Joseph

This is a picture of the man to whom I left my powerbars to upon departure. I got word yesterday that he is turning the corner in his recovery. I was sent this picture by one of the physicians still in Haiti who has been continuing to work with Joseph and his multiple injuries. He was the victim of a car vs. pedestrian accident in early April and underwent less than optimal care by the local hospital there. He was transferred to HAH for more definitive Orthopedic care and, honestly, needed to be in an ICU. We battled a raging infection in his lower left leg and had to consider amputation as a viable option in order to save his life. However, with a lot of hard work on the part of many people, including Joseph and his wife, he is sitting up in a wheelchair and his wounds and fractures are healing. He looks to have lost weight, but he looks healthy and is smiling.


This was our team on morning rounds one on Tuesday the 27th discussing with him and his wife the possibility of having to amputate. We were able to pray over him together for his healing that morning which brought tears to my eyes. His wounds and complications from his injuries were starting to get complicated and we weren't sure we could continue to work to save his leg with the resources we had available for his care. Here is a picture of his leg and the massive tissue deficits from all the debridements we had to do to control the infection.


He lost most of the musculature and tendons of his anterior compartment, which will make ambulating difficult as he won't be able to pick up his foot normally, but he may very well keep his leg and just need a brace to support his foot.

In addition, he began developing multiple pressure sores from being bed bound. We were able to get him into a hospital bed from the cot he'd been on for a couple weeks and our therapists started to work with him and his wife on repositioning to help, but things were progressing from bad to worse. We had to do daily washouts and debridements of his leg to battle the infection and necrotic tissue, and we were battling his hemoglobin which kept falling despite our attempts to get blood for him. If the hospital had had the equipment to process blood, I'm sure a number of us would have donated as my blood type was a match for the major antigens at least. Obtaining blood was another hurdle as was getting accurate hemoglobin counts. He had been hovering in the 6.2-6.4 range for a few days. At one point, Joseph's reported hemoglobin was down to 4.5. Since he was hemodynamically stable, we had to wonder how accurate the result really was, but nonetheless, he was losing blood and we could not get enough packed red blood cells to transfuse him up to a stable number.

I was educated on the process for getting blood. First, a nurse or lab tech will draw a tube of blood for a "type and cross" so his blood can be matched to donated blood. Next, the family takes the tube of blood and the prescription for blood to the Red Cross down town. For every unit of blood, two family members must donate a unit of whole blood. Therefore, if we wanted two units, Joseph's family needed to take four people to donate blood. Then, they would be given a unit of type specific blood and the family's donation would go into the general bank to be matched to someone else. Also, blood can only be obtained during the day, so there was no way to get blood after dusk. Even with the prescription indicating the low blood count and need for more than one unit of RBCs, Joseph's wife returned with one unit of blood and the promise that if she returned again the next day, she'd be given another unit of blood then.

It is just another example of the uphill battle these people face in getting healthcare. Howeve,r had it not been for the earthquake in January, there would not have been any resources to save this man's life. Instead, because of the relief effort, surgeons and skilled medical personnel, the Red Cross, the orthopedic and wound care equipment were all nearby when Joseph suffered a life threatening accident. Thankfully, it appears he is starting to improve and while his life will be forever different because of his injuries, he will live, and it looks like he'll also keep his leg.

This was going to be a quick post of a picture, but I guess the story was waiting for me to tell it. I have actually been fairly sick since my return from Haiti, and so have not been feeling well enough to post pictures and write more, but I am starting to turn the corner myself and get back to processing my pictures and my trip. Look for more posts this week as I have energy.