Nephrologist Rita Mankus had been on trips to Haiti and other areas of the world before to provide medical help. As a doctor, she has the skills that can make a difference to those who need it most. And no where in the world needed more help than Haiti after it was devastated Jan. 12 by a massive 7.0 magnitude earthquake.
This was the fifth-most catastrophic earthquake in history, according to U.S. Geological Survey, with 222,521 deaths and more than 1 million people displaced within the tiny country, which is about the size of Massachusetts.
It was a dangerous situation, and Mankus understandably had some misgivings prior to leaving. “My husband was holding up the newspapers and saying that they’re rioting down there in the streets,” she said. “You can’t pay too much attention to that, though. There was a call for help.”
Mankus is a nephrologist with the Lafayette Center in Indianapolis, Ind., and the center’s parent company Liberty Dialysis offered to provide money to the relief effort and to help the doctors in their efforts.
Arriving in Haiti
Nothing could prepare her for the scene that awaited her when she arrived to Port-au-Prince a week after the earthquake. “It was like a war zone,” she said of the Haitian capital. “I’ve never seen so many buildings toppled. The second floor of the [presidential] palace was sunk into the first floor. As people were clearing the rubble, you couldn’t get close because the smell of the bodies was so strong.”
The night she and her group arrived in Haiti they felt a tremor around 5.2 in magnitude, and the next day another one at about 6.0. Within 12 days of the initial earthquake, Haiti had suffered at least 52 aftershocks of 4.5 or greater.
Mankus and her team arrived first to Port-au-Prince, where there was only one operational runway for planes, and went to a hospital in St. Marx. “The hospital had cracks in it, but we didn’t know whether they were there before or after the earthquake,” Mankus said.
Because of the structural instability, and the constant threat of aftershocks, they had to wait for a civil engineer to check out the building before it could be cleared for use. Unfortunately, they had to move to another hospital in nearby Petit Riviera. It was primarily used as a maternity hospital, but it had enough clean operating rooms for the medical team to use. And it had one anesthesiology machine.
Life as a Volunteer
“Only two to three days in, I thought to myself, ‘Oh my God, it’s only Monday.’ But as the week went by things seemed to get a little bit better,” Mankus said about her seven-day stay in Haiti.
The volunteers were told to bring their own bedding. She lost hers, but she was able to find some padding for the concrete floors of the hospital and a little blanket to cover herself with. “You were so exhausted it didn’t matter,” she said.
There was no plumbing or running water for the volunteers, so they had to use the “bucket method.” Everything was rationed, and everyone would joke about how many cups they would use to wash themselves with.
In addition to the Spartan lifestyle, the usual trappings of medical care were nowhere to be seen. “You just go and do what you can. You learn on the job,” Mankus said. “We would have to figure it out when we were there. If I wanted something I had to go out and get it. Nothing was convenient. You had to run. There was none of the ancillary help doctors are used to. A simple task at home could take an hour [in Haiti], but you just had to go and get it done.”
Complicating the relief effort, Mankus said some Haitians were spreading propaganda that the Americans were there just to cut off their legs. This was not so much an anti-American screed, but a reflection of culture. She explained that handicapped are not accepted in Haitian culture. “They’re not considered worthy,” Mankus said.
However, as a doctor, she had to ask Haitians, “What about their life?” Most said they would rather die than have their limbs cut off, said Mankus. “It was heartbreaking to see. One man’s daughter had a fracture on one leg and an open wound on another. She was his only child having lost his four other children in the earthquake.
“We fought to get everybody treated, and to save as many limbs as possible.”
Caring for the Victims
With her training in internal medicine and nephrology, Mankus spent most of her time in Haiti treating wounds, infections, crush syndrome patients, and hooking people up to IV bags to treat dehydration. The hospital she worked in was overwhelmed, and people would pile into small rooms. It was hot, humid, and had no air conditioning. “Flies were circling around,” Mankus said.
Many of the wounds were described as “sticky” with serious infections. There were pelvic fractures, but none of the right tools to fix them. “No one there knew that victims had to be turned over in their beds to prevent bed sores. People would be crying out in pain. We would have to scrounge around for narcotics, and there were little to no wound dressings to use.”
Caregivers would have to ration what pain medications they did have. “Only take if the pain is really really bad,” she would say while chopping Vicodin pills in half. The Liberty Dialysis funds helped Haitians who couldn’t afford to pay for the painkillers themselves.
“It was hard to hold a lot of hope for some of these people, she said.”I knew they were going to die. I think we did some good despite all of this.” They also did everything they could to educate Haitians on some basics to care for themselves with translators, who were usually locals and would help for a small fee.
Four months after the quake, Haiti still has a long way to go, and still needs the sustained help of the international community. However, volunteers such as Mankus helped stabilize the country during the first horrifying weeks after the earthquake. “The first few days we were there, they were stacking bodies in the streets,” she said. “Towards the end, we made a difference on a number of lives. I’m glad we put our lives on hold for a week for this purpose. I felt pretty good about mankind after this.” RBT
