Sunday, March 28, 2010

Closing thoughts






Closing thoughts by Ruth Thomas:

As soon as I knew there was a way to get to Haiti after the earthquake, I wanted to go. Initially Kathy Sexton was the only one who would commit with me. Carlos Lewis wanted to go from the start, but waited to get his shots until I could say it was really going to happen. But I knew we couldn't be a team with just we three. I didn't want to be the lone orthopod, and having done 99% foot and ankle only for the last 20 years, I was a little worried about operating anywhere else in the body. So I asked my fellow, Vinay Sathe, if he would consider going with me. In his typical agreeable fashion he said "oh sure", and I simply wouldn't let him back out. Now we had 4. In mid-February commercial flights to Haiti resumed. Now we could take as many volunteers as we could convince to go. I was trying to convince Loch Trimmingham of Bellingham, Washington to go with me, and initially he agreed. Later a health issue arose and he had to back out. However, in the process of thinking about going he mentioned his plans to Jessica Yoos, an anesthesiologist who works with Loch in Bellingham. Jessica wanted to go, so we signed her up. We needed an anesthesiologist. Now we needed more nurses. Kelly Rusher said yes, then Jessica got June Jones' committment. I read an article about the big need in Haiti for Physical Therapists. I imediately thought of my friend for 30 years, Martha Mayland. I asked, and she too jumped aboard. Majid Saleem needed the blessing of the Anesthesia department at UAMS to take "vacation". We weren't real hopeful because our week coincided with Spring Break. Then, the day we were ready to start buying tickets, Majid got approval. Then Jessica e-mails me and says Jeni Wright, her anesthesia tech has bought her ticket too. Our team is rounding out nicely with 2 surgeons, 3 RN's, 2 anesthesiologists, a therapist, a cast tech, and an anesthesia tech. 10 days before our planned departure I tell Naomi Shields that it is really going to happen, all the details have been worked out, and suddenly she is on the internet and on the phone and she and her nurse, Susan Roby are coming too. We have 12. When we finally found each other and our luggage in the Haiti airport, another physical therapist and a CMA were joining us, Yolanda Malick and Jenny Chambers, from Ohio. We are at 14. We reach the guest house in Pierre Payen and find Tim Pratt, a 3rd year family practice resident from Iowa, and LeeAnn Campbell, an ER nurse from Pennsylvania. Our medical team has hit an amazing 16.
One week later we are all friends. It is difficult to imagine doing what we did this week without any single member of our team. Everyone worked hard. Everybody shared the workload and their snacks. Every member on this team contributed to make this mission successful. Not one member balked at their lack of sleep or campstyle living quarters. Everyone is talking about coming back to Haiti to do this again.
I admire these volunteers. Most of them took vacation to do this. Others took leave without pay. They will not be reimbursed for their expenses. I am especially proud of the younger volunteers with small children at home who still found a way to make this mission trip. They, like me, are hooked on the emotional highs and lows that come with donating your time, energy and resources to help people with real needs.
We did good. We saved the lives of two young men and took medical steps to improve the lives of many others. In exchange we came away with memories that will last a lifetime and a deep appreciation of what it means to be an American. We have new friends, and we have learned something about our neighbors in Haiti.
All missionaries share certain core values. They are good, honest individuals who want to help others. They are willing to self sacrafice and not are not afraid of hard work. They want to understand the culture and get to know the native people. Perhaps that is why this team bonded so well.
As team leader, I want to thank you all for everything you did, and thanks too for keeping a sense of humor and adventure through it all.

Ruth Thomas

Thoughts by Vinay Sathe

Written by Vinayak Sathe on the way back to Little Rock

I am now on a special jet flying back from Fort Lauderdale to little rock as this is being typed. Feel incredibly lucky to have been a part of this mission. Cant believe that Team 10 has finally made it happen. Just over 7 days ago this journey began with lot of trepidation , excitement and hope that we can do something for the people of Haiti. We all worked hard and achieved something and on the way gained invaluable experience and made some good friends back in HAITI.

