{"id":4775,"date":"2010-02-11T11:38:38","date_gmt":"2010-02-11T16:38:38","guid":{"rendered":"http:\/\/asweetlife.org\/?p=4775"},"modified":"2016-09-25T03:59:10","modified_gmt":"2016-09-25T07:59:10","slug":"haiti-after-the-quake-an-interview-with-dr-barry-koffler","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=4775","title":{"rendered":"Haiti After The Quake: An Interview With Dr. Barry Koffler"},"content":{"rendered":"

\"\"<\/a><\/p>\n

Dr. Barry Koffler is an orthopedic surgeon in Atlanta, Georgia (and he is also our uncle).\u00a0 He has been practicing medicine for over thirty years, and does volunteer medical work in Central America.\u00a0 A few weeks ago, horrified by the devastation in Haiti, he left everything and went to help.\u00a0 It wasn\u2019t easy to get there, but\u00a0 he found a way.\u00a0 He took the time to tell us about his experience.<\/p>\n

How did you get to Haiti?\u00a0 Where did you land? <\/em><\/strong><\/p>\n

I flew to and from Haiti on private jets donated by wealthy philanthropists who are part of a Christian Missionary group called MFI, or Missionary Flights International<\/a>.\u00a0 The flight to Haiti was in a beautiful five passenger jet and the return was on a large turbo prop jet owned by a race car driver.\u00a0 The flight there was interrupted by a short stop in Exuma, Bahamas to refuel since there was not likely to be enough fuel in Port Au Prince for the refueling of private jets.<\/p>\n

Can you describe the scene when you arrived?\u00a0 Who was in charge?<\/em><\/strong><\/p>\n

When I arrived in Haiti, the airport looked like a military base with tents everywhere.\u00a0 I saw flags from many different countries, including Central and South American, European, and Asian countries.\u00a0 There were representatives from all over in the airport, but mostly from the United States since\u00a0the airport and airport traffic was being controlled by the US.<\/p>\n

\"\"<\/a>
Arriving in Haiti (Barry on far right)<\/figcaption><\/figure>\n

Haitians lined the road out of the airport hoping for food and water.\u00a0 The streets were filled with trash, and makeshift tents made of blankets, sheets or whatever people could find to offer some kind of shelter and privacy at night, lined the streets. Almost no one had work.\u00a0 The people stood, talked, and watched all day.\u00a0 Large parts of Port Au Prince have totally collapsed, and many bodies are yet to be found.\u00a0 Many people were trying to escape the city, since it will be years before the infrastructure is rebuilt.\u00a0 And it is filthy.\u00a0 People were drinking from the same water they bathed in.\u00a0 There was no garbage collection, no running water, and no electricity in the city.<\/p>\n

\"\"<\/a>
The Hospital inTown<\/figcaption><\/figure>\n

Where were you taken to treat patients?\u00a0 Were you in Port Au Prince the entire time?\u00a0 Were you working in a hospital?\u00a0 A tent?<\/em><\/strong><\/p>\n

I was taken 10 miles outside of Port Au Prince to a place called Caberet.\u00a0 It was an hour and a half drive because of traffic and the poor condition of the roads.\u00a0 I was taken to a Christian mission which – in the best of times – is an orphanage and school.\u00a0 Only 25% of Haitian kids get any education.<\/p>\n

Post earthquake this church became a drop off point for post-amputation observation, for fractures and for orphans of the quake.<\/p>\n

What kind of injuries did you see? <\/em><\/strong><\/p>\n

The injuries were primarily crush injuries.\u00a0 The extent of the severity ranged from traumatic amputations, to open fractures, and to closed fractures.\u00a0 There were also closed nerve injuries from nerves struck by heavy stone, and nerves damaged by pressure from soft tissue swelling called a \u2018compartment syndrome\u2019.\u00a0The amputations had to be kept clean, and those that were infected needed to be debrided<\/a>.\u00a0 The open fractures had to be set or sent to Port Au Prince for more definitive treatment.<\/p>\n

