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The Providence of the COMFORT: Letters from Haiti

by Clydette Powell, MD, MPH, FAAP
Today's Christian Doctor - Winter 2010

Letters from Haiti while on the Hospital Ship USNS COMFORT January 15 – February 15, 2010

“‘For the mountains may be removed and the hills may shake, but My lovingkindness will not be removed from you, and My covenant of peace will not be shaken,’ says the LORD who has compassion on you” (Isaiah 54:10).

At the first break of news about the earthquake in Haiti on January 12, I knew I was called to serve those who had been injured. It was just a matter of finding the best way to get there. Through a remarkable series of rapid events, I was offered a place on board the USNS COMFORT, the US Navy’s white hospital ship emblazoned with red crosses, where I would work nearly non-stop for the next four weeks. What follows are excerpts of letters to my mother over that time.

January 19

It has taken us almost four days to sail from Baltimore to Haiti, traveling at fifteen miles per hour! I cannot fully describe how privileged I feel to be a part of this humanitarian mission to Haiti, in the wake of the earthquake’s devastation barely one week ago. As an American citizen, I am honored to represent my country and USAID (the US Agency for International Development) in this endeavor. Thank you so much for your prayers and your support!

The USNS COMFORT team on board is impressive. CAPT James J. Ware, the Commanding Officer, has my full admiration. He is a wise leader, humble, confident, and deeply caring about the team. His relationship skills are exceptional; his professional military experience is deep. The team morale is high; everyone is “pumped” for tomorrow’s morning arrival in Haiti and the humanitarian mission over the next several months. The Navy discipline and esprit de corps are outstanding.

January 20

Our USNS COMFORT dropped anchor in Port-au-Prince before daybreak, just before a “welcome” quake of 6.1! The first helicopters were off at dawn to retrieve patients from the USS CARL VINSON. What a sight to see them careening over the harbor, with Haiti’s mountains in the background, off to the humanitarian mission we so eagerly have awaited in these four days since sailing out of Baltimore!

On board, the Casualty Receiving area (ER) was busy with its first patients. I quickly found a young Haitian woman, thirty-two weeks pregnant, who had suffered multiple episodes of blunt trauma to her abdomen and burns during the quake. Her unborn child was moving in her womb — visibly. I was glad to see those movements and relieved to learn that she had had no premature vaginal bleeding. Then the Cas Rec doctor asked if any one spoke French so the patient could understand his process to dress her severe burn wounds. I immediately volunteered and translated for him. Also at her ER bedside, the ship’s chaplain asked me to translate his prayers for her, as we both tenderly held her arms. What a joy to be able to help! She seemed appreciative and relieved. My very first contact with the wounded of Haiti! What a privilege. Thank you, Lord.

January 22

Among all the suffering and cries we have heard over these past days, the best sounds were the new cries of a little four-pound, five-ounce preemie named Esther who arrived by C-section. She was born in our operating rooms on the ship some seven weeks before she was due. They say this is a milestone because little Esther is the first baby born on board since the ship was converted from an oil tanker to a hospital ship back in 1987!

January 30

In God’s foresight and His plans for me years ago, my training in child neurology has been custom-made for this mission. The US Navy did not deploy a single pediatric neurologist for this mission! So I, the civilian doctor, am it! With all the head trauma and spinal cord injuries, crush injuries, and seizure disorders secondary to brain injuries, we have been busy. I am working some very long hours, but I am in my passion. Of all the ways for me to help the Haitians in this crisis, this is the best. And I am getting a lot of exercise up and down the ladder wells (stairs) all over this ship. Mom, the COMFORT is three football fields in length and the equivalent of ten stories high! I am so glad I packed my running shoes!

January 31

This evening at the ship’s chapel we attended a funeral/memorial service for a ten-year old patient, Alexis R, who died four days after contracting meningitis. Her mom grieved deeply, clutching her stomach and saying she still remembered the labor pains she had for her daughter when she was born. Between tears, she cried out details about her daughter — little conversations they had as mom and daughter, ways that Alexis helped her at home, and how this child was the most treasured among her other children.

The American chaplain and a Haitian pastor co-led the simple service of hymns, Bible readings in English and French, and prayers. What moved me the most, however, was seeing about four rows up in the front of the chapel the mom of Catherine Jean B, a baby who had just died earlier this morning. This mom had given birth to Catherine one day before the earthquake. The next day, the quake killed her husband, destroyed her home, and forced her onto the streets, twenty-four hours post-partum. Although Catherine had survived briefly, now she was gone. Seeing that mom sitting in Alexis’ funeral service, this mom newly widowed, newly bereft of her baby, newly homeless, just tore at my heart. Although the service was for another child, my greater grief was for a mom who had barely had time to hold her own little baby in her arms.

As the service came to an end, each person lined up to come by Alexis’ mom and hug her, then they slowly filed out of the chapel. The Haitians were singing over and over again a song in Creole; it included the words “Hallelujah.” As we left the chapel, and as we silently went up the many steps in the ladder-well back to the patient wards, I heard the clicking of crutches against each of the metal steps in the ship. I had forgotten that to arrive at that chapel, some patients on crutches had made the big effort to climb up and down those stairs . . . to honor this mom and perhaps to give thanks that their lives were spared. In that passageway, Catherine Jean B’s mom broke down and sobbed. . . . I could not hold back the tears, myself.

