Audio: Haiti's 'crush' victims receive life-saving care

My name is Stefaan Maddens, I am 47 years old, and a nurse in nephrology. It is my eight mission with MSF but this is the first time I have come to the field for an earthquake. I have been here since Friday.

Something that happens in earthquakes is that patients, or wounded people, they stay a long time in the rubble and once they get out of the rubble with crushed muscles and so many tissues that have been damaged that a lot of toxins come free from the leg, for instance, and so much that sometimes that the kidney fail to remove all of this and the only solution is to give them dialysis.

Crush syndrome is acute renal failure. Normally all crush patients are going to die or they are going to live, because at a certain moment the kidney function restarts, and this can be after 24 hours, after two days - and sometimes some patients with crush do not recover, so those people become chronic dialysis patients. So for them, now, there exists the opportunity to treat them for long life with dialysis.

We were very lucky because we found a dialysis centre in l’Hopital Generale. It was broken down, there was no water, there was no electricity because of the earthquake. But with the MSF logisticians we could restart it in 36 hours. But once you have established your renal unit and you can communicate it to all the other medics around the town, at that moment we had an influx of patients with crush syndrome. On Monday we had the first patient and on Tuesday we already had six and yesterday we had eleven - so it is going to grow very fast now.

It is difficult to tell how many. From experiences in earthquakes in other countries, sometimes we have dialysed three or four hundred people. For the moment, we only have 20 but this can grow very fast. That’s the reason also for the scouting team, and we have decided to send in more nephrologists, more nurses, more equipment because we think we will have to dialyse some patients with crush syndrome of the next few weeks, at least.

It is quite unusual that six days after the disaster you still find so many crush patients, because normally you have to be as early as possible, but we have seen that, the day before yesterday there were a lot of patients that were referred to our centre with crush syndrome so we think there are still patients to come, a lot of patients to come.

We also actively try to detect the patients but the most important thing we have to do is communicate to all the surgeons, all the doctors that are working here in Port au Prince, not only MSF staff, of course, but to everyone who is now working with the wounded patients that there exists a possibility of treating renal failure.

We have a total capacity of seven machines and this means we can go up to 35 patients a day we can treat and for most of those people this is really life saving.

Sometimes they recover in 24 hours and they need only one dialysis [treatment], sometimes it needs three, four, five, six treatments each day, sometimes it takes three weeks, and sometimes they never recover.