HOPE Volunteer Chick Fitts Journals from Haiti

Nurse Charles "Chick" Fitts from Community Medical Center in Missoula, Montana is currently volunteering for Project HOPE, caring for injured Haitians being treated onboard the USNS Comfort. Here are a few excerpts from his journal.

January 26-- Long day's trip across country to Jacksonville, Florida Naval Air Station, achy from half a dozen immunizations piled on after about 4 hours notice to join the Project HOPE volunteer nursing contingent on the USNS Comfort off the coast of Haiti. It took a whole community to get one volunteer off from Missoula. My primary physician Rebecca Hoover had done all my paperwork, and contacted three different agencies to arrange medications and immunizations, all before she saw her first patient, all on email notice Monday morning. Costco and Community Medical Center pharmacies and the Public Health Service had me immunized and supplied by midday. My employer and several offices quickly accommodated my changed plans. I was on a plane Monday evening, and arrived at Jacksonville NAS by evening Tuesday.

January 27-- Old folks will remember the Project HOPE hospital ship, SS HOPE, an early health care NGO that began doing world tours in 1958. The original vessel was scrapped in 1974, and Project HOPE was strictly a land-based international operation until 2004, when it supplemented the Navy health care staff aboard the Mercy during the tsunami relief work.

The Comfort is a converted supertanker, 1000 feet long, 6 stories high, up to a 1000 hospital beds. We're told it is currently full to capacity, a first. There are 33 of us. Docs, nurses and techs, recruited through Project HOPE, to supplement the Navy health care staff. There are several veterans of prior volunteer relief work on the Mercy or the Comfort. Several of the nurses are experienced traveling nurses. The boss of this contingent was Chief Nursing Officer aboard the Mercy during the Tsunami relief, now "retired." Among the professionals are one Venezuelan and two Haitians. The pediatric ER doc is having bad separation pangs from her 2 year-old.

January 29-- ...By the end of the day we finally had berthing assignments, although puzzling them out was a challenge, since it's all unfamiliar. The Comfort was never conceived as a tertiary hospital for disaster relief, so it is not really laid out for the intense bed and manpower requirements of this huge scale. They are to having to choose between room for patients and for caregivers -- paradigm of a rock and a hard place. Almost everyone needs surgery, predominantly orthopedic (the chief building material is, or was, concrete). The many operating rooms on board could spend the next four days solely on first time surgeries for those already on board, and then they would have to catch up with the repeat cleanup procedures. This would require ignoring the large number of injuries that require procedures now only available on the Comfort. More than two weeks after the earthquake it is still a daunting

January 30 --I've been slow on this update in part 'cause I was busy learning how to work on 12 off 12 and get enough sleep in a three high stack of bunks and get to meals and shower and .... so on. The bigger reason is that it's time for me to talk about the Haitian people we are caring for, and it's difficult. I've decided I can't do it all of a piece, so here it comes, or more probably starts, in pieces.

We recovered over 50 surgeries today, on the daylight 12. I saw my first grey haired patient today. That is substantially less than 1%. Almost all the injuries are orthopedic, and crush injuries as well. It appears that the elderly simply did not have the reserves to survive. A huge portion of the patients are pre-adolescents, usually unaccompanied. Few are over 40. It has occurred to me to wonder, without possessing anything like data (as a nurse, I don't see those that are uninjured, those that have been adequately treated by the multitude of international organizations, governmental and NGO, working in and around Port-au-Prince), whether the city will be seen to have lost a generation.

Something approaching half of the surgery patients we see, children and adults, pretty clearly are experiencing significant Post-traumatic stress disorder, an assessment supported by the unfortunately great experience of the large and very able contingent of Bethesda Naval Hospital nurses on board. It is difficult to imagine what events have led to the inconsolable tears and distant visions we care for.



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