Emergency Information Take Over
Tuesday, March 23, 2010
Marcus Sciadini, MD, assistant professor of Orthopaedics; Dr. Scalea; surgical technologist Smith; and Linda Goetz, CRNA, head nurse anesthetist in Haiti.
(This article first appeared in the March/April issue of UMMC Connections. The story and photo have been reprinted with their permission.)
Medical teams from around the world flocked to Haiti after the Jan. 12 earthquake. Two months later, many had begun to leave. But not the University of Maryland Medical Team – a partnership between the Medical Center and the University of Maryland School of Medicine. The UM Medical Team is developing a long-term relationship with the surviving staff of a Haitian teaching hospital – St. François de Sales. The Maryland volunteers are available to the Haitians for as long as the fundraising effort back home sustains the mission.
Why? Because after the first wave of emergency care and surgery, the team is now dealing with the tougher cases, such as fractures that healed badly because the patient couldn't get to a doctor earlier and infections from wounds that did not heal amid the unsanitary conditions in the country.
"Almost all of the other teams that have been coming to help are doing good work, but then they leave," says Thomas Scalea, MD, physician-in-chief of the University of Maryland Shock Trauma Center and professor of surgery at the School of Medicine. "We have made a commitment to go and stay for several months, to see this group of patients from start to finish."
Catholic Relief Services (CRS) is a partner in this mission, providing important logistical support for the UM Medical teams in Haiti as well as contributing funds for medications and other supplies. John Spearman, UMMC senior vice president for external affairs and community relations, has been working with the organizations and leading the effort to find resources to cover the cost of sustaining the unprecedented mission.
The mission has three goals:
The sustained effort by the rotating teams of clinicians could help victims of future disasters. The teams are recording data and monitoring patients over the long term to fill a void that exists in the current medical literature.
Andrew N. Pollak, MD, head of trauma orthopaedics at UMMC and associate professor of orthopaedics at the School of Medicine, has been at the forefront of the mission.
The teams that travel to Haiti include many Shock Trauma staff, because of the nature of the patient injuries, but each team has included at least one nurse from a non-trauma department, says Karen E. Doyle, MBA, MS, RN, vice president for the Shock Trauma Center. Doyle has been coordinating all the medical personnel and supplies and serving as the go-to person for the teams once they are in Haiti. If they need anything, they call her.
"We had more than 200 people volunteer to go," Doyle says. One requirement was a valid passport – there was no time to wait for anyone to get a new one.
"Then, we had to make sure they had the right capabilities and experience," Doyle says.
The UM Medical Team has been working in a unique partnership with CRS, a leading worldwide disaster relief organization headquartered in Baltimore.
The CRS partnership was a natural, because the Institute of Human Virology in the School of Medicine has worked with that organization to provide health care in third-world countries. IHV and CRS operate an HIV/AIDS program at St. François de Sales Hospital, under the leadership of Robert Redfield, MD, co-founder of the IHV and professor of medicine at the UM School of Medicine.
"We plan to continue this partnership with CRS for many months to come," says Jeffrey A. Rivest, president and chief executive officer of UMMC.
Early in March, Rivest and Doyle went to Haiti with Redfield and Pollak to meet with CRS officials about additional funding to support the mission. Rivest says he is hopeful because of the praise CRS officials had for the UM Medical Team.
For Doyle, the visit gave her a better perspective for one of her tasks: to arrange for training in Haiti for Haitian health care workers. The surviving workers in that country need more training in trauma, orthopedics, anesthesia and other areas to continue caring for their people.
The UM Medical Team members wear the pink scrubs that are a signature of the Shock Trauma Center – even if they are not Shock Trauma staff back here in Baltimore. Haitian patients and health care workers have come to trust and take comfort in the pink scrubs.
"One patient who came in a month after being hurt, when I asked her why she had not gotten treated until now, told me she had been to several hospitals and was turned away," says Patti Jones, RN, BSN, CCRN, a nurse in the Surgical Intensive Care Unit (SICU). "She then said that she was told to come to the hospital with the people in pink, and that we would help her. We did, and she was so grateful and kept thanking me for taking care of her."
"Even if they don't know the individual doctor, they know the pink scrubs and trust us now, because we've been there all along," Doyle says.
Rivest was particularly moved when his group encountered some US soldiers in Port-au-Prince.
"They said, 'Oh, we've heard about the Shock Trauma doctors and nurses in pink. You guys are doing a great job,' " Rivest says.
Pollak notes that the UM Medical Team has, from the start, approached the mission with respect for the culture and Haitian health care professionals.
