Thursday, November 25, 2010

Visiting the Cholera Tent - Lizandra

It is Thanksgiving. And I am most thankful for the privileges I have that allow me to be here in Haiti in a time like this. I am thankful for the support of my friends and family behind me as I am here, and also for the wonderful people I have met in Haiti over the past two days.
Today started off a lot like yesterday. Awoke at sunrise to do sun salutations on the patio, then shower, breakfast, internet and off to the hospital. On our ride into we did all talk a bit about the fact that it is Thanksgiving and shared what our friends and families were probably doing. There were again 8-10 patients waiting for us, I started off with Pierre just as we had yesterday. I saw two of the same people I had worked with yesterday, and got to work with a couple of new ones. All with either hip or low back pain, so again very standard stretches and basic postures. They are so happy and thankful for the poses, and I hope it helps to ease their pain and discomfort some.
At noon when the patients had dwindled I decided to join the German doctor on a visit to the Cholera tent. Before we could enter we had to wash our hands in a diluted bleach solution and have the soles of our shoes sprayed. They do this on entrance and exit and also when moving between sections of the ‘tent;. The idea is to keep new germs/bacteria from being introduced either direction.
The group who set up and run the 'tent' are from France, and they are running a tip top program. I am calling it a tent -but it is really a tent community, with constructed temporary walls, hallways, and several separate tent rooms. They have a triage space, and then a tiered room system depending on the severity of the case. We saw about 25 patients in the different rooms, ranging in age from 1 to 50 years of age. The sicker patients of any age were very hard to see, the pain and discomfort very clear in every aspect of their being. The worst was some of they eyes. In some cases blank, and in some pain filled. There was one small boy who was very alert, but with the saddest eyes I have seen in a long time. It was heart-breaking. But at least they are being treated, and the German doctor said overall it was a much better environment than he has seen in other places. Most of the people we saw today will live, because they are receiving topnotch treatment.
The French are clearly following a well thought out and planned system and are working hard to get Haitian nurses and orderlies to work with them within their plan and structure. Each room has a nurse’s station where they take careful notes, and also dispense the basic medication, food and liquids. There are 2 doctors and 8 nurses and at least 15-20 orderly types who are disinfecting and keeping things in order. Everything is labeled and every room has treatment instructions and plans posted on the walls.
The tents are constructed quite well with some scaffolding and then also clever use of branches, small trees and ropes to help construct the walls. The German doctor was very impressed with both the operations as well as the care being provided. They are well staffed and well equipped. The only issue will be patient load. As long as the Cholera stays this contained level in the area they will be fine.
The Haitians are an amazing and resilient people, I really hope the resources will come together to help create treatment centers like this all over the country.

Wednesday, November 24, 2010

Au L'Hopital by Lizandra. Lizandra is a certified Yoga instructor who volunteered to assist our therapy team at the clinic this week.

Just back from the hospital. Wow, what an experience it was.
Most of the day was spent in the Outpatient Physical Therapy clinic. When we first got there I was unsure about my role. My thought was that I would just be like a PT assistant, and help how I could and keep my eyes open for yoga opportunities. As it turned out, I got to work with the very first patient we saw. Leslyn was working with him doing some basic leg stretches, so I joined her and started working with the patients breathing as he did the exercises. Then Leslyn was needed with another patient and so I finished up with Pierre.
From there I started seeing patients on my own. Of course, none of them were acute, they were all people with older injuries or basic back or shoulder pain. I worked closely with 4 other patients and it was amazing. We did a lot of a cat; and cow stretches, and child’s pose, and some forward folding seated poses and neck and shoulder rolls. It was a great experience and the patients were all so thankful. It was a day well spent for sure.
There were two highlights to the day. One was when I asked one of the men I had been working with how he felt afterward, and he did a little whole body shake, and said, “Much looser”. That was perfect, it was just what he needed with some chronic back and hip pain, he needed to loosen. The other highlight was when one of the PT’s, Madge, came over and asked me to work with a guy who needed to “find” his scapula muscle. He was recovering from a stroke and had not yet strengthened his scapula muscle. I worked with him very carefully, and it was amazing to find postures that would really engage that muscle and work with him to ‘find’ it and work on strengthening it. He was a tailor who really wants to get back to work and so motivated to do what he needs to heal.
While I was in the tent doing these basic stretching exercises – the other PT’s experienced some drama. A patient vomited while one of the PT’s was wrking with her, that patient ended up in the emergency room. Then that same PT was summoned to help with an acute repertory problem in the ER, and finally someone from a motorcycle accident was rushed into the area right by us, so all the PT’s jumped in to help out. Meanwhile, I was doing Sun Salutations with a young woman who has a bit of a palsy and some balance issues. What a day!
By 1pm the patient load had reduced to a only a few people, and so Pascale took me on a tour of the hospital. It is a community hospital that was built in 1984, by Haitian standards it is well constructed and also well equipped. By US standards it is not exactly a sterile environment. The PT’s who have spent more time in US hospitals than I, were a bit non-plussed by the conditions. But while not perfect, it is much better than not having a hospital at all.
At present the hospital is not at capacity. I saw a lot of empty beds and unused equipment. I guess that it is a good thing in a way, not too many sick people in the area. But of course one wonders about access and are enough people connected, and also cost. There is also a transportation issue, so many sick people in places that they can’t get to this hospital. I guess in the aftermath of the earthquake, the place was overflowing with people and also plenty of foreign help; it was a major center of relief work.
The Cholera has only just gotten to this area. The main hospital does not treat cholera, there is a separate Cholera tent run by a French group. Today there were 14 new cases, yesterday there were 25, we’ll see how many more there are tomorrow. I haven’t gone there at all, it is a bit intimidating to go “sight-see’ in such a critical environment.
We met a lovely German doctor who is here on a three-month rotation. He is working out in the remote villages and comes to stay at the Port Au Prince hospital for a bit of a ‘break’, while he is here he helps where he can. He is here with the German Red Cross, but he says that he really manages his own work load, going where he thinks he is needed and doing what needs to be done. So amazing and inspiring to meet him. So great to see people like him doing this kind of work.
OK, I am being summoned to the ping-pong table. The house we are staying in is nothing short of amazing. Today with the patients I stepped out of my comfortable bubble and felt like I was able to share directly with an important aspect of humanity I don’t always get to engage. All day long I interacted with Haitians where they were, in a fun and connected way. I am very thankful for that, In the evenings, I am back in a privileged and comfortable world, and I am also thankful for that.

Sunday, October 31, 2010

Karen -Week Two

We continue to be busy at the clinic. We saw 16 patients yesterday, which is not a lot for 2 of us for a full day, but they all come at the same time! I asked about making appointments, but that seemed a foreign concept – always first- come first- served. Tom and I are finally getting used to having our patients wait. Some hang around after they are finished anyway, so they don’t seem to mind. Even the toddlers are waiting patiently. Most of the patients arrive by 8:30 or 9:00. We rarely get patients in the afternoon, so we are usually finished by about 2:30.
We are enjoying our patients. We had 5 new patients yesterday, so we continue to grow. I am so glad that I am here for 2 weeks, because I have the same patients coming back this week and I can really see progress. I have one woman who is only 2 weeks after her stroke, so this week she is coming every day. She is very motivated and her family is very supportive. She arrives smiling, works hard, and leaves smiling and is making progress daily. It is gratifying to know that this would not happen if we(Global Therapy Group)were not here providing this service.
I have also had a chance to visit with our host family and our translators. On Tuesday I sat down to talk to the translators about my expectations, etc. and I specifically chose to sit in a low child’s chair. One of the interpreters commented to the others in Creole and they all started laughing. The only words that I understood were “voodoo doctor”. When I asked him about it later he said that I looked like a voodoo doctor because a doctor would always sit in a low chair. Of course I had to ask the question “Is that a compliment or an insult?" He laughed and said “Neither, just an observation”.