This was a time for all of us to show that we can work in a group as a team. We all jelled together very well and the alien conditions helped in a way towards that. The week passed with smoothly but with some highs and lows too. Purely from Orthopedic surgeons view this was incredible as we had to work in some difficult conditions and with an OR setup which was totally different from what I was used too. Dr.Thomas, me and Naomi Shields had to work together keeping our egos behind for the cause of the patients.

My first day in running the clinic was unique as I had to see patient with a large inguinal hernia, post mastectomy and some peditric cases thrown in for some variety. Several patients were from Earthquake time, who had been operated by another time and we had to make sure the follow up was taken care of. On the 2nd night of our stay a truck came through at night and parked right in front of hospital. There were 2 casualties and after triaging them we had to operate of them with multiple fractures. Again it was an unique experience treating them with no X rays, CT scan and the usual investigations one is used to having, working in USA. Luckily both patients made good recovery after several operative procedures.

Luckily on day one, as soon as we arrived in Pierre Payen, all the team members put in the effort to organize all the surgical instruments and implants and medicines so that those could be found easily when we needed them. Unfortunately, the main autoclave broke down but we did manage to find another just in time . Getting some blood transfusion for our patients too was hard but somehow things worked out so that we could go ahead with surgeries without problems.

On our last day the Team went to Club Indigo which is decent place from where we were staying. For 20 US $ we could have a buffet dinner, free swim in a nice pool and get some clean fresh water to drink., plus the cool sea breeze with sandy beach thrown in for free. This is recommended if one wants to break away from the daily grind.

The interpreters and the local Haitian were very helpful and I felt safe leaving my belongings in the residential rooms, while I was away at the hospital working. Pierre Payen is a place certainly for someone who wants to do some charity work, use their knowledge of medicine for the benefit of local people and on the way take home some great memories of the place.

I would like to Thank ALL the team members who helped each other and made my first mission trip worthwhile. We are landing back at Little rock and time to go back to our routine and mundane life.

Majid in Port Au Prince


Monday 22 – Wednesday 24
Trip to University of Miami Hospital, Port Au Prince
By Majid


