Friday, May 21, 2010

A new start

MGHfC provides comfort and care to young girl and her mother from Haiti

CARE AND COMFORT: From left, Benjamin, Curran, Gedline and Ginette

The media's coverage of the destruction and sorrow in Haiti following the Jan. 12 earth-quake may have slowed, but the grieving and efforts to rebuild are still in the early phases. The following is the story of 12-year-old Gedline Agard and her mother Ginette LaForest. With help from their faith and the assistance of volunteers from across the world, including from the MGH, they are recovering.

When the earthquake struck, Gedline was at her school in Port-au-Prince. Tragically, the building collapsed with everyone inside. Gedline's father was running to the school to find her when another building's wall fell on him. He died from those injuries several days later.

Gedline and her schoolmates were placed in a morgue, says Ginette, whose brother went to recover the child's body. When he saw his niece, however, he realized that she was not dead. Her wounds -- a head injury, broken spine and fractured femur -- were critical.

Along with thousands of others injured, Gedline was treated in a field hospital, where she spent nine days. Due to the severity of her injuries, the U.S. military transferred her to the USNS Comfort, a U.S. Navy hospital ship docked off Haiti.

"On the ship, she was transfused with red blood cells and underwent surgery to fix her broken femur as well as a spinal fusion for her spinal cord injury," says Marjorie Curran, MD, unit chief of Pediatric Group Practice and director of the Pediatric Coordinated Care Clinic at MassGeneral Hospital for Children (MGHfC). Curran helped care for Gedline while deployed to Haiti with Project HOPE Jan. 26 through Feb. 16. The MGH deployed dozens of caregivers to Haiti with Project HOPE, the Disaster Medical Assistance Team, the International Medical Surgical Re-sponse Team and Partners in Health (PIH) in the aftermath of the earthquake.

When it was apparent to Curran that Gedline would need additional services that could best be delivered in the United States, she began the process of bringing her to MGHfC by contacting Ronald E. Kleinman, MD, physician-in-chief of MGHfC. He told Curran to move forward and arrange for Gedline's care at MGHfC working with PIH, the U.S. Navy and Spaulding Rehabilitation Hospital.

While appropriate and safe travel accommodations were being made to bring Gedline to the states, her condition deteriorated. The Comfort had left Haiti, and she was receiving care in a local hospital. Her injuries left her unable to urinate, and the catheter that had been put in place had led to recurrent urinary tract infections that rapidly became resistant to antibiotics. Unable to move her legs, Gedline lost 20 percent of her body weight.

"She likely would have died if she had not arrived at MGHfC when she did," says Curran. "She wasn't eating because of the pain and fevers from the infection. The infection and weight loss would have killed her within a few weeks."

MGHfC resident Phuoc Van Le, MD, MPH, who had been working with PIH, flew with Gedline and Ginette from Haiti to Florida and cared for Gedline while they awaited transport to Boston. When she arrived at MGHfC April 15, a medical team treated Gedline's infection and provided pain medicine. William Butler, MD, of Pediatric Neurosurgery, reviewed her case and determined that she did not require any additional spinal surgery. Rafael V. Pieretti, MD, of Pediatric Urology, provided a plan for catheterization and bladder training. A team of physical therapists and nutritionists began the hard work of helping her regain weight and muscle function.

Ellison 18 pediatric nurse Kiki Benjamin, RN, who emigrated from Haiti more than 20 years ago, has become close to Gedline and Ginette. She has not only provided care, but she also has translated for the family and spent time with them during her off hours. She has offered much comfort and support, bringing them Creole food, clothing and serving as a compassionate and caring friend.

Today Gedline is recovering at Spaulding Rehabilitation Hospital, where she has taken her first steps and can stand for short amounts of time on her own.

"She is regaining control of her bladder," says Curran, who also has a special place in her heart for Gedline and Ginette and often visits the two. "Her recovery is especially miraculous given the elapsed time between her spinal injury and her spinal fusion. She has exceeded all of our expectations."

When asked the first thing she would like to do when she leaves the hospital, Gedline says that she plans to go to church to thank God for saving her. She also looks forward to going back to school.

Since the earthquake, Ginette has not left Gedline's side. She often thinks of her other children in Haiti -- 1-year-old twin daughters Brianna and Rianna, her 9-year-old son Junior, and her 17- and 19-year-old daughters Waneska and Joanne -- who are being cared for by family members.

"I need to be here with Gedline at this time," she says. "If I had 20 children and one was sick, I would be with the one who needs me the most. I pray for all of my children every day. I thank God for saving them, and I thank God for Marjorie, who is like my angel. I also am so grateful to Kiki and all of the doctors and nurses at the hospital."

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