A Pan-American Tragedy

A North Creek paramedic treats those hurting most

by Joe Connelly

 

The author, left, helps a wounded Haitian girl. Photograph by Phil Suarez.

Anyone who's driven through the North Country knows the house I'm talking about, sunk back from the road, in a sand-blown lot fenced with junk. It might have been an old trailer once, the walls since patched with plywood, boxed out with closets and half-finished porches. Or maybe it was a large house once, three stories proud, now broken to half that size, cracked through the middle, weeping at the edges, like someone dropped it off a cliff.

 

The type of building isn't native to the Adirondacks but it seems to have thrived here, and it makes up the bulk of my work. I'm a paramedic with the local ambulance squad, Johnsburg EMS, and when people ask me why I do my job, I only have to point to that house. The calls are usually harder there, the residents sicker, the spaces cramped and cluttered and dark. And yet, despite all the help they need, they always give me something back, a lesson on living: that life is often strongest when it looks most lost, and hope shines brightest where it looks most in doubt.

 

Post-quake makeshift home in Port au Prince. Photograph by Phil Suarez.

In the world's village, that broken house is a country called Haiti, just 90 miles off I-95, a house whose roof just fell and killed 200,000 people. I went there with a disaster relief organization called NYCMedics, a group we d formed at the Pakistan earthquake four years before. We had no paid staff and very little money to back us, just 15 emergency workers from around the country, heading off to one of the most desperate 911 calls in human history.

 

We got there the same way we went to Pakistan, by phoning every connection we knew. JetBlue donated tickets. A friend in the Dominican Republic arranged a hotel and bus. Another friend knew a lawyer in Port au Prince. He offered his house to us, too damaged to sleep in, but with a driveway wide enough to set our tents, and, most important, a wall with a strong gate.

 

We entered the city at night, like driving into the Inferno, streets barricaded, some ablaze, people everywhere shouting, running wild. We unloaded our supplies in the lawyer s driveway and closed the gate and lay our sleeping pads on the warm cement. I stayed awake listening to the cries and gunshots, the mournful chanting, the bursts of cheering and the singing, from every direction, some full of lament, but more, many more, unmistakably joyful.

 

The lawyer referred us to a reverend who served a very poor area. The church had collapsed but we could make use of the school. One week after the earthquake and no one had been there to help.

 

We traveled in the back of an '85 Dodge pickup, wheels bending under the weight. We carried our supplies past the fallen church, the islands of families living under blankets. The school in back was too fractured to work inside, so we set up our stations in the yard: pharmacy and triage, primary care, pediatrics, wound care and orthopedics.

 

Our main goal was to kill infection, save the limbs. In Pakistan we d honed our skills as wound scrubbers, drainers of pus, and right away we went to work, treating a parade of open sores. Our patients walked in or were carried piggyback, rolled up in wheelbarrows or on homemade litters. Sometimes their families came and led us out to the wounded. One 12-year-old girl had gone to the hospital the day of the quake and been sent out with a cast on her foot. Somehow they missed the open fracture of her lower leg, just above the cast, plus the obviously deformed fractures to her upper leg and arm, and the depressed fracture of her skull. When we cut the cast off her foot we found no injury whatsoever, one of the few places on her body she wasn't hurt.

 

That night I lay on my pad listening to the sounds of our team sleeping and to the shouts from outside the gate, the gunshots and the singing. I stayed awake until dawn, when we rose and loaded our truck and headed out.

 

Our second day in the clinic we saw another 400 patients, this time more sick than injured: respiratory infections and dehydration. We took turns for lunch, hiding in one of the rooms so our hungry patients wouldn't see us eating. The desks in the classes were covered in dust, the blackboards all written with the same date, January 12.

 

At noon the following day the numbers began to slow, and just as we began to wonder where to go next we ran into a U.S. Army captain who asked us to ride with his men. They'd been patrolling the indigenous camps south of the airport, seeing plenty of sick and wounded they didn't know how to treat. Just like that we were in the Army.

