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Bringing Help and Hope to Haiti
By Dr. Edgar A. Gamboa
The January earthquake in Haiti killed an estimated 250,000 people and wiped out the capital's fragile infrastructure. Here is the story of how one Filipino-American surgeon responded.

Q U I C K S C A N

Arriving With Supplies
Working 'Under a Pall of Death'
A Poignant Funeral Mass
Tragedy and Hope
Addressing Long-standing Problems
Answer to the Cynics
The Resilience of the Haitians
The World Responds
How Can I Help Haiti?

Pediatrician Dr. Lucie Noel Gamboa asks her surgeon husband, Dr. Ed Gamboa, to examine eight-year-old Joana Derice's hand infected with residual debris. Surgical tech Noelia Castro brings special instruments to treat the wound. PHOTO BY TOM TRACY

WHEN CNN FIRST broadcast heartbreaking images of collapsing buildings and children being extricated from Haiti's earthquake rubble last January, I thought of my friend, the papal nuncio to Haiti, Archbishop Bernardito ("Barney") Auza. I quickly e-mailed him: "Praying that you and your people have been spared the disaster and are faring well. Anything we can do for you?"

Thirteen hours after Haiti's worst earthquake since 1770, he e-mailed back: "Thanks. I survived but we are still camping outside. No film can capture the gravity of the devastation. Just horrible...thousands and thousands still under rubble. +Barney."

"What can we do aside from donating to Catholic Charities?" I responded. It was tough to watch live on HDTV a poor Haitian girl pinned under the rubble. I could easily do amputations, repair wounds and take care of various kinds of trauma, I wrote back. I could check with the Red Cross, the Catholic Mission Board and Doctors Without Borders, or I could simply drop into Haiti, which I knew would not be easy.

Archbishop Auza urged me to come to Haiti quickly. "There is so much work to do now," he wrote. "It may be too late days from now." He suggested I travel via Santo Domingo and asked Archbishop Jozef Wesolowski, his counterpart in the Dominican Republic, to meet me so I could join the convoy carrying provisions to the apostolic nunciature in Pétionville, 200 kilometers across the border.

So on January 19 Dennis ("Pancho") Cook, the unordained but de facto deacon of St. Joseph's in Holtville, drove me to the San Diego airport. The sleepy porter helped unload the two boxes my pediatrician wife, Lucie, and son John Paul had packed with medical supplies.

After two and a half days of travel, I was met by Archbishop Auza's chauffeur, Bernard, who delivered me safely to St. François de Sales Hospital in Port-au-Prince, Haiti. It is located close to the epicenter of the 7.1-magnitude, 45-second, strike-slip earthquake which struck on January 12, 2010.

An estimated 250,000 people died from the earthquake that destroyed the Haitian capital of Port-au-Prince, shattered lives, scattered families and wiped out whatever fragile infrastructure the city had. (For a variety of reasons, accurate numbers are impossible to obtain.)

Arriving With Supplies

My wife and I had met Msgr. Barney in 1989 when he was in Rome doing postgraduate work in canon law and sacred theology at the University of St. Thomas (the Angelicum). Despite a busy schedule, he had always found time to show us around Rome. On May 18, 2008, he was appointed nuncio in Haiti. (Apostolic nuncios represent the Holy See to national governments. Archbishop Auza is one of only four Filipino apostolic nuncios.)

For hours after the quake, Archbishop Auza toured Port-au-Prince with his alternate chauffeur, Gilbert. After assessing the widespread damage, he filed the first comprehensive disaster report to Agenzia Fides.

He also told Vatican Radio: "We are in great distress. We have no water reserves and gas stations are closed. There is no electricity....We are in need of everything."

I arrived with two boxes of antibiotics, wound-care supplies and surgical instruments donated by El Centro Regional Medical Center and the Lay Brothers of the Poor. Another 20 boxes, collected by Luz Bayot of Hawaii Gospel Rescue Mission, were shipped from Honolulu to Santo Domingo.

I had flown into Santo Domingo because the U.S. Air Force had closed Toussaint L'Ouverture International Airport to regular commercial traffic. Its control tower had collapsed, compromising air-traffic communications. When airline personnel saw the labels my son John Paul had taped to the boxes—Haiti Medical Mission—their faces lit up. They wished me safe travels and waived the excess baggage fees.

At St. François Hospital in Haiti, Archbishop Auza introduced me to Dr. Jean Marie Caidor, the medical director, and Dr. Hans Thomas, the assistant director, and showed me what remained of Hospital Saint François de Sales. Though surrounded by traumatized patients sheltered under makeshift tents, they were beaming, happy to see the nuncio's Filipino-American surgeon-friend.

