Cooper team arrives on quake-ravaged island

SANTO DOMINGO, Dominican Republic - The seats: plush leather. The lunch: three sumptuous courses. By the time the Bose stereo headphones came out on the private jet carrying Cooper University Hospital's medical team to Haiti, orthopedic surgeon David Fuller had a yin-and-yang moment of insight.

"We're going from luxury I've never known to poverty I've never known in 24 hours," Fuller, of Haddonfield, said. "From one extreme to the other. No one is entitled to one or the other. We're the same people in both places, but our surroundings change."

The eight-person vanguard of Cooper's relief mission, expected to last two weeks and involve potentially dozens more volunteers, touched down in the Dominican Republic as the sun set yesterday.

The airport buzzed with stories of quake victims airlifted to Dominican hospitals, dangerous Haitians set free by the collapse of the central prison, and panicky displaced people taking a run at the Dominican border, guarded by Dominican troops.

"They are desperate," airport transportation coordinator Jackie Hernandez said, "with nothing to lose."

Bearing boxes of "lac kits" for stitching lacerations, and black duffels filled with antibiotics, bandages, water, and enough food to sustain themselves, the Cooper team moved with more caution and urgency as its members worked the phones with Haitian clinics and U.S. sources, including the National Disaster Medical Center and White House staff, which gave them moment-by-moment security updates and guidance about where their skills were most needed.

There was talk of beginning at a small clinic near the border on the Dominican side that was being overrun by injured Haitian refugees, and then moving on to Leogane in Haiti, closer to the quake epicenter near Port-au-Prince.

"We have to be smart about this," said team leader Anthony Mazzarelli, Cooper's director of emergency medicine. "Otherwise, we're just doing medical tourism."

In addition to Mazzarelli, 34, and Fuller, 45, the first wave includes Ian Butler, 34, a critical-care specialist with experience at clinics in Peru, India, and Ghana; and emergency-medicine residents Angela Guerrera, 27, Josh Torres-Cruz, 29, and Jessica Mitchell. Physicians Orlando Debesa and Sacha Montas, 34, a Creole speaker, whose parents were born in Haiti, round out the team.

Every summer, Cooper Hospital sends medical personnel to a clinic in Ghana through a program, International Healthcare Volunteers, that was founded by a Cooper physician. The hospital was thinking about adding a program that would work with Haitian clinics, and Mazzarelli was scheduled to take a trip in March to explore the possibilities.

Then the earthquake struck, and in some ways, Mazzarelli said, this crisis mission is a test under fire.

Fuller, the orthopedist, said the team was prepared to see the aftermath of a lot of "crush injuries" of arms and legs. Reports from Haiti have indicated that some people with compound fractures that became infected, leading to sepsis, are dying needlessly.

"Our hope is that we can align limbs, stabilize them, and, hopefully, reduce the infection-related morbidity and mortality," he said. But under the circumstances, he quickly added, "we're under no illusion that we can provide the same care as in a hospital."