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Louise Johnston is an Australian nurse who has been working for Médecins Sans Frontières for about a year. Before this, Louise was an emergency nurse in Melbourne and had also spent some time working in a remote Australian Aboriginal community.
Haiti is her third time working with Médecins Sans Frontières and like the first two times, this experience is just as different in nature. Louise’s first field placement was on a massive emergency vaccination campaign against an epidemic of meningococcal meningitis, where Médecins Sans Frontières vaccinated 1.2 million people in Niger in just over two months. “It took me out into the remote depths of the sub-Saharan desert in the worst heat I have ever experienced, visiting some amazing villages.” Louise’s second field placement was in the northern part of the Democratic Republic of Congo, establishing the project’s pharmacy and supervising the running of paediatric and surgical interventions in the hospital. Most of the Congolese people in the area were displaced through war and the terror inflicted by frequent violent attacks of the Lord’s Resistance Army.
Overhead view of Médecins Sans Frontières' inflatable hospital. It hosts 180 beds and two surgical units. © Bruno Stevens / CosmosIt was clear Médecins Sans Frontières needed people to go to Haiti quickly, and after some days of deliberation I decided to put my break on hold and set off again. Within just a few days I found myself in Port-au-Prince. I already knew many people in the team, and they seemed very tired, and totally immersed in setting up hospital beds quickly for the wounded in the city. The demand for post operative places in the city is huge and will become more pressured soon as the spotlight turns away and other aid organisations move out.
I have been here now for just over a week and I have completely lost track of time. We have all worked very long hours building an 80-bed hospital from scratch in the grounds of a damaged school and all within just a few days. It has been an absolutely awe inspiring experience to witness how quickly things can be done here by Médecins Sans Frontières for the Haitian people. We have set up a fully equipped inflatable operating tent inside the school stadium, and six large tents outside that very quickly were inundated with patients. We have set up a recovery room, a hospital kitchen, laundry, sterilisation area, physiotherapy and psychologists area, bathrooms, hospital laundry, pharmacy etc all within a matter of days. We have used carpenters, plumbers and electricians to pull it all together and we are now almost full. We have been receiving patients while construction has been going on. Patients keep arriving on stretchers, many of them amputees or with badly broken legs, backs or head injuries. One nine year old patient was having his appendix taken out on the day of the earthquake and in the chaos that followed, received no post operative care. He has become very unwell since and extremely emaciated. One patient has a large part of her skull missing. But most are recovering amputees, struggling to get used to the idea of a disabled life. Being disabled in Haiti is not easy. And a mind blowing number of the population will be left disabled after this.
One patient who stands out for me is a six year old girl called Jenna who has a badly broken leg, and is all alone with no family support because she lost everyone in the earthquake. She often becomes hysterical and inconsolable.
I spend most of my time working with the group of Haitian staff we have employed to work at the hospital. They are amazingly motivated and a pleasure to work with.
I have enjoyed overseeing and setting up the services in our hospital so it can operate to a high standard. It is great to see it all coming together so efficiently given the difficult context. The logistics of putting it all together has been incredible.
As soon as we can, Médecins Sans Frontières is going to find another space to build another hospital to accept more wounded. Space is tight in Port-au-Prince, as so many groups are competing for space. From what I have seen we won’t have any trouble doing it again with such a great team.
Every day we drive through the busy streets of Port-au-Prince. We pass a lot of rubble and completely crushed buildings. The ones left standing are balancing precariously and I feel vulnerable even driving past them. I am unable to fathom how long it will take to rebuild a place like this.
It seems nearly everyone is living on the streets under makeshift tents. The city is full of camps. Most people are still too afraid to sleep inside. When you drive through the city you see people bathing with a bucket on the side of the crowded streets, and just a few metres away, people are defecating. The environment is ripe for an epidemic... and the wet season is fast approaching, bringing with it the possibility of hurricanes and rain that will surely weaken the already fragile foundations of the structures that are only just still standing.
This evening just as we were rounding up another long and challenging day we received word that a building had collapsed trapping or crushing people underneath it. Even almost a month after the earthquake, it is clear that the danger is not over. Médecins Sans Frontières was at the scene quickly ready to treat and refer the wounded.
Part of the area we drive past every day on our way to work winds down a hill that has a view over the township on the other side. It looks like a hill of smashed concrete, everything has been completely obliterated. The original houses are barely discernible in the mess that is left. The dimensions of the destruction still catch my breath, even though I have driven past about 15 times now.
Bodies have all been removed from the streets. Unlike my predecessors here in Port au Prince, I have luckily not had to face the horror of seeing death. One day whilst stagnant in the car at a traffic light, we were right next to the crushed mess of a collapsed building in the midday sun. The stench was strong and I don’t like to think about what it was I could smell. I am sure there are so many bodies just metres away from me at any time of the day. Out of sight, out of mind. Yet people are carrying on as normal.
My work in the pharmacy is a mess. We received so much stock to use so quickly that it is difficult to keep track of where it is going and how much we have left to use. I am in the process of putting systems in place at our hospital to help our other pharmacists who manage our big warehouse of stock. The bigger the scale of the project we are dealing with, the bigger the demands are on our pharmacy resources, and the scale of this project in Haiti is huge. The project I worked on before was a small one, where a small number of expats worked hard to achieve things on a much smaller scale. Here we have so many expats living under one roof (currently almost 50). This means that what we are achieving is happening at a mind numbing pace, we are all working in a whirlwind of fervour. We all stumble up off our mattresses on the terrace roof of our building at around 6:30 am, and even now as I type this at 11pm there are still people working around me.
Achieving so much against the odds, seeing such direct benefits for the many, many wounded people here and realising first hand Médecins Sans Frontières’ capabilities is a wonderful experience for me. Working on the edge of exhaustion every day has a certain pleasure to it because what we are achieving feels so satisfying. I wouldn’t want to be anywhere else.
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