sunday prepacking-rpm
packing and sorting on Sunday prior to departure-out of sight but so essential!-rpm
shrink wrapping in preparation for loading the plane-rpm
0515 hrs at the Penkhus hangar-rpm
our ride from the airport was a bit cramped-rpm
750 lbs of medical supplies and gear + 9 people at the airport-rpm
Private homes serve frequently as neighbor hood churches in this predominantly Roman Catholic country-rpm
I found a pallet of paper towel boxes which formed our mattresses for the first night. Mosquito netting used in this malaria prone country-rpm
We made 5 day baggies full of oral antibiotics for our post op patients-rpm
off to CDIT in p/u truck rpm
we traveled by truck to the hospital...this morning shared with a Korean team-rpm
Doug peering into the void of endless suffering...-rpm
stoicism in the recovery room...crowded, stifling heat, flies...rpm
recovery room in tents provided by the French in the CDIT courtyard-rpm
Horrific open IIIB distal femur at 2nd debridment-rpm
after debridement and partial closure of wounds-rpm
CDIT courtyard with pre and post op tents-rpm
sunset over Port-au-Prince. you realize this could have been another caribbean paradise-rpm
fires were common-frequently trash, sometimes funeral pyres, and maybe gas-rpm
Dr Michelle Henderson who was pivotal at coordinating arriving teams at CDTI with Dr Al Bach-rpm
IIIB open pilon fracture with spanning ex fix-rpm
IIIB open tib fib fx being lavaged after ex fix-rpm
Post op instructions are written on the dressing for subsequent providers-rpm
Dr Karre performing ketamine sedation and spinal anesthetic for ex fix and debridement-rpm
Above knee amputation and ex fix for contralateral IIIB proximal tib fib fx. Pt being transferred by French to Martinique for flap-rpm
Historic Cathedral--most people attending mass died -rpm
tent city in front of presidential palace-rpm
tent city in square near presidential palace-rpm
one of the many colorful trucks with religous theme-rpm
Jesus nearly returned in the form of a rear end collision with this bus-rpm
car crushed by falling debris-rpm
Sean and Teresa Karre-rpm
Unstable malgaigne pelvis fracture at 2 weeks w/o treatment-rpm
R Meinig and A Bach performing double plating of unstable pelvis, J Cothran scub This is a surgery that makes me nervous in our Colorado hospital. In this environment, sepsis, lack of supervised rehab, and potential blood loss made for a stressful surgery. The injury however was unlikely to be treated well in an external fixator-rpm
The postop fluoro view was limited but it appeared with the double plating that the reduction was near anatomic...now its a waiting game for infection....-rpm
paramedics from Washington state head into the streets for mobile care-awb
P Rahil with black and decker drill. Coban was used to wrap the unsterile drill handle, The chuck was dipped in betadine-rpm
Our colleagues eating a hospital provided lunch-rpm
Deanna Walker with baby boy born via C-section by Dr Camille ? from Houston,Tx. A bit of joy between brutal limb injuries-rpm
Paul Rahill with pressure sterilizer borrowed from German team -awb
Preop pts in hallway. Pt in lower L is singing quietly to herself-rpm
Additional debridement of massively septic open tib fib fracture. This was subsequently converted to BK amputation-rpm
Below knee amputation for unsalvageable open tibifb fxs Dr James and J Cothran. CDTI hospital was run as a morphing of Summit County, St George, UT, and FL personnel-all who found a way to Port-au-Prince outside of "official" rescources-rpm
storage room later converted to OR-awb
6 year old's possesions while she is in surgery-rpm
Doug, Sean, Jim, Jeanie preparing for next case-awb
bilateral femur fractures untreated for 2 weeks. I doubt the patient has had even an aspirin during this time-awb
Multi story house adjacent to our undamaged compound-rpm
Team "1" at compound for first night The second half of our group arrive the next morning as Bob Penkhus ferries them from Ft Lauderdale. We ended up being one giant team at CDTI hospital with everyone doing everything as needed-rpm
my wife Kathy sent some friendship bracelots along-rpm
kids next door...rpm
family next door sleeping outside. we were awoken by their church service and hymns in the darkness...rpm
stoic determination-rpm
roosters, dogs, and children abound-rpm
kids next door peering into compound over toppled wall-rpm
Jim Smith is a surgeon from Pueblo, CO. He made it happen for us! Jim has had a long term relationship with improving health care in Haiti and deserves our future financial support and sweat equity. One of the unsung heroes of the early days of the disaster response-rpm
our staging room in a private residence for the first night-rpm
muli story buliding-rpm
Team "1" prior to heading to the Quisekaye School for subsequent deployment to CDIT hospital-rpm
Typical street scene: an intact house surrounded by rubble of its neighbors-rpm
multi story building-rpm
hillsides had slid...rpm
some buildings were mostly dust...-rpm
house ware among the debris reminded you of the deadliness and utter destruction...-rpm
entire blocks reduced to mounds of debris and twisted rebar-rpm
the first floor is only inches now-rpm
vendors on the street-rpm
To think how many of the school desks will remain empty....-rpm
food, drink, motor oil, clothing, and virtually everything else being sold on the street-rpm
I can count at least 4 stories that have been pancacked-rpm
rubble fell into the streets but was being rapidly cleared-rpm
masks helped with the dust and sometimes the smells-rpm
our last 6 external fixators were scrounged from other volunteers at the central camp-awb
Tents provided by the French served as recovery rooms and patient wards-rpm
CDTI was converted into the epicenter of orthopaedic trauma surgery. Many amputations were performed in the first week but during our stay it was stabilization and debridement of septic open fractures-rpm
Tiffany and team at group dinner after a very long day-awb
household belongings and twisted rebar-once a family's home-awb
Many patients stayed adjacent to the hosptital in tents provided by the French-rpm
families trying to sift through the rubble for housegoods or their loved ones-rpm
help with dead casulties.... 2nd floor now at ground level-rpm
we casted this 11 yo out of the back of the pick up-rpm
Betadine cleansing of an open fracture-crush wound on the pick up truck outside of a tent city-rpm
open hand fracture reduced and spinted in the tent cities-rpm
totally flattened building-awb
Russian jet off loading supplies-awb
scrambling to unload Bob Penkhus's KingAir. The military gives civilian small planes a very limited time on the ground. It was never certain that Bob would have landing rights and it was always hectic on the ground with people desperate for a way out.-awb
We found a restaurant for some much needed food. Tiffany is exhausted from a day in the trenches spent debriding countless wounds...Texting was surprisingly reliable for communications-rpm
Bob Penkhus and his co pilot Dave transported our 16 team member and 1500+ lbs of gear. They made several other ferries with gear and passengers in the Penkhus Beechcraft KingAir. This is the Saturday contingent-the reamainder arriving in Chicago on a United Flight arranged by Dr Willard-rpm
Moonrise over Port-au-Prince...paradise lost...rpm
we never felt unsafe in Haiti but some locals did guard there compounds-jg
The roof top offered a breeze although the morning roosters and sometimes smoke from trash fire were an issue-jg
wound care was often done in the field-jg
traumatic amputation of ring finger receiving field wound care-jg
foot wounds were very common and frequently addressed in the "ER"-jg
crush injuries resulted in many untreated compartment syndromes-jg
Tiffany and Jamie at work in the ER bays at CDTI where many debridements and complex wound care was performed-jg
Haiti has a median age of 20 years so many, many patients were children-jg
tiffany and khurram perform additinal wound care in the ER-jg
tiffany with a young boy with multiple extremity lacerations-jg
open hand fracture undergoing bone debridement to allow for wound closure and granulation-jg
As soon as the Penkhus plane was off loaded there were eager passengers trying to leave Haiti-pbr
an ankle injury untreated for 2 weeks prior to ORIF-pbr
Our Haitian nurse was of immense comfort to our patients, especially the children. We had many volunteers who helped translate Creole...pbr
a patietn with a previously debrided and splinted open tibia fracture awaiting the OR in the "pre op holding" area which was the hallway leading to the OR's-pbr
A two week old hip fracture treated with a compression hip screw. We had brought the implant with us but not insertion instruments--pbr
Paul with Haitian orthopaedist Dr Nau
Heading to the field-pbr
triage in the CDTI courtyard-pbr
CDTI courtyard was triage, ER, recovery room, and ward-pbr
pt ward in courtyard tent-pbr
leaving CDTI after a very long day...pbr
our flight in to Haiti was nervous anticipation-jh
Fron the air,Haiti could be another Carribean vacation spot-jh
triage in the CDTI courtyard-jh
France provided much of the triage and ER care at CDTI-jh
Doug "inspecting" some of the earthquake damage present in the CDTI hospital building-jh
the CDTI courtyard was filled with tents that served as pt wards, recovery room, and field hospital...jh
Kids were ever so resourceful making toys from plastic bottles and kites from cellophane and sticks...jh
care was provided on several trips to surrounding areas-jh
traumatic amputation to the hand recieveing field care-jh
field care-jh
Haiti is a nation of children and the risk of infectious disease is immense in the coming months-jh
friendship bracelets--ever the hit! -jh
earthquake damage to the streets...jh
we found respite at a pizza restuarant, a bit of sanity in an otherwise insane landscape--jh
reorganizing supplies at the school which was our accommodations and volunteer hub-tw
text messaging was the most reliable means of communications-tw
Most injuries at this point were extremity injuries although there were many scalp lacerations -tw
flies on the tent canvas, tropical climate, infectious disease, possibilities are endless for ongoing misery in Haiti-tw
The CDTI Hospital while standing had many cracks and holes throughout. It is currently hoped that the building can be repaired and reopened as a hospital-tw
triage was an enormous task each morning in the CDTI courtyard-tw
patients would arrive on stretchers to the CDTI hospital courtyard and require immediate evaluation-tw
With a median age of only 20 years, Haiti is a nation of children. Many of the injured were children and newly orphaned-tw
Field units were essential in treatment as well as finding the injured that required transfer...-tw
Haiti--a nation of children....tw
wound care to the extremities was very common and most of the debridement and dressing changes were performed in the ER or field as the OR capacity was so limited-tw
crush injuries to the foot were ubiquitous-tw
it was a multinational effort in the ER.....tw
application of external fixation frames provided improved stability to unstable open fractures that would require continued debridement and wound care-tw
upper extremity injuries included closed compartment syndromes from crush or being trapped under debris-tw
the tents that acted as recovery room and wards were provided and managed by a French agency but were staffed by everyone-tw
leaving Haiti.....tw
the playgrounds are largely abandoned...db
ex fixation was the mainstay of our surgical approach....Dr Nau from CDTI performing ORIF-db
Haitian Flag at half mast-db
a totally devastated church--symbol of hope or despair?--jh
