Monday, February 22, 2010

Dr. Rick Colwell, Gone 2 Haiti

John Quinlan of the Sioux City Journal reports [excerpts]:

This is the story of two men who went to Haiti.

In the wake of the earthquake that devastated that island nation on Jan. 12. leaving more than 230,000 dead and many thousands more hurt and homeless, a doctor and a banker from Sioux City were among scores of Siouxlanders who traveled to Haiti as missionaries.

Dr. Rick Colwell, an emergency-room physician at St. Luke's Regional Medical Center, went to Port-au-Prince on Jan. 24 on a week-long humanitarian and medical mission sponsored by the Islamic Medical Association of North America (IMANA). It was his third such mission with the group, his last exactly one year earlier when he went to Gaza during the bombing, his first in 2005 to Pakistan when an earthquake struck that country.


"Everything still smells like dead bodies over there. Everywhere you go you can smell death. So you know there's lots of bodies buried in that rubble still," said Dr. Rick Colwell whose team was the second from IMANA to hit the ground in Haiti, replacing the initial team that set up its base of operations in Boujeaux Park, an amusement park near U.N. headquarters at Port-au-Prince. A week later, they were replaced by another IMANA team.

Colwell and his colleagues, specialists of every kind, flew into a staging area at Santa Domingo in the Dominican Republic, then trucked across the mountains to Haiti. Most of the team members, another ER doctor, anesthesiologists, vascular surgeons, interventional cardiologists, even an OB-GYN doctor, were from the East Coast, including some folks he knew from previous missions. And they came with their own food and supplies so as not to add to Haiti's problems.

What they saw 12 days after the quake was a lot of destruction, a lot of tarps and tents set up over drainage areas.

There were a lot of people walking around. "It seemed like a lot of people were living out of wheelbarrows," he said. "If you had a wheelbarrow, you were golden 'cause you could put your stuff in there and kind of move around with your wheelbarrow."

Though several buildings had fallen down in the amusement park, some structures remained.
"They were like the tiki-tent things with the poles and maybe a wall on one side, like where we set up our main area to do the wound care and stuff," Colwell said. "It looked like it had been a concession area, which we turned into the pharmacy. All the donated supplies we stuck in the back room and we filled the shelves with the medicines and the casting stuff that we were using the most."

Some of the larger medical groups in Haiti, the ones that had everything, were so cumbersome they were not getting anything done, Colwell observed.

"The people that are getting work done over there are the small groups like ours that just went in and took an area and made a little tent area out of it and started seeing people," he said, pointing to two of the successful groups what worked on-site with IMANA: NOAH (the National Organization for the Advancement of Haitians) and AIMER (Love) HAITI, the group that established the site.

"It's exactly like a MASH operation," he said. "We did cerclages, which is where somebody has an incompetent cervix, and we took her in our new surgery tent and sewed her cervix together so that she wouldn't lose the baby," he said. "And we did amputations outside. We had an orthopedic surgeon, a vascular surgeon. They both ran wound-care clinics back in their respective hometowns of Atlanta and Richmond or Norfolk,Virginia."

The "new" air-conditioned surgery tent was a gift from the fabled Fairfax (Virginia) Urban Search and Rescue guys who always leave their supplies behind when they fly home.  They wanted an indoor surgical area. And they got it. Doing an amputation outdoors amidst flies and other creatures was an experience that Colwell, for one, did not care to repeat.

Colwell said his team, whose members were lucky to catch four hours of sleep a night, saw about 300 patients a day -- 1,300 in their 4.5 days on site. Without CAT-Scans, the docs were limited to doing things the way medicine was done years ago.

"You can see them fast because there's no charting," he said. "They're glad to see you. They're very appreciative. You know, you don't have to practice defensive medicine. You just see the people and you take your best clinical guess at what you think is going on and try to treat it. And you have them come back in a couple of days if they're not doing better."

The Haitians proved to be "resilient" patients.

"Most places where you see wounds like that, those people die," he said. "But they fought the infections pretty good. I can't say why for sure, but they tolerated that stuff pretty good. They're pretty tough."

But health conditions could get even worse in Haiti.

"It's been very difficult because of the lack of infrastructure with the Haitians," Colwell said. "We had some problems with being able to do stuff with patients because of political nonsense that goes on there. A lot of the aid is still sitting on the tarmac."

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