November 2010
Feature Story

Anne Ford

David M. Andrews, MD, found it hard to watch the tents come down. Since shortly after Haiti’s devastating earthquake of Jan. 12, the tents had housed the University of Miami/Project Medishare field hospital on the grounds of the Port-au-Prince airport. Along with many other volunteer pathologists and laboratorians, Dr. Andrews had made numerous visits to the hospital to help oversee its laboratory. There they’d run well over 20,000 tests on about 3,000 patients—tests that helped save or improve the lives of many of the poorest of the poor in the quake’s aftermath. And now, in June, those tents were toppling.

“Within a day it was an empty field,” remembers Dr. Andrews, associate professor of clinical pathology and director of the special coagulation laboratory at the University of Miami. “It was an emotional moment, but it was needed. We were heading into the rainy season, and the airport grounds were going to become a mud bowl. We’d already had a flood that came up through the floorboards of the pediatric tent. We needed to get into a solid structure.”

That solid structure had already been located in the form of the Bernard Mevs Hospital, an existing hospital in downtown Port-au-Prince that had been virtually abandoned since the quake, despite it having suffered only minimal damage. Project Medishare, a nonprofit organization affiliated with the University of Miami’s Global Institute that provides health care services in Haiti, formed a partnership with Bernard Mevs, which in June replaced the previous, tent-housed hospital. Staffed by Haitian hospital employees and volunteers from the United States and Canada, it is the only trauma and critical care hospital in the country, Dr. Andrews says. “In Haiti, gaining access to a respirator is a big deal.” (Dr. Andrews is Bernard Mevs’ laboratory director.)

In addition to finding a brick-and-mortar home, the hospital recently received desperately needed funding from the American Red Cross to the tune of $2.76 million, an amount that is expected to keep the facility open until mid-2011. “The partnership [between Medishare and Bernard Mevs] has really been solidified because of the Red Cross money,” Dr. Andrews says. “Prior to that, 100 percent of operations were based on charitable donations to Medishare, and you can’t sustain a hospital that way.” The hope is that before the Red Cross money runs out, additional funding will be obtained to allow the hospital to keep running until it is in a position to become self-sustaining.

At the moment, the hospital laboratory is permanently staffed by seven Haitian medical technologists, with a complement of rotating volunteer pathologists and laboratorians from the United States and Canada. In addition, “there’s discussion of setting up a telemedicine station down there with the capacity to include telepathology,” Dr. Andrews says. “The goal is to be able to do consultations, so Haitians or volunteers could interact with specialists in the United States if, say, a tumor with difficult features was being processed.”

At this point, he adds, one of the biggest needs is to train laboratory supervisors—“people who can convey quality assurance concepts, set goals and objectives, and assure quality on an ongoing basis. We’ve got to get people on the ground who are going to move things forward.”