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Article about Maimonides Society Work in Haiti

Read about the work of Ann Lynn Denker, one of the wonderful Maimondies Society members who worked in Haiti shortly after the Earthquake one year ago.

The trip was a partnership of the JVC, Maimonides and Project medishare

18 American Nurse Today Volume 6, Number 1 www.AmericanNurseToday.com

ON JANUARY 12, 2010, a
major earthquake struck Haiti.
That evening, Project Medishare
(a nonprofit agency based in Miami) began an emergency
relief effort. A United Nations storage tent at the
Port-au-Prince Airport in Haiti’s capital was transformed
into a busy emergency hospital where 225 severely injured
persons began to receive treatment. High-quality
nursing care became essential to the relief effort.
Ready to contribute
I felt an instinctive urge to volunteer to help. I’d had
previous disaster relief experience and felt ready to
contribute—even if to save just one life.
I immediately began to explore volunteer options
while planning how to balance work responsibilities and
preparing for travel. Five weeks after the quake, I went to
Haiti to work with Project Medishare as part of a group of
healthcare professionals from the Greater Miami Jewish
Federation. After arriving, we were taken to the University
of Miami Field Hospital near the airport. The compound
included three large tents, which housed an adult trauma
center, a pediatric trauma center, an operating room, a
wound-care area, and sleeping facilities. I was assigned to
the pediatric tent, where I worked 12-hour shifts. I was
buoyed by the environment of collaboration and teamwork
among nurses, physicians, pharmacists, physical
therapists, translators, social workers, soldiers, and missionaries.
(See Tending to a tiny quake victim.)
Gratitude and hope
Among our patients and their families, I encountered
gratitude and a positive spirit. Patients rarely complained,
despite critical injuries and few comforts. Every child I
cared for made a lasting impression. They included a
13-year-old girl who had to have both legs amputated, a
baby burned in a cooking accident, a 9-year-old boy recovering
from an appendectomy, an 11-month-old baby
diagnosed with acquired immunodeficiency syndrome
(AIDS), and a young boy with broken legs who anxiously
awaited surgery in the United States.
My first day’s assignment included 35 children with
a wide range of problems. I quickly bonded with the
healthcare team and fell into a rhythm of caring and
problem solving. The wide variety of our patients’ ailments
created a diverse environment
that called for continuous
problem solving. We dealt
with amputations, burns, failure to thrive, HIV/AIDS,
fractures, crush injuries, malaria, labor and delivery,
malnutrition—and more. Many patients had been rendered
homeless or orphaned by the quake; others
didn’t know where family members were. We provided
postoperative care, end-of-life care, and emotional support
for the anxious and grieving.
Volunteers must collaborate with the local population
in a spirit of joint effort and solidarity. As in most
disasters, local citizens were central to the Haitian relief
effort and successful recovery. Haitians worked beside
us, lending support and invaluable information and familiarizing
us with cultural norms and perspectives despite
their personal losses and tragedies.
After the earthquake:
Volunteer nursing in Haiti
By Ann-Lynn Denker, PhD, ARNP
Mind/Body/Spirit —
A tale of cross-cultural caring
in a devastated country
Tending to a tiny quake victim
The author feeds a small premature Haitian infant, who grows
and survives against the odds.
www.AmericanNurseToday.com January 2011 American Nurse Today 19
Living conditions
Each volunteer was given a cot in a
large sleeping tent. Amenities included
outdoor showers, portable toilets, bottled
water, and meals ready to eat
(MREs). One must bring sleeping bags,
personal supplies, and desired food
provisions from home.
The quake’s aftershocks constantly
reminded us of the disaster and the
ongoing danger, so even after our 12-
hour shifts ended, we had little opportunity
to escape its reality. Satisfying
rest was limited and we were always
on alert for a pending emergency call.
Also, we had to be prepared for
changes in schedules and travel plans
due to the unpredictable nature of
the situation. Communications with
the outside world weren’t always reliable
or consistent. Even our departure
from Haiti turned into an adventure:
We were left stranded on the airport
tarmac after a 4.8 earthquake disabled
the runway lights.
Working with“workarounds”
If you decide to volunteer, be prepared for the unknown
and approach the experience with creativity
and flexibility. In the United States, healthcare professionals
work in highly regulated environments with adequate
resources. But in other countries, especially after
a disaster, expect a much different situation. Scarcity
of structure, information, and supplies necessitates a
high level of professional autonomy and critical thinking—
and the need to create “workarounds.” Equipment
and supplies (mostly donated) aren’t always ideal and
may need to be adapted on the fly. In Haiti, we faced
such problems as lack of documentation systems and
tools, a dearth of pediatric medications, supplies with
labels from many countries and languages, and incompatible
I.V. equipment. These conditions required constant
attention to detail and problem solving.
Also be prepared to function in multiple roles as dictated
by the situation. One day, you may be viewed as a
novice; the next, you may be called on to take charge.
Besides being a caregiver, you may need to serve, for
instance, as errand runner or supply agent. During a disaster,
ethical standards for nursing practice also may
shift. (See Ethical perspectives during a disaster.)
Bound for home, hopeful for the future
When I got back from Haiti, I was tired but extremely
satisfied with our efforts. I’d passed through the gamut
of emotions—excitement, fear, anxiety, camaraderie,
frustration, fatigue, and love—and gained a renewed
perspective on life. The experience had been intense
and immensely gratifying, largely because of the relationships
I’d built with Haitians and my coworkers.
Volunteers continue to donate their time and money
to the Haiti relief effort. Donations to reputable relief
organizations are still crucial, as is on-site volunteerism.
Rebuilding and education efforts for clinics, hospitals,
community services, and resources will be in demand
there indefinitely.
Project Medishare offers numerous opportunities for
healthcare volunteers. The volunteer environment is continually
evolving and changing. Project Medishare has
moved its pediatric care in Haiti from airport tents to
Bernard Mevs Hospital in Port-au-Prince. The wards are
air-conditioned, and volunteer quarters are located in a
real building. Ultimately, the pediatric census will be maintained
at 40 beds. Activities will include active training of
Haitian doctors and nurses in delivering high-acuity and
critical pediatric care. Miracles are happening every day.
I feel I received so much more from the people of
Haiti—and the experience as a whole—than I gave to
them. My desire to return there and continue to support
relief efforts remains strong.
Visit www.AmericanNurseToday.com/Archives.aspx for a list of selected
references
Ann-Lynn Denker is director of the Center for Nursing Excellence at Jackson Health
System in Miami, Florida.
Ethical perspectives during a disaster
In Haiti, we had no formal ethics process or committee structure to guide us
through challenging clinical decisions and ethical quandaries. Instead, we made
difficult decisions as a team, acting as an ad hoc committee.
As in most disasters, our goal was to provide life-saving care to as many people
as possible.We had to focus not on the individual but on achieving the greatest
good for the greatest number of people.We strove to provide satisfactory
care—the best we could offer in the circumstances, given the lack of resources.
This approach can be challenging for a professional nurse, who strives to provide
excellent care to all patients.
During patient triage and when determining how aggressively to treat patients
unlikely to survive, we focused on such questions as:
• How critical is the patient?
• Are adequate resources available to meet the patient’s needs?
• Can the patient’s life be saved?
We also had to consider bed availability, the patient’s potential for rehabilitation,
available medication and supplies, and continuous reevaluation.We had to
assign lower priority to patients we believed would need complex and extensive
follow-up care if we knew such care wouldn’t be available. These are the difficult
facts relief workers face when up against limited resources.

tags Helthcare, Nurse, Doctor, Maimonides (all tags)


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