Letters from Haiti
John Pyles '76
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For four weeks in late 2010, John (J.R.) Pyles, M.D. ’76 volunteered his medical services to the J/P Haitian Relief Organization (J/P HRO) to help victims of the earthquake that struck Haiti Jan. 12, 2010. Pyles practices medicine in Kane, Pa., and lives on a 137-acre farm with his wife Freda. Both previously worked with humanitarian disaster aid agencies in the Balkans.
Below are excerpts from e-mails Pyles sent to Freda, his former teacher Professor of Biology Surendra Singh, Ph.D., and other friends. These messages appear as written, although they have been edited for content, length and clarity.
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Sent: Sat, Oct 16, 2010, 7:37 PM
Happy Saturday night from Petionville, Haiti. Sitting up on the hill above downtown Port Au Prince, smelling the garbage piles burning, listening to the lizards cackling and squacking their weird sounds, and I’m sweating like a pig in the heat and humidity. The huge tent city for a portion of the displaced Haitians from the January quake is directly below me in the ravines and valley, home to 55,000 people. I arrived a week ago on an early flight from Miami carting two fifty pound duffles full of assorted med. gear, three large boxes sent to me in Miami containing six badly needed state of the art pulse oximeters (donated from Masimo Corp), and my backpack with skivy shorts, and bug spray (which) have proven to be extremely valuable over the past six days.
Arrival in Haiti is a free for all, luggage tends to get “displaced” so was relieved to get all my stuff in the hot and I mean SWELTERING crowded baggage claim. I was met by my bodyguard and driver from the airport, Robinson, who reminds me of Lawrence Taylor in his prime, only armed. Jay, a PA from Colo. also was being picked up. I arrived at our compound. Was a nice villa at one time. People on the various teams (Rubble removal, demolitions, medical, and so on) stashed everywhere. Tents everywhere, lawns, veranda, next to the small pool…yes a pool! Ain’t too clean, but wow what a sensation after a hot dripping sweat day in the medical tent. Have I mentioned the heat yet? ha More later when time…..Daddy JR
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Tues, Oct 19, 2010, 8:12 PM
Lots to tell, but little time to do so. It’s Tuesday, 9 days in now. Funny in that I’m now a veteran of this crew. Newbies coming in now. I work in a small tent hospital with the Haitian docs, slightly down the hill is a large tarp covered area called triage where 6 days a week routine, non emergency care is delivered. Three days a week, mobile clinics go out to destroyed areas where there is no medical care. Last week with two Haitain docs and nurses and bodyguards I went to the rubble area Delma 32. Combined patient visits mobile, hospital triage 1 and 2, OB and Women’s clinic were 2,400 for 6 days. Runs the gamut, ingrown nails to intracranial bleeds from head trama. Fevers, dehydration, ringworm, scabies, diarrhea, intestinal parasites are the norm. Newest member of the camp is a ten pound baby boy. All are traumatized still by the quake and the Haitian docs refused to work “inside” a house on mobile clinic. Everyone has heartburn headaches as reaction to the stress at minimum. Maximum seems to be what the Haitian docs called the “Haitian Flop,” pseudo-seizures, pseudo-catatonia. The heat is a killer, dripping all day and at times is hard to stay hydrated, drink tons of water, and getting hooked on cherry flavored pedialyte when over the dry line. Hard to complain though, as i have the option to go home after completing this tour….they have no alternatives and will be muddy, sweltering, for what I foresee as years as slow as the recovery is coming. 2% only of the rubble has been cleared now 10 or so months after the quake. makes me sad. Very tired, to my cot now in my little hole in the basement secure in my mosquito net. It’s late for me, 8:00 PM….morning comes fast. More later, JR
Sent: Wed, Oct 20, 2010, 6:00 AM
Sorry to be so disjointed. grab a computer when available and the thoughts are scattered. Will try and take a look at my diary when home and do a better job for anyone who may be interested. Wish I’d taken that typing course in HS.
