Tweets from Haiti

I had this series of tweets forwarded to my attention. I found the reflections and the reporting impressive--especially in consideration of how to communicate the vast and overwhelming tragedies via the Twitter media which requires such an economy of words. Also, some of the time stamps are pretty impressive:

Jan. 28

9:11 a.m. -  We are packing for Haiti

4:35 p.m. -  Loading the jet for Haiti

4:57 p.m. - We just loaded the trucks and are off to the airport

10:32 p.m. - What a great trip. Landed in wa dc. The crew and passengers were great Its cold here. Waiting 2hrs, refuel.

Jan. 29

4:27 a.m. - Just taking off from Miami for haiti. 9am landing slot. May need to circle pap 30-90min or go DR.

11:05 a.m. -  landed in Haiti no problem. Mayhem at airport. 200-1000 at hospital seeking care. Military will bring 300postop here

11:14 a.m. - we landed without probs. Hot & disorgaized here. About 1000 people waiting outside hospital. Military wants 300 postop in

6:17 p.m. - Nighttime now. Sleeping outside no rooms tents full hot anyway. Good thing we brought food.

Jan. 30

4:08 a.m. - Many fractures lots to do. 8 am mtg rounds then surgery all day tomorrow

8:39 p.m. - Relief workers encampment international experience. Italians made pizza pasta we had dehydrated meals but all ok.

8:47 p.m. - Sat nite. Operated till 22:30 8 cases. Kids c amps. Pregnant 18 yo girl c floating elbow open fx. children c femur & tibia frxs

8:52 p.m. - Derek did rounds on 25 pts then set up Ortho impant room. We set up equip we brought. Organizing daily schedule. OR. Clinic. ER

8:57 p.m. - Mary working to hard. Constant OR cases. No rest. make sure she has breaks need change her routine. We will kill her otherwise

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Jan. 31

4:23 a.m. - Bon jour. 75 @ 07:00. I'm on my second cup of tea. Sleeping outside. Can't stand the tents. Skeeters bad, bug nets good

4:33 a.m. - Plenty of difficult cases. Hospital ship full, they are sending overflow to us. All ages.

4:38 a.m. - Docs s boarders, French, Italian mobile hospitals sending open fxs here. Many ped femur frx. Using hip spica casts & exfix

5:07 a.m. -  Helicoptors are up again picking people up and distributing supplies

5:14 a.m. - Smoke in the air is better today. They have been pouring diesel fuel into the rubble to burn the decaying bodies making thick smoke

11:10 a.m. - OR functioning well. No Ortho implants avail except what we brought.

1:35 p.m. - Yahoo. Baptist hospital says they can provide exfixes and screw sets. They do not have a c-arm. I'll go there tomorrow to pickup.

7:45 p.m. - 8 cases today in 1OR. Turnover time 10-15 min.Doctors mopping floor. Teamwork prevails in our efforts for our fellowmen,women,kids

7:49 p.m. - Showers and cold beer tonite. God Bless, there are miracles.

Feb. 1

4:33 a.m. - Busy night. The wind shifted and the stench of death woke me. Sirens and yelling and 2 helicptrs. Thought we were under attack.

4:38 a.m. - Army flew in and set uptent wards in front drive of hosp. More injured arrive today. Just found out 6 femur frxs coming today

9:30 a.m. - Heading to Baptist Mission hosp.pick up more plates rods etc. Also will pu 2 adults c femur/hip frxs. That makes 8 femur frx today

10:21 a.m. - Just shook hands c Gen Keen. US Army. His impression of the situation is same. They are working hard logistcs of distibution hard

7:25 p.m. - Brought 22yo back from Baptist Hosp c severe femur frx in back of pu truck c impants. His whole family died. He Drawing pictures

8:18 p.m. - We were7 Ortho surgeons yesterday 5 today and4 tomorrow. Wed 2 more will come. All for one week except VM team. They are great

8:24 p.m. - We work as team. VM team working on routine Ortho model. establishing structure for future surgeons that rotate in.

8:32 p.m. - We are sharing rounds(4hr).clinic(6hr).OR(12-14hr)assist each other in OR. 20 cases on the schedule. ankle, forearm frxs, 9 femur frx

Feb. 2

3:35 a.m. - Quiet night.Good morning haiti.people still being injured working in unstable rubble trying to rebuild. forearm frx lastpm

4:50 a.m. - Hospital ship backed up 150 cases.we are backed up 20 now. The day is just beginning

6:56 a.m. - Headed back to Baptist Mission Hosp to pick up 76yo c femur frx. Other sugeons operating.

7:02 a.m. - Army will resupply our implant and equip needs. Thank you General Keen.

