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Posts Tagged ‘Haiti’

Our last morning in Port-au-Prince were were awoken at 1 am by another 4.7M earthquake, quickly followed by several small ones, and another larger earthquake (I’d guess somewhere around a 3.0M).  There was a small group of tents almost directly across the street from where we were staying.  People ran into the streets screaming.  I can not even fathom having to live there, having no option out.  I knew I got to leave and go home to my nice secure apartment, where the electricity and water always work, and yet I was still very freaked out.  This trip definitely changed my prescriptive on post traumatic stress and how the body copes with extreme situations.  I have no doubt that this knowledge will make me a better doctor.

 

I’ll spare the details of the morning leaving Haiti.  But let’s just thank the American Air lines pilot and flight attendant for holding the plane for me.  Delta is not on my list of things I like at the moment, mostly because they didn’t bother to tell me they had not resumed flights out of Haiti until I got to the airport.  (and I checked the website the night before and the flight said it was on-time and ready…boo Delta).  So the short story is for 3 hours I was almost stuck in Haiti and there was much freaking out.  But thankfully I made it home, and I have never been so excited to be in the Miami airport than I was that day.

 

I hope you enjoyed the pictures and the stories.  The photo album above has some of my favorite pictures – some old and a few that I hadn’t posted yet. 

 

Thank you to everyone who helped me go on this trip.  Thank you for caring for the Haitian people.  Your generosity made it possible for us to treat 1,600 patients and to help hundreds of families.

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After spending several days in Les Caye we headed back into Port-au-Prince.  Knowing that travel is hit or miss we did not dare try to drive into the city on Tuesday morning the same day as our flight.  That is just crazy talk there.

 

On our way back into the city – Dr. Ashby wanted to stop in Leogane and check on wheelbarrow Lady’s foot.

So we stopped, talked to the “leaders” of the tent city so they could go find her and bring her to us.  Darrah and Josh spent the time playing soccer with the kids.   We got out the wound care supplies, walked around, talked to people and waited.

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Wheelbarrow Lady was brought to us.  Jenna undressed her foot and was prepared to remove more dead tissue.  But there was hardly any.  We cleaned it up again, the edges were pink healthy looking and bleeding.  Bleeding is a good sign.  That means there’s enough blood flow for it to actually heal.  Blood also brings in nutrients and proteins.  YAY bleeding foot.   So we redressed it and gave her an orthopedic foot brace. 

OLYMPUS DIGITAL CAMERA         She had a thing for Dr. Mike… but how can you blame her.  He saved her foot.  She may lose one or two toes (which aren’t really needed for general walking purposes) but she’s not going to lose her whole foot.

 

Apparently when you do minor surgery in the middle of a field atop a cooler it attracts a crowd.  Or they just wanted to see what the white people were up to.

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After our “house” call we headed back to Port-au-Prince to get ready for our last day of clinic.  Our organizers went out searching for a tent city to visit the next day.  They found one near where we were staying.  It was housing over 10,000 people.

We were awoken in the middle of the night to a 4.7M earthquake.  Being awoken up to the ground making the most horrible screeching sound is not really fun.  We had at least one more small earthquake that night too, I am not sure on the strength of the smaller one, the USGS website only reports Worldwide earthquakes greater than 4.5. 

Over breakfast we talked about who felt the earthquake.  We apparently brought a few HEAVY sleepers, who were unfazed by the shake.  We drove to the tent city.  As we started setting up the tarp/bus/wall clinic people started forming a line.

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I am not even sure what they were lining up for.  As we continued to set up there was another small earthquake.   It was a very different feeling from the one over night.  For starters I was standing and not laying down this time.  I got the sensation of falling, like when your stomach feels like it’s in your chest.  This is one of my least favorite sensations of all time.  I do not like the sensation of falling.  As we checked around to make sure everyone was ok (we had people atop our bus tying ropes at the time).. the people in line were screaming and running into the streets.  The fear in their faces is something I have a hard time putting into words.  It was heartbreaking.  They live in this fear everyday.  Will there be another earthquake today?  Will today be the day that building or that building falls down?  I can see why most people are sleeping in tents vs. buildings.  After the tremor, they could see we were still setting up and not leaving people got back in line and waited.