I worked with Drs. Pierre and Andre and the surgical staff of St. François, Belgian professor Dr. Luc Beaucourt and his team from the University of Antwerp, Professor Otto and his German contingent, and military paramedics from Poland. The oldest and most damaged hospital in Haiti needed all hands on deck.

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When I arrived, one million homeless people were camping in tents throughout Port-au-Prince or wandering the streets, starving and desperate. Over 4,000 prisoners had escaped.

Archbishop Auza called the situation "overwhelming" and brought me to the Missionaries of Charity where other volunteer physicians, including Dr. Robert Walley of Mater Care International, had congregated. After resurveying for medical needs, he concluded that St. François de Sales Hospital needed the most help.

Dennis Sadowski of Catholic News Service, touring the hospital with CNS photographer Bob Roller, put it succinctly: "In what remains of St. Francis de Sales Hospital, the doctors work under a pall of death."

Archbishop Timothy Dolan of New York, chairman of the board of Catholic Relief Services, soon arrived with the Rev. Msgr. David J. Malloy, general secretary of the United States Conference of Catholic Bishops. Together with Archbishop Auza, Bishop Thomas Wenski (then in Orlando and now archbishop of Miami), representing the USCCB Secretariat for Latin America, and many local ordinaries and priests concelebrated a poignant Mass for the repose of the souls of all the victims of the earthquake.

Among these was the beloved and humble 63-year-old Port-au-Prince Archbishop Joseph Serge Miot and Vicar General Msgr. Charles Benoit. The archbishop had died from head trauma suffered in a fall off the balcony of the archdiocesan office.

In the cathedral loft, rehearsing choir members were trapped and perished. Several priests and seminarians perished in adjoining buildings, as did nuns and parishioners attending services at Perpetual Succour Church.

The funeral Mass was celebrated across from the ruined Cathedral of Our Lady of the Assumption.

Among those who perished was a well-known pediatrician from Brazil, who had devoted her life to working for the poor and the elderly. Dr. Zilda Arns Neumann was the founder and national coordinator of two social-action branches of the Brazilian Bishops' Conference, which significantly reduced the national infant mortality of Brazil. She and her organizations have served as a model for other impoverished countries in Asia, Africa and Latin America, and were nominated for the 2002 Nobel Peace Prize. The 75-year-old pro-life pediatrician was a sister of retired Cardinal Dom Paulo Evaristo Arns, known for his resistance against the military dictatorship in Brazil.

It was a liturgy filled with meaning and symbolism. The archdiocesan cathedral had been one of the two most prominent architectural and historical landmarks of Port-au-Prince. The other was the Presidential Palace, also destroyed by the quake.

President René Préval and First Lady Elisabeth Delatour Préval joined Church dignitaries, priests, religious and laity in mourning the dead and in praying for healing and national solidarity. It was the first formal gathering in the earthquake's aftermath, an occasion to pause from relief efforts, console one another and somehow make sense of the enormity of human suffering and loss.

"It was symbolic to have it in the courtyard of the damaged cathedral," Ken Hackett, executive director of Catholic Relief Services, remarked. "That helped in the grieving process. That's what faith can bring to you; when people are traumatized and grieving they can turn to their faith."

I was particularly struck by the somber, resonant and deeply moving music played by the Haitian police brass band before the start of Mass.

I see St. François de Sales Hospital as a microcosm of Haitian tragedy and hope. The oldest hospital in Haiti had not been perfect, but it was functional. The earthquake destroyed its pediatric and ob/gyn wards, burying approximately 75 patients, family and staff.

Before the last tremor stopped, hospital personnel ran through falling debris to rescue trapped survivors and retrieve x-ray and ultrasound machines.

Tents on the hospital grounds soon sheltered trauma patients, and makeshift wards expanded daily. Tents were designated for male and female adults, surgery and orthopedics, medicine and pediatrics. Five operating rooms were busy in the hospital.

Army personnel built durable tents for the pharmacy and the laboratory. I was pleasantly surprised to see computer screens appear in the pharmacy. The laboratory started processing chemistry panels in addition to basic blood tests. When I developed a reaction to prophylactic antimalarial drugs, mine was the first blood drawn for a liver function panel, courtesy of the University of Maryland.

Haiti's apostolic nunciature has become the nerve center of operations. A general fund and specific funds such as those designated for church reconstruction or particular projects are in place.

Nunciature Apostolique en Haiti
Bank of America
New York
Swift ID: BOFAUS3N
ABA n. 026009593
For Credit: SOGEBANK
Swift ID: SOGHHTPP
For Further Credit: NUNCIATURE APOSTOLIQUE EN HAITI
Account No. with SOGEBANK:
N. 31-6011121

Catholic Relief Services has very low administrative costs among charitable organizations. Ninety-four percent of donations go directly to their "efficient, effective and accountable" projects.