"We're not in there to take over – we're there to help partner with them," Pollak says. "They do trust us now, but that didn't come right away – we had to earn it."
All of the Maryland volunteers, once they arrived in Haiti, pulled together to do whatever was needed, whether they were surgeons, nurses or technicians.
"We took some crackerjack nurses and scrub techs," Scalea says. "Everybody did everything. Everybody carried boxes and washed the floor."
On a typical day, the teams have evaluated an average of 300 patients, with about 20 of these patients undergoing surgery. The hospital has maintained an average of about 80 inpatients.
The medical relief workers have had to cope with the threat of diseases such as malaria, dengue and typhoid fever. The first team had no hot water and slept in tents set up in an elementary classroom.
Only the newest wing of St. François de Sales survived the quake. The rest of the hospital collapsed, killing an estimated 140 physicians, nurses and patients.
Many of the UM Medical Team members, such as Jake Smith, EMT, a surgical technologist in Shock Trauma's OR, said they were struck by the strength of the Haitian staff members who had to come to the hospital each day, working just a few yards from their deceased colleagues who were buried in the rubble.
"I don't know if I could do that," Smith says. Still, they all had to do what was needed.
Smith said when he first arrived, he focused on organizing the supplies that had been brought by various teams. He worked with the staff at the hospital to set up an efficient supply room with everything labeled in English and in Creole.
Sharon Henry, MD, head of wound healing and metabolism at Shock Trauma and associate professor of surgery at the School of Medicine, was able to create a wound care chart for staff to use in complex cases, and found great satisfaction in making a difference for the Haitian people.
"When you look at it as a small piece, it's totally satisfying," Henry says. "But when you step back and you look at the 20,000-foot view globally over the whole problem, you can see that the part we play is very small but very necessary."
Going back, she says, is a "no-brainer."
"This is a long-term project that the hospital has committed to, and I'm very proud of the hospital for doing that," Henry says. "Many of the organizations are there for a short time. We were still getting patients, a month after the earthquake, who had never gotten any medical care, with fractures that had never seen any kind of treatment whatsoever."
Cozanne M. Brent, RN, BSN, CNOR, a nurse in Cardiac Surgery at UMMC, had to resist feeling overwhelmed. "Not only were there so many people in dire need of medical care, there was a huge need for help with getting the basic essentials like water, food, shelter and clothing," Brent says. "I have to say I was amazed at how organized and helpful CRS was in trying to fulfill these needs. I am so thankful that UMMC is committed to staying and helping, because Haitians really need this ongoing support. I am proud to be part of it."
While the clinical teams from UMMC and the School of Medicine have been traveling to Haiti to provide hands-on care, thousands of Medical Center staff have been doing their part to support the effort and raise the dollars necessary to pay for it.
Paula Henderson, UMMC strategic support manager, has been coordinating a number of efforts within the Medical Center to raise awareness of the mission and the fundraising to support it.
Nicole Bailey, UMMC guest services manager, is heading a committee of staff from all over the Medical Center doing everything from holding bake sales to raffling off basketball tickets – coming up soon will be a "Gong Show" – all in a spirit that has energized the staff to go the distance.
"We have such a positive vibe going among the staff," Bailey says. "Our committee has been coming up with ideas to raise money and to have fun doing it."
Bailey and her team held a bake sale March 2 to coincide with the day-long briefings in the Medical Center Auditorium that drew about 400 people throughout the day.
At the briefings, medical team members spoke about their experiences in Haiti.
All four Baltimore TV stations and two radio stations covered the event, which was also streamed live over the UMMC public Web site. For more information and to view video interviews of members of the staff who have gone to Haiti, go to www.umm.edu/haiti.
The Medical Center staff members had contributed more than $18,000 in cash and payroll deduction contributions by mid-March. More raffles, auctions and events are planned for the future. Bailey and the committee welcome ideas from staff. "We have a goal to raise $30,000. With that amount, we can send one team to Haiti," Bailey says. "Let's bring it!"
For more information on how Medical Center staff can make a tax-deductible monetary donation all at once or through payroll deduction, go to the UMMS Foundation Web site, www.ummsfoundation.org.
UMMC will also allow any medical center employee to donate accrued vacation time to the Haiti relief effort. This donation will be converted to a direct cash donation to a specific fund set up through Catholic Relief Services to support the UM Medical Team in Haiti. So far, 75 employees have donated vacation hours that equal $53,000. For specific information and the required form, visit the UMMC Intranet, the HR Service Center or the Paca-Pratt HR reception desk, or call the Benefits Hotline at 8-9806.
University of Maryland School of Medicine