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A Surgeon’s Experience in Haiti

Author(s): M. Assal1
Affiliation(s): 1Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Switzerland
Background: On January 12, 2010, at 16.50, a devastating earthquake of high magnitude (7.0) struck the island of Haiti. Two hundred thousand lives were lost in the first few seconds. Those who survived the initial overwhelming event were left with severe physical and psychological injuries. There were a very large number of crush injuries to the extremities with or without associated fractures, multiple extremity fractures and more rarely axial (pelvic or spinal) fractures, open contaminated wounds, compartment syndromes, and traumatic amputations. The immediate psychological injuries comprised mostly of posttraumatic stress disorders.
The Swiss Humanitarian Aid Unit was rapidly deployed in Port au Price. The first medical team reached Port-au-Prince General Hospital on the 5th day after the earthquake and quickly began surgical activities after just 3 hours on site. The team consisted of one team leader, one orthopaedic surgeon, one general surgeon, two anesthesiologists, two pediatricians, one obstetrician/gynecologist, one anesthesia nurse and three polyvalent nurses. Medical equipment brought to the scene consisted of light equipment (surgical tools, dressing and casting material, some medication), in addition to some material already present in the Port-au-Prince General Hospital (operating tables, some medication, etc.). The team focused on providing medical and surgical care to children and traumatized pregnant women. Orthopaedic surgeons were on the frontline in providing acute care, with fracture stabilization using plaster of Paris, traction, or external fixation. Adequate débridement and delayed primary closure of wounds, fasciotomies, and amputations were also among the major orthopaedic procedures. In addition, all the routine medical and surgical emergencies of daily life needed to be addressed by the specialists of the same team. This was a substantial additional burden placed on our team.

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