Partners in Health, a nonprofit that has been working in Haiti for years, sent out an email to the medical community shortly after the quake asking for orthopedic and trauma surgeons. Most other organizations followed similar guidelines, including a team from Stanford composed entirely of ER doctors and nurses. This is because the type of medicine currently being practiced in Haiti is unlike any medicine most of us have ever seen; disaster medicine.

Grace Children’s hospital, a small pediatric hospital run by ICC international, has transformed their front lawn by hanging sheets between the trees to create an outdoor clinic. Physicians, mostly international volunteers, long ago ran out of gloves and antiseptic and are using their bare hands and street vodka to clean materials. Rationing limited pain medications and coming up with creative ways to set broken bones have taken a toll on the physician’s creativity. I saw a Black & Decker drill, normally used to hang paintings now being used to connect two bone pieces back together. I was impressed when I read a report about an ER physician inserting a central line (catheter into the large vein in the neck) into a patient laying on a slab of concrete under the baking sun. Physicians are carrying patients on their shoulders hundreds of feet to open areas being used as operating rooms.

Disaster medicine is being practiced without everything we consider to define the profession; no gloves, white coats, x-ray, or even medications. Everything that is, except for the doctor.

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