'Many small things amount to much' in Haiti mission

Editor's note: The following story is a personal essay submitted by a nurse anesthetist from Jackson who visited Haiti recently to provide medical assistance after the earthquake.

MIRAGOANE, Haiti -- We arrived on a blistering hot, chaotic day in Port-au-Prince, Haiti. Our "team" was composed of Dr. Bob Cady of Florida, Dr. Dick Whitaker of Pennsylvania (both orthopedic surgeons) and myself, Melanie Dillard, a nurse anesthetist from Jackson.

It was 11 days since the earthquake, and we had been delivered to Haiti by the organization "Hope for Haiti" to provide medical care to the injured. Mike Stewart, in-country director for Hope for Haiti, met us at the airport and took us from there to assess the needs of makeshift outdoor clinics and badly damaged hospitals in Port-au-Prince.

The destruction in Port-au-Prince is widespread and massive. Bed sheets form makeshift tents that house displaced people are everywhere -- both in and off the streets. Later that night we retired to the Villa Creole Hotel or, more accurately, we stayed outside of the hotel as the guests (mostly journalists) pitched tents or slept on the ground. The hotel was heavily damaged in the earthquake; part demolished, part still standing but unsafe. In addition, Haiti was still experiencing tremors, leaving everyone wary of buildings.

On Jan. 24, Stewart informed us we were needed in a village about two hours from Port-au-Prince called Miragoane. A driver would take us there and pick us up later in the week. We reached our destination later that day and found there were three orthopedic surgeons and one obstetric/gynecology physician from Florida already there. The doctors had arrived the day before and found many injured people who had been sitting since the earthquake with fractured bones waiting. They were unable to operate as they had no one to administer anesthesia. Fortunately, I had arrived with a backpack full of anesthesia supplies all donated by Southeast Missouri Hospital in Cape Girardeau, without which I would not have had means to provide anesthesia. We started working within an hour of arriving and continued for the next five days working all day and into the night. The hospital was spartan to say the least. There were no patient rooms and no recovery rooms. The patients were all outside in tents provided by the U.N. or makeshift tents they made themselves out of bed linen. After surgery the patients went immediately outside to the care of their families. There was no recovery period and no nurses to monitor their condition following the anesthetic.

Family is central in Haitian life. Without family to feed and provide water for the patients, they would have neither. The operating room itself had none of the items we Americans consider standard fare such as operating room lights or electrocautery. The surgeons had to both operate and be their own operating room staff. Often they were operating under flashlight that was their adaptation for an "operating room light." It was a week of improvising and trying our best to do surgery with the bare minimum of supplies, which were constantly depleting. Every day brought a new shortage and a new strategy for how to get the job done.

Through it all I was struck by the patience, gratititude and quiet acceptance the Haitian people displayed regarding their situation. They bore it all with courage and grace. In those five days we completed 20 surgeries, reduced multiple dislocations and applied multiple casts. Considering the multitude of people injured, ours was but a small contribution. However, Haitians have a saying, "Antil ti patat fe chay," which translates to "many sweet potatoes make a load ... many small things amount to much."

Melanie Dillard has been a nurse anesthetist for 15 years. She has worked for Anesthesia Associates at Southeast Missouri Hospital for 10 years. She and her husband have been married for 27 years, and they have a 20-year-old son, Ross, who is a student at Southeast Missouri State University.