Scratching the Surface

Saba Ghorab, a second year medical student at the George Washington University School of Medicine and Health Sciences (SMHS), remembers the day in January 2010 when a 7.0 magnitude earthquake struck Haiti.

She remembers it well because it was the same day her father underwent heart surgery. At the time, concern for her father took precedence over concern for a nation over a thousand miles away.

But as her father recovered — and Haiti did not — Ghorab, who was working as an Emergency Room technician at the George Washington University Hospital at the time, became increasingly determined to travel to the nation to aid its overwhelmed healthcare workforce.

And now, one year later, Ghorab has done just that — twice. First in June 2010; and most recently in July 2011. Both trips were led by Ghorab and former colleague Shafi Rehman, an ER technician in the GW Hospital.

“You learn a lot about third world medicine in the classroom, but I wanted to experience it firsthand,” says Ghorab, who studied Public Health as an undergraduate at GW and is currently leading SMHS’s Global Health Coalition. “I think it’s important for future health care professionals to see the world outside of their bubble and to be challenged in that way.”

The most recent trip, which returned July 29, included four SMHS medical students and five GW Hospital ER employees including nurses, technicians, and a physician assistant. The team traveled to Port-au-Prince, Haiti, to provide supplies, support, and basic medical care to local health care teams and international nonprofit organizations including Project Medishare and Global DIRT.

While last year, the teams worked only in mobile clinics and with public health outreach organizations, this year, Ghorab and Rehman added a level one trauma center to the rotations — an addition that made this trip significantly more powerful than the first, they say.

“The acuity of the patients at the trauma center was extremely high — most had very severe illnesses,” explains Rehman. “We saw everything from infectious diseases like typhoid, cholera, and tuberculosis to traumatic injuries like car accidents and assault.”

Working with and learning from “very welcoming” Haitian doctors, the GW team administered antibiotics, placed IV’s, and even performed CPR.

But despite caring for hundreds of patients, Ghorab and Rehman admit they returned from the trip feeling dissatisfied, even dejected — a feeling they still can’t shake, nearly two months later.

“You know you worked as hard as you could, but there was just an overwhelming amount of death,” reflects Ghorab. “What we did was really only scratching the surface.”

Perhaps most difficult for the team to swallow was the apparent lack of rhyme or reason for the deaths. They watched patients die because their conditions lacked treatments, and others because supplies were not available. Some patients died because there was no room at the clinic or no transportation available to get to there. And still others died simply because the employees of the Haitian General Hospital, or l’Hopital de l’Universite d’Etat d’Haiti, were on strike.

“You come back realizing that there is so much that we take for granted in the United States,” says Rehman. “For example, a medicine in the US can treat a stroke, but it is not available in Haiti.That’s the difference between life and death - it’s that simple.”

Though the trip was no vacation, Ghorab and Rehman say that they wouldn’t have traded it for one. “There was definitely a lot of personal growth for everyone. We all took back something and changed in different ways,” says Rehman.

“For many of us, it solidified why we are in the health profession,” adds Ghorab. “A lot of medical students came back and said ‘I can’t wait to be a doctor so that I can go back and do more.’”

In the meantime, both Ghorab and Rehman plan to return to the nation to continue their efforts. And, as word of their experiences spreads, they are witnessing a “ripple effect” of peers and colleagues who are inspired to join them.

“No matter how much you do, the impact the Haitians have on you is always greater than what you could do for them,” says Rehman, who returned from his third trip to Haiti in September. “And I think that’s what keeps us going back, always wanting to do more.”