Medical teams in Florida ramp up to care for Haitians
By Darryl Fears
Washington Post Staff Writer
Tuesday, February 2, 2010; A07
TAMPA -- Joseph Perno's cellphone started buzzing at 9 a.m. Monday. The county medical coordinator told him to stay sharp. A C-130 cargo plane, carrying 22 seriously injured Haitians, would be arriving at Tampa International Airport that night.
On the day that airlifts from Haiti to hospitals in the United States resumed after a five-day hiatus because of concerns about costs and overburdened hospitals, Perno asked himself: Where will I put the children this time?
Perno, a doctor at All Children's Hospital, is part of a team assessing Haitian arrivals in need of medical care since the Jan. 12 earthquake. On Wednesday, before airlifts were suspended, he had rushed to a plane on the tarmac with immigration officials, interpreters and emergency personnel, lifted the Haitians' sheets, looked at them from head to toe and made the calls.
"I just do the medical care," Perno said. "I don't worry about someone's insurance or their ability to pay. Wednesday night was one of the most satisfying nights of my career, sad as it was. I want to see the government do what's best for the patient."
Perno didn't know it Wednesday, but the government's ability to respond to the emergency in Haiti had been cast into serious doubt. In a letter, Florida Gov. Charlie Crist (R) told the Department of Health and Human Services that his state was at a breaking point with Haitian patients, 413 of them in the Miami area, 76 in the Orlando area and 37 in the Tampa Bay area, four of whom were recovering in beds at All Children's Hospital on Monday.
In reaction to the governor's letter, the airlifts were suspended hours after Perno stood on the Tampa International tarmac, directing injured Haitians to Tampa General Hospital, which has a burn unit, and the Bayfront Medical Center in St. Petersburg and the University Community Hospital near the University of South Florida, both of which have trauma centers.
A Defense Department official said Florida officials were concerned that the Pentagon wasn't able to provide a clear sense of how many would be coming. "They complained about the lack of a grand plan," the official said.
Crist was criticized in and out of his state for requesting a military plan that wouldn't overwhelm Florida hospitals and for musing about who would pay the estimated $7 million medical bill. Doctors treating Haitians who needed advanced care in the United States reacted sharply, saying the government was leaving patients to die.
Bruce Rueben, president of the Florida Hospital Association, was livid. "When you take the entire state into consideration, we have ample capacity to help out," he said. "There never should have been a question."
"I was puzzled over where it came from," Rueben said. "It certainly didn't come from anyone on the ground that I knew. We had calls from hospitals saying 'How can we help out?' "
Federal officials said Monday in a joint statement that U.S. hospitals that treat earthquake victims with life-threatening injuries will be reimbursed by the federal government for up to 110 percent of rates paid by Medicare.
Questions also arose about Crist's motive. He is in a tight Senate primary race with former Florida House speaker Marco Rubio. Rubio has seized on Crist's appearance with President Obama to accept Florida's stimulus package as a way to question the governor's conservative bona fides. Obama told Haitians that the United States would not abandon them.
Crist said he never intended to halt the airlift. "Let me be clear -- at no time has Florida closed our doors to those impacted by the earthquake in Haiti," a weekend statement from his office said. "To the contrary, Florida has been at the forefront of the crisis in Haiti -- caring for the injured, reuniting families, comforting those who have been devastated by loss."
But Crist wanted other states to help. He asked HHS Secretary Kathleen Sebelius to activate the National Emergency Medical System to distribute the burden of care. She did, and flights from Haiti resumed Monday afternoon, said Col. David Lapan, a Pentagon spokesman.
Which is why Perno's cellphone rang. At All Children's, the three pediatric surgeons, four pediatric orthopedic doctors and nine full-time emergency medical specialists were primed to do the work, Perno said. "When I called them and said are you okay with this, they were like, 'Joe, I'm good. What do you want me to do?' "
But Perno knows that flooding the emergency room after every airlift is no good for the workers. "We hit the hospital with 10 patients, they wouldn't be able to do the job well," he said. "It has nothing to do with how to pay for it."
Florida is a two-hour flight from Haiti. "But maybe the extra time to fly patients to Atlanta is quicker than to fly them here and not have the resources to treat them," Perno said.
At noon, however, none of that seemed to matter, Perno said.
"I got a call back saying the airlift got canceled and wouldn't be coming tonight," he said. "I don't know where things stand."
Staff writer Greg Jaffe contributed to this report from Washington.