October Adventures - Karen

The patients have been great. They are very motivated and interested in patient education. We have seen many young, male stroke patients (40s and 50s), lots of upper extremity injuries, a couple of kids with cerebral palsy and a mix of other diagnoses – some related to the earthquake, but not all. One of our patients comes every day. He is an older man who has had a stroke. He comes with his daughter. They are at the hospital all day, every day in the heat, because once they are dropped off, they have to wait until the end of the day for a ride home. Talk about dedication. That is why it is such a pleasure to work with these people. Many of our upper extremity patients have frozen shoulders and extreme weakness due to prolonged immobilization and no follow-up or activity guidelines/patient education. I realized that one of the most important things that I had to do was to tell them that it was OK to use it- simple but critical. Most of our patients are pretty poor – they come with dirty socks and worn shoes, with casts and bandages that are falling apart - but some are working professionals. We have a couple of teachers who are not back to work because their schools are not yet rebuilt. I am glad for the diversity, as I think that will help spread the word about PT to different sectors.
It is a good feeling to know that I am providing care that would otherwise not be available if I were not here. Another great thing is the container of donated supplies arrived from the states about 2 weeks ago, after many months of waiting. There are lots of therapy supplies and equipment, so we are able to give patients theraband, hand splints, walkers, wheelchairs, etc. I had a patient who was elderly with very painful arthritis in her knees. She hobbled along with a cane, but I was able to give her a walker (a rollator so she could maneuver on tough roads)and it made a big difference. We are also able to refer patients for prosthetics or orthotics to a local group. I have also been able to distribute toiletries that were collected and sent via Barbara-Jo Achuff. The patients are so appreciative – we have an instant friendship.
Today we were able to go to an arts festival that was held on a former mill that processed sugar cane. I bought a couple of souvenirs. It was fun to see all the local art Рpaintings, sculptors, tin work, macram̩, etc. What was most interesting, though, was the fact that the attendees were primarily the elite Рa switch from who we see at the hospital. Everyone was clean, well dressed and with nice cars Рa strange contrast.

Monday, October 25, 2010

Two Months of Challenges and Honors Donna

September and October brought excitement weekly for the Global Therapy Group. Both the good and the bad kind!
On the good side, Jo Ann and Donna were chosen as Alumni of the Year by their alma mater Washington University in St. Louis PT program and presented with an award in September. It was a wonderful honor, but also an opportunity to spread the word about our clinic and the need for volunteers and funding. Donna was excited to fully book our schedule of volunteers for 2010 by mid-Speptember and be able to open up dates for 2011.
The fall has also presented some challenges. A severe storm in late September tore the entire roof off our clinic. Our volunteers then struggled working in the hot sun all day. Thankfully, a PT friend traveling to Port au Prince brought us a new large tarp the next week, but it was then torn off during another storm! Luckily, the tarp was found and will be re-attached soon. Our container of donated supplies and equipment arrived after sailing from Texas, escaping the "black hole" of customs in Haiti, being delivered to the wrong place and lost for 4 weeks, then delivered to our hospital but sent back as it was labeled incorrectly. It finally arrived the day after the severe storm and had to be unloaded in just one day due to all the mix ups. Now cholera is in northern Haiti. We are monitering it closely and hoping it remains contained there and does not spread into Port au Prince.
We are hoping for a few weeks in succession without a crisis so we can begin to recruit help for fundraising, website development, accounting, etc. In spite of all the challenges, our volunteers continue to treat 16 to 25 patients each day and receive new ones weekly. People are improving in their function, have less pain, are able to return to work and are more independent. The volunteers all tell us what makes this an unforgettable experience for them, is watching the people of Haiti rise above all the challenges they are presented with. They are our role models and we know we can rise above our troubles as well!

Tuesday, September 7, 2010

Donna - August in Haiti

Re-entry into everyday life in the US after two weeks in Haiti is always tough. Even after my third trip in four months, it still required some adjustment. I am just finding my feet and voice again three weeks later. And I am enjoying air conditioning more than ever. Haiti is HOT in August. Below are the highlights of my most recent trip and work at the clinic.

Teaching Clifford to play soccer with his new prosthesis. Watching the smile spread across his face as he kicked the ball back to me with his prothetic leg, made all the hard work and long days of the past five months worth it. He sums up for me the reason why this therapy clinic needs to be here and why what we are doing is important.

Watching Judeline dance. A new friend and handsome 20 year old man named Pascal volunteered to help at the clinic the weeks I was there. Judeline noticed him immediately and we asked him to practice walking with her with only one crutch. As the week progressed, Pascal took things a step further. One day he asked her to dance. Pascal is over 6’ tall and Judeline, when she stands fully upright without her walker, is about 5’9”. They looked so elegant gliding across the concrete floor of the clinic. Judeline looked beautiful and had a smile on her face unlike any I had seen before. For the first time in a long time, I think she felt normal. I suggested the next day we walk without even her crutch. She was very hesitant at first, but soon did well. I mentioned at the end of the therapy session that if she was wearing a long skirt or pants and did not have a crutch, no one would be able to tell she even had a prosthetic leg. She’d look like any other teenager. Judeline’s eyes lit up and I could see the light bulb going off in her head. Everyday from then on, she came to us asking for therapy and wanting to walk without a crutch. When my son arrived the following week, she was able to take turns dancing with two 20 year old men each day and her smile grew even bigger!

I treated a new patient with severe hypersensitivity in the nerves of his calf and foot after an injury in the earthquake. It had been several years since I had done any trigger point massage, but gave it a try and worked on him for 20 to 30 minutes. (Much to his dismay I might add, as it was painful!) After only 3 sessions however, the pain that had plagued him for the past six months was gone. He was so appreciative and said he had his doubts about this “therapy” that first session, but now believes!

Watching a dad and his young son with cerebral palsy work with a therapist for the first time. He lovingly began moving his son’s arms and legs through more normal movement patterns at the direction of Lindsey, a therapist from the Perkin’s school in Boston. The look of happiness on the dad’s face, all the questions he asked and the sweet way he smiled at his son told me how happy he was to finally have help. And hope. There were no services available to these children before and word of our clinic has started to spread from parent to parent.

Our volunteers always ask before they travel what items they can bring. The clinic can always use “things”, but I believe now more than ever, that it is our skills as therapists that are our greatest gift to the Haitian people.

We went back to visit Julien and the 100 children he is caring for at his make-shift orphanage. He had told us it was “right down the street” which we have learned is what everyone in Haiti says when you ask where they are located. The walk there is an experience in itself. We took a “shortcut” through the hospital fence, across a small cornfield, along the top of an 8” wide concrete wall, followed by a jump down onto the roof of a broken pick-up truck and a climb down the truckbed to the ground, up a hill, past the town dump and several pigs that had to weigh 500 pounds each, (they seem to be eating well in Haiti even though no one else is!), up a steep hill, past the local beauty salon where a woman sat on the ground and sewed hair weaves into the heads of her clients, around two more corners, down a hill and through a red iron gate. All the children greeted us with a loud “Welcome Global Therapy Group!” This visit we did not bring medical supplies, but instead brought twizzlers, fruit loops, crayons, paper, and rubber balls. I asked all the children to draw me a picture of something that makes them happy or would make them smile. Most of them drew a picture of a house. I guess living in a tent gets old fast. We sang songs, played soccer and laughed a lot. It was a great afternoon.

We discovered Haitian and Dominican rum this trip. The Haitian tastes a bit better, but the Dominican is half the price. Only $1.91 US for a 350ml bottle. Mixed with fresh mangos and juice, it was a great way to end a long hot day at the clinic. A new friend at the guest house taught us we could also mix the rum with a teaspoon of brown sugar and a fresh lime. Also excellent.

