Haiti's Floating Hospital

Since the USNS Comfort, the Navy's giant 1,000-bed floating hospital, arrived off the coast of Haiti on Jan. 20, helicopters have been shuttling earthquake victims to its flight deck multiple times a day. Patients are first admitted into a Casualty Receiving area, then seen by medical experts. There are 80 doctors (24 of them surgeons) and 140 nurses on board. As of Tuesday afternoon, more than 400 patients had been treated and 179 surgeries performed. Deaths: 13 (plus three dead-on-arrivals). Births: At least two. Michael C. Radoiu, an optometrist based in Harrisonburg, Va., and a captain in the Navy's Medical Service Corps Reserve unit, is a member of the medical team and one of 1,200 personnel aboard the ship. A father of three, Radoiu says seeing children in pain is his toughest challenge. NEWSWEEK's Claudia Kalb and Radoiu communicated by e-mail. Excerpts (note to readers: some descriptions of patients' injuries below may be graphic):

What are the most common injuries you're seeing?
By and large the most prevalent injury seen is orthopedic in nature. This is due to the crush injuries frequently seen with falling brick buildings and concrete structures. Those Haitians who did not expire immediately as a result of the earthquake were either able to extricate themselves from fallen buildings quickly or were entrapped by the debris. Sadly, those entrapped probably died later on from crush complications, bleeding, or dehydration. We actually saw the lucky ones onboard ship. These patients typically presented with several broken bones, blunt crush injuries to the torso and head trauma. We didn't see too many head trauma cases because these people simply didn't survive the week unattended. 
 

The most common surgical procedure has been the amputation. Many damaged limbs were simply deemed not salvageable and had already had become necrotic and infected. Some patients became double amputees with, sadly, a few children and teens in this group. 
 
What kind of eye injuries are you seeing and treating?  
I would say that the really tough eye cases are those where almost all of the contents of the eyeball have been literally ripped out of its socket. We have had three like this. Thankfully all had no effect to the companion eye so they will have vision. When the patient flow lightens up at the end of the day, another optometrist and myself have been able to perform routine eye exams while the patients lie in bed in the recovery wards. We have already been able to dispense some medication for abrasions, infections, as well as several pairs of eyeglasses (we have opticians onboard and have lens-fabricating capabilities).
 
Have you done this kind of work before? 
I have been involved in many civil-affairs projects around the world (Africa, Latin America, Southeast Asia) as a team leader, planner, operations specialist, and clinician. I have never seen anything like the Haiti earthquake. When we operate in a civil-affairs or medical-readiness exercise capacity, we do so in remote, undeveloped, and often hazardous areas but always under peacetime conditions and never with so much death and destruction involved.

What is the most difficult moment you have faced so far?
I think that seeing young children in pain, and often horrid pain, has been my toughest challenge. Although we are medical professionals and many of us have seen death and dying in wartime, nothing prepares you for the screaming and obvious agony seen in the young. 
 
The most uplifting moment?
When you see a horribly damaged body come in with a patient barely clinging to life and then see that same person 48 hours later on the ward eating a full meal and looking up at you with a half-smile. Then you know that they'll make it. I had "my moment" when I saw a 36-year-old woman with a full thickness facial laceration extending from her left brow down to her jawbone, two broken arms and a broken leg. The eye was spared but she was terribly disfigured. I saw her two days after a plastic surgeon worked on her and the face, while still quite scarred, looked remarkably good. Both arms and the one leg were in casts and given a good prognosis of 100 percent recovery.
 
How are the patients doing emotionally?
The Haitians are a remarkably resilient people. I believe that they have had to be due to a terrible history and an accident of geography (earthquakes, hurricanes, etc.). They have a very strong sense of family, community, and are deeply religious. This morning I walked into Ward 3 and about 15 were singing the rosary in unison. They clearly are healing themselves mentally and spiritually.
 
How are you and the other doctors doing and how are you handling stress?
I have it easy compared to the surgeons, surgical nurses, surgical techs, and, of course, the ward nurses. They have clearly been taking the brunt of the early stages of the operation. Many get no more than 3 hours of sleep a night and we have been working nonstop (no Sabbath here!) since being on station. With the tempo possibly changing in a few weeks, we (the land medical teams) will then get hit hard as we will man the onshore clinics for 12- to 14-hour days.
 
I would say that the civilian and military health-care providers (let's not forget the ship's crew, Haitian translators, helicopter pilots and security personnel) are consummate professionals. There's no fuss, egos are kept in auto-check and the staff is very focused on the mission. That being said, of course, I foresee replacements arriving soon. No one can sustain this tempo forever.