In Haiti, healing under hardship

A doctor learns how to help, and cope, from a relief veteran

Click here to see a photo gallery from the Haiti relief mission.

David Gulliver - posted 12:01 a.m. Monday, Feb. 8

It was after dark on Tuesday, Jan. 19, and the four Sarasota doctors -- surgeons Joe Pecoraro and David Sugar, and anesthesiologists Trey Bernard and Tom Nutter -- had been traveling for seven hours, crammed in a van with sacks of medical supplies.

Finally they approached the outskirts of Port-au-Prince, Haiti. Sometimes they maneuvered around shattered roads, with one section jutting two feet above the other. It was seven days since the earthquake had struck.

The city was dark, and the quiet was foreboding. Although Pecoraro, a co-founder of local medical mission group Hearts Afire, had been on 20 such trips, even he felt unsettled. “We felt a bit like Delta Force commandos, not knowing what to expect,” he said.

For Sugar, though, it was his first such trip, and he was overwhelmed.

“Awe is the biggest thing you feel," he said. "You're driving through the Dominican Republic, and you say, ‘Oh my gosh, the people here, look how they live.’ And then you come into Haiti, and it's like the people in the Dominican Republic live in Lakewood Ranch.

“And then we got to the area ravaged by the earthquake, and there just aren't any words for it. There are streets you look down and every building is a pile of rubble. It's not even recognizable as a building anymore.”

But what he saw over the next few days left him with an entirely different sense of awe.

---
Sugar has been an orthopedic surgeon since 1993, though with his laid-back manner and shaggy brown hair he seems not far removed from medical school. He had given little thought to a charity medical mission until he got a mass-mail email on Friday, Jan. 15.

Dr. Vilma Vega, another co-founder of Hearts Afire, contacted the medical staff of Sarasota Memorial Hospital, seeking supplies and volunteers, particularly orthopedic surgeons and anesthesiologists. He called Vega and said he was interested.

At 6:15 a.m. Monday, Jan. 18, she called, said the group was ready to send a scouting mission, and hoped he was still willing to go, though she couldn’t guarantee his safety. Sugar dashed to his office and grabbed casts, splints, bandages, dressings, betadine and peroxide. “I literally took every medical supply I had in my office, three large duffel bags,” he said.

The team took a commercial flight from Tampa to Santo Domingo, the capital of the Dominican Republic, which shares the island with the nation of Haiti.

Hearts Afire has been working in the Dominican Republic for many years -- the group had already planned a mission there in March. So, unlike many aid organizations, it had a network of support there - this time, mission outfitter Paul Emery and Dominican missionaries Francisco and Diane Sabado of Corazon del Siervo.

The team met with its contacts late on the 18th and had planned to start that night, but found its van would not run. Their contacts secured another van the next morning and they set out.

At the border, other contacts with Christian relief organization World Vision International helped them cross into Haiti. And by that night, they reached the grounds of Quisqueya, a Christian school whose largely intact buildings were serving as a command center for many faith-based relief groups.

At 6 a.m. Wednesday, they were welcomed with the quake’s biggest aftershock to date. The 5.9 magnitude tremor moved the solid school building under their feet.

They soon set off for the city of Petit Goave. Via its contacts and a separate trip a few days earlier, Hearts Afire had already identified the 150,000 people in its area as being in desperate need of help.

The 30-mile trip took two and half hours, and what they found in the little-known city equalled or surpassed the devastation in Port-au-Prince that television crews were beaming to the world.

---
“Walking through the streets, on some of them, about 100 percent of the buildings had crumbled,” Pecoraro said. “Walking past some buildings, you could smell the decomposition.” When officials reach these outlying towns, the death toll will surely climb higher than the current 200,000 estimate, he said.

They met up with another friend, missionary Ed Lockett, and joined a small medical team performing some procedures on the mission grounds.

Meanwhile, they tracked down a city official to ask if they could work in the local hospital. The official said they would have to find someone to certify it was safe, so they then tracked down a Swiss engineer to assess the damage. Of the five small buildings, he approved just one -- which happened to have two operating rooms.

They soon found that conditions were far less than optimal. There were no boom lights, so they relied mostly on light through the windows. More problematic was that the anesthesia machine didn’t work.

But as word spread of the doctors’ presence, patients began streaming in. And so the doctors improvised. They scrubbed in with Purell hand sanitizer. They sterilized instruments in betadine and iodine. They used ketamine for anesthesia and cleaned wounds, some of them maggot-infested, with a three-step process of bleach, betadine and peroxide.

By Thursday, Sugar said, their system was humming. Outside on the sidewalk, a pair of Cuban doctors -- one a veteran, one just out of medical school -- did triage. Under a tarp and in a hallway, Drs. Nutter and Bernard administered ketamine, dilaudid and morphine. And inside, the surgeons got to work.

Pecoraro recalls 25 procedures. He repaired a hernia for a man who has come in from another city. He amputated a man’s foot, where the ankle had been crushed beyond repair. A vascular and general surgeon for 25 years, it was far from his first, but unlike any other. “I never did an amputation with such a lack of equipment,” he said.

