I am blown away by our Lord’s goodness.
I know that sounds contradictory amidst the Haitian earthquake suffering, and all the “How could a good God allow it” questions. But it is how I feel, and I know it to be true.
There were innumerable moments of His working, both in Haiti and back home, during my 9 days on the island. We estimate over two thousand people were praying for the team. Uncanny timing of solutions and working out of big problems occurred in an area of the world where transportation, communication, and power are unreliable (see some stories below).
We flew out on a Monday afternoon. There were no hiccups with the flights except that the trip organizers had misspelled my name, which drew me a trip through the body scanner at DFW airport. We arrived in Santa Domingo, DR at midnight. From there we traveled 6 hours in a very crowded bus to the border town, Jimani, DR. We hung out at a state-run hospital which was staffed by a Dominican team of physicians. There were about 60 Haitians lying on beds and every available floor surface. Many were reaching their hands out to us asking for help and pain relief. I felt terrible that I couldn’t use our meds and equipment. We prayed for many, and then left them to the good care of the Dominican team.
Elsewhere in Jimani, some missionaries had created a very functional, makeshift hospital. Located on the 10-acre grounds of an old, white-stone orphanage, the hospital provided 4 operating rooms, a chapel which held about 100 post-op patients, and dormitories for the hundreds of Haitians arriving and waiting to be seen.
The folks in charge assigned most of us to the not-yet-seen group. I spent that day triaging, cleaning and dressing wounds, giving antibiotics, and splinting fractures. The sickest received first priority for surgery, and part of my job was to identify those who were nearest death or loss of limb. An eccentric American veterinarian setup our pharmacy. It worked wonderfully.
The Haitians were lying on single mattresses, inches from the other injured. They ate, moaned and took care of bodily functions in that setting. Most spoke only Creole or French. A few were bilingual and became interpreters for the medical teams. Overall, they seemed in shock at what had happened to their city, their dead family members and their broken bodies. But none were hysterical, inappropriate or violent. We prayed, at length and with fervor for each one we treated that day. Prayer moved many of them and us to tears.
While we treated and triaged, more injured arrived throughout the day. Most came in the beds of pickup trucks, bouncing along the pot-holed road between Jimani and Port-au-Prince. With broken bones not yet set and splinted, they suffered greatly during the 3 hour trip. Helicopters transported the few who were the most ill. At one point, there were helicopters coming and going every 30 minutes. Some of the worst injuries were a 30% burn victim, a back wound extending through the vertebral bone and into the spinal cord, and a chest crush which required a chest tube. There were many with broken femurs. The physician in charge told the rest of us that one of our goals was to make sure there were no deaths in the non-acute section. I made sure that any of mine that were looking especially ill were moved to the acute area. Several of the sickest had died overnight. Fortunately, their pain was controlled. There were several pregnant women with long-bone fractures, and lots of wound infections. One lady was missing a fair amount of skin on her left 3rd and 4th fingers. With good wound treatment she can hope for pretty good healing and a modest return of function.
We remained at the hospital until mid-afternoon. Having not slept or eaten since the previous day, we were physically and emotionally exhausted. The adrenaline had worn off and I was feeling a bit woozy. I tried to drink lots of fluids and I ate as much beef jerkey and as many Cliff Bars that I could get my hands on. I must have looked awful. Our team leader moved us to a local Episcopal church where we took turns showering, and then resting on floormats. It seemed very comfortable, and the weather was beautiful. A cool breeze blew through the big room. Some of us sang together, some slept, and others read. I think we were numbed by what we had seen. Later, after the trip was over, I was able to process what I seen. But while in Haiti and the DR, I just reacted to the need in front of me and moved to the next.
Our team leader, who had planned for us to continue on to PaP, was considering staying in Jimani. The local missionaries warned us about the trip dangers: some vigilanties were throwing bodies onto the road to stop and then rob travelers. Our bus drivers insisted that the road into Pap was too dangerous and refused to go. But, our leader met a World Vision associate who told us about a Christian school in PaP that had become a command center for medical teams like ours. And, sometime during that day, he saw a vision of a bulls-eye, indicating to him that God wanted us to go to the center of the damage.
He decided to find a new bus and driver and leave for PaP the next day. After a good sleep and waking to what felt like an aftershock tremor, most of us went back to the Jimani hospital while a few worked on procuring a new bus and driver. That tremor we felt was the 6.1 earthquake that struck PaP on Wednesday morning. We acquired a bus in time to make it to the border by the 2PM cutoff. The border officials closed the Haiti entrance to white-skinned people at that time of day because it was dangerous for us to be on the road after dark.
God protected us during an uneventful 3-hour ride into PaP. We had to turn around and re-route once or twice in the city because of road damage or downed power lines. The converted school turned out to be the perfect place for our team. It was completely undamaged, walled in, shared with us by about 40 US soldiers and Humvees. There wasn’t a safer place in PaP. The school officials had sent all the kids home (they boarded the students), moved all the computers to one command room, and provided food for us and a place to sleep. They told us their goal was to keep us safe, to transport us daily to the places in PaP which were the hardest hit and medically unserved, and get us back before sunset.
