Dr. Patrick Ulysse (Part 1): "Life changed. Everything changed."
Voices of Haiti – Patrick Ulysse (Part 1): “Life Changed. Everything Changed.”
[Voices of Haiti intro begins]
Patrick: It was kind of surreal
Loune: I was there just after the earthquake. You have all the aftershocks…
Dimitri: And I could see all the chaos and destruction.
Anany: Why I should continue to live if all this have to happen to me?
[Intro fades out]
Leslie: Byenvini or welcome. I’m your host, Leslie Friday. Thank you for listening to Voices of Haiti, a Partners In Health podcast that shares the stories of our Haitian colleagues as they reflect on the January 12th 2010 earthquake.
Today, we hear from Dr. Patrick Ulysse, the chief operating officer for Partners In Health. Before this role, Patrick was the executive director of PIH in Liberia, where he helped rebuild the country’s health system after Ebola. But even before that, he worked in his home country of Haiti with Zanmi Lasante, as PIH is known locally.
Patrick: I start with Zanmi Lasante now maybe 14 years ago, when I start as a General Practitioner. I was managing the program of HIV and TB patient at Petite Riviere, which is a Zanmi Lasante health center. This health center was a community of um, about a 130,000 people which is in the Artibonite region in the northeast of the country.
Leslie: Zanmi Lasante primarily works in two regions within Haiti: the Central Plateau and the lower Artibonite. In 2010, the facility where Patrick worked in Petite Riviere was modest, but he and his team had worked over time to equip it with the right staff, stuff, and space to meet patients’ needs.
Patrick: Is a health center with few inpatient beds having the capacity um, to do cesarean section um, because we-we built a operating room at this time because the health center used to receive um, more than 2,000 women coming to having safe delivery of their baby. Usually you got like 40% of those women would need a c-section. Um, and we decide to have this operating room at this time.
And outside of that, where we used to see patient with HIV, we try to provide like drug, make the IV available for them. Provide them food, social support, um, and also supporting their kids, and keep continue to provide basic services like for child, for adult. That was the kind of classic and normal activity we used to do at Petite Riviere at this time. Before the earthquake.
Leslie: Before the earthquake. Before the earthquake, Patrick led the medical team at a health center that did normal activities: prenatal care and deliveries, well child visits, outpatient services, and even specialty care for patients suffering from TB or living with HIV. But all sense of normalcy evaporated with the earthquake.
Patrick: This afternoon of January 12, is still clear in my head. Um, where I was in a meeting with a group of, um, health center staff and different partners. We were working and discussed um, about a plan for humanization program. Um, and I remember that none of us, um, understand what's going on. And when we got the first um, tremors like shaking and-and everybody feel like "Did you feel what I feel, or it's in my head or this thing happen?" But, we didn't know clearly this is the earthquake. And what we did, we said "Okay", seeing the glass of water shaking on the table we said "Okay, let's leave the place, let's continue the meeting outside in the courtyard."
And that's what happened. And a few minute after, I think, we heard from a small radio with someone, um, it was the security guard um, there, and we heard like the capital has collapsed, um, the palace has collapsed, um, people are dying and I think that was the end of the meeting and that was the end of everything. The world changed. I think that was the time I say life changed. Everything changed. That's why I exactly I remember this afternoon of the 12th.
I think one of the first thing we did, we tried to call um, other colleague in the capital, and when we see the phone, um, cannot going through um, now the first thing I did, I call everybody from the staff like the security guard, the nurse, the doctors, the volunteer at this time, everybody. And I remember we say "I'm trying, we're trying to reach our people to the capital, we cannot reach out to them. This is the information we got about the-the palace and everything is kind of collapsed in the capital. We don't know what to do, clearly, but let's imagine or let's figure out what we'll do if we start receiving injured patient here."
Um, and I recall again um, what the nursing director at this time say. He say "You remember it's not about like, your job title like, you are a physician, you are a nurse, or you are who you are, or security guard. It's not about that. If needed, you as a doctor, you may need to clean the floor and you as a security guard, you did-you may be needed to support like the triage of patient. We really need to be one to try to fix that." That was the plan we put in place at the moment.
Leslie: Because they all needed a plan desperately right then, a next step. Inaction wasn’t an option. But how do you know what to do in that heartbeat after disaster, when the world as you’d known it just flipped upside down?
Patrick: And I think this is the feeling sometime, you f-feel you want someone to tell you what to do (laughs). You expect "Hey tell me what to do, because I don't know what to do." And, but ... what was agreed we say like "We need to go to the capital." Um, we don't know what's going on, if we cannot have the information, we need to go. And it was like 3 a.m., like kind of the day before, like, we spend the afternoon talking, trying to figure out what to do. Um, when I took a car and a driver with a first um, aid kit like to start the journey to Port-au-Prince and as we approached to Port-au-Prince, we ... it was kind of surreal, like I could see it, but you could not imagine, like that's really what I-what you saw. And all of it was like, nearly like impossible. You cannot cross it because you got a lot of debris, you got a lot of body everywhere and-and you meet a lot of people like with car, or walking, on motorbike try to continue to travel from the capital to the North um, seeking for care and we keep sharing all the painkiller we have with us, like, for people and let them go-keep continue to go away, continue away to the capital, I think, yeah. That the only thing we think we could do at this time, yeah.
