By: Dave Gordon
Destruction, death and devastation. The effects of the catastrophic magnitude 7.0 earthquake, centered just 16 miles west of Port-au-Prince, the capital of Haiti, shook the small Caribbean country earlier this year with reckless abandon. An estimated three million people were affected by the quake according to the Red Cross and the Haitian Government reported that an estimated 230,000 people had died, 300,000 had been injured and 1,000,000 made homeless. But the human tragedy could have been far worse if not for the brave rescue workers and doctors and nurses from around the world who quickly descended upon the largely impoverished nation to provide humanitarian aid and medical services. But what kind of person throws themselves directly into the chaotic turmoil of what has been ranked as one of the ten worst natural disasters on record?
These resilient volunteers must selflessly brave perilous living conditions (including numerous aftershocks), primitive shelter, grueling work shifts and the psychological toll of bearing witness to the harsh realities of terrible human suffering. They are the true modern day heroes – and they far removed from those in our circle of contacts. Or are they?
Leading the acclaimed Israeli team of medical responders in Haiti, just days after the quake, was one Dr. Ofer Merin. While it may not surprise that Dr. Merin, a Lieutenant Colonel in the IDF’s Medical Corps, should be counted among the heroes in Haiti’s rescue, it may surprise many to learn that he is one of us – a man of Syrian-Jewish heritage with many relatives and strong ties our own New York/ New Jersey Sephardic community.
A Community Boy?
Dr. Merin’s mother, whose maiden name was Rachel Sutton, and her mother, whose last name was Massry, are both of Syrian extraction. Dr. Merin’s grandmother was six years old when she moved to Israel from Aleppo. Her father lived in Israel for three generations, making his way via Beirut.
Cousins of his moved to Brooklyn in the 1920s, and many relatives, including Joe Cattan, Jesse Salem, Shirley Hanan, Albert Sasson, Joseph Sasson, and Jack Sutton, currently reside in the Flatbush section of Brooklyn.
“We are very proud of Dr. Merin’s bravery and accomplishments overall, and in Haiti,” remarked Jack Sutton, who is a second cousin to Dr. Merin’s mother. “I feel a great deal of satisfaction to know one of my relatives had a hand in so many heroic rescues.”
Joseph Sasson, whose father is from Aleppo, and who is a second cousin from Dr. Merin’s mother’s side, admitted he only realized the familial connection after the Israeli team had returned home. Nevertheless, he shared the same sentiments as other relatives. “It was a great source of much pride, not only because he is a cousin, but it’s a great source of pride to know that these rescuers were from the Jewish people, from the Jewish State, as a whole.”
First cousin to Dr. Merin’s mother, Shirley Hanan, recalls what it was like to see Dr. Merin for the first time on television during the Haiti mission. “I remember seeing a very tall man on the TV, and he was wearing army fatigues.”
It was a something like a surreal moment, she explained. “The humanitarian effort was enormous. I don’t know how they set up a whole hospital there [in a soccer field]. I looked at them with such pride, that they do it just for humanitarian reasons. Then it dawned on me, is that my cousin?!” It took Dr. Merin’s mother to confirm that it was, indeed, the Ofer they know and love that was leading the Israeli team in chaos-riddled Haiti.
No stranger to operating on patients of disparate and desperate backgrounds, Dr. Merin has regularly performed eye surgery on Arabs in Israel, and, as part of his work as the Deputy Director General and Trauma Surgeon at Shaare Zedek Medical Center in Jerusalem, he serves the spectrum of nationalities represented in Israel’s kaleidoscopic population.
But soon after the remarkable work his team did in Haiti, Dr. Merin was tapped by the IDF to share the unique knowledge he acquired by presenting lectures of his team’s mission to audiences around the world. He has spoken in Toronto, Los Angeles, New York and other cities on the East coast and he expects to return to New York in August and September.
Preparing for a Rescue Mission
Within 24 hours of Haiti’s first tremor on January 12, an Israeli team of medics were already on the ground, doing surveillance and reconnaissance to scout out what would be needed for a “rescue mission”. Less than 45 hours later, the Israeli team of medical professionals were already treating patients in a field hospital splayed out in a Port-au-Prince soccer field. The team included 109 support and rescue personnel from the Israel Defense Forces and 121 medical personnel. Among them were more than three dozen doctors, 20 nurses, 20 paramedics and medics, and 20 lab and X-ray technicians.
