Dear Colleagues:

We have been awed by the stories coming from AAOS members on the ground in Haiti. Since the earthquake on Jan. 12, the AAOS has confirmed that 182 orthopaedic surgeons have been deployed to Haiti. Another 500 volunteers are standing by.

These initial stories all reinforce the long-term need that the Haitian people will have for orthopaedic services and humanitarian missions. Again, I assure you that if you haven?t been called upon yet, do not become discouraged. There will be time to serve and people who need your skills in the months to come.

Let me share with you some of the most striking comments from our members?

Timothy D. Browne, MD: Just returned from Haiti with Hope Force International. We were partnered with World Relief, Medical Teams International, and SIGN in Port au Prince at King?s Hospital. It is a fully functioning hospital with approximately 60-bed capacity and two fully (now) functional operating rooms. Our teams were doing approximately 10 cases a day?wash outs of open fractures and stabilization, amputations, IM nailing of femur fractures using the SIGN nail. The amount of orthopaedic trauma is unprecedented.

Many hospitals have not had electricity or sterilization. Most patients are without X-rays, and we know of no facility that has a c-arm. Hope Force International was able to secure and transport a new anesthesia machine to the hospital. USAID helped in getting the machine to Port au Prince and the Canadian military delivered it to the roof of the hospital by chopper.

No time in history has there been such an event that created a total collapse of the country?s main infrastructure. Many volunteers have been frustrated about not being able to get in country and help, but people need to understand that this is very much like a war zone. Just the logistics to house and feed the current volunteers is a tremendous challenge.

This tragedy has created a huge opportunity for the orthopaedic surgery community to respond, and it will be a long-term project. All these fractures that have been provisionally stabilized will need definitive treatment. Untreated fractures will need addressing. The unfortunate complications, nonunions and malunions will require care.

Robert D Loeffler, MD: Just returned from a week in Haiti (with University of Miami Medishare project). I would urge you to let Academy members know that there appear to be enough orthopaedic surgeons with respect to available facilities and equipment. The greater need will be in a few weeks or months when the media attention begins to wane but the orthopaedic needs will increase as the non?life-threatening injuries decrease but the vast number of fractures and other injuries need attention.

Brian S. Parsley, MD: It is a bit overwhelming to see all the destruction that has occurred as the result of a natural disaster?It looks like an A-bomb hit this city?entire areas without a house standing and people all living in the streets ?

Please don?t believe the negative news reports that question where are the Americans and why aren?t they doing more. I am proud to be an American and proud to be here representing my country caring for those in need. We all are doing the best that we can with what we have ? It is impossible for anyone to step into a country that has little healthcare infrastructure in place in the first place and is light-years behind where we are in the USA, and add to that the destruction of what little they had left and then have this type of disaster that requires tremendous resources to address. This is an impossible task at any time, at any place, and anywhere ?

I feel like the M*A*S*H series when you hear the helicopter coming and Radar O?Reilly announces their arrival. It is either feast or famine. The patients are now a week and a half out from their initial injuries and in need of secondary wound care and external fixation ?

The situation appears to be improving on a daily basis based on reports here from all those we meet but it will take months to years. Once the acute situations and needs are addressed, the multitude of secondary procedures that will be needed. The challenges of rehab and the need for prosthetics will be incredible due to the number of amputations.

Seth Sherman, MD; Gary M. Sherman, MD; Mark F. Sherman, MD, Michael R. McLean, MD: Along with Travis R. Von Tobel, MD; Dapeng Fan, MD; Patrick Yost, MD; and an industry surgical instrument representative, we have just returned from 4 days at a Haitian border town hospital in the Dominican Republic. Approximately 65 surgical orthopaedic procedures were performed in a 48-hour period. ? As we were leaving, several truck loads of massively injured people arrived, adding to the hundreds already at the hospital. This was so terribly frustrating. What was salvaged was miniscule in comparison to what needs to be done.

John F. Lovejoy Jr., MD: We now have about 50 volunteers, have received about 300 patient and done over 160 surgeries. It is a bit staggering considering that we have been here about a week. Every new group is so enthusiastic they want to change forward. We have to remember we are guest at their hospital and they have been working 16 or more hours a day since the earthquake and are physically and emotionally stressed.

We are all okay; our bodies are fatigued but our spirits are high with the knowledge that we have given our best effort to make a difference in others? lives and that helps to ease the anguish of this experience.

Timothy C. Gueramy, MD, and Joel H. Hurt, MD: A driver for one of the teams is a survivor from the earthquake. He was on the ground floor of a building with 50 or 60 other people when the quake hit. He was crushed under rubble, pinned down. He heard people screaming and dying slowly. He reached his friend?s hand and held it until she died. Another friend dug him out. Twelve other survivors had gashes, wounds, amputations. He was the only one walking with barely a scratch. He said, ?Why me??

As orthopaedic surgeons confronting the results of traumatic situations?whether motor vehicle accidents or earthquakes?we have all heard that question. We know there is a reason?because our work is not yet done.

The AAOS is continuing its efforts to find ways to facilitate the movement of orthopaedic surgeons and medical equipment to Haiti, and to develop plans for bringing Haitian patients to hospitals in the United States for definitive care. As these plans are finalized, we will keep you informed. We encourage you to visit our dedicated Web site, www.aaos.org/haiti, on a regular basis for the most up-to-date information, and to remember your comrades in Haiti and their patients on a daily basis.