On Tuesday morning I looked down at the elderly woman lying in the corner of a hotel car park and suspected that my efforts would be futile. She was in a serious condition and obvious pain: intestinal paralysis caused by a broken pelvis and shoulder, the result of being trapped under tons of rubble. Her treatment should have been simple: not surgery necessarily, just careful nursing. But in Port-au-Prince, the hospitals are barely functioning. Wards and operating theatres are cracked and falling down. Most hospital staff are missing, dead, or too grief-stricken to function.
My patient had nowhere to go. I could see her abdomen visibly distend. It was so tender that even a gentle touch caused her to scream. I placed my ear against her swollen belly: no sound of bowel activity, a sure sign that, left untreated, this problem would kill her. I talked to her daughters, quietly, in my best French. ‘Your mother will die,’ I said, ‘unless we can find proper nursing care in a hospital.’ I was telling them what they already knew. Their mother needed a huge stroke of luck — something I could not provide.
This is Haiti one week after the earthquake. The hospitals are in ruins or full. Medical teams are working ceaselessly in corridors, landings, on the hospital steps and car parks. Drugs and medicines are running out, and single-use instruments are being re-used hundreds of times as amputations are performed on kitchen tables.
I had to move on from the woman in the car park, this time to Delmas in the centre of town. Our driver battled against the crowded streets, swerving to avoid earthquake rubble, his hand never far from the horn. He too had lost someone: his brother, just 40, crushed to death with so many others.
The massive American-driven aid machine is throwing its might against an almost unsolvable problem. As the casualty toll mounts, available food, water and petrol decline. I lay awake last night listening to the airlifts. Huge machines fill the sky. Helicopters take off and land endlessly. The locals become restless. There are riots, and though they’re here to help, UN soldiers move everywhere, rifles and machine guns at the ready.
On Wednesday we had to move the clinic because the smell of the rotting bodies — children from the crushed school beside us — is making work impossible. Tomorrow, I take up residence on a former tennis court; the patient waiting area will be the spectator stands.
It is hot. ‘Can we have food?’ the locals ask. ‘When will you rebuild my house?’ I explain that I am just a doctor, a surgeon. They look unconvinced, at times aggressive, as though I were to blame. Perhaps I am — perhaps I am giving these helpless people unreasonable expectations of what I can offer. Perhaps, when my Merlin colleagues from England arrive tomorrow, the situation will be different, better. I hope so. It can’t be any worse.
Richard Villar heads up the emergency surgical team in Haiti for Merlin, the British medical aid agency. To find out more about Merlin and donate to their emergency appeal, please visit www.merlin.org.uk/haiti. Merlin is a member of the Disasters Emergency Committee. To donate to the DEC please visit www.dec.org.uk.
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