After the earthquake, in Les Cayes, August 2021 — by Dr André Wislet
This is a guest-publication, written by Dr André Wislet, head of resident doctors at the State University Hospital of Haiti. This post is a translation of the original, written in French, published in a medical newsletter, The Lancet (page 6) in August of 2021.
It is the first essay in a series that will feature articles, essays or memoirs by Haitians currently living and working in Haiti. Haitians who do not live in the diaspora, or speak from that perspective. Haitians who are not on the move across the South American continent, and for that reason are not interviewed, and presented to the North American public, through the lens of current journalistic practice.
The Haitians whose writings will be featured here are the ones who stay in Haiti, either out of their free will or due to the lack of alternatives. They face and overcome the difficulties of life in Haiti routinely, while also do their best to stay positive, to live and to move forward, step by step, day by day. They are not victims or survivors who need a voice. They are individual human beings who have a voice, but cannot be heard, debated, or considered outside of Haiti, because they speak their own language and many times prefer to use their own words to tell their story, rather than scripted slogans or institutional jargons established in the United States. They are people whose names are not well-known, so the legacy media in the global North will not feature them in their publications. They are human beings with complicated lives who prefer not to be pitied, and who do not shy away from humour; to the contrary, their sense of humour is an essential part of what helps them to live and to keep moving on. They are welcome on this platform.
*
Explanation of terms: The name State University Hospital of Haiti is the direct translation of the original Hopital d’Université d’Etat d’Haiti, the name of the largest state hospital in Port-au-Prince, the Haitian capital, where the author of the article works as the head of resident doctors. The French name is abbreviated as HUEH. It is also referred to as ‘the general hospital’. In this translation of Dr. Wislet’s essay I will refer to it either as State University Hospital, or HUEH.
While HUEH is the largest state-hospital in Port-au-Prince, and it is arguably also the least materially equipped to properly care for sick patients. Doctors who complete their residency there learn hard and lasting lessons about the difficulties of emergency patient care with scarce or nonexistent resources. They also learn lessons about the meaning of selfless service, resilience, ingenuity, and the precarious nature of life under conditions where slogans and grandiose goals have not led to entitlements. The doctors are left with facts on the ground to navigate.
I added a few notes in the translation, for better understanding by a public not familiar with details of life in Haiti.
Article by Dr Wislet:
It was at 4 o’clock in the afternoon on August 14th, 2021, when the first group of doctors left [for Les Cayes] from the State University Hospital yard, in Port-au-Prince. A few hours before that, about 30 minutes after the earthquake happened, resident doctors at the hospital, interns, and former residents who now work at the hospital’s social services, started organizing to see what concrete actions we could take. We met and talked in the hospital yard, or on social media. Decisions taken by Dr Jessy Colimon, Executive Directrice of the University Hospital, by Dr Philipe Desmangles, Dr Edouard Michel, and Dr Jean Junior facilitated the swift dispatch of nine resident doctors from orthopedics and surgery, to the affected areas in Les Cayes. Forty-six additional doctors were to follow them, by taking Route National No 2, the road that passes through Martissant. The country has just been hit by a 7.2 magnitude earthquake and urgent action was needed. We all understood that, and we were ready to serve.
{Editor’s notes:
- On the day of the earthquake, two groups of doctors were dispatched from the general hospital to Les Cayes. The first group travelled by plane and included nine doctors, the second, forty six doctors, travelled by bus.
- Route National No2 is the only available road that goes to the South-West from the capital. The road passes through Martissant, a neighbourhood of Port-au-Prince where random shootings, gang activity and kidnappings are at one of the highest levels in Haiti}.
Being dispatched to a devastated area with no resources actually did not frighten us, but having to pass through Martissant filled us with dread. The realities reining in this war-zone can push even the most determined soldier to defection. So [to help our fellow countrymen] we had to rise to that challenge and be more than soldiers, as our deployment to the effected region was planned to begin the next day.
Due to lack of even the minimum of material resources and basic medical equipment, our range of action was limited in the beginning. Donations from national and international institutions and from private individuals were expected to arrive to ease this situation of need. Two days after our arrival the calls for donations have showed their first results. Now we had basic supplies, such as: bandages, gauze, plaster for casts etc., and could start attending to the wounded in the area.
The population living in larger towns had the best opportunity to access care, because our group of surgeons and orthopedists were based in the main hospital of the area, the General Hospital of Les Cayes. We worked under the supervision of Dr Philippe Desmangles. The real challenge arrived when we tried to reach people in more secluded areas. With the help and the active support of the local authorities, particularly that of Congressman Dr Sinal Bertrand, we could reach remote areas such as Beaumont in Grand-Anse, Camp Perrin, Cavaillon, Maniche, Port-Salut in the South, to mention a few. The help these local leaders supplied was invaluable to our mission, and the motivation of all our doctors exemplary.
When travelling between the various areas [of the Les Cayes region], the physical help of doctors on the team was frequently needed, so we could continue moving on the road. Doctors had to remove large rocks that had piled up on the road, as a result of landslides following the earthquake and the heavy rains. Certain places were not reachable by car, so we had to get to them on foot. In secluded communities that hardly ever receive medical care, we had to attend not only to people wounded in this latest disaster, but to those who sustained prolonged and serious medical conditions that had started and have become chronic since way before the earthquake. People with hypertension or diabetes, to mention only a couple.
[Editor’s note: Photograph of a long neglected and infected open fracture, and that of a newborn baby are included with the article, representing cases that are unrelated to the earthquake but constitute an emergency situation.]
The conditions in most hospitals in the area where the earthquake hit were such that basic supplies swiftly ran out. We needed to take action to improve the situation. Against all odds, seven days after the earthquake our team of surgeons and orthopedists performed 62 (sixty two) surgical interventions, and other members of the team have cared for individuals in three nearby areas every day, referring some patients to the General Hospital of Cayes.
It was a very rough task, but the dedication of our doctors, alongside the support of medical and religious organizations, international nonprofits, local leaders, and private individuals, Haitians living both in Haiti or abroad, made the work possible. On behalf of the population of Southern Haiti, we want to thank them all. This experience taught us that we should never run away when faced with a situation that appears to be impossible to handle. We had but meagre means at the start, but with the support of the larger medical community in general, and that of the Haitian community in particular, this humanitarian feat was made possible.
We left the area accompanied by the smirks of some representatives of an international community still in shock over their own disarray. The soldier-like efforts of our doctors and interns, the initiative of Congressman Sinal to offer us a place to stay and to accompany us on the way, and the dedication of Dr Colimon, Dr Demangles, Dr Henold Buteau and of Odilet Lesperance to coordinate and supervise so the we can work the best that was possible under the circumstances, have showed definite results. As I write this article, some members of our team are still in the area to provide follow-up or continued care and to manage emergencies until mobile clinics can be set up.
Their example of solidarity will live on.
Dr André Wislet
Resident Doctor on Internal Medicine
Chief of Residency at HUEH
Dr Wislet was the chief coordinator and a member of the group that was dispatched to the South of Haiti, after the earthquake. He spent many days in the area during the first month directly following the earthquake, travelling back and forth between the capital and the Les Cayes area, caring for patients.
