January 12, 2010. At 4:53 PM, local time, a magnitude 7.0 earthquake shook the country of Haiti, killing an estimated 316,000 people, injuring another 300,000 people, and leaving over a million people homeless. A year later, the country of Haiti is still struggling to pull itself out of the rubble and has been hit by tropical storms, all the problems associated with "tent city living", and is in the middle of a cholera epidemic. Beautiful, stoic people are rebuilding their lives despite all the tragedy around them.
February 27, 2010. At 4:00 AM, local time, I showed up "bright eyed and bushy tailed" at the Miami Airport to board a charter flight to Haiti to volunteer with Project Medishare to help with earthquake relief. Almost a year later, I am the Chief Pharmacy Officer for Hopital Bernard Mevs Project Medishare, living in Port au Prince. Today the world is once again focused on us here in Haiti, and while much of the media is focused on what still needs to be done, I'd like a moment to focus on what HAS been done. Sometimes, in the midst of all that is going on, it is easy to forget how far we have come.
In the beginning...
When I first arrived in Haiti, the field hospital pharmacy was several folding tables and shelves with piles of medications. No one had any idea what sort of inventory we had or how to get more medications; there was no “institutional memory” of what medications had a good track record with local strains of bacteria and very few drug references. In the early months, there were countless drug shortages due to factors such as a lack of inventory control and protocols...
We are now in a building, and we have a medication formulary that is continually adjusted based on what medications are readily available and effective for local diseases. We are able to give out a month or more of maintenance medications upon discharge or to patients seen in clinic. We have created “quick reference charts” with critical information such as maximum concentration, diluent compatibility, infusion time, and stability (both time and temperature). Local employees go through training on aseptic technique, serial dilution, deciphering prescriptions, and using references. Employees are actively encouraged to ask questions and learn from volunteering practitioners.
We have learned the true meaning of Alterum Alterius Auxilio Eget (Each Needs the Help of the Other).
-Multiple NGOs came together to form the Combined Response Team to coordinate rapidly available (i.e. “in country”) medical assistance and supplies in case of another natural disaster or disease outbreak. We had medical teams providing care in facilities within 24 hours of the official news of the cholera outbreak, and have continued to coordinate medical personnel and supplies for cholera clinics throughout the country of Haiti.
- Within hours of the microburst from Tropical Storm Matthew destroying the tent hospital for J/P HRO, the emergency hospital kits that I'd built were in their hands so that they were able to continue to triage/treat patients.
- I now run an on-call pharmacy service to assist other NGOs and healthcare providers in the Port au Prince area, that currently serves more than 11 organizations. This has decreased the number of medication errors (and subsequent hospitalizations) and increased the quality of medical attention received by patents.
And, on a personal level, I have "found my calling in life": medical relief and education in developing countries. While I am proud of all that we have accomplished over the past year, what I am most proud of is the lasting difference I have made in the lives of the patients and the local and international practitioners that I have touched. A few weeks ago, I was talking with a pharmacy intern about the difference that I feel I am making for the profession of pharmacy. Not only here in Haiti, but the difference that is being made for providers from the United States. Here we work as a team, and I am often side by side with providers directly assisting in care. Many past volunteers have expressed that being here - working this way - has changed how they view the role of pharmacists in their practice. Being here has touched, moved, and inspired them, and I am grateful to have been part of that.
January 12, 2011. At 4:53 PM, local time, I stood in a circle of friends and family from across the globe. Some, I feel like I've known all my life instead of for one short year. We sang "Amazing Grace", and prayed in Creole. Although my Creole is still fuzzy, the sentiment transcended the language barrier. We prayed for those who we've lost, and for those who have come to help, and for the future.
So a year later, are things better in Haiti? As a friend of mine has come up with a far better answer than I ever could, so I'll use hers (thanks Beth). When people ask if things are better in Haiti, I say:
Is there rubble still in the streets? YES. Are there still condemned buildings, ready to collapse at any minute? YES. Will it be cleared up this year, or in 5 years? NO. BUT... Is there less rubble than there was yesterday? YES. Has progress been made in the past month? YES. Are we working to rebuild what has been lost, to come out of this tragedy and be stronger than before? YES.
Are people dying of conditions easily preventable or curable in the United States? YES. Is there still a great need for care? YES. BUT... Are there people who are alive because of the care we provided who would not otherwise be here today? YES. Did us coming down here make an impact, that will continue to touch lives long after we leave? YES. And, most importantly, Will the people of Haiti succeed, and overcome the adversity that surrounds them? YES."
~PJ
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