Hey again!



Alright, I know its been way too long since my last post, and probably most of you have given up on waiting for my next.  Luckily, my last class before spring break is tomorrow, so I should be able to keep up a much more regular schedule for the next few days, and maybe even have time to build up a backlog of posts so I can keep the pace up when school starts again.



Anyway, today I'm going to continue with my experiences working in the ICU of Port-au-Prince's main hospital.

Every day on arrival we would drive past a long line just inside the main gate.  This was the line for new patients to the hospital to go to the Japanese triage station.  Many of the different sections of the hospital were run by a single nationality group.  For example, triage was run by the Japanese, infant care was run by the Dutch, etc.  The ICU in which I worked contained a combination of American, Swiss, and Haitian personnel.  For those that don't know, triage is the process of accessing the severity of a patient's maladies in order to insure the patients who are most in need receive treatment first.

Here we see the ICU (Intensive Care Unit) in the background, and the Post Op tent in the left foreground.  The tent in the back is where I spent most of my time in Haiti, leaving our residence every day at daybreak and returning after darkness had fallen.  The unit was understaffed, and the staff was overworked.  In an intensive care unit in the United States one nurse would typically be responsible for two patients.  Here, in the emergency condition of Haiti, we would have five or six nurses most days, and all 24 beds would be nearly constantly occupied.  There were only two reasons we would have an empty bed: a patient was deemed healthy enough to be discharged, or a patient had lost their life.  Unfortunately, the later was more common than the former.  On these occasions, either happy or sad, the bed would not remain unoccupied for more than an hour or two; the number of those in need far outweighed the ability of the hospital to provide succor.  In addition to our lack of nurses, the ICU was also hurting for doctors.  All of the doctors who worked in the ICU also had responsibilities elsewhere in the hospital, forcing them to split their time.  Nevertheless, all of the staff was competent, committed, and hard working.

Here is our first view of the inside of the ICU.  I am going to leave this post at this and get into the inner workings of our tent in the next installment.

Arrival at the Hospital

Alright, I have to get going on this or I'll never start.  Today I'm going to share some of my first impressions on arriving at the general hospital.

Early in the morning the day after our arrival in Port-au-Prince we loaded our Land Rover to more than capacity (probably around 10 people, it varied day to day) and set off towards the center of the town and the General Hospital.  Most of the pictures of destroyed buildings you have seen so far were taken on one of these trips too and from the Hospital. 

Arriving at the hospital we found the main entrance gate guarded by the marines.  They quickly opened the gate and waved us through.  They saw no need to check credentials; being white and wearing scrubs was all the "paperwork" we needed.  The Haitians seeking medical help had queued up outside, being let through single file via a door located at the edge of the gate.  I will go into detail about the patients later, but for this post I am going to concentrate on the infrastructure of the hospital.

On of the first things I saw after entering the hospital was a group of men operating out of the back of a tractor trailer rig.  Reading the sign on the back told me it was an "off the grid" water plant.  I wasn't exactly sure what that meant, but later found out this was a scene straight out of the first Star Wars movie.  These men were "moisture farmers" like Luke Skywalker's aunt and uncle.  They operated the machines in the trailer to condense water vapor in the air into clean, drinkable water.  The service these men provided was absolutely essential to the operation of the hospital.

As we moved father up the road I saw the Marines and their trucks.  The marines were there primarily to guard the hospital, but also proved very helpful.  Throughout the time I worked at the hospital they helped carry oxygen tanks, transport patients on stretchers, and even let me borrow their hair clippers to trim off my beard when it grew too long and the heat became unbearable.

This is the tent I operated out of for most of my time in Haiti.  Sitting outside in this photograph is a young boy named Eric, who occupied one of the 20+ beds inside the tent.  He had had his leg and jaw broken in the quake, and his parents were either missing or dead.  Unable to speak above a whisper or eat solid food due to his jaw being wired shut, he still managed to endear himself to all of the ICU staff.  If you look closely enough you can see my name signed just above and to the right of the flower on his cast.