Leslie: Before he left for that first trip to Port-au-Prince, Patrick and his team tried to think about what he would need to respond to survivors along the way, and they packed and packed as many things as they could into his vehicle knowing that it would never be enough.
Patrick: We start doing the basic thing like things you need for um, like painkiller, like bandage, those kind. And again, I remember the nurse saying, director at this time say "Oh, take some water." (laughs) "Bring some bread, let's pick some food, we never know". It was funny, like, and we are to the ambulance we say, “go with it”. And I don't think we-we reached Port-au-Prince with some of the drugs or painkiller but the water, the food was gone like on the way, because we start doing the distribution, things like that, yeah.
Leslie: The magnitude of need only grew as he got closer to Port-au-Prince. Ultimately, he wished he’d brought more of everything, but he especially wished he hadn’t gone alone.
Patrick: Maybe more than one ambulance. I wish I got more than one ambulance on our way to Port-au-Prince, yeah.
Leslie: Patrick and his driver made their slow journey back to Port-au-Prince, with regular stops to provide aid and assistance. A trip that would have taken an hour and a half on a normal day, took 4 to 5 hours that morning.
Patrick: It was like you got the traffic, but the traffic is not because you have a lot of car, it's like people and the road wasn't um... have a lot of body and um, debris at this time.
The city was chaos. Like a mess. Street and building, they not exist like the way they used to. Um, when we heard of this, that we cannot contact people, and we say the first thing we have to do is like "Let's go to the General Hospital."
We ... at this time was the largest public hospital um, to the country. We say "Let's go there", because maybe people will send people ... let's go there. Um, when we reached there, we could not enter to the hospital because the driveway was full of people on the floor. And-and people with broken leg, and with a lot of dead people also on the driveway. And I could say for more than three days what we did is go there, spend some time, help the team moving like dead body, separate dead body to people alive, take people to the car and move with them to the North and do the distribution for any hospital you can find on your way. At this time, maybe one or two. Um, keep continue to move with them to Petite Riviere.
Leslie: In those first chaotic hours, Patrick made multiple trips transporting patients from Port-au-Prince to the interior of the country, transferring them to any hospital that was open and could give them care, including Petite Riviere. He worked tirelessly, as if part machine. He was on autopilot. Until the day he wasn’t.
Patrick: I think that was day two, like two day after the earthquake. Um, when going back and forth to the General Hospital, to Petite Riviere um, and I went back to General Hospital to pick up patient and I met someone say to me, um, "Hey, um, do you know Honore is there?" And I say "What?" He said, "Yeah, Honore is there, you could move and you would see him." And Honore was a-my colleague, well he was my colleague. And he is a physician, we do our training together and ... and I saw him laying on the floor.
Leslie: Patrick met his friend, Honore, in medical school in Haiti. It was the first time he saw someone he knew, and suddenly something shifted in how he viewed the tragedy in front of him.
Patrick: Both of his hand was broken, with one leg also. And I'd feel like until that moment, I've been moving, like, so quickly. I wasn't feeling it was real. I was like, yeah, like something surreal, you just have to move.”
And when I saw him, I feel like I came over to the reality. To say, “Wait a minute, Honore should be with me, moving and pick up patient to-to go there. Now he's on the floor between other people now who are suffering and dead body.” That's bring me back to say, “Okay.”
And what's shocking me, I say, “Okay, Honore, we have some painkiller, like-like, take them." And it was clear when he say, “No, like, um, give it to other people because I'm going with you. Start doing that.” And I say, “Okay.” I feel like now somebody was the one tell me what to do, okay and I start giving nice, “Okay, let's go.” And he say, “Okay, take those people also with you, Patrick.” I say, “Do you know them?" He say, "No but I don't think they have any choice. Just go with them."
Honore, um, had been with his fiancée and his brother when the earthquake happened. And when I saw Honore, like moving to, back to the hospital, he keep asking like, "Do you see my brother? Do you know where is my fiancée?" And, I think the next day we find his brother and, and we got the information like, his fiancée died, um, from the earthquake. Um, I think it took me like two or three days to tell him that because I didn't know what to tell him. Like, “hey, this is, this is what happened”. When, when I know what he was going through. When I know the way he was suffering.
I don't feel at this time I heard Honore as a physician. Honore was the one who was suffering. He was the one who had breaking leg, breaking hand, arms. He was the one who lost his partners. But he was the one who keep telling us, "Oh, we have hope. We, we need to keep pushing."
I think when you see, those kind of things, that gives you more energies, energy to continue to do more.
Leslie: Tune in next week to hear the rest of Patrick’s story, and how he and Zanmi Lasante went on to manage 4 camps for the displaced in Port-au-Prince. Continue to learn and explore more stories about Zanmi Lasante and PIH by visiting P-I-H-dot-org-backslash-haiti.
Follow Voices of Haiti on Spotify, or subscribe on Apple Podcast and now on Google Podcast. Also Rate us! Let us know how we’re doing. And look for us @partnersinhealth on Instagram or @pih on Twitter, and DM us with any comments or questions. As always, thank you for listening, and we look forward to sharing the rest of Patrick’s story next week.