Hospital

I've been trying to sort out how best to give you a tour of the hopsital facilities. What I really need is an aerial view as an overview. I haven't tried, but perhaps Google maps has a view that will at least give you an idea of what the complex used to be. The hospital isn't designed like an American hospital. Rather than having one or two large buildings with many large departments within the buildings, this is a sprawling walled complex with different 1-3 story buildings housing different departments and services. I have no idea what it felt like before the quake, but now it feels like a field hospital, with most of daily life occurring outdoors. As you can see from the map, many of the structures are inhabitable (red buildings are destroyed, grey are OK, and beige are tents). Among the buildings destroyed were the lab, the pediatrics buildings, OB/GYN buildings, outpatient surgery center, church, and the nursing school building. About 70 nurses and students were killed when that building collapsed. Most medical care happens in tents set up in the middle of the streeets of the compound.

For this post I'll focus on the ED, as it's the place that I currently have the most pictures of. The ED (where I spend most of my time) is made up of 2 main tents and one "observation" tent. We're essentially a self-sufficient unit, with our own pharmacy, dedicated interpreters, and security. For the most part it functions pretty much like any ED, with a triage area, a resuscitation area, and regular beds. Here is our triage area and waiting area. About 60 to 70 percent of our patients never make it past here. The nurses out here sew lacerations, splint broken bones and write prescriptions for medications for most of our patients. (At one point I had a suture clinic going teaching 3 nurses at once how to stitch on three different patients).

Once the patients make it back from triage, they are put into either Tent 1 or Tent 2. There's no difference in acuity between these tents, but we try to put kids and obstetrics into one tent, and the rest into the other tent. Here is Tent 1. I'm standing directly in the spot where we reduced the dislocated hip the other day. On the right is our supply area, and on the left are obviously the patient beds. Often family members will sleep on the ground below the beds.

Tent 2 has a similar set up, as you can see below, but also has our "pharmacy".

I think the pictures adequately show what the physical situation is like. What the photos cannot covey, however, is the smell. As we are in tents, there are no bathrooms. There is also an overall lack of bed pans and emesis basins. Combine that with daily temperatures of 105 degrees inside the tents, and you get the idea.