Hey guys sorry for the lack of posts.  I've been really busy with school and been having some writers block about how to best go about telling the story.  I promise I'll get a new post up tomorrow, even if I'm not entirely happy with it or I have to show some more pics of things I've already gone over (I do have a million pics of just about everything.  My strategy was shoot as many as I can and sort the best out later.) or if I just have to go off topic a bit and post some unrelated photos I've taken.  Follow me @futilephenom on twitter to get notified as soon as the post goes up.  I'm thinking mid afternoon.  Thanks for the patience loyal readers!

PS- Can't remember off the top of my head who asked in the comments, but BNA is the code for Nashville's major airport.  Anyone have other questions, feel free to ask in the comments on this post and I'll make sure to answer them at the top of next post.  Might even be a good way to help stop the writers block.

Jeez, I probably could made a whole post in the time it took to write all that.

Well I'm a little pressed for time and a little emotionally drained from thinking about all this so today I'm just going to take a little break and post some pictures I took just after takeoff from BNA.

 

I hope you enjoy these photos, I'll try to get back into the flow of my storytelling tomorrow, probably begin the real meat of the tale: working in the ICU of the Port-au-Prince general hospital.

Temporary Housing

Due to the destruction of people's homes, there were many in need of shelter.  Thousands of homes were destroyed and thousands more were damaged to the point of being dangerous.  In addition to that, due to the aftershocks many people who's homes were still standing were afraid to be inside them.  These factors lead to huge numbers of people who had suddenly found themselves homeless.

A few families were lucky enough to receive a shelter box from the UN.  The box contained some food, water purifier, and a large tent.  However there were nowhere near enough boxes to go around, and a UN tent like this one was a rare sight.

Much more common were shelters like this one.  The Haitians made temporary housing out of sheets, tarps, and sticks.  Shelters like this offered little to no protection from dangers such as mosquitoes and rain.  The rainy season had not yet arrived during my time in Haiti, but it did rain one night, and the water soaked the sheets and flowed under the edges on the ground.  Everyone unfortunate enough to be living in a shelter such as these must have gotten wet, and in some places the weight of the water collapsed the makeshift tents onto the people inside.

Despite these flaws, makeshift tents were better than no shelter at all, and tent cities sprung up everywhere.  any large open space became covered in these shelters, and some people simply set up next to the rubble of their broken home.

Scenes on the Street

I'm going to take a break from showing destroyed buildings for a little while, but don't worry, I have over a hundred such images and will be posting more in the future.  Today I'm going to share some of the other scenes I captured as we were traveling through the city.

One of a seemingly endless amount of similar signs.  All of these signs were written in English and Spanish, not either of the native languages of French or Creole.  This shows how much faith the locals had in their governments ability to provide relief.  The Red Cross had set up 6 distribution points throughout the city to provide food and drinkable water.  Port-au-Prince and its surrounding residential area are home to an estimate of over three million people.  A little quick math and we see that each of those distribution points would need to service over 500,000 people.  On top of that, many Haitians did not have cars and would have to carry the large bags of rice and heavy containers of water for miles back to their home.  I'm not trying to fault the Red Cross for their efforts, but to show that the scale of the disaster lead to many people lacking access to basic essentials.

Another basic essential unavailable to the average resident was garbage pick up.  Trash ended up piled on the side of the street,  in alleys, and in channels designed to drain the massive rains out of the city safely during the rainy season.  Shown here is one such channel, as seen from a bridge of the street running over it.  With no disposal service the trash either sat in place or was burned.  I'm not sure if this particular fire was intentional, as no one seemed to be watching over it.  However, scenes like this were common enough that the locals ignored it and went about their business.  While the threat of fires spreading and the health issues involved with inhaling the smoke are serious issues, I believe the most danger would come with the rains.  Large currents of water would sweep through areas like this and leave trash strewn about the city.  Wet, rotting trash in the tropical climate would be an idea breeding ground for infection and disease.  Trash like this could lead to major outbreaks of disease like tuberculosis, dysentery, and cholera, and maybe be the cause of the recently reported outbreak of the latter in Port-au-Prince.