At the Quisqueya Christian School there were already two other medical groups, one from Germany, the other from Virginia. By the time we left, there were probably 10 groups, from all over the world, all Christian-based and all medical. It was a beautiful picture of the body of Christ. One German doctor said to me in thickly-accented English, “You know Brian, we are all here because we serve the Lord.” The food was good enough. We slept on camping mats. Someone ran a water hose and spray nozzle through the ceiling of a tool shed, so we had a shower the last 3-4 days. Given the weather, which was temps in the lower 90’s and high humidity, we were delighted to have the waterhose showerhouse.
The first stop in PaP for us was a hard-hit orphanage. Of the 75 original kids, 40 had perished. Their bodies remained under the broken buildings. The orphanage workers kept the surviving children in a courtyard in front of the old buildings. Some kids were lying in the back and front seats of a run-down economy car. A few were sequestered under a tree and two of the adults tended their wounds. These were the most severely injured kids. One had a large face laceration, which we sutured. Another had a right femur fracture with an overlying wound. Our transporters evacuated that child to a US Navy hospital. The remaining children suffered minor to moderate wounds, which we treated with wound debridement, antibiotics, and instructions to the orphanage staff regarding ongoing care. As one typically sees in orphanages, all the kids wanted to be held. We loved on them for the hour or so we stayed. Fox News showed up and took some video of the children. Later, CNN and some other networks did a story on the orphanage.
From there we carried our supplies, about 6-7 good sized crates and 3-4 duffles full of medical supplies, ¼ mile to a tent city forming on a soccer field. We setup two tents to function as clinics and started seeing patients. The Haitians did a good job of spreading word around the area to bring the most severely injured. That day the three of us doctors saw a total of 200 or so patients. I saw mostly orthopedic injuries and wounds. Again, we prayed and laid hands on each one we saw.
I treated some of the most gruesome injuries I have ever encountered as a physician. One 15 year-old girl suffered a crushed right lower leg. The twisted fibula bone stuck out through the skin above the ankle. The foot was rotated inward almost 90 degrees. The whole lower leg smelled from the infection that was eating her flesh and ascending almost to her knee. After trying to arrange transport and cleaning her wounds, I talked to the other docs about attempting a field amputation at the knee. We decided to wait a few hours for a transport before proceeding. Our driver, who traversed PaP daily, at anytime could be several hours away. In the city, roads and communication systems were unreliable, so arranging for emergent transportation was a near impossibility. After only about 15 minutes, our transport driver and van just showed up at our clinic. He said he felt like we might need an emergent transport. I could hardly believe it when I saw him. I was pleased that this precious young lady would get a ride to the hospital, and blown away by how God arranged it. For the first time, I broke down emotionally and cried.
What moved me to tears was not just seeing God’s hand and timing with our patient’s transport. It was seeing the poor girl who was about to lose her leg and the other two patients who arrived right after she did who also required amputation as a life-saving procedure. All three received a ride to the Navy hospital. I heard that the Navy personnel put the two worst on the next helicopter to the hospital ship parked in the PaP bay.
There was a 30-year-old woman who was cooking beans when the quake struck. The beans and boiling water spilled onto her bare feet, causing full-thickness burns on the tops of both feet. Several team members walked into the nearby neighborhood to look for untreated people and saw her feet. They were black and charred. It took them an hour to coax her to be brought to our clinic. She believed her feet would heal on their own. These types of burns are life and limb threatening. The heat damages the underlying tendons, nerves, and blood vessels, which die and become infected. Working with two members of our team, we soaked her feet in an iodine/water mixture, and began the slow process of removing the dead tissue. As we cleaned the burned feet, the skin and fat sloughed off in large pieces, revealing the deep, live tissue underneath. This woman would require weeks if not months of hospitalizations, surgeries, and infection treatment.
On that day, I had three patients that needed transportation to a hospital, but none required emergent treatment. We decided to carry them to our bus which was parked about 4 blocks away. During that walk, someone had setup a food distribution right in our path. The uneven, narrow road was congested with hundreds of folks trying to get to the bags of rice. While four of us carried each patient, several of our team went ahead to clear a path. It was a dangerous moment. Sometimes, I had heard, Haitians will try to mob and steal from Americans. But this 8-10 minute trip ended successfully, with the three patients, all 10 team members, and about 8 duffels and crates loaded onto our bus.
After we arrived back at Quisqueya School that afternoon, we tried, but failed to arrange helicopter transport for these patients. A couple of the German physicians overheard us and offered to take the patients to their hospital, which was a 5-minute drive away. Norman, who was the German physician who approached us, was about 6 foot 4 inches tall, and spoke with a deep German-accented voice. He was an imposing figure. He and I visited at the end of most days, and even played a little soccer. It seemed that we enjoyed the escapism of a soccer match.
