I looked forward to volunteering at Hôpital Albert Schweitzer Haiti (HAS) in Deschapelles, Haiti with eager trepidation. I relished the opportunity and challenge of safely providing high quality anesthesia using antiquated and limited supplies, testing my clinical knowledge and skills to help others. Having said that, I had a nagging fear that I wouldn’t be up to the task of providing “bush” anesthesia.
The week I spent at HAS was all that I hoped for and more. My colleague Dr. Dan Eloy and I provided anesthesia for a variety of surgical procedures, ranging from emergent caesarian sections and laparotomies to scheduled orthopedic surgeries. Our ability and creativity were stretched not so much due to limited supplies or older medications but more because of the infrastructure, particularly with regard to limited post-anesthesia care. Perhaps our most challenging case best exemplifies this: a six year old boy with an approximately two week history of typhoid fever required an emergent exploratory laparotomy due to a suspected small bowel perforation. In the U.S., this child would have had invasive monitoring lines inserted and would have remained intubated in an intensive care unit post-operatively. Here, that simply wasn’t an option. Fortunately, despite having several bowel perforations and peritonitis, he did well during and after surgery; he was to start eating the day I left HAS, on the fourth post-operative day.
One of the most pleasant aspects of volunteering at HAS was being immersed in an atmosphere where people collaborate to help others. During our stay at Alumni House, we encountered a motley but fascinating group of internists, pediatricians, and geologists. Additionally, we met a host of others, including members of the Mellon family, all of whom were very committed to not just the health but the overall well-being of their neighbors.
In closing, I wholeheartedly encourage those who are so inclined, particularly my resident colleagues, to contact HAS about volunteer opportunities. This was a most rewarding experience on many levels that I intend to repeat.
Arun L. Jayaraman M.D., Ph.D.
Department of Anesthesiology
University of Pittsburgh