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Christopher Hutton, a third-year medical student at AUC, outside of a hospital in Jacmel, Haiti.

By Christopher Hutton, a third-year medical student at AUC

I didn’t plan for it ahead of time, I didn’t even know about it until two days before I left. But, I went down to Jacmel, Haiti on a medical mission trip and it changed my life.

At a restaurant near Aventura Hospital (just north of Miami, Florida), I met Dr. Elie Dumeny, a Haitian-American OB/GYN whom I trained under during my cores at Center for Haitian Studies. He mentioned that he was going to Haiti and without a second thought, I asked, “Can I go?”

Under Dr. Dumeny’s tutelage, I had been engaged in more hands-on activities than I could count. We had developed a strong bond through the rotation. He demanded aptitude, commitment, and confidence from me as a student doctor, and rewarded these attributes with unforgettable experiences. I knew I wanted to be with him in Haiti.

Less than 48 hours later, we landed in Port-au-Prince and quickly hopped aboard a small aircraft for the southern coastal city of Jacmel. Dr. Phillipe, Medical Director and General Surgeon of the Emmanuel Medical Center, picked us up from the airport in his SUV and drove through downtown.

This place, only 4 hours from the US, began to feel like a remote world. Gangly-limbed children played happily in the street, women walked to and fro carrying large tin bowls filled with the daily groceries, and men carried loads of tree fruits, lumber, and sugarcane harvested with their machetes and axes. At any given stretch of road you might find hundreds of people moving about their daily business, on foot, by scooter, and rarely driving a car.

I spent the majority of my medical experiences in Haiti with Dr. Phillipe. He is a U.S.-trained general surgeon who practices general surgery in the broader sense of the word. On my first day in Jacmel, we drove up to his hospital in the jungle foothills and rounded through his surgical recovery floor. He was treating patients with almost every imaginable problem. Some had large bandages over their abdomen, others had a chest tube emerging from between their ribs. I noticed two patients sitting outside under a stand of Bamboo, both with handsomely healing scars along the outside of their thigh.

“These two came in separately but have become friends in recovery,” I remember Dr. Phillipe saying proudly. He had performed the same internal fixation procedure of their femur fractures, and it would be four more weeks until they could bear weight completely.

The first night operating with Dr. Phillipe was perhaps the most unforgettable experience of my trip.

I was called in at 9pm; a young boy had been injured in a scooter accident downtown. It was a powerful scene in the triage bay: His mother tightly clutched her 5 year-old son’s hand in bed while women were standing around in support, wailing softly with the mother’s silent tears. The boy had been sitting backwards on his scooter, leaving his left ankle exposed to a side-swipe from a car.

His ankle was tightly wrapped but we removed the bandages in the operating room. He had transected his Achilles’ tendon, the major nerves and blood vessels nearby had been spared. The surgery to repair his tendon and carefully close his lacerations was several hours. Dr. Phillipe was a spectacular teacher as he and I debrided and carefully sutured his tendon in place. We then bandaged his foot.

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Bonus points to anyone reading who can tell me what position we ordered his ankle to be kept during recovery.

I remained with the boy as Dr. Phillip retired to his office to document the surgery. Minutes later, a nurse burst through the door and told me to come quickly. In the trauma bay, 12 people were crowding around a man covered in blood: bar fight.

I immediately evaluated the patient: three stab wounds in the abdomen, one to the left elbow, and a contusion to the skull. He was bleeding profusely from the arm despite a haphazard tourniquet. I reapplied the tourniquet, stemmed the bleeding, and bandaged the wounds with strips of his t-shirt tied with pressure. The hospital administrator eyed me suspiciously, ensuring I didn’t use any of the hospital’s precious resources—these people could not pay for the surgery, which was an expensive procedure by the region’s standards.

“If we had more resources, things would work differently,” I recall being told later.

I sought out Dr. Phillipe to report my findings. When I returned to find the patient however, all I found was a trail of blood drops from the triage bay leading to the streets.

For three more days, I slept 4-5 hours a night, worked, and operated non-stop. I will never forget the lessons that first night in trauma taught me. I am still frustrated at the harsh realities healthcare faces down there. That is why I want to write about it. There is an enormous need for well-trained medical professionals to evaluate and treat patients in places just hours from your home. In caring for patients in Haiti, you will sharpen your toolset and broaden your experience. I promise you, this is an experience that drives home the core principles that physicians embody: to provide care for the sick and injured and do no harm.

Funny how it wasn’t planned out: this trip happened just as I finished all my third year core rotations. More and more, I am convinced that such a great capstone mission should be offered in some formal way to all students completing their cores at the Center for Haitian Studies. 
 

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Shannon Toher

Posted August 13, 2016 12:33 PM

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