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SANJAY GUPTA MD
Devastation in Haiti: A Month After the Earthquake
Aired February 13, 2010 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN HOST: I'm Dr. Sanjay Gupta in Port-au- Prince, Haiti. Thanks for joining the program.
I'm here in Port-au-Prince to show about a month now after the earthquake, exactly what is happening here and not let the world forget, as well.
Going to the hospitals, so many patients received important life- saving care. But what's next? How do they recover? Where do they recover? Often times, it's in tent cities like the one behind me.
And the USS Comfort, it was called a ship of medical mercy to me. What exactly does it do? I'll sit down and talk to the chief of surgery aboard that ship.
And people have said there's a ticking time bomb in these medical hospitals, as well. Something that could potentially affect the entire world, what is it? I'll tell you.
You're watching SGMD.
GUPTA: You know, I was at many of the hospitals in Port-au- Prince right after the earthquake -- if, in fact, you could call them hospitals. Most of them weren't even still standing and I can tell you, they were certainly overwhelmed. So many injuries, so many life- threatening injuries, they're really struggling and to try and keep up.
A month later, the entire dynamic of these hospitals have changed. The question is: how will they continue to keep up? And where do the patients go after they leave the hospital? Is there enough resources for them in the tent cities like the one behind me?
Take a look.
GUPTA: What you're looking at is a long line forming outside one of the largest public hospitals in Port-au-Prince. It's nearly four weeks after the earthquake and a couple things you'll notice right away. First of all, the majority of the patients here are not people who are injured in the earthquake. These are people who have chronic disease like diabetes and heart disease, were seeing a doctor perhaps for the very first time, some of them in their entire lives. The other thing you'll notice is that things are much more organized than they were a few weeks ago. Compare that to just two weeks ago. Here you see mainly quake survivors, patients dramatically injured requiring amputations. There was a lack of organization. There's a lack of supplies. Certainly, things have improved in a very big way.
You may be wondering, like I was, what happens to so many of those patients? Well, you're looking at it, many of them end up here, in what's supposed to be a temporary tent city.
Let's take a look around. I mean, this is the condition in which people are supposed to recover from major operations. I can tell you, back in the states, patients would be getting all sorts of different treatments. They might still be in the hospital. They would be getting dressing changes.
But, instead, they're forced to recover in conditions like this. It is dirty. There's a lack of medications, and there's a lack of food, as well, lack of good nutrition.
And there's something else here that people are really worried about. It's rainy season, we saw our first rain in a month. And with come -- with rain, comes all sorts of potential infectious diseases. The World Health Organization says the incidence of measles goes up, the incidence of tetanus, and the incidence of diarrhea, as well.
But, I mean, just take a look at this. I mean, rainy season is pretty tough here. Imagine living in this. This is somebody's home in the middle of rainy season. Instead, they opt for structures like this, corrugated tin to try and protect them.
It's not to say that people aren't trying to help. In fact, mobile clinics are going out into these tent cities, trying to give vaccines in a country that has not seen nearly enough vaccines in the future. But this is it. People are trying to recover in a temporary tent city that I can tell you is increasingly becoming more permanent.
GUPTA: There is still a lot of work to be done in many of the hospitals here in Haiti, as you can see there. And I can tell you, no one knows that better than the special envoy to Haiti for the U.N., former President Bill Clinton. Obviously, he's been in the news this week as well. He was discharged from the hospital after undergoing a stenting procedure.
I can tell you, he was here down in Haiti just a couple of weeks ago. And, in fact, I toured around with him. He was looking to be in good spirits and good health.
People have asked me, did I notice anything that seemed amiss? And I wasn't looking for anything amiss with him, but he seemed fine. He was not short of breath, not complaining of anything.
You know, he had his bypass operation back in 2004, that was the cardiac bypass operation. And there was a lot of questions: how was he feeling after that? Did the operation go well? I asked him those same questions less than a year ago.
