• Stories by surgeons and orthopedists in Haiti.

BY LETICIA MARTÍNEZ   PHOTO: JUVENAL BALÁN, SPECIAL CORRESPONDENTS

Rafael Frías and ana María during an operation at Delmas 33.

They got Ana María out of bed, there in beautiful Cienfuegos, at three in the morning. Her daughter’s prophecy seemed to have come true. While watching the news that night, she had suggested to her mother: "Mom, we should get your bag ready." At that hour, the versatile orthopedist, who had been in earthquakes in Pakistan and China, had established her reign in the kitchen and didn’t take any notice of her kid’s remark. At 6:30 a.m. Ana María was already in Havana, ready to fly out.

Doctor Rafael was not taken by surprise. He arrived in Port-au-Prince a week after his colleagues, when the hospitals were packed with injured people and the exhaustion of Cuban doctors fighting death since January 12 itself was reaching the limit. For him, it was just another day at work in the Cuban capital’s Fructuoso Rodríguez Hospital, until he was told that he would leave for Haiti any minute. The stories that followed -those of Rafael, Frías and Ana María- have not been written yet, but were lived with courage among the scalpels.

Dr. Orlando Frías doesn’t boast about being an eminent surgeon, although he could do so for the knowledge he treasures. However, when we spoke recently he specified a maxim before narrating any of the tragedies lived here: "Do you know what the most important thing I’m taking with me from Haiti is? The possibility of realizing that one person is no more important than any other in such disastrous situations. We’re all equal, from the most distinguished specialist to the cook that arrived a few days after the quake and saved our lives."

That’s how the dialogue with surgeon Frías, who hasn’t stopped operating on since he set foot in Haiti, began: "We arrived within the first 24 hours of the earthquake. We went to the Annex directly from the airplane, where the doctors from the Brigade set up the first field hospital. We began to operate at 5:00 p.m. During those first hours, I experienced the greatest terror in the world.

Nearly two months after the earthquake, Dr. Frías can’t forget his first case. "It was a five-year old boy whom we had to amputate one of his arms." There couldn’t have been a worse welcome for this doctor. "It was infernal; we performed our surgery in a tent of about seven meters square. We had Haitians lying by our feet, pulling at our clothes. If you lifted one out of the stretcher, relatives brought in another four. And that scared us because there was no one to keep order. The only light in the area was the one we had in the tent where we operated. They took away one of our doctors so she could see to a patient.

"That first night we worked until 5:00 a.m. We had a three-hour break and then we continued until two in the morning. We even performed a thorax operation, considered one of the longest and more difficult operations, and we saved the patient. Here I have had to do more amputations than in my entire life as a surgeon. It’s very sad."

Things have changed. The emergency is almost over, but work continues to be hard in the operating room: "since the hospitals collapsed, emergencies fall on us. We receive patients with traumas due to accidents, bullet and stab wounds, intestinal perforations as a consequence of typhoid fever…we see around 50 cases for surgery every day, and we perform over five full operations."

There are people who say that there are very few women graduates in Orthopedics, but that’s a false taboo, affirms Doctor Ana María Machado. "It’s a speciality like any other. It’s true that we have to make more use of strength, but it can be practiced. Here we do the same amount of work as compared to male specialists." And if this Cienfuegos resident -the only woman orthopaedist here- says so, there’s no other choice but believing it.

This is the third earthquake to which Ana María has contributed her work to heal people. However, nothing can be compared to Haiti’s tragedy, she says trusting her experience of having suffered the disaster herself. "You have to live through it to believe it". And that’s because she has been a member of the Henry Reeve Brigade since its founding. "I used to get nervous, but every time I hear of a disaster, I know I can be there any minute."

"When I arrived to the Annex, 24 hours after the catastrophe, I concentrated on children. We set up another three operating tables, and we prioritized one of them for children. It’s very hard to see how a child loses one of his legs. Many children arrived here missing one of them already. In Cuba, amputation on children is very rare. The most frequent ones are due to tumors, but traumatic ones are hard to see. That makes you more sensitive, but here you didn’t have time to sensitize, because the life of a child is at risk."

Ana María still sees infants with injuries from the earthquake. Today she’ll see Mackendi, the small boy who lost his entire family, who has an open fracture on one of his legs and who doesn’t want to leave the Cuban doctors once he’s cured, since then he’ll have no one to take care of him like they have. These are the pains that have marked this Cuban, who doesn’t waste a second to go and cure someone.

Amid so much tragedy, Dr. Rafael Roque also thinks about performing science. He says he’ll make a compilation of his experiences here as soon as he gets home. He wants to pass on the magnitude of the disaster in Haiti to colleagues who didn’t come here -how they lived through it, faced and treated this disaster. Perhaps his voice will be heard in the next congress on Orthopedics held in Cuba.

For now, away from the academic stand, he doesn’t stop seeing cases in the emergency room at Delmas 33. One after the other, patients arrive with their X-Ray plates under their arms, so the orthopedist on duty gives his or her verdict. And although things have become somewhat calmer, Rafael doesn’t forget the days that shook his life either.

"This hospital had collapsed when he arrived. There wasn’t a place where you could walk. Many people were waiting to be treated. We fitted out even the cafeteria of the surgical area to operate. There were times in which we operated on up to 30 people in one day. I’ve performed more operations here than in a year in Cuba."

Rafael also has a dramatic memory of his own: "It was the mother of a young Haitian, who had graduated in Cuba. He brought her to Delmas so Cuban doctors saw her. That night, around midnight, it was my turn to clean up her stump under her knee. But the infection was getting up almost to her gluteus. We decided to consult her son about the urgency of amputation to save her life. Trusting us, he gave us his consent. Every now and then he comes to see us to express his gratitude for keeping her alive."

Frías, Ana María and Rafael have shared countless hours in the operating room. Many are the lives saved by these Cuban physicians since their first days in the field, and they continue to make history plucking up their courage among the scalpels.