The Congregation des Petites Soeurs de Ste. Therese (Congpsst@yahoo.fr or srbernadetteinicolas@yahoo.fr) needs to rebuild its school and library as soon as possible.

Hands Together feeds as many as 10,000 children and 1,000 senior citizens each day.

St. Joseph Buddies—Help Haiti organizes medical/surgical missions. Donations fund antibiotics, vaccines, surgical supplies and transportation.

Drs. Edgar & Lucie Gamboa 1745 S. Imperial Ave., Ste 104
El Centro, CA 92243

The Web sites for all these organizations can provide more information on how to transfer funds.

Volunteers from all over descended on St. François to offer their services. The Poles made leg elevators. The U.S. Army Corps of Engineers surveyed standing structures for seismic stability. Missionaries from an orphanage assisted the nurses. Medical students served as physician assistants. High school kids from a Catholic school, run by lay missionaries Patrick and Christine Moynihan, acted as interpreters. My Spanish had served me well in the Dominican Republic, but in Port-au-Prince it was strictly French or Creole.

Relief work is often sporadic, laments physician and Passionist Father Rick Frechette, national director of Nos Petits Freres et Soeurs and medical director of St. Damien Hospital. Maintaining continuity is a challenge. Providentially, when the Belgians were about to leave St. François, Scripps Health San Diego's CEO Chris VanGorder and trauma surgeons Dr. Brent Eastman, Dr. Steven Shackford and Dr. Drew Petterson arrived at the scene. As the Germans were ready to head back home, the Maryland Shock Trauma team, led by Dr. Thomas Scalea, took over.

It was frustrating, nevertheless, that critically paralyzed patients, such as 19-year-old Jean Marie Danielle and 27-year-old engineering student Loraus Renaud, could not be transferred to a tertiary spine center once the USS Comfort was filled and air transport to Miami ceased.

In March I undertook a second mission to Haiti, this time accompanied by my wife and by OR scrub technician Noelia Castro. But eight weeks after the quake, it was frustrating to see that a 17-year-old vehicular accident patient with head and chest injuries could not be properly treated without a mechanical ventilator. A team of specialized trauma surgeons and nurses stood by the patient's gurney, unable to provide anything beyond basic care. The patient was transferred to another center where he was left to die.

Among the poorest countries in the Western Hemisphere, Haiti needed help long before the January 12 earthquake rocked the nation. This I learned firsthand from the nuncio and from local bishops, priests, nuns and missionaries who frequented the nunciature for strategic meetings.

Before the disaster, unemployment was a staggering 80 percent! Minimum wage for the lucky ones who found work was $1.75-$3 per day. Gasoline cost $5 a gallon, or $100 to fill up the SUV that took us back and forth from the hospital to the nunciature.

The first few weeks following the earthquake, when banks were shut down, were extremely difficult. Half of the economy is sustained by money sent in from the so-called "Haitian Diaspora," gifts from families and friends abroad.

In the United States, physicians and nurses hardly ever see patients with tetanus. At St. François de Sales Hospital, two had died days after the earthquake. I helplessly saw the third, a 16-year-old boy, terminally ill with spastic paralysis, lockjaw and labored breathing, as a consequence of a minor wound infected with tetanus. That could have been averted by timely vaccination. Only a third of the population, however, have access to medical care and half the children are not immunized.

An estimated 50 percent of school-age children cannot or do not attend school. More than 90 percent of education is accomplished by nongovernmental agencies such as the Catholic Church, other faith-based organizations and private individuals. Many of those schools were destroyed.

During my second visit (February 28-March 10), the papal nuncio brought us and representatives of humanitarian organizations, including Nancy Rivard of Airline Ambassadors International, up the mountains to Carrefour, where members of the Congregation des Petites Soeurs de Sainte Thérèse L'Enfant-Jesus work with peasants and their families. The order was founded in 1948 by a diocesan priest, the Rev. Farnese Louis Charles.

Sister Bernadette Nicolas, the mother superior, showed us the remnants of the buildings where, prior to the catastrophe, classes were held for 1,500 students, ages three to 22, from preschool to junior college. One hundred fifty students and four nuns perished in the rubble.

Some have expressed cynicism about helping Haiti, pointing to a history of government corruption as justification to let things be. Even those who are involved in humanitarian work express disappointment that foreign aid barely trickles down to those who need it most.

It is worth keeping in mind, however, that Haiti witnessed the first successful slave revolt in history. Freedom came at a very steep price: 150 million francs in gold (reduced in 1838 to 90 million francs) demanded by French colonizers in exchange for international recognition. Haiti spent 80 percent of its national budget towards debt repayment. This huge debt, which kept Haiti shackled in poverty, was not paid off until 1947!

Remember, also, that many tireless and dedicated individuals toil in Haiti with very minimal administrative cost. They need outside help and funding to keep their projects running.

One such individual is Father Tom Hagan, founder and president of Hands Together. My wife and I met him at a Mass for the Missionaries of Charity during the visit of their superior general, Sister Mary Prema.

I cannot say if I was more impressed by the utter humility of Sister Mary, who graciously offered me her hymnal so I could participate in the liturgy, or the down-to-earth wit and humor of Father Tom. It is always a special day when one gets to meet and break bread with a living saint—but two saints in one morning?

While Sister Mary supervises Blessed Mother Teresa's 600-plus houses of charity in 136 countries around the world, Father Tom oversees 15 schools and various clinics and projects, which for the most part are located in Cité Soleil, one of the poorest slum areas of the Northern Hemisphere.

Due to the inherent danger, relief workers hardly penetrate the area, which is unfortunate because 300,000 of Haiti's poorest reside there in subhuman conditions. I could not have seen patients there had Father Tom not arranged it so that I was accompanied by Hands Together staff and Dr. James DellaValle, who has worked with Father Tom. Dr. DellaValle is program director of the Family Medicine Residency at Guthrie Clinic in Pennsylvania.

Overall, however, I remain hopeful, partly because I see the strength and resilience of the Haitian people, especially in the smiling face of Benia Celestin. Her historic wristband says "#1." She was the first trauma patient admitted to St. François following the January 12 earthquake.

Benia was watching TV when her house collapsed, pinning her and fracturing her pelvis. Her x-rays show a severe "open book" type of fracture, and her shattered pelvis is held together by external fixators. She is able to move her legs, but weakly. She has some pain, she admits. But Benia is happy to be alive, is grateful to the doctors and nurses who care for her, and looks forward to the day when she can walk again.

Compassionate and sustained involvement is the key to rebuilding Haiti.

EXPRESSED IN THE URGENT APPEALS for a global humanitarian response from Pope Benedict XVI to U.N. Secretary-General Ban Ki-Moon to President Barack Obama, the earthquake struck a tragic chord which reverberated throughout the world. The United Nations deployed peacekeeping forces to control anticipated rioting immediately after the earthquake. The U.S. military took over control of the government hospital.

The United Nations had already intensified its presence in one of the poorest and most fragile countries in the Western Hemisphere. In 2004, the world organization deployed 9,000 military personnel and 2,000 civilians to staff the U.N. Stabilization Mission in Haiti (MINUSTAH). The January earthquake killed 125 U.N. staff members, including the head and deputy head of MINUSTAH.

United Nations agencies, including the World Food Programme, the Children's Fund, World Health Organization and Information and Communication Technology, were rapidly mobilized and deployed. International search and rescue teams, medical and surgical contingents and various nonprofit and humanitarian organizations—the International Red Cross, Catholic Relief Services, Caritas Internationalis, Oxfam and many others too numerous to list—aided disaster victims, a third of Haiti's population.

CNN anchor Anderson Cooper and Dr. Sanjay Gupta, among others, highlighted the disaster on the world stage. The media kept the world's attention focused on Haiti.

The United States government pledged $100 million in aid and dispatched the U.S. Army's 1st Battalion, 73rd Infantry from Fort Bragg, North Carolina, and the aircraft carrier USS Carl Vinson. The U.S. Navy's hospital ship USS Comfort offered specialized medical and surgical care.

About 500 critically injured patients were treated at the University of Miami's Jackson Memorial Hospital and other U.S. medical centers.

Catholic Relief Services (CRS) and Caritas Internationalis, along with Doctors Without Borders or Medecins sans Frontieres, and other NGOs, immediately swung into action. Ken Hackett, executive director of CRS, noted that, in decades of involvement in relief projects, he had never seen such destruction and death following an earthquake. At St. François Hospital, CRS worked around the clock in the aftermath of the quake to get the heavily damaged hospital functioning as best it could.

By February 1, CRS's Sean Callahan, executive VP for overseas operations, and its Haiti representative, Karel Zelenka, had distributed two weeks' worth of packed meals to 100,000 Haitians. A month after the earthquake, Catholic Relief Services reported that it had provided food for half a million people.

Through a special collection taken up in parishes in January, Catholics in the United States donated $60 million.

 

Edgar A. Gamboa, M.D., FACS, is a fellow of the American College of Surgeons. He serves as chief of surgery at El Centro Regional Medical Center in Southern California. He is married to Dr. Lucie Noel Gamboa, a pediatrician, and they have three sons and a daughter. He authored Virtuous Healers: Models of Faith in Medicine, published by St. Anthony Messenger Press.


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