waited two hours on the sidewalk for my driver to get through the traffic and bad roads to pick me up.  After a three hour drive we finally made it to Fond Parisien where I lived and worked in the tent hospital created and run by the Harvard Humanitarian Initiative. Patients were flown here after the earthquake by helicopter which landed on the grounds as directed by the Haitian government in order to reduce the burden on the limited medical resources in Port-au-Prince.  Over 900 volunteers from 16 countries came to serve at the camp over the 5 months that it existed. Literally, everything in the camp was donated and as volunteers would depart they would leave useful items for those coming along behind them.  We lived in tents and were provided two meals a day cooked by the local staff who were hired by the camp managers. There were 120 local people employed in the camp to manage supplies, cook and deliver food to the patients, mediate disputes, maintain security, clean bathrooms, etc. 

Every morning and afternoon all volunteers attended the team meeting with camp management team. All issues from each care group were updated, new issues posted, resolved issues closed. New staff were publicly introduced, welcomed and thanked. Departing team members were recognized and thanked for their service.  

Bedside patient rounds were conducted twice daily. The highlight of the afternoon were PT rounds where all patients would gather in wheelchairs, walkers, crutches, etc.  Community leaders working with PT staff would lead the exercises, with all repetitions counted out loud in French.

I worked inside a concrete block classroom which had been renovated to provide as close to modern OR standards for orthopedics as possible in this setting.  The walls and ceilings were covered with industrial strength plastic to keep dust out of the air. The floor was painted to keep dust down and a HEPA filter was installed into the wall in front of the window where the air conditioner was.  Our electricity was provided by a generator outside the building. Power would go out when the gas would run out.  Flashlights and LLBean head lamps light sources were used when power went out.  Our team provided anesthesia and surgery for 35 patients who had been treated for multiple trauma after the earthquake. All cases were done under general anesthesia or sedation with local anesthesia.  The team successfully removed all of the external fixation devices and definitive care for the few patients whose fractures were non-union. Wound irrigation, debridement and dressing changes were provided under GA for two patients with wound infections.  Due to the very close monitoring our infection rates were very low.  At the end of each day It was wonderful to make rounds and see the patients whose cumbersome fixator devices had been removed. Patients were happy to be rid of them. I watched the prosthetist and PT get 5 men back on their feet again for the first time since their amputations in January. This was most gratifying. Watching amputees navigate the rough ground was always an amazing site to see.

At the end of my day, I would have an evening bucket shower under the stars in my blue tarp outdoor shower stall using my bucket of water which left to warm in the tent all day as average temps were 90 degrees.  Everyone worked well together while providing 24 hr round the clock care. 

After the surgeons departed I changed roles and became a public health nurse visiting the local refugee camp a mile down the road from the tent hospital. This is where our healed patients and families has been moved to if they had no home to go back to.  Our clinic ran for 4 hours and we saw 30 patients who almost without exception complained of heartburn, depression, insomnia and headache. 

I will long recall the memories of this mission experience working with so many kind and caring people along with the gratitude from those whom we aided and supported during our stay in Haiti.