Up early, 0400, roosters making a ruckus and dog packs sound as if they are on to a scent. Lots of new arrivals last eve, 4 nurses, two of which are old ER hands. Doesn’t get much better than that. Mobile clinic out today, hospital as usual. They drive us in a big suburban to the medical compound which is on the edge of the camp, but would only be a ten minute walk from the house. Apparently security doesn’t allow it, and even the shelter-building crew has bodyguards. So we sweat jammed together in the diesel filled streets.
Our pig showed up at the hospital. Have our chickens too, hen, ten chicks, and cocky rooster. dog and pup also companions, can’t pet as of ringworm. Puppy is “Pirate,” playful, happy, skin and bones. Mom has sweet disposition too…….think of my Dodji digging through the hospital trash as a pup and so glad Freda made me (or strongly encouraged, ha) bring her out of Bosnia. Few of the crew has been ill with bad GI stuff, fevers…..always on the alert for malaria, dengue, invasive diarrhea and typhoid fever and check on them as we can.
The entire team here works long hours out in the heat, haven’t met one whiner, and like them all. I’m old grand dad again, closest is Helen RN aged 54, the rest mostly 20’s and 30’s. They have fun, jag each other. It’s not all work, but I’ve been on now 10 days straight since arrival, but only half day on Sunday. We get home, beer in the reefer, at times even cold. There is a small pool they shocked, looked like a swamp and seems clean enough to take a dip on arrival home. Food I grab it before gone, Oatmeal in AM, pasta out at the hospital, pasta, rice at night. Not so bad, am losing weight.
Main thing is stay hydrated…young Andy just came through and told me he just looked at weather channel on his ipod…..110 degree heat index today (actually in the 90’s) but the sun and humidity are killers. I drink tons of water, and only barely able to keep up. Is 0500, opportunity shower, best to all, and maybe more later, JR
Sent: Sat, Oct 23, 2010, 7:09 AM
Up early as usual. My right ear canal abscess is almost resolved and can hear again. Still doing one ear auscultation.
Cholera has raised its ugly head, must say that Haiti is the perfect petri dish for growth. Is isolated to a rural area and we are ok here at the camp in Petionville. Oxfam gave us the water test yesterday and we are ok for now. SOP has changed and now no mobile teams going out, cholera isolation tents, ORS, supplies and teams prepared. We pack bags everyday in case we can’t get back to the compound and have to stay at the med. compound inside the camp. Twins born yesterday. 242 babies delivered by the team so far. I really enjoy the crew. Have four more RNs now experienced ER nurses, public health and med-surg. Left there families (kids are mostly grown), came to help and not only make my job easier (but) are a great bunch of women. To say I’m pleased is an understatement. Two 30 year old nurses mothering me, “Did you eat? Dr. John, are you drinking enough, Dr John?” and so on. Who’s the kid around here? Oh well, if it makes them happy to mother me, so be it. ha Welp every one up, have to go, hopefully more later, JR
Sent: Sun, Oct 24, 2010, 9:48 AM
Hi everyone, Freda cutting and pasting your replies and am receiving your vibes, means a lot. I am off this morning and go back to the hospital tent this PM. Nice to rest, do some wash, catch up a bit and hang out at the “house.” It has cooled down somewhat and I think maybe I’ve acclimized (sp) a bit. Only sweat through my scrub top a few times a day now. Life with the team is hilarious at the “house,” we can get beer at night and We sit out on a small cement wall next to my little basement cubby hole like a bunch of birds on a wire, yak, laugh and even sang “Lean On Me” last eve.
At present i suppose you have seen on the news, we are dealing with Cholera now. Most still isolated out on the plateau near St. Marks, about 100 kms from here. have a few cases confirmed here in town, people who have traveled in from the area. Everything that can be done to prevent the spread to the large camps here in the city. We are set as well as possible, isolation tents, no exchange of personnel from contagion area and clean areas, hydration supplies (ORS) and Ringers if we need it. Of course we are all a bit nervous, but taking extreme precautions, and thus far no one on the crew has opted out of the camp. Fine, fine comrades.
