It pays to have connections—or at least a well-connected parish member. Ron Spruill, an orthopaedic physician’s assistant, heard his pastor’s plea for medical help in Haiti. The pastor, who lived in the country for eight years, was part of Project Help Haiti and understood the magnitude of the situation. The following day Ron approached his friend and orthopaedic surgeon, Ralph Salvagno, MD. “I tossed and turned the night before whether to ask Ralph to go,” says Spruill. “But when an opportunity is dumped in your lap, you have to grab it.” When Ron asked the question, Dr. Salvagno responded with an immediate yes. Through a series of chain reactions, Dr. Salvagno, Richard Milford, MD, and Jim Roupe, CRNA, were on their way to earthquake-ravaged Haiti.

Superbowl in the OR:  The surgical team from Meritus Medical Center spends the Superbowl in a Haitian OR.  On the far right is Ron Spruill, PA, who practices at the Center for Joint Surgery and Sports Medicine in Hagerstown, MD.

Meritus Medical Center's operating room staff and medical office personnel all worked to juggle the busy schedules of two orthopaedic surgeons. Understanding patients agreed to have their surgeries moved up or delayed. The hospital donated medical equipment for the trip, Dr. Salvagno convinced a sales representative to loan orthopaedic implant material, and Dr. Milford persuaded another rep to donate orthopaedic materials. Weather was the only showstopper. An impending historic mid-Atlantic snowstorm was looming in the distance.

To beat the storm, the Meritus Medical Center team arranged for an early morning departure on February 5, involving stops in St. Louis, Tulsa, and Dallas. Their final destination was Pierre Payen, a town two hours north of Port-au-Prince. In Dallas, the team boarded a donated corporate jet and flew to Fort Lauderdale. There they picked up a woman who was traveling to Haiti to complete the adoption of her eighteen-month-old son. On Saturday, February 6, the private jet received permission for a mid-afternoon landing spot at Port-au-Prince airport.

Once on the ground, the team received a debriefing from the departing Project Help Haiti doctors. Dr. Salvagno’s team was the fourth group to arrive in Haiti, with six additional teams expected to rotate into the country over the following weeks.

Driving away from Port-au-Prince, Dr. Salvagno viewed a landscape of tent cities and mass graves made from piles of transported city rubble. Along the stretches of dusty roads, people peddled goods. Cinder block and corrugated tin homes appeared as desperate as the ruined homes in Port-au-Prince.

A twenty-plus bed hospital with one operating room awaited the team in Pierre Payen. When doctors Salvagno and Milford arrived at the hospital, they found medical supplies dropped off at the front door. “Some unnecessary medical supplies made it to Haiti,” commented Dr. Salvagno. What they needed, and did not see, was orthopaedic materials. However, the team quickly got to work. Dr. Milford operated on a complex fracture dislocation of the wrist. That same afternoon, Dr. Salvagno repaired a tibial plateau fracture (upper shinbone). “During the fourth week after the quake, we moved from acute to sub-acute care,” noted Dr. Salvagno.

As clinic and walk-in traffic increased during this period, treatment primarily involved follow-up wound care. Surgical procedures included fracture re-adjustments for bones not properly healing, and bone grafts for infected fractures. Team members also made several trips into Port-au-Prince in a makeshift ambulance—an appliance delivery truck with four mattresses in the back—to collect patients who needed orthopaedic work that wasn’t available in other clinics. Soon, word spread that orthopaedic surgeons and equipment were available in Pierre Payen and patients were transferred from other hospitals.

According to Jim Roupe, certified registered nurse anesthetist, the team used all the resources it had while in Haiti. One woman in the hospital had very low hemoglobin levels and needed an immediate blood transfusion. Lacking a blood supply or the ability to run tests on donated blood, Roupe opted to use the blood of a pediatrician from Texas. His highly compatible type O negative blood helped save the woman’s life. “To see her respond so well—it was our save of the week,” said Roupe. The team also pulled together for a caesarean birth and a spinal shunt on a child.

In the open-air hospital, Haitian family members played the role of caregivers. Although the hospital could accommodate twenty-four patients, at least 100 family members slept on floors caring for their loved ones. “The tradition there is that family members come and stay at the hospital with the patients. They bring food, often bring in and change the bed linens, and even give oral medications,” explained Richard Milford, MD. He added that in the mornings, it wasn’t unusual for patients and their families to sing, mostly spiritually-based songs asking for healing. On the team’s last day in Haiti, the brother of a woman Dr. Milford had been treating asked to speak to the entire group. They weren’t sure what to expect, but “he thanked us so nicely that at the end, he had reduced everyone to tears,” Dr. Milford said.

Now one month after the quake, medical needs center around wound care, orthopaedic re-adjustments, amputations, plastic surgery, rehabilitation, and mental health services. Back at home, the snowstorm of 2010 dumped over forty inches of snow and diverted our attention away from Haiti. Our aching backs made us forget about the three million people needing emergency aid and the one million seeking shelter. Like Meritus Medical Center’s operating room staff and medical office personnel who helped him prepare for the trip, Dr. Salvagno believes that everyone can lend a hand to help Haiti. He urges people to know where to donate and what to donate. “Don’t let Haiti fall off the radar screen,” he said. “Keep these people in your thoughts and prayers.”

Ron Spruill, PA; Richard Milford, MD; Ralph Salvagno, MD; and Jim Roupe, CRNA