The journey began for most of them, along with hundreds of other critically ill and injured victims, on the USNS Comfort, a floating state-of-the-art, 1,000-bed hospital ship docked in Port-au-Prince since Jan. 20. There, doctors treated severe head injuries, trauma, broken bones and acute infections. They delivered babies and performed more than 600 surgeries aboard the mobile medical facility.
But the Comfort is not meant for long-term care. Many patients have been released back to Haiti. Fifty of 59 hospitals are up and running, according to the U.S. Southern Command. And for those patients who need continuing care, rehabilitation or follow-up treatment -- or who are just too ill to return home, assuming they still have one -- the next stop is a one-way ticket to the United States.
Tampa has received some patients, but Florida has limited resources due to other humanitarian missions taking up hospital beds.
So Atlanta has been the major go-to destination, with more than 39 hospitals within a 50-mile radius, ready to supply beds and treatment to those in need. About 17 hospitals are currently hosting at least 40 critical Haitian patients and their family members.
The operation is part of the National Disaster Medical System, under the Department of Health and Human Services. The system was first activated during Hurricane Katrina, said National Disaster Medical System area manager Kenneth Wheeler, based at the Atlanta VA Medical Center.
"Atlanta is looked upon favorably in these situations because we have experience doing this. It's a well-oiled machine," he said.
Friday night, for instance, six ambulances lined up along the tarmac at Dobbins, waiting for the plane and its precious cargo to arrive. Inside a huge hangar, a mini-army of doctors, nurses, translators, customs officials and a myriad of military personnel were making final preparations.
Some 21 volunteer soldiers from the Georgia State Defense Force filled in roles usually performed by the National Guard, whose members are serving elsewhere, like Afghanistan or Iraq.
"Our job," Sgt. Leonard Goodelman told his group, "is, if asked, to help assist offloading, take our turn, get back in line and do it again."
One of the VA nurses getting a last-minute briefing was Haitian-born Marie Mompoint. Working as a translator, she's greeted every flight that's come in to Dobbins. She says more than half the patients have been children or young adults. Most are conscious and ask a lot of questions. "I assure them they will be OK, let them know where they are going, and once they got there, who's going to help them as far as follow up," she said.
When the plane landed at 10 p.m., this good-will army went to work, quickly. Customs and border patrol secured the plane. Cargo was unloaded, some if it coming in from Afghanistan. Patients were wheeled down on gurneys. Medical teams and translators checked that everything was ready for transport. Paperwork was signed. Thirty-five minutes passed instantly. The ambulances full of patients took off. And the army dispersed.
Welcome to America.
Haitian medical evacuees and their families enter the United States on Medical Parolee Status, which is administered by the Department of Homeland Security, and separate from refugee or asylee programs. They are still eligible for many of the same benefits, such as Social Security, Medicaid and food stamps.
But it's not an easy road to navigate. They don't speak the language. They were uprooted from their homes, first by the earthquake and then by aircraft to another country. And often they have no ties here.
Mompoint and many others from the 15,000-strong Haitian community in Atlanta are working with the nonprofit Refugee Resettlement and Immigration Services of Atlanta (RRISA) to help them find their way.
The Red Cross provides immediate assistance, but after three to seven days, RRISA takes over.
RRISA is one of 10 national resettlement programs. The government contracted with it to help these patients and their families get adjusted and stabilized, through their medical treatment and after.
First, they make sure accompanying family members have housing, food and warm clothes, "As patients are being discharged from the hospital, they also need housing, food, warm clothes," said Paedia Mixon, RRISA's executive director. "And they may need special accommodations, and we work with the hospitals to make sure they have those special accommodations."
It's a similar program, she says, to what they've done in the past with Cuban parolees.
"The only difference with this group is we're not certain how long people will want to stay. Some will want to go back; that's a detail still to be worked out," Mixon said.
As the Haitian medical evacuees begin their journey through the medical and social systems in the U.S., finding their way home may seem a long way off. And, according to the U.S. Southern Command, there are fewer than a dozen people aboard the Comfort who still need a place to go.