Local Response to Devastating Earthquake in Haiti

Shortly after the massive earthquake of 2010 in Haiti, I wrote a story about Eric Siedenburg, an ER doctor from Laguna Beach who went there in the immediate days afterward to provide medical care. He had done medical aid missions in Papua New Guinea, Africa, Nepal and after Hurricane Katrina, but said nothing came close to what he saw in Haiti.

“They figure 150-200K dead,” he said. (The final number was 230,000). “Then an immense number of people with missing limbs, or dead limbs that are useless, in a country that already had horrible infrastructure, and horrible poverty. It’s not just the insanity of what’s going on right now but what’s going to happen in the future.”

 

As we sat at his house in Laguna Beach, talking, I was gripped by his story. I had just finished my EMT certification and the more I listened to him, the more I wanted to act. He mentioned his team was organizing a trip to go back. I went on that trip.

 

Below are images I shot on the trip, a few articles I wrote for the local newspaper, and my journal from the trip.

Local Doc Helps In Haiti

Laguna Beach Independent, February 5, 2010

By Ted Reckas

 

Emergency physician and Laguna resident Eric Siedenburg stood in a sea of people and tents outside of a makeshift hospital in Jimani, Dominican Republic. Hundreds of Haitian earthquake victims had been inside moments ago, but with the 6.1 aftershock, all the beds were suddenly empty. Two people jumped from the second floor, one of them becoming partially paralyzed. A small tent city emerged outside the half-built orphanage turned field clinic. No one would go back in.

“These people were so traumatized,” said Siedenburg, “We couldn’t really understand it, but what they had seen was so horrific, they couldn’t even think about going back into a building.”

 

He continued, “You would hear this screaming going on. They were doing everything just with Motrin. That was the first thing we did when we got down there – we said, stop. We had a little red fanny pack, with all the (pain management) drugs in there, we had needles and we’d get everything ready and hit them (with the pain killers), do the dressing change, they’d wake up and we’d move to the next patient…I was doing it on my knee, in the dirt, injecting it into people, and changing the wounds out in this tent city that developed.”

Jimani, the closest Dominican border town to Port-au-Prince, was hit by streams of Haitians leaving their shattered capital, by truck, helicopter, or on foot. In response to the influx, the Dominican government pulled the border back, according to Siedenburg, leaving the outpost as a neutral zone between its home country and its crippled neighbor to the west. Good Samaritan Hospital, a makeshift facility occasionally visited by traveling doctors that sits in the small town about 30 miles from the Haitian capital had become crowded with refugees, many with horrible injuries, and the hospital was at capacity, with little staff or supplies. Teams of medical workers began arriving one by one. Siedenburg’s was one of them.

 

A physician at Saddelback Hospital, Siedenburg, was part of a self-organized, self-funded team of doctors and ICU nurses. The experience, while harrowing, was not Siedenburg’s first; he traveled the world on a fellowship after medical school, providing emergency care in impoverished places like Papua New Guinea, Peru, China, Nepal, and Africa. The team leader, Jim Keany is an emergency physician at Mission Hospital, Medical Director for JetWest International Air Ambulance and medical analyst on the Bill Handel Radio Show. They had supplies and equipment donated by Mission and Saddleback Hospitals, and drugs from a local pharmacy, but the destruction was almost overwhelming.

 “I went and worked after Hurricane Katrina. I thought that was rough,” Siedenburg said, “That was nothing compared to what we were doing here and seeing here. It was just insane what those people are going through.”

One evening a pickup truck pulled up with three patients. Two of them had level three LaForte fractures: all of their facial bones had been broken and separated from their skulls. Siedenburg was shocked, not out of lack of experience – he’s been at it 14 years – but due to the rarity of the injury.

“The amount of force necessary to cause that normally kills you,” he explained, “You could go a whole life in the US and never see that. Here were two in the back of the same truck.”

One of Siedenburg’s colleagues had to remove one of the patient’s eyes to keep the infection from spreading to the rest of her head. Since he had never done the procedure he got on the phone with an ophthalmologist from Saddleback who talked him through it. All in an hour’s work in Jimani.

Siedenburg describes his first day there: “I stayed until about two a.m. because I was working there the next morning at seven and wanted to know what went on there. When I showed up the next morning they said, ‘You’re the lead ER doctor now.’”

