We're still in surgery at 10pm hoping we can call it a day soon. Doing amputation of leg on 56 year old man that fractured his leg. Dr. Vanek saved a 15 year old boy today. But he is severely anemic with Hb=3 preop. We borrowed 2 units blood from our other patient to keep him alive in recovery room overnight. We are fighting to receive more blood tomorrow for him which required a special meeting with hospital administration and we were assured he would be airlifted to US Compassion offshore.
A young plastic surgeon from Dallas just visited us to see our surgery. She showed me photos of IMC-Internal Medical Center (Red Cross) and their MASH unit. Community Hospital is a private hospital, nicely equipped and staffed. There are patients outside due to structural damage from the earthquake. They had to convert their emergency room into operating rooms. The National Hospital collapsed and that was widely covered by the media. As a side note, we've heard different estimates on the prevalence of HIV among Haitians. Today I was told it used to be 10% but now its 2.5%. I will check that when I get home. Two surgeons just signed out three patients to us since they return home tomorrow.
We operated 15 hours today and 12-15 hours yesterday. We start at 7:45am tomorrow and have three big cases so far.
Saturday, January 23, 2010
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Dear Brandon and Jack,
ReplyDeleteThe following article on HIV/AIDS in Haiti is copy-pasted from Wikipedia under the category of "HIV/AIDS in Haiti". The only reference cited is the US Department of State (2008). The article`s content as a whole risks being faulty. Of course, these figures pertain to the pre-earthquakes -Haiti.
Haiti is the Caribbean country most affected by HIV/AIDS. The epidemic is generalized and fueled by endemic poverty and high illiteracy rates. By the end of 2005, the national HIV prevalence among adults aged 15 to 49 was 3.8 percent[1] but has since decreased to a mere 2.2 percent by the end of 2008 due to effective HIV/AIDS education programs, and increased standard of medical treatment.
In Haiti, HIV is primarily transmitted through heterosexual contact, followed by mother-to-child transmission. Half of the people living with HIV/AIDS are women. The recent declines in HIV infection rates are most notable in urban areas, and have been attributed to significant behavioral changes, including fewer partners, delayed sexual debut, and increased condom use. Other explanations for the recent trends include AIDS-related mortality and improvements made in blood safety early in the epidemic. Continued political instability, high internal migration rates, high prevalence of sexually transmitted infections, and weakened health and social services persist as factors with potential negative impacts on the epidemic. Antiretroviral coverage in Haiti is minimal for rural populations, people in prostitution, and men who have sex with men — ultimately reaching less than 20 percent of the people who need it.[1][dead link]
http://en.wikipedia.org/wiki/HIV/AIDS_in_Haiti
I hope this will be of some help. Be strong.
Nick
Also there is reference to the GHESKIO report that was in the New England Journal of Medicine
ReplyDeletehttp://projectmedishare.wordpress.com/2009/08/25/gheskio-research-featured-in-new-england-journal-of-medicine/