ARTICLE - AFTER THE EARTHQUAKE

AFTER THE EARTHQUAKE
(Drug Topics) - By Joel Claycomb, PharmD

Volunteering in Port-au-Prince, Haiti

The airplane touched down in Port-au-Prince, Haiti, on a Saturday morning in late November. The airport was stifling, and the only relief was a lazy ceiling fan slowly pushing the humid air. The airport itself was chaotic, with throngs of humanity everywhere.

Our group consisted of 20 volunteer doctors, nurses, emergency medical technicians, and pharmacists. We came from all over the United States, and there was a team from Canada as well. We were all excited about the opportunity to provide aid to this city left devastated after the earthquake of January 12, 2010.

We traveled from the airport in battered, windowless passenger vans. The road itself appeared to have been repaired, but many of the buildings we passed were still badly damaged and collapsing. Our driver took us past miles of hastily erected tent cities. At stoplights, children came up to the vehicles asking for money.

The vans finally turned off the main thoroughfare onto a narrow dirt road clogged with pedestrians. Weaving adeptly through the crowds, the drivers brought us to Hospital Bernard Mevs (HBM). Located in one of the rougher parts of the city, the hospital was gated and fenced with razor wire. It consisted of a dozen single-story buildings. Armed guards stood watch at the main entrance.

After a brief orientation, I was given a tour of the pharmacy. It was a small, freestanding building close to the entrance of the hospital. One of the few air-conditioned buildings, it was a popular destination for people to visit during breaks. Directly outside the pharmacy is a small area where walk-up clinics are held during the day.

The pharmacist's duties at HBM did not really differ from tasks seen in most institutional settings. We prepared medications for the rounds nurses and filled orders for incoming patients.We were also involved in pediatric compounding, the compounding of IV medications, and the dispensing of oral medications for the hospital-run health clinic each morning.

One of the big challenges at HBM was the language difference. Most of the staff knew at least a little English. On the other hand, I knew absolutely no French-Creole, making explanations a trial at times. Another challenge was that many of the medications compiled in the pharmacy were donated from countries all over the globe, requiring me to confirm exactly what the active ingredients were before dispensing them.

During the week I spent at HBM, the area was fraught with turmoil. The presidential elections were held on a Sunday. The compound was on lockdown, and curfew was set for sunset. The Haitian staff members were advised to stay onsite until the curfew was finally lifted on Tuesday. Shots were fired in the streets over the next few days. Throughout our stay in the secured compound of HBM, we could sense the tension in the city.

In addition to the elections, the country was devastated by a cholera epidemic. When our group arrived, 1,500 people were already dead from the outbreak. At HBM there was a designated corner of the facilities known as "Choleraville," where stricken individuals stayed to prevent further spread among the patient population. The staff members were well trained in caring for sick individuals, providing IV fluids and oral rehydration solution, as well as bleaching contaminated surfaces to prevent further spread of the disease.

Working with the Haitian staff, patients, and volunteers turned out to be a remarkable experience. In a situation rife with sadness, difficulty, and political unrest, and in a city still in great disrepair, I was amazed that the Haitians were able to maintain such a high level of good cheer. Volunteering there, I discovered the importance of having a positive outlook on life, even in the face of hardship and tragedy.

Joel Claycomb is a community pharmacist in the Pittsburgh area. He can be reached at jcclaycomb@gmail.com