Siedenburg spent the day getting the place organized: numbering the beds, identifying where patients were, making an order sheet detailing what was needed, and tracking when medications had been given.

 

“By six p.m. we felt like we had done an amazing thing that day,” he said, “we started to solidify it, and then there was another earthquake.”

Luckily Jimani was far enough from the epicenter that its infrastructure had survived; they had electricity via generator, a water supply refilled daily by trucks, and cell phone reception.

“My wife was able to text me pictures of the kids, which was a huge help. One morning my daughter McKenna called and said, “Daddy! How are you doing! Are you helping people? And that was a huge help, sanity wise,” said Siedenberg.

Eventually, security went downhill, however. A team of Harvard doctors who had gotten there earlier established a command structure and after working for several days, left, thinking order was in place. “Then it slowly started to fall apart,” Siedenburg explains, “One of the guards shot his M16 at a squirrel in the middle of the facility grounds. So they said, ‘You’re out of there.’ They were fired. Slowly there were more and more people in the grounds and we hadn’t gotten many more patients, so we said, ‘Who are all these people?’ Turned out they were just looking around for food to steal. Our interpreters said they heard people saying they were going to come back tonight and steal stuff.”

Siendeburg happened to be leaving the next day. His first few days at home have been spent calling and emailing, gathering a team and resources to go back this week, but at the last second, it was called off. The security situation in Jimani had deteriorated, and back up locations were difficult to get to. Border crossings and support at the new site, a refugee camp and medical center in Fond Parisien, Haiti, run by International Medical Corps, could not be guaranteed. The time for freelancing missions like Siedenburg’s had passed – the big orgs were in command now.

 

“They figure 150 to 200 thousand dead,” he said, “Then an immense number of people with missing limbs, or dead limbs, that are useless, in a country that already had horrible infrastructure, and horrible poverty. It’s not just the insanity of what’s going on right now but what’s going to happen in the future. Its horrific what’s going on in that country.”

The recovery in Haiti has transitioned from initial response to longer-term treatment. Now, said Siedenburg, “I want some physical therapists. Now we need to start teaching these people with no legs how to walk with crutches. And how to walk on them with one arm. And all these things for the next step. This is going to be months and years.”

Haiti is Calling

Laguna Beach Independent, March 12, 2010

By Ted Reckas

 

I was in the peds tent. 20 kids all surrounded by their families were waiting for a dressing change, a popsicle, attention of some kind. One boy would wheel his chair up to me, saying. “doctor!” pointing at his knee wrapped in thick bandages and stare at me unflinchingly.

 

A boy of seven, with one arm amputated at the shoulder, was playing soccer amid the pediatric ward – a collection of beds in an unfinished bare concrete chapel with a roof and sidewalls, but only tattered tarps at the front and back, that billowed in the strong gusts.

 

I started taking pictures, kicking the ball back to him when it came my direction. He was impressed by my ability to juggle the ball and began kicking it to me more and more. There were other things going on all around me; patients needed attention. I felt pulled from the implicit bond I had made with the kick of the ball – we were play pals now, and he needed to hold onto friends fiercely – but by my duty to provide medical aid, and my duty as a journalist to document the incredible stories all around me were pulling on me.

 

Every time I made a motion to go, the boy kicked the ball to me and waited, expectantly, or jumped higher as he juggled the ball in a more impossible way, always seeking my attention. I was the only one helping the nurse on duty and she needed me. I motioned again. But the boy kept kicking the ball to me.  It rolled outside the tarp that formed the back wall. I followed it. I needed the fresh air anyway. As I went outside a tiny boy of about three had run to the ball and grabbed, looking up at me like his treasure was about to be ripped away. These kids have no cell phones, no gadgets or toys. There was no change of clothes in the closet back home. There was no closet. His family lived in a one-room dwelling. Alain was his name. He didn’t even have shoes. A ball was a wonderful thing to him, the type of thing that only comes along a few times a year maybe. His five-year-old sister was a few steps behind. They looked at me as though I held the key to their happiness in my hands.

 

By now the kids inside the tent were singing songs with the pastor. It was a raucous and fun kind of singing. I invited them into the chapel.