“Haiti is a poor countrywith minimal civil facilities,” Dr. Merin observed, “and the earthquake’s destructionof infrastructure left millions of people homeless and hundredsof thousands in need of medical assistance. When we arrived,there was no functioning authority coordinating the distributionof the available medical resources.”
During the 6,000-mile flight en route to Haiti, Dr. Merin and his team were apprised in real time of any changing situations on the ground. They learned that about 300,000 Haitians were injured. Every minute, people died because of lack of medical attention. More than a million people became homeless. Untold tens of thousands of children had no guardians, parents or adults to help them.
“Everything was chaotic,” Dr. Merin described. “There were thousands and thousands of people lying in the streets.”
It didn’t take long for the word to spread among the survivors in Haiti that the Israeli team had advanced medical equipment. Some patients decided not to wait for the hospital to be fully set up, and rushed in – some brought in by wheelbarrow.There was one young Haitian man, for example, who was apparently caught in crossfire during looting, and took a bullet in his chest. He managed to make it to the field hospital and receive a blood transfusion. With just two hours in intensive care, he was discharged the following day.
The “Rolls Royce of Healthcare”
“Although the medical facilities were not state-of-the-art, for a field hospital it was about as twenty-first century as one could get,” Dr. Merin said.
He described the makeshift facility as a “multidisciplinary hospital” that included not just physicians, but also basic hospital equipment such as imaging, ultrasound, laboratories, a blood bank and a computerized registration system.
The fully operational field hospital included radiology and maternity facilities, which caught the attention of the CNN reporters, who were “amazed” at the Israeli medical team’s level of preparedness, calling the setup “the Rolls Royce” of healthcare.
Over the course of ten days, Dr. Merin’s team treated some 250 patients daily, not including the 242 operations it performed, the approximately 100 x-rays it took each day, the16 babies it delivered, the 70 hospital beds it filled, and the more than 1,100 lives it saved. Among the babies that were delivered was a set of twins, and a new mother expressed her gratitude to the Israeli medical staff by naming her new son Israel.
In addition to the fully stocked, portable field hospital, the Israeli team members also brought along the necessary equipment to ensure their own spiritual health – such as a Bet Knesset (synagogue) tent and tallitot (prayer shawls) as well as kosher food for the entire team. Although only approximately one-tenth of the team was observant, by Dr. Merin’s estimates, Friday evening Kabbalat Shabbat services were extremely well attended.
As prepared as they were, nothing could have prepared them for a country-wide medical emergency as unique as Haiti’s. Although Israel has considerable experience in offering medical assistance during catastrophes, and has sent medical teams to at least 10 other disaster sites including those in Armenia, Turkey, India and parts of Eastern Europe, the team quickly realized that they were in for some frightening and heartrending surprises, and difficult decisions to make.
Amid the chaos, several ethical dilemmas arose – who to treat, who to turn away, and who take an uneducated gamble on treating. With many more patients than they could possibly handle, medical care had to be rationed wisely.
In one tragic case, the rescue team found a 22-year-old woman who had been stuck in wreckage for five days. They had to amputate her hand so she could be pried out of the rubble, but then they discovered that she had gangrene on her back and legs. In a normal hospital, there’d be an emergency room working around the clock to save her. But what do you do when it becomes clear that it’s not likely she could be saved – and there were others seeking care who stand a much better chance of surviving?
“You cannot stand at the gate and say, ‘You know, I think she has a low chance of survival, so let’s not accept her.’…” Dr. Merin reflects. “How do you choose who to admit under such conditions, with people around you dying by the thousands? How do you decide who gets treatment when you can choose only some?”
Writing of his experiences in the New England Journal of Medicine, Dr. Merin provided some insight into the ethical dilemmas and decisions: “We believed it would be inappropriate to deny treatment to apatient who had survived days under the rubble before a heroicrescue, even though this policy meant potentially divertingresources from other patients with a better chance of a positiveoutcome. Indeed, one patient who was rescued a week after thequake was brought to us in dire condition. She was admitted,and underwent surgery but ultimately did notsurvive.”
Thinking Out of the Box
From a logistical perspective, perhaps the biggest challenge for the team was managing with the finite amount of medical supplies on hand. But thanks to some improvising – and help from Above, the team managed to avert several critical equipment shortages.