I enjoyed having time this trip to get to know more of the Haitian people on a personal level. It was so fascinating to discover all the ways in which we are different and so many ways we are the same. I was glad to have time to see more of Port au Prince. The crumbled buildings and large tent cities, but also the places where life is trying to return to normal. Haitian artwork is back along any open wall around the city in the hopes that tourists will stop by. People are once again busy buying and selling everything you can imagine along the sidewalks. Homemade charcoal, sugarcane, fruits, vegetables, meats, shoes, clothing, cell phones, champagne, beer, soda, sunglasses, watches, fans, plastic tubs, books, pills of any kind, and chickens. Guibson one of our translators was appalled to find out that most Americans would have no idea what to do with a live chicken. He offered to show anyone interested.

I have had many volunteers offer to travel this fall and have nearly all the weeks at the clinic covered from now until the end of the year. Our July fundraiser in St. Louis was successful and gave us enough money to pay the translators, clinic costs and cell phone in Haiti through October. But then the money runs out. Anyone out there want to organize another one? We have applied for funding through a variety of sources, but most of the purse strings in Haiti still appear closed. I am trying to just keep the faith that God will stay busy, and I’ll just keep sending the e-mails.


Sunday, August 8, 2010

A few journal entries: Jean Peteet Two week volunteer in July

7/8 A 22 young man came for bilat knee pain. Plays basketball- had a PA Strikers jersey on- had gotten hit in both knees. Looked at least like bilat medial strain to his knees. His passion was playing ball. Able to find an elbow elastic support that we turned into a knee support! He was so pleased. He told us how much Haiti needed volunteers from around the world and how grateful he was that we had come. Made me tearful. I told him how beautiful and courageous I thought Haitians were. He seemed surprised to hear that. That’s all I needed to make my day.

7/9 Seeing lots of generalized pain as well as job specific pain. 22 yo taxi driver came with acute low back spasms. Drives a manual transmission all day, old cars, poor support in the car seats. Another young girl, about 18 came in with neck/shoulder, knee, foot pain. Had bilateral flat feet. Has been unable to work. Her job was carrying heavy goods on her head- footwear in Haiti is so inadequate for the work they do. She really needs orthotics or at the least shoes with some arch support. I had brought a pair of crocs; we asked our Haitian speech therapist if crocs were considered fashionable in Haiti and she said no. Not surprisingly, the girl did not like them. No solution for her. A 60 yo woman can in with an old symes’ amputation. She had beat up high top shoes filled with rags to fill the space of her foot. Put her on the orthotics list but it will be a long time before they get to her. Diana Cherry from Mission of Hope came by to pick up some supplies left by Keith, the CPO who volunteered the previous week. She said MH is only able to make 3 prostheses a week. Given that there seem to be only 3 places in the area that are geared up to make prostheses, it’s going to take a long time to get everyone fitted. Many of the amputees are kids, too, and will need ongoing revisions to their limbs.

7/10 Glad that we had the clinic open on Saturday morning; no other clinics in the hospital are open on Saturdays. Two families came in and one woman who cannot come during the week. Henri, the host at the guest house invited us to go up to a high point where there is a wonderful view of the city and we spent the rest of the day into the evening with him and Vincent, his son. His cousin has a beautiful art shop in Petionville where we shopped. From there we went up the mountain and the view was striking. We could see many of the tents, and the density and lack of trees or anything green around port-au- prince was striking. He then took us through the worst of the earthquake. It was hard to look at it. It was like a bombed out city; block after block of collapsed or partially collapsed buildings. It looked like pictures of Germany and London in WWII. Street life has returned and people have set up stands outside the rubble selling bed frames, mattresses, used clothing, candy, used shoes, new shoes, new suits in plastic bags, as well as prescription drugs that Henri said have expired dates. We saw the partially collapsed palace and immediately in front of it is a huge tent city that stank of urine, so much so that we raised the windows. The tents are packed in with no room between and only a narrow path going down the rows of tents. People able to buy charcoal and have a means of cooking apparently cook just inside their tents. In the midst of this chaos, we passed by two wedding parties with people immaculately dressed and it was incredible to see with most of the people, how clean and neat their clothing was, despite the awful conditions in which they live. Henri says that the government wants to tear down the inner city that has been damaged and start over, creating an area for businesses and markets. He is pessimistic that this will happen; often the government starts such projects but never finishes them. Stopped in a grocery store; food and non food items are much more expensive than in the U.S. because the Haitian government has no way of collecting income tax, thus they tax things people buy in the stores. Also, everyone has to buy water and a ½ liter costs $1. There have got to be a lot of people who are chronically dehydrated.

Friday, August 6, 2010

Donna - I want a magic wand to make all that we need just appear!

Julien, a dynamic man with an amazing smile, came to our clinic with a friend earlier in the week who had a badly infected finger. We referred her to another hospital for care. When he learned what we were doing, he told us his story. He has created an orphanage near the hospital for children who were orphaned after the earthquake, or simply had families who could no longer care for them. He has a two room concrete structure he found, and has set up 2 tents outside for sleeping. He is caring for 100 children from babies up to about 12 years. He said he only has room for 100 to sleep, but wishes he could fit more. He has another 50 children who he feeds when he is able to get provisions but they are on a “waiting list” so to speak to stay full time. He asked if we could come by and see some of the children as many have infected cuts and foot wounds. We gathered a bag of supplies today and walked down several dirt roads, over an abandoned truck, up a steep hill and arrived to the sound of children singing. Julien had the children practice a program of several songs for us, and they announced in their best English, “Welcome Global Therapy Group!!!” We created an assembly line to dress wounds and take note of children who needed to be taken to the free community clinic at the hospital as they were beyond our scope of help. One of the adult helpers had what at first appeared to be an infected pimple on his cheek, but after examination I think it may be a parasite infection. I had no clue how to address that and honestly did not want to try! We handed out vitamins, peanuts and M&M’s, and inflated blue rubber gloves as balloons. The children were all so appreciative and sweet. Julien told us he is able to find money to buy them bread most days, and occasionally rice, but he is struggling. JoAnn and Jane are looking into how to connect him with an aide organization. He is doing this all on his own and said he could not simply walk away from all these children in need. We wonder how many others are doing the same and how many children there are now alone in Haiti.
We discovered several of the “Lost Boys” that come to the clinic are on his waiting list. We have tried to make sure all the boys who visit us each day have a decent pair of shoes and eat at least one meal with us. And we try to “play” each day. Frisbee, volleyball with beach balls, Keep away, dancing. Anything to elicit a smile and make your troubles evaporate for a short time. I think we need it more than they do most days.
When my family comes next week, I will have my daughter visit the orphanage several days to sing and play with them. They are all so pleased to just receive the attention. We hope to come up with some food options at least for the short term. So much need here. We do the best we can and sometimes find we do not ask the questions as the answers are too heartbreaking. The children’s smiles are what keep us going daily.

Wednesday, August 4, 2010

Donna - Wednesday 8/4/10

Clifford came to the clinic today!!! He received his prosthetic leg yesterday and today was walking all over our clinic with it and his little crutches. Best of all he had a big smile on his face. The sad and traumatized little boy we first met seems to be recovering.
Judeline walked with the assist of only one hand today, without her crutch. She did not do this to impress us as therapists, but because a handsome 20 year old man who was assisting us asked her to try. She just turned 16 and we have learned what motivates her best. We will enlist my 20 year old son next week!
We have had several new patients this week both in the clinic and in-patients at the hospital. They have arrived with various complaints, but asking for exercises to help make them better. Before we arrived, “physio therapy” in Haiti meant massage. Our first week patients arrived asking for massage and we tried our best to educate them about our version of therapy. The word seems to have gotten out now that exercise is what will make you better. Yeah!!!

