Seattle doctor fears for fate of Haitian amputees

A Seattle surgeon returning from Haiti is concerned about the fate of amputees and other patients in the chaotic aftermath of the Jan. 12 earthquake, fearing that postoperative infections could claim more lives and a lack of prosthetics could threaten the future of many others.

"There's a whole new generation of amputees, and how are they going to survive?" said Dr. Jim Krieg.

Krieg was part of a first wave of Northwest medical teams that responded to the earthquake and are now back home.

A second wave has headed off to the Caribbean island nation, including a 15-person team that set out Friday to work in northern Haiti, an area less damaged by the earthquake but swelled by refugees from the epicenter in and around Port-au-Prince.

Krieg traveled to Haiti as part of a 50-person medical team organized by the U.S. government to respond to disasters. Among them were doctors, nurses and paramedics who set up operations at an AIDS clinic transformed into a field hospital.

In his 10 days in Haiti, Krieg treated dozens of patients who required amputations and other surgeries. He grappled with a chronic lack of supplies and sometimes was daunted by the sheer scale of the disaster.

"It felt like going into battle unarmed," said Krieg, an orthopedic surgeon based at Harborview Medical Center.

Krieg arrived in Haiti three days after the quake, and for two frustrating days his team waited for supplies to arrive before setting up a field hospital in the courtyard of the Gheskio Center, a pioneering AIDS clinic that hosted a throng of survivors.

The Gheskio Center's director, Dr. Jean Pape, is internationally renown for his work in establishing a primary-care network for AIDS victims. And Krieg said that, in retrospect, he wished his team had had more time to tap into Pape's knowledge to help guide the emergency response.

"When Americans go in to do relief work, we tend not to fully appreciate the resources that are already there and how they can help us," Krieg said.

As the days wore on, Krieg said, infection became a much bigger problem, and amputations became more of a necessity for fractures that — if doctors had seen them earlier — could have been treated.

Dr. Lew Zirkle, a Richland surgeon, also has returned from Haiti, where he utilized a low-tech procedure to treat compound fractures of the femur that does not depend on a steady supply of electricity for X-rays.

Zirkle treated nearly 50 people and left enough equipment to treat about 350 more with the system developed by SIGN, a nonprofit medical-technology company that he founded.

Zirkle and SIGN's Chief Executive Officer Jeanne Dillner worked marathon hours and at three different hospitals in Port-au-Prince. They typically got four to six hours of sleep, but one night had only two, on a tile floor.

"In a situation like that you can't complain because the right personnel aren't there, and you do what is needed," Dillner said.

On Jan. 26, Zirkle and Dillner flew out to a Navy hospital ship to train surgeons there in the SIGN techniques for setting femur fractures.

The Navy ship had an X-ray machine, but it was in constant use because of the tremendous volume of patients. So, physicians there wanted to learn Zirkle's system, which uses specialized equipment that enables doctors to place screws and nails in the bones with the aid of X-ray images.

Zirkle demonstrated the technology and left behind equipment so Navy doctors could continue to set fractures without X-rays.

Zirkle hopes that in the months ahead, there could be greater coordination in setting up specialized surgical centers to treat — and offer follow-up care — for the different types of fractures suffered by earthquake survivors.

The second wave of Northwest medical volunteers now in Haiti includes Dr. Harry Low, a Seattle primary-care physician who joined a 15-person team organized by Northwest Physicians Network. Low left Friday and expects to spend most of his time — seven to 10 days — in a clinic about 100 miles north of Port-au-Prince.

Hal Bernton: 206-464-2581 or hbernton@seattletimes.com