Population & Family Health

Jeff Kinyon, DO

After the earthquake, six students from the International Emergency Medicine Fellows, a program directed by Dr. Rachel Moresky from the Mailman School's Program on Forced Migration and Health and Emergency Medicine, deployed with the International Medical Corps (IMC).

Physicians from NewYork-Presbyterian Hospital, the fellows are trained in international health and disaster mitigation and management.

Reflections on Haiti details their experiences.

Tell me a little about the program you are in.
The International Emergency Medicine Fellows (IEMF) program is a fellowship where you work in the emergency room as a physician and your MPH is paid for. We do the MPH in three semesters. The first semester of second year is spent travelling for your internship.

Last year I went to Thailand for 1 month and the South Sudan for 3 months.  I was in a local clinic working with returning refugees with the International Rescue Committee.

Had you ever been to Haiti before?
No, I’d never been in Haiti.

How long were you in Haiti after the earthquake?
I spent 10 days in country.

What were your responsibilities?
I went in with a group of doctors planning to get in as fast as we could to treat the patients that we came across.  We got there 5 days after the earthquake and set-up a general hospital in Port-au-Prince.

Patient's arm
Photo credit: J. Schwieger

Were you working around the clock?
No, they were strict about getting us out before dark to get back to the hotel. For the first few days no one was staying with the patients at night. They were left pretty much on their own. That was really hard to do – to just leave them.

We stayed at one of the few standing hotels in Port-au-Prince – the same place for CNN. We were all in one room with one shower for all of us. Some bathed in the swimming pool.

What was your first impression?
Chaos.

There were so many patients there - people with broken bones who’d been waiting for days to be seen. Bones were sticking out of their skin. Really sick patients.

I got assigned to set up a pharmacy which was frustrating because I wanted to be seeing patients, but we knew that someone needed to set it up. 

After that I worked on triage. Even though [the Haitians] had been sitting in the hospital grounds for days, decisions still had to be made about where to put them.  I have no idea how many patients we saw.

I was warned that it would be dangerous. But I felt pretty safe everywhere we went. The first couple of days it was quiet. Everyone was in shock.

Anderson Cooper interviewing a Haitian family
Photo credit: J. Schwieger

What made the strongest impression?
In the first couple of days a mother brought in a dead girl. A cameraman started circling around taking pictures of the kid. The mother went through almost a ritual of picking up the child’s soul and making these motions and waving her arms – I couldn’t really understand the Creole.  It was a mix of really tragic to watch her and be sickened by the voyeurism of the cameraman zooming in.

It was sort of a circus – with cameramen everywhere. I was frustrated by it, but also knew the more media coverage the more aid would come in. A necessary evil.

Was this your first disaster response?
Yes, this is the first disaster I’ve been in. Sudan was poor but not a disaster.  It was different – in Sudan, it’s a way of life. It’s sad when a kid dies, but that’s how life is. In Haiti, it was just a tragedy all around.

I’d like to do more international work. But with so much student debt, I’ll most likely need to take an emergency medicine job and get things squared away first.

How many medical staff were there?
There were initially seven maybe nine doctors - four from Columbia and four or five from Stanford. 

It was chaotic but I thought we made something out of it while we were there. We stepped in and were able to help and provide some order. As more doctors came in, it became more organized – we were able to set up an operating room and post-operating areas.

Sanjay Gupta was running with a story on how chaotic it was. Some people were frustrated that the press was making more of a story about the chaos – but it wasn’t as disorganized as the media portrayed. At least, not where we were.

When did reinforcements start coming in?
More doctors came in everyday adding to the group there.  A new group came with the IMC, a rotation of doctors that got there on the 15th. Two others showed up a week later.

The 34th Airborne then arrived and it felt safer when they were there. They provided a lot of supplies and helped with patients. It was nice to let the new doctors take over.

But not everyone has a plan when they go there. I met a girl in her 20s who showed up with her 6 month old child from the States. She wanted to show Haitians how to make rural houses out of banana leaves.