Wednesday, January 27, 2010

Haiti diary: Pharmacy perspective #3

January 26, 2010

Hello everyone,


I realize I have not updated since January 20. We are so busy operating our medical teams, supporting the operations, and adjusting our response to the event that everything is a blur.


During the past 5 days, many things have happened.


Our teams are out in the city in operational sites established to provide health care or support other operations. One of our operations is in the middle of one of the worst parts of Port-au-Prince. I had to ride into the site a couple of days ago, and I will say, it was one of the scariest rides of my life; however, the operations are doing some amazing things. Unfortunately, because of the time lapse between the earthquake and access to care, many patients, young and old, need to have various parts of their limbs amputated. Young children, adults, and older adults are all affected by this event. Our teams that are doing this work are some of the most amazing professionals I know--working under austere conditions, with long days and little sleep and surrounded by thousands of displaced residents. They have delivered numerous babies at our operational site. In normal situations, some of these babies would not have made it because of the conditions they live in. These events significantly raise the morale of our teams working on site.


One of our other teams is supporting the USNS Comfort. The Comfort is a Navy medical care ship that is staged off the shore of Haiti. If you have been following this in the news, you will know that the Comfort arrived a couple of days ago. One of our Disaster Medical Assistance Teams is managing the staging point for patients to be medvac’d from Haiti to the Comfort. Unfortunately, not all of the patients are in strong enough condition to survive the flight to the Comfort. Again, an amazing group of clinicians try to make these patients as comfortable as possible, making their passing as peaceful as possible.


Two of our teams were deployed above the city in one of the towns outside of Port-au-Prince. The world has focused on Port-au-Prince, but other areas and towns outside of Port-au-Prince were devastated by the earthquake as well. Some towns were totally leveled. Our teams are trying to do outreach to those towns, but roads in Haiti are challenging at best.


Pharmacists are members of all of these teams; they are some of the greatest pharmacists I’ve ever had the privilege to work with. Last night, Scott Miglin, who is from the PA-1 team but is deployed with the NJ-1 team to Haiti, came into town to pick up a resupply order I had put together. He was escorted in by a team of soldiers from the 82nd Airborne Division in the middle of the night. These soldiers have done a phenomenal job protecting our team members. They are encamped in the area above Port-au-Prince with our team and continue to watch over them. Thank you to the 82nd Airborne Division.


Since I wrote you last, we have had three more earthquakes/aftershocks, the highest being a 4.3 aftershock that hit on January 22. Again, it’s a little scary when your desk starts moving, followed by the filing cabinets, etc. Not something I’ve experienced before and not something I will ever forget.


I’m still camping out on the American Embassy lawn with about 50 of my newest best friends under the stars. The bugs are still a little hungry. Parts of my arms are a little bitten up. I think the mosquitoes drink DEET for dinner.


There are so many stories I can’t even start to tell you all of them; however, I have been humbled to really appreciate what we have in the United States, like drinking out of a cup--not a bottle--of water, drinking something other than water, and eating hot food. As I wrote before, I have not had a hot meal since leaving home. MREs are not what they are cracked up to be. After a while, they all start looking the same and basically taste the same.


In closing, I will share one story. On Sunday, my replacement arrived in country. Dave "Clay" Griffin from Texas arrived midmorning. The irony of this is that Clay is the same pharmacist who replaced me after my first tour of duty during Katrina. We spent part of the day at the Port-au-Prince airport reviewing all of the pharmaceutical supplies we had out there. Then we went to the American Embassy to do the infamous paperwork needed to complete the transition. During the day, a large pharmaceutical order request came in from one of our sites. I knew it would be a challenge to get to the airport where our supplies are and back to the embassy safely at night. Therefore, I advised Clay that, as one of my last operational acts, I would go to the airport, pull and pack the order and wait for the team, escorted by the 82nd, come in and pick up the order; I would just sleep out at the airport.


While traveling out to the airport, I was talking to the driver. As I stated in one of my other e-mails, for numerous reasons, we have to hire all local drivers. As I usually like to, I asked the driver about his family and asked if they were okay. "Paul" stated that they were all ok, but his wife and kids still refuse to sleep inside. They are still scared. In order for his kids to go to school, he must pay their tuition. However, his daughter, although smart, needs some extra tutoring. This costs more, and he is upset that he does not have the money. He can barely pay for his sons' tuition and doesn’t know how he is going to come up with his daughter’s school money. Paul has had to spend a lot of the money he had saved to care for his family during these times. Everything is now very expensive compared with what it was before and his house is damaged, as were most of the things inside. After a couple of minutes of conversation, I was able to find out the cost of his daughter's school tuition.