We were all awake around 7 am Monday morning and enjoying the breakfast. Tim came and informed us that van is here to transport one of the young men with the head trauma that kept all of us very busy throughout the night. It was decided that LeeAnn and I would go with the patient to University of Miami Hospital. Tim said hurry up guys, the driver will leave very soon if we kept him waiting and we only have 10 minutes. Here comes the rush. LeeAnn and I packed our bags (clothes, power bars of course) and went to hospital across the street to get the patient from the Big Daddy’s ICU (yes this was name of our ICU/Recovery room which was about 8 feet from the operating table).
Patient was sedated but he was breathing (lucky man), we moved him to the SUV after folding all the seats except the driver seat. We did not have portable oxygen and we decided to take him without oxygen and keep our fingers crossed. Thank God, trip was without any problems except our back were so stiff because there was not enough room for us to sit comfortably.
Here we are at front entrance of the hospital and we moved the patient to ER. (Just to let everyone know that this was a tent hospital). After 45 mins we took the patient to the operating room and surgery was started. I had about 40 min to get to know the Operating room, Anesthesia and supply area and check our sleeping area Dr. Vincent (chief medical officer) showed us our sleeping area. It was a big white tent and as we walked in, there were about 200 portable beds lying in about 6 rows. Most of beds had mosquito nets. We were lucky to find two beds that already had a mosquito net big enough to cover both beds. We left our luggage there and went to the operating room. They had operating room (four but only one functional because they had only one anesthesiologist, Joana, until I came), supply area, sterilization area, recovery room, ICU, NICU and Peds area ALL IN ONE BIG TENT. (Just imagine yourself the partitions). I talked to Vincent that I will stay for two days because they really needed another anesthesiologist to cover their surgery schedule. After the young man (the kid we transported), I had few more cases to do. All of staff was really polite and friendly. They kept bringing me water bottles and food at the lunchtime. Joana helped me a lot to find thing from the supply area. It was about 6:30 pm when we done with the cases. So finally I came out of this big tent to get some fresh air. There was a truck with BBQ grill outside the big white residential tent and there was a long line of people in front of it. They were selling burgers, soft drinks and beer. This truck comes on Monday and Wednesday only. So the hospital only provides one meal a day (mostly rice with chicken) and for the rest of time you are on your own. The hospital does provide water bottles free of charge. While we were in line, Vincent was kind enough to give us few bed sheets. There were people not only from US but also all over the world. Burger and beer was a hot commodity at this camp. We were chatting with the people while waiting for burgers. Finally we made it to the counter and paid nine dollars for chicken burger and coke (not so cheap, but I guess it was worth it). We got the drinks and found out there is another line to get the burgers. I was really hungry and my stomach started to make some strange noises. Finally I had my burger and we sat on the bench. It took me 40 min to get the burger and only 5 mins to eat it. People were getting crazy with the beer (I guess it was end of their shift and burger and beers only come twice a week). After eating and chatting, I was on my bed. LeeAnn found two foam mattresses for our beds. At nighttime it was not hot inside the tent. Now the dilemma started. I need to go rest room and found out that there are about 8-9 porta-potty along the back wall and next to these there were four showers. I did bring my flashlight with me incase I have to use. I stayed outside this porta-potty about 5 minutes thinking whether should I go in or not. I guess I did not have any options. I had my flashlight on and entered. It was my FIRST experience and also will also be the last. Then I went to shower booth. The flow of water was really great (not like the trickling water we have in Pierre Payen) that I spent extra 10 mins in the shower. Once I was in the bed, it did not take me long to go to sleep.
The next day started. I ate power bars and ready for work again. We had a very list for operations that day. LeeAnn went back to Pierre payen with Annie. The day went on, doing cases after cases. I was excited to do 3-4 pediatric cases as well. I talked to Vincent about leaving to Pierre Payen on Wednesday, he told me that he would arrange the transport. In the morning about 9, I was told that transport is ready. There were about eight people already in the SUV (land cruiser). Vincent said don’t worry, all these people are going to General Hospital (which is a local hospital in Port Au Prince). At the time when we were at the general hospital, driver got the call from THE BOSS, that she needed the car right away and they arrange transport for me later on. Who was the BOSS? Director of Medishare, a project of Univ. of Miami that includes other areas of interest including hospital. Driver then went to the local hotel (La Corela I think that was the name) where most of the medishare people were staying. There was some damage to part of the hotel, but most of it survived. But the hotel across the street had more damage and it was closed. The driver did not speak English but we were still able to communicate with the help of sign language and tooti-phooti (broken) English. I waited 15 min outside the hotel then finally four ladies came and then director talked to the driver something in French (Haitians speak French) and we were on the road. We went through various winding streets in the downtown area and looking at the damages that has caused so much disastrous in this region. It was really amazing to see that one side of street there were most of the houses were destroyed but across the street there was only minimal damage.
Finally we arrived at their meeting place, some UN office. I thought the driver will drop me back at the hospital, but the director told me that they would be back in 20 minutes. AT IT WAS LONG TWENTY MINUTES !!!!! My watch was telling me one hour and thirty minutes. In the mean time driver received a call about my whereabouts. Dr. Vincent called Pierre Payen to make sure I did arrive safely and to his surprise I was not there. The driving distance was about one hour and thirty minutes. He called medishare and then medishare called the driver and talked to me. Few minutes later the ladies came out of the office and told me that once driver drop them at their hotel, I can go. I was relieved to some extent. Finally I was in Pierre Payen with this formula 1 driver. I got a warm welcome from my group, especially from Jessica (another anesthesiologist from WA).