 

The rest of the kids were fully engrossed, singing at the top of their lungs and clapping. I sat on a bed nearby and put Aileen in an empty chair. She furtively looked around as the other kids sang their heads off, waving bandaged arms and clapping swollen hands.

After the songs, the pastor pulled out a box of popsicles and was swarmed with kids. Aileen was pushed to the back. For her, getting a popsicle would be a thing to write home about. As the pastor made his way toward me, I grabbed Aileen’s arm and pulled her in front of the pastor.

“Would you like one?” he asked me.

“No thanks,” I said, “but can she have one?”

Aileen looked up excitedly.

“I can’t afford everyone,” he said, looking annoyed, “Only patients of the hospital.”

 

The others slurped contentedly at their popsicles dripping down scarred and bandaged arms. Aileen disappeared to the back of the chapel. I felt terrible. It had never occurred to me she had no physical injuries. She was actually a local kid, from the Dominican Republic. She had snuck into the camp somehow, and knew she wasn’t welcome, but hung around in a torn state, desperate for food, water, attention. She fell into that same category of constantly struggling poor people that are not bad enough off to get aid but still need it.

 

I went back to helping Patrice, the nurse in charge. A kid needed his IV removed. It gave me a slight lift. Not only was it a new experience, however simple – you just pull it out and put pressure on the skin around it – but it was a small step toward normalcy for one kid; he no longer had an IV in his arm.

 

I stood near the altar of the chapel, now piled high with medical supplies and hand-written charts. It was a ragtag bunch, to say the least, but they were getting along. They had settled in here enough to have something approaching normalcy. There was a strong poke at my lower back, made by hands that had not yet learned to be gentle. Two boys of about five years stood at the back of the chapel, where the tarp flapped open and revealed the yard beyond. “Thirsty,” they said in thick Spanish accents.

 

Like Aileen, they were Dominican locals who were not earthquake survivors but were still desperate for the basics. No one would give them water. I found a bottle and gave it to them.

Fundraiser Returns a Nurse to Haiti

Laguna Beach Independent, September 3, 2010

By Ted Reckas

 

Nurse Erika Tillman, a daughter of Laguna Beach residents Michael and Marcy Tillman, spent three months providing medical care at the General Hospital in Port-au-Prince, Haiti.

 

Despite working long days in pressured conditions with inadequate equipment and putting herself at personal risk, she is raising money to go back.

 

“The thunder was deafening and the streets were flooding as we drove to ‘The General,’” Tillman wrote in an email, describing a harrowing night, which came in a string of three 20-hour workdays.

 

Working by headlamp all night, Tillman recalled performing triage. “I block people at the door, assess if they need emergency treatment or can be sent to the clinic in the morning. Power is still out and there are 30 people waiting in triage with five of them on the ground not looking so good. One is a new-onset stroke. Incredibly, the only thing we can do is give aspirin and send them to the clinics where they are starting to have rehab services,” she said.

 

During one night of drenching rain, she recalled treating a gravely ill elderly woman, a man with a gunshot wound, a victim of a car accident and a child with a bloody pillowcase swaddling his head, injured by a wall that collapsed.

 

Tillman also helped two women deliver babies in the space of five minutes because there were “10 extremely pregnant women,” the OB/GYN staff was on strike, and the doctor had gone to the bathroom.

 

She, too, became a victim when someone stole her belongings, forcing a trip to the U.S. embassy for a new passport.

 

Tillman’s parents are holding a fundraiser at their Laguna Beach home, 570 Cress Street, Saturday, Sept. 12, from 2-5 p.m. for Materials Management Relief Corps, the organization she worked for in Haiti.

 

Tillman’s $15,000 goal would enable the organization to continue operating through  Nov., 30, the end of the hurricane season. She has received $2,000 in pledges via email and another $1,000 when she and her younger brother Connor held an impromptu fundraiser in Chicago, where they live.

Area Locals Push the Edge of Rescue Work

By Ted Reckas

 

Jeff Miller, a former Army special forces member from Newport Beach, was working for Phoenix, AZ mining company Freeport-MacMoran, when they sent him to Haiti with a team using new technology developed by the mining industry to find signs of human life under large amounts of rubble.