During these first few days in PaP we met and were befriended by some wonderful Haitians. Three were brothers, who had seen some family members die. They got to us because they were multi-lingual, and we needed their interpretation assistance. These men were intelligent, somewhat educated, humble, articulate, and a delight to work with. They prayed alongside us, and after a few days were leading prayer with the injured Haitians. These guys are unemployed. If they lived in a developed economy they would be sought after and would have meaningful professions. As it is, they, and Haitians just like them, manage by living day-to-day, finding any way they can to just have enough food.
At Quisqueya school, new teams were showing up almost daily. By the time I left, there were over two hundred people living there. We all slept either in the school rooms or in tents wherever there was space. I could walk out in the morning and see a cluster of Koreans on my left and some tents where the German team slept. At mealtime, I could hear multiple languages being spoken. Most of the people I saw there seemed in good spirits, but the stress of it all was taking its toll on all of us. Our team stayed a total of 9 days. I don’t recommend staying any longer than that. Waco-based Antioch Community Church, the organization I was with, sent a second team which arrived the day we left. A third Antioch team would arrive a week later, and a long-term team after that. I appreciated being a part of a group that had a long-term view. I didn’t want to feel like we were abandoning the Haitians after we left.
The folks in charge sent a group of us to a small, unused hospital about a 25 minute drive from the school. We opened a clinic and started taking inpatients, mostly post-operative cases. One man we saw had extensive wounds. One of our nurses worked for about an hour and a half on him. It seemed that whenever we finished with one wound, we would find another on the back of his leg or some other area. With antibiotics, wound care, and follow-up, he had a good chance of not losing any limbs or his life.
A Haitian physician assisted us by seeing patients in the streets. She was about 50, and had pretty wild, strawberry-dyed hair, and spoke and worked quickly. Someone gave her the nickname Tina Turner. We all saw dozens of patients that first day. We were slow the second day. On the third day I saw many of the patients we had treated the previous days. It was rewarding to see that their wounds were healing, and they were more comfortable in the splints and casts. I am frustrated that I didn’t take more pictures because I cannot remember many of their faces.
One 25-year old woman who had suffered a left shoulder dislocation, was seeing a doctor for the first time since the quake, about 9 days. She had a quiet demeanor, and spoke to me through an interpreter. I told her there was a good chance we could get the shoulder back in place, and set her up on an exam table for the treatment. As I was hooking up the arm traction, she turned her face to me, and with a few tears on her cheeks, said in perfect English, “My mother died.” A few of my team members, including one of our interpreters, laid hands on her and prayed for a long time. I couldn’t get the shoulder back in despite the usual techniques. And the morphine was causing her to have nausea and vomiting. We sent her to another hospital for general anesthesia. When a shoulder has been out of socket for more than a few days, the muscles clamp down like concrete, and it is almost impossible to reduce the joint into place. She made it to the hospital and was treated by an orthopedic surgeon.
I walked around this little hospital several times to get a sense of the neighborhood and the people. Most were just sitting in their yards all day long. The younger folks played soccer and dominoes. One guy had a guitar. The city sits on large rolling hills, making for spectacular views. Low-flying helicopters continued to traverse the sky, almost one every 15 minutes. There was an orphanage, all girls, situated next to the hospital. It was a joyful place. The girls were fixing each others’ hair. In my best French I told all the little ones how pretty they were.
At the end of our days, we gathered as a team and shared stories, thoughts, concerns, and prayer requests. We would break into two or three and pray for each other, the Haitians, and the teams. After our last day, we listened to a licensed counselor talk about post-traumatic stress, and what we would experience after we returned home. It was helpful and continues to be so.
On the morning of our departure we had planned to go early to the airport and pray for a ride home. I enjoyed sitting on the tarmac watching the giant planes and helicopters come and go. We hitched rides with people flying two business jets, a first-class treatment. It was a delight. I had my first cold bottle of water in a week. We landed in Ft. Lauderdale and were greeted by four armed immigration officials and a German shepherd who sniffed each of our bags. All of us wanted hamburgers, fries, and cokes. There was a Chili’s in the airport.
Let me close by saying that the woman who is my wife is an exceptional person. She handled many unforeseen tasks, such as counseling our kids who were worried their father would get hurt in Haiti. She took on one of my projects which couldn’t wait for my return. She gave an interview to the Fort Worth Star-Telegram, and posted our texting online.
The Antioch folks showed that they know how to do disaster relief mission trips. I was struck by the way they asked God for direction, and then waited until they heard before making a decision. They were professional, prayerful, excellent in providing medical care, and respectful of the team’s needs. It was a joy to work with them.
Lastly, I love Jesus. All death, sorrow and brokenness are captured in the awfulness of the cross. He doesn’t run from suffering. He doesn’t wear out when we are hurt, and leave us to figure it out. He shows up when and where we are hurting. I don’t believe he wants just happiness for us. His plan for us takes us into darkness, for it is there that we most clearly see the light of the world.
Brian Byrd, February, 2010