Home Sweet Home

HI all, Susan and I arrived in Chicago at 12:30 am, slept til 5 at the Hilton airport and then got on our flight to Wichita. Arrived safely about 9:30 am. I would like to thank all the people on the team. Anyone on the team has a job with me either working with or for me! A great group of people who came together for a common goal..the patients. We had fun and made new friends. I hope that we get to Haiti within a year as a group. Naomi

Saturday, March 27, 2010

The wonders of a hot shower

Written by Naomi Shields:





Susan and I have made it to Miami. The trip from Pierre Payen this morning to PAP was in the open back of the truck. Our white t-shirts were gray when we arrive in PAP. We passed a funeral enroute, a musician at the front, followed by woman and men wearing white. Bananas were stacked by the road. Water runs in an open channel along the roadway. People dip buckets in the channel, others bathe. Multiple refuge camps exist. Some with nice tents, others with cardboard walls built on sticks. The road is better north of PAP. As we approached PAP, the pot holes became navigational hazards. There is a large crack running down the center of the road, presumably from the earthquake. Compared to Vietnam, there are very few scooters and pedal bicycles. I wonder if you either have enough money to buy a vehicle (and trust me, in the US many of these would not pass any inspection!) or you walk or take a tap tap, not having the resources to buy a scooter or bicycle. There are some horses and donkeys. After 2 hours, we entered the chaos of north PAP. We dropped everyone else off the the long line at the "departure terminal" and then went with Steve, Stephenson, and Cenofa (the missionary and 2 young Haitian men who have been invaluable this week) to wait at the "gas station". We sat in a clean airconditioned convenience store that could have been in the US, except 75% of the shelves were empty. They did have cold water, gatorade, fruit juices and Coke/Sprite. We sat there waiting and watching the flight line trying to guess which plane might be the private plane bringing in Dr. Ric Bonnell, the organizer of the whole project, and a young woman who was injured the day of the earthquake, airevaced to the US and returning to Haiti with a Dan Rather film crew. Her parents are waiting at Pierre Payen and expect her there about 1 pm. After sitting and talking, asking Stephenson and Cenofa what they would like to do (engineer and computers/pilot) and their hopes for education, we piled back into the truck and entered the stop and go (more stop then go) traffic around the airport. We went first to the terminal that serves the private prop planes. Sitting there, I watched various people get their shoes shined by the outdoor shoe shiner. One gentleman was nattily dressed in a suit, holding his cell phone and keys in one hand, and sipping a beer with the other while his shoes were buffed to a high shine. Finally the door opened, a young lady in a wheelchair accompanied by a camera man (his camera weight depends on what time of day it is! About 20 pounds on his shoulder), a reporter and a multitude of others. All the bags, including 2 floor fans and a bunch of plastic shopping bags filled with food, toys, supplies, etc were loaded into the back of the truck. Off we were into the traffic. I estimate it was a 1/2-3/4 mile to the private plane jet terminal. This took easily 20 minutes. Then we waited until more docs, nurses mostly from Branson, Missouri came out. The truck bed was overloaded with bags and gear. Susan and I guarded our bags to keep them from being buried. After confusion was controlled, we pulled out back to the departure terminal where Susan and I entered the check in maze! We went through the first x ray screen and attempted to enter the business class check in line. The security guard was skeptical that 2 very grubby smelly dishelved women could possibly be sitting in business. He wanted our itinerary which we didn't have, a ticket/boarding pass (hey, we're in Haiti...printing boarding passes prior to the airport was not an option, my elite card (left at home)...but eventually, he acquisted and we got in the line. BIG MISTAKE! The guy behind use went throught the regular line and was easily checked in 30 minutes before us. Then thru immigration, another xray screen, shoes off, bags, etc. We then went up and escalator and another xray screen. At this point, no liquids. We then entered the waiting area that was cool. Time passed. Now mind you, we were up at 5, left Pierre Payen at 6:30 am and our flight was not until 4 pm...so time passed SLOWLY. As it came time to board the plane, everyone pushed forward despite the multiple English, French and Creole announcements that boarding would be by group number. They stared in disbelief that we were in business! But those seats were comfortable!! Once we arrived in Miami, we cleared customs, wended our way to Terminal D. The uppity young TSA agent did not seem to think that either Susan or I resembled our passport pictures! We told him that a little hot water would improve that. Off to the Admiral Club and awesome hot showers and cold drinks (they seemed to recognize 2 desperate for showers women). We are now clean and can no longer smell ourselves waiting for our delayed flight to Chicago. The fire alarm is going off....

