Friday, April 02, 2010

From Barbie @ Heartline Hospital

I have been asked to post this request to help our field hospital find a neurosurgeon for one of our patients.

Amanda, a 22 year old young woman living at the Heartline Field Hospital in Port au Prince, Haiti, was crushed when her neighbor’s house collapsed into hers in the Haiti earthquake on 12 January 2010. She has multiple injuries, including a severe nerve (brachial plexus) injury which causes her to live in incapacitating pain. There are no specialists in Haiti who can perform this repair. We are seeking help to get Amanda to the United States (or elsewhere) to a neurosurgeon/ brachial plexus specialist, in a last hope effort to resolve this young woman’s incapacitating pain. If you know any orthopedists or neurosurgeons, please share Amanda’s story with them, and see if they know anyone who might be able to help Amanda. We are asking that the surgeon and treating hospital donate their services. If and when a surgical team is identified, we will also need financial donations to pay for Amanda’s medevac to the United States, and her room and board while she is there. Amanda has a passport, which will facilitate her travel out of the country.

Here is Amanda’s story:

On the evening of 12 January 2010, young Amanda was standing in her mother’s kitchen outside of Port au Prince. When the earthquake hit, her neighbor’s house came crashing down into hers, trapping Amanda under its crushing weight. Her neighbor – Amanda’s best friend – was killed instantaneously. Earthquake survivors describe the shaking and grinding of the earth on that day as horrific and surreal; many believed the world was coming to an end. In the minutes after the large quake, neighborhoods were filled with the sounds of thousands of screams – some crying out in pain, others calling desperately for their crushed loved ones. The sound of screaming echoed eerily and incessantly into the dark night, through the near and distant neighborhoods; they could reportedly be heard for miles. One in every ten people in Port au Prince and the outlying communities was killed in the earthquake that shook for less than one minute.

Amanda’s screams of pain were heard by neighbors, who worked aggressively through severe aftershocks to free her from the concrete and rebar rubble which pinned her. When she was finally rescued, it was evident that her life was in danger. Her left arm and femur were crushed – both exquisitely painful, with large open wounds; the latter – her deformed femur -- was potentially life threatening. In the United States, such severe injuries would get Amanda life-flighted by helicopter to the nearest trauma center for emergency surgery. In Haiti in the week following the earthquake, Amanda was one of more than 100,000 severely injured individuals desperate – and unable – to find care.

Imagine if this were your daughter, your sister, or your friend. And you are desperately trying to find her care. You drive first to your local hospital – which is absolutely overwhelmed. She is there for two days, and receives an IV, but no pain medications and no orthopedic care. She is in agony, with a deformed femur and an open fracture of her arm. You become desperate; you decide to drive her to the city. Certainly there, at one of the big hospitals, she will receive help. But many of the big hospitals, you soon discover -- to your horror -- have been destroyed. You find one – hospital number two – and take her there. After a day, she again receives no care. You drag her unsplinted, broken form in search of a rumored orthopedic field hospital. You cannot find it, so you sleep with her in the streets, cradling her crying form through the night in your arms. In the morning, you take her to hospital number three. No care. You search again for the rumored field hospital and finally move her again – still unsplinted, still without pain medication, to hospital number four. There, she is loaded into a truck and convoyed across the countryside – still without pain medication and still unsplinted, every jolt on the country highway causing exquisite bone on bone grinding – to the Dominican Republic, the country east of Haiti, to hospital number five. There she finally sees an orthopedist, who places a metallic external fixator into the shattered bones of her left femur and a metal rod to stabilize the open fracture of her upper left arm. There they discover that her left arm is paralyzed, yet in the cruel irony that is severe nerve injury, her arm is not numb, but instead burning with severe, intractable nerve pain. And she develops a severe infection at the surgical site of her left arm. You meet a representative of another field hospital located back in Haiti, that has orthopedists and plastic surgeons, and can manage her open wounds and infections. So, you truck young Amanda, once again, over the bumpy rural highway, back to Port au Prince, the city from which you started, to hospital number six -- Merlin Field Hospital. There, in a collection of canvas tents on an old tennis court, European physicians place skin grafts over her open wounds of her left leg, and further manage her infection. You discover that they, too, are overwhelmed with patients, and recommend transferring her to hospital number seven – Heartline Field Hospital – for pain and infection management and rehabilitation. At Heartline, it becomes obvious that the nerve pain in her arm is severe and unremitting; so she is transferred temporarily to Miami Field Hospital – hospital number eight -- where an anesthesiologist places a temporary catheter into her chest through which pain medication can be infused to blunt the nerve pain in her now non-functional left arm. This is a time intensive infusion, done over 30 minutes three times a day. She is then transferred back to Heartline for regular care and rehab; there, her pain management catheter is found to be ineffective. Her unremitting pain continues. Imagine this is your sister, your daughter, your friend. The agony of her journey. The agony of months of intractable pain. The overwhelming hopelessness.

While Amanda’s femur is slowly healing, her arm pain remains severe. The unfair irony of Amanda's arm injury -- a probable stretch or tear of the brachial plexus -- is that although the nerves to her arm now fail to function, and it hangs limp and unusable at her side, she is plagued not with arm numbness, but with severe, incessant pain. Nerve pain. Imagine the worst ice cream headache of your life. Or the worst sciatica of your life. Imagine the pain you get when the dentist pokes his metal hook right into that sensitive part of your tooth. Fiery, electrical, intolerable pain. That is nerve pain. Now, imagine living with that constant pain, with no hope for relief. This is Amanda’s burden.

Some have proposed an amputation of her arm. The problem with this solution is the arm can be removed, but the nerve pain -- coming from higher up, near her neck -- will persist. After such disfiguring surgery, she would still feel severe, phantom pain into the tips of her fingers -- even if her arm were no longer there.

There is a possible surgical intervention for Amanda. But there is no one in Haiti trained to perform it. There are a few specialists in the United States who can. But the clock is ticking. The farther she gets from the injury, the less likely the injury can be successfully repaired. And the more likely this young 20 year old woman will live with ongoing, devastating pain. As one orthopedist bluntly put it, "This injury will not kill her. But suicide, from the ongoing, unremitting pain, could."

Please help Amanda. We need to find her a surgeon. And we need the funding to get her to the United States, and support her while she is there.

If you can help in any way – be it a donation, an offer of housing or transportation, or a medical contact, please contact Heartline Ministries at Together, we believe the Heartline Field Hospital community and contacts can come together to find Amanda a final solution – at hospital number nine. We will keep you informed of our progress to find Amanda care.

Please forward this request on to anyone you feel might help with Amanda’s case.

Heartline Field Hospital, Heartline Ministries, Port au Prince, Haiti