Facing life and death in the early morning in Haiti
A Chinese popular proverb says “a day’s plan starts with early morning.” My working day in Haiti starts even before dawn.
One day at four in the morning, we received a man with multiple gunshot wounds in the emergency room at the MSF’s Tabarre trauma centre in Port-Au-Prince. Wounds were found on his right chest and right inner elbow. Another bullet entered his right inner thigh and went through the scrotum. The patient was conscious when he was admitted. His blood pressure was normal but his respiratory and heart rates were raised. With multiple examinations including X-ray and ultrasound, we ruled out the possibility of abdominal trauma. We gave him some fluids, and sent him to the operating theatre right away. There we repaired his wounds, and placed a gauze pad in the abdominal cavity to create pressure to stop the bleeding.
The patient later told us that he was injured at 11am the day before. The incident occurred at the city center of Port-au-Prince, which is only a thirty-minute drive away from the trauma centre. Why did it take him so long in seeking treatment?
In fact, shootings happen frequently in Port-au-Prince, and the locals often carry a gun with them when they go out. Gangs are a commonly sight. Our trauma centre is located in the city centre and is easy to reach. But the delay might be because he couldn’t call the ambulance for fear of being arrested by the police during daytime. Or he simply couldn’t find a car to take him here. Whatever the reasons, MSF provides medical care to people in need. As long as they abide by our “No Weapons” policy, they are regarded as our patients who should receive treatment. This patient was fortunate, as most of his important internal organs and intestine were not injured, otherwise he could have lost his life.
On another early morning, a patient in her 40s was sent to us. Her right leg had an open spiral fracture of the tibia while the same bone in her left leg was nearly exposed. She did not say a word. The elderly mother who brought her here told us that her daughter SS had mental health problems. She didn’t know how the accident had happened to SS at midnight. Fortunately, SS’ key blood vessels and nerves were not affected. Other major organs and systems also functioned normally. After surgery, she was transferred first to the recovery room and then to the in-patient ward.
How did SS get hurt? From the wounds on her tibia, SS might have fallen from a higher point or a slope. She might have suffered from a traffic accident. In Haiti, there are few traffic lights. Almost none of the local drivers respect traffic rules. Motorbike accidents are common.
Sadly, SS might encounter similar accidents again because she is a bit more at risk in an already risky environment. Imagine the pressure on her mother, having to care for her daughter and deal with the financial burden at the same time.
For myself, Chinese people place emphasis on right timing, proper location and favorable human resources to complete a mission, which can be applied to saving lives too. I will do my best, which is all I can do.
Jennifer Tong is an orthopaedic surgeon from Hong Kong. After her first field assignment with MSF in Kunduz, Afghanistan in June 2015, she worked in another MSF mission in Haiti from January to April 2018.
Dr. Jennifer Tong, an MSF orthopaedic surgeon very often starts her work before dawn in Port-Au-Prince, Haiti.
The MSF’s trauma center is located in the city center of the city, which can be easily accessible for people in need.