So Far It's A Success

HAITI GROUND REPORT 24th of February 2010

From the very start, MiST's mission objective in Haiti was to operate for the greatest benefit of the Haitian people. Our medics and other personnel have a clear mission: we we offer what is needed, we do what we can as well as we can and we work in harmony with other NGOs.

When you arrive at a scene of mass devastation, the overwhelming need can leave you feeling helpless, as though you are just a 'disaster tourist'. This is how Dr. Shoaib felt 4 days ago when he arrived in Haiti (apologies for using your name, Amer, as i know that you are publicity shy)

Palacio Nacional - Haiti (c/o Wikipedia)

Yesterday, Dr. Shoaib gave a powerpoint presentation in his 'school boy' french to an official from the Haitian Ministry of Health, with backing from the chief of the Haitian Orthopaedic Association, which was well received, especially as he made the effort to speak in a foreign language.

"There is a lot of work to do in Haiti and there is a big gap that no-one is addressing, one which will suit MiST perfectly.” (see last blog post for MiST history in Pakistan earthquake).

Mist will be working with the CARIS foundation, based in the US, who were working in Haiti long before the earthquake. We will be working together to provide outpatient care to the many thousands who have limb injuries but are not currently being cared for. 

MIST has been fortunate to find local Haitian Orthopaedic surgeons who are keen to work with us to provide a trauma service to the local population and training to young Haitian doctors.

There is a great need for MiSTs’ expertise in wound care - it is an expertise lacking across the disaster area.

  “The local [medical staffs] had no time to apply external fixation or medical care to the wounds, and patients were left outside hospitals with no care,” said surgical trainee and volunteer Ihab Boutros in Pakistan 2005.

We hope to further deploy our available surgical teams immediately – and somehow we aim to find a way to raise another £50,000 to enable a successful trip.

The earthquake and the poverty of Haiti that pre-existed the earthquake have resulted in a paucity of special x-ray machines that are mobile enough to be used in an operating theatre. These mobile x-ray machines, or image intensifiers, are used to ensure that the position of implanted orthopaedic metalwork is ideally placed. As there were none available after the earthquake, bones were not necessarily set straight, and there is a real risk that the bones will not heal at all, or may heal in a poor position, leading to disability.

With a huge amount of worthy fund-raising around the world and projects full of passion still imploring 'more for tents, more for sanitation, more for water', MiST implore you…for an X-Ray Machine ($80,000)*. 

It may sound crazy with such devastation, but with just one x-ray image intensifier, we could ensure a high quality of treatment for orthopaedic surgery for broken bones, enabling MIST and local Haitian orthopaedic surgeons can give Haitians access to a better quality of life.

The implications are massive. An estimated 250,000** people suffered one or many crush injuries, and after shocks continue to injure more.

This affects a considerable amount of the Haitian population.

This affects their long term life quality.

Please please help us in our balmy but crucial aim.

Donate Here

*$80,000 = £52,000

* Quoted from Science Daily http://www.sciencedaily.com/releases/2010/01/100127085542.htm

Volunteer British surgeons aid Pakistanis injured in devastating 2005 earthquake

An article by Tina DiMarcantonio in
ORTHOPAEDICS TODAY INTERNATIONAL 2007

MiST volunteers still offer care while they work to create a Level 1 trauma center in Pakistan.

A number of British surgeon-volunteers cared for severely injured patients in Pakistan after the October 2005 earthquake that destroyed hospitals and roads in Pakistan, Afghanistan and India.
The earthquake measured 7.6 on the Richter scale and lasted 73 seconds, taking 86,000 lives and leaving 120,000 injured. With a lack of hospitals and surgical experience in these countries, injured patients received little or no care before the British surgeons arrived.
“The local [medical staffs] had no time to apply external fixation or medical care to the wounds, and patients were left outside hospitals with no care,” said surgical trainee and volunteer Ihab Boutros.

British surgeons arrive

In early November 2005, the Mobile international Surgical Team (MiST) sent multidisciplinary teams of experienced orthopaedic and plastic surgeons to Al Shifa Eye Hospital in Rawalipindi, Pakistan. Boutros was among the volunteers.
“We went 4 weeks after the earthquake because of logistical problems,” Boutros said at the British Orthopaedic Association Annual Congress in Glasgow. MiST sent teams to Pakistan. Each team transferred patient care to the next team to ensure continuity of care.
When Boutros arrived at the small, local eye hospital with his team, they found 97 patients with 107 orthopaedic injuries. “On the first day we saw the patients, 72 patients [with 84 injuries] required immediate surgical treatment. The rest were discharged to camps because they had no homes,” Boutros said.
The surgeons found interesting demographics among the admitted patients, which included mostly women and children, Boutros said. Patients were a mean age of 34 years (range, 0.5 years to 80 years) with 34 patients younger than 16 years old, five infants and only five patients older than 60 years.

MiST surgeons performed an additional four amputations and revised 11 amputations when they arrived to Pakistan 4 weeks after the earthquake.	MiST surgeon volunteers encountered injuries such as this open fracture when they arrived at Al Sharif Eye Hospital in Pakistan after the earthquake. They implanted external fixators in most cases and performed multiple washouts and debridements for all patients. Images: Khan S

Lower-limb injuries common
Most patients presented with lower-limb injuries and significant soft tissue loss. Of the fractures, 64% were 3B open injuries, according to a study abstract. When the surgeons arrived, 12 patients had already undergone amputation.
Surgeons performed multiple washouts and debridements for the patients – 202 in total during their time there, Boutros said. They also performed 34 definitive orthopaedic procedures, 57 definitive plastic surgery procedures and 19 combined procedures.
Orthopaedic procedures included 11 Taylor spatial frame fixations, four Ilizarov frames, five open reduction and internal fixations, seven K-wire fixations, five manipulations under anesthesia, and two hip Spica applications.
Plastic surgery procedures included 21 split skin grafts, four amputations, 11 amputation revisions, 17 fasciocutaneous flaps, three musculocutaneous flaps and one free flap.
“The overall amputation rate reported by the Pakistani government was 3%, but from our sample – which you have to keep in mind is very small comparatively – the amputation rate was 18%,” Boutros said.
Because the government provided camps for the injured patients, Boutros and his colleagues did not follow their typical discharge protocol in order to admit more patients to the hospital.
“Even if the patient seemed to require care but did not require surgical care, they would still have to be discharged to allow other people to come in. We had to compromise on our standards,” Boutros said.