Brutal day yesterday. Walked into two multiple traumas(hit by vehicles) and the day went down hill from there. The pathology we see here is fascinating at times. Many babies being born, and think their survival is a testament to the strength and adaptability of the human body to continue its species. Twins yesterday.
Back downtown yesterday on a transport (5 year old with bilateral crushed hands from a week before) to Medishare hosp. run by Univ of Miami who had a volunteer orthopod this week…so got the kid into the OR and debrided, and avoided amputations I hope.
A young doc came in 2 days ago, 2nd yr Peds resident, looks likes she’s 13….find out she’s been in the field in Africa before med school doing an anthropology thesis and has had 3 episodes of malaria. She said she had so many parasites she decided to go to med school and quit spending all her money on doctor bills. She fits in and every one is enjoying her. Can’t spell me in the hospital yet but another MD arrives today….not sure the specialty, but probably will be my new roommate. Close quarters and hope he doesn’t mind the smell of dirty socks, or the sound of the tree rats skittering around outside the door. Will make sure he doesn’t have any food in his pack. Rooster on everyone’s hit list, he’s up at 0300, so we will search and destroy soon. i already have dibs on one of the legs.
2 weeks down today with two weeks to go, has both sped by and also seems I’ve been here a long time. My old body is holding up well, But, do wonder about my stamina sometimes. sean penn has been here for a few days… seems ok. he will return on the 30th, gotta go, JR
Pyles with "Doc Mike," center, and "Doc Ian"
Sent: Tue, Oct 26, 2010, 7:23 AM
Bon Jour from our “villa” compound. Looks like a hillbilly campground as I look down on all the tents and gear scattered everywhere. Household is starting to awaken and stumble in I am the early bird here and get my stuff done before the line to the BR starts. Cooler this morning and the elusive rooster is still loudly cock a doodleing. He starts about 3 AM and now the bounty on him has increased to a six pack of cold beer (thats not a nominal amount around here). The kid goat just beyond our wall is also becoming public enemy # 2. Bleating loudly when the cock awakens him too. I had a great day yesterday, found and ate a Tootsie Roll. As my old cynical sage of a friend Asim stated in the middle of war torn Bosnia after receiving a metal flake ballpoint pen from one of the expats as a gift, “Now my life is complete!!”
The entire crew is tired. The cholera threat and resultant preparation and surveillance has added to all our workloads. So far so good and no cases in our camp. have heard the epidemic out in the central plateau is also slowing down. may be a rumor, but will accept it, as it is a comforting thought.
Our new MD arrived two days ago, think I smelled a margarita on his breath after arriving from Miami, so think he will be a good fit for this rowdy crew. A real mishmash of experience, personalities, countries, and backgrounds….RN’s, PA’s, EMT, pharmacist, MD’s, demolitions, HR, finance, admin, and so on. Blue water sailors, mountain climbers, computer whiz’s, old Africa hands, Asia hands, a myriad of interesting stories sitting perched on our crumbled wall late at night. Have to pack my jump bag for the camp, spray up, fill my water bottles and so on, so more later.
Passing thoughts for the day…don’t ever leave home again without a port computer, instant coffee, and a stash of tootsie rolls. I am healthy, happy and send my love to all and love to hear from you via Freda’s clearing house. “Daddy” JR
Sent: Tue, Oct 26, 2010, 11:44 PM
Out of camp early today, was my day off, so got out by 3 PM. hey, I’ll take it. Sat by pool (we are spoiled by it) and even though it is pretty dirty and bath tub warm, it feels soooooo good. My ear canal abscess is back with a vengence and am deaf in that ear. On opthalmic Cipro drops, as it is all I have and it seems to work.
Jay is being pulled up to St. Marks the center of the cholera outbreak tomorrow. They need more help and hearing some pretty gruesome stuff from out that way. looks as if we will be rotating out there to relieve other crews. apparently the rumor that the epidemic is burning out was wrong. No cholera here at the camp still and as ready as we will ever be at present. If it does come our 200 cholera isolation beds (looks like a traveling circus with big tents out on our landing zone) will be like a drop in the bucket.