As I was getting out of the truck, I pulled out some of the cash I had brought with me on the deployment. Since I have had literally nothing to spend money on, I had almost all of the money I had left home with. So I pulled out enough money to pay for his daughter's tuition. This cost was less than a couple of tickets to a sporting event. I walked up to Paul and asked him if I could give his daughter a gift. Remember, although the country of Haiti is destitute, the people of Haiti are a very proud people. They will work for everything, if possible, and only take handouts basically because they have to in order to survive. Therefore, this was a gift to his daughter, not charity to him. He graciously took the money. He went back to his vehicle and came back with a box. With tears in his eyes, he opened a small box. Inside were several cigars, including Cuban Cohibas. He opened it and pulled out two of the Cohibas, handed them to me, and said, "A gift from my daughter; thank you." At that moment, it sort of made the whole challenging deployment a little more worth it.


At this time, I am finally back on U.S. soil. I am in Atlanta. I left Haiti this morning after spending the night at the end of the active runway at Port au Prince airport. The army was moving supplies all around us all night. The dust, mosquitos, bugs, and looters trying to take whatever is not tied down are challenging. Our forward camp is next to the French National Search and Rescue team. They are always laughing, singing, and cheering all day and all night.


When we arrived in Atlanta, we had to clear Customs. Apparently, the White House had called ahead and advised the Atlanta Customs and Border Patrol (CBP) to "take care of us." Because I was the senior member on the plane, I had to meet with the CBP officers when we first arrived. They were great. They escorted our plane full of team members through the custom clearing process, while holding back all other passengers until our whole group was done. All the agents were shaking our team members' hands and extending words of thanks. It made our team members feel great.


Our leadership from Washington, DC--Director Jack Beal and Deputy Tim Walton of the National Disaster Medical System (NDMS)--met us at the luggage area. We were then loaded onto buses and taken to a local hotel. There we were debriefed, offered health care screening, any postdeployment medications, and counseling.


On Tuesday, I will be finally traveling home. Although I’m back, I will be taking the next week to spend time with my family. They are the ones who truly pay the price when I go out and deploy.


Thanks again for all of your e-mails, words of kindness, and concerns for my family and the people of Haiti. I truly appreciate it.


Thanks, and take care.


Bill Drake



William C. Drake, PharmD

Chief Pharmacist, IRCT Haiti, US Embassy-Haiti

US Humanitarian Medical Mission to Haiti Earthquake

HHS/ASPR/OPEO/NDMS/Pharmacy Logs

Tuesday, January 26, 2010

Haiti Response: Letters from Bill Drake

Many of us witnessing the devastation of earthquake-stricken Haiti have been moved to generously donate to the heroic recovery and rebuilding efforts. For William C. Drake, PharmD and NCPA member, that wasn’t enough.

Just hours after the deadly earthquake struck Haiti Jan. 12, he was getting ready to leave snowy Shelby Township, Mich., for the Caribbean island.  
 read full article

Thursday, January 21, 2010

Haiti diary: Pharmacy perspective #2

January 20, 2010
Hello everyone,


I apologize for not updating you sooner. I’ve been and am a little tired. My work day has been averaging between 16 and 20 hours a day.


This morning, while working in the U.S. Embassy, we got hit with a 6.1 earthquake, apparently. I know the earthquake hit; I just didn’t know it was a 6.1.


Since our command center is on the 2nd floor and my cubical is near an outside wall, it was a very interesting feeling when the whole building started to move. Some things fell over, but no one was hurt. We understand some more damage occurred in the city.


Many people have been working very hard to get care to the people out in the city and countryside. It is an enormous challenge in a country that had minimal infrastructure before the event.


Many people have been thrown here with minimal preparation. A lot of my work for the past several days has been making sure everyone under our command is properly protected from malaria. This requires taking doxycycline. Additionally, immunizations need to be updated to include typhoid, hepatitis A, and tetanus. Now they want everyone to receive the H1N1 vaccine because of an apparent breakout in the country.


I am finding that some of the military personnel who arrived in country quickly are without some basic comfort meds or any of the malaria prophylaxis. I was able to explain to my commander that we need to help and support everyone in this effort. So I’ve been playing pharmacist to many very appreciative Marines and Airforce, Army, and Navy personnel. The appreciation in the eyes of these young men and women is unbelievable. Many of them have recently returned from combat tours in Iraq and Afghanistan. And they tell me "Thanks for being here"!!! I don’t think they understand how much we all appreciate that they are now here, guarding us, and protecting us when we go out into the city. They are unbelievable members of our armed services, and they do it without blinking.