Usually near the trash could be found animals such as livestock and dogs searching for food.  I took this picture of two baby goats playfully headbutting each other while a large hog nosed through trash just out of frame.  I don't know if these animals escaped when their pens were destroyed, or if their owners had been killed and the animals were turned out to fend for themselves.  As far as I could tell, no one claimed the animals scrounging on the street.  They seemed to wander where they pleased in search of food.  Surely there were a great many pets and domestic animals killed in the quake or left without needed care due to a tragedy befalling their owners.  Unfortunately, with the relief capacity already stretched beyond the limit trying to assist the human population, there was almost no chance that the animals would receive the care they needed.

More Destruction

Ok, before I get started today I just want to mention a couple of small changes in the layout of the blog.  First of all, near the top of the page you will see a bank of little colorful icons.  I have added these to help anyone who wants to share my blog on their social network of choice.  In making this blog I am attempting to show Haiti's plight to the larger world.  If you think that is a noble endeavor, please share with all your friends who may be interested.  Secondly, I have set the main page to only display the most recent post.  This is a step to insure the blog runs smoothly and quickly for all readers.  I know that people with slower internet connections will appreciate not having their browser try to open lots of large picture files at once.  The archive section links are located directly underneath this post in the red lettering.  I urge new readers to read through the archives, and regulars to check the archives every visit to insure nothing is overlooked.  So far I have been attempting to update every day, but in the future I may move to multiple smaller updates a day or update twice to make up in the event of a missed day.  I'll try to keep you posted.  Now that that's over...



Today we are going to continue where I left off with images of the structural damage to Haiti's buildings.  I chose yesterday's pictures with a mind towards displaying the massive range and scale of the earthquakes damage.  Today's photographs were chosen in an attempt to showcase the raw power and destructive force of the quake.

This image was chosen not because of the size of the rubble pile (although in any other context it would seem massive, surely weighing more than a ton), but because I think it can be used to illustrate the power of the force which struck Port-au-Prince.  Looking at the top of the subject building, you can see that the entire front and at least some of the left wall have been almost neatly removed by the earthquake.  Around and above the watermark, you can observe pieces of that wall.  The piece closest to the door is the perfect illustrator for my point.  The thickness of the slab of concrete is visible due to the side on view,  you can judge by the door the length of the former wall section.  Clearly this is a huge piece of material, and the fact that it didn't break apart upon impact shows its strength as a building material.  The quake tore several similar pieces clear off.  No crumbling, no cracking, just pure force to rip it of in large chunks.  Another indicator of the power that created this scene can be found in the bottom left area.  There you see metal signs, torn either off the side of the building or out of the street and bent and mangled by the force. 

I captured this tableau of rubble out of the side window of our SUV while traveling to the hospital.  It is almost too massive for my purposes here, taking up the whole frame leaving very little for sense of scale.  It is also so disorganized it is hard to tell what is going on or what's what.  However, after consideration for a moment, you will begin to notice the very middle, with the splash of red, has somewhat more cohesiveness than its surrounding.  That is a car.  Or, I should say, part of a car.  To its left is another piece of a car, but it would be very hard to definitively say it is a piece of the same car.  In addition to that stunning demonstration of force, you can what looks like metal wires around the car and on top of the pile.  Again, this is a trick of perspective.  When you take the size of the "wires" in relation to the car under consideration, it becomes apparent that these are in fact pieces of steel rebar.  Steel rebar (short for reinforcing bar) is used in construction to add strength and resilience to concrete structures.  The bars are meant not only to lend their strength to the concrete, but also to act as a skeleton of sorts to hold the structure together despite cracking or full breaking of the concrete.  These bars, of which there are too many to count in this picture alone, not only failed to adequately reinforce the building, but were torn out, bent, twisted, and mangled by the quake until they came to resemble a tangle of yarn.

Wreckage

As we continued on our way to find the home we were staying in the damage began presenting itself to us.  Never in my life have I seen anything like it.  Some buildings were completely fine.  Others had only small cracks or minor damage to the windows.  From there it ranged all the way up to wondering if a pile of rubble could have possibly ever been a building at all.

