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.


William C. Drake, PharmD

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

U.S. Humanitarian Medical Mission to Haiti Earthquake