Thursday, February 11, 2010

What He Saw

A Spokane surgeon gives a firsthand account of the disaster in Haiti

Blair Tellers

Six days after a 7.0-magnitude earthquake ravaged Haiti, Dr. Mathew Rawlins sat in the middle of a Port-au-Prince intersection, scanning his surroundings. Casualties, everywhere. “Coming out of the woodwork,” he recalls. “That’s what was impressive — you didn’t have to look for people that were injured. They were just all over.”

A general surgeon for Rockwood Clinic and trauma specialist for Sacred Heart Medical Center, Rawlins belonged to a group of physician volunteers associated with the Church of Jesus Christ of Latter-day Saints.

The team had recently arrived and was procuring accommodations when the car they were following temporarily vanished from view.

Not wasting stalled time, a family-practice doctor hopped out of the vehicle to suture a man’s scalp closed. On his heels was an orthopedist, who spotted a victim with a dislocated shoulder.

“The easy part is leaving work and your family for a week and showing up,” says Rawlins. “The hard part is figuring out how to help once you’re there, because there’s no infrastructure.”

The group set up a clinic close to a partially damaged hospital. What chaos did ensue, says Rawlins, had not so much to do with a lack of manpower as it did a lack of resources.

Hospital walls had gaping holes; sterile supplies ran dangerously short, and there was little anesthetic.

Rawlins was forced to use the same gown for at least five patients. A number of amputees had developed dangerous infections and were severely ill or delirious as a result.

“Most of these injuries were the kinds of things where, if we had been there immediately, it would have been treatable,” says Rawlins. “But due to neglect, and no care available, we were doing amputations — and it was just horrendous.”

Having to downgrade and inflict what he considered sub-par care due to primitive working conditions was nightmarish. But a glance at the courtyard outside, filled with dying people, reminded them all: The group was doing the best they could with what they had.

Doubly impressive was the prevalent sense of stoic altruism that Rawlins encountered among the victims. While wounded and traumatized, a number referred to their injuries as minor.

Rawlins cites the team’s interpreter, who waited until the end of the day to politely ask if a doctor could examine his cut.

The “cut,” as it turned out, was a considerable scalp laceration — five inches across — casually concealed under a bandana.

“He had been like that all day,” marveled Rawlins. “And at the end of the day, just goes, ‘Oh, and by the way, could you look at this?’ To us, something like that would have been a huge deal.”

The biggest obstacle was infrastructure, or lack thereof. The real heroes, says Rawlins, were the ones already working in Haiti trying to establish it.

He mentions Paul Farmer, a medical philanthropist and infectious disease doctor from Harvard — residing in Haiti since 1984.

“This guy could be living a really comfortable life, but he’s been down there for 25 years just because he saw a need,” says Rawlins. “We need to be bigger and more grand in our scale of how we can help. Going down for a week is huge, but it’s nothing like what other people are doing. They’ve been down there for the long haul, setting up something sustainable.”

While explicit, Rawlins’ account is one of acute insight and nuanced perspective. He outlines a dichotomy between what was broadcast to the world and the panorama of what he personally witnessed.

“When you see it on places like CNN, it looks like hell,” he says. “People are in pain and there’s destruction all over. But when you get there, and you see people survive it, you enter that survival mode with them and become buoyed up by their resilience.”

As far as the eye could see, neighborhoods and buildings lay in a goliath maze of rubble, with victims pinned beneath.

Put Americans in this situation, Rawlins asserts, and it would be 1,000 times worse.

“These people know how to survive,” he says. “They’ve been doing it forever. They’re incredibly resilient, where most of us would just buckle into a fetal position.”

Graphic moments relived, it’s a moment caught on film that continuously strikes sharpest. It was taken in the poorest part of Port-au-Prince, where people and their chickens were living on top of trash piles.

Running across the lot was a young boy who, according to Rawlins, flashed a massive grin at the camera, looking like the happiest thing on earth.

“He embodies what I saw in Haiti,” says Rawlins. “If you look at the background, you see inconceivable poverty and horrendous conditions. Yet these people eke out a life. They laugh and smile and enjoy parts of life — even a week after an earthquake. It was horrendous, yet amazing.”

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