Probably around fifty percent of the buildings seemed completely undamaged.  In the remainder there were building like this one: formerly more than one story.  I sometimes played the "guess how many stories it used to be" game.  It was a lot harder than it seems at first, and I'm sure I guessed incorrectly a few times.  The piles of rubble and trash were everywhere.  While we would see people cleaning up and hauling away rubble, the city just didn't have the manpower to do the job.  All of these photographs are taken a month or more after the earthquake, so you can imagine the pace of cleanups and how much longer it would take.  I would not be surprised at all if I went back and saw some of the same piles and broken buildings to this day.

Another "how many stories was it?" structure.  The pile of rubble must have come from clearing out the streets.  This task is clearly one of the most important immediately after an earthquake, and it seemed the Haitians had been successful in opening transportation lines again.  This particular pile reaches up to the ceiling of the first floor of the building behind it and almost to the lights on the telephone pole.  It was not uncommon in size from several others I encountered.

I had trouble discerning the original purpose of many of the ruins I saw.  This one, due to the size and location, I believe might have been a warehouse.  Again, I'm not a hundred percent certain how many floors there were in the original blueprints, but I'm pretty sure I can point out at least three.  The roof of the building which formerly stood at I would guess at least 30 feet high was now within reach of an outstretched arm while standing a street level.

Entering Port-au-Prince

Not long after we drove over the border we starting encountering small concrete and metal homes along the road.  These structures, perhaps due to their size or to the distance from the epicenter, seemed to be relatively unharmed.  Damage was not noticeable on most of the buildings, and very few were completely demolished.  As we pressed on, traffic began to thicken.  It was then that I caught my first glimpse of Haiti's ubiquitous travel method, the taptap:

Brightly colored trucks and vans of all sizes serve as Haiti's taxi fleet.  Here a rather large one is parked on the side of the road just outside of Port-au-Prince.  Most taptaps were much smaller, ranging all the way down to a small pickup truck.  This one, I imagine, was used to transport people on the unpaved roads leading out of town.  I have a hunch its main job lately has been taking people to the border.

Here we have a smaller taptap made from an old truck with a roof and sides attached to keep out the weather or maybe someone trying to sneak on.  Each taptap in town had a crew of two: a driver, and a man on back to collect fees or make sure no one got a free ride.

Some were more drab and bland and some really stood out with bright colors and extravagant decorations.  This one I found particularly entertaining with its mass of headlights and turn signals on the front, nuclear warning design on the wheels and US Flags painted on the top and flying behind.  Taptaps would sometimes be bursting with people.  The local joke was: "How many people can you fit on a taptap?"  "One more."

 

Some carried advertisement for preachers of politicians.  This picture was shot through the spiderweb cracks in the windshield of the truck which served as our transportation, and is one of my favorites from the trip.

As we entered Port-au-Prince proper I noticed a large mass of people waiting in a line.  At first I assumed it was a line for food or fresh water but as we approached i realized that was not the case.  The line lead to a phone store, where people were attempting to place a phone call or charge their cellphones.

As we continued traveling, I began to see the devastation...

Entering Haiti

We left Santo Domingo at around 3 am local time to head to the border.  The Haiti border was completely closed off at night for security reasons, and despite the fact the we were only around 120 miles away the trip would take us around 10 hours.  The road was unpaved, too narrow for two way traffic, and lined with small villages and houses.  This caused our van to be unable to reach a high top speed, pull over often to let other vehicles by, and be restricted by low speed limits in inhabited areas.  Unfortunately due to the lighting conditions in the middle of the night I was unable to capture these images.

As we approached the border we entered a town of small city.  There were people and livestock on the streets going about their daily business, some wearing surgical masks.  If this was to prevent catching a disease or prevent spreading one, I don't know.  As we drew closer to the border we passed a military barracks, and saw armed soldiers on the street.  These were the Dominican border guard.

This is the view out of the left side of our bus when we arrived at the border.  We were stopped, had out passports collected, and told to wait in the bus.  After a period of a few minutes our passports were returned, stamped by the Dominican government, and the border gate was opened for us to pass.

As the gates opened, I captured my first view of Haiti out of the front windshield of our vehicle.  The Haitian side of the border was cluttered with people, vehicles, and ramshackle structures made of corrugated metal, sticks or timber, and cloth.  Obviously these were temporary structures thrown up by Haitian refugees trying to flee across the border.  The main task of the armed Dominican guards became apparent: to keep the Haitians from flooding over the border.

