In Haiti, aid worker's efforts show lives can hinge on luck and resourcefulness

This gallery collects all of our photos of the crisis in Haiti, starting with the most recent images and going back to the first photos that emerged after an earthquake hit the impoverished nation Jan. 12.
By David Brown
Wednesday, January 27, 2010

PORT-AU-PRINCE, HAITI -- Tony Redmond -- a professor of international emergency medicine turned temporary relief worker -- set himself two goals at the end of last week.

He wanted to secure a supply of medical-grade oxygen that would allow doctors with Britain-based Merlin, an international aid agency for which he works, to perform surgery on children. He also wanted to get two grievously burned patients out of a local hospital and into a place that might save their lives.

Redmond's two-day quest epitomizes an essential aspect of relief work here, two weeks after the 7.0-magnitude earthquake: the need to solve problems posed by the logistical impediments to caring for the injured and the ill. For all the skill and experience of the many people like Redmond who are working here, his story shows how the success or failure of relief work in a disaster zone -- and the life or death of patients -- can hinge on determination, nimble thinking and no small amount of luck.

It also shows how impossible it is not to get caught up in the fate of individuals even when confronted with mass casualties.

"You know, we talk about and teach the 'most good for the most people' approach," Redmond said. "But if you are presented with a problem of one particular person, and you think you can do something about it, give it a shot."

Redmond's mission began when a BBC News crew told him about two patients at Hopital Universitaire de la Paix, down the street from Merlin's headquarters at a tennis club: a 26-year-old woman named Jenny and a 24-year-old man named Claude. They were burned when the bank they worked in collapsed, causing a propane tank to catch fire.

The two, swathed in bandages, were getting pain medicine and nursing care but little else. Redmond said he would be back in the morning with Waseem Saeed, a plastic surgeon.

Saeed agreed that the patients urgently needed more care. He estimated that the woman had burns on 60 percent of her body, the man on 40 percent. The estimates were imprecise, especially because the doctors did not take off the bandages, but they were factors in a piece of crucial arithmetic: Add the patient's age and extent of burns, subtract from 100, and the result is the chance of survival. Jenny's was 14 percent; Claude's was 36 percent.

Merlin, which has an operating room in one tent and a post-op ward in another, both set up on tennis courts, could not take them. But both would soon become infected and die if their burns weren't meticulously cleaned, trimmed and covered with skin grafts.

So Redmond set off Friday morning in a Merlin-rented car through the jammed, debris-strewn streets to check out a French civil-military relief team. It had a hospital housing 75 patients in a half-dozen tents off the main road in a shady and undamaged canyon.

A variety of armed guards led him to a man with a high forehead and thin lips who bore a resemblance to Edgar Allan Poe. He escorted Redmond to a second man, who led him to a third.

The cases were explained repeatedly, with the first question always centered on the patients' ages and extent of injury. At one point, Redmond noted that "both are making urine," which meant they weren't in kidney failure or septic shock. After some waiting, Redmond was dispatched to the person who could help, who turned out to be the first man with whom he had met.

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