7:13 a.m. - FatherRick working to set up St Camile Hosp nearby as rehab facility for amputees. Need CADCAM prosthetic fitting machine program

7:45 p.m. - Busy day today. The USA Ortho team did 17 operations today in one OR. 6 were femur frxs, as many as the comfort ship did today

7:52 p.m. - Medishare sent 7 more pts c femur frxs. 2 had hip socket frx dislocations. We will fix them in AM.maybe 1.5 d surgery backed up.

7:56 p.m. - Medishare is backed up with frxs. Sent 7 femur frx wants to send 15 more. I asked them to wait 1.5 days till we clear backlog.

8:05 p.m. - Two more Orthosurgeons coming from US tomorrow.We need the help.Hospital ship sending pts mostly postops.Ortho rounds 50 in house

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Feb. 3

4:22 a.m. - Gd morn Haiti 2 femurs 1 severe pelvic crush came last noc. Need to send pelvis & L2 burst frx to ship helicop land @0800

4:25 a.m. - Surgeon from ship coming to evaluate our program & capacity on first copter 2USAsurgeons arrive today c sign nails. War Zone Haiti

4:53 a.m. - Lew Zirkle from Richland Wa & partners devel Sign nail for long bone frxs in underdeveloped contries. I get my first lesson today

5:07 a.m. - 71 patients to round on today for USA Ortho. Uncovering postoperative infections and loss of fixation or metabolic probs important

Feb. 4

2:07 p.m. - USA Ortho operated on 12 pts today. All went well. We recieved two severe pelvic dissociations that need to go to USS Comfort.

5:25 p.m. - We are fine. The tweets have slowed with the volume of work and the incidental mtgs and offers of help. Everyone wants to do something

5:34 p.m. - I lost a day thought this was Wed. We lost a lady to tetanus today. I have pts to discharge but they have nowhere to go and their family died

5:39 p.m.- A 3yo c Abov knee amp blames her older sister for her amp. Her sister threw herself on her to protect her during equake and died

5:43 p.m. - We need crutches and REI dome like tents to give to people on discharge so they have somewhere to stay

5:46 p.m. - Father Rick spent the day burying the dead like he does every Thurs. There were many in all stages of decomp. they had last rites

Feb. 5

7:47 a.m. - Docs s borders is sending us 12 femur frx tomorrow.They will take care of them postoperative. Still revising amputations daily.

7:59 a.m. - The coastgaurd brought 50 sets of crutches and dressing supplies today. Keeping us going. 7cases on the sched today. 10 yesterday.

8:06 a.m. - Took a rock shard out of a childs head today. Been there 3 weeks. Comfort ship may be leaving and Italian hosp ship coming

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Feb. 6

3:42 a.m. - Slower surgical day. Italians had the OR till 2pm. Tom&I went to st francis hosp today. Close to palace most buildings leveled.

4:29 a.m. - Dr in charge @ st francis said 120 staff &pts perished in hospital. They could not get them out of rubble. could hear them 10 days

4:59 a.m. - A WHO supply truck just outside the hosp just got mobbed and pallets of food stollen. The people are trying to get what they need#vminhaiti

5:07 a.m. - St camille hosp sending us 5 pts. Humerus, femur tibia frxs. Surgeons are coming and going. Tom Mary Derek& I are stability.

Feb. 7

4:58 a.m. - Slow day inOR. 3cases.Toured the city worstareas.Devastationof biblical proportions.People scavenging anything. Homeless families

5:03 a.m. - Mass burials continued this week. 20 babies to a coffin. 4 adults to a coffin. Sadness. Rebuilding is continuing.

5:12 a.m. - Fa Rick held mass yesterday on the rubble of the old hospital where Molly Hightower and others died

12:56 p.m. - Worked in clinic till noon. Rounds as well. Cancelled all surgery today,nothing urgent.Haitians deserve Sunday off. Church,family

Feb. 8

3:24 p.m. - Things are more sane today. Pts are being admitted at a steady pace rather than 3-6 at a time. Maybe I am just getting used to it

5:21 p.m. - earthquake has caused destruction and suffering. The world maythen recognize the need for rebuilding, basic sanitation sewer garbage

5:25 p.m. - These people deserve help no drunkeness. No obvious drug problem. Hard working resilient. Haven't met a Haitian that I don't like.

5:28 p.m. - Lots of poitics happening in the Catholic heirarchy. We are staying out of it. Focusing on excellence in pt care

5:32 p.m. - Frxs coming in now show significant early healing. Many in bad position. We take them to the OR and rebrake the frx and straighten out

6:16 p.m. - 9:15pm and the helicopters are up. That is unusual and some cause for concern

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Feb. 9

4:36 a.m. - I saw children climbing into a building that was ready to collapse...scavenging. There will be ongoing injuries.