 

I treated several day old babies – as in 3 and 8 days old.  They were born in the tents.  Their moms wanted them to receive vaccines.  Unfortunately we were not able to bring vaccines with us.  We do not have the coolers needed to keep the vaccines at the correct temperatures.  I did tell them to try to find a UNICEF clinic – because I know they are doing vaccines.  We were able to give them formula, bottles, and clothes.  For the moms we were able to help with their anemia – B12 shots and vitamins.  Healthier moms equals healthier babies.

 

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We also did a few minor surgeries.  I love a good incision and drainage.  There’s nothing quite like draining an abscess.  Maybe it’s because I’ve had one in my tonsil and having it drained was pretty much the greatest thing since sliced bread.  I drained an abscess on one man’s chin.  It was 3x2x1 inches.  While it might not have killed him immediately, eating and drinking are out of the question with something like that causing pain. 

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I’ll spare you with the really gross pictures.  But if you can see the slightly yellow tint on his neck.  That’s the area I cleaned with iodine and where the abscess was.  Nothing like healing with cold hard steel. 

 

I was amazed with all the work we accomplished the last day.  We treated over 500 patients.  We saw everyone who wanted to be seen.  Because it was our last day most of us gave away our shoes.  This was especially hard on me.  I had some random swelling of my feet – as in 3+ pitting edema.  Still haven’t figured out what caused it, and I still have some of it now.  So my feet would only fit in my athletic shoes.  I had my flip flops and danskos.  If I needed to wear socks and flip flops home, I could do it, because I do not really need the extra pair of athletic shoes at home.

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That’s the lady taking my shoes.  She only had worn out sandals that had holes in them.  Princess puffy feet did manage to wear danskos all the way home without losing feeling in her toes.

 

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The VCOMers – Me, Heather Class of 2010, Adrian Class of 2007, Jenna Class of 2011, and Jeanne Class of 2008.

 

A few pictures taken of the tent city before we headed back to the Villa Ormiso.

 

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While in Les Caye we were able to visit a school run by the Bethanie Mission (where we stayed while in Les Caye).

Can you say cutest kids EVER…

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When we went to the orphanage (also run by Bethanie Mission)… Robert (who’s a full time missionary in Guatemala) brought wooden flutes to give to the kids.  It’s a good thing he also brought someone who knows how to play flute (me in case you didn’t know).

So I taught a blind girl to play a recorder style flute and another little girl how to play a more traditional flute.  They are similar to penny flutes – as their fingers are slightly different than a concert flute.  Not that most people care, but I am telling you anyway because it’s my story and I want to.

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A few of the children at the orphanage were victims of the earthquake losing their parents.

The city of Les Caye was relatively spared from the earthquake.  We did receive word that about a week after we left there was a big flood in the city.  The school we visited flooded.  I haven’t heard word as to how much damage was done, but hopefully it was minimal.

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After our day in Leogane we traveled to Les Cayes, Haiti.  A city on the south western coast.  The trip in theory should be about 5 hours, but for anyone who’s traveled in a developing country knows that any estimate should automatically be doubled.  Getting a flat tire on a school bus is never a good idea, let alone when things like mechanical assistance is not available.  Luckily we had the most awesome driver ever who changed that tire by hand.

Leaving the city – we drove through the epicenter.  Tent city after tent city.  This is a picture of the crack in the road near the epicenter.  To give you perspective it’s about a foot wide and a foot deep.    OLYMPUS DIGITAL CAMERA         OLYMPUS DIGITAL CAMERA

From Les Cayes we were able to go to small villages between Lay Cayes and Port-au-Prince where people were refugees now staying with relatives.  We had 3 days of clinic in Les Cayes.

