On January 12, 2010, the nation of Haiti was struck by a devastating 7.0 magnitude earthquake leaving more than 230,000 people dead and more than one million people homeless. The overwhelming need for medical care spurred thousands of volunteers into action. Kevin Mollenhauer, BS, RN, CNOR, ONC, Orthopedic Service Line Nurse at Sycamore Joint and Spine Program in Miamisburg, Ohio, was one of the volunteers inspired to help.
Shortly following the earthquake, Mollenhauer traveled to Haiti to provide medical and surgical care to victims. After assisting in Haiti for approximately one month, he returned to the United States; however, his trip home was short lived as the Haitian people were yet again touched by misfortune. Only a few months following the earthquake, a cholera epidemic began sweeping through the country.
Mollenhauer returned to Haiti to be a part of the medical team sent to provide aid at the Saint Therese Hospital in the city of Hinche. A team of four nurses, including Mollenhauer, and two translators took a three-hour journey to Hinche along narrow and broken roads through the rugged mountainside of Haiti.
Once they arrived, they were given a brief orientation at the cholera treatment center (CTC), a fenced off area on the hospital grounds intended to isolate the cholera patients. The facilities consisted of a triage and short-term oral rehydration tent staffed by Cuban and Mexican physicians and nurses, as well as three additional tents for men, women and children. Each facility held up to 24 patients at a time.
“The tents were made of old military canvas, and were dark and hot, even during the day when we would roll the sides up for ventilation. Cots and cholera beds were crowded inside with very little space between them to provide care,” explained Mollenhauer.
Additionally, an old church was reserved for critical patients requiring IV rehydration. Mollenhauer and his team of nurses, along with two nurses from Canada, a physician from the U.S. and limited Haitian nursing staff, were responsible for patients in critical care.
“We all became very adept at positioning ourselves to start or manage IVs. Even finding ways to hang the IV bottles became a skill as we had few IV poles. We found creative ways to secure the IVs to the tent framework using pieces of rope often appropriated from parts of the tent support system,” said Mollenhauer.
The CTC at night provided additional challenges – less staff, poor lighting (both inside and outside the tents and church), broken foundations, exposed tree roots, tent ropes and stakes, and constant noise, including cries from patients, sounds of dogs, goats, and chickens; the sound of passing cars, trucks, motorcycles, U.N. vehicles; and occasional shouts from the gate for help from the families of arriving patients.
The group either never had, or ran low, on many basic items. They were left to work without any IV extension tubing, few IV poles, very few cots and cholera beds, and when gowns to cover patients ran low, they were replaced with bits and pieces of clothing from the volunteers’ own suitcases.
“We learned to work with extra large gloves and a limited choice of IV needle sizes. When certain supplies ran low we made difficult decisions on how they would be allocated,” said Mollenhauer. “When our U.S. physician left and we were without a doctor, we remembered his words – ‘Do what you can, you are all they have’.”
According to Mollenhauer, one team member shared a way to cope with the darkness by advising each person to “find a face to remember” of a patient for whom they know they made a difference. For Mollenhauer it was a young child who, when they first carried him from triage to the children’s tent, was unresponsive, severely dehydrated and had only a femoral pulse.
Three members of the team, including Mollenhauer, worked for more than three hours to find IV access on the child, finally succeeding in placing two IO needles in his legs to provide the vital fluids his body so desperately needed. “Three hours later he was sitting upright, and as I left that morning to return home, he gave me a fist bump and the most beautiful smile,” said Mollenhauer.
Over the course of five days, filled with tears, laughter, life and death, they became a close team, forged by experiences and enduring conditions they could not have imagined upon their arrival in Haiti. They became friends, colleagues, teachers, mentors and “shoulders to lean on.” They found strength in each other during even the darkest moments.
“Even now as time and miles separate us, and our memories begin to blur and our stories begin to fade, we will remember this – together we saved lives, we made a difference,” said Mollenhauer.