A Year Later, Miller School Hearts Remain in Haiti
On Wednesday, a year to the day since Haiti’s devastating earthquake refocused their lives, the Miller School’s Enrique Ginzburg, M.D., and Gillian Hotz, Ph.D., will meet in Port-au-Prince with leaders from the American College of Surgeons international program and other universities to coordinate the education and training of critical care health professionals for the hemisphere’s most beleaguered nation.
And on Thursday, they hope to finalize the architectural plans that will double the 45 beds at Hospital Bernard Mevs Project Medishare and add an education center to train Haitian health professionals in critical care, eventually ending their pivotal roles, and those of fellow Miller School faculty, who are overseeing Haiti’s first and only critical care, trauma and rehabilitation hospital with a $2.7 million grant from the American Red Cross.
“The goal is to make Haitian health care in the critical care arena self-sustainable,’’ said Ginzburg, professor of surgery who is serving as the international medical director of the community hospital Project Medishare partnered with after closing the tent hospital the University established at the edge of the international airport just 10 days after the quake.
“The medical directors of Hospital Bernard Mevs Project Medishare are Haitian, and over 150 Haitian doctors, nurses and allied health professionals are on the staff, so we are where we want to be. But there is still a lot of work ahead of us.’’
As a member of the first medical team that Barth Green, M.D., professor and chair of neurological surgery and co-founder of Project Medishare, led to Port-au-Prince, Ginzburg knew when he returned to Miami after transitioning the University’s impromptu critical care center from a pair of cargo tents to the 240-bed tent hospital that he could not disengage from Haiti. “It got under my skin,’’ he says.
He’s not the only one. A year after the temblor killed more than 300,000 people, and left more than a million homeless, Miller School faculty and staff who volunteered at the field hospital, or with the Global Institute’s Haiti Relief Task Force in Miami, continue to help Green fulfill his longstanding vision of establishing a critical care and trauma network in a country that didn’t have a single trauma hospital before the earthquake so cruelly highlighted the gaping need.
In just six months and amid a cholera outbreak and a government crippled by disputed elections, Ginzburg, Hotz, associate research professor of neurological surgery, and a host of others under Green’s leadership have continued to move mountains to help Project Medishare, the Bernard Mevs staff, and about 40 volunteers a week from across the U.S. treat more than 45,000 patients, perform more than 200 surgeries a month, and operate the only pediatric and neonatal ICU in the country.
Among them: David Andrews, M.D., associate professor of pathology; Gwen Wurm, M.D., assistant professor of clinical pediatrics; Robert Gailey, Ph.D., PT, associate professor of physical therapy; Jeffrey Augenstein, M.D., Ph.D., professor of surgery; Ron Bogue, assistant vice president for facilities and services Mike Kelley, M.B.A., vice chair for administration; and Steven Falcone, M.D., M.B.A., associate vice president for medical affairs. One of the Miller School’s earliest responders, Haitian-American Antonia Eyssallenne, M.D., Ph.D., a resident with the Jay Weiss Center for Social Medicine and Health Equity, remains in Haiti as the hospital’s chief medical officer.
“We probably have about 20 core people in UM that are really key in the operations,’’ Green said. “It’s all about being surrounded by people who share the passion for evening the playing field in Haiti, giving people an opportunity not to just survive, but to live with dignity. As we saw after the earthquake, when everybody from the Dean and the administrators to the people who clean the operating rooms got involved, it’s not just a job at this medical center, it’s a mission. People never say no.’’
Like Ginzburg, Hotz had never been to Haiti before she dedicated herself to the Miami-based task force that arranged planes and volunteers to supply and staff the tent hospital. Now, as another of Bernard Mevs’ international directors, she is immersed in training, budgeting and numerous other issues.
Her next challenge: overseeing the 12,000-square-foot expansion that will include four classrooms and an auditorium where training teams recruited from medical centers across the U.S. can share their skills and knowledge with Haitian doctors, nurses, and other allied health professionals. The goal: train the trainers who can assume leadership roles at Bernard Mevs and other planned trauma hospitals across Haiti.
“To be able to use our skills, experience, compassion and humanism to develop programs from scratch and drastically improve a nation’s health care is a challenge of a lifetime,” Hotz said. “ It’s exhilarating.’’
Andrews, who set up the pathology laboratory at the field hospital, is now directing laboratory services at Bernard Mevs. Primarily through daily Skype teleconferences with the laboratory staff, he is nurturing a supervisor and seven other medical technologists in implementing basic lab practices, such as quality control, quality assurance, safety, test validation and method comparisons. As Andrews notes, procedures for potassium and other common test protocols are handwritten on pieces of torn cardboard and need to be printed, dated and stored in laboratory notebooks.
And that’s exactly why Andrews can’t let go.
“It’s been transformational,’’ Andrews said. “Here you work hard and make an incremental change and nobody notices. There, you do a little bit of work, you make a large incremental change and everybody notices. I’d like to see Haiti be part of my life forever. It’s very rewarding.’’
Augenstein, who helped establish telemedicine capabilities at the field hospital, plans to integrate Bernard Mevs into daily rounding conferences at the Ryder Trauma Center. For now, Ryder specialists are performing telemedicine consultations at the request of the Bernard Mevs staff. Also on Augenstein’s list: equipping Bernard Mevs with the same mobile care information tools developed at Ryder with the U.S. military to enable surgical teams deployed to Iraq or Afghanistan to review learning modules, seek distant consultations, input or review patient records, and keep track of their vitals and warning signs – all with a hand-held device.
“My goal is that everything we have in Mobile Care at the Ryder Trauma Center will be in place in Haiti,’’ Augenstein said. “But no matter how much we think we can provide to Haiti, we’re probably going to learn more about medicine from Haiti and from the people who practice there then we’re going to teach. Exchanging information is such an incredible opportunity.’’
Gailey, who is about to open the Ossur International Prosthetic and Orthotic Laboratory at Bernard Mevs, is helping reshape Haiti’s perception of disability. He and his team received a $1 million grant from the Knights of Columbus to fit child amputees with new limbs, and so far have given dozens of adults renewed lives. One of them, Wilfred Macena, now a prosthetic technician-in-training at Bernard Mevs, founded an amputee soccer team just five months after taking his first steps on his robotic leg.
Bogue, who led the team that erected the 25,000-square-foot field hospital in four tents in less than a week, is tackling another monumental challenge: moving a 55,000-pound trailer containing what will be one of Haiti’s only CT scanners from Indiana to Bernard Mevs.
“It’s a logistical nightmare, but you get intoxicated,’’ Bogue said. “You’re helping people and you hope you’re making a difference.’’
Wurm, who had volunteered in Haiti before the quake, is now helping set policies and direction and assembling the pediatric teams that are rotating in and out of Bernard Mevs. She calls her service “a privilege.’’
“Not to use some of our basic skills to save lives just an hour and a half away from Miami just seems wrong,’’ Wurm said. “We would obviously like to train ourselves out of business, but as long as we’re able to keep our infrastructure going, we’ll be there. Funding is a challenge and peoples’ eyes are off of Haiti, but Dr. Green is such a dynamic visionary we have complete faith in his ability to get the message out and keep the programs going.’’