February 7

Oh, Mom, your notes sustain me. They make it possible for me to do this hard work and to reap rewards in so many ways. But I kept thinking about this day one year ago when Dad died. No one here on the COMFORT, no one in Haiti, knew this day’s personal significance. Yet, God has placed this work before me, and so it helps me to focus on His tasks for my day.

Today in a helicopter (helo) I accompanied a ten-year-old girl named Faika from the USNS COMFORT to a field hospital, near the Haitian border with the Dominican Republic. Because the story of this child and her dad and the timing of events were extraordinary, I must share with you God’s providence in her life and mine.

I had first met Faika and her father in our PICU on January 24. Not home when the earthquake struck, her dad was spared. But when he arrived home, he found that his wife and two of his daughters had immediately died. His third daughter Faika somehow survived, with head, leg, and pelvic injuries, and was rushed to a field hospital in Port-au-Prince. Over the course of time, Faika developed multiple medical problems, including kidney failure and fluid in her lungs, which caused her to stop breathing and be placed on a breathing machine. Two weeks later, she was transported by helo to our PICU here on the USNS COMFORT, where she remained on a breathing machine for another few days.

Faika nearly died. Yet, over the course of her PICU stay, she began to improve slowly; her kidney failure and respiratory distress resolved. She received a transfusion for marked anemia, and finally was well enough and awake enough to recognize her very grateful father. Throughout all this uncertain course, her father quietly expressed his faith in God and his unending hope for his daughter, the only precious thing that remained to him. He had a deep faith in the Lord in the face of unimaginable tragedy.

Over the next two weeks, I followed Faika’s course, both in the PICU, where I was spending most of my time — and then on the patient wards after she had been transferred. Conversing in French, her father and I spoke of their circumstances and needs, but Faika remained silent, never saying a word, likely traumatized by all that she saw, in the earthquake and in the PICU.

Today was her patient discharge day from the COMFORT. Though not completely healed, she was ready for transfer back to the mainland. This morning, I waited with them in Cas Rec (the ship’s ER) for her move up to the flight deck and helo transport out. She and her dad were excited though apprehensive about what awaited them. Their home and his livelihood had been completely destroyed by the quake, and they were being transferred to place far from Port-au-Prince. I was initially very concerned about this destination, and fought that decision by the discharge planners; but this destination decision (FDP) was nonnegotiable at that point, and the father convinced me that he wanted the best for his only daughter, no matter where that place was. I decided to stay with them as long as possible.

To my surprise and delight, at the last minute the “air boss” gave me the thumbs up to accompany Faika and her father in the helo transport to FDP. Oh, I was thrilled! They first loaded Faika’s litter into “the bird,” and then her dad and I got on board, while the helo’s rotor blades thumped loudly. When we suddenly and finally lifted up from the flight deck, Faika gripped my left hand; and in my right hand was her dad’s. We became a threesome, flying over the bay, over Haiti’s capital city, and then into the rural interior, arriving some 15-20 minutes later at FDP, which none of us knew. As soon as the helo pilots dropped off Faika, her dad, and me, they told me they had another run to make but promised to pick me up on their way back. “Powell, you’ve got 40 minutes to get your work done at FDP, because we cannot wait for you at the landing zone, and we don’t know when we will be back.”

FDP’s site looked well organized and welcoming. We were greeted by an orthopedic surgeon from Chicago and two Creole speaking female volunteers working in the triage tent. The FDP surgeon carefully took off Faika’s wound dressings and commented on how well cared for she had been on the COMFORT and how nicely the wounds were granulating in. The FDP staff treated Faika and her dad kindly and helped them start the process of admission to this field hospital.

Knowing I had just 40 minutes till my own pick-up, I decided to wander around and check out FDP hospital where I was placing Faika and her dad — and potentially other patients from the COMFORT. As I was making my informal site visit, taking some photos, and waiting for a return helo, I heard someone call out my name “Clydette??!!” I turned around, astonished that anyone could know I was here. It was my dear friend Diane, also a pediatrician and whom I had last seen in February 2009 in Asia. Diane was a missionary doctor in Pakistan. Temporarily based Stateside, she had volunteered to come to Haiti and help in the relief effort. She was the only pediatrician at FDP and had extensive experience in refugee health care. I had no idea she was in Haiti, let alone at FDP. You can imagine my surprise in seeing her.

Moreover, I was delighted that I could hand over Faika’s care to FDP’s only pediatrician and a trusted friend. That in itself seemed divinely orchestrated. However, what made this meeting up with Diane even more significant and personal was that exactly one year ago to the date — February 7, 2009 — my father had died, and Diane had been with me after I received that news. She had been an immense source of comfort. All today, in the back of my head, and deep in my heart, I wondered what God would do to address my grief. Here was Diane, the only person in Haiti who knew and had experienced my own personal earthquake 365 days ago. Diane and I hugged hard and long. I brought her over to Faika’s bed and introduced her to my patient and her father.

Forty minutes later, the noise of thumping blades suddenly announced the return to FDP of my helo ride. I quickly ran for last hugs with Faika and her dad, and then Diane one more time, and then I ran for the landing zone. As I jumped on board the helo to fly back to the USNS COMFORT, I wished Dad could have seen all that had happened. Then I realized, “Of course he is, and he is looking at all this from the best seat in the House.”


Clydette Powell, MD, MPH, FAAP