Take a listen.
(BEGIN VIDEO CLIP)
GUPTA: Are you back 100 percent?
BILL CLINTON, FORMER U.S. PRESIDENT: I think so. It's interesting. In some ways, I'm stronger than I was before my surgery and by conventional measures, I'm healthier. I've still got about 10 pounds to lose that I gained on the campaign last year working for Hillary. But otherwise, I think I'm fine.
The one thing I've noticed was -- and my balance is better when I'm doing balance drills. But the one thing I noticed that what a friend of mine referred to as "raw country strength." I don't know if I've recovered. I can't hit a golf ball as far even though I can lift more weights.
(END VIDEO CLIP)
GUPTA: Now, when we're talking about the stenting procedures specifically that he had done this past week, not to trivialize it anyway, but it is really basic plumbing.
Look at it like this, there are some blood vessels in the heart that simply aren't getting enough blood flow. They put these stents in to essentially open up those blockages and allow more blood flow to the heart.
We're told by his doctors that he'd been having some chest discomfort over the last few days and the battery of tests ultimately concluding that he needed to have the stenting procedure done. It took about an hour, and again, in the hospital, just overnight.
He is said to be in good spirits and the doctors say that his prognosis is excellent. My guess is that we may see him back here in Haiti even over the next couple of months and probably traveling around the world like he is so famous for.
A lot of questions do remain about Haiti. One of the biggest ones that we get is: what about the water? Even before the earthquake, about half the percentage -- half of population here had access to clean water. What is it now? How is it going to change? We'll take a look.
Stay with the show.
GUPTA: SGMD -- every week around this time, we try to answer some of your questions. Well, we've been getting a lot of questions, specifically about Haiti. Eduardo in California asked some important questions, something that we've really been focused on and that is about the water. He says: "Bottled water and portable treatment facilities are OK for now, but what is the status of the water infrastructure in Port-au-Prince at this moment?"
That's a great question, Eduardo, and a very important one as well. As I mentioned before the break, there's a significant percentage of the population here in Haiti that did not have access to clean water even before the earthquake.
But we did check in with our colleagues over at UNICEF to try to figure out what they're saying specifically about this. And they're saying that they believe that the current system here is functional. Urban sources of water do seem to be working at this time.
The big issue has really been distribution. How do you get water that is clean? How do you get water that is safe distributed to people in places like the tent city behind me or all over the country that really need the water?
There is a water corporation down here. It's called Dnepa (ph) and it's been assessing their plans, and according to the U.N. has already begun some repairs.
Now, they do believe that the current system of distribution is going to need to be in place for about three months. Still from now, but there are plans in place to try to figure out how to best assess the needs of clean water around the country and how to meet them in the months and years to come after that. So, really important topic, obviously.
We want -- we want to shift topics now to something else that we talk a lot about here on the program. And it has to do with childhood obesity. We now know that the White House is starting to take this on and that the first lady is really going to spearhead a campaign called Let's Move. She spoke pretty candidly about this with our own Larry King.
Take a listen to what she had to say.
(BEGIN VIDEO CLIP)
MICHELLE OBAMA, FIRST LADY OF THE UNITED STATES: One thing that I try to emphasize is that this isn't about weight and it's not about looks. It's not -- it's not a physical issue. It's really about the quality of life of our kids, because - you know, teachers are seeing, you know, the challenges that kids with weight issues are having. Not being able to participate in gym, feeling a little more sluggish.
This is a quality of life issue. And it's not about weight and diet, it's about fitness and it's about overall nutrition that we really have to be emphasizing here.
(END VIDEO CLIP) GUPTA: The first lady even spoke about how her children's pediatricians pointed out some warning signs in their own children when they were on the campaign trail about some of the decisions they were making and some of the decisions they needed to make to reverse some of the trends. So, you know, it really comes down to some basic advice: a healthy living, making very smart food choices, making sure to get exercise, and ensuring that all of those things start at a very young age.
