Night Transport in Port-au-Prince

摘要

id="p1">The author leaves a rural clinic in Fort Morgan, CO, to briefly join a medical relief team responding to the Haitian January 2010 earthquake. While transporting an ill newborn, he reflects on similarities between the Haitians’ displacement and resulting vulnerability and that of his patients back home. “Jeff! Jeff! Get up!”Elias’ headlamp pierces the thin tent and catches me in the eyes, blinding me.“There's a sick baby at the hospital they want to transport…they need someone to go.” class="kwd-group KWD">

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>class="kwd-search" href="/search?fulltext=Transportation+of+Patients&sortspec=date&submit=Submit&andorexactfulltext=phrase">Transportation of Patients id="p-5">I pause. It is February 1, 2010. Elias and I had left our rural community health center in Fort Morgan, CO, the day before to be part of a small medical relief team hastily assembled in the wake of the Haitian earthquake. We gathered that evening in Miami from 4 different states. In the darkness, we took off in an 8-seat, twin-propeller Chieftain, climbing up through heavy clouds and drumming, steady rain. Several hours later, orange and yellow rays sliced through the clouds as dawn broke over the Caribbean. We refueled in Turks and Caicos Island to the north because Haiti's international airport had no jet fuel. We landed in Port-au-Prince and eventually cleared customs and US military checkpoints. We took a jarring ride in an old school bus with broken seats and shredded upholstery to our base camp across from Hopital Adventiste de Diquini. id="p-6">But we did not come all this way to sleep while Haiti dug itself from the debris. So I fumble around looking for my headlamp, sweating even more in the airless tent as I think about what we might be getting ourselves into. id="p-7">“We wanted to intubate, but the smallest laryngoscope blade we have is a 3.” id="p-8">I peer past the tight crowd into the back of the ambulance. “She was born yesterday. There was thick meconium. She started having difficulty breathing tonight.” id="p-9">Lying on the ambulance bed is a newborn baby. She has been diapered and placed on a thin, white blanket. She is breathing fast, but has good tone and color. A pulse oximeter is reading high eighties. id="p-10">I exhale. id="p-11">“We got a line and started some intravenous fluid. The other hospital is only 10 minutes away.” id="p-12">Elias and I climb into the back of the ambulance. The doors close. We pull out of the ambulance bay and into the dark. The headlights do not work, but there are no other vehicles on the road. id="p-13">“Just so you know…” An anesthesiologist swings his body around from the front seat. “Just so you know, the back of the ambulance sucks in exhaust from underneath. We transported a ventilated patient earlier tonight and the doctor in the back got carbon monoxide poisoning. He's lying on a cot with a horrible headache. I’m coming to get our equipment back. I’ll keep these windows open to get you some fresh air.” id="p-14">I look down. The baby is crying, and working hard to breathe. Elias adjusts the oxygen mask and I take stock of our supplies. Some sort of bulky hand-pump vacuum for clearing secretions. A single, small, cuffed endotracheal tube. Five percent dextrose fluid hanging above me. A tongue depressor. Two small-town family doctors in the back and one half-asphyxiated anesthesiologist riding shotgun. id="p-15">The oximeter is now reading in the low 80s. id="p-16">“Maybe I can see the cords.” I snap the tongue depressor in half then split one half lengthwise and guide two overlapping pieces into the back of the baby's throat. The ambulance lurches in the dark over potholed roads and around tight corners. I adjust my headlamp. id="p-17"> Fort Morgan rests on the high plains of Colorado's dusty northeast corner. Our center was founded to care for mig