Brian W. Loggie, a professor of surgery at the Creighton University School of Medicine, has gotten little sleep in the past week.
Days after a devastating magnitude-7.0 earthquake rocked Haiti, Dr. Loggie and several of his colleagues arrived at a medical facility in the Dominican Republic, 30 miles from Port-au-Prince, Haiti's capital. Since then, they have been operating on victims and trying to manage the flow of the hundreds of people overwhelming the facility.
"What we've been seeing are just many, many, many patients, a lot of orthopedic injuries, a lot of open fractures that are infected," Dr. Loggie said in a telephone interview. "We're seeing so many amputations."
There are dozens more doctors like Dr. Loggie spread across Port-au-Prince and nearby towns, performing surgeries in makeshift hospitals and calming frantic patients. While many American colleges are providing financial assistance to Haiti, some, like Creighton, have sent teams of nurses and surgeons.
These universities have longtime connections to aid work in Haiti and were able to quickly dispatch doctors in the days following the quake.
"They're saying that there's hundreds and hundreds of patients—they can't even count how many," said Charles J. Filipi, another professor of surgery at Creighton, who is coordinating the university's relief efforts from the medical school, in Omaha. "It bothers them to eat because most of the patients have not eaten very much if anything. They're getting a little bit of sleep."
Building a Field Hospital
The largest effort to put teams of university doctors on the ground has come from the University of Miami, which began sending medical professionals to Haiti the day after the earthquake.
Miami has sent several flights each day back and forth, transporting doctors and supplies to Port-au-Prince and bringing severely injured patients to Miami hospitals.
The university's Miller School of Medicine has dozens of team members on the ground. Well over 100 affiliated medical professionals have made the trip, said Pascal J. Goldschmidt, dean of the medical school.
Dr. Goldschmidt, who traveled to Haiti the weekend after the earthquake, said hundreds of patients have visited the medical school's compound, which is made up of two large tents set up at the Port-au-Prince airport.
Miami's medical team initially performed surgeries on kitchen tables. Since the first days after the earthquake, the school has improved its facilities and is building a more sophisticated field hospital.
The doctors have seen many limb injuries and had to perform amputations, said Dr. Goldschmidt. They are also treating many "injuries to the skin, bone and muscle tissues," he said.
"We had a patient who was a young girl, 13 years old, who was hit by a rock on her chest," Dr. Goldschmidt said. "The rock scraped the skin off, scraped the muscle and bone off, and basically you could see the movement in the tissue surrounding the lung."
Families and friends are carrying patients to the compound in makeshift ambulances, he said. "You can have two or three people who are brought at the same time, one basically dying and one in severe condition and one with minor injuries. We also have people who have gone through such a dreadful experience that they are very much manic at the time they get to us."
Miami's aid work in Haiti is far from new. Dr. Goldschmidt credits Barth A. Green, chairman of the medical school's department of neurosurgery, for quickly setting the relief effort into motion.
In 1994, Dr. Green and Arthur M. Fournier, vice chairman of family medicine and associate dean for community health, co-founded Project Medishare to improve health care in Haiti through training and aid.
Dr. Green is also chairman of the school's Global Institute for Community Health & Development, where Dr. Fournier is interim director. The institute promotes health and development in underserved communities in Latin America.
The City of Miami already has a large Haitian population, Dr. Goldschmidt noted. Doctors from the school hold an annual medical fair in the city's Little Haiti neighborhood.
"We're working with Haiti chronically," Dr. Goldschmidt said. "We were able to build this camp so rapidly because of our relationships with the people of Haiti."
Dartmouth College was able to quickly send medical professionals to Haiti following the earthquake, thanks to its connections in the country. The university's president, Jim Yong Kim, is a co-founder of Partners in Health, a nonprofit group that provides medical assistance to poor countries.
A few days after the earthquake, Dartmouth Medical School sent nine people, including surgeons and nurses, to the Partners in Health hospital in Hinche, a town in central Haiti. This week, another team of nine, mostly nurses this time, was on its way.
Because of Dr. Kim's connection to Partners in Health, Dartmouth has been in close contact with the organization and sends personnel and supplies based on specific needs.
"We're in daily contact," Dr. Kim said. "The minute it happened, I was getting e-mails from my students and colleagues in the field."
Dartmouth is concentrating now on sending medical supplies. "We just got an e-mail this morning with a desperate call from more surgical equipment, and we were able to mobilize within minutes," Dr. Kim said.
Robert M. Gougelet, medical director for disaster response at the Dartmouth-Hitchcock Medical Center, works with Dr. Kim, among others, to coordinate the relief effort. Many doctors have volunteered to participate.
Dr. Gougelet, who has served on federal disaster-response teams for more than 20 years, said the doctors on the ground were treating an influx of patients stable enough to make the journey from the area most affected by the earthquake. The medical team was seeing patients with broken bones, contusions, and head injuries, he said.
"I have never seen so much poverty and am humbled by it," Dr. Kurt K. Rhynhart, a general surgeon at Dartmouth-Hitchcock, said in an e-mail message from Haiti. "But the people are the most friendly, proud, and thankful I have ever met. I am certainly glad I came and am sure this won't be the last time."
Overwhelmed With Patients
Creighton University sent nine doctors and nurses to the Dominican Republic on the Saturday following the earthquake, and three nurses and a pharmacist this week. Hundreds of patients have been streaming into the outpatient center and small hospital where they are working at Jimaní, a small town on the border with Haiti.
The hospital "wasn't basically anything," said Dr. Filipi, Creighton's relief coordinator, so the Nebraska institution has sent in a lot of medical supplies. In fact, according to Dr. Loggie, the team leader in Jimaní, there were "horror stories" of doctors there performing operations without anesthesia before teams like Creighton's arrived with supplies.
"People are dying, and it's pretty grim," Dr. Filipi said, "but they are using their operating rooms very completely."
Creighton, a Jesuit institution, also has a special connection that allowed it to mobilize quickly. The school's Institute for Latin American Concern, a Roman Catholic health-care and educational organization that holds service-learning programs throughout the year, operates out of Santiago, in the Dominican Republic.
Dr. Loggie was in touch with a priest at the Santiago center who knew a priest in Jimaní and said the town needed more medical professionals, Dr. Filipi said.
"Creighton's been working there for 25 years, and then people from the university are going down there all the time," he said. "It's kind of a place that allows us to get there quickly."
Students Out Front
While most colleges providing direct aid have sent medical teams to Haiti, the students at one online institution, American Military University, have been significantly involved themselves. Many are members of the military.
Christopher M. Reynolds, program director for emergency and disaster management and homeland security, said he knew of more than a dozen students and faculty members in Haiti, doing such work as logistics operations and search-and-rescue missions through the military. The university's students get course extensions on the basis of their deployment papers.
The university hopes to do even more. Following the earthquake, Wallace E. Boston Jr., president of the parent American Public University system, wrote to the Federal Emergency Management Agency, pledging the institution's support.
Mr. Reynolds then sent an e-mail message to more than 1,000 students and alumni, letting them know he was creating a list in which people could describe the skills they could offer in Haiti. He plans to give the list to FEMA if it asks.
"What we are now doing is waiting for them to contact us back," he said. "If they need a particular skill, we have the database."
"In the world of emergency management, we call this 'leaning forward,'" Mr. Reynolds said. "We're already identifying who our people are, what their skills are, and what their availability is."