Three of our team will be leaving later this week and will be missed badly. Hear many more are on the way, RNs and if they are half as good as the ones I’m working with they will be a welcome sight. I spent most of the day trying to organize the docs (Haitians and Denver Mike) and trying to keep triage, hospital tent, and isolation tents staffed depending on volume. In between transferred three and stuck with a 20 day old baby in our little 10 stretcher tent hospital who has pneumonia and no place to transfer. I found a vial gentamicin finally buried somewhere, so hopefully with the other antibiotics, he will turn the corner by the AM. he’s been with us for three days and making me nervous. Also a Lisfranc fx on a woman beaten last night. Considerable violence down in the camp itself, sexual assaults, domestic abuse. The police do come if reported and “investigate.” our total combined patient volumes on a daily basis break 500. It is brutally busy.
Is hot and humid again, sitting here dribbling with sweat and so glad I brought three bandanas, Night mosquitoes out and buzzing me. Lets hear if for netting. at times tire of laying on my cot soaking the pillow with sweat I just get up and wander around, then hopefully can sleep again. Know I’m sleep deprived, but don’t feel so bad. thunder in the distance now, few gunshots down in the city and a sudden breeze is not only refreshing but blowing off the skeeters. Hope it rains tonight so can curl up in my little crib and sleep, deal with the mud tomorrow. Thinking of you all as I send this, JR
Sent: Sun, Oct 30, 2010, 7:51 AM
Dear Doctor Singh,
Haven’t had a lot of time to communicate since arriving in Haiti. Our teams are working hard, the conditions here were all ready deplorable on arrival (J/P HRO manages this camp and think probably its still the best camp in Haiti despite the limited resources and skimpy budget it struggles with). Now the cholera epidemic has added to our work loads (we have had no cases of cholera in our camp). I work in the camp medical compound for the earthquake displaced Haitians which was built on the old Petionville golf course in the hills above Port Au Prince immediately after the quake in January. Last count we had a camp population of 55,000. There are still 1.3 million people displaced 10 months after the quake. We are approaching 260 new babies delivered by the J/P HRO crews and actually had a set of twins last week. 
I spend my days running between the less urgent daily clinic (triage), isolation triage area (because of the cholera surveillance, that we have had no cholera cases here at J/P HRO camp is testament to our team’s hard work, effectiveness, and ‘quick on their feet’ forward looking management style.), and our little 10 bed tent hospital for the sicker folks, traumas and so on. I’m actually doing what I enjoy, what I’m good at, and what I’m trained for, so please don’t worry about me. I am happy, healthy, but feel sometimes, as I roll into my mosquito net, exhausted, I may be too old for this kind of field work. I am the old Grand daddy of this mostly young team again. ha I work with people from all over the world and such diverse backgrounds. Docs, nurses, PA’s, communications, administrators, demolition guys, security professionals, architects, water engineers and so on. We are like family and look out after each other.
Surendra, I am now and have been (during Haiti and after Bosnia and Macedonia) a true believer in the concept of “destiny.” My life’s book was written with a most important chapter: you taking me under your wing at Newman as a young hippie military vet. You remember? Little did any of us know that Newman, you or I had begun the preparation for the previous Balkan tours and these weeks in Haiti. Thanks and my gratitude as always. I will talk to you on arrival home. All my best to you and your family,
John
PS: Hurricane Thomas prowling around, battening down this AM for a possible mid week arrival, poor, poor Haiti if it blows in here.
Side line, Sean Penn (founder of J/P HRO) is due back today. When in country he lives with us, sleeps in the same conditions, eats with us and seems to be good man. it doesn’t matter if one agrees with his politics or not, at least he is doing something when most all others have seemed to have forgotten Haiti. He deserves any accolades received.
Sent: Sun, Oct 31, 2010, 11:36 PM
Halloween, Sunday
Howdy from the JP house, campground, and trailer park. Have a day off. Crew spontaneously had a party on the verranda last night and blew off some stress and fatigue. Thought i hadn’t slept, but awakened to the sun coming up this AM. Slept in to 6 AM.
