SIGN is committed to eliminating the inequalities of fracture care throughout the world. Haiti is an excellent country to pursue this goal. The population of Haiti is roughly 8 million, 80% of whom live in poverty.

I just returned from the second of two trips to Port-au-Prince. The largest hospital, which is also a university in Port-au-Prince, has been on strike for many months because the doctors go without pay and do not have adequate equipment to treat their patients. During the strike, Trinity Hospital, operated by Médicins Sans Frontierès (MSF), has been the only source of orthopedic care for poor patients. Their staff works diligently to serve the patients affected by trauma such as road traffic accidents and gun shot wounds. The Haitian MSF surgeons do excellent surgery. MSF requested an evaluation of internal fixation to move the patients out of their beds sooner, thereby freeing up beds for new patients. Fracture patients are placed in traction or French army external fixator. These patients often must remain in bed, creating overcrowding in the ward.

I demonstrated SIGN technique at the MSF facility on two occasions during the first trip. Five SIGN surgeries were done between trips by the MSF surgeons from Haiti. Seven surgeries were done on the second trip at Trinity Hospital during the second trip. The last few surgeries done by the Trinity surgeons were done with excellent technique and results. The surgeons were trained in how to report their cases on the SIGN surgical database so that I could review their cases upon my return.

David Templeman, M.D. Professor of trauma surgery at University of Minnesota, and future President of the Orthopaedic Trauma Association (OTA) accompanied me on the second trip. He added a new depth of knowledge to each surgery. Every surgery was a team effort amongst the surgeons who scrubbed. Dr. Templeman is also interested in teaching pelvic fracture treatment.

We operated in a newly opened government University Hospital. Dr. Serge Sabalat, a surgeon from Trinity, accompanied us to the University Hospital. The residents were very eager to learn SIGN surgery. They have already reported their surgeries onto database.

Haiti is an ideal place for SIGN programs. The people are too poor to afford implants. The doctors are very capable and willing to learn. They have a good grasp of the fundamentals of orthopedic surgery. I look forward to working with the doctors in Haiti, both at MSF and in the University Hospital.