Can you tell us about any specific cases? <\/em><\/strong><\/p>\n

\"\"<\/a>The devastation was indescribable.\u00a0 There were people on the clinic floor with broken legs, broken arms and amputations.\u00a0 Within the first two hours after arrival I had reduced and casted two children, one with a femur fracture and one with a tibia fracture.\u00a0 Their pain was gut wrenching but after getting them immobilized, the smiles were equally poignant.\u00a0 I casted an adult with bilateral femur fractures who lay on the floor in agony with every twitch of her leg muscles.\u00a0 We found a small table that I was able to move her onto, reduce the fracture, and\u00a0 cast.\u00a0 No x-ray, no anesthesia.\u00a0 As I was about to leave the clinic, I saw a little boy on the floor with a high femur fracture. Ideally, he would\u00a0 have been treated with surgery, but that wasn\u2019t possible.\u00a0 I was able to put him on the small table, reduce the fracture and put him in a spica cast, which is something I hadn’t applied in more than 30 years.<\/p>\n

What is the supply situation?\u00a0 Did you have the necessary equipment? <\/em><\/strong><\/p>\n

\"\"<\/a>I was able to cast many broken tibias and femurs that were closed.\u00a0 I ran out of plaster quickly – long before\u00a0 I ran out of strength – as what I had brought with me was grossly inadequate, and the church didn’t have much either.\u00a0 Fortunately the manager of the Belgian unit was kind enough to give me a case of cast padding and plaster casting material.\u00a0 I used every roll and was able to cast every one of my patients who needed a cast.\u00a0 When I finished, I did not have one drop of plaster left.\u00a0 Casting was not the best treatment for many of the hip fractures and femur fractures, but there was no other option.\u00a0 There was no operating room with hardware to fix the kids with hip fractures.\u00a0 I ran into a pediatric orthopedist from the Children’s Hospital in Dallas and he told me they were manipulating and casting as well.<\/p>\n

With no x-ray to guide me, I did all of my work by feel, blind luck and faith.\u00a0 Two of my patients died, one of septic shock after an above knee amputation, and the other because of a tension pneumothorax after a road accident.\u00a0 She couldn’t breath and we didn’t have a chest tube to help her.<\/p>\n

What kind of follow-up care will be available to the injured?<\/em><\/strong><\/p>\n

Follow-up will be the subacute phase of this crisis.\u00a0 Casts need to be removed, patients need therapy,\u00a0 those with problematic stumps will need revisions, and those with amputations will need prosethetic legs.\u00a0 Hopefully the world will not forget these people when the media stops covering the crisis.<\/p>\n

The greatest tragedy of all is the orphans.\u00a0 There are even more now in country that had too many before the quake. \u00a0 There were five orphans who were taken to the US\u00a0on the jet that I arrived on, and the day after I left, the last of our patients who were orphans were flown to northern Haiti by a philanthropist, hopefully to start a new life.<\/p>\n

Everyone understands that there is a vast amount of devastation in\u00a0Haiti, but seeing it first-hand must have been overwhelming.\u00a0 How did it affect you?\u00a0 What were your feelings while there, as you left, and now that you’re home?<\/em><\/strong><\/p>\n

Sleep was sparse in Haiti.\u00a0 Roosters crowed all night long.\u00a0 Hungry, emaciated dogs barked, but the shock of what I saw was the most likely cause of my sleeplessness.\u00a0 At 4:30 am the people in my compound got up to pray.\u00a0 At 5:30 they sang Amazing Grace<\/em>.\u00a0 Hearing it was a very poignant experience that I will never forget.\u00a0 This was one of those experiences that is beyond words.<\/p>\n

\"\"<\/a>
Barry and Jo Ann<\/figcaption><\/figure>\n

Photography by: Jo Ann Beltre<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

With no x-ray to guide me, I did all of my work by feel, blind luck and faith…<\/p>\n","protected":false},"author":129,"featured_media":4776,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1541],"tags":[569,541],"yoast_head":"\nHaiti After The Quake: An Interview With Dr. Barry Koffler<\/title>\n<meta name=\"description\" content=\"A few weeks ago, horrified by the devastation in Haiti, he left everything and went to help. It wasn\u2019t easy to get there, but he found a way. 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