Girl's 15 Days in Haiti Rubble Raises Survival Questions

Jan. 29, 2010 — -- Haiti's government called off search-and-rescue efforts four days earlier, yet rescuers found a Haitian teenager alive Wednesday, surviving against all odds after being trapped in the rubble for 15 days.

Sixteen-year-old Darlene Etienne had apparently been taking a shower when the earthquake struck and brought down rubble on top of her. When rescuers found her, she was weak, but very much alive.

"We were very surprised," Colonel Claude Fuilla, head doctor of the French Civil Protection team, told ABC News. "I was at our [headquarters] when a Haitian man walked in and said 'come quickly, we've found a young girl alive in the rubble.'"

Fuilla said the girl was stuck in a space barely bigger than her body. "It would be as if you were stuck between the front and the rear seats of your car, without the possibility to move... I'm deeply convinced she would not have made it another night."

The fact she was in the bathroom at the time of the quake may have saved her life, because she had access to small amounts of water.

But even so, experts say, her chances of surviving for that long still were very slim.

"She remarkably survived both her injuries and the prospect of dehydration after that many days ... [when] normally a person can die from dehydration in just three to four days," said Dr. William P. Bozeman, associate professor of emergency medicine at Wake Forest University School of Medicine in Winston Salem, N.C.

Scientists say a 150-pound person can only afford to lose about 20 percent of his or her water weight. The body sheds five or six cups of water a day. So without access to water, it's rare to last more than three or four days. After 14 days, a 150-pound person would have lost nearly 60 cups of water, or one-third of their water.

Amazingly, Etienne still survived.

After a night of treatment on the French Navy hospital ship Sirocco, Dr. Evelyne Lambert, who has been treating Etienne there, said she is currently stable, drinking water and eating yogurt and mashed vegetables, according to the Associated Press.

Though rare, successful rescues many days or even weeks after a disaster call into question how long rescue teams can expect to find survivors.

How Long to Hold On to Hope

"There's no agreed on limit for when [to expect] no more survivors, as this case illustrates," Bozeman said, but "typically between two to five days you see fewer and fewer survivors, and after roughly seven days the teams may transition from search and rescue to body recovery."

Why Some Injuries Become Life-Threatening Under Rubble

For survivors like the teen recently found, major concerns are dehydration, crush injuries from the initial building collapse, and infections that might result when those injuries go untreated.

"What kills somebody who is simply trapped is dehydration -- most would probably die within the first week or so [because] you cannot get rid of the toxins from your body and your kidneys shut down," said Dr. Martin Schreiber, chief of trauma, critical care, and acute care surgery at Oregon Health and Science University in Portland.

"All your organs suffer, though the kidney is most vulnerable," he added.

If someone is young, healthy, and well-hydrated at the time of being trapped, the chances for a longer survival are better, Schreiber noted.

"The other major factor that would come into play is if she sustained any injuries," Schreiber said, because injured muscles release a substance "that directly hurts the kidneys and the combination of crush injuries and dehydration is a deadly combo."

In Etienne's case, Schreiber said she was lucky to have lived two weeks and he guessed "she probably didn't have any major injuries."

This story is one of a few miraculous search and rescue stories to come out of the aftermath of Haiti's quake.

Buried for Days

Dr. Dominique Jan, the chief of pediatric surgery at Montefiore Medical Center in Bronx, N.Y., spent a week after the earthquake with a surgical team working under the Surgeons of Hope Foundation.

One of the more remarkable stories Jan saw was that of a 12-year-old girl who came to doctors after surviving nine days buried under rubble without food and water.

Her mother had been begging for her to be rescued, and "the girl was knocking on the concrete" trying to signal to rescuers, Jan said.

"She was very bad when she just arrived in our clinic," he said, but her recovery went smoothly and quickly.

"I think the first thing, when we like to resuscitate the patient…is to make sure there are no other injuries," explained Jan, noting that problems can emerge when doctors are focused on treating the most obvious trauma but may miss other problems.

Dehydration, Crushing Injuries Make Rescue More Difficult

In this case, "obviously her chest was compressed for nine days and she wasn't breathing well."

But Jan said the doctors needed to look for other potential problems.

"We want to avoid any brain injury. Our main concern was to make sure there was no abdominal injury but also brain injury related to trauma or [lack of sugars in the body]," he said.

Jan said doctors attended to the 12-year-old girl every 10 minutes for the first six hours after she arrived at the hospital.

"My main concern was probably the fluid and obviously she was dehydrated when she came, but she responded pretty well to the treatment," said Jan.

"She was absolutely off liquid and food and she survived nine days. The fact that she had no major trauma and probably in a warm condition [a tropical country versus a cold climate where exposure is a concern] was [part of her] survival," said Jan. "I think that she was lucky."

While the girl was able to leave the hospital after a few days, Jan said her family's house had been destroyed and so the family brought her home to a camp.

As most search and rescue teams have transitioned to finding bodies, so too will the aid and medical teams transition to helping survivors leaving Port-au-Prince.

Few Resources Force Rescue Workers to Prioritize the Living

For the two girls now recovering, "the good news is...if the kidney is not too damaged, there should be no long-term effects and you can expect a full recovery," said Bozeman.

But when resources are stretched thin, it is not necessarily prudent to dedicate time to search and rescue when others already found need medical attention, notes Schreiber.

"In this situation where there is no infrastructure and an overwhelming number of patients needing care, [lack of resources] is going to be play a big role in when would you 'give up' looking," said Schreiber.

But "we know that these miraculous cases do occur," adds Bozeman, "so we tailor our efforts to address the possibility. We tend to give the benefit of the doubt -- there have been lots of examples like this in other events that make us keep [hope] in mind."

Fuilla agreed that Etienne's survival was a surreal occurrence that may offer some hope -- though he said that the chances of finding someone else alive after being buried for more than two weeks are slim.

"This young girl is an exception, a miracle," he said. "But as for every earthquake, there may be people under the rubble who unfortunately die of thirst because we never locate them.

"Fifteen days after the quake, I think that it is rather extraordinary there was a miracle, but I don't believe in a second miracle."

ABC News' Christophe Schpoliansky and Lauren Cox contributed to this report.