EMBA training helps earthquake victims
Feb, 2010
It was hot, humid, dusty and chaotic after the magnitude-7 earthquake shook the Caribbean country of Haiti. City buildings, schools, hospitals and infrastructure were totally devastated.
Eight days later, on January 20th, a surgical team from Boston, led by John Meara, arrived at the National University Hospital in Port-au-Prince to help provide medical and surgical care-thirteen doctors, nurses and anesthetists in all.
The hospital looked like a war zone scene with only half the building still standing and safe to occupy.
In the midst of this chaos, while performing complex surgeries, the team triaged patients into groups who required immediate amputations and surgery and groups who could survive a waiting period.
"We got there on the first day at about 8am," Meara says. "I sent half of my surgery team back to a base camp to sleep at 3am the following morning. The other half went back several hours later, then we came back at noon and worked again until about 11pm.
"The first three or four days were really bad but after that we started sending some of the sicker patients to the U.S. Navy hospital ship, USNS Comfort, and were able to organize functional operating theatres in a previously unoccupied building on the campus that we deemed to be safe, things began to get a bit better."
From Boston to chaos
In his day job Meara is Plastic Surgeon-in-Chief at the Children's Hospital Boston.
As part of this role he had a long-standing history in global health in a number of places with different organizations. More recently he worked with a group called Partners in Health started by Paul Farmer. Through that organization he had started to expand and improve surgical care delivery in Haiti.
When the earthquake struck he was lecturing in Europe. He finished up immediately, came home, put a team together and flew to Haiti the next day.
During the next ten days, he spent much of his time doing orthopedic surgery-with one of the other surgeons from his department who had orthopedic training-managing extremity trauma, facial trauma, difficult wounds and skin grafts, while putting his EMBA training to work on organizing the chaos.
He recalls that the University Hospital had been a reasonably good hospital for Haiti but a lot of it was devastated by the quake. The Army Corp of Engineers deemed many buildings unsafe so Meara and his team used tents in the main courtyard to house patients.
"We had a pre-op tent, a post-op tent, a triage tent and we picked one of the buildings which was thought to be the safest to set up operating theaters. It was like a big MASH unit."
Meara described the volume of patients and problems as "overwhelming" saying there were hundreds if not thousands needing attention.
"The electricity was intermittent, there was a severe lack of surgical instruments and we were understaffed in every way," he says.
With much of the hospital staff losing half or more of their family, the hospital was run by various international aid workers during the first week or so, until the local nurses and doctors returned to work.
Taking EMBA training to its limits
"The EMBA training in negotiation, team building, coalition building in this environment was invaluable," Meara says.
"When we arrived, there were at least 25 different NGOs working on the hospital campus grounds, and no organizational structure. Operating theatres were being run by a French group, a group from New York University, a group from Mount Sinai, a group of Haitian surgeons, our group, a group from Boston and the Red Cross, which had Swiss, Norwegian and Israeli doctors. For the first 48 hours everyone was doing their own thing.
"We started talking to the various groups about our options and how we might better leverage the different skill sets in each group. It became clear that if we worked together, and pooled our nurses, anesthetists and surgeons we could staff a batch of theatres more effectively.
"The hardest thing was getting everybody to realize it was better to work as a team. That's where the EMBA training in team building, creating a common vision, defining the sense of urgency, building coalitions and negotiation skills taught by John Onto were critical."
Climbing the corporate ladder
Meara entered the workforce after completing a fellowship in craniofacial surgery at the Royal Children's Hospital (RCH) under Tony Holmes in 1999. He then worked at Children's Hospital Los Angeles until 2003 when the RCH enticed him to return to Australia as head of the Plastic Surgery Department.
He joined RCH in 2003 and after realizing how critical it was to have leadership, management, accounting, finance and all the business skills that people in the business world take for granted, he enrolled in the EMBA at MBS.
He recalls that after speaking to John Onto he was sold on the concept of the EMBA structure.
"The residential format suited me. It would have been hard to fit part-time or after hours study into my schedule but oddly enough it was easier for me as a surgeon to say, OK I'm going to be gone for four weeks at a time. My colleagues will cover my practice. I won't be available to call."
In 2005 Meara became Chief of Surgery at Royal Children's Hospital but after much agonizing, left a year later when the job in Boston as Plastic Surgeon-in-Chief became available in 2006.
Caption: "Partners in Health had a realationship with one of the schools so we slept there. None of us felt comfortable in the building so we ended up in our own little tent city in the courtyard."
