Vox Populi: Lessons from the 2010 earthquake in Haiti

This week was supposed to be one of professional growth and camaraderie at the Society of Critical Care Medicine's annual conference in Miami.

On January 12, 2010, everything changed when a 7.0 magnitude earthquake struck Haiti, just 700 miles away. The devastating earthquake killed tens of thousands of people and displaced more than a million people.

Within a week I found myself leading a team in the aftermath of chaos.

Fifteen years later, the memories are still fresh: the desperate need, the despair, the devastation, but also moments of success and even joy in the midst of despair.

Jim Kim, then president of Dartmouth, and Paul Farmer, co-founder of Partners in Health in Haiti, reached out to the Dartmouth community for support. Many questioned the feasibility and safety of responding to such a massive disaster.

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Fifteen years later, the memories are still fresh: the desperate need, the despair, the devastation, but also moments of success and even joy in the midst of despair.

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Jim Gilling, professor of medicine

However, within days, students, parents, alumni, disaster experts, health care providers and other stakeholders developed a plan to send two trauma and critical care teams to Haiti to support Partners in Health.

Two days after the Dartmouth trauma team deployed to the hamlet of Hinch, I led the second group—a critical care team of seven nurses and me—to the capital, Port-au-Prince.

As we approached the city, the extent of the destruction became clear. Makeshift tents covered the open spaces, and the air was thick with dust, noise and despair. UN soldiers and the US Army provided security amid the chaos.

When the nurses arrived at University Hospital after a daylong drive from the Dominican Republic, they quickly changed into their scrubs, met with the hospital's acting leaders from the International Medical Corps, and went to work. On the hospital grounds we were faced with the sight of collapsed buildings, crowded squares and corpses awaiting removal. Temperatures rose above 100 degrees, amplifying the odors and fatigue.

Our initial attempt to set up the ICU in a fixed building was thwarted by aftershocks, forcing patients and their families to remain in open spaces. We then moved to a tent near the operating room, near what had been the hospital morgue a week earlier.

Geisel Professor Jim Gehling, left, and other providers from Dartmouth-Hitchcock (now Dartmouth Health) prepare to fly to Haiti at Lebanon, New Hampshire, Municipal Airport on January 19, 2010. (Photo by Joseph Mehling '69)

The volume of patients was amazing. Most cases involved serious injuries awaiting surgery or postoperative care, including amputations. The care provided by the nurses was nothing less than ordinary. Communication barriers limited conversations, but through touch, smiles and gestures, we were able to connect with patients and their families. Pain medications were rare, and changing clothes often relied on family members for emotional support through prayer and singing.

In the midst of suffering, we have witnessed moments of profound humanity and resilience. Families share resources and support each other, through feeding, bathing, toileting and exercise for family members. Haitian nurses, despite personal losses, returned to the hospital and thrived under the guidance of our team. Together, we improvised solutions, implemented bedside procedures, and innovated care with limited resources.

At the end of each stressful day, we found solace in a home provided by Partners in Health. There, we had access to a flush toilet, cold showers, and meals supplemented with military rations. Evening conversations and journaling provided opportunities to relieve stress and prepare for the challenges ahead.

When I think about those 11 days, I am amazed by the lessons they taught me and our team. Practicing critical care under these extreme conditions requires adaptability, dexterity, and teamwork. The bonds formed within our team were forged in adversity and remain unbreakable.

Although I reflected on this mostly personal story, the larger narrative of the event lies in how the broader Dartmouth community played such a pivotal role in our mission and the missions of the six other Dartmouth teams that eventually deployed.

Student veterans offered their military expertise, the New England Center for Emergency Preparedness at Dartmouth coordinated logistics, and parents offered corporate aircraft for transportation. Dartmouth-Hitchcock Medical Center, VA, and regional health care organizations provided supplies and staff. This collective effort demonstrated the power of collaboration and community in responding to crises.

Through the lens of our team we saw Dartmouth's brilliance. Later, patients came to DHMC for care, students came to visit them, virtual medical tours developed, Haitian art and music spread, and even the Haitian soccer team came to play.

With so many competing priorities, political views, financial constraints and social agendas, it is hard to believe that what happened 15 years ago could once again mobilize this community to confront such a crisis. However, I believe that if asked, Dartmouth could once again respond with its talents, innovations, and resources to help residents or areas in need.

Professor of Medicine James Gilling is an intensivist at the VA Medical Center in White River Junction, Vt., and a TeleICU physician at Dartmouth Hitchcock. He received his Master's degree in Public Health from Geisel College of Medicine in 2014.

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Vox Populi is The Dartmouth News' opinion page for commentary written by members of the Dartmouth community intended to inform and enrich the public conversation.

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