Pacesetter - Spring/Summer 2010 - Haiti Relief

Haiti relief: A mission of service and learning

Amid poverty and destruction, workers provide care, comfort, compassion
by Julie Thompson

Kettering College professor Paula Reams knew she was stepping onto new ground when she signed up to be a part of a national disaster relief team.

As a seasoned nursing instructor at Kettering College, she had taught about disaster situations but had never actually been in one. She was confident, however, that her knowledge and her extensive federal training would prepare her for what was ahead.

Last summer, she completed her training and orientation through a mock disaster relief scenario at the Dayton Air Show and officially became a part of the Dayton Disaster Medical Assistance Team OH-5, called Ohio 5 for short, sponsored by the U.S. Department of Health and Human Services’ Office of Preparedness and Emergency Operations.

Reams was eager and ready to participate. Still, her turn came sooner than she thought and in a place she never would have dreamed when a catastrophic 7.0-magnitude earthquake rocked and leveled Haiti’s economic and political center in January.

Within a few days of the deadly disaster, Reams and some Kettering Health Network colleagues on the team knew they would be called in to help. It would be the first time that such national groups would be asked to serve on international soil.

Kettering Health Network employees who went to Haiti as part of the DMAT included (kneeling) Kriss Haren, psychiatric crisis worker, Kettering Behavioral Medicine Center; (standing, left to right) Robert Ensign `81, physician assistant, Greene Memorial Hospital; Kevin Mollenhauer `01, staff educator, Kettering Medical Center; Janet White `75, staff nurse, KMC; Bill White, A/V engineer, KMC; Kim Kwiatek, doctor, KMC; and Paula Reams, professor of nursing and chair of health professions degree, Kettering College.

The call to a foreign land created a sense of anxiety for many of Reams’ colleagues, but for her, it provided a bit of familiarity. While she had never been in a disaster situation, she was accustomed to serving abroad and had even recently been to Haiti.

“I had been to Haiti when there wasn’t a disaster,” Reams said. “I knew it was going to be pretty bad because it wasn’t in good shape before the earthquake hit.”

Reams’ team was among the second round of teams called to Haiti, arriving two weeks after the disaster hit, so the medical needs had shifted from critical to maintenance and follow-up. Still, time didn’t change certain realities of Third World countries: poverty, orphaned children, poor health care and starvation.

It was these conditions that Reams found most of her teammates struggling to reconcile with their Western medicine and ethics.

Stepping into a whole new world
Reams’ team set up in a camp that had been constructed and used by an Israeli team a week earlier. They were fortunate to have tents, military meals and the use of portable toilets and warm showers. In such contrast to these relative comforts, the surrounding realities were hard for many to digest.

“Our team wasn’t used to doing health care outside of the United States,” Reams said. “In America, if someone walks into the ER, they are taken care of, but that isn’t always true in other countries. You have to make decisions — even when it is not a disaster — as to who should get health care and who shouldn’t.”

Life often boils down to survival of the fittest in a Third World country; when an earthquake strips away the structure, that mentality becomes the rule. The first lesson the medical team had to learn was that the severity of a person’s medical condition didn’t dictate whether they were treated. The deep Haitian culture did.

“Even if there are sick babies, it’s the mom who gets treated first because she is the fittest,” Reams said. “You have to keep her fit because if you don’t, then there is no hope for the little ones.”

Perhaps the biggest problems they faced were stark malnutrition, dehydration and lack of supplies. The team was unable to deliver the acute fluids needed to sustain the children brought into their tent, and even if they had enough, the follow-up care wasn’t in place to sustain them past that day.

Reams found herself acting much like a hospice nurse, delivering the comfort care needed for that moment in time. It was often very hard for Reams, who specializes in obstetric and pediatric nursing.

“We fed them the best we could and then after that had to transfer them out to a hospital where chances were pretty good that they wouldn’t live,” Reams recalled.

Once in a while, a Haitian would walk into the clinic, telling a story that bolstered their resolve and reminded them that their time there was valuable.

A grandmother’s inheritance
The first baby Reams treated was brought in by his grandmother. Like most infants after the quake, the baby was malnourished and dehydrated, but this one, an orphan, had been malnourished for most of his one year of life, and he was only the size of a 5-month-old. His grandmother could no longer find formula to feed him.

