“I am the only surgeon”: after the earthquake in Haiti, thousands of people seek rare care

LES CAYES, Haiti – With broken bones and open wounds, the injured found themselves stranded in damaged hospitals or headed to the airport, hoping for relief flights. A handful of medics worked all night in makeshift triage rooms. A retired senator used his seven-seat propeller plane to transport the most urgent patients to emergency care in the capital.

In the aftermath of a magnitude 7.2 earthquake that left at least 1,300 dead and thousands injured in western Haiti, the main airport in the city of Les Cayes was inundated on Sunday with people trying to evacuate their relatives to Port-au-Prince, the capital, about 80 miles to the east.

There wasn’t much to choose from. With only a few dozen doctors available in an area home to a million people, the aftermath of the earthquake was becoming increasingly dire.

“I am the only surgeon there,” said Dr Edward Destine, an orthopedic surgeon, greeting a temporary corrugated iron operating room set up near Les Cayes airport. “I would like to operate on 10 people today, but I just don’t have the supplies,” he said, listing an urgent need for intravenous drains and even the most basic antibiotics.

The earthquake was the latest calamity to shake Haiti, which still lives with the aftermath of a 2010 earthquake that killed around a quarter of a million people. Saturday’s earthquake came about five weeks after the assassination of Haitian President Jovenel Moïse, leaving a leadership vacuum in a country already struggling with extreme poverty and widespread gang violence.

Haitian authorities were scrambling to coordinate their response to the earthquake, aware of the confusion that followed the 2010 earthquake, when delays in delivering aid to hundreds of thousands of people worsened the death toll.

Prime Minister Ariel Henry on Sunday pledged at a press conference “to give a more appropriate response than the one we gave in 2010”, with a single operations center in Port-au-Prince to coordinate efforts to ‘help.

Dr Paul Farmer, co-founder of relief agency Partners in Health, which oversees several hospitals in Haiti, said the country’s ability to respond to an earthquake – with new emergency medical services and training programs – had improved considerably in the intervening years.

“The things we had available to us in 2010 compared to now are night and day,” Dr. Farmer said.

But he acknowledged that Haiti was still facing what he called “old problems” like bad roads, poor transport and political volatility, fueled by gang violence, which could make disaster management all the more difficult.

Among the organizations that provided assistance over the weekend were the United States Agency for International Development, which sent a search and rescue team, and the United States Coast Guard, which said they deployed helicopters to provide humanitarian aid. The Pan American Health Organization sent experts coordinate medical support and UNICEF distributed medical supplies to hospitals in the south; and water and sanitation assistance.

The earthquake – more powerful than 11 years ago – triggered widespread landslides, with rocks and other debris blocking many roads, making it difficult for the injured and needy to reach. The road from Les Cayes, on the coast, to the Marceline neighborhood about 16 miles away in the mountains overlooking the city, was cracked in the center, with boulders and tree branches blocking it.

Families in the area slept in the open, their homes badly damaged or completely destroyed. Others were too nervous about the aftershocks that were devastating the area to feel comfortable taking shelter under a roof.

Sunday in Marceline, Honoré Faiyther had just discovered the body of his aunt among the remaining benches of the Church of Saint Agnes when a replica shook the city, shaking the corrugated iron roofs which had collapsed and littered the ground .

Mr. Faiyther closed his eyes and waited for the shaking to subside as he sat down on a concrete slab that had been part of the church wall. A few steps away, the body of her aunt, Ilda Pierre, was lying on a metal grid, covered with a white sheet.

Ms. Pierre was cleaning the church with a friend when the earthquake struck.

“My aunt has four children and she is very active in our community and has volunteered in this church for five years,” said Mr. Faiyther. “Her husband is in denial. He can’t admit she’s dead.

Reverend Jean Edy Desravines said he was preparing a sermon for Sunday “to inspire parents to send their children back to school next month, to join our community after such a difficult year”, referring to the pandemic.

“Now there isn’t even a school to send them to,” said the priest, explaining that the primary school run by his church had also been razed.

“In a small town like this, the church is all we have,” he said.

Marceline’s mayor, Fenicile Marssius, passing by to check on the priest’s condition, said his own house had been destroyed.

“We have not received any help from the government,” said Ms Marssius. “Maybe they have so much to do in the cities that they can’t reach us in these remote areas.”

In the town of Mazenod, outside Les Cayes, volunteers attempted to extract two women from the rubble of a collapsed church guesthouse, a metal crash of a bulldozer amassing the debris as the men used their bare hands to move concrete slabs.

Almost the entire complex of the Saint-Eugène de Mazenod chapel was destroyed, including the seminary and the high schools run by the church.

“I don’t think there is hope,” said Melchirode Walter, 31, whose sister, Solange Walter, 26, was trapped. “We’ve been calling him by name since yesterday and knocking on the concrete, but there’s nothing.”

Reverend Corneille Fortuna, who helps run the complex, said he barely survived when his residence on the property collapsed. He was trapped by bricks blocking the entrance until friends managed to get him out.

“Haiti is a country where all disasters are possible,” said Father Fortuna. “And there is never any help.”

The Cayes authorities estimated that only 30 doctors served the entire western region. They now face the overwhelming prospect of dealing with thousands of serious injuries from collapsed buildings.

All major hospitals are damaged; doctors worked overnight to erect the temporary operating room near Les Cayes airport as local hospitals were in terrible shape.

At Les Cayes general hospital, two surgeons operated on eight people on Sunday with declining stocks but were forced to turn away for the most part.

After their procedures, patients were transported from their beds under the scorching Caribbean sun to the parking lot, which became an outpatient center.

Dr James Pierre, one of the surgeons, had just completed surgery on a 5-year-old girl with abdominal trauma who was crushed by a wall in her house while playing in the yard.

“We can only do simple surgeries here, we have nothing to work with,” said Dr Pierre, watching the girl’s chest work with each breath under a blanket in the open.

Medical records, stacked two feet high on a metal table, lay next to an open faucet where patients, families and friends bathed. Chickens were running between the wounded.

At the airport, Hervé Foucand, former senator from the Cayes region, used his small propeller plane as a flying ambulance this weekend, taking the most needy to the Haitian capital, in a 45-minute flight. He said he had evacuated 50 people since Saturday. “Hospitals are broken inside,” he said.

“I have 30 people in serious condition waiting for me,” added Mr. Foucand. “But I only have seven seats.”

Palmera Claudius, 30, lay in the bed of a truck her relatives had hired to take her to the airport, the entire left side of her face swelling.

She was at home in Camp-Perrin, at the gates of Les Cayes, when she felt her whole house shake. As she tried to run outside, a wall collapsed on her.

Like many others on their way to the airport, she hoped for a free flight to the capital, as her family could not afford a ticket.

Ms Claudius said she couldn’t feel her legs and her town clinic didn’t have the capacity to take an x-ray to determine what was wrong.

Taking a break from caring for the injured, Dr Destine, the orthopedic surgeon, was trying to bring his own father, also a surgeon, to the United States for treatment. His father suffered a major head injury from a collapsed roof, he said.

Dr Destine said he expected thousands of people to contract life-threatening infections unless the proper supplies were delivered on time. The prospect of malnutrition, too, was likely to exacerbate the natural disaster for an already impoverished and starving population, he said.

“We can’t even do lab tests,” he added.

Constant Méheut contributed to the report from Paris and Alexandra E. Petri from New York.

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