Project Medishare | Nurse anesthetist reflects on volunteer experience in first few days after January quake
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Nurse anesthetist reflects on volunteer experience in first few days after January quake

  |   Earthquake Response

Nurse anesthetist Tonya Via helps a patient get transferred to be airvacced to the United States. Via volunteered in the first few weeks after the January 12 earthquake. Photo courtesy of Tonya Via.

By Tonya Via

After the 7.0 earthquake struck Haiti on January 12, I sat silently and watched the news as my heart turned violently in my chest.  I saw many images of the massive destruction, devastation, and despair. The most vivid one that stood out in my mind and forever changed my life was a man lying on a coffee table found among the rubble having his leg amputated as he lye there awake under a tarp in the city.  It was then I realized there was something I should do, I could do, and wanted to do to prevent another human being, who survived one of the worst natural disasters we have ever known, from having to experience the same inexcusable horrific pain. I am a Certified Registered Nurse Anesthetist. My responsibility is to alleviate pain and keep my patients safe and comfortable during surgical procedures.  The Haitians desperately needed anesthesia care, and I knew I needed to respond.

I knew it would be a logistic challenge getting to Haiti so I began working quickly to align myself with an organization I could volunteer with that shared my same passion, helping the people of Haiti in dire need.  The University of Miami Children’s Hospital and Project Medishare graciously afforded me that opportunity. The endless, tiring and unselfish work of Ann McNeil from the neurosurgical department at University of Miami Children’s Hospital, was nothing short of amazing. Through her efforts, she made it possible for me, a complete stranger to her, to become part of the medical volunteer team at Project Medishare and University of Miami’s field hospital.

As the sun was setting in Port-Au-Prince, the jet landed. My heart raced I had so many of those images I had seen on the television and Internet invading my mind. Would I too see the same things? Would I get to take care of the Haitians and provide the anesthesia care I came to do?  I took a deep breath and began to prepare myself for the real thing.  I had waited nearly two long weeks with a broken heart.  I was finally there to do what I came to do, help the victims I had seen suffering. To provide the one thing that the man lying on that coffee table needed the most, proper anesthesia care. We climbed down the stairs of our luxury jet and life, as we knew it ended. It was a sight I couldn’t believe. Waiting our arrival was a team of mentally, physically, and emotionally exhausted volunteers standing on the tarmac waiting to return home. Their sense of urgency in returning home quickly changed into an unbelievable organized group of helpful cooperative exhausted individuals. They quickly began helping off-load all the supplies we had brought down from the underside of the jet. It was truly a sight to behold. As if they had any ounce of energy left, here they were passing box after box of food, supplies, drugs and equipment down a line of volunteers next to the dangerously hot engines of the jet. Within 30 minutes the massive amounts of medical supplies and food were unloaded onto the tarmac. Our fellow volunteers boarded their plane to return home, their lives forever changed. Mine was about to be too.

I climbed aboard a truck with my duffel bags full of anesthesia supplies and protein bars and headed toward the tent hospital down the dusty road. I was greeted by a team of volunteers that quickly oriented us to our quarters where we would be for the next week.  The mood was somber, the cries coming from the tents were overwhelming, only masked by the constant hovering of helicopters and airplanes landing and taking off. Every one of my senses was on overload.

I worked with complete strangers in such a cooperative organized respectful manner; I could only hope to have the privilege of working like that back at home. I was proud to be part of such an incredibly dedicated and talented group of volunteers. What an eclectic team of medical professionals we were.  It became immediately obvious; people who shared my passion of helping those in desperate need surrounded me.  I’m glad to say these strangers have now become a part of my life!

We began operating in a diligent organized fashion in mass chaos. We never stopped to take a break, it wasn’t needed. We worked 20+ hours a day trying to keep up with the procession of trucks bringing in the injured while maintaining the highest level of care possible, given our resources.  What resources?  A new meaning to reuse, recycle, renew was created that week. We became very resourceful, makes me wonder why we can’t do better here at home.  Our meals consisted of a bottle of water and a protein bar we rationed throughout the day. The patients consumed us and took top priority. As quickly as we finished one surgery, we were bringing in another child. We carried them from the pediatric tent to the OR tent on their cots gently or in our arms, making sure to never jolt them, that might stir memories of that horrific day when their world was forever changed. We didn’t know how to explain to them that they had just survived the worst natural disaster we have ever known.  The injuries were unimaginable, their stories of survival undescribable, their will to survive unbelievable. Everyday I was completely amazed at the people I was caring for. If the children didn’t loose their lives in the earthquake, they lost a limb, as if life wasn’t difficult enough for the people of Haiti. A young boy walked into the tent with his right arm missing. It was very difficult for even me to look at, a seasoned expereinced anesthetist. He never made a sound, courageously got up on the table and layed down as his arm was being cleansed with Betadine. We seen a severly burned patient who nearly died, we flew him to Miami to a burn facility. There were multiple fractures, x-rays I had never seen before, demonstrating gut wrenching injuries. Severe compartment syndrome had set in on the ones who were crushed and went without medical treatment. I had never seen so much necrotic tissue and limbs removed in my life, I hope I  never will again. I provided doses of anesthetic drugs to children that weren’t even recommended for adults, but yet kept every one safe and comfortable. They were already malnourished and dehydrated before the earthquake, trying to find an I.V. was an everyday challenge. The children were so stoic and brave.