Tuesday, August 3, 2010

Donna - Tuesday 8/3

We are back in a rhythm at the clinic after just two days. It is so wonderful to see some of the patients we cared for back in April and May again and celebrate with them all the progress they have made. The hospital doctors welcomed us back and thanked us for continuing to run the clinic. An orthopedic surgeon sent us a referral today on a complex patient and when I stopped by to thank him he said,” I knew I could count on your group to help her. You are all so wonderful.” Encouraging words like that from one of the doctors makes all the hard work worth it. We also received big hugs from the nurses we had become friends with. Marie Nichole, one of the head nurses, still wears the scrub top I gave her every day. Another great moment yesterday was receiving a referral from one of the doctors for a woman who had a new stroke. She had come to the hospital the day before we arrived. When we asked the family if they were moving her at all in bed they responded, “The nurses told us we have to roll her over every hour.” Hooray!!!!!! JoAnn’s inservice teaching about preventing bed sores was effective if the nurses are now instructing the families themselves.

We spent time this afternoon with all the young boys who hang around the hospital. Anyone with shoes that were worn was given new ones. Little David who I wrote about before, was thrilled with his new sandals and had a smaller pair of pants on today so could run better. He asked me often today for water and I poured many drinks into his mouth. We marveled at how children that young run free in Haiti. He appears to be about four. Does he have a family? Where does he sleep at night? He was so grateful for the attention and shoes today that he wanted to help us put all the clinic supplies away. He insisted on carrying big items, one in each arm, and would not allow us to refuse his help. He seems to have already learned at four that if you make yourself useful to others, you may find a way to receive what you need. We brought out a Frisbee and taught everyone the game. Little David was the best of all of them! Jane, another OT volunteer, blew up blue surgical gloves and made volleyballs for everyone to play with. We shared a box of Fruit Loops which no one had ever heard of. Even the translators enjoyed those.

We had a meeting with the main hospital administrators Monday afternoon and are working out details for a partnership to ensure the clinic can continue long term and eventually without us. I am encouraged, but know much work is still ahead.

We bought some sugarcane from a sidewalk vendor today to enjoy for dessert. We are finding the mangos and avocados delicious and found a new fruit of white banana tasty. It is still rather hot and humid, but I guess Kansas City was 105 today so I feel better! Granted you all have a/c, but we are managing fine with just our fans.
We have decided the Haitian beer Prestige is far superior to the Dominican beer Presidente and will now move on to rum tastings.

Bon Nuit!

Sunday, August 1, 2010

Donna - Haiti in the summer? Not as hot as I expected!

I am back in Haiti for the third time in four months. I feel a calm this time that I know is partly because things have become familiar and easy, but also seems to come from the city of Port au Prince itself. The chaos that existed after the earthquake has been replaced by the even rhythm of everyday life. The airport is more organized. Some of the rubble is starting to be removed. More sidewalk space is open for people to sit everywhere again and sell their wares. The hospital is quieter with fewer patients and no foreign medical volunteers in sight today. Except for us that is. What a welcome we received! Our translators were so happy to see us and the children full of smiles. Judeline is still staying at the hospital, but will be traveling soon with her mother to the US for follow-up surgery on her hand and rehab. She giggled when she saw us, and then looked nervous when she realized we would make her begin working hard again! She was happy to show us the progress she had made with her left arm and hand as long as we did not want to touch it and stretch those tight joints and tendons ourselves. She is able to walk with only one crutch now with assistance, but still tries to get her mom to put her prosthesis on for her. JoAnn did not let her get away with that today!

The previous teams have done a great job of organizing the clinic and our supplies. We have several rows of chairs now for the waiting area and a few chairs for the therapists as well. We have a new metal “check-in” table and a set of parallel bars created for us by college students from Canada from what appears to have once been a red iron door frame. We have two treatment tables and neither of them wobbles when a patient climbs up on them! We have a new supply of wheelchairs to give out as needed and found many supplies today we thought had been lost, but only misplaced. It was like coming back to your house after a vacation and finding someone had cleaned, redecorated and added great things. Unfortunately, the rains continue to take a toll on our tarp roof. There is a large hole in the center again, but it’s still standing.

Our new guest house, in the home of Caroline and Henri, is just lovely. It is 3 rooms of beds and a bath, with a large outdoor patio and eating area surrounded by tropical plants and flowers. It is less than a mile from the hospital in a dense, wooded, park-like setting. It reminds me of Central Park in New York. An oasis of nature and calm in the midst of a busy urban area. Tina and Oreo their sweet dogs greet us in the evenings and Cassie the kitten chases the lizards. We have learned the lizards in the morning are dark green, and the ones that come out at night look almost albino they are such a pale green. And there are no tree frogs here to keep us awake with their mating calls all night!

We visited the JP-HRO camp to speak with their medical director today. JoAnn was very disappointed that Sean Penn was not around. She is still kicking herself for not going with me the last time and missing his great smile. What a marvel of organization they have created in a small area serving over 50,000 people. They are in this for the long haul and it’s obvious how hard everyone is working. We also visited with the heads of Healing Hands for Haiti and learned the Red Cross has awarded them funding to build a major rehabilitation and prosthetics center over the next 18 months. We are so excited for them. They were serving the people of Haiti for years before the earthquake and I know this will enable them to provide the services in a way they had only dreamed about before.

Best Haiti moment today: The hugs and smiles from the translators and children at the clinic. It was like seeing family again.

Saddest Haiti moment: A new little boy of about four I had not met before was wandering around outside the hospital. He is wearing pants too large for him, so he must hold them up while he runs. He has a pair or sandals with the front piece torn off one foot that he carries most of the time and occasionally is able to re-attach. After tripping over the broken piece for about the 10th time today he stopped in front of me, looked so frustrated, and simply pointed at them as if to say “I could really use another pair of shoes lady!” In my feeble creole I said “lundi” meaning Monday. He shrugged his shoulders, picked up the broken rubber front flap, grabbed his pants and moved on. One of our previous volunteers Mary, had sent many pairs of sandals with me for the children, so we decided Monday will be “New Shoe Day.” I will also use one of our Velcro straps to create a belt for him. With new shoes and a belt, walking or running can be effortless for him again. Isn’t that how it should be when you are four?

Tuesday, July 6, 2010

July Update

It is the first week of July and thanks to our amazing volunteers, we have been able to staff the clinic without interruption since April 5th!
We were concerned mid-June when one of our volunteers had a death in her family and had to cancel. Another volunteer stepped up to take her place, only to have to cancel herself one week later when her father had a stroke. It was Sunday, June 27th and we had only Jean, a PT who would now be at the clinic for two weeks alone. How would she be able to handle the 25 people a day who were arriving for treatment? What were the odds we could find another therapist who could travel on 5 days notice to assist her? Astronomical at best.
And then I received an e-mail Monday morning from Anne, an OT who had booked a trip to Haiti leaving 7/4. She was traveling with her sister to help at a convent, but wondered if there might be a need for an OT somewhere in Port au Prince. She did an internet search and found us. When she heard our story and needs, she paid a hefty airline change fee and volunteered to stay and work at the clinic with Jean until July 17th! Would you believe she also lives in the same city as Jean and they worked in the same hospital 30 years ago? Once again, whatever we need continues to fall into our laps.
We do not have a team yet for 7/16 to 7/31 but after the events of last week, I feel confident that everything will once again work out. (Still, I will sleep better once it has all fallen into place!)
Bondye Bon—God is Good.

Tuesday, June 29, 2010

Kim and Tyler Day Six.

We have just finished our sixth day at the therapy clinic. Words really can't describe the week we just lived. The Haitians are wonderful people and they have been so kind and helpful to us. They really appreciate the teams that are coming to the clinic. We have seen quite a few orthopedic and neurological conditions (including three cases of bell's palsy which I found a bit unusual) and we have seen some interesting conditions as well such as the young man who came in with right and left foot drop from tuberculosis. We were able to find a brace for his left foot but then we were not able to place his foot back into his shoe with the brace. My son has feet the size of a clown so he was more than happy to give his tennis shoes away. It was great to see how much better he walked with his new brace and he loved his new shoes. Others have come to the clinic to seek medical advice because you must pay for medical services in Haiti and many can't afford care.