4:55 a.m. - Haiti needs public sanitation and garbage services. The streets are covered with plastic bottles and garbage...stench, foul water

9:31 a.m. - spent the morning straightening out frx sent to us some of ours. Adjusting the exfixs some children are terrified, screamers

9:35 a.m. - catholic archdioceseis organising 7outposts for medicalaid food distribution healtheducation. Helicoptorpads forItalian military.

2:27 p.m. - Ran out of cast padding today,frustrating. Containers with donated material offloading tonite hoping for plaster, fiberglass etc

2:52 p.m. - Sun is going down. Red sunset. Enjoying a cold beer. Pleasant breeze. Hoping for Haitian recovery. Think positively,for healing

5:10 p.m. - Tom is going to assiston a surgery for a kid with an incarcerated hernia tonite. It is 8pm. Ortho is branching out. New territory

Feb. 10 (exact times not yet available for the following posts)

2:01 p.m. - New scenario. Italians report that there was a mass exodus from PaP including injured. Now rural clinics overloaded c injuries

2:06 p.m. - Rural clinics maytransfer pts back to city(us) for surgery and frx care. Our present lull maybe short lived.150K dead, 20Kinjured

2:11 p.m. - 80% injured Ortho problems. Multiple extremity injuries.Many crush injuries, frxs&nerve injuries. Many skin grafts, amp revisions

2:17 p.m. - Many helicopters coming & going bringing new pts.USAComfort decided to stay.Taking a few days to reorganize.glad they are staying

2:58 p.m. - Italians bringing 6 more helicopters. More pt transport. Italians are committed disaster relief responders. Great people.

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Feb. 11 (updated at 8:22 a.m.)

3:44 a.m. - It rained hard last nite. Mary and I had to move inside.We are fortunate.The mothers with babies and no tents just get wet

3:46 a.m. - We have one volunteer with Malaria.She has been here since the quake.She refuses to leave.

3:48 a.m. - The hurricaines come in 4 months.

1:32 p.m. - Tomorrow is 4 weeks since the quake. Many pts are coming in with frxs partially healed in a poor position.More difficult surgery.

3:04 p.m. - The Haitian Govt has declared the next three days for mourning.We will stop operating until Monday unless it is an emergency

3:08 p.m. - We were contacted by another community medical clinic today that will send us another 3-4 pts c femur/hip frxs Monday.

3:10 p.m. - We have been doing 6-8 surgeries a day.

7:04 p.m. - We had dinner with the Italian rescue workers tonite. Great pasta. Mary was stunning c red hair.We now have friends in Florence.

7:09 p.m. - Peter Ackerman MD from VM anesthesia will arrive in DR tonite and travel overland; be here in AM. We need anesthesia experts.

Feb. 12

4:18 a.m. - Peter Ackerman arrived safely this morning. New anesthesia blood.

9:21 a.m. - Today is a day of mourning and reflection. Mass was conducted at the mass burial site. All the churches are full today.

9:25 a.m. - Just had a starving kid come in to the kitchen here. Gave him some of our food. He told me his whole family died. Looked 13 yo.

9:33 a.m. - I spend hrs a day on email networking with Ortho surgeons coming down to resupply our equipment and implants.

9:37 a.m. - NPH has 3 containers of donated hospital supplies arriving. Ortho surgeons from US networking getting specalty items, effective.

9:43 a.m. - Implant companies told us there would be plenty onground onarrival. We have not found any equip except Synthes from Baptist hosp.

11:30 a.m. - Had lunch c navy officer here.Comfort interested in oursite. Took themto OR and Italiancamp. They will takeus to comfort for tour

2:31 p.m. Just drained an infected hip in a 8 yo boy.Sick for 3wks.In severe pain. He'll be OK now.Brought to us from another tent hospital.

Feb. 13

6:18 a.m. - Visiting u of Miami tent hosp called medishare. have surgical capability but no sterilizers. not doing internal fixation

6:22 a.m. - U Miami will send us pts Monday

9:38 a.m. - Have been touring different hospitals and the PaP devastaion area c a Haitian Ortho surgeon. He is in tears at times.

9:42 a.m. - searched the airport drop area for plate and screw sets.There are none. Talked with the army.Best source is our Ortho doc network

9:44 a.m. - U Miami not doing internal fixation due to sterilization problem. They will supply us with some implants

3:46 p.m. - Feeling good. Just heard from Dr Guidera Shriners Minniapolis. Phili Shriners may take the 14 yo boy c TB of spine

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Feb. 14

6:03 a.m. - Happy valentines day! Another day of mourning in Haiti. Going to USS Comfort for tour. Father Rick will give Mass this evening

6:06 a.m. - Visiting Ortho docs yesterday brought 6 screw sets and plates. We are in business.