Every patient was heartbreaking, some more so than others. Having to see a patient die from tetanus from a small cut was extremely difficult, considereing the magnitude of some of the injuries. We were faced with HINI, Yellow Fever and Meningitis. All the sudden it became a grim realization that the traumatic injuries we were treating that were initially sustained would lead to very dangerous communicable diseases. The patients being housed in the tents in close quarters were so malnurished and  immunosuppressed, in addition to not being vaccinated created a potentially deadly situation. I became concerned.  The vulnerability of children made it worse. Not only were there physical injuries there were emotional wounds as well. I found myself overwhelmed trying to answer the questions of a young man who was sobbing uncontrollably. Through the help of a wonderful compassionate Haitian volunteer named Edry, he helped translate the man’s questions? The young man had lost his parents in the earthquake and his home was destroyed, one leg amputated, one leg shattered, multiple cuts were the only thing left to remind him of that fateful day. He wanted to know where he would go after he was released from the tent when he got better. I had no answers, I went there to provide anesthesia care, no one told me I would be so consumed with so many emotional and painful tasks and questions I had no idea how to answer. That was far more difficult than trying to figure out how to provide modern anesthesia care in a tent off of a dusty tarmac with no blood pressure cuff, heart rate monitor or oxygen. I cried. Edry cried too. He said he didn’t know why God spared his life. I told him I did, to help me understand his people and take care of the fellow Haitians. We all three shared a big group hug. I still cherish that moment.

There was  healing in the midst of chaos. I don’t know that we would all be here to talk about our stories if we didn’t find that one patient who helped see us through. Mine was a 12 year old whose second floor of her home collapsed on her and her family. Her father and dog were killed. As she lie on the cot in the tent with her mother, unable to hardly open her eyes from all of her facial swelling, she cried and told me she missed her dog. I found a brief moment to step away and go to the supply tent we called “Wal-Mart” and find her a stuffed animal. I brought it back to her and tucked it in with her in her cot for the evening. The next day she came to the OR tent to have her wounds debrided and dressings changed. As I looked down at her, I began to cry. The tears flowed as I tried to imagine how she felt, what she thought, the confusion, despair and uncertainty. I too missed my 4 dogs back at home, but I knew I would see them soon. She had no home, no father, no dog.  She had lost everything. She looked up at me and wiped away the tears on my cheek, smiled at me and said,  “It is OK”. Wow, here was a girl who had just survived one of the most horrific natural disaters this world has ever known and she is comforting me. The patients I took care of never ceased to amaze me or inspire me. They made me so proud to be  who I was, doing what I was doing. I then knew I was making a difference.  We had two babies born the week I was there.  It was bittersweet. We saw life begin for one as it was ending for another. All the sudden the phrase ” life is short” took on a whole new meaning. It was truly a miraculous thing to see among the widespread devastation. Life goes on.…

My final evening in Haiti was very difficult as I walked through the tent playing with my kids, taking pictures, blowing bubbles and tossing balloons. I wondered how they would feel the next day when we weren’t here. What would they think?  Would they feel abandoned yet once again? Many had lost their parents and a whole new generation of orphans had been created.  I absorbed their hugs and kisses and cherished every one. If I could, they all would have been on that plane home with me.  It was comforting to see a beautiful banner freshly hung in the pediatric tent that was sent down with the Army. It was artwork made by Miami school children for the children of Haiti.

I boarded the plane the following morning. I had a great sense of guilt. There was so much work that needed to be done and still does for many years to come. How could I justify leaving?  We had worked so hard to create our operating room; we worked smoothly and efficiently and took pride in knowing we were the envy of the operating areas in the tent. We took care of each of the patients as if they were our own. The surgeons were very compassionate. The new team was waiting on the tarmac as we arrived. The look in their eyes was so familiar. In an hour and a half I would be back to my world. I would eat again, shower, sleep in the comfort of my own bed, have shelter and enjoy all the wonderful amenities I have been so blessed with, so I thought. I have been graciously blessed and for that I have a huge place in my heart for helping others less fortunate than I.

I will be forever thankful to my family, friends, and strangers for allowing me to follow my vision and my heart to help the people of Haiti.  The trip was life changing in ways that I can’t ever begin to put in words, but will always be with me in my heart.  I accomplished what I set out to do. Little did I know, providing anesthesia was only a small fragment of my time spent in Haiti working through the University of Miami and Project Medishare. I gained so much more than I could have ever given during my week there. I anxiously await my return.

I continue to have dreams of my patients and the images I seen in the city. It took a week to be able to fall asleep. I had no hovering aircraft above my bed, no crying children, no doctors yelling for some one to come stat to intubate a child in severe respiratory distress at 2 a.m. My little girl who lost her father and dog, where is she living at now? The first patient I treated, the severely burned 12-year-old who was flown to Miami, the ones who lost their limbs. I will never forget them. How could I?