With no surgical drills available, orthopedic surgeons had to use garden-variety home hardware electric drills to bore holes in bones. Afterward, they sterilized the drill bits again, then overlaid plastic bags on them to keep them separated from the elements until the next operation.
“You have to think in a flexible way,” Dr. Merin said, adding that it was important to “consider patients’ open limb fractures in the poorest country on Earth.” The majority of the patients coming in had broken limbs with open, infected wounds that, if left untreated,meant certain infection, gangrene, anddeath. “You try to salvage as much of the limb as you can. The chance of an amputee to find rehab is zero. They’d never have $10,000 to find prosthesis.”
And so, the team brought with them 70 specialized orthopedic nails, at $8,000 a pop, that were placed in broken bones to help them heal. There was a problem, though. Within four days, the entire supply of nails ran out. In a desperate bid to solve the problem, an enterprising team member drove into the city, eventually finding a blacksmith who duplicated 200 “generic” versions of the original nails for a few dollars. The Italian and American medical teams in other field hospitals found them useful, too.
To further help amputees, follow-up teams from Magen David Adom, Herzog Hospital and Jerusalem’s Alyn Children’s Orthopedic Rehabilitation Hospital flew in later to provide follow up services.
In another miraculous story of industriousness and resourcefulness, the Israeli team managed to restock the thousand limb casts that had run out within a week. Somehow, word got around that the Moroccan embassy in Haiti had a cache of casts stashed away in their basement. “We thought they were kidding, but it was true,” Dr. Merin recalled. In short order, boxes adorned with the Moroccan flag and Arabic writing and containing 3,000 casts were delivered to the team. The Israeli team made sure enough of the casts got around to other field hospitals, as well.
Then there was the baby admitted with severe gastric problems. Doctors correctly determined that the problem was congenital lack of vitamin K – even though this potentially fatal condition is highly uncommon in the West and therefore more difficult to diagnose. The solution was to pump plasma into the child. One of the attending physicians who happened to be a match was quick to donate 20 cc’s of his own blood. The baby was sent home a day later.
Efficiency Through Technology
A primary feature that set apart the Israeli mission from others operating on the scene was the ability of the fairly large scale operation to run so efficiently in spite of the hectic environment.
At the outset of the operation, the Israeli team set up an interconnected computerized system of 20 laptops – one for each tent in the field hospital.
“With absolute chaos all around us, the hospital was like an island of intensive lifesaving,” said Dr. Merin.Each patient was photographed and bar coded in order to streamline treatment, keeping track of each patient as he or she received treatment.
“We didn’t have to tell the story over and over, or have to do any translating. They had a barcode to tell us,” said Dr. Merin. “As nobody in Haiti has identity cards, the photos were used to keep track of patients and for loved ones to identify them.”
Then, when a patient was discharged – usually to the street – he received a CD that contained his case history and medical file. It documented all the x-rays and scans that had been taken, for possible follow-up treatment.
Perhaps most remarkable was the ability and willingness of a tiny nation like Israel (with an area that is about 25% smaller than Haiti’s and a population that is roughly 34% less), which technically remains at a state of war with several of its neighbors and under constant threat of attack, to devote such significant and valuable resources to a nation with which it doesn’t have particularly close ties. During those ten days in Haiti, Dr. Merin’s team performed extraordinary feats of medical wonders, making a world of difference to thousands of people a half a world away. And, in yet another remarkable gesture, the Israelis decided to head home with an empty cargo plane, leaving behind all their state-of-the-art medical equipment to those who desperately needed it.
Both individually and collectively, Dr. Merin and his team have been recognized internationally for their heroic life-saving work. Even Ban Ki-moon, the figurehead of the UN, a body that is habitually critical of the Jewish State, heaped praise on Israel’s response to the Haitian earthquake. And this past May, Dr. Merin received the Medal of Valor from the Simon Wiesenthal Center in Los Angeles on behalf of the IDF for their work in Haiti.
Closer to home, the pride in Dr. Merin’s work is no less palpable. “We feel honored and proud to have a member of our family make such a positive contribution to the health and well-being of others,” enthused Shirley Hanan. But Dr. Merin shrugs off praise, instead crediting his team and the distinctly Jewish value of hesed (kindness). “The Spirit of Israel was common to everyone,” he concludes “When it comes to volunteering and assisting strangers… Israel is always willing.”