Jimani Update: 1.21.10

Dear all,
8:20 PM
Another day of highs and lows. We had multiple communication breaks today. The patients that need surgery are more stable and less emergent. We have identified quite a few still lying at the orphanage with fractures that need repair. Unfortunately the volunteers fed them breakfast and lunch, so we (OR teams) decided not to do surgery on these and delay until tomorrow. There is less risk of anesthesia complications if one hasn’t had food or drink for 8 hours pre-op. Less likely to vomit and choke when awakening. Given our limited safely equipment, and that the patients seem stable, we chose the lesser
risk of waiting for tomorrow. I had some lined up for surgery tonight but powers that be decided to close the OR’s at 9PM. A group from Boston came in today ready to go, don’t understand the decision process. Overall very frustrating combination of events. Harvard sent a 5 member disaster management team and they are coordinating the overall flow. We do hope to make contact with the Navy tonight and arrange to transfer the sickest to the USS Comfort in PAP. I will believe it when I see the helicopters.

So we did several surgeries today, but had a lot of down time in the OR. This allowed us (the ortho guys) to take stock of the post-op patients and we did find several that need surgery tomorrow. I found Dr. Tom Rivers from Sugarland, TX in his OR down time unloading an ultrasound machine at the orphanage so the OB guys can check out pregnancies. Just one example of so many. And we discovered several patients in need of surgery for lower leg fractures that we didn’t know about. We will have a lot more help tomorrow, but as of now we don’t have nurses to take care of 22 post-ops thru the night. I feel sure that will get covered soon, we expect the Puerto Rican group soon.

I operated on my first patient from 1/19 again today. One month old Amica. She has an aunt here caring for her. Father is definitely dead and Mother unknown. Her pediatrician, Kurt from Omaha, is threatening to take her home to Nebraska. I had to remove burned and dead skin from the top of her forearm. I have an orthopaedic hand surgeon from the Boston group lined up to take over her care for me when I leave (Saturday). I just don’t know if her hand will survive.

Now we have very many people on site, doctors, nurses, EMT’s,lots of people….which requires the bureaucracy to become involved. In the long run it will help. In the short run, we still have over 300 patients here that need a lot of care.

Several new states represented today. We had anesthiologists and OR nurses from New Hampshire and South Dakota arrive with a lot of equipment. Craig Greene from Baton Rouge got in a lot of orthopaedic fixation hardware we needed. We are still short of Xray in order to do more advanced procedures.

From what I hear talking to the folks in the administration end, we are the best functioning facility next to the Navy ships in the area. We had Dominican media in and out last 24 hrs and they agreed. I understand many small places are trying to treat patients inside the Haitian border without any resources. Our biggest problem is where to send the patients as they improve. 30 have been moved down the road to a Church.

We had a man come in today with 40% body burns. He is about 30 and was in his car when the quake hit, a building fell onto his car, and it exploded. I have no idea how he has survived until today, or how he got here. Mike Cobb and 3 general surgeons worked on him for 2 hours. He is our first priority to fly out if the Navy connection works.

Clint has been all over the place today. Trying to get help from the Dominican Republic. Trying to get us Xray stuff. Worrying about little kids here, there and everywhere. Kristine, he did sleep in a bed last night and I promise he will again tonight.
Troy Moore is doing a good job as Clint’s “handler” or as Kelley said, “wrangler”.

I am not much for commercial hype, but that TV ad for AT&T wireless internet is the honest truth, as I have found the internet in Jimani, DR. I enjoy the chance to send out this information and hear back. It is slow, so no pictures until I get home.

Computer battery is going out so guess that’s it for now.

Hey Luke!!! Tech guys with Troy Moore say WIFI will be up any minute. Thanks!!!!! Pictures at 10 o’clock if I can recharge the laptop.

Thanks EVERYONE for the love, prayers and support. I promise I can feel each of you out there,
Love
Dad/Ed

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