On February 12, BCFS’ Emergency Services Division deployed a strike team to Port-au-Prince at the request of the Haiti Children’s Rescue Mission. The orphanage was sheltering a number of youth, ranging from infants to teenagers, many of whom were suffering from painful illnesses and injuries due to the quake. During the course of the next two weeks, BCFS’ team would extend operations to meet the needs of those also seeking medical help at one of the primary Haitian hospitals and others living in tent camps, bringing relief and recovery to countless victims.
“When BCFS' team arrived at Hospital Adventist, the scene was very chaotic,” said BCFS President Kevin C. Dinnin. “Patients tugged desperately at physicians and nurses to get their attention as they tended to other patients. Donated medications and surgical instruments were thrown into boxes stacked in hallways and makeshift supply rooms unorganized and undocumented. And a tent city recovery ward for 150 patients was operating in the in front of the main hospital for victims who had undergone amputations and surgeries after the quake.” Normally functioning as a hospital for approximately 50 inpatients, the facility had surged to more than 250 inpatients and another 300 or so individuals in triage and the emergency department.
Having responded to major medical incidents previously, including the 2004 Sri Lankan tsunami, Dinnin stood before the hospital leadership and suggested the hospital operation should be treated and run like an incident rather than a hospital. His recommendation: implementation of the U.S. National Incident Management System principals, which would quickly bring about effective command and control. With the help of a found white board, Dinnin conducted a meager just-in-time training on the Incident Command System (ICS) that brought administrators and top medical staff onboard with the new strategy. Within 24 hours of implementation, command and control of the hospital was achieved.
“It was a high point for me when hospital personnel and responders were asked at the conclusion of the ‘A’ shift briefing – just 36 hours after implementing ICS – if there were any unmet needs, and not one hand raised. None,” Dinnin said.
Dinnin implemented the ICS structure into all hospital operations and BCFS IMT members assumed key roles in logistics, plans and operations. The agency’s medical team also took on critical roles managing the emergency department. The BCFS IMT began operating two 12-hour shifts and producing daily incident action plans, providing medical staff – most of whom were American volunteers from around the U.S. – with better situational awareness and short- and long-term goals. BCFS became an integral component of the management team that cared for more than 250 inpatients and an average of 300 outpatients daily.
Aftershocks as strong as 4.7 have set off panic, with patients leaping off their hospital beds with IVs still attached to their arms and mothers grabbing their newborn infants from the pediatric ward and running outside in the middle of the night for fear that the buildings might collapse. This past Tuesday at approximately 1:30 a.m., a strong aftershock prompted two expectant mothers to flee from the labor and delivery ward. BCFS IMT and hospital staff quickly acquired the necessary resources to accommodate the delivery of two new babies under a makeshift tarp set up on the grounds of the hospital. Since the BCFS IMT engaged with the hospital nearly two weeks ago, there have been more than 50 births.
Dinnin praises the acting hospital administrator, Andrew Haglund, for his diligence since the quake. “Andrew quickly embraced the values and principals of ICS, which I frankly think saved this hospital as much as the medical resources did,” said Dinnin. BCFS has committed to stand by Haglund in his on-going assignment to return the hospital to normal operations. Should another major quake occur while Haglund is in Haiti running this hospital, Dinnin said, “we won’t wait for his call for help; a full BCFS Incident Management Team will be on the way. This is a pact we have made to each other and for the people of Haiti.”
The youth at the Haiti Children’s Rescue Mission (HCRM) are also in better health and spirits thanks to BCFS. The orphanage, which is normally home for 60 children, had surged to 125 since the devastating quake. When the BCFS team first arrived, all the children had scabies and many were suffering from upper respiratory illnesses. BCFS’ medical director, Dr. David Marks, and volunteer nurses treated children with antibiotics, tetanus shots, de-worming medication, and wound care. Since potable water was not readily accessible, BCFS purchased three potable water dispensers to provide clean drinking water for the children. Dinnin also agreed to fund the hiring of 10 child care workers for a year to ease the burden since the quake. The organization has also committed to assist with the purchase a large permanent facility for the orphanage. Dinnin tendered an offer of $200,000 for a vacant property that would have made an excellent orphanage, but the offer was rejected. Now, BCFS will either increase its offer or continue looking for a new home for the children.
BCFS’ first team has since returned safely from Haiti and the second team has taken their place at Hospital Adventist and the rescue mission. The remaining team members will return home March 1, 2010, transitioning incident management back to the full control of hospital leadership. While the mission has been challenging, answering the call for help from the victims of January’s devastating earthquake has been an unbelievable reward that BCFS’ team will remember for years to come.