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Expert Hands, Caring Hearts
By Robyn Nissim

Nurses from University of Miami and Jackson health systems and beyond Florida answered the call, pouring into Haiti to care for the grievously injured and desperately ill.

A grateful patient thanks Stephanie Fletcher, R.N., of California, for her compassionate care.

Even after witnessing the mass chaos and carnage in post-quake Haiti, where hundreds of patients waited and punishing schedules kept volunteer nurses on their feet for hours, Patrice Gallagher, R.N., and Michelle “Shelly” Easey, R.N., remember David the most.

Top to bottom: A volunteer admits an injured survivor. Jackson’s Odiane Medacier, A.R.N.P., was among the first nurses to arrive on the scene. Judith Seme, R.N., from University of Miami Hospital, prepares IVs.

The toddler was found in a dumpster three weeks after the earthquake and was either unwilling or unable to talk to anyone. The first time he was fed, he ate half his food, and then carefully covered the other half with his leg.

Gallagher and Easey, both from the University of Miami Sylvester Comprehensive Cancer Center, tried to keep David and many other children in the pediatric unit as long as they could. They knew what they were dealing with in the field hospital; they had no idea what the children would face when they reached an orphanage. But the general consensus among the staff was that it was not likely to be an improvement.

Long after their return from nearly a week of volunteering in the ravaged country, they still carry David in their hearts. “We fell in love with him,” says Easey, a nurse manager.

In the wake of the disaster, Easey, Gallagher, a clinical research specialist, and many more nurses rushed to Port-au-Prince in response to a desperate call. As the death count from the earthquake rose and survivors grew sicker, these women and men with big hearts and skilled hands left their day jobs behind and took their own vacation time as well as donated vacation days from colleagues to help in one of the greatest medical crises in the Western Hemisphere.

Odiane Medacier, nurse practitioner at Jackson Health System and first vice president of the Haitian American Nurses Association of Florida, or HANA, was among the first nurses to arrive on the scene of the tragedy. The day after the January 12 earthquake, HANA mobilized and compiled a list of more than 100 nurses ready to lend their craft of critical care to the medical teams assembling in Port-au-Prince.

It is hard to overstate just how important the teams of nurses arriving in Haiti were for the country. The earthquake that devastated the capital also paralyzed the government and literally decimated the country’s health care providers. The public medical school collapsed, but students were on strike and luckily not in the building. The midwifery school in the same area was nearly demolished. Tragically, one of the main nursing schools in the country crumbled, taking with it the lives of 150 student nurses.

“Every nursing student in that school died. The professors died. Just think of the impact that will have for the nurses in the country,” says Arthur Fournier, M.D., the Miller School’s associate dean for community health affairs, vice chairman for family medicine, and co-founder of Project Medishare.

When Medacier first arrived in Haiti, her work was cut out for her. The sea of patients seemed endless and the number of nurses seemed far too low. An ideal ratio is one nurse for every five patients. “When we got there, there were about 20 doctors and just four of us nurses,” she says. “The doctors are trained to assess, diagnose, and formulate a plan of care, but someone has to execute that care. They can issue the orders, and you need the nurses to follow the orders. It’s a collaborative process.”

In addition to helping establish a smoother process for delivering the care, the HANA nurses also were able to communicate directly with the patients in their own language: “We were rendering care in a culturally sensitive environment and able to respond in a culturally sensitive manner,” says Medacier.

Clockwise from top left: Nurses from Miami help doctors resuscitate a patient in cardio-respiratory arrest. Ali Aserlind, of Coral Gables, feeds a newborn. Jessica Limpert, R.N., a neurosurgical ICU nurse from Allegheny General Hospital in Pittsburgh, reviews the charts of patients in the ICU/recovery section of UM’s field hospital.

Just a few weeks after Medacier made the trip, Easey and Gallagher arrived for their stints. Although they had been prepped by a colleague who had just returned, they were still stunned by what they saw. “It looked like M*A*S*H (a ’70s-era television series about the Korean War), but even more basic than that,” Easey says. “You unloaded the plane yourself, threw your luggage in a pickup truck, and went right to the ‘hospital,’ which was a tent.”

Gallagher worked in the “emergency” area of the hospital, where weeks after the earthquake volunteers were still seeing scores of patients with broken limbs and festering wounds, as well as many of the primary illnesses associated with a lack of running water and basic sanitation.

Neither Gallagher nor Easey speaks Creole, so the potential for miscommunication was a big fear, but the Haitians rallied together and translators were found to help them. “Everyone watched out for everyone else,” notes Easey, adding that, when necessary, workers often extended their shifts beyond 12 hours.

Both Gallagher and Easey came home from Haiti with mixed feelings. They were impressed with the well-organized center of operations set up and staffed by UHealth/Miller School employees and other volunteers, at the time headed by Dushyantha Jayaweera, M.D., professor of clinical medicine in the Division of Infectious Diseases. They were proud of what they were able to do.

But hardly a day goes by when they don’t remember the scared look on David’s face. They can still see him hiding his food.

Despite the poignant memory, Gallagher says she would like to return to Haiti, where working in the UM field hospital emergency room was “intense but emotionally rewarding.

“The Haitian people I cared for were kind, courteous, and helpful to the medical team and to one another under incredibly trying conditions,” she adds. “I would have liked to serve longer.”