Friday, July 9, 2010

Team Sinai in the Baltimore Jewish Times


Sinai Team Back From Haiti

Sinai team returns from earthquake-ravaged Haiti.

July 9, 2010

Alyssa Jeffers
Editorial Intern

Sinai Team Back From Haiti
“We take for granted what we have here — food, clean drinking water, state-of-the-art medical equipment, even oxygen,” says Dr. Aaron Zuckerberg. “They don’t have any of that, and yet they don’t complain.”
Last January, a magnitude 7.0 earthquake rocked Haiti, a poor Caribbean country the size of Massachusetts. Approximately 230,000 people died, and there was widespread damage, particularly in the capital of Port-au-Prince.
Since then, relief has poured in to Haiti from all over the world, including a recent volunteer group from Sinai Hospital of Baltimore.
Dr. Zuckerberg and Dr. John E. Herzenberg, along with 16 other Sinai-affiliated doctors and health care workers and volunteers, as well as some of their family members, traveled to Port-au-Prince to help take care of injuries sustained in the quake. They were there from June 11 to 17.
Getting to Haiti was not easy because of airline restrictions, according to participants. Not allowed to transport crates, extra bags and narcotics, they said the team worked around the clock to pack three bags per person — for food, clothing, and necessary gear and supplies.
Upon arrival in Port-au-Prince, they said they immediately saw tents lining the streets and roads covered in sewage. Trash removal was provided only by wild pigs roaming the areas, they said.
Dr. Herzenberg, head of pediatric orthopedic surgery at Sinai and director of the International Center for Limb Lengthening, said Haiti was “orders of magnitude worse” than what he has seen on 13 other relief missions. He said Haiti was “three levels worse” economically than prior to the disaster.
The Sinai team was based at Adventist Hospital in the capital. During 6 1/4 days, they performed 54 surgeries, on little to no sleep. Dr. Zuckerberg, a pediatric anesthesiologist/intensivist who is director of the pediatric intensive care unit at Sinai, performed anesthesia on 31 of the patients, while Haitian medical personnel anesthetized the rest.
“Normally, [anesthesiologists] get the day off after a late night, but not here,” said Dr. Herzenberg. “Aaron would work all day, get a few hours of sleep, and be up again bright and early the next morning. He personally saved the lives of two patients. He went above and beyond what he was trained to do and performed two very important surgeries. With any other anesthesiologist, those two
patients would have died.”
The team grew particularly close to an 8-year-old girl named Mia.
“Every mission I go on, there is one patient that sticks out in your mind,” said Dr. Herzenberg. “[Mia] had been struck by a car and broke her femur. Her leg from the knee down was completely dead. She had a fractured femur that was completely infected. She was very anemic, with her hemoglobin down at 3.5 [the normal rate is 15].”
The Sinai team operated on Mia four times. “She needed blood, but it was taking too long,” said Dr. Herzenberg. “My wife [registered nurse Merrill Chaus] donated her own blood in order to receive blood for Mia. During the transfusion, Mia began bleeding profusely. She had citrate poisoning, meaning her blood wouldn’t clot. That night we decided to operate, even though we had wished to do it the following morning.
“I was convinced she was going to die on the table,” he said. “Thankfully she didn’t, and we successfully amputated her leg. We took her back two days later to redress her and see how things were doing. There were bits of dead tissue we missed the first time, so we went in to clean them out. Suddenly, the femoral artery burst and was spewing everywhere. With the team working together, we saved her. The next morning, we went to check on her before we left, and she was sitting up brushing her teeth.”
Despite language and cultural barriers, the team communicated with Haitians “through smiles and laughter,” as Dr. Herzenberg’s daughter, Brittany, put it to Dr. Zuckerberg.
Team members were particularly impressed by the Haitians support for each other. They said nearly every patient had at least one family member with them at all times, and if a patient did not have any relatives, a stranger would step in to help.
In addition, the team members said they were impressed by the Haitians’ commitment to their faith system and respect for other religions.
“The Haitian nurses and doctors pray before every operation and have a prayer service every morning,” said Dr. Zuckerberg, who was one of the shomer Shabbatteam members. “They tried incorporating Judaism into common practices, making it very workable. There was an understanding that life-saving operations fell under the umbrella of work allowed on the Sabbath.”
At the end of the trip, all of the team members were in tears. “We were all very touched by this,” said Dr. Zuckerberg. “We were all crying when we left. We all want to go back. The question isn’t if, it’s when.”
Check out the team’s blog at teamsinaihaiti.blogspot.com/.
Photo captions:
Sinai Hospital’s Dr. John E. Herzenberg chats with a Haitian patient.