Tuesday, June 22, 2010

Kim and Tyler -- Louisville Kentucky to Port au Prince

We have just finished our second full day of work in the therapy clinic at the Haitian Community Hospital. My eighteen year old son Tyler is with me as are two physical therapists. We have been fairly busy so far. The patients are so happy to see us. We have seen a lot of fractures from the earthquake, five stroke patients, two patients with bells palsy and an assortment of aches and pains. They have ranged in age from three to seventy. We have a pediatrician from one of the missionary groups coming to work with us tomorrow to consult on some of our cases. I am excited about that because he brought some prednisone with him which may be helpful with our bells palsy cases. I have needed splints on several occasions and we have enjoyed getting creative with the bits and pieces of splint supplies. Tyler is using the candy we brought to entice the children in therapy to reach and stretch a little bit further.

He also has been entertaining the “lost boys” and there are usually about 8-12 of them hanging around him. Today we brought an extra gallon of gatorade for them to have. It is so sad to hear a child tell you that he is hungry and thirsty. We are going to acquire some shoes for two of them because their shoes are completed filled with holes on the bottom. They also found out that I have band aids so we covered many of their cuts.

We spent time with the missionary groups that were here this past weekend. They included us in all of their service work. We helped to pass out fifty pound bags of rice and we played with some children at an orphanage. It amazes me to see the joy and appreciation the Haitains have given their extremely challenging living environment.

I have found out the hard way that it can take three days to dry our clothes around here (hand washed clothes may I add). The first two days they hang in the bathroom and remain completely moist because there is so much humidity in the air. The third day I got smart and hung them outside only to start the whole procedure over again when the late afternoon five minute storm hit.

Friday, June 4, 2010

Seven Weeks! So many successes and such immediate challenges.

Two months ago today, Jo Ann, Eliott, Judy and I arrived in Fort Lauderdale and excitedly began repacking bags in our hotel room so we could fit more crutches in them. Who knew there were entire rooms filled with crutches already awaiting us in Haiti!
The Global Therapy Group clinic has been open for seven weeks now and is already seeing 20 to 25 patients a day. The teams who followed us did such a marvelous job. They expanded on what we had started and began new ideas of their own. One team created an outreach program to a nursing home behind the hospital and began holding group exercise classes there a few afternoons a week!
Our immediate problem is that we are coming to the end of our scheduled volunteers. Our last team leaves June 19th and as of today, I have no team in place to follow them. The idea of the clinic sitting empty for 2 weeks makes me so worried and sad. Patients will come each day and no one will be there. Will they ever come back? Will they just assume the volunteer therapists have now gone like all the other medical teams?
I have some therapists scheduled for July, August and early September but need many more. I have had lots of email inquires from volunteers asking for more information, but few have made a formal commitment to dates. I just keep trying to have faith and put one foot in front of the other each day. (Or one finger in front of each other as most of my work for this project concerns sending hundreds of emails!) I keep waking up at 4:00am worrying, say a prayer, and then try to go back to sleep.
Jo Ann and her husband have been busy working on our website and hope to have it up and running by this weekend. Try typing in soon and hopefully pictures of some of our wonderful patients will appear.
Judy has volunteered to host a fundraising event for us at her family’s new venue in south St. Louis called “The Warehouse”. Save the date for July 17th at 7:00pm. It will be a great party with music and a silent art auction featuring photography from an artist who just spent a month in Haiti.
Things have come together over the past 2 months in such an amazing way. We just need to find a way to keep it going!

Tuesday, June 1, 2010

Catherine, Lynn and Sandy: Amazing time in Haiti since May 22

We realize that our time in Haiti will come to an end this weekend and feel we are just beginning to hit our stride. Yesterday we had 24 therapy sessions with both inpatients and outpatients - both referred by doctors and others who have received care at the clinic. Catherine is thrilled to see children with disabilities who have been referred to the clinic by doctors and their friends, while Sandy and Lynn have taken on the inpatients with strokes and other acute conditions.

Judilene, the youth with the BK amputation and reflex sympathetic dystrophy has made great strides, now ambulating with her walker independently AND tolerating a splint on her left wrist (she would not even tolerate light touch of her left hand). Last week a reporter from a Dallas newspaper came to the clinic last to photograph Judilene in therapy with Sandy and Lynn in hopes that this story might generate support for the care of earthquake victims.

We continue to see a stream of patients who have not been seen since the earthquake and who continue to present problems associated with immobilized limbs. But we also see people with more recent trauma who are as eager to restore their body function for their jobs, ranging from sellers in the market to professors who lost their job because the university is demolished. Daily we benefit from the blueprint provided by Donna and those who have helped assemble this busy clinic before us.

What we did not expect during our trip here was the opportunity to travel to downtown Port-au-Prince near the epicenter of the earthquake to see the miles of collapsed buildings. Major facilities used the government, business, and educational sectors supporting the community lay in rubble across the city. These sobering sites are contrasted to the magnificent views from the mountaintops that we were able to see during our Sundays off from the clinic. Haiti is absolutely beautiful; the people are caring and appreciative; and the experience here is indescribable.

Along with Donna and others in the Global Therapy Group, we see that our efforts are truly making a difference and we hope to sustain these efforts while the Haitian people regain their footing and open their own therapy clinics in this beautiful country.

Thursday, May 27, 2010

Lynn OT, Catherine PT, and Sandy PT

Our impression of Haiti began in the air and is evolving daily. We are in awe of the country's beauty and the devastation it has suffered. We were oriented by Mary Beth and Jeff after arriving on Saturday, May 22nd. The patients we have seen are so gracious and appreciative. Many travel by one or two tap-taps or walk to the clinic for therapy. We generally give a home exercise program and find that these have been done religiously. Family support is incredible; each patient has at least one family member that is devoted to their care. The translators warmly welcomed us in the clinic and are providing essential communication for the clinic's operation. This is our first opportunity to use the Internet as weather conditions dictate connectivity. Stay tuned for more...

Sunday, May 16, 2010


Darn! Why did I come here and have to follow Jennifers Blogs. She is the funniest person ever and now I have that pressure. After looking thru our photos from the last few days, I have reflected on all the good that has come from this trip. My first day, I hit the ground running. It took a couple days to figure out the System, NOT! There is no System. All you need to know is how to be a Doctor, Administrator and how to do Physical Therapy. Actually the Hospital Administrator, Josian, really knows the ropes and can do anything. We did not pull that card so many times not to be able to ask again. We have had the best environment in the Clinic this week with all the Feng Shui type arrangement of equipment. The Translators have been wonderful and feel like our Boys. Sometimes you encourage, keep them on track, track them down, threaten or just beat them silly (not really). Just like your own Kids. With out them, we would not have as much fun or be able have fun with the Patients. It was pretty funny trying to persuade one Patient that as I did Soft Tissue Release I discovered that he was white underneath the dark skin. He did not know that he had been born a white child. I know this is almost as good as Jennifers but, I will stop now and pick up again tomorrow.
It is my last day in Haiti and I am already sad to leave all of my new Friends and the good that I know I can do. Jennifer has been here for 2 weeks so, she feels the same but, ready to get back to her Loves in the US. The MU Professors come in this Morning for the "Orientation". I am excited for that. I wonder if MU pays for their travel. As for me, my lovely Husband has held down all of his Jobs (Parent, IS Director etc.)so that I could be here. Today I will measure the feet of the Lost Boys so I can send shoes back to them and see what our Translators would value most (Wet Wipes I am pretty sure). I will post again.

