In those first few moments, just before 5 p.m. on Jan. 12, when the devastating earthquake struck about 10 miles outside of Port-au-Prince, Haiti, Dr. Patrice Severe found himself working off his most basic instincts.
"My first thought was to ensure my own safety and the safety of my co-workers," said Dr. Severe, director of clinical services at GHESKIO. "I found out my wife and children were safe, but that our house had been damaged."
Since that time, Dr. Severe, the rest of the staff at GHESKIO and the dozens of volunteer physicians, nurses, medical students, residents and therapists who traveled to Haiti to assist amidst the wreckage have worked tirelessly to help rebuild an already embattled nation.
More recently, Haiti has dealt with outbreaks of cholera among local residents — many of whom remain in refugee camps — and the damaging effects of Hurricane Tomas.
On Wednesday, Nov. 3, Dr. Severe took part in a panel discussion that explored those first days, weeks and months after the earthquake. "In the Wake of the Haiti Earthquake: Perspectives From WCMC and NYP Responders on the Immediate and Long-Term Recovery Efforts" was moderated by Dr. Warren Johnson, the B.H. Kean Professor of Tropical Medicine at Weill Cornell Medical College and director of the Center for Global Health at Weill Cornell.
"The dimensions of loss and destruction are almost incomprehensible in the scope of our own experiences," Dr. Johnson said.
Joining Dr. Severe were Dr. Satchit Balsari, an emergency physician at NewYork-Presbyterian Hospital/Weill Cornell and a Harvard Humanitarian Initiative Fellow; Debra Tupe, associate professor of occupational therapy at Columbia University; and Dr. Daniel Fitzgerald, co-director of the Center for Global Health and associate professor of medicine at Weill Cornell.
Dr. Severe was at the GHESKIO clinic when the earthquake struck, and as soon as he knew he, his co-workers and his family were safe, he and the rest of the staff began implementing a field hospital for the wounded.
While treating the thousands of injured, GHESKIO staffers still had a responsibility to the HIV/AIDS patients they regularly treat. Making sure those patients still had access to the medications meant setting out on foot, among the rubble and destruction, to personally locate each patient.
Dr. Balsari was one of the more than 700 doctors, nurses, physical therapists and psychologists deployed by the Harvard Humanitarian Initiative in the months following the earthquake.
"All norms, all policies that keep a normal hospital running, do not hold true in a field hospital," Dr. Balsari said. "You get in from your flight, report immediately to the hospital, and are given an assignment along the lines of, 'You are in charge of row E. You have 95 patients. Start now.'"
Many of the most pressing challenges, Dr. Balsari said, aren't even clinical. As much as doctors are treating patients, they are dealing with ancillary concerns, like water, sanitation, nutrition and security, specifically creating and maintaining records so children weren't discharged to strangers or humanitarian groups not authorized to take them.
"The challenges are humungous and these are issues that medical students, residents and attendings are completely unprepared for," Dr. Balsari said.
Like much of the rest of the world, Debra Tupe saw what was happening in Haiti on her television and, like hundreds of thousands of others, wanted to help. Tupe knew that with the types of injuries usually seen with such disasters, the relief effort was going to have to include physical therapy and rehabilitation medicine.
She traveled to Haiti in February to make an assessment of needs and resources. The next month she returned with other volunteers to begin work in a makeshift rehab clinic.
"We saw a lot of compound fractures, amputations and compartment syndrome," Tupe said. "I don't think people often think of the role of rehab in disaster situations, but to me, you have to get there very early."
When Tupe and her team weren't treating patients, they were training volunteer physical therapy technicians, Haitians that could stay on after the emergency teams left to continue treatment and ensure that the patients wouldn't stall in their recovery.
It has been almost one year since the earthquake in Haiti, and while the efforts of GHESKIO and thousands of volunteers have initiated the rebuilding process, the enormity and difficulty of the challenges haven't changed, just the look of them.
"We are now working on vaccines, job creation, schooling and permanent housing," said Dr. Fitzgerald, who lived and conducted research in Haiti for seven years. "It has transitioned from a dash to provide emergency services to the marathon mission of rebuilding and rebuilding better."