So, we'll certainly be keeping on of that with our own Fit Nation program and touring around the country talking about these very same issues.
Here in Haiti, as we've been talking about, one of the big resources for so many patients is a medical ship of mercy. It's called the USS Comfort. And we had a chance to sit down and talk to the chief of surgery on that ship about what he's seeing and what he thinks he might see in the months to come.
Stay with the program.
GUPTA: Welcome back to the program. I'm Dr. Sanjay Gupta, in Haiti.
We're now on the USS Comfort -- a ship that a lot of people have been talking about for some time, especially with respect to what's happening here in Haiti. You can see where we are, Haiti obviously behind me.
And with me is commander, Dr. Tim Donahue, the director of surgery here on the ship. Thanks for being on the show.
CMDR. TIM DONAHUE, CHIEF OF SURGERY, USNS COMFORT: Thank you, welcome.
GUPTA: You guys have been very busy. Give me a little bit of an idea of how long you've been here and how busy you've been.
DONAHUE: Well, we took off from Baltimore on the 16th of January. We arrived here on the evening of the 19th and actually receiving our first patients. We were about 150 miles away from Haiti when they started flying patients in. The first day, we took about 100 patients and did so in subsequent days. So, by our fourth day here, we had over 320 patients on the ship -- all of whom were critical casualties.
GUPTA: Was it -- I mean, did you feel like you were able to keep up? Because we kept hearing that the Comfort was overloaded, you know, it was impossible to get on. What was happening?
DONAHUE: Well, you know, to get on to the ship, you have to fly by helicopter. And we had helicopters arriving about every six minutes during daylight hours and, in fact, we were even taking them at night. So, you can get about three patients at a time onto the ship. So, they were coming downstairs at a pretty quick pace. We had enough folks down in casual receiving.
The problem is: everybody needed to go to the operating room and triage on those folks was the challenge I think downstairs. And we were running operating rooms 24/7, you know, up until about four days ago.
GUPTA: This is obviously a huge ship. It's known for its medical capabilities. Is there anything you guys can't do on the ship? It sounds like just about everything.
DONAHUE: Well, you know, from a surgical standpoint, we can do everything except for a transplant and open heart surgery, in terms of bypass. But we have dialysis capabilities. We've got all of the surgical specialties covered -- everything from neurosurgery to oral surgery, neurology. We've even done eight deliveries on the ship and had nine babies, one set of twins.
GUPTA: When this all happened, you obviously heard about the earthquake, where were you? And how did you find out you were coming here?
DONAHUE: Well, I found out -- I was in clinic. So, I worked at the Navy hospital in Bethesda. And I got an e-mail saying we're activated, we're going to be going. I need you to come out.
That was on a Wednesday, and Friday afternoon, everybody who was leaving was on the ship. We took off first thing that Saturday morning.
GUPTA: So, the earthquake was on Tuesday, and by Saturday, you guys were on your way here?
DONAHUE: Underway, yes, sir.
GUPTA: What goes through your mind when you're here? I mean, is this -- do you have a family? I mean, how does -- how do you coordinate everything?
DONAHUE: I've -- thankfully, my wife is used to this. I've been out on three other missions on the ship. So -- in fact, we'd just gotten back in August from a deployment down here.
Getting underway for Haiti was interesting because not quite a year ago we were here in this almost exact same spot doing a humanitarian mission. And the number of folks that actually came back out with me here were, you know, incredible. So, we had folks who knew doctors on the ground. We know the folks from the Ministry of Health, from the General Hospital there.
So, we already had connections with NGOs. And we're e-mailing back and forth.
GUPTA: You have patients on this ship such as patients with spinal cord injuries, patients with brain injuries, kids. DONAHUE: Yes.
GUPTA: It would be impossible for them to go back to Haiti and live there. The resources aren't there. On the other hand, they're not necessarily in the life-threatening condition. What happens to those patients?
