Garamone's Blog: Life and Death at Terminal Varreux
By Jim Garamone
American Forces Press Service
PORT-AU-PRINCE, Haiti, Jan. 24, 2010 I watched a woman die yesterday.
A U.S. Navy sailor carries a Haitian boy off a helicopter at Terminal Varreux, Haiti, Jan. 23, 2010, as the boy's mother follows behind them. The child received treatment aboard one of the U.S. Navy ships serving as a hospital in Port-au-Prince harbor, and he was later discharged. U.S. military personnel are providing aid and support to earthquake victims in Haiti. DoD photo by Jim Garamone
(Click photo for screen-resolution image);high-resolution image available.
The young Haitian woman -- call her Marie -- was fifty feet from the helicopter that was to take her to the USNS Comfort, the Navy hospital ship providing state-of-the art medical care for the victims of the Jan. 12 earthquake here.
Marie was connected to medical equipment through tubes, and medics were working on the equipment. She had intravenous fluid drips in her arms. Her chance of survival, for even a few more hours, hinged on getting to the Comfort.
But she didn’t make it. The litter bearers who were carrying her put Marie down, and a nurse listened to her vital signs. A doctor came over and listened, and stepped back. The bearers picked up Marie’s litter and walked back into the tent.
She died despite all best efforts by many organizations to save her life. Marie was hurt in the earthquake and received medical care from one of the local clinics. But the wound became gangrenous, and sepsis set in. A non-governmental organization brought her to this triage site because there was nothing they could do for her, and the hope was that the medical staff aboard the Navy ships in the harbor could help.
Terminal Varreux is in Port–au-Prince’s seaport area. The site looks like the industrial area it is. The Navy chose the site because helicopters can land and airlift casualties to the ships providing medical aid. The Comfort is the biggest such ship, with the most staff and facilities, but the USS Carl Vinson, an aircraft carrier, and the USS Bataan, an amphibious warfare ship, also have excellent capabilities. The USS Nassau, another amphibious warfare ship, is joining today with much needed medical assets.
U.S. Department of Health and Human Services disaster medical assistance teams manage the site along with medical personnel from the Navy. The site has one tent where the medical staff, in this case a group from Georgia, assesses the patients and another tent, where they wait for the next lift off the site.
“This is the main evacuation area,” said Navy Dr. (Lt. Cmdr.) Marguerite McGuignon-Shuster, a medical expert assigned to the Comfort. “We are actually taking patients from hospital out in Haiti that need surgical intervention or definitive medical care, bringing them through here.”
Most of the patients come from Haitian clinics, but others come from nearby military facilities -- the Israelis, French and Belgians have fed patients through the facility, she said. The Comfort, alone, receives between 80 and 90 patients a day from the site.
The Haitian clinics bring patients in a wide variety of vehicles -- buses, vans, cars. One patient even showed up in an actual ambulance, which surprised the Georgia team. There are 30 Georgians at the site, with most coming from Atlanta.
“The team has doctors, nurses, mental health (specialists), chaplains, respiratory therapists, emergency medical technicians and logistical staff,” said Wendy Nesheim, a nurse with the team.
Representatives from the Haitian Ministry of Health work with the team to coordinate the efforts. Before anyone even arrives at the site, the team works to ensure appropriate treatments are available on the ships, and that they have bed space. “Once that’s done, they send them here, we make sure they are medically stable and we send them out to the ships,” she said.
Sepsis is the big killer now, said Navy Dr. (Capt.) Richard Sharpe, a trauma surgeon with the Comfort. The earthquake killed hundreds of thousands immediately. Those hurt in the quake may or may not have received treatment. If they didn’t receive anti-biotics, now is the time for gangrene to take hold an shut down the major organs. Sharpe said medical authorities have noticed this rise in deaths in many other disasters.
The terminal area is less than ideal. It takes time to get patients to the site, Nesheim said. It has knee-high grass and the ground is uneven, with mounds of dirt and concrete semi-hidden by the underbrush. Two Seahawk helicopters squeezed into the site once yesterday – at night by choppers from the USS Vinson – but it is a chancy proposition.
Conditions are pretty sparse also. There is no shade and temperatures are into the 90s during the day. The treatment tent and the holding tent become very hot very quickly. Conditions for the workers are sparse, but they didn’t expect a vacation spot. They have set up a rudimentary shower, but the latrine is a tent over a bucket.
The space is constrained. So much so, that the prop wash from CH-53s knocked the roofs off the facility twice.
The evacuation point was the grounds of the Haitian presidential palace. Sharpe said that four birds could land there, and it was only two blocks from the University Hospital – Port-au-Prince’s main medical facility. Even though he had the permission of Haiti’s president to fly missions from the area, the site was shut down.
The site also receives patients back who have received treatment. The Navy has contracted with locals to drive the patients to their homes. Unfortunately, often their homes are gone.
Ten days after the earthquake, Haitians are still dying. Besides Marie, two babies died at Terminal Varreux yesterday. This morning, the first flight into the terminal brought the body of a Haitian who died on one of the ships.
Still, American civilian and military specialists continue to do their best. They continue to work to make the system better and faster.
“I never in my life expected to be doing something like this,” said U.S. Navy Senior Chief Petty Officer Sergio Esparza, the communications chief at the terminal. “We’re helping so many.”
(Jim Garamone of American Forces Press Service is reporting and blogging from USNS Comfort during its humanitarian deployment to Haiti.)