Friday, May 14, 2010

Comfort and Music- Jennifer

Here on Day thirteen, Mary introduced me to two amazing comforts: How to freeze your water bottle at night so it's frozen the next day for your water, and the fact that our seats in the Arnoldmobile recline a little bit so you can chill on the way home. There is a big group staying at the guest house now. Forty-five people from a mission in the US. So, last night I was the expert at where the restrooms are, and where the hidden light switches are, how to find the water, and things like that. I hatched a plan to tell them how mean Dr. Bernard is-- a real tyrant, and not to look him directly in the eye. I tried to convince him it would be fun to be like Hitler for a day. I'm sure he will follow through. I showed him how you can see his house and the pool on the GPS and he was amazed.
Today we continued the ongoing of our legacy of bringing American Slang to the clinic. Today's glossary includes: "Take a load off", "What the heck are you doing", "Chillax", and "That sucks." So the guys went around saying, "that socks!!" Translator Quotes of the Day: "Cats and dogs will be raining tonight!" and "Jenny-fer will be gently to you."
I exchanged addresses with two of my female patients today. They are so sweet and so beautiful and we love each other. They are fighting so hard to recover from their serious injuries. I told them that even if it takes twenty years, they need to come to my doorstep and stay at my house. One of them is named Elita, and she asked me if I could give her something to remember her by and I told her I would. Then Mary and I sat around racking our brains for something we could make her or give her. In the process of doing that, the "lost boys" (five or six children that befriend us daily) saw us playing with a few colored paper clips and immediately wanted to construct something with these interesting new objects. We showed them what they were used for, but we were struck by how these children's brains are so active, creative, ingenuitive...moreso than priveleged children in the US, and how noteworthy that is. What a lesson.
Guibson is continually and tirelessly recruiting patients for us. He is worried that if we don't grow as a clinic, he will not have work. Today he hit the jackpot with a four year old boy named Junior that lives near him who has a below-the-knee amputation. He has no crutches, so for two months he has been hopping on one leg. He is excellent at it, but we gave him a pair of crutches to use for when he gets tired, and we showed him how to make his limb stronger and ready for a new leg! We are in the process of connecting Junior to a prosthetist because I know he will be one of those who instantly puts it on and runs around.
I've decided they need more music here. At night, in the tent cities, I am told there is lots of music, singing and dancing. I think music heals the soul and I want some big name musicians to set up on the street and play free concerts here right in the middle of town. I see how popular my ipod is with the young men and young patients here, how they want music that lifts them up, and empowers them. They know the words to popular American music and they crave it. It is this hunger and perseverance that will rebuild and heal things here. It can only get better, that's for sure.
Haiti Dum Dum Sucker Flavor of the Day: Sun-dried Fish
Craving of the Day: cottage cheese and pineapple
Haiti Myth #212: You should use caution when passing on the left, when on a curve, when on the side of a mountain.

Thursday, May 13, 2010

Jennifer Thoughts...

It is day twelve for me. I feel like this is where I live now. It is routine, in a good way. We feel interested and eager to see what comes our way each morning. I have feelings of not remembering my life at home and the strange priorities I had there. At first when I arrived I was afraid of not knowing how to provide care to my Haitian patients. I had an anxious feeling when Guibson handed me his "intake", and I was left to diagnose and discern how I could help. I so quickly wanted to become comfortable with the structure of things. I was excited when I saw something obvious, like a knee injury with a known healed fracture, versus an unknown, such as a possibly unhealed fracture, or someone with vague pain all over from multiple sources. So now I feel pretty much comfortable with whatever comes along. It took about three or four days to know the storage room, to develop my alternative hand cleaning regimen, and to know how to do patient education with pauses. For Translation. So that. The translators could. Understand what I'm. Explaining to the patient. Without forgetting what. I said.
We say incredible things such as,"I am a shoulder therapist." or "Today I am a pediatric therapist." or "I am a wound care nurse" or "Today I evaluated cranial nerves." (I actually don't know how to do that.)
Today at the end of the day a man appeared in a wheelchair. A hospital worker brought him out to the clinic and said he was waiting for a ride, then he left the man there. The man seemed dazed and he had some sort of a splint and bandage all down one leg. After Alex talked to him we realized the man did not know where he was. Apparently he was hit by a car in Port-au-Prince but instead of being taken to a nearby hospital, the ambulance drove him all the way to our hospital. He was far from home. OK, first things first. Can we get you some crutches. (I know how to do that.) The man was grateful, shocked that we would offer. Inside the hospital they said he couldn't have any. OK, crutches are done. Now, hmmmmm.....he wanted to use my phone. OK, that's easy. Long story short, he made three calls over an hour and a half, finally got a hold of his family who had been worried sick and had not known where he was for 24 hours. After an additional 45 minutes, they arrived to get him. He had to walk, on crutches, about a half mile to catch a tap-tap to get back home. Mary and I so badly wished we could do more. Still, he had a face of eternal gratitude. I took a picture of him crutching away.
At first I felt like I was not making much of a difference, and that I was not doing enough. Then I thought about that well known story about the boy on the beach, who finds a starfish and throws it back in the water to save it. The man approaches and says, "What are you doing? There are millions of them here, you cannot possibly save them all." The boy replies, "I can save this one." It really speaks to those of us who have come here. It is by far the most emotionally difficult thing I have done.
Mary heard from Clifford's mother that they are in need of a tarp. Mary asked Arnold to buy one with her money so he did. He is such a cool dude. It seems like many of us who have come, have that one thing we do that we cannot NOT do. This is Mary's legacy for Clifford. Mine is to get him onto YouTube next week. :) It was really hard yesterday when I took him into the doctor's office, laid him on the table, took out my phone and called Josaine, handed it to the doctor and said, "Talk to each other." Please. Talk to each other about what he needs. It was a risk, because I looked like an idiot. A desperate interfere-er. Eh, who cares. Today he hitched a ride to a children't hospital, that's all I care about. When his little one legged body laid on that table, as the doctor and the administrator talked in Creole for ten minutes...blah blah blah blah...I put my head on his little head and I cried. I tried not to. I told him I loved him.
Judeline is much the same. She is walking farther, showing initiative to come to therapy on her own (we choose our battles with her), but she still will not work her left hand. We put vitamin E oil on it now, my hand chases hers with the little pill capsule until it drizzles on it. Then she gingerly rubs it in with one finger. I tell her she can listen to Brian Libeer's cool music if she will walk, so she is eventually lured into my trap. I gave her mother the number of the LEAP group who will be here doing surgery this weekend. Together we fire that flare into the night sky.
This is the week of referrals. It feels good to have a tentative new prosthetic contact. We sent about eight of our patients names to a new source via e-mail. We hope that works out and that some faceless man will respond.
Mary, Amy and I have decided that if we could combine the compassion, devotion, strength and dedication of the caring Haitian family members with the equipment, environment and technology of our American medical community, we would have a perfect healing utopia. I read about previous teams and their observations of how families watch our care, absorb our techniques in positioning, turning, skin care and the importance of mobility. It is so true. They know nothing else other than
being by their families side, protecting until death.
I knew I would eventually figure out why I was here. I definitely did not know before I came. Some do, I did not at all. I thought it would be more like and a-ha moment, or a light bulb thing. But its more like a maze that takes time to wind through, and you don't know what you've done until you're done. I'm sort of mad because I was homesick for 5 days, then happy for 5 days, now something new is happening and its getting raw and twisty again. Pain of leaving. Grief. Loss. Life. Wishing. Seeing. Smelling. Touching. Tasting the last few days....

Tuesday, May 11, 2010


OMG!I am shocked that I made it to Haiti without any problems. Everything went as planned. Coming to Haiti was a shock due to the collapsed buildings and I have not even been near the epicenter. Contrary to the brokeness is the beauty of the Haitian people and their strength to recover. I am reminded of my Mission trips to El Salvador in a lot of ways.
When I got here I was driven right to the HCH Hospital and started PT treatments pronto. It is the kind of experience that lets you know why you decided to work in this Profession. It is the basic functional care that everyone deserves. Our Translators are great and my Teamate, Jennifer, has just the kind of Sarcasm that I really like. It cuts right to the heart of the matter and relieves everyones tension. Jennifer speaks the truth in a way that all ears can listen. That is, if the tranlations are accurate. Our Patients have been ones that for me cause me to dust off my brain. Recalling Inpatient type skills is a challenge.
The first day was long and tiring due to the time change but, today was very managable. I am looking forward to each day as an adventure. Hopefully we are doing some good and not just bandaide treatment. More when my brain is rested.