Sugar remembers 18 procedures. He set the leg of a woman who walked in, from miles away, with a broken femur. He placed casts and splints. He amputated fingers and legs. But one of his first cases moved him more than the rest.

A man and woman brought in their 15-month-old boy, who had suffered a hip fracture. Sugar put him in a body cast, then moved on to other patients.

Two days later, Friday, Jan. 23, they had to begin working their way back to Santo Domingo. They drove slowly through Petit Goave, Sugar said, scanning the devastation one more time.

“And we look over and on top of a pile of rubble of what was probably their living room, were the father and the mother, and they were holding the baby, and they’re just smiling.”

Later that night, Pecoraro debriefed the other doctors, trying to help them adjust to what they had just experienced.

He told them they would get home and not be able to get this out of their heads, Sugar recalled. He said that they would want to do more, to come back, do more surgeries, stay there, adopt orphaned children. And he told them they can’t save the entire world, and have to be satisfied that they did what they did.

Then Pecoraro reminded Sugar of that 15-month-old baby in the body cast, both doctors recalled.

“That little child is not going to be crippled,” Pecoraro told him. “And maybe that child, or one of his great-grandchildren, is going to go on to do something great. If you just touch one life, you've done something.”

Then Pecoraro continued. “That family will tell stories of the help they received that day, and that child will tell it, too. Someday, though, the story will be forgotten and told no more. But it won’t be forgotten by God, and that is what counts.”

In an interview two days after his return, Sugar was as obsessed as Pecoraro had predicted. He had wanted to stay, but needed to return for his patients’ planned surgeries. He had an annual fishing trip with old friends coming up, but was ready to cancel it.

“I know this sounds like an overstatement, but I'm changed,” he said. “I don't see the world the same way anymore. It's not enough to sit here in Sarasota. You've got to get your hands dirty. I really feel like we have an obligation. These are our fellow human beings.”

----
Editor’s note:
On Saturday, Feb. 6, another team from Hearts Afire traveled to Haiti. Dr. Sugar returned, with Hearts Afire co-founder Dr. Vega and nine others. They planned to return to Petit Goave and push on to Jacmel, a city until recently accessible only by helicopter.

Hearts Afire is locally operated and has minimal overhead, according to IRS records. It pledges to put 100 percent of all donations to its “Haiti Relief Project 2010” to use in that country. For information on how to help, including a list of supplies needed, go to the group's website, at this link.

Disclosure: The website designer for Sarasota Health News is on the board of directors of Hearts Afire.