We saw more crush injuries out in the villages than in the city.  The big organizations weren’t making it out of Port-au-Prince.  Some of these places have essentially no medical care to begin with, let alone after a major event.

One lady I treated was carried in by her husband.  She had been trapped for over a day, with her foot being crushed.  She was rescued after people helped removed the rubble that had her trapped in Port-au-Prince.  She told me that she had seen a doctor in Port-au-Prince, had an xray (of something) and was told nothing was broken.  I believe they xrayd her leg and not her foot.  Her ankle joint had NO movement in it.  No matter how I tried to move it… nada.  Stuck in place.  From my exam I believe she had an untreated foot fracture.  Not much you can do about it after a month.  We luckily brought a physical therapist with us who was able to fit her with an orthopedic boot and give her crutches.  Between that and the massive amount of pain meds I gave her, she walked out of the clinic without pain.  She hadn’t put weight on her leg in over a month.  While it might not have killed her immediately, if you can’t walk, you can’t get food or work.  Not a good combination of things when you are already below the poverty line.

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This is pretty much my favorite picture from the trip.  She was the cutest thing ever, she laughed at me the whole time.  If she had been in an orphanage I can’t guarantee she wouldn’t have come with me, but alas she had a mom so I gave her back.  Also this picture makes my mom crazy, because all she wants is a grandkid or 10…. you know you want to AWWWW at it.

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Every clinic we had, we usually had an audience of small kids that would gather at the doors of the church we were using for the day.  All those funny white people showing up doing stuff and giving away clothes… man that’s exciting stuff.

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A few more actions pictures….

Zany Bday and Haiti 312

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Well I finally decided to come out of my little rabbit hole I was hiding in. It took me a little longer than normal to get back into the swing of things. I’ve stopped having panic attacks when the cat knocks things over, and my heart no longer races when I read the news. All in all that’s a vast improvement from last week.

We had 5.5 days of clinic. In those 5.5 days we treated over 1,600 patients.

We started out in Port-au-Prince. Our first clinic was about an hour from the city limits in an area called Leogane, which is about 7 miles from the epicenter of the first earthquake. Over 90% of the homes in the area were destroyed. Any remaining building were not safe to live in, or people feared being indoors too much to stay in them.

We arrived at one of the tent cities which had previously been a soccer or futbol field to a school. There were so many tents. Most were smaller than a small bedroom, housing 4 or 5 people. We drove our bus into a clearing, attached a tarp to the top of the bus and secured it to a wall of the school. Instant clinic. We brought fold up tables and chairs that have been around the world a few times.

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We had about 10 people seeing patients at any given time. There were 6 physicians, 2 medical students and 4 nurses. The nurses traded off seeing patients, doing wound care and being the runner for supplies and injectable medications.

Each patient had a triage form that had their name and age on it, if female if they were pregnant or not, and the list of common complaints – cough, fever, diarrhea, pain, tooth pain, etc. The triage people would try to circle what the main problems were so we could be more focused with the exam and thus see more people.

In Leogane they live too far outside the city limits to receive care from Port-au-Prince. Some doctors had been out that way already, but living in tents causes infectious diseases to rapidly spread.  Anyone needing long term treatment would receive things in spurts if someone came to them.

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One lady was brought to us in a wheelbarrow.  A wall had collapsed on her foot during the earthquake.  It was black and necrotic.  Dr. Ashby (an ER doc from Charlottesville , VA) spent about 2 hours removing the dead tissue from her foot and cleaning it.  He did all of this with local anesthetic and a few shorts of  versed.  So while she didn’t feel pain, she was definitely awake during all of it. 