Reams’ team decided to go to extreme measures and insert an IV into the baby boy’s bones to deliver the much-needed fluid for 24 hours straight.

Reams observed the grandmother’s deep concern for the child. She stayed by the baby’s side during the entire treatment, leaving only periodically to check on the remaining five children she was also caring for in her home.

The grandmother’s strength marked the difference between what is expected in the United States and what is just accepted in places abroad where the average person is lucky to live to 55 and where grandparents find themselves parenting again when their own children die too young.

The Haitian people’s ability to cope with devastation struck Kriss Haren, a psychiatric crisis worker at Kettering Behavioral Medicine and the mental health specialist on Reams’ team. Her job was to support the team so that they were in good enough shape to help the patients.

“By and large, these people are very resilient,” she said. “They don’t live in the best circumstances and have had a lot of tragedy. I didn’t see a lot of people bemoaning their fate. They more or less looked at it as another hurdle to get over.”

Hope in a little boy’s dream
While Haren’s job was to help the medical team, she was often called in to help with a patient whose problem the doctors might feel is more psychological than physical. Such was the case when a 9-year-old boy named Pierre came to their clinic with his mom. He hadn’t been eating or sleeping well. His mom was concerned about him because before the earthquake, he was known as a vibrant, energetic boy.

Haren spoke to Pierre through an interpreter and learned that he had loved to go to school and learn, but he could no longer do that now that his school had been destroyed. With the help of his mom, Haren devised a plan for Pierre to create his own school among his neighbors where he would teach younger kids until they were able to return to their real classes.

“When there is a huge disruption in a child’s schedule, you need to find things that are comforting to them and that seem normal,” Haren said. “Since we couldn’t help him get his books or to go to school, we decided to make him a teacher.”

Haren said Pierre was perhaps the patient who exhibited the most specific stress reaction to the disaster. Haren played her role in helping move that along.

By the time Pierre left the camp, he was equipped with pencils, crayons and paper and lovingly given the name “Monsieur Pierre.” The title brought out the first smile in Pierre, who up until then couldn’t look anyone in the eye.

Hope for today
In the end, the team had to focus on the individual stories like Pierre’s in order to stay hopeful. They couldn’t predict or control what the next day held, but they could help heal or comfort the Haitians for the days that they were there.

Janet White ’75, a registered nurse with Kettering Medical Center, has been an emergency department nurse for 25 years and felt prepared for the acute need in Haiti. Still, the lack of supplies and follow-up care left her feeling depleted at times.

“It was good to do some things, but it was frustrating because you think of how much more you could have done, given the right resources,” she said.

Since their camp was slightly outside what could have been considered “ground zero,” they didn’t encounter the worst sights of dead bodies or mass burials. Instead, they encountered diseases like malaria that are now eradicated in the United States. They saw people walking around with treatable problems, like one woman whose neck had been overtaken by a benign growth simply because she’d been unable receive care for it and have it removed.

The disaster team was affected by the poor living conditions themselves. Several became ill on the trip, and most came home with upper respiratory conditions caused by the burning of trash and debris left behind by the earthquake.

White returned to Kettering wondering about children who had lost parents and people who had lost limbs. She’ll never know if they received the long-term care so desperately needed in their situation. But one thing is for sure: the world was reaching out, and Ohio 5 was a part of it.?

“I was so impressed by the amount of help they were getting from us and the world,” White said. “You could sit at the airport and watch the huge planes coming and going, bringing people and items to help. It’s neat to know we’re part of something that is reaching out and helping others.”

Texting for Haiti

	Human biology students (from left) Kaylie Snyder, Katie Glander and Kasidy Carroll prepare to text their donations to the American Red Cross Disaster Relief Fund.
	Cherie Rebar (left), associate director of the Division of Nursing, and Beverly Cobb, Dean for Assessment and Learning Support, text their donations.

In the wake of the earthquake in Haiti, the Kettering College recruiting staff and the office of spiritual life coordinated a “Texting for Haiti” event in January. The event allowed members of the Kettering College community to show support for Haiti by gathering to text donations to the American Red Cross Disaster Relief Fund at the same time. The event raised nearly $3,500 in cash, text donations and independent gifts from the Kettering College community.