Day 4 Update from Howard

Arne, Kim and I went with the Army to a remote site clinic. They goal of these is to provide some medical care to people in tent camps who have no access otherwise. Today's site was down between the airport and the port. Hot. We set up shop under the cantilevered second story of a private school. It is cracked but still standing. You can bet I had an escape route planned. Hot. Five of us saw 230 patients in 3 1/2 hours. Most just wanted some over-the-counter meds and to know somebody cared. Others had legitimate medical problems, infections and wound checks. Hot.

The ride to-and-fro was interesting...about 6 Hummers in a row with lotsa guns. Much demolition going on. A few jack-hammers, but mostly strong backs and sledge hammers. Break up the concrete from around the re-bar and haul it to the street in a wheelbarrow, make a big pile and someone with a front-end loader and dump truck carries it off. A rubble causeway extends out into the bay and dump trucks can be seen making the "island" bigger and bigger. Ships are bringing in more and more heavy equipment. Some buildings are being demolished in a more American way and some lots are already ready for utilities and reconstruction. The American presence is shifting more from disaster response to assistance with rebuilding. Many Haitians are going to end up with livable wage construction jobs (if that pesky 1/10th of 1 percent doesn't somehow shave a big hunk off the top).

The medical role is also changing from Trauma Care to Refugee medicine and ensuring the premises of good Public Health are met...namely, to keep the poop out of the water. WHO/CDC are also watching closely for any signs of infectious disease outbreaks. Medicine is transitioning from tents to hard-side temporary facilities, then eventually to permanent neighborhood clinics and new hospitals.

Wade continues to improve our basic sanitation and is having a great time interacting with big names in refugee health. Bruce, Rick and our great team of nurses and techs not only saw some very sick patients in the clinic, but also cleaned the place up wonderfully. Scott continues to wheel and deal with locals, military and international organizations to trade and borrow the things we need most. The archbishop cardinal somebody of Boston was here (black is a hot clothing color).

Howard

Pics from Day 3 & 4 are also up:
http://picasaweb.google.com/howardleibrand/HaitiDay34#