6:12 a.m. - Ever seen "Good Morning Vietnam" Robin Williams. Every morning and all day helicopters are ever present overhead till after dark.

6:17 a.m. - Working on Haitian govt permission to transfer14yo boy c spinal TB to states for surgery.Need to send Mother and interpreter also

7:01 p.m. - Toured the USSComfort today.Very capable, very interesting.Here is Dr Ackerman on shuttle to the comfort

8:07 p.m. - I think we are all feeling a bit tired and lonely tonite. Three days of mourning has taken it's toll. Love, Faith,& Hope endure.

Feb. 15

4:28 p.m. - Surgery is ramping up again.After the 3 days of mourning we were hit hard today.Admitted 6pts with 5 femur fxs and one pelvic frx

4:41 p.m. - Volunteer workerscoming and going. Consistency ofcare Rsuffering.Nurses and ORstaff at a premium.Crisis is evolving.Late stage

Feb. 16

3:29 p.m. - Still working on transferof boy with TB ofspine.Shriners in philidelphia is bestchoice.Working onflights family stay in phili etc

3:34 p.m. - Today is carnival or Madi Gras. Haitian nurses in OR took the day off. We worked anyway and did 5 surgeries.

3:37 p.m. - Lew ZirkleMD Ortho surgeon from Washington Sign Nail program and hisyy

6:02 p.m. - Lee Zirkle MDand his asst Jeanne were here today toteach us howto use the Sign intredullary nail.Invented for disasters like this

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Feb. 17

4:01 a.m. - It rained hard last night. Homeless mothers children were lucky if they had tents. Many do not. Rainy season coming

4:05 a.m. - We are sharing our operating room with U of Miami today. They have 3 open upper extremity fractures to fix

4:08 a.m. - Drained a thigh abcess in a 4yo emergently last night. He had it for 3 weeks. He will be alright now.

Feb. 18

3:15 p.m. - When it rains at night in Haiti,do people lie down in the mud and sewage or do they stand all night or crouch in doorways.

3:48 p.m. - They stand all night and there are not very many safe places to crouch. Unless the are lucky enough to have a tent.

3:59 p.m. - The rice came in today and the staff was excited and happy.

4:25 p.m. - Many hospital staff are homeless or living with relatives. Fa Rick's following. artists for social responsiblity sent truckloads of rice

Feb. 19

5:02 a.m. - The rain is coming. Another concern is for the emergence of a cholera epidemic. We haven't seen it yet.

Feb. 20

4:08 p.m. - Tom and I cleaned out a 15 yo kids knee of caseating granulomatous material....looks like TB for sure. No ability to culture it.

4:12 p.m. - We did 7cases today. Thought it would be light...Saturday. Plenty to do. U of Miami wants to send more pts. We will take them.

4:17 p.m. - The US Embassy is 1/4 mile away. They have a swimming pool. We are taxpayers. We are going there tomorrow afternoon, asking for a swim

4:20 p.m. - One week to go. Happy and Sad. Need to tie things up for surgeons that follow us. We have set up a quality Ortho program here.

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Feb. 21 

2:37 p.m. - Sunday in Haiti. Rounds, clinic, cleanup. Walked down to US Embassy, went for swim in their pool, heaven.

Feb. 22

5:43 p.m. - Lost our first pt today on USA Ortho.Tears.Benita Delva diabetic ketoacidosis septic c multiple washouts BKA--AKA today lost her.

5:47 p.m. - Got killed today c new pts and problems.200 people trying to get into the hospital. clinics bringing pts. doing good work

5:20 p.m. - Other Doctors coming from other clinics and hospitals wanting to use our facilities. Difficult because we are at full bore.

5:52 p.m. - New Ortho Docs have arrived, thank God. Maintaining work load

6:15 p.m. - The wind is blowing. It muffles the sounds of crying children in the hospital. Can we relieve their pain? Phantom limb pain?

Feb. 23 (exact times not yet available for some tweets)

4:45 a.m. - The ground shook last nite and people were scared. The hospital was emptied. The children and adults are sleeping on the lawn.

4:48 a.m. - We are alright. There will be more injured from the unstable rubble downtown.St Damien hospital is unharmed from last nite quake.

About 17 hours ago - Patients in courtyard outside hospital. Scared to go back inside.

About 16 hours ago - The mothers with premies don't want their babies inside because earthquake risk. It will get to cold tonite, too cold for babies.

Feb. 24

About 3 hours ago - The children are back inside the hospital. It was a quiet night. We did 6 cases yesterday. Will do 4 today