Update #1

Well I am here at last and my first job is to go take a nap because I will be taking the night shift tonight, hard to nap when your so wired after the experience of the last 10 hours but will try. We got to Miami Airport at 3am. They took us in buses directly to plane bypassing TSA (thankfully as my pocket knife and 20 lbs. of water probably wouldn't have made it through) there were enough people to fill a 737 with people from all over the world in different relief capacities.

American airlines was great. They had meals, pillows, blankets, care packages on the flight. With Miami's large Haitian population, many of the American flight crews are Haitian and they were working tirelessly to get our flight off the ground. All the more impressive considering we had to stuff anywhere from 50 to 150 pounds of gear per person on the plane itself as the belly was full of supplies.

Flying in (a beautiful above cloud sunrise at 6 am), Cuba, Dom. Rep. and Haiti all look like beautiful mountainous, islands with miles of reefs and beaches. Descending in, the only abnormal thing was smoke plumes from multiple fires throughout the city(was to learn later that they've started burning the garbage and human waste piles to try to clean up the streets, and produce coal for fuel).

On the tarmac, there was a veritable UN of relief efforts visible. The entire infield was filled with small compounds of crates and machinery from US, Germany, France, England, Italy, Israel, Mexico, Bolivia, and many others. Cargo jets were landing and helicopters were taking off hauling large pallets continuously. Once our planes were unloaded,2 things were evident. First, our supplies which should have been there on Sat. were not there. Second, all the groups got picked up but us.

As an aside, they started refueling and reloading the jet with outgoing relief personnel as soon as we emptied. I saw an Israeli jeep pull up to the plane and 2 fully armed paratroopers hopped out and began to escort a physician to the plane. I thought I recognized him so I went and said hi to Ruben Cohen, my freshman year dorm Hall mate from Brandeis University. A Facial surgeon at NYU university, he had been here for over a week in the Israeli hospital compound fixing facial trauma. I can only imagine the tremendous good he accomplished while he was here.

As another aside, there were four nuns on the plane and while waiting on the tarmac, I saw one lift her right hand and then with her left index finger point to a spot on her hand. This maneuver is easily recognized as the universal sign for "I live in Michigan", so after introduction were made, I found myself with four Sisters of Mercy (the same order as my sponsoring hospital) from Michigan, one of whom was not only a general surgeon but also a graduate of my alma mater Michigan State, Her excitement was quickly doused however when she realized that 20 years had passed from her class of 83 to my class of 03.

Once our 4 vans showed up, I went in one with a few of the physicians to scope out a possible hospital and the other four from our group went to the mission compound itself. What followed was a 90 minute drive through the streets of Port au Prince.

I think the biggest realization was that except for the destroyed architecture, this city looked really awful before the earthquake. I suspect that a 90 minute drive a month ago would have evoked much of the same emotions as today except for the realization that this couldn't have happened to an already worse off people so it just makes you wonder whats next.

We passed the Presidential Palace, and I felt like I was looking at an Escher drawing with pieces collapsed and sticking out at all angles. We saw the demolished courthouse, general hospital, and nursing school. In downtown I saw very few injured people. There were numerous areas of tent cities and shanty villiages throughout the drive however I am unsure whether these were new or old.

The saddest thing I saw was driving on the 4 lane highway (biggest in capital), in the median which can't be more than 6 ft across, a tent row was evident and clearly new and spontaneous. The vast majority of inhabitants were under the age of 10. I saw babies and toddlers inches away from traffic because they had nowhere else to go. As the father of 3 young boys who don't like to 'look both ways', it was very sad to see these kids just sitting and watching traffic. This was tempered by the occasional glimpse of a bright smile when eye contact was made with one of the kids.

We got to the hospital around 11 am. It is a 7th day Adventist Hospital in Diquini (sp?), I believe we are west or NW of the city based on my sense of direction. As we pulled in, the human face of this tragedy emerged. The entire grounds of the complex are covered in tents. There is a large (40-60 including security) French military contingent that appeared to be doing most of the work. Hand written signs for
registration, pre-op, post-op and others were nailed on trees. They have a PCU (think ICU for post-op patients) outside in a 30 ft inflatable air conditioned tent. Everywhere one looks there are sick and injured Haitians, some with one bandage, but most with multiple.

There are other contingents of providers here including Japanese, South African, Southern California, and Boston teams. They are basically running two shifts 16 hours each with the overlapping used for sign-out.

They were very happy to see us and appreciated the offer of assistance. Their volume has not lessened as they continue to battle quake injuries and everyday sick people too. Mike Rush (radiologist), his son Tommy (a med student) and I stayed here so we could start helping right away while the rest of the van went to go to the mission and see what was going over there. I think that we are going to move the entire team over here tomorrow as they definitely need us here and there is plenty to do. While the mission is only 20 miles away, it can be a 4hr car ride because of the traffic.

I have been teamed with an orthopedic surgeon from LA and at 5pm we will take over as the night crew for all the surgical patients both new and post-op, as well as function like an urgent care center for the approximately 700-1000 people staying within the hospital compound

My adrenaline rush has finally wound down and I can't feel my thumbs anymore after bb'ing this email so its bed time, gotta go to work in a few hours.

Incidentally, our supplies somehow landed in San Juan, PR. American is sending a special plane over to pick them up and get them to us. Somethings never change

Regards,
Elie