Monday, May 10, 2010

Jennifer Week 2

Amy boarded her plane this morning and made it safely back to the US. Passing her in transit was Mary, and I was very excited to see her when she arrived at the clinic at 10am. Mary hit the ground running, as we were well into a busy morning of patients already, when she arrived. I oriented her as we treated and tried to take care of everyone.... things from joint contractures, healed and healing fractures, arthritis,
We spent the second half of the day working with inpatients ranging from a CVA, a diabetic, a man with sacral ulcers, and of course Judeline and Anise. Today Anise left the hospital with baby Isaac. I wish those of you who started her off could have been there to see her off, but we were emphatic with her that she continue to return to see us to keep up with her wearing and ambulation! She has been ill the past three days, so she has not been wearing her shrinker as she should, which is a concern. I think that is the hardest part for me, how an inpatient returns "home", and has no transportation, yet desperately needs our care and attention. I'm glad we confirmed her phone number so we will be in contact. On Saturday, Amy made a video of Clifford walking, my favorite video ever!! It is on Facebook, if you send a friend request to me or Amy you can see it too. In the foreground is Clifford on his little crutches, but you cannot see from the video that there were 6 videos right before it of him just standing there like a tiny statue, refusing to walk in his silent defiance. Then he carefully, adorably walks through the clinic, and Judeline is in the background listening to my ipod and refusing her therapy. We had kept her there a good part of the afternoon stretching her knee and her heelcord and watching her put tiny dots of antiseptic gel on her sensitive hand. She likes my music a little too much and keeps wanting me to listen with one earphone so we can dance. I cannot resist!!
Mary brought up something interesting today. She noticed that in her crutch training, she had forgotten once or twice to address the patients stairs. She was reminded of this when her last patient mentioned that she had a whole bunch of stairs to climb. At that moment, I too realized I had not addressed stairs with my crutch walkers!! We laughed together and I realized I had still not figured out how to transition from my familiar environment to this one....should I ask if they have a sturdy handrail?? Do I tell them to do their exercises on their bed? No, I say, "Do this where you sleep." Amy figured out last week not to say, "Stand at your kitchen counter," and instead say, "find something to hold onto." We hope our translators figure out what the heck we are would think by now, watching us teach the same things over and over and over, they would be used to explaining this. Still I am not sure. As we send them back into their environment, whatever that may be, we do it a tent? A second story flat? A little curtained room? Or the same house they were in before? We continue to search for words to say, ways to understand what they are going through, and I knew I had been here a long time, because today the ride home was a little boring. That says a lot if you have ridden these streets!!

Friday, May 7, 2010


Today was yet another great day! After a very busy morning, the afternoon slowed down and we were actually able to finish up relatively early today.
My morning began with a discussion on the age of our patient, Clifford. Clifford is a "three-year old" patient whose leg was amputated after the earthquake. Yesterday when I first met Clifford, his mom told me he was five. However, all previous documentation indicated that Clifford was three. When I asked her about the discrepancy, Clifford's mom stated that she did not know why everyone was documenting his age to be three since he was, in fact, five years old.
Today, Clifford and his mom were back at the hospital, this time to see a pediatrician. When Clifford's age was brought up again, Clifford's mom told us that she was sure he was five, but that she did not actually know when he was born.
So, he's three or he's five...that's a big difference in age. We are skeptical that Clifford is actually five. For now, we don't have an age for this beautiful little child. Our translator Alex asked me, "How can she not know when her own child was born?".
Since we finished up early this afternoon, Jenn and I took our first trip to downtown Port au Prince. So much damage, so much rubble, so much trash and so many tents. We wondered, how will they ever be able to repair this city? How long will these people have to live in tents? There is still so much to do before rebuilding can even start.
We were driven through streets of downtown PAP by our driver, Ernold. Despite the tents, rubble and damage, Ernold was so clearly proud of his city and his home. He was so excited to point out different monuments, museums, the soccer stadium, the "largest hospital in all of Haiti"! When we asked Ernold how he felt about his country, he told us, "It's my home! I'm proud to be from Haiti!".
This is what I love about the Haitian people...they don't dwell on the earthquake and the damage it caused in their city. They don't ruminate on the injuries they sustained in the earthquake. They still see the beauty in Port au Prince and in life itself. They still go about their days and try to make a living. And they do it with laughter and smiles.
Ernold also walked Jenn and I through one of the tent cities. Jenn had two small bottles of bubbles, so we gave them to a couple of the children we passed by. They were so delighted and their parents very appreciative.
After we returned to the guest house, we went down to the orphanage for the first time loaded with donations from us and from our wonderful friends. The children were so excited to see us and were tugging at our clothes. We spent just a little bit of time with them, as it was almost 7pm bedtime!
As fully expected, we fell in love with the kids! I told Dr. Bernard that I'm not quite ready for kids yet, but once I am ready, I'll definitely be returning to Haiti to adopt!!
Every day here has been so rewarding and so fulfilling, but today was such a special day for Jenn and I. We feel so fortunate and grateful that we are here to help, but we both agree that the Haitians may be nurturing us even more!

Thursday, May 6, 2010

Jennifer Moments

Well, you may be wondering why so long since posting? Well, our internet is very very patchy the past few days, very slow and inconsistent, or, not here at all!! Maybe clouds? There are many theories passed around...
Wednesday brought a slow clinic day, only about 9 patients total, which was good, because Amy was all by herself in the afternoon so I could go to the NGO (Non-Government Organization) meeting in the afternoon. There were what seemed eight to ten countries represented, presenting and discussing issues related to a new proposed document for Emergency Aid Plans. There was lots of talking and discussing, much in French and Creole. Hopefully the minutes sent to Donna will be in English!!
Today is Thursday, which we had heard was market day, but apparently our many many patients needed us more than the market! We saw nineteen patients today including three inpatients. Yesterday and today I became a hand specialist, which is a first. I practiced my joint mobilization, distraction and ranging techniques with three patients, all earthquake crush victims. They are so tough, sitting there letting me do my thing and gritting their teeth. I am glad to see them progress and be able to use their hands in small functional ways in only a few days. My moment of the day came at the end, when I went to see an inpatient stroke victim who came in over the weekend. She is a fairly dense hemiplegic and we had only been able to sit her up or stand her twice. Her family had been attentive but I knew she needed so much more than we could provide. I went to work with her and to my surprise the nurses said she was being discharged today. I took a deep breath, scooped up all my emotions and set them way over to my right. I grabbed Alex and told him to "buckle up" (new slang I'm teaching) that we were going in to try to do some basic teaching for her family. Our translators have been having some issues with modesty with inpatients who need care but have little in the way of covering...they are not comfortable and we are trying to work on this. We ended up together, me, Alex, our patient and her son and daughter, helping them quickly learn how to dress her, transfer her to a wheelchair which I found in the storage and gave to them, discussed turning and supporting her arm, and most importantly coming back to see us as soon as possible. Thankfully, we know from others who have gone before, they will return to our clinic, and they will care for their mother. I am told there is only one nursing home in all of Haiti.
I have a new understanding of the previously explained concept of "Lost in Translation." My favorite new examples are when our translator will have a rather lengthy exchange with a patient, back and forth a few times, clarifying a question I needed answered. For example, I might ask, "How long has it been since he has not been able to walk?" They discuss it for a long time, I will then ask the translator, "What is he saying?" He will say, "Two weeks." Hmm...I know there was more there....
Oh well....
Days are hot, but more bearable than I'd imagined as long as we drink water. We are very busy, and I have learned the Creole words for "Sweaty" and "Flies" and "Squeeze it!"
Amy and I laughed hard on the van ride home, singing some American songs to Arnold and pointing out the polar ends of the spectrum of beauty on the Haitian streets. Tonight we are listening to one of the house workers play his guitar and sing for us. I will remember this...