 

The larger camps were like small towns, with their own governments, camp leaders who'd guide us in to the more serious cases, but it was the smaller makeshift camps where we did the most: two dozen families crowded into a 50-foot lot or at the bottom of a steep ravine. We tried to stay together but were easily split up; a kid grabbed my arm and dragged me through a maze of sheets, ducking under one to show me a 15-year-old with a broken pelvis, unable to move his legs. His mother was changing his shorts, cleaning him off. How many times had she done this since the quake? His brothers and sisters sat on the ground, watching me. When was the last time they'd eaten? What would happen when it rains? In those moments I could feel my sanity stretching, and if I didn't concentrate on that point just above the boy's hip, the crack in there I wrapped with a sheet, the stretcher I yelled for someone to bring in, I felt like I would never leave.

 

The next day it reached 102 degrees on the street, but under the blankets, between the sheets of makeshift tents, it was much hotter. I remember one especially hard-hit place, 40 families living on a rubble-strewn hill. I was helping to splint a boy with a broken leg when a man came up and grabbed my arm and begged me to come. He led me zigzagging over the hill, the walls so close we had to walk sideways. He pulled up one of the sheets and showed me the baby sitting on the ground. I could hear him wheezing five feet away, his lips blue, body straining.

 

That night I lay on the ground and watched the faces come through, all the kids I'd seen, the ones saved in my head, and all the others too, the ones I hadn't seen but knew were there. It was my worst night yet, and when the sun came up it didn't stop.

 

We were supposed to set up a clinic in the city's poorest slum, Soleil, but when we got to the Army base we found it besieged by thousands of men, desperate for jobs. The captain there said we couldn't work in that area, it had become too dangerous. For the next four hours we sat trapped in traffic, staring helplessly at the chaos around us, crowds fighting for water, people hunting the streets for food. It was as if, sometime during the night, another disaster had struck the city, even larger than the first: a tidal wave of despair that threatened to drown us all.

 

That evening, desperate to do something, our medical director, Dr. Rob Bristow, arranged for us to work a shift at the University Hospital. The emergency ward had recently gone to 24 hours, the first in the city to do so, but they'd struggled to find staff willing to stay after dark. The day nurse we were relieving gave us a quick rundown of the patients waiting and pointed out the supplies we could give freely—and the ones we had to conserve. On a cot lay a young man barely breathing, an oxygen mask clamped to his face. He's got AIDS, the nurse said, there's nothing we can do. Just make sure you turn off the oxygen when he's gone.

 

I walked to the courtyard out front and watched the sickly lights of the generator buzz in. When I had entered the space just 10 minutes before I'd found it teeming with staff: soldiers and nurses and yellow-shirted Scientologists. Now that the sun had fallen the yard was nearly empty. Nobody wanted to be outside at night; that was clear from the first patients that came in. In rapid succession we saw a looter shot in the hand by police; a four-year-old girl, her face bashed in by a chunk of concrete; an older woman struck by a car; and a man who'd taken a machete to the head. We wore head lamps in the near dark, using equipment most of which would have been thrown out in New York.

 

I kept returning to the AIDS patient in the back, his pulse all over the map, his lungs so filled with fluid it spilled over his lips. The man's family stood by him the entire time, through each unyielding breath, and I explained to them again that his prognosis was awful, better off in the end if we didn't do anything. They stared at me angrily, pointing to the IVs I'd shut down, the medicines piled on the shelves. My interpreter, who seemed to know only 10 words of English, turned to me and asked, "Why are you?"

 

When the first wave of trauma had passed, Dr. Bristow came back to the patient and decided we couldn't keep doing nothing. No matter how bad his chances the next day, we were going to get him through the night. We hit him with everything we had and an hour later the young man was sitting up in bed, asking for water—the one thing we couldn't give.

 

Another wave of cases passed through, and another. I was sitting at a table soaked with bloody gauze, eating cold chili out of a bag, when I heard the singing outside, the same song I'd heard in my bed while trying to go to sleep. I ran to the hospital gate and climbed to the top. In front of me stood a hundred children, their arms raised in joy, dancing and singing, asking God's blessing, praising His love.

 

We left the next morning and three days later I was back on the ambulance in North Creek, driving past the houses I knew so well, their own hurt and hungry inside. In my mind they're all in the same place, from Haiti, Pakistan, Harlem and Johnsburg, each with their own room. When I close my eyes I can hear those children singing, dancing in the street, crying with joy. That's how I go to sleep.