Notes from an Iowan in Haiti -- Dr. Chris Buresh

Chris Buresh, Trinity Episcopal Church, Iowa City, shares his medical team's experiences in Leogane, Haiti, in dispatches below. Thanks to Karen Nichols and Chris's wife Ginny Ryan for providing this information for the Diocese of Iowa mission blog:

January 18, 2010, 9:38 a.m. in Iowa
Hi everyone,

I promised you details, so here's what I know. Much of this has come together in the last few hours and is subject to change at a moments notice. I'm going to send this to as many folks as I can in a short time, but please feel free to circulate it.
Team: Me, Josh White, EM doc in Twin Cities, Harold Latta, Peds doc from Winston-Salem, NC, took me on my first trip. Trips to Leogane for last 15 years. Single-handedly cared for multi-victim (adult) trauma on last trip and guy in shock from Afib with RVR. Not bad for a pediatrician! Dan Wing, senior EM resident and wilderness med guru. Brett Faine, EM pharmacist who just got back from Haiti last week. Brett Mayne from JCAS. Former USMC. Shane Clifton, paramedic, firefighter from Twin Cities, former Navy SEAL. He just got back from Haiti, too. Matt Monjes, same as Shane, but probably more handsome. Nathan Michaels lived in Leogane for several years, knows everyone who's everyone, called "the Mayor of Leogane" by some...
Plan: Fly to Florida today (January 18, 2010). Plan A: Fly from MIA to PAP at 0430 tomorrow and transport via Save the Children and Episcopal Diocese of Haiti to Leogane. Plane B: Fly MIA to Jacmel, then take tiny rinky-dink plane over mountains to land on straight road in Leogane. Locals assured me that they've cut down tree that last flight clipped on take off. Plan C: Fly FLL to Santo Domingo Tuesday afternoon. Overnight there. Cross border by air or facilitated by Episcopal Diocese of Haiti and 82nd Airborne (in civilian capacity) by ground. Return trip: 1/28. Not booked yet, but I promise I'll be back by the 29th.

Plan on the ground: Arrive with a ton of stuff; bandages, antibiotics, minor surgical stuff, three water chlorinators... into an airport somewhere on the island. Plan A: make way to Leogane. Establish base near nursing school with locals who are coordinating aid. Find source of clean water, set up shop, begin triaging. Plan B: Meet up with Livesay family (check out the Livesay Haiti Blog) north of PAP and do what we can to help there. Subplan: Arrange for helo drop of supplies, one chlorinator and potentially providers to Trouin, halfway between Leogane and Jacmel. They have been isolated since quake and have NOTHING. Sounds like road to Leo and Jac passable by foot, but dangersous.

Problems: Almost no gas. Have some connections and resources to start working on that. Tens of thousands sleeping in the street. Festering wounds and compartment syndrome. Nowhere to bury the dead. People still trapped. No food or water. No medicines on ground. No bandages or gloves.

Reinforcements: Save the Children is bringing in huge container in one to three days for more supplies. Ours will be gone by then, so that will be nice. Generators at HSC and nursing school said to be operational when there's gas. MSF apparently had a few docs in Leogane yesterday, but no supplies. Unclear, if they intend to make that a focus. Group from MI heading to Jimani today to assist, then hoping to make way to Leogane. They have ortho and trauma surgeons. We have a group traveling part way with us that is connected to the nursing school. They have an ortho surgeon. Hoping to get a 50 bed field hospital from CA arranged this week. Several water purifying and sanitation groups working our direction. Leogane started getting news coversage yesterday, so hoping that will generate more interest in our area and others will come. UN and local police very helpful so far with security. Strong connections with both groups on part of Nathan and Cathy. Ginny's hoping to get another trip headed our way next Sunday or Monday.

That's as much as I know. It's been a lot to coordinate. I can't even begin to guess at the hundreds of folks who have put in thousands of hours on this. I wish that I had time to personally thank everyone for their support and help in putting this together. The Leogane area has come to mean so much to Ginny and I, and a lot of folks who have come with us over the yearts, that it's gutwrenching to hear about the suffering there. I'm more thankful than I can express that people and Providence have allowed me to something about it. I don't know what sort of impact we'll be able to make, but we're going to throw everything at this that we've got. I feel like we've got some good partners on the ground, some great logisticians state side, and a bunch of folks praying for us. I know tht this is going to be completely overwhelming, and I hope that my team and I are up for it. Again, to the hundreds of folks that have rearranged my schedule, covered my shifts, picked up my slack, put u0 with my moods, helped care for my kids while I'm organizing, fed us, donated to us, prayed for us, packed us, got the word out, worked to arrange transportation and supplies, fundraised, provisioned, and did a lot of scut work. Thank you from the very bottom of my heart. I hope that we can do right by you and make your efforts worthwhile.

I'll report in when I can. Ginny will probably be updating my facebook page and hers, but I'm not counting on access to email. Take care of yourselves.

Bondye beni ou, Chris

January 20, 2010 11:53 p.m. in Haiti

Good day. More aftershocks today. Saw about 80 folks in clinic. A few amputations. A lot of bad wounds and some injuries that I'd have throught were not survivable, especially eight days out. Team was awesome. Logistics folks able to find everything we needed. We're set up under tarps in a courtyard, so it's nice to be outside. Brett's thermometer read 105 in the shade and the duct tape melted. Felt lucky to be able to duck inside on occasion. Better than living under a propped up piece of tin. Saw Drs. Mathieu and Merrisier today. Both OK. Houses and clinics gone. Nobody compalins, though. Everyone sleeping on street, nobody trusts buildings. Even badly injured don't compalin, just keep going. Amazin self-pity vacuum amidst such destruction. Singing humns at night and in a.m. Cooking meals together and caring for one another. We've got a lot to learn from these guys. No riots at all, so you'll probably never see us on CNN. Folks friendlier than ever despite no food, water or solid walls. Started water and food distribution today. Tons more coming in next few days via Wwv connections, Save Our Children and Americares. Field hospital coming, too, as well as five more docs and two orthos. Really need anesthetics. Doing things on awake pts that are hard to stomach. Lots of activity and trying to coordinate.

from Ginny Ryan, Iowa CIty:

Got a nice long call from Chris last night, with intermittently good satellite reception. Sounds like they are hot, hungry and dehydrated (temperatures >100 each day), but inspired by an improving sense of integration/cooperation amongst the NGOs. Chris was finally able to walk around the town and was heartbroken by the destruction. Aftershocks continue, but everyone is outside and safe. Saw >100 patients yesterday, and are starting to do some procedures with inadequate anesthesia/pain meds. My favorite news: they are tentatively making plans to return home 1/27 or 1/28. We're working hard on travel plans for team #2 to head down to Haiti early next week.

Chris is Assistant Clinical Professor of Emergency Medicine and Associate Residency Director, University of Iowa, Iowa City.