Had time to organize my hospital pack, find a pair of high top rubber barn boots with good clete soles, trim my nails, treat Julie’s torn toe nail, send a few emails (we are trying to nurse back to health our hospital tent mascot, an emaciated, mangy pup, with one good eye named Pirate.), and unfortunately looked at weather.com.
Projections of Hurricane Tomas are looking a little scary and hoping it will change course or burn out before possibly hitting us on Friday. Plans are in place to break down our entire medical compound, cholera isolation tents and anything that isn’t solidly tied down to ride out the blow. Am admittedly a bit nervous as i’m a hurricane virgin, but also a bit excited to experience it. (Stupid I know). Worry it may delay my departure on Sunday next, but if he gets us straight on will be needed here anyway for a few more days. (Freda, I am not voluntarily going to extend but won’t leave if I’m absolutely needed after the blow).
last night . Sean Penn came back in. Had a chance to talk to him for a while at the airport awaiting the cargo flight. Just a regular guy.
Pulled out of my relaxed state for a work party, 5,000 cots for the cholera outbreak on a flight. 3 hrs of waiting 1 hour of loading, somehow 4,500 cots missing somewhere. All are very tired and somewhat frustrated.
Still no cholera in our camp, unfortunately will be some carriers in town for the holiday from St. Marcs, the epidemic area. Hopefully we will only get a few cases, or even none. So far quite the trip, with Tomas on the prowl now south of us, never a dull moment. Haiti just can’t get a break. Looking forward to heading home next Sunday, more later hopefully, JR
Sent: Fri, Nov 5, 2010, 5:14 PM
Good morn typing as fast as I can as we may lose power. Winds shifting and Tomas is sure taking his time getting here. Think he’s moving towards Jama now. pity them, but better them than the Haitians right now.
Latest update, Tomas out on the peninsula, moving towards us with 85 mph winds. Think is going to be a long day for us and longer for the poor Haitians down in the camp itself. feel helpless at times, packed 20 first response kits for the poorly trained local camp first responders, but don’t think a bandaid and antibiotic ointment will quite fit the bill. we won’t be allowed down there if its deemed unsafe by our director.
But hey, Sean Penn may do a Sean penn and head on down, think he plays himself in his movies. ha Good story, had a one day old born with part of his guts outside his abdominal wall. Wasn’t feeding at the breast. All hospitals and our usual referrals overflowing, no surgeons at present and felt the likelihood of baby’s survival not good. Ran out of options, felt a bit helpless, called Alistair (country director) for suggestions. This is in the middle of cholera, and battening down for hurricane Tomas. 20 minutes after my call, a truck rolls in, Sean jumps out and says where’s the baby? We did finally find a peds unit with the help of the NGO community and some great docs around the island to at least get the baby to a place where they can tube feed, and hold on until the peds surgeon gets back in the next few days. Sean penn is the man.
Hey, not depressed yet?? story from our team in St. marc’s, cholera epicenter. Young woman delivers baby, shortly later gets cholera, on a cholera cot crapping her fluids out, husband at the bedside gently cleaning her up, puts the baby to the mom’s breast even though she was unconscious. Don’t know if she survived or not. Poor, poor Haiti.
4 PM now, weather not so bad, soaked, 10 lbs of mud on my boots, everything covered with mud, camp hanging in and was allowed out of the house to build another cholera kit for city of Hinche and our team, ended up with a girl with subarachnoid hemorrhage rode with Beth 2 doing airway and trying to stop the seizures to the General Hospital, which I’ve had the displeasure of being at 3 weeks ago and is a place of horror, and cannot describe what i see there without almost blubbering. I have nightmares everytime I go there and will not detail what I saw.
on a lighter note, Tomas didn’t get us to hard, wind was manageable, nor mud slides yet, but am soaked , muddy and tired. Its essentially a quagmire in the camp itself when I went down to the “school house” to check on the disabled temp. housed there. They were ok, and have some Haitian friends I’ve made over the past few weeks in there. was relieved they were high and dry.
