Wednesday, February 17, 2010

Injured Haitian earthquake survivors' fate is unclear after treatment in the U.S.

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Washington Post Staff Writer
Tuesday, February 16, 2010



MIAMI -- From down the hall, a high-pitched voice speaking Haitian Creole came booming into Clermond Junior's little hospital room. 

"Junior, sak pase?"
-- what's happening?

Myrtho Gracia, a Haitian American nurse, sashayed through the door holding a blue plastic-foam box over her head like a waitress and carried on as though she and Junior were in the middle of Port-au-Prince. "we have curried chicken for you."

Junior, 19, smiled for the first time in hours. "I will enjoy this," he said in Creole, turning away from the half-eaten lunch prepared at Jackson Memorial Hospital. He seemed to forget for a second that half of his body was broken, that his useless left arm lay on his lap like a dinner napkin, that he could slide his thin left leg only a few centimeters, that his slowly healing head wounds, opened by the wall that buried him for two days in Haiti, itched like crazy. He eyed the greasy chicken curry. "I never had it, but I know I will like it."

America is another experience that Junior has never known but is certain he will like.

"Haiti is gone. Haiti is no more," he said, describing the rush of emotion he felt while viewing pictures of the devastation on a news Web site. In Haiti, he had few employment opportunities even before the Jan. 12 earthquake, and now his mother sleeps outdoors there because their house collapsed.

He is ready to embrace America, a fabled land that people in his Port-Au-Prince neighborhood could only talk about. In Miami, his life and his limbs were saved by his Haitian American doctor, Angelo Gousse. Haitian American workers, of which there are many at Jackson Memorial, often stop by to chat, treating him like family.

But Junior isn't part of the American family, and there are questions over whether he should stay here. Gracia would like an answer, saying she would take him in if she could. Opponents of illegal immigration would also like an answer. Some say Haitians should not have been brought to the United States for treatment, while others say they deserve medical attention but should be flown back as soon as they recover.

The question -- stay or go? -- could become a major headache for the Obama administration. Unlike Cubans, Haitian immigrants are often unwelcome in the United States, a double standard with roots in Cold War politics. But advocates for the patients point out that Haiti, one of the poorest nations in the world, lacked adequate health care even in the best of times and that the injured who were saved might be sent back to die.

An uncertain fate

The total number of patients brought to South and Central Florida is about 500. Junior, with his wispy, boyish mustache and fuzzy sideburns crawling down his cheeks, is one of 105 Haitian nationals being treated at Jackson Memorial's Ryder Trauma Center. Hospital officials said charges for the Haiti patients total just under $7.7 million so far, nearly two-thirds of which has not been covered by insurance or other sources.

Some victims are babies without parents. And some are fairly well-known, like Romel Joseph, an esteemed violinist trained at the Julliard School, who survived a three-story fall from his New Victorian Music School during the quake. His back was impaled by carpenter nails in a wall, which crushed his left leg and broke three fingers on one hand.

Their presence in Florida has already generated controversy. Two weeks ago, medical airlifts from Haiti were halted when Florida Gov. Charlie Crist (R) complained that, while the state was willing to help, the U.S. military was overburdening it with earthquake victims.

The federal Department of Health and Human Services activated the National Disaster Medical System, which reimburses hospitals for treatment costs. At the same time, the U.S. Agency for International Development started flying patients to Atlanta area hospitals and identified Washington, Philadelphia, New York and Boston as places willing to take patients.

But unresolved is the question of what the future holds for Haitians granted an array of visas to enter the United States. Will they be allowed to apply for Temporary Protective Status, forced to leave, or will some be allowed to walk out of the hospital and blend in with Haitian immigrants in their communities? U.S. Citizenship and Immigration Services said it has yet to determine how to track earthquake victims in this country once they're well.

Protecting her 'baby

Junior said he missed his mother, Suzanna Lindor, and his three sisters, who escaped the earthquake without harm. But, he said through an interpreter, "I would be dead if they had not brought me here." Gousse, his doctor, nodded in agreement.

On Jan. 12, Junior turned on the shower on the second floor of his house and climbed in after checking to see if the water was warm. He was talking to a friend through the curtain when the earth shook. They ran downstairs but didn't make it to the door before a wall and metal grate tumbled down, trapping them for nearly two days.

The falling debris crushed muscle, cracked bones and opened flesh. Dead tissue sent a toxin into Junior's body, causing his kidneys to fail. Gousse came across Junior at the University of Miami medical station set up near the Port-au-Prince airport six days after the earthquake.

"He was swollen," Gousse said. "His face was swollen. He's a thin guy. He was swollen twice his size. He couldn't make urine . . . and the liquid was building up in his body."

Junior needed kidney dialysis. "He didn't need surgery," Gousse said. "You just needed to take over the function of the kidney with a dialysis machine until it's better."

But Haiti couldn't provide that. "The way he looked to me, based on my clinical experience, he would not have made it more than 24 hours. He had difficulty breathing," Gousse said. On Jan. 18, Junior was flown to Miami and placed in Jackson Memorial's intensive care unit.

"He was the baby on my floor," Gracia said. Other Haitian American workers kept popping in to check on him. "We would babysit him," Gracia noted.

Last week, Junior had recovered enough to be released to the hospital's general care unit, and Gracia followed him.

"I have two sons, two grown kids, they're gone," said Gracia, who emigrated from Haiti when she was 18 and has worked at Jackson Memorial for 24 years.

"I am a proud Haitian." She looked down at Junior, a soft-spoken teenager whose future is as cloudy as the dust that shrouds Port-au-Prince.

"I don't mind to get him in my house," she said. "Especially him. He's the youngest guy to come into the ICU. Others have a wife. He's the kid of the floor."

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