I saw two children – while not related to the earthquake – who definitely had things wrong them.  One little girl was badly burned as an infant and had a scar tissue contraction from the middle of her shin attaching to the top of her foot, deforming it so she could only walk on the heel of her foot.OLYMPUS DIGITAL CAMERA

100_0268 It’s sad in the fact that her foot could be corrected in a really short and simple surgery.  Just cut the contraction and her foot would go almost flat immediately.  She walked relatively well for the deformity that she had.  I wish we had better shoes to give her.

The other baby I saw – I’m about 99% sure it had some genetic/trisomy/Down Syndrome thing going on.  The baby did not cry correctly – more of an eh sound, had a cleft lip, low set ears and close set eyes.  In pediatrics terms – a funny looking kid.  Not sure exactly what the issue is, but we treated the general illnesses and I asked a bunch of questions to make sure the baby was eating well without coughing.  I saw no cleft palate – but a baby like that can die from aspiration or malnutrition easily. 

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After seeing the doctors the patients headed to our high tech pharmacy.  A numbered roll out bag with little baggies of medications in it.  Portable and able to be used by non-medical people.  In fact everyone who worked in the pharmacy had no medical training.  They got a crash course in what BID/TID/PO/IM/PRN meant.  They did an awesome job, not knowing what we were writing and not knowing what the drugs were for.  Way to go Pharmacy team!!!

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After the pharmacy was a trip to the out reach group… who distributed clothes/diapers/bottles/baby formula.

 

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At the very end of the day we gave out water.  We couldn’t do it earlier in the day because things like water and food tend to cause mobs.  It’s harder to control the masses after that.  So we gave out water and headed back to Port-au-Prince.

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Even while living in tents… the Haitian people still fly the flag and have pride in their country.

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I am not sure how many blog posts I’ll write about Haiti… but there will be at least a couple.  It’s taking a while to process everything in my head, and with the recent earthquakes in Chile and Japan I am very emotionally drained.

 

I met up with the group in Santo Domingo.  It was nice to see familiar faces waiting for me in the airport when I arrived.  Commercial flights to Haiti did not resume until half way into our trip – so we had to bus across the border from the Dominican Republic.

 

We were stopped along the way into Haiti by a demonstration in the street by local high school students.  The government built them a poorly constructed school and they were worried about it collapsing like the schools in Haiti.  Traffic was stopped for about an hour and a half.  This did not stop post of the cars from turning a two lane road into a 5 or 6 lane road trying move around them.  The police finally came and broke it up using tear gas.  The students reconvened 1/2 a mile up the road – at which point they started throwing rocks at the passing vehicles.  One of our buses got through, but the other one did not.  We had to wait another 15 minutes or so to pass.  After that we made it in to Haiti without any problems.  Easiest border crossing ever.

025 Protest in the street

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As soon as you approach the city limits of Port-au-Prince the tent cities start popping up.  Any empty space is filled with tents.  Some people were lucky enough to have a military tent or a camping tent.  We even saw a few Shelter in a Box tents.  The median between the highway had tents lining it.  With an estimated 2 million people homeless you can’t look far without seeing a few thousand tents.  Most of the homemade tents are made from tree branches and bed sheets.  We did see a few with tarp roofs or aluminum siding walls, but those were not the majority.

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The frames for the tents

 

Looking past the tents we started to see the collapsed buildings.  Buildings half collapsed or even leveled.  Every street corner you could see something that was destroyed.  Our first stop was to the Royal Palace to drop off a missionary we met in Santo Domingo who needed a ride into Port-au-Prince.

 

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We then drove through parts of the city on our way to the OMS International Villa Ormiso Hospitality Center where we stayed while in Port-au-Prince

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We settled in and started organizing the medications and wound care supplies to take to our first clinic in the morning.

 

I’ll write about the medical clinics tomorrow and more of the trip…

Off to have delicious food with Jacie and Tracy, hopefully watch the Men’s USA Hockey team win Gold and spend sometime with an unfinished sock.

 

Stay tuned.

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