Team Sinai’s Haitian-born Dr. Job Timeny gives a patient Mia, 8, a big squeeze.

The team’s John D. Logue examines an earthquake victim.

(photos provided)

Getting to Haiti




Reading through the blogs of first responders to the January 12, 2010 earthquake, travel to Haiti at the time was difficult, as all commercial flights were cancelled in the initial emergency phase. Those intrepid volunteers who ventured to Haiti in the early weeks hopped aboard military transports, freight planes ferrying relief supplies, or flew commercial to the Dominican Republic, and took a long overland route on four wheel drive vehicles from Santo Domingo, DR to Port-au-Prince (PAP), Haiti. For my first trip to Haiti in late January, I went the latter route. At the time, the border between Haiti and the DR was free flowing so we went through without so much as a glance from border officials.   However, the mass exodus of Haitians created a bottleneck at the border gate, as throngs of aid workers tried passing them on the narrow dirt roads.

Commercial flights from Miami to PAP resumed in March, so now the American Airlines flight is a mere 90-minutes from Miami to Port au Prince (PAP). For our recent Team Sinai mission, we flew American Airlines from Baltimore to San Juan, Puerto Rico, and then caught a small American Airlines commuter jet from San Juan to PAP. There is one inviolate rule that I have learned over the past 10+ years of mission work, namely, “something always goes wrong”. For us, it began early, at 5am in Baltimore. We had arranged for our entire (n=18) team to meet at BWI airport at 6am, a full two hours before our departure.  As team leaders, John and I decided we ought to arrive 15 minutes early, to set a good example, and scout out the landscape before the rest of the team arrived. We had spent most of the night before doing our final packing, weighing and re-weighing each bag to make sure that we were exactly at 50 lb. maximum allowed per checked bag, using extra packages of “Plumpy Nut” as ballast to bring us up to exactly 50 lbs on those bags that were a tad under. Our family (John, Brittany, our nephew David, and myself) woke at 4:30am, washed, dressed and waited for our 5am pick up. I had arranged for a car service to take us to BWI, as that would be less expensive than parking our car for 8 days at BWI. I even managed to find a budget car service that would take our luggage and us to BWI for $100. (The first company wanted $150).  A 5am pick up would give us plenty of time to make it to BWI before the required 6am meeting time.  After waiting 20 minutes, we began to become suspicious that something was wrong. I called the car service, and they initially pretended to not know who I was, and then claimed that the pick up was scheduled for 5pm not 5am. We immediately went into crisis mode, putting together Plan B, despite the reassurances from the car service that they could send someone out right away, to arrive at our house by 6:15am. OK, we’d be late for the meeting time with our group, but still in time to make the 8:00am flight to San Juan. Not willing to bank on that, we woke up our daughter Danielle, just home from graduate school, and prepared two vehicles (we couldn’t possibly all fit into one vehicle with our luggage). We would have to leave one at the airport, but that was the least of our concerns. We piled the 8 large duffels, and 4 carry-on bags outside our house, and began to wait once again for the car service. We decided on a drop-dead deadline of 6:30. If the car service did not show, we would leave without them. Danielle wasn’t happy about being woken at 6am, but she put on her best game face and waited on the ready with us. At 6:20am, we called the car service again, and they confirmed that they were on the way, and only about 15 minutes away. On a whim, I asked them what kind of vehicle they were bringing, as we had originally agreed on a van. The answer came back, “Lincoln Town Car”.  Knowing that there was no way we could fit four of us and all of our bags into a Town Car, I said, “Thanks, but no thanks” and vowed never to use that car service again…

Next came the frantic piling of suitcases and bodies into Danielle’s Ford Escape, and my Acura MDX, and we were off the runway (well, actually the driveway) by 6:30am. John called ahead to our anesthesiologist and chief medical officer, Aaron Zuckerberg, to let the rest of the group, by now fully assembled at BWI, minus their team leaders, to explain why we were running late. Aaron, always cool, calm, and collected, was in full relaxed mode. After all, he deals with disasters and emergencies every day as Director of the Sinai Pediatric Intensive Care Unit.  He answered John’s frantic call not with the usual “Hello…” but rather in the calmest voice imaginable, “The patient is asleep, prepped and draped, ready for you..” John had to laugh, and went into the lengthy explanation as to what was happening on our end of Baltimore. What a great way to start a mission. We were sweaty and breathless and in crisis mode, yet we had barely left our driveway….