	In Haiti, healing under hardship A doctor learns how to help, and cope, from a relief veteran Click here to see a photo gallery from the Haiti relief mission. David Gulliver - posted 12:01 a.m. Monday, Feb. 8 It was after dark on Tuesday, Jan. 19, and the four Sarasota doctors -- surgeons Joe Pecoraro and David Sugar, and anesthesiologists Trey Bernard and Tom Nutter -- had been traveling for seven hours, crammed in a van with sacks of medical supplies. Finally they approached the outskirts of Port-au-Prince, Haiti. Sometimes they maneuvered around shattered roads, with one section jutting two feet above the other. It was seven days since the earthquake had struck. The city was dark, and the quiet was foreboding. Although Pecoraro, a co-founder of local medical mission group Hearts Afire, had been on 20 such trips, even he felt unsettled. “We felt a bit like Delta Force commandos, not knowing what to expect,” he said. For Sugar, though, it was his first such trip, and he was overwhelmed. “Awe is the biggest thing you feel," he said. "You're driving through the Dominican Republic, and you say, ‘Oh my gosh, the people here, look how they live.’ And then you come into Haiti, and it's like the people in the Dominican Republic live in Lakewood Ranch. “And then we got to the area ravaged by the earthquake, and there just aren't any words for it. There are streets you look down and every building is a pile of rubble. It's not even recognizable as a building anymore.” But what he saw over the next few days left him with an entirely different sense of awe. --- Sugar has been an orthopedic surgeon since 1993, though with his laid-back manner and shaggy brown hair he seems not far removed from medical school. He had given little thought to a charity medical mission until he got a mass-mail email on Friday, Jan. 15. Dr. Vilma Vega, another co-founder of Hearts Afire, contacted the medical staff of Sarasota Memorial Hospital, seeking supplies and volunteers, particularly orthopedic surgeons and anesthesiologists. He called Vega and said he was interested. At 6:15 a.m. Monday, Jan. 18, she called, said the group was ready to send a scouting mission, and hoped he was still willing to go, though she couldn’t guarantee his safety. Sugar dashed to his office and grabbed casts, splints, bandages, dressings, betadine and peroxide. “I literally took every medical supply I had in my office, three large duffel bags,” he said. The team took a commercial flight from Tampa to Santo Domingo, the capital of the Dominican Republic, which shares the island with the nation of Haiti. Hearts Afire has been working in the Dominican Republic for many years -- the group had already planned a mission there in March. So, unlike many aid organizations, it had a network of support there - this time, mission outfitter Paul Emery and Dominican missionaries Francisco and Diane Sabado of Corazon del Siervo. The team met with its contacts late on the 18th and had planned to start that night, but found its van would not run. Their contacts secured another van the next morning and they set out. At the border, other contacts with Christian relief organization World Vision International helped them cross into Haiti. And by that night, they reached the grounds of Quisqueya, a Christian school whose largely intact buildings were serving as a command center for many faith-based relief groups. At 6 a.m. Wednesday, they were welcomed with the quake’s biggest aftershock to date. The 5.9 magnitude tremor moved the solid school building under their feet. They soon set off for the city of Petit Goave. Via its contacts and a separate trip a few days earlier, Hearts Afire had already identified the 150,000 people in its area as being in desperate need of help. The 30-mile trip took two and half hours, and what they found in the little-known city equalled or surpassed the devastation in Port-au-Prince that television crews were beaming to the world. --- “Walking through the streets, on some of them, about 100 percent of the buildings had crumbled,” Pecoraro said. “Walking past some buildings, you could smell the decomposition.” When officials reach these outlying towns, the death toll will surely climb higher than the current 200,000 estimate, he said. They met up with another friend, missionary Ed Lockett, and joined a small medical team performing some procedures on the mission grounds. Meanwhile, they tracked down a city official to ask if they could work in the local hospital. The official said they would have to find someone to certify it was safe, so they then tracked down a Swiss engineer to assess the damage. Of the five small buildings, he approved just one -- which happened to have two operating rooms. They soon found that conditions were far less than optimal. There were no boom lights, so they relied mostly on light through the windows. More problematic was that the anesthesia machine didn’t work. But as word spread of the doctors’ presence, patients began streaming in. And so the doctors improvised. They scrubbed in with Purell hand sanitizer. They sterilized instruments in betadine and iodine. They used ketamine for anesthesia and cleaned wounds, some of them maggot-infested, with a three-step process of bleach, betadine and peroxide. By Thursday, Sugar said, their system was humming. Outside on the sidewalk, a pair of Cuban doctors -- one a veteran, one just out of medical school -- did triage. Under a tarp and in a hallway, Drs. Nutter and Bernard administered ketamine, dilaudid and morphine. And inside, the surgeons got to work. Pecoraro recalls 25 procedures. He repaired a hernia for a man who has come in from another city. He amputated a man’s foot, where the ankle had been crushed beyond repair. A vascular and general surgeon for 25 years, it was far from his first, but unlike any other. “I never did an amputation with such a lack of equipment,” he said. Sugar remembers 18 procedures. He set the leg of a woman who walked in, from miles away, with a broken femur. He placed casts and splints. He amputated fingers and legs. But one of his first cases moved him more than the rest. A man and woman brought in their 15-month-old boy, who had suffered a hip fracture. Sugar put him in a body cast, then moved on to other patients. Two days later, Friday, Jan. 23, they had to begin working their way back to Santo Domingo. They drove slowly through Petit Goave, Sugar said, scanning the devastation one more time. “And we look over and on top of a pile of rubble of what was probably their living room, were the father and the mother, and they were holding the baby, and they’re just smiling.” Later that night, Pecoraro debriefed the other doctors, trying to help them adjust to what they had just experienced. He told them they would get home and not be able to get this out of their heads, Sugar recalled. He said that they would want to do more, to come back, do more surgeries, stay there, adopt orphaned children. And he told them they can’t save the entire world, and have to be satisfied that they did what they did. Then Pecoraro reminded Sugar of that 15-month-old baby in the body cast, both doctors recalled. “That little child is not going to be crippled,” Pecoraro told him. “And maybe that child, or one of his great-grandchildren, is going to go on to do something great. If you just touch one life, you've done something.” Then Pecoraro continued. “That family will tell stories of the help they received that day, and that child will tell it, too. Someday, though, the story will be forgotten and told no more. But it won’t be forgotten by God, and that is what counts.” In an interview two days after his return, Sugar was as obsessed as Pecoraro had predicted. He had wanted to stay, but needed to return for his patients’ planned surgeries. He had an annual fishing trip with old friends coming up, but was ready to cancel it. “I know this sounds like an overstatement, but I'm changed,” he said. “I don't see the world the same way anymore. It's not enough to sit here in Sarasota. You've got to get your hands dirty. I really feel like we have an obligation. These are our fellow human beings.” ---- Editor’s note: On Saturday, Feb. 6, another team from Hearts Afire traveled to Haiti. Dr. Sugar returned, with Hearts Afire co-founder Dr. Vega and nine others. They planned to return to Petit Goave and push on to Jacmel, a city until recently accessible only by helicopter. Hearts Afire is locally operated and has minimal overhead, according to IRS records. It pledges to put 100 percent of all donations to its “Haiti Relief Project 2010” to use in that country. For information on how to help, including a list of supplies needed, go to the group's website, at this link. Disclosure: The website designer for Sarasota Health News is on the board of directors of Hearts Afire.