1. Provide the title of your story or series and the names of the journalists involved.
Sheri Fink, Reporter David Baron, Editor
2. List date(s) this work was published or aired.
23-Feb-10
3. Provide a brief synopsis of the story or stories, including any significant findings.
Soon after the January 2010 earthquake struck Haiti, reporter Sheri Fink realized that the situation would be a crucible for disaster triage, the process of prioritizing patients for treatment in an emergency. While patients are often triaged in small-scale emergencies such as bus accidents where help is close at hand, rarely are the protocols — and the medical workers who implement them — tested to this extent. In the courtyard of a destroyed college in central Port au Prince, Fink located a tented field hospital that had been established by members of the National Disaster Medical System under the auspices of the U.S. Department of Health and Human Services. Fink, who has reported extensively on medical issues in emergencies, was able to secure 24-hour access to report on the facility and its patients. Working alone without production assistance, Fink spent long days and nights in the sweltering, outdoor field hospital, observing and recording dozens of patients and medical workers, following rotating medical teams to their debriefing sessions in the U.S., and returning to Haiti to find out what became of the central patient in the story. Out of this painstaking exploration, Fink assembled a compelling account that showed that while the principles of triage may be well established in theory, they are exceedingly difficult to put into practice, particularly when it comes to implementing traumatic decisions that are likely to result in patient deaths. Health workers prepared to make these decisions on an intellectual level coped by keeping the whole truth from patients they believed would die; others attempted to enact heroic rescues. In the 10-minute radio report broadcast February 23, 2010 on PRI's The World, edited by health and science editor David Baron, Fink follows the progress of a single patient, Nathalie LeBrun. LeBrun arrives at the field hospital in need of emergency treatment for breathing problems. When a perilous shortage of oxygen and fuel supplies later develops, staff members elect to disconnect her oxygen supply and send her away. One of the field hospital's leaders acknowledges that he believes he is giving LeBrun a "death sentence" by instructing the staff to remove her oxygen. The story depicts scenes of great stress, as critical supplies run low and re-supply is uncertain. The story also shows how a new medical team, facing a similar situation several days later, comes up with a radically different solution.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The medical records of the patients were obtained as well as hard copies and electronic versions of protocols and logs involved in the functioning of the field hospital and communications between HHS officials in Washington, DC and medical officials on the ground.
5. Explain types of human sources used.
Staff of the field hospital (doctors, nurses, EMTs, logisticians), patients at the field hospital, Haitian medical professionals, and U.S. HHS, Department of Defense, and Centers for Disease Control and Prevention officials were followed and/or interviewed as events developed. Reporting was also undertaken at other field hospitals (e.g. run by Doctors without Borders and other non-governmental organizations), Haitian hospitals, a U.S. Defense Department hospital ship offering disaster relief, and interviews conducted with Haitian and American health professionals to provide a perspective on the events occurring at the NDMS
6. Results (if any).
The story elicited compassion both for the patient and for the medical workers who cared for her. "This is a haunting story," one listener wrote on the program's website. Another wrote: "I can't imagine what a difficult and emotionally taxing decision that must have been and feel fortunate that I don't have to make decisions like that." The story aired soon after an influential Institute of Medicine report urged state and local public health officials and hospital administrators in the U.S. to prepare disaster plans laying out which patients should get a limited share of resources in massive emergencies that overwhelm the health system. As a result, interest in the subject was great among medical professionals and policymakers, and Fink facilitated discussions of the story at national, regional and university bioethics conferences and at a think tank in Washington, D.C., where medical professionals and members of the general public grappled with the policy choices that could impact response to future disasters. The story brought an important on the ground reality check to the theoretical scenarios being contemplated.
7. Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
In a comment on the story's webpage, a member of the disaster team praised the way the story raised awareness of the plight of patients, but said that it implied criticism of the medical team, in part by "erroneously reporting that the patient was not informed of the plan to transfer her." However the allegation was untrue and the story was accurate. The story stated that the patient was informed about the transfer, but she was not informed about the more consequential decision to discontinue her oxygen, a point confirmed on tape at the field hospital by both the patient and her doctor.
8. Advice to other journalists planning a similar story or project.
Immersion reporting is a great way to get beyond the narratives offered in official press releases and develop a much richer and sometimes opposing understanding of how organizations operate. This type of reporting can be physically and emotionally taxing and demands a great deal of time. It also involves the collection of vast amounts of information. The challenge is to search for and recognize the events and characters whose experiences best convey the larger story.