The Haitian government had no presence on its own side of the border.  I snapped a shot of what i assume was their version of customs, but no one appeared to be inside.  No officials came to authenticate and stamp our passports.  I can only assume every available resource of the government had its hands full in the capital.  With no immigration officers to check in with, we headed on towards Port-au-Prince.

After passing the "quarantaine" building I was greeted with this sight.  It seemed to be an echo of the former beauty and splendor Haiti once possessed, reverberating years out of its own time.  It was a brief respite from the clutter and chaos at the border, before we plunged into the disaster and devastation of the earthquake ravaged land.

Santo Domingo

Unfortunately I have misplaced my journal so I won't be posting it today.  Hopefully I can find it tomorrow and share my thoughts as i recorded them at the time.  Nevertheless I am going to continue with my impressions of Santo Domingo.

First a shot of a storefront taken from the bus which transported us from the airport to the house we spent the night.  I have no idea what they are selling, I don't speak spanish.

A few men standing in front of an auto dealer.  The cars look relatively nice, the roads in the city were well paved and maintained, and, in a contrast to Haiti, they had stoplights.  Traffic was heavy in certain areas but for the most part orderly and well organized.

Here we see a Dominican ambulance parked outside what appears to be a small medical center.  Unfortunately I didn't get a chance to stop and investigate, so I am unable to make any comparisons between The Dominican's state of healthcare and Haiti's.  However I would venture a guess that it follows the same pattern as everything else.  When I get into my time in Haiti I will have a very telling picture of the first ambulance I saw.

While the state of infrastructure and traffic in Santo Domingo was mostly very good, not everything was perfect.  This is another bus owned by the same company as the one we were traveling in.  We happened to drive past in on the outskirts of the city.  It was very surreal to see a bus that was almost a perfect replica of ours (we had orange curtains) wrecked on the other side of the road.  Amazingly the driver seemed to be fine despite the horrific looking damage to the area he was sitting in.  That's him in the blue.  Only a small bandage and still able to walk.  Very lucky!

Tomorrow I will begin the trip to the border and across into Haiti.  The transitions from Santo Domingo to rural Dominican Republic and then to Haiti were shocking in both the acuteness of the difference and the abruptness of the changes.

I have decided to try to make this account of my time in Haiti a bit more chronological so you can see the differences and transitions i went through in my travels.  Today I am going to begin with my departure from Nashville, the flight to the Dominican Republic, and my arrival there.  Tomorrow, hopefully, I will begin transcribing a journal entry written during my first night after arriving in the Dominican.

This is the view that greeted me as our plane gained altitude after takeoff over Nashville, TN.  I have included it to note the contrast in the weather.  Below freezing, snow covering the ground when I left to tropical warmth, almost too hot to sleep on the island of Hispaniola .

Beautiful crystal clear waters surrounding a small island chain somewhere in the Caribbean between Miami and Santo Domingo.  Not much to say about this one just thought it was pretty.

One of several small cities we flew over in the Dominican Republic.  While from this distance the city its self doesn't look much different from one you would find in Haiti the lush green farm plots and trees would be very rare.  Hispaniola is an island of two nations, the Dominican Republic and Haiti, and an island of two colors, green and brown.

This is the view across the street from the airport we landed at in Santo Domingo.  Again you see the lush green plant life, the beautiful scenery, and this is in the middle of the largest city in the Dominican Republic.  This beauty is the reason the Republic is able to gain so much from its tourism industry while Haiti's tourism is nonexistent.

These pictures came from my trip to Haiti a month after the earthquake last year.  I'm going to start the blog off adding a few of these a day and begin trying to share my experience.

Border guard on the Dominican side of the border.  Haiti had no guards posted on its side.
I don't know about the gun, but that's a high caliber juice box.

A crack in the middle of the road in residential Port-au-Prince.  About three or four feet deep.

Two of the many buildings which have collapsed.  Quite a few buildings mirror the larger building on the left, a single floor collapsed with the top of the building crashing down but relatively undamaged.