 

“It’s very exciting when you are sweeping the rubble and you find a heart beat. It’s very exciting. When they found the 60 year old woman, she was actually singing hymns. Getting her out was probably the highlight of the entire trip. I’m pretty sure it was on CNN. Anderson Cooper was there when it happened,” said Miller, referring to Anna Zizi, a 69 year old Haitian woman his team helped find in the rectory building near the central cathedral in Port-au-Prince, seven days after the earthquake.

 

Ms. Zizi was quoted on the NY Times blog as saying she spoke with a vicar under the rubble at first, but he went silent after a few days, at which point she said, “I talked only to my boss, God. I didn’t need any more humans.”

 

Also found by Miller’s device was Charles Benoit, the vicar general of the archdiocese of Port-au-Prince, whom Miller said still had life signs when they began trying to rescue him.

 

“We broke through to (Benoit) after several hours of digging and they estimated he had been dead for 30 minutes after we found him. The Mexican team was very upset,” he said, referring to one of several international search and rescue teams helping.

 

Craig Lockwood, a Laguna resident, author and former war correspondent who has traveled extensively with Miller said, “Jeff is highly, highly trained. He is a man of infinite resources under desperate situations. This is the guy who can get people out of tight places, including rubble and earthquake-destroyed buildings. They literally put together the expedition overnight, buying stuff out of REI and getting a Lear jet from Miami from Port-au-Prince. It was an incredible adventure, and his ability to get people out of tough situations – I can’t tell you how many kidnap retrievals he’s done. And many with no weapons drawn.”

 

Lockwood added, “Jeff is involved with a company that has developed a technology that allows detection of the electromagnetic field around a human heart. Specifically human. It is undeterred through miles of junk, debris, darkness, or whatever.”

 

In addition to Ms. Zizi, Miller’s team also helped locate eight buried victims, although not all were successfully excavated. Nick Brokhausen, a security consultant and leader of Miller’s team, said their devices found two signs of life at the cathedral, but it took over eight hours for heavy equipment teams to unearth them. When they reached the victims – a young woman and a man in his 40’s according to Brokhausen – they had died so recently they were still warm.

 

After removing some rubble, search and rescue dogs confirmed that live humans were there. So the teams – from Iceland, South Africa, Germany, Mexico, hungary, the UK, Puerto Rico and Poland – then continued to remove debris until they found the victims.

“The Poles had 80-90 guys with power saws, pneumatic drills, generators and lights and everything. They get through it quick,” said Brokhausen.

 

Miller’s team also found a few surprises. After sweeping a convent with their devices and finding signs of life, they directed a team to dig immediately, but what they found were some kids, deep inside the rubble, looting.

 

Miller said, “We turned them over to the Uruguayan Army and I think they just chased them away.”

 

“The population seemed almost shell-shocked,” said Miller, whose team camped alongside the runway at the Port-au-Prince international airport with approximately 1800 search and rescue personnel from all over the world, most of whom never left the airport for lack of transportation into the city, according to Miller. He said security was not an issue while he was in Haiti, “People were just standing and staring, or walking around town. I didn’t see any aggression, they just seemed to be almost comatose. Outside the base there were several hundred people who just stood there. It was really strange.”

 

Miller slammed the UN for its handling of the crisis, and his team’s difficulty in getting to and from work sites, saying the loss of 300 UN staff members in Haiti, who were still missing or dead at the time was no excuse for the lack of leadership. “I talked to a lot of people who all said the same thing: nobody knows who is in charge. The overall management of everything down there was horrendous – I would almost say criminally negligent. It took us two and a half days of haggling to get a landing time. And of course our technology would have been most useful in the earliest days. I think Hurricane Katrina ran like a Rolex watch compared to Haiti,” said Miller.

 

Despite the fact that Katrina was a much smaller, less complicated disaster, Brokhausen reiterated this sentiment, saying, “The UN kept saying we’ll be there in half an hour. All the team leaders finally got together and rented dump trucks and tap taps (local taxis) and went on our own. The 82nd Airborne came screaming after us and said they got clearance to join us,” adding, “When we showed up we immediately got a life sign, and once we established an area, we got four more, just like that. (The devices) saved a handful of people. They did what they were supposed to do. They should have saved hundreds if the UN had their act together.”

 

The State Department confirmed 75 U.S. private citizens and four U.S. government officials are dead in Haiti, and the U.S. Embassy has been asked to help account for 3,000 Americans there, according to a State Department report.