Civil–Military Collaboration in the Initial Medical Response to the Earthquake in Haiti

By Paul S. Auerbach, M.D.Robert L. Norris, M.D.Anil S. Menon, M.D.Ian P. Brown, M.D.Solomon Kuah, M.D.Jennifer Schwieger, M.D.Jeffrey Kinyon, D.O.Trina N. Helderman, M.D.Lynn Lawry, M.D.
The New England Journal of Medicine

Two days after Haiti’s devastating earthquake, a medical relief team made up in part of four emergency physicians and four emergency nurses from Stanford University Hospital and three emergency physicians from Columbia University Medical Center traveled under the auspices of the International Medical Corps, a nonprofit organization based in Los Angeles, to provide emergency medical support. After an all-night bus ride from the Dominican Republic, the team arrived at the Hôpital de l’Université d’État d’Haiti in Port-au-Prince on the morning of January 17. The scene we faced was apocalyptic. Approximately 800 victims were within the hospital compound, most of them outdoors. A damaged building was filled with the patients deemed in greatest need of emergency surgery. Hundreds of patients awaited evaluation and treatment. An internal medicine ward was packed with patients with crush and other severe soft-tissue injuries, amputations, open and infected fractures, compartment syndromes, hemorrhagic shock, and other conditions threatening to life and limb. In a central wooded area outside, the ground was barely visible for the suffering people, many of whom had distorted limbs, maggot-infested wounds, deforming facial injuries, skull fractures, and spinal cord injuries. A single operating room with a few tables was staffed by overworked surgeons who amputated limbs and débrided infected tissue. The morgue was overflowing, and approximately 40 bodies were stacked near the medical ward.