This has been an incredible experience. Haiti is a beautiful country, filled with contrasts. The colors of the taptaps, the sounds of singing-even from the overcrowded back of the pickup in front of us as we drove to PAP, the braying of the donkeys, the crowing of the roosters, and the honking of the horns blend together to form an indelible memory. The look of gratitude when treatment is given and the hugs from patients and family will linger in our memories. The people were welcoming, friendly, grateful and eager for attention, assistance and friendship. The younger generation thirsts for knowledge and opportunity. Education I think is key. They will be the ones to rebuild their country. We talked with a business man on the plane. Perhaps, we can make a difference together. Haiti's needs are many but what if we, as medical professionals, could establish a hospital in PAP that educated nurses, physicians, dentists, optometrists that could then spread throughout the country establishing a network of health care for all. Susan and I will be going back.

Friday, March 26, 2010

Bellingham trio:

From the Bellingham crew of June, Jeni and Jessica:

It’s our final night in Haiti. We’re so excited to come home and see our families but at the same time, so incredibly sad to leave. We have put so many hats on this week: ICU nurses, ER nurses, Trauma docs, pediatricians, equipment sterilizers, floor moppers, toilet un-pluggers and shoulders to lean on. We have had sleepless nights caring for Junior Joseph, our 20 year old “ICU” patient who we cared for 24 hours a day in shifts in a room that lost power from midnight to 8 am. After his third surgery yesterday which lasted 7 hours, he made it out of our “ICU” and into the “penthouse” where his family was finally able to assume care. We don’t speak Creole but as mothers we all have somehow able to form an incredibly strong bond with Junior’s family. We have shared many tender moments which in and of themselves have made this whole trip worthwhile. The way his mother looks at us when we come to visit is like nothing else. We will miss them terribly and hope to keep in touch with them and his progress.

This afternoon we went with our new friend Annie to visit her orphanage. She is quite a lady, to say the least. She has collected a crew of children, most of them with physical disabilities, and is providing them with a home like no other. We all took a walk to the beach which was littered with trash. At first we were reluctant to get in but after a few brave souls started dodging flip-flops, we were all in. In a matter of minutes we were surrounded by naked Haitian children who were initially shy but after we tossed the first one of them into the air with a “one, two, three” they were all clamoring and eager to be launched into their best belly flops by whoever was willing. We laughed and had a blast together though we didn’t speak the same language and at one point I turned around to find Jeni standing in waist-deep water holding a 1 year old child who had fallen asleep in her arms. Our hearts are so full of joy, sorrow, heartache and love. We’ve made a promise to ourselves that just because we’re coming home tomorrow, we will never forget these people and will do everything we can to continue to make a difference for them in some way…to be continued…


Color

Written by Ruth Thomas:


I'm going to add a little color here with a little background stuff:


The young man we coded on Sunday was about to leave Haiti to go to the United States and get married. His best friend couldn't go with him so they had their own early celebration. So they went to the beach with a few others. They were drinking. His best friend suddenly realized that he didn't see his friend anymore and dove under the water to find his friend. He carried him to the back of his truck and drove wildly to the hospital, just a few minutes away. He screamed for help and we began pouring out of our various work spaces for a full CODE. We tried for over an hour before stopping our efforts. The best friend cried over his friend's body. We helped load the victim back into the back of the pick up truck. An older man showed up with a small black book and the crowd of Haitians bowed their heads while the little older man read a few things from his book. The best friend hugged the victim and several others reached down to touch him, Then the truck started up and drove away.