Wednesday, May 5, 2010

Jennifer-First Days

Amy and I arrived on Monday morning eager to see what this airport thing was all about. It was indeed quite a crazy scene!! I did accidentally hire a nice young man, mostly because I had a duffle bag I was very tired of carrying and he knew that. After some negotiating, we agreed on $2 and half of my airport sandwich. Next time I will repeat to myself, "Get the cart, get the cart." We arrived at the clinic around 10:00 and began a whirlwind day of seeing patients, orienting to the storage areas and small intense conversations with Donna and JoAnn about communication, translators, culture, documentation. My head was very full and we were very tired from our 3:30 wake up!! All of us rode back together through the unbelievable streets of the market, packed with wall to wall people (who walk in the streets dodging cars like a video game). There was one puzzling detail about the ride. A woman riding with us needed to get out to buy some garlic. We sat for 15 or 20 minutes and waited for her. Donna named her the garlic lady. She never came back so our driver said, "We will leave." Interesting. So we left, then 15 or so minutes later she called and (of course) needed a ride, so we turned back to get her, through the market streets all over again!! I was taking many pictures of this unreal scene of pill sellers and vendors. On Tuesday we arrived at the clinic 2 hours early to accomodate Donna and JoAnn getting to the airport on time. I enjoyed practicing walking around and saying "Bonjour!" to the staring faces and watching them light up and respond to that. It is important to me that they understand we want to help them. We had a great day, the translators were eager and willing to be present and helpful, we saw many orthopedic patients, back pain, a man with an ACL tear from 7 years ago who was swelling, lots of hand trauma (thank goodness we had an OT there from another therapy effort nearby.) Many patients are returning from being seen before. They are very compliant!! Amy helped one woman I had seen the day before and diagnosed her bad kidney infection that I had missed. She handled it great. She and another PT who was visiting got her a lab test and she will return tomorrow for results. After the day, Gibson told us that we had seen more patients that day than any other day yet!! We were excited about that. The most exciting thing was at the very end of the day an enormous shipment of bottled water arrived. Everyone from the entire hospital came out to see. Cases and cases and cases of water. Hospital workers were carrying water inside and the workers unloaded it into a huge mound of cases of water right at the loading dock. We were hoping some of it would make it to the patients. We were a little distracted as we thought about where all those 50,000 plastic bottles would end up. Let's just say its not in the local Deffenbaugh recylcing center. All in all I was very happy to get our first day under our belt, no pun intended!!

Sunday, May 2, 2010


Driving through the streets of Haiti this afternoon, JoAnn and I had a great conversation about what is it we enjoy about this country. It is ungodly hot, the traffic horrid, there is no infrastructure or organization to anything (we do not believe the word “organize” exists in the Creole language!), the poverty and lack of medical care is appalling and yet there is an energy here that draws you in and you find you don’t want to let go or back away, but only embrace it. We decided it is the connectedness between the people that helps them to survive as a group. In the US we have such a focus on independence and individualism, but I think at times that separates us and maybe leaves us feeling a bit alone. Here in order to survive, you must function as a collective unit. One person on their own would never have the means to make it. I drive through Port au Prince at 5:00 pm after work on streets as crowded as those in New York City, but the people here interact with each other completely and with an energy you want to share. There are no masses walking quickly and anonymously, ignoring each other.
The traffic here is so bad with the drivers nearly hitting each other and the pedestrians every minute or so, but there is no “road rage” or anger ever seen. JoAnn asked why in the US where life is comparatively easy, do many people have such anger? We decided it was because people in the US often feel so isolated, alone and maybe afraid. The Haitians may be poor, but in terms of spirit they are so rich. When you come here that spirit is intoxicating and you want to join in and connect to that collective energy. It has been hard for each of the teams so far to leave Haiti and the “re-entry” to US life has been a struggle. I think leaving that feeling of belonging to something bigger than yourself and drawing your energy from that on a daily basis is difficult.
On a lighter note, these were my favorite “only in Haiti” moments today. We passed a sign that advertised Plop Plop service. JoAnn’s best guess was a plumber? We passed an old woman with a T-shirt on that said “Sexy Diva.” I am guessing she had no idea what it said in English. At the hospital another grandma had one that said, “Too sexy, Too smart, Too much attitude.” Seeing that on a small woman with sagging breasts, stooped shoulders, knocked knees and grey hair was great! We saw a goat “mowing” the lawn in front of the Gold’s Gym building. Yes, they have a building that says “Gold’s Gym” on the top with paintings of muscled men and women on the sides. It appears to have been turned into a government building of some sort as it has a “No Parking” sign in front. Not that anyone pays attention. People here also carry everything on their heads. Baskets, water jugs, food and things you would expect. As well as toilets, cinder blocks and what appeared to be a 50# bag of charcoal by a 5’tall skinny little woman.
Nothing seems impossible for the people here. They do what they have to each day to get by. And they do it with smiles on their faces and a song on their lips. I will miss them.

Saturday, May 1, 2010


Early this morning, while waiting for out-patients, a group of men arrived to check out the water purification tanks that had been set up for the hospital immediately after the earthquake. Apparently they had trained several men in the process however no one was following through! (and no one knew what was in those big black tanks!!)
I still can’t believe the two large water tanks just outside our clinic could have been providing drinking water the whole time we’ve been here! Most days have been a challenge just to wash our hands. Once a water filtration system is in place this will make a huge difference for the patients, their families and for us.

Today we had two additional P.T. volunteers from Quisqueya that are in town but without a place to work. We were quite excited to have them until we realized that May 1st is a national holiday in Haiti (similar to our Labor Day) and NO patients came to the clinic all day!! Judeline was treated to the undivided attention of three P.T.s and two new translators (very handsome male medical students). She relished the spot light and made amazing progress. We worked on standing tolerance, posture and balance without any UE support followed by walking with only one crutch held with her uninvolved arm! She is looking so much better and stronger! We’re hoping to have a prosthetist look at her tomorrow for adjustments and to progress to her permanent prosthesis. Her hand continues to improve slowly but steadily.

At the end of the day another soccer ball mysteriously appeared for our young friends who show up at the clinic at the end of every day…we will post pictures of Guibson, Alex, Emmanuel and the kids at a pick up football game.

Adventures in Haiti is our theme and our latest happened today while returning home from the clinic. We were about half way up the mountain when the car stalled with smoke pouring in through the vents! Donna and I were ready to jump out of the car right then but Ernold and his buddy said…”wait…wait” while they attempted to restart the engine…Ernold got out and, looking under the hood said, “get out”!

Some things happen the same way all over the world….three men, a broken down car, the hood propped open and long serious discussions. One of the mysteries of life! Donna and I watch as they look at the dip stick…even we can tell there’s no oil in this vehicle. We gingerly suggest that maybe…just maybe… the radiator needs some water too….seems to fall on deaf ears…really?! Just as they finish adding the 4th quart of oil, Alex (our knight in shining armour) pulls up behind us and sweeps us into his AIR CONDITIONED car to take us home! On the drive he recounts some hilarious conversations he has had with Sean Penn!!! He tells me he will take me over to the country club tent city to meet him soon!
More adventures to come!


We went to the clinic this morning and no patients showed up. Turns out May 1st is a national holiday kind of like our Labor Day. You would think someone might have mentioned this to us! No hospital staff, none of our translators, no patients, no one at the guest house said a word. I guess they all assumed we would know somehow? There was no traffic today with the holiday, so that was one nice change. We had a team of 2 