By SCOTT TRAVIS
Miami Herald
MIAMI – Five years after they treated earthquake victims in a Port-au-Prince hospital, some University of Miami physicians are again assisting Haitian patients, now from 1,100 miles away.
The University of Miami Miller School of Medicine has launched a telemedicine program that provides doctors at a Haiti hospital with access to around-the-clock medical support through live video communication with UM trauma specialists.
UM’s Miller School of Medicine started a telemedicine program in December in which physicians in Miami consult daily with doctors at Hospital Bervard Mevs in Port-au-Prince, Haiti’s only trauma and critical care hospital. The facility sees a large number of adult and pediatric patients with a range of critical injuries and conditions, but its physicians don’t always have the best access to supplies and training.
“These are great doctors doing the best they can, but they don’t always have the best advantages,” said Dr. Carl Schulman, a professor of surgery who specializes in burns and critical care. “We often provide direct advisement and support or acknowledgment that they’re doing the right thing.”
Schulman works alongside two other UM physicians, Dr. Antonio Marttos, director of trauma telemedicine, and Dr. Antonia Eyssallenne, assistant professor of internal medicine. Eyssallenne, who is fluent in English and Haitian Creole, travels between Miami and Port-au-Prince.
“Haitian doctors who staff the hospital will be a lot more comfortable and confident doing trauma stabilizations with a UM doctor virtually by their side,” Eyssallenne said. “Although the basics of stabilization are in place and can be done by the majority of the Haitian staff, there are cases that require more sophisticated and specialized attention to manage properly.”
Common injuries seen are ones from motorcycle accidents, falls from trees and gunshots.
The videoconference is the latest in a longstanding relationship UM has with the Haiti hospital. In 1994, two UM physicians founded Project Medishare, in which UM faculty and residents volunteer in Haiti. Many of the Bervard Mevs doctors have received training by UM physicians, although the Haitian doctors are not specialists in trauma or intensive care. The UM physicians who started the telemedicine program were also among the first responders to the Jan. 12, 2010 earthquake.
UM physicians have also used webcams in recent years to consult on a weekly basis with physicians from around the world, including ones from Colombia, Brazil, Iraq and China.
In the Haiti project, the lead physicians, along with a team of other doctors, nurses, nurse practitioners and students, meet in a conference room of the Ryder Trauma Center weekdays with physicians at Jackson Memorial Medical Center. A webcam connects to the hospital in Haiti.
During a recent videoconference, Dr. Sebastian Mondiere at Hospital Bernard Mevs stood next to a man who had been shot in the chest the night before and was bleeding heavily.
“Can you show me where the gunshot wound was?” Marttos asks.
Mondiere first shows a picture he’d drawn of a patient’s body, with a wound to the lower right side. Then he shares an X-ray. The team in Miami can see the patient’s liver was ruptured. The Haitian doctor used a chest tube to stop the bleeding, and the man’s vital signs were good.
Marttos advises Mondiere to monitor the patient every few hours but warns “if he starts bleeding, he will probably need surgery.”
The videoconferencing effort was easy and inexpensive to set up, UM physicians said.
“The project is phenomenal and literally requires just a laptop and webcam,” Eyssallenne said. “The improved outcome and prognosis for patients will be immeasurable.”