Written by Jennie Chambers:
We are thrilled to see the amazing progress of our 73 year old patient, Jean. When we arrived she was extremely depressed, resisting her meds, and not getting out of bed. After working with therapy this week she is now getting out of her room, walking 20feet at a time, and smiling at any passerby. It is a joy seeing her hope return.

Written by Ruth Thomas:
While we work at the hospital, there are Haitians at the guesthouse doing all the chores. The chief is the grandmother. She has been here for over 19 years. Initially she brought her daughters; now she brings her grandchildren. They start around 6:30 am cooking our breakfast, and washing all our dirty dishes from the night before. Two of her granddaughters take all our dirty scrubs and whatever clothes we leave to be washed, and using two great big tubs out in the yard they wash our clothes by hand and hang them out to dry. Another granddaughter sweeps and mops our floors, cleans our bathrooms and unstops our toliets. Grandmother and another granddaughter chop up vegetables and meat, cook rice or spaghetti, make tasty sauces, and squeeze limes for fresh juice. All morning long you can smell the cooking. We have a hot meal every day for lunch and most evenings. They work until about 6 or 6:30 every night. They don't try to start a conversation, but if you speak to them they always smile and nod in return. The amount of laundry that goes through here each day is incredible. Naomi and I have been folding scrubs and sorting by size. We cleaned out some very dusty shelves in the hallway and stacked scrubs for future medical missionaries. Martha and I cleaned out the OR bathroom which had become a very dusty catch-all, and stacked cleaned scrubs by size in the closets. One night I even boiled water and washed the 20+ plates, pots, and pans. The next morning grandmother was very, very nice to me making sure I got water and helped me chop ice. I'm really not sure how she knew it was me, but I could tell she knew.

Annie Hume is from Michigan. She came to Haiti as part of a humanitaran mission 15 years ago. 12 years ago she made the decision to start an orphange in Haiti. She now has rented a big house and is taking care of 13 children. She has a partner in Haiti who helps her organize and run the mission effectively. She goes around to churches and civic groups telling the story of Haiti's needs, and specifically about her orphans. She has a regular job in a Michigan hospital as a lab tech and xray tech. Whenever she can she comes to Haiti to help with the orphanage. After the earthquake she flew back to Haiti and using a cargo truck with mattresses laid in the back she made over 35 trips back and forth to the earhquake zone transporting critically injured patients to available hospitals. Annie is loud, hyper, and prays about everything. She comes in the door calling your name and announcing the plans for the day. Annie doesn't ask what you might want to do but rather tells you what is happening and what you WILL be doing. Nnannie has invited us all to return and stay at her orphanage. She points proudly to the great blow up beds she purchased for $30 each from Walmart. She self describes herself as that "bipolar Mother Theresa you have already heard about", which was true, we had already heard about that crazy Annie. She is very proud of her orphanage. She has a website bonsamaritan.org. She helps the hospital at Pierre Payen by transporting patients and supplies all over Haiti. Her next project is to open a free clinic next to the orphanage. Check it out. You might want to help her.

Haiti's defunct Club Med;
We came here today for a beer. It was obviously once quite plush. In fact, we were told today that Bill and Hillary Clinton came here for their Honeymoon. It has a clean, private beach with volleyball set ups and a huge, fancy bar. The attendants wear Carribbean shirts. There are no bargains, but prices are acceptable. We understand many UN workers choose to stay here rather than in the big, beautiful new Embassy in Port Au Prince because it is nicer here. That means they have to drive 2 hours back and forth to Port Au Prince to work. Club Med pulled out about 15 years ago when there was so much hype about Haiti and AIDS. Anyway, it is one of the few "nice" places to eat or drink around Pierre Payen.


Carlos and LeeAnn celebrated their birthdays with us in Pierre Payen. LeeAnn was tickled pink that "our" baby girl was born for her birthday. Carlos was just happy to be with sooo many good friends. Annie made sure there was a cake and we all sang off key to celebrate. Someone put icing on Carlos' face. It is the white blob you see.