DONAHUE: Yes. I mean, that's a great question. We have -- right now, we've got about 15 people with spinal cord injuries. And we have another six who have incomplete spinal cord injuries. So, we're trying to find the best place to take care of them. They've gone through the initial trauma of the quake. They've gone through surgeries to sort of repair those final fractures that they've had, and now, we're trying to get them to what would be a rehabilitative center.
There's nothing really in Haiti at the moment that can take on these patients. We're hoping -- we're working through our NGO partners to see what they can bring to bear. We're trying to work with some of our colleagues back in the States.
GUPTA: And I understand, you guys are probably going to be here for several months if not longer.
DONAHUE: You know, that's the big question. You know, Haiti, you know, needs, you know, a big hospital -- a hospital that can help take care of these folks. Whether we're that hospital or whether something can be sort of set up ashore, I don't know. We're here as long as they need us, as long as the president tells us we need to be here.
GUPTA: Good to meet you.
GUPTA: Director of surgery, Dr. Tim Donahue, you do amazing work. And hopefully we'll come back and visit you.
GUPTA: We'll be back after the break.
GUPTA: Welcome back to SGMD. We're here in Port-au-Prince, Haiti.
I don't know if you see behind me, but these tent cities have been up almost since the earthquake happened more than a month ago now. And if you talk to health experts on the ground here, they'll say, there are some real concerns about infections. Exactly what types of infections and how bad could it become is a question we had as well.
And we really zeroed in on an infection: tuberculosis, that could have impact certainly here in Haiti and as it has for so long, and could potentially have an impact all over the world. Here's why.
GUPTA: There is something happening here in these blue tents behind me. And I can tell you, what's happening inside there could impact people all over the world.
Think of this as a quarantine tent. People in here have been quarantined since the quake. Many of them have tuberculosis, which is why we're going to wear a mask like this.
You'll notice, the doors are open. If you stay about 10 en feet away from someone with tuberculosis, you'll be OK. And sunlight kills the bacteria as well. But once we go inside, you have to wear a mask like this.
Let's go meet some of the patients.
This is Syndia. She's 20 years old. We've spoken to her already.
Take a look at her. She's obviously had a lot of difficulty since the quake. She lost her home. She also lost her medications, which puts her at high-risk of developing drug-resistant tuberculosis.
How are you feeling?
SYNDIA LAURLENE, QUARANTINED TB PATIENT: I don't feel well.
GUPTA: There's a lot of things doctors pay attention to. Syndia, she definitely has some sweating. It's hot outside, the sweating is a little bit more than that. Also the sweats often occur at night. Her lips are so chapped as well. You can see, just from the dehydration.
It's hard to tell, but she's breathing quite quickly. It seems like she has a little bit difficulty breathing. Tuberculosis is a disease of the lungs.
What brought her in here was this dramatic loss of weight. I mean, just look at her arms. She's lost so much weight. Malnutrition, difficulty eating. That often happens as well.
A lot of these patients, including Syndia, say, you know, after the earthquake, they lost so many things, including her home and also her medication. So, she couldn't take her medications for a period of time.
What's the risk there?
DR. MEGAN COFFEE, UCSF DIV. OF INFECTIOUS DISEASE: Two big risks. One, of course, that we worry about the most is developing multi-drug resistance. She might be taking only one med that's working for TB, and she might then develop resistance to all the other meds. And then, she might be more infectious, because the TB can grow back. And most of these patients here are living in tent cities where they're sleeping nose to nose with their families, with hundreds of thousands other people sleeping nose to nose with them. So, it's a chance of just spreading it and spreading it.
GUPTA: People think of Haiti as over there, someplace else, not here. London, New York, Atlanta, San Francisco -- do people need to be worried about what's happening in this tent?
COFFEE: Over time, this is going to grow and grow. If we allow TB to grow in Haiti, people are going to travel, people are going to be infected, even workers like us here. And that can really spread to Miami, New York City, and eventually, to San Francisco and the southeast.
And we really do not wish to have multi-drug resistance. It's something that even the U.S., we can't treat well. So, it'd be terrible if we had that spread.
GUPTA: Where will you go after you leave here?
UNIDENTIFIED FEMALE: She doesn't know. She doesn't have a house to go to.
GUPTA: What happens to someone like Syndia? I mean, is she medically -- from a medical standpoint -- is she going to be OK?
COFFEE: I hope so, if the right infrastructure is in place. She has totally treatable diseases in the U.S. And right now, I know I can treat all of their diseases.
GUPTA: I'll tell you, it's tough to watch, to hear what Syndia's life is like and what it might be like. And it's a theme that comes up over and over again that people are getting good care now here in Haiti. But, you know, people cannot forget that that need is going to be ongoing for a long time. People like Syndia, there's so many like her, she doesn't have a home to go to. So, she really is going to need her medications and she's going to need a lot of follow-up.
You know, Haiti has one of the largest concentrations of tuberculosis in the Americas even before the earthquake. And tuberculosis is a disease that kills 5,000 people a day around the world. So, very important to keep a focus on this.
People who lose their medications cannot take their medications, can develop drug-resistant tuberculosis. And that drug-resistant tuberculosis can spread all over the world. So, again, this is something we really, really need to pay attention to.
We are staying here in Haiti. You know, one of the things that really strikes me is what happens to patients after acute life-saving operations. I had a chance to perform an operation aboard the USS Carl Vinson, a 12-year-old girl. What I was most interested in was -- though she's done well from her operation, what is her life going to be like now. I'll have some final thoughts.
Stay with the program.
GUPTA (voice-over): So many times over this past month I have had my faith completely trashed, as I saw unjustified loss of life and suffering. I saw amputations being performed without adequate anesthesia, as nurses and doctors held down a patient while performing brutal operations. I saw the tears running down those same nurses and doctors' cheeks while their faces were still with desperation, determination, and little anger at the awful position they were all in together.
But I also had moments where my faith was restored. Small improvements in water distribution, a slow trickle of supplies turning into a river of goodwill and a rush of health care providers and private citizens with sleeves rolled up and grit on their skin. Like my wife, they all wanted to help, in any way possible.
You know, if you look throughout the history of our own lives, there are a few occasions where we see something that galvanizes the entire world -- in a world where there's too much bickering about politics and too much fascination with pop culture, every now and then, people simply come together.
I returned to Haiti because I wanted to show the slow but inevitable medical recovery happening here. People shouldn't forget what has happened, what's going to be necessary for a long time to come.
I returned to Haiti because I wanted to remind people of the relentless and extraordinary resolve of the beautiful Haitian people.
I came back because the story I'm telling is of the scales of faith being tipped here just a little bit.
GUPTA: I can tell you, some of the things we've seen down here in Haiti, they have been faith challenging in so many ways. But things are getting better. It is safe to say that a lot of work still needs to be done, and I think that's something you've heard over and over again in today's show.
One of the girls -- one of the people we got to know down here in Haiti, is a young girl. Her name is Kimberly. She's 12 years old. I got to know her personally because the United States military asked me to fly to their carrier and perform a brain operation on her because she had a terrible brain injury. I was very worried about her, but delighted to report that she is doing well. And you're looking at some images of her now. We have reunited her with her father, which was very heartwarming -- a father's love for his daughter was really obvious.
But one of the things I wanted to leave you with was that this is -- what you're looking at is going to be her life now. She's going to recover in this setting underneath this tarp -- tough for anybody to recover here, but really emblematic of what still needs to be done here in Haiti, for Kimberly and so many others that are like her.
We won't forget. We'll keep coming back down here to Haiti and bring you the stories of what's happening here.
I'm Dr. Sanjay Gupta in Port-au-Prince. Thank you so much for watching the program.
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