Delivering in Haiti

When David Walton (HMS ’03) stepped off the plane in Port-au-Prince, Haiti, 48 hours after the Jan. 12 earthquake, he viewed a world of death and devastation: buildings reduced to rubble, bodies piled outside morgues and people whose limbs were crushed and broken.

On May 28, Walton, an HMS instructor in medicine at Brigham and Women’s Hospital and a physician with Partners In Health, showed that world to attendees of the 2010 Alumni Day Symposium: “Harvard Medicine in Haiti: Acute and Chronic Challenges.” Walton described, in words and pictures, how hundreds of thousands had been either injured or killed by the quake, a toll that quickly exceeded the capacity of Haiti’s hospitals and morgues.

Attendees listened, gasped and wagged their heads in disbelief as Walton and other Harvard physicians and public health professionals detailed the plight of that Caribbean nation and its people before, during and after the calamitous earthquake. The symposium panelists—Walton and Louise Ivers of PIH, George Dyer (HMS ’02) of Brigham and Women’s Hospital and Michael VanRooyen of the Harvard Humanitarian Initiative— were joined by Steven Weinberger (HMS ’73), president of the Harvard Medical Alumni Association.

“Our work turned into a triage exercise of patients and medical personnel,” said Walton. “Haitian doctors and nurses who hadn’t perished were digging out their own families, making it hard to gather a sufficient number of medical professionals for the hospitals.” PIH stepped in, tapping more than 4,000 employees from its 10 hospitals and clinics in the nation’s central region. That relief, Walton said, was augmented by good will and resources from HMS.

Among the first to answer the School’s call for help was Dyer, an HMS instructor in orthopedic surgery at BWH. He was in Saint-Marc, a port city about 50 miles west of the capital, just four days after the quake, helping to transform its woefully maintained and equipped hospital into a functioning tertiary care unit.

“Surgery was unending,” Dyer said, “and in the early days consisted primarily of amputations. Most of our patients had four-day-old gangrenous wounds, and amputation was the only way to save their lives.” He said he was proud of the care and concern that team members showed all patients despite the cramped quarters, lack of rest and frequent electrical outages that forced surgeons to don headlamps for illumination.

With seven years of service in Haiti, Ivers provided attendees with perspective, explaining that Haiti’s devastation was exacerbated by the poverty, poor nutrition, low literacy and low life expectancy that has long placed it near the bottom of the world’s human development index. The earthquake, she said, only served to further fragment infrastructure, especially the healthcare system. An HMS assistant professor of medicine at Brigham and Women’s and the clinical director for PIH in Haiti, Ivers said PIH will work to reestablish medical education on the island. The quake destroyed nursing and medical schools and scattered their student populations.

Acknowledging the help from HMS, Ivers added, “The voice of HMS is a large one that needs to continue.”

Sustaining the University’s voice on humanitarian issues is the goal of the Harvard Humanitarian Initiative, said VanRooyen, the initiative’s director and an associate professor at both HMS and HSPH. By placing the resources of the academy behind humanitarian assistance, he said, the initiative hopes to bring “self-reflection and critique to the humanitarian sector.” It also aims to help in “knowledge translation” by bringing the training, analysis and resources of the University’s institutes, hospitals, and arts and sciences to nations sundered by strife or, as with Haiti, rent by natural catastrophe.

A video of symposium is available online.