At Haitian Hospital, Tough Choices For Docs, Patients

Doctors work on a patient with two broken legs in a field hospital in Port-au-Prince i i

Doctors work on a patient with two broken legs Tuesday, implanting bolts so they can attach stabilizing rods to each leg, in a field hospital in Port-au-Prince. The hospital was set up by emergency medical teams dispatched by the U.S. Department of Health and Human Services. John Poole/NPR hide caption

itoggle caption John Poole/NPR
Doctors work on a patient with two broken legs in a field hospital in Port-au-Prince

Doctors work on a patient with two broken legs Tuesday, implanting bolts so they can attach stabilizing rods to each leg, in a field hospital in Port-au-Prince. The hospital was set up by emergency medical teams dispatched by the U.S. Department of Health and Human Services.

John Poole/NPR

The U.S. government has sent in six medical and surgical teams to deliver care to Haitians injured in last week's earthquake. One of them, the International Medical Surgical Response Team, set up a field hospital next to a soccer field, where one Haitian woman with two broken legs got good care. But there was an unexpected complication.

After surviving the quake and the wait for medical care, and after finally getting major surgery, she refused to be flown out for more extensive treatment without seeing her sister first.

Denise Bazile was lying on an operating table put together in a hurry with pipes and wheels. She was clearly still stunned — and scared. She stared at the walls of the hospital tent and then at all of the surgical equipment around her.

Brazile, 40, was selling butter in an open-air market when the earthquake hit. A brick wall fell down on her, she said. Both of her legs were badly broken, and she couldn't walk.

Her son Wondu, 21, was at home when the quake hit and had no idea where his mother was. He found her the next day and paid $60 Haitian to help get her to a hospital. All they could do there was bandage her legs and send her out.

Their house is unlivable, Wondu said. They'd been camping out in a field, and she was in terrible pain for six days. He got his mother to the field hospital Monday, when the U.S. team began arriving. They operated on her Tuesday.

In the operating room before the surgery started, nurse Roberta Dee said Bazile had been a great patient.

"If this were in the United States, man, and we had two broken legs, they would be screaming. They're so grateful for any little thing," she said.

Photo Gallery: Treating The Wounded

With Bazile lying there quietly, Dee held up the X-rays.

"Her fractures, as you can see — she went to see a local doctor first, and they did X-rays," Dee said. "But you can see — look at the bone. These are her legs; see the breaks."

The bones weren't just broken — they were out of alignment.

Orthopedic surgeon Christopher Born prepared to stabilize Bazile's legs using something called an external fixator. It's done sometimes to stabilize a bad fracture for a few days or weeks until an internal metal rod can be inserted.

Born and colleague James Kreig began the surgery by making small incisions.

"We're going to have two sets of pins — one above the fracture and one below — and a system of clamps and bars that go between the pins," Born said. "We'll try to align the fracture."

At the end of the 45-minute procedure, Bazile had what looked like scaffolding on each leg, held by pins going through her legs into her bones. Born said the surgery went well.

The next day, the doctors had arranged to get Bazile to the Comfort, a U.S. Navy ship, where she could have a permanent rod placed in each leg.

But an unexpected complication arose. When a helicopter arrived to take her away, Bazile refused to go.

She didn't want to be flown off to a ship or anywhere else unless her sister — who did survive — could visit her first. And her sister could not be found.

At that point, Henri Ford walked up. He's a native Haitian, a surgeon with positions at Childrens Hospital Los Angeles and the University of Southern California.

He's the camp "fixer" — doing surgery and helping the staff with cultural differences. Even he couldn't convince Bazile to leave. "My people are stubborn; they know what they want," he said.

Bazile didn't get transferred.

"She's going to stay here, and we will have some serious hard choices to make," Ford said. "If we need the place to take care of more acutely injured people, we'll have to put her in the hallway. This is a combat zone."

The staff will have to discuss trying to get her back in line to get on the Navy hospital ship. Within a few weeks, she'll need a second operation if she can find a hospital where she can get care.

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