Enough for now, feeling lucky, now if my luck holds, the airport will open by Sunday and I can head home. Doc mike and Doc Ian got cancelled, hopefully they get out by tomorrow. Ready to go home. Love to all, JR
Sent: Tue, Nov 9, 2010, 6:50 PM
Hello everyone,
I’m holed up on the farm. Making the jump mentally from Haiti to Pa. Is a strange feeling to be caught between two places you can call home and care so much about. Return from Bosnia was similar, so was prepared this time. Actually doing fine and think maybe tomorrow I’ll be ready to venture out and socialize a bit. Freda is spoiling me and kinda like it, so may play it for a while. Nice to be in the cool North, wear a stocking cap and jacket and even slippers. Have to admit I miss my flip flops at night, but not the drenching sweats. Awoke last night and wondered where my mosquito net was, ready to grab my mag light and search for skeeters, centipedes, and other varmits until I realized I was home in my own bed next to Freda.
Mother nature welcomed me home with freezing fog this AM, quite a site. Comfortable with a good cup of coffee and our old dogs laying at my feet, snoring and kicking in their dreams. Hot showers until I think I’m water logged and scalded a bit, and think I finally got the diesel smell mixed with smoke out of my hair (what I have left), and the mud from out from under my nails.
Last few days have been confused, almost schizophrenic in nature. The hurricane came through the channel between us and Jamaica, and actually spared us.
Sent: Wed, Nov 10, 2010, 3:20 AM
As I said, about hurricane Tomas, we were spared the brunt of the storm and had heavier rains and winds from routine squalls earlier in the month. He did his damage though by making us suspend operations for three days and wearing down all our crews with the breakdown and set up again of the entire medical compound. He also made it difficult to get our outbound cholera response teams and supplies out to the central plateau and the disease epicenter. I’m now watching news reports of the possible spread to a slum in Port Au Prince and just holding my breath that it’s just the press sensationalizing and being their usual idiot selves. Fictional example, but close to the truth……sound check, make sure hair looks good, disaster reporter pose with a good camera angle and finally go live and ask a tearful mother whose child just died “How do you feel right now?”
Think a good response would be to muss up the blonde’s reporter hair, give her a big wedgie followed by a stinky mud bath…..“I feel kinda like that!” Thankfully the Haitians are more gracious and kind than me.
Tomas did close the airport, so those of us who were due to rotate out were going to be out of luck getting home for a while because of the back log of passengers stranded. I must admit I was exhausted and ready to cry “Uncle.” Don’t think physically I could have helped the team rebuild the camp med. compound. (They did I hear and had a barebones hospital back up and running in a few hours after my departure). Doc Ian (British Columbia) and Doc Mike (Denver) were all ready 2 days late and I was ticketed the next day. Of course, Sean’s the MAN as usual. He had chartered a plane to get back to Miami from closed down Port Au Prince in order to hop a commercial flight to LA for a short visit with his family and other commitments scheduled. He invited all of us to fly out with him. So, 2 hrs after slipping out of my stinking muddy boots and rain gear I boarded a Lear 55 jet and enjoyed the ride of a lifetime. Chicken salad sandwiches, cokes, little bitty cups of peanuts, the morning newspaper, all of us yacking back and forth, feeling a special bond that was shared between only ourselves. Dare I say brothers? it is the same with soldiers and all disaster relief field teams I have worked with whether convoying out of snowy Sarajevo or bouncing in a truck down muddy ruts on the Kosovo frontier. People get tight quick in adverse situations because you all take care of each other, like a family…dirty and stinky family, but a family just the same.
Freda and John Pyles
I love you all, and now to bed for a good sleep. JR
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Editor’s Note: Pyles and his fellow volunteers paid for all personal items during their time in Haiti. Donations to the J/P HRO were used only for humanitarian purposes.
Tags: Bosnia, Freda Pyles, Haiti, Hurricane Thomas, J/P Haitian Relief Organization, J/P HRO, John Pyles, Kosovo, Macedonia, Oxfam, Professor of Biology Surendra Singh, Sean Penn, The Balkans