“When we saw the images from the quake, we knew that we had to help the Haitians,” said Humberto Guzman , MD, a pediatric orthopaedic surgeon. “And when you see so much need, you want to do more.”

Magdiel Mayol, MD, an orthopaedic surgeon specializing in sports medicine, added, “Once we realized how many people could be helped by our efforts, we knew that we would return.”

Drs. Guzman and Mayol were among 160 volunteers from Puerto Rico who arrived in the Dominican Republic border town of Jimani within 4 days after the quake to treat the hundreds of injured Haitians who had traveled from Port au Prince seeking medical help. The trip was the result of a government-initiated effort by the Senate of Puerto Rico that involved physicians and industry.

The volunteers, who included seven orthopaedic surgeons, brought along medical equipment, orthopaedic supplies, medications and IVs, and two ambulances. They quickly set up a field hospital in a newly built, unoccupied orphanage run by U.S. missionaries.

“The orphanage had what we needed—walls, water, and electricity. We brought the rest with us,” said Dr. Guzman. “We immediately started performing damage-control orthopaedics—our priorities were life-threatening fractures and infections.”

During their 7 days in Jimani, word spread that the orthopaedic surgeons were treating patients. By the week’s end, the number of patients had swelled to nearly 800. The surgeons performed approximately 200 surgical procedures, most of them amputations.

“When we told patients that we had to amputate a leg, they would say, ‘Let me die,’” said Dr. Mayol. “They said it would be impossible to find work to support their families with just one leg. We knew we couldn’t just leave them like that—we promised to come back with prostheses.”

New limbs and more
When they returned to Puerto Rico, Drs. Guzman and Mayol were determined to make good on their promise. With the help of others, including the Puerto Rican Orthopaedic Society and its executive director Angel Bosch, they established “Haiti Stands on its Feet,” a nonprofit foundation that provides prostheses and rehabilitation to Haitian amputees. Since October 2010, the foundation’s team of three physicians (Drs. Guzman, Mayol, and Manuel Castillo, MD, a surgical oncologist), three prosthetists, and a physical therapist has made eight trips to Haiti. The doctors pay their own travel and living expenses; the foundation covers the costs of making the prostheses.

“At first it was difficult to locate the amputees because most were living in refugee camps,” said Dr. Mayol. “But once word began to spread that we had returned, the patients found us. We measured them and then returned to Puerto Rico to make their prostheses.”

“We travel to Haiti every 6 weeks,” said Dr. Guzman. “On each trip we fit patients with the prostheses that were made for them, adjust the children’s prostheses to compensate for their growth, and measure new patients. We’ve successfully placed approximately 60 prostheses, both above and below the knee.”

During one of their trips, Drs. Guzman and Mayol met with Terry J. Dietrich, MD, who had been volunteering full time at Hopital Adventiste d’Haiti (HAH) outside of Port au Prince since November 2010. According to Dr. Dietrich, 80 percent of HAH’s patients have congenital limb deformities, and, before the quake, they had nowhere to go for care. The hospital is now a haven for patients seeking orthopaedic treatment.

“When we returned on our next trip with five orthopaedic surgeons, Dr. Dietrich already had a long list of surgical patients waiting for us,” said Dr. Mayol. “We performed the country’s first shoulder arthroscopy and treated many patients with congenital foot deformities. One of the patients was a 2-year- old girl who was born without a tibia—her foot was attached to her knee. We were able to remove the foot, and 2 days later, measured her for a prosthesis.”

“The work being done at HAH is a gift from the heart from everyone involved,” added Dr. Guzman. “Anyone who volunteers there will have one of the most incredible experiences of his or her life.”

Providing hope
While it works to rebuild and strengthen its healthcare infrastructure, Haiti is still very reliant on outside medical support. Because most Haitians do not have access to orthopaedic or other specialty care, the need for orthopaedic surgeons is huge, according to Drs. Mayol and Guzman.

“We’ve been able to give patients a fighting chance and hope for the future, but there is still a lot of work to be done in Haiti,” said Dr. Mayol. “But you have to go with the correct mentality—it is not the best environment for doing surgery. Physicians have to be able to adjust to working with a lot less than what they are used to at home.”

“It’s very rewarding on a personal level to be able to help people who have nothing. In return, you gain a lot of perspective on the problems that other people deal with, and that is something that we bring back with us to Puerto Rico,” said Dr. Guzman.

“Honestly, once you go to Haiti and see how your efforts can help so many people, you can’t help but go back,” said Dr. Mayol. “For us, it’s been a great experience; but we’re not doing it for the recognition—we’re doing it because it needs to be done.”

Other Puerto Rican orthopaedic surgeons who have been involved in the relief efforts in Haiti include Juan Bibilioni, MD; Jose Perez, MD; Artemio Torres, MD; Pablo Marrero, MD; Ricardo Canals, MD; Pedro Tort, MD; Jose Urdaz, MD; and Gabriel Garcia, MD.

For more information about volunteer opportunities in Haiti, email the AAOS international department at international@aaos.org

For more information on “Haiti Stands on its Feet,” visit www.haitiseponedepie.net

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org