Hard times call for creative solutions: Medical improvisations at the Israel Defense Forces field hospital in Haiti


  • Guy Lin, MD
  • Haim Lavon, MD
  • Reuven Gelfond, RN, BA
  • Avi Abargel, MD, MHA
  • Ofer Merin, MD




improvisations, field hospital, Haiti, earthquake


Mass disaster medicine is characterized by the need to manage limited resources that are far inadequate to meet the population’s demands. Under these hectic conditions, lack of specific medical equipment is expected and requires improvisation using available items.
We describe the innovative use of medical improvisations at the Israel Defense Forces field hospital, working in the earthquake zone, Port-au-Prince, Haiti, on January 2010.
Creative solutions were found to several problems in a variety of medical fields: blood transfusion, debridement and coverage of complex wounds, self-production of orthopedic hardware, surgical exposure, and managing maxillofacial injuries.
We hope that the methods described will help to inspire medical teams working in disaster regions.

Author Biographies

Guy Lin, MD

Israel Defense Forces Medical Corps Field Hospital; Trauma Unit, Western Galilee Hospital, Nahariya, Israel.

Haim Lavon, MD

Israel Defense Forces Medical Corps Field Hospital; Otolaryngology, Head and Neck Surgery Unit, Ziv Medical Center, Safed, Israel.

Reuven Gelfond, RN, BA

Israel Defense Forces Medical Corps Field Hospital; Operating Rooms Department, Hadassah Har Hatzofim Medical Center, Jerusalem, Israel.

Avi Abargel, MD, MHA

Israel Defense Forces Medical Corps Field Hospital; Obstetrics and Gynecology Department, Assaf Harofe Medical Center, Zerifin, Israel.

Ofer Merin, MD

Israel Defense Forces Medical Corps Field Hospital; Trauma Unit and Department of Cardiothoracic Surgery, Shaare Zedek Medical Center; Hebrew University, Jerusalem, Israel.


Hrezo RJ, Clark J: The walking blood bank: An alternative blood supply in military mass casualties. Disaster Manag Response. 2003; 1: 19-22.

Spinella PC, Perkins JG, Grathwohl KW, et al.: Fresh whole blood transfusions in coalition military, foreign national and enemy combatant patients during Operation Iraqi Freedom at a US combat support hospital.World J Surg. 2008; 32: 2-6.

Spinella PC:Warm fresh whole blood transfusion for severe hemorrhage: US military and potential civilian applications. Crit Care Med. 2008; 36 (Suppl.): S340-S345.

Hess JR,Thomas MJ: Blood use in war and disaster: Lessons from the past century. Transfusion. 2003; 43: 1622-1633.

Scalea TM, Boswell SA, Scott JD, et al.: External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures: Damage control orthopedics. J Trauma. 2000; 48: 613-623.

Pape HC, Hildebrand F, Pertschy S, et al.: Changes in the management of femoral shaft fractures in polytrauma patients: From early total care to damage control orthopedic surgery. J Trauma. 2002; 53: 452-462.

Courtenay M, Church JCT, Ryan TJ: Larva therapy in wound management. J R Soc Med. 2000; 93(2): 72-74.

Fitzpatrick M: Tiny “surgeons” prove surprisingly effective. JAMA. 2000; 284: 2306-2307.

Gupta A: A review of the use of maggots in wound therapy. Ann Plast Surg. 2008; 60: 224-227.

McGhee A, Swinton S,Watt M: Use of autologous transfusion in the management of acute traumatic haemothorax in the accident and emergency department. J Accid Emerg Med. 1999; 16: 451-452.

Mardini S, Agullo FJ, Salgado CJ, et al.: Delayed skin grafting utilizing autologous banked tissue. Ann Plast Surg. 2009; 63: 311-313.

Al-Assaf DA, Maki MH: Multiple and comminuted mandibular fractures: Treatment outlines in adverse medical conditions in Iraq. J Craniofac Surg. 2007; 18: 606-612.




How to Cite

Lin, MD, G., H. Lavon, MD, R. Gelfond, RN, BA, A. Abargel, MD, MHA, and O. Merin, MD. “Hard Times Call for Creative Solutions: Medical Improvisations at the Israel Defense Forces Field Hospital in Haiti”. American Journal of Disaster Medicine, vol. 5, no. 3, May 2010, pp. 188-92, doi:10.5055/ajdm.2010.0023.



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