When a magnitude 7.0 earthquake devastated Haiti in January 2010, it left more than 200,000 Haitians dead, 300,000 injured and 1,000,000 homeless. From celebrities to civilians, thousands of volunteers rushed to Haiti’s aid.
Nurses on the Ground
Michael Beach, DNP, was one of many nurses who traveled to Haiti to help earthquake victims. An assistant professor at the University of Pittsburgh, Beach is an acute care nurse practitioner experienced in emergency nursing as well as in search and rescue and local disaster response. He is a member of the PA-1 Disaster Medical Assistance Team (DMAT) administered by the U.S. Department of Health and Human Services. This was the first time that a DMAT team ever deployed outside the continental United States. Beach’s team included physicians, two nurse practitioners, several other nurses and paramedics.
“We had no idea what we were getting into,” Beach says.
After spending the first night at the U.S. embassy, the team took over care at a triage tent and a hospital tent on a small hill on the ninth hole of the only golf course in Haiti. They treated about 300 people each day and slept on cots under mosquito netting on an outdoor tennis court. Beach worked in triage:
“It was hot and dirty… There was no infrastructure, no toilets or running water in Haiti, so we had to assume that everything was contaminated because of the lack of plumbing and toilet facilities.”
As one might imagine, everyone—particularly the nurses and paramedics—acted in expanded roles. They were expected to step up, ask the right questions, diagnose, get the right medications and give them to the patients.
“With so many people needing help, we just couldn’t dispense medical care the traditional way,” Beach explains. To deal with this, the team quickly established protocols. They would perform a quick physical exam and, if they couldn’t pinpoint a diagnosis, they sent the patient to the hospital tent.
Despite the hardships, the team treated everything from broken bones to respiratory infections. The most common problem was dehydration from diarrhea and vomiting, particularly in children. They also saw a lot of people with palpitations or anxiety, resulting from extreme stress.
But probably the most dramatic cases were the patients who came to the tent for follow-up wound care:
“These patients had large, open wounds because, in this environment, you couldn’t close them—either because you couldn’t send them to the operating room or because of the risk of infection.”
Beach found the Haitians to be amazing people:
“One young woman had a wound on the inside of her lower leg that encompassed her entire calf. I applied antibiotic ointment, packed the wound with gauze and wrapped it. She walked up the hill with this injury to our tent for treatment and walked back down when she was finished.”
In another case, an elderly woman was brought in unresponsive with her eyes closed, apparently having suffered a stroke. Her condition seemed grave. She was sent to the hospital tent where she was rehydrated and, a short time later, she walked down the hill.
Three births occurred while Beach was working in the triage tent. All of the pregnant women walked up the hill to the tent in labor, gave birth, got a liter of fluid and then walked back down the hill with their newborns.
Strike teams went out on foot and in military vehicles to search for victims who couldn’t walk in for treatment. One of the strike teams brought in a child with bilateral femur fractures. Beach’s team transferred the child to another facility where he could have surgery.
A physician who had flown in from Germany to help in relief efforts spotted a baby who probably had a meningitis infection and ran him up the hill to the DMAT tent. The baby was having seizures. The team started him on antibiotics and fluids and transferred him to a surgical center in Port-au-Prince. Without this intervention, the baby almost certainly would have died.
“I think we accomplished what we set out to do,” Beach says. “We dispensed good medical care. We did the best we could—and we did some good.”
The hardest part of the journey, according to Beach, was leaving:
“Another agency was going to take over our facility, so we knew that other people were coming to help. Still, it was difficult to leave knowing that I wouldn’t see these people again.”