More excitement awaited us at BWI. One of the team members had forgotten her passport, and her husband was racing back home to pick it up (left on the photocopy machine while making the recommended copy of her passport to keep in a safe place in case the original was lost). We checked the rest of the team in, and only had to pay for a few overweight bags. (The trick of placing your toe under the edge of the bag while it was being weighed hadn’t been adequately disseminated to all the team members…) Some scrupulous pre-trip planning had averted a minor disaster. Aaron had packed his sensitive and delicate anesthesia monitors and glass vials of medicines into hard sided packing cases. Merrill spoke to AA a few days before we left about extra bag fees in case we wanted to bring more than the two bag, 100 lb limit per person. She was informed of a baggage “embargo” to the Caribbean so NO extra bags (even if you’re willing to pay) were allowed, and NO packing crates or cases either, only soft-sided luggage or duffels, thank you very much. That bit of information came in handy, as it allowed Aaron a few days respite to re-pack all of his anesthesia team gear into some quickly acquired duffle bags.  As an aside, a colleague from Pennsylvania who traveled last week to volunteer for the Adventist Hospital, was not aware of the embargo. He was not allowed to board last week on AA out of Philly because his two checked bags were plastic hard sided packing cases. He had to rebook for the following day, and repack everything into duffels. We had a similar experience years ago on a mission to Nicaragua, though we managed to run to an airport luggage store and purchase (at exorbitant prices) from Wilson’s Luggage some soft sides suitcases, and transferred everything on the floor from our cases into the newly acquired bags, while being stared at by everyone else in line at check-in.  Having experienced this, we were vaguely aware of the potential for a clerk at check-in to turn you down for the unmentionable sin of packing your gear into hard sided cases, even if they do fit the 62” linear size limit and the 50 lb weight limit. Go figure. It’s an “embargo”. (I thought an “embargo” was what we are doing  to Iran for not allowing nuclear inspectors…)

John waited behind with our passport-less member (name deleted to protect the not so innocent), and the two of them caught up once hubby screeched to a halt in front of the AA terminal with the priceless passport. One last hurdle, no-passport team member also had a rough time going through security screening due to an excess amount (according to TSA) of little Jello cups in her carry-on bag. Apparently, liquids must be not only 3 oz or less, but also the total volume of liquids must fit into a one quart plastic baggie. I’m not sure how anyone would hijack a plane with a few cups of Jello, but it’s generally not a good idea to argue with a TSA inspector, so we said goodbye to six individual serving cups of Jello.

We all made it to the 8am flight to San Juan, and picked up two out of town team members who had flown from Dulles and Montreal.  After a 45-minute layover, we trundled into a small commuter jet bound for PAP. One more roadblock….one of the ground crew members packing our luggage into the fuselage smelled something suspicious coming from one of our team bags. Apparently, a plastic bottle top from a large Purell dispenser broke, and the entire 16 ounces of Purell spilled into the duffel bag.  After a standoff of 45 minutes, with detailed negotiations between the captain, ground crew, Aaron, and the tower chief, AA agreed to let us empty the contents of the offending duffle bag into a plastic garbage bag. The duffle, sadly, was not allowed to travel, and is now enjoying a new, and very sterile life in San Juan.  At least we made it off, with all of our 36 duffels, headed towards PAP. The commuter jet was only half full, and the flight attendants carefully balanced the plane by asking some of us to move from one side to the other so we could presumably fly straight. I couldn’t help but notice that the passengers were either wearing blue Ekip Sinai Lespwa pou Haiti shirts (us) or they were Haitian nationals. I guess Haiti is not much of a tourist destination these days.

To summarize, we had more than our share of misadventures on the first day, and we hadn’t even arrived in PAP. More about our arrival in another posting…