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Jennifer Lewis cares for a newborn in Port-au-Prince.
As members of the D-MAT team, Terri Traskos, RN, Yaeko Karantonis, RN, and Jennifer Lewis, RN, are skilled in the art of “MacGyver-ing” and go “from zero to a hundred when it’s time.”
In Haiti, that meant riding in the back of dump trucks sitting atop their 35,000 pounds of equipment, sacrificing personal comfort and carrying supplies on their backs—all as a means of getting to disaster situations and providing care for victims as swiftly as possible.
Traskos, Karantonis and Lewis presented at Nursing Grand Rounds last week, sharing their experiences of providing nursing care in austere conditions as part of D-MAT MA-1, a medical disaster assistance team run by the federal government. Despite difficult conditions, the team cared for 506 patients and delivered nine babies in less than two weeks during its most recent mission in Port-au-Prince.
On Jan. 13 at noon, members received a text message that their D-MAT team was on alert for potential deployment to Haiti. Just 12 hours later, they boarded a plane that ultimately took them to Port-au-Prince.
“When we get that initial text, we have to get packed, notify our managers and start to prepare for the type of environment that we are going to enter,” said Traskos, a nurse in the MICU.
That’s where their initial and annual training come in handy. Team members—who include administrators, communications staff, physicians, physician assistants, nurses, nurse practitioners EMTs, respiratory therapists, pharmacists, security and others—learn how to adapt to any situation and receive training in helpful skills such as truck driving.
They pack two bags: a day-pack they carry at all times with enough personal supplies to last them 24 hours and a pack containing 14 days worth of gear. “We can’t roll a suitcase through a field; we carry everything we bring, so we pack light,” said Karantonis, a nurse in Emergency Medicine.
Once they landed in Haiti, the 35-member D-MAT team loaded their gear into the back of dump trucks supplied by the UN, with security from the 82nd Airborne Unit, and traveled to Port-au-Prince to set up a hospital and their own living quarters, which included tents, ready to eat meals, bathroom stalls they set up themselves and bottled water. “Hooah!” bars are another source of quick nutrition and energy.
Yaeko Karantonis, Terri Traskos and Jennifer Lewis present on their experience at Nursing Grand Rounds.
Team members look out for each other, noticing when someone seems dehydrated or needs to rest. “The number one thing is that we have to be healthy and safe so we can help people in need,” Karantonis said. “You have to be able to work 12- to 16-hour shifts 14 days in a row. You can do it, surprisingly.”
The team adapts to providing care without the resources available at home, and amid aftershock tremors and poor air quality. They managed to care for more than 500 patients with limited equipment; they had just one wheelchair, a suction machine that repeatedly broke and a small lab machine that kept overheating. “We had to keep putting the lab machine in the refrigerator,” Lewis said. “We’d need to run people’s labs three times sometimes before we could get results.”
That’s when what Karantonis calls “MacGyver-ing” really comes in handy. “You have to rely on your own skill and be inventive and flexible,” Lewis said. “You jump in and do what you can to make things work.”
They also counted on local Haitian residents, whom they paid to serve as interpreters and transport personnel.
In addition to the physical hardships, the team members also faced emotional ones. For Lewis, her toughest moment was turning away a patient who had been diagnosed with TB and came to the hospital seeking care. “We don’t have the means to treat people for diseases and things other than what we’re there for,” Lewis said. “At the Brigham, we aren’t used to turning anyone away.”
“Despite all the hardships, you can do it because you have your whole team behind you supporting you,” Lewis added. “They make it a great experience.”