Injured in Haiti quake at high risk of infection
LES CAYES, Haiti — The home of clothing merchant Felix Pierre Genel collapsed before he could flee outside as a powerful earthquake shook southwestern Haiti. He was dug out of the rubble that same day with a broken arm and was among the somewhat fortunate ones who promptly received medical care at a local hospital. But even so, he could not escape amputation, a common consequence of the calamity.
Doctors at first told the 36year-old they would try to save his right arm. He had surgery to place rods in to stabilize the broken bone. Then came an infection and a second operation.
“Instead of dying, I took the decision of letting them cut off my arm,” Genel said from his bed at the Les Cayes’ general hospital, his right arm bandaged where doctors amputated it above the elbow. “From where I’m coming from, inside the mouth of death, it’s best that they cut the arm off.”
Broken bones that cause open wounds are frequent injuries in devastating earthquakes like the one that battered the Caribbean nation on Aug. 14. That combination causes a particularly high risk of infection, and even more so when, as in Haiti, access to health care is limited or people delay seeking medical attention in favor of natural remedies.
“The risk of infections goes up the longer you wait to get care, and some of that is related to access to health care, not all of it,” said Dr. Christopher Colwell, chief of emergency medicine at Zuckerberg San Francisco General Hospital.
“If there are fractures or broken bones that are associated with those open wounds, those infections can be devastating and can result in the need for amputation, or, in some cases, even threat to life, over the next days and weeks,” he added.
The magnitude 7.2 quake, centered under the country’s southwest peninsula, killed at least 2,207 and injured 12,268 people. About 130,000 homes were damaged or destroyed. Hospitals, schools, offices and churches were also affected.
Health care facilities were already at a critical point before the temblor because of the pandemic. Many of the injured had to wait under the blistering heat, even on an airport tarmac, for care. One hospital was so overwhelmed that it placed patients in patios, corridors, verandas and hallways.
The ability to get medical attention also was complicated by a tropical storm that trailed the earthquake and the two-day closure of a major hospital in the capital of Port-au-Prince to protest the kidnapping of two doctors, including one of the country’s few orthopedic surgeons.
The nongovernmental organization Humanity and Inclusion now has a team in Haiti assisting health care personnel and assessing patients’ needs. They can examine scars and stumps, teach patients exercises and work on joints to avoid muscle stiffness. They also help psychological support efforts.
“People can be traumatized, and they can be very sad, depressed, but also some of them, they’re kind of in denial, and they believe extremely strongly that their life is going to be the same, which can be true, but same but different.” rehab specialist Virginie Duclos said.
Governments too have sent aid to southwestern Haiti, including the U.S. military, whose USS Arlington arrived with a surgical team.
The NGO Samaritan’s Purse also opened an emergency field hospital in Les Cayes a week after the temblor.
“When we opened, we saw many people who were seeking care for the first time — and that was already a week after the earthquake — with broken bones and with wounds,” said Melanie Wubs, medical director for the field hospital.
She said others “had been hastily patched up right after the earthquake but now required more further care, whether that is surgery or debridement of wounds.”