Future MiST volunteer work

The MiST team concluded their work at the Al Shifa Eye Hospital in December 2005, but they remain in Pakistan. Since April 2006, the group sent teams to Ayub Medical College in Abbottabad, Pakistan, every 6 weeks, according to Sohail Khan, FRCS, MiST co-director.
All fractures are either united or undergoing Ilizarov treatment, Khan said.
“Our long-term plan with the Pakistani government and private funding is to set up a Level 1 trauma and limb reconstruction center in Pakistan,” he told Orthopaedics Today International.
MiST surgeons at the center will perform limb correction surgery using ring fixators. They will also teach the local medical and nursing staffs how to use ring fixators with the hope that they will eventually run the surgical center, Khan said.
MiST recently became the medical arm of Islamic Help-UK, a volunteer organization that provides aid to countries, including Lebanon, Mali and Indonesia. As the medical arm, MiST will provide medical advice and rapid response teams in disasters.
“Islamic Help has experience in providing housing, food and water in acute situations and water and other education projects in the long term,” Khan said. “If there is another disaster, MiST is ready to travel at a short notice.”

X-rays and The Walking Wounded

Dr. Amer Shoaib from the UK has been meeting with many Haitian doctors. He reports that although many medical areas are 'secure' with the presence of US military personnel, he describes the atmosphere as tense - and frustrations are increasing.

There are long queues outside medical areas, yet  people are walking the streets despite obviously being in need of medical attention. The walking wounded.

Despite rumors that Haiti is flooded with medical aid, demand way outstrips supply. It is inevitable that  untreated injuries, or poorly treated wounds will become infected unnecessarily leading to swathes of the Haitian population with lifelong and irrevocable physical damage.

MiST specialises in limb fixation and amputations. We worked in Pakistan during the 2005 earthquake developing prosthetics that can be manufactured 'in the field' at less than a tenth of the cost of modern Western prosthetics. It is MiSTs' aim to help Haiti with quality treatment and limb fixations. Yet on initial assessment there are no X-Ray Machines available in Haiti. It is likely that treatment will be faulty if diagnosis is inaccurate.

One X-Ray Machine costs $80,000.

MiST are seeking funds for such equipment. It will make a long term difference, ensuring some of the countless people with crush injuries to limbs will be able to walk, write, lift, hug and work in the future.

We hope that those with resources do not tire of funding the reconstruction of Haiti and providing essential  aid to its people. Professional journalists, doctors and aid workers with decades of experience report that Haiti is suffering the worst devastation they have ever witnessed.

Donate to MiST Haiti fund here.

This Is Not A Time To Decrease Aid

Thursday has brought rain to Haiti.
Salam Obaidi and Amer Shoaib, Manchester based doctors have been in Haiti for two days now on behalf of MiST.
The instant they crossed the borders from the Dominican Republic the devastation was visible. The roads, the mountainside, all ravaged. As Salam and Amer approached Port-au-Prince they saw a scene comparable to a bomb site. Completely flattened houses, people using ANYTHING for protection from the elements.
Some people have tents or plastic sheeting, others are using cardboard for shelter.

 Dr. Amer Shoaib and his relatively deluxe accommodation.

Arriving at a scene were 200,000 people have been killed cannot fail to shock.

One month and seven days after the earthquake and charities are leaving. Salam Obaidi emphasized that Haiti is an incredibly poor country and needs increasing aid not decreasing aid. Problems such as stress, sanitation, lack of water and food, plus that of straining to cope with destruction and damage to physical selves and the environment are not decreasing.

With the rains starting to fall, and hurricane season due in early June - communicable diseases will be on the increase.

Our doctors will continue to visit organisations and people, trying to understand actual needs and where MiST can create an impacting role. It is a challenge to find their way around the destruction, rain makes it more difficult for all in Haiti.
MiST are still fund raising in a bid to increase the support we give to the victims Haiti .
Visit our website to donate.

Author: Alice Hutt

A MiSTy Valentines

  Two Cherubs (Source: Wikipedia)

On Valentine's Day, two of our members have flown out to Haiti to carry out essential groundwork before we send out full Medical Teams.

One month after the terrible Haitian earthquake, it's time for precise and effective action.

MiST is an organisation formed to respond to disasters - it has been deeply frustrating to await funds to fly out to the disaster-stricken zone.  Prior to the disaster, MiST had been processing paperwork to purchase Emergency Response Kits. The terrible disaster in Haiti caught everyone by surprise: the sheer scale of the disaster has been hard to take in.

Our aims are clear: MiST must synergise its work with existing services and resources, we must pin-point who needs what and where. We aim to work in partnerships with other charities and NGOs to ensure the future health of Haitians.

Now that our personnel are in Haiti, MiST can bring its experience of sustained development in Pakistan, India and Gaza to the fore. Not only do we provide Trauma Surgery on the ground, but we also train local medics and develop local medical infrastructure: this is what makes us unique the in the world of international  medical support.

Visit the MiST website.