Our teams are staged in several sites in the city. There are numerous other medical care sites being provided by other countries and groups; however, it does not seem to be enough. As I stated in one of my other e-mails, this country was in bad health care shape before; now it almost does not exist except for the groups that are now in country because of the earthquake.


They don’t want us to drive, so we have to use local drivers for everything. Based on how that goes, I’m actually glad I’m not driving.


Some of the biggest challenges are the people who are coming down here to help, but end up being part of the people in need. They come down unprepared, pampered by the life in the United States, and when they show up here and there is no 7 Eleven, everything falls apart. We have seen several of these people who have had to then be rescued. This is nothing like a domestic disaster, where at least you can drive a distance and then at least the world is somewhat normal. NOTHING down here is even near normal to life in the U.S. That has been very humbling. For example, we had a group of five Haitian men who came up to us at our Airfield Logistics base. That is where we are storing most of our supplies that have been delivered in country to support out operation. We needed some trucks loaded and some pallets unloaded and moved. The only payment they asked for was food and water. After they worked for awhile we made them take a break and get some water and gave them an MRE (Meal Ready to Eat) that the military uses for their troops. We noticed they only ate about half or less of the meals. So we asked them weren’t they hungry?? They told us that they didn’t want to eat it all and that they were saving it for some of their family members. Needless to say that they left with multiple MREs each and as much water as they could carry. Truthfully, water and food are more important than money.

Now comes the emotionally challenging part. When taking the break we were talking with them. Four of the five had family members crushed and killed in the earthquake. One man lost his whole family, wife, and three children. One man lost his youngest son. You could see they grieved and probably needed to grieve more, but they had to think about their family members who are alive. Right now, at this moment, that is the most important thing ... staying alive. Working for our food and water was the best thing that had happened to them for the past week. We told them to come back tomorrow and we can see if we can put them to work. Several of us have agreed to give up most of our MREs for them while we are here. We are allowed three per day and I can barely eat one at this time.


As for food, I haven’t had a hot meal in more than 7 days. Nothing stronger than bottled water for the same amount of time. I assure you I can afford to miss some calories, but a hot meal does sound so good at this time.



Tomorrow looks to be a big day. A lot going on--our team will be engaging in some of the most challenging areas.


We are not allowed to travel at night any longer, and I’m ok with that. We had, let's say, a challenging ride the other night.


Thanks for the continued e-mails of support, comments, and prayer for me and my family. I appreciate that .


Until next time, take care and goodbye from the U.S. Embassy in Port au Prince, Haiti.



Bill




William C. Drake, PharmD

Chief Pharmacist, IRCT Haiti, U.S. Embassy-Haiti

U.S. Humanitarian Medical Mission to Haiti Earthquake

HHS/ASPR/OPEO/NDMS/Pharmacy Logs

Friday, January 15, 2010

Haiti diary: Pharmacy perspective

January 13, 2010; 10:52 pm

Hello to all-

In addition to my day job of working at Advanced Care Pharmacy in Shelby Township, I am one of the Chief Pharmacists for the Department of Health & Human Services Disaster Response Teams. Officially I work for HHS, Office of the Assistant Secretary for Response and Preparedness/Office of Preparedness and Emergency Operations, National Disaster Medical Systems. I am part of the command and control group that deploys forward during a federally declared disaster or emergency response.

As you know, yesterday the country of Haiti was struck by a significant earthquake. As part of a global humanitarian response, the United States has committed to assisting in many ways. At this time, I have been activated and told to stage forward toward the area. I will be leaving early in the morning for Atlanta, and then ... who knows where?


January 14

At this time, we are staged in Atlanta. We have multiple teams with us staged here. This afternoon, we may depart for Haiti and be on the ground by this evening. That is still fluid and may change at any time. Once in Haiti, I doubt I will have communications in or out, so this may be my last e-mail for a while.

As you may have seen on TV, a group from the 82nd Airborne is on the ground and will be providing security for us. In addition, an aircraft carrier is apparently enroute, along with (possibly) the USNS Comfort hospital ship. We may be working in conjunction with them; not sure.

I appreciate all of the well wishes and acknowledgements.

Most important, please keep my family in your thoughts. Although I do this for our country and to help people, my family are the real heros. They are the most important thing to me, bar none. Leaving them during events like this brings challenges to them and for me.

Thanks for all the thoughts and support.


Respectfully,

Bill Drake


William C. Drake, Pharm.D.
President
Advanced Care Pharmacy Services

Chief Pharmacist
HHS Humanitarian Mission to Haiti
HHS/ASPR/OPEO/NDMS/LRAT