Bayhealth physician finds despair, hope amid devastation in Haiti

“I had a skill they needed. I had something that was useful to them.”

Those words sum up Dr. John Brebbia’s reasons for deciding to go to earthquake-torn Haiti last month. People were in need and they needed him.

A specialist in general and trauma surgery, Brebbia returned from Haiti Jan. 28 after spending nearly a week working 18-plus hour days either in a makeshift operating room or in tent clinics trying to help the thousands of people injured in the Jan. 12 disaster.

Although he was familiar with what had happened from television news and Internet reports, he was not prepared for the enormity of the suffering he encountered once he and a group of Delaware doctors reached the Haitian port of Jacmel, where they set up their emergency hospital.

“I had worked in some Caribbean islands doing general medical clinics,” Brebbia said. “But I had no experience in anything like this. In a disaster zone and with patients on this scale, I did not.”

Brebbia was drawn into the disaster relief effort through a group of fellow physicians working with Hands International and Voices for Haiti, which was planning a medical mission to Haiti. He also went out of respect for the memory of a friend, U.S. Army Maj. Dr. John P. Pryor, who was killed in Iraq on Christmas Day 2008.

“Had John been alive, he would have gone,” Brebbia said. “But since he wasn’t, someone had to fill that spot, so I went.”

Days and nights in Jacmel

Part of a team of 23, including physicians, nurses and technicians, Brebbia set out for the Dominican Republic, which shares the island of Hispaniola with Haiti on Jan. 21. The sometimes frustrating trip included baggage mix-ups, run-ins with obstinate government officials, a nighttime nine-hour trip through jungles on one-lane roads and a sea journey to reach Jacmel, about 80 miles south of the hard-hit Haitian capital of Port-au-Prince.

There, they unloaded their own medical equipment from the cargo ship, as well as supplies brought by a group of nuns. The nuns gave them all of their medical equipment as well as supplies of drinking water.

“We found a city destroyed,” Brebbia said of Jacmel. The Saint Michel Hospital was little more than a pile of concrete and dust, but still under the control of an administrator, deeply suspicious of foreigners, who thought the Americans were there to take away what little he had left.

And then there were the Cubans.

“They were there already, and also suspicious we were there to take over,” Brebbia recalled. But suspicion turned to trust and eventually to comradeship as the American team freely shared their massive amounts of supplies with the Cubans and the teams even ended up working together in the operating room.

With the Canadian military supplying a tent for surgeries as well as handling logistical problems in bringing patients in and out, the group fell into something resembling a routine. Three members of the Delaware team had been raised in Jacmel, and they helped scrounge materials to keep things moving. Concerned about aftershocks – and there were several – the team slept in tents outside. Three-minute showers were taken under a pipe when water was available.

“It was the roughest Boy Scouting I’ve ever done,” Brebbia, a former Scout himself, said.

Electricity for the operating room tent was supplied by generator and the team’s Jacmel natives found an air conditioner that brought the temperature inside down to about 90 degrees.

The Delawareans would get up at 5 a.m. and sometimes work at the hospital until 5 p.m. Afterward, they’d go to the tent cities to see patients or set up clinics where they’d work until 11 p.m. or even later.

“There were times you were so exhausted but there were so many patients left you just pushed on,” Brebbia said. “We’d work as much as possible until we just had to stop. We’d go and sleep and start all over again.”

The surgeons worked on many crush injuries and open wounds, many that had been left untreated for days and were deeply infected. Many required amputation. A lot of wounds were treated outside the OR.

International pressure

There also was the Medecins Sans Frontieres, or Doctors Without Borders problem. Members of the well-financed international group told St. Michel’s apprehensive administrator they only would come in if the Americans left.

“They told him they could bring in everything they needed, but you’ll have to kick the other people out,” Brebbia said. “Or you can stay with [the Americans] who may stay only a short time.”

Brebbia thinks pressure from the American and Canadian governments made the group change their tune.

“They came back and said they just wanted to do what was best for the patients,” he said, “that their goal was not to push us out. They ended up telling us as long as you’re doing what you’re doing and doing it well, it’s OK.”

The squabble has soured Brebbia somewhat on the possibility of working for the group.

“They suggested when we get back we could join them, but I don’t like their policies. I’ve put in applications for other medical disaster teams, including Project Hope.”

The trip home was much better than coming in, Brebbia said. They drove to Port-au-Prince, their only visit to the destroyed capital, then flew to the United States after another bus trip to the Dominican Republic. They arrived home Jan. 28.

Two days later, after cleaning up and getting some much needed sleep, Brebbia was back at the Bayhealth-Kent General Hospital emergency room, where he took a break to think back on the experience.

Of the thousands of people seen during their week in Jacmel, many were suffering from injuries and diseases such as tuberculosis, HIV/AIDS, diabetes and high blood pressure in addition to the wounds caused by the earthquake.

“You see on TV how, for ‘30 cents a day’ you can feed someone, but you cannot imagine how poor these people are until you see it,” he said. “I heard they had pulled someone from the rubble after she had been there 15 days.

“Only in Haiti could that happen because I doubt it was the first time she’d gone without food and water,” Brebbia added.

The surgeon also was less than happy politicians in the country seemed more concerned with protecting their turf than helping their citizens. In addition to the St. Michel administrator, that included the mayor of Jacmel who at first said the doctors had to be approved before they could go to work.

“You’d think these people would be open to letting help come in, but instead they were afraid,” he said. “They thought everything would be taken away.”

Despite these problems, Brebbia said he would go back.

“When I called my wife (fellow Bayhealth trauma surgeon Dr. Nasrin Ansari) to tell her I wanted to go, I was ready for the big sell,” he said. “But she said one of us should go.

“She’d like to go herself, but after I saw how hard it was, I don’t know if I’d let her – as if I could stop her.”

He already has been contacted by Project Hope about returning to Haiti, this time for at least three weeks.

“It will be a hard sell to my wife, but when they pin it down, I’ll consider it,” he said.
Brebbia figures he can make these decisions because of the sacrifice of his friend, John Pryor.

“This was my first short-notice disaster trip,” he said. “It was worth it, but it was hard. It was definitely hard.

“I had to amputate the foot of a two-year-old girl whose wound had been left open for 13 days. It was horribly infected, with flies and maggots in her foot. There’s no good way to do that.

“But I owe it to John,” he said. “It was his life that made me consider doing things like this.”

(Note: local physicians looking for a way to help should call Brebbia at Bayhealth Medical Center.)

Email Jeff Brown at jeff.brown@doverpost.com.