On a normal day, Gillian Hotz, Ph.D., would be working in her concussion clinic; administrators Lazara Pagan and Marianne Finizio would likely be in business meetings; Rafael Campo, M.D., would be worrying about employee health, and retired foreign service executive James Vermillion would be in Washington, D.C., far away from this frenzied conference room at the Miller School.
But this is no normal day. This is three weeks after the Western Hemisphere's deadliest earthquake killed and injured hundreds of thousands in Haiti. And this is the command center, now located in the Medical Training and Simulation Lab, where Hotz, Vermillion, Pagan, Finizio and about two dozen other members of the Miller School's Haiti Relief Task Force meet every day to coordinate medical relief in the ravaged country under the umbrella of UM's Global Institute/Project Medishare.
Miller School physicians were the first to arrive in Haiti, just a day after the quake. The task force also formed that day, and the two teams, separated by many miles and much heartache, help each other perform miracles large and small. Under the most dire circumstances, the Miami task force, with the UM medical team in Haiti, worked feverishly to open a 240-bed hospital with four operating rooms less than two weeks after the earthquake left Haiti in ruins.
They've also filled a warehouse to overflowing with medical supplies, wrangled charter jets from devoted donors, pressed government officials into action, signed up 1,400-and-counting medical volunteers, and somehow, some way, managed almost every day to move desperately needed personnel and equipment to a country in complete chaos.
"It was incredible,'' said Eduardo de Marchena, M.D., associate dean for international medicine. "We would say we need this and, magically, it would appear the next day because it had been shipped down by people here on the ground who were working 24 hours a day."
As Miller School Dean Pascal J. Goldschmidt, M.D., noted upon returning from Haiti, the rapid response was made possible by Barth Green, M.D., professor and chair of neurological surgery who co-founded Project Medishare 15 years ago to improve health care access in Haiti.
"Few groups have been able to deploy an effective system, and we were the first to be able to do so because Barth Green and the Global Institute team at UM have such a deep knowledge of the region and its people," the Dean wrote in a letter to faculty and staff.
Now, on this morning, like all mornings since the Jan. 12 catastrophe, a frenzied pace defines the task force activity. With assistance from volunteers, Hotz, a research associate professor of neurological surgery, and Milen Gonzalez, senior practice manager for UHealth Atherosclerosis Center, are ferociously updating a whiteboard with names of medical staff and equiment heading to Haiti on charter flights. Vermillion is on the phone relaying UM's good work to a key legislative aide in Washington. Paulette Richards, executive and administrative manager of the Global Institute, is culling a batch of new volunteers from a list of 1,400 who have signed up.
Charged with fundraising, Jenna Green, a senior administrative assistant at The Miami Project to Cure Paralysis, is reaching out to donors. And Bill Sims, manager of facilities & operations for The Miami Project, is making sure telecommunications and facilities are adequate for volunteers and administrative leaders such as Steven Falcone, M.D., who, along with Pagan and Finizio, is running a tight ship, with room for the expected surprises.
"It looks chaotic but it's really a system of collaboration, coordination and clear communication," says Finizio, vice chair of neurological surgery. "We're making sure there are enough people on the ground and that they have the supplies they need. Having enough food and water is a big deal in Haiti right now. Things are still being worked out, but what you see today is the system we improved upon as we went from day to day."
Finizio and her colleagues will never forget Day One. That's the day, less than 24 hours after the earthquake, Green and his team landed in Haiti and immediately began saving lives amid the ruins and misery. With the medical experts already on the ground in Haiti, the barely formed task force began building a complex pipeline to move personnel and supplies to a country that, in an instant, lost the few resources it had.
"They are the heroes in this," Finizio emphasizes. "They simply wanted to get down there to save people and work on getting infrastructure in place later. Somehow we used all our skills and contacts to pull it all together. But it speaks volumes about the dedication of our medical staff."
Like other task force members, Hotz's duties are many and priorities change minute by minute. She draws on her trauma skills and her knack for making things work when the clock is ticking.
"The days right after the earthquake were rough," she says. "We didn't have minutes, we had seconds. I felt like I was on a trading room floor."
At 10 a.m. each day, the mad rush quiets as the large group gathers for the daily briefing. Medical staff and administrators in Haiti join by speakerphone, benefitting from a far better connection than the satellite phones they relied on during the first few days.
After the Haiti team members identify themselves, Finizio and Pagan, chief operating officer and chief nursing officer for University of Miami Hospital & Clinics, ask for updates: Any problems? Is security adequate? Are there enough people? Specialists? Medical equipment? Food and water? Will any patients be transported to Miami?
Though she's been in Haiti supporting the medical team for days, fourth-year medical student Liz Greig appears to be holding up well, by the steady sound of her voice. She talks about the ability now to serve three hot meals a day, good collaboration with physicians from the U.S. Navy hospital ship, USNS Comfort, the need for more tables, chairs and notepads, and counseling services for the volunteers in Haiti.
"It's mentally exhausting," she says. But offered a brief respite stateside, she answers quickly: "I'm fine.''
Arthur Fournier, M.D., professor of family medicine, associate dean for community health affairs and co-founder of Project Medishare, is conferencing in from Washington, D.C. He reports on his legislative efforts to raise money. He has a meeting coming up and can only talk for a few minutes.
Falcone fields questions about the need for medical equipment. Enrique Ginzburg, M.D., professor of clinical surgery, who recently returned form Haiti, explains that UM personnel will now be required to spend five days in Haiti and, after conditions improve, maybe seven. Campo, medical director of employee health and infection control, discusses a plan to make sure employees going to Haiti are properly immunized.
Green walks in. With his BlackBerry attached to his ear, he conducts a conversation with a donor and still pays attention to the meeting. He praises the work so far but reminds the task force how much more needs to be done. Those in Haiti are relying on them.
"There are so many things we still need," he says. "Trucks are still pulling up with people who are badly burned and with bones sticking out. We need refrigerators. We need vehicles. We need a dialysis unit. We need prosthetics. There are so many amputees and, in Haiti, if you can't walk you can't get anywhere."
A momentary silence indicates the message is clear, even haunting.
Indeed, the need will remain dire and the task force plans to stick around for the long haul. Members are committed to the Global Institute here and the volunteers who will rotate in and out of Haiti for months. As a result, the task force moved last week from the Lois Pope LIFE Center to its more permanent and spacious quarters.
Now, Falcone says, a task force brought together for a singular purpose with virtually no planning is writing the playbook for future large-scale emergencies.
"A great part of our effectiveness here and in Haiti is directly dependent on the unrelenting dedication of the volunteers from UM and elsewhere," Falcone says. "People were coming in at 8 a.m. and leaving at 2 a.m. We knew we needed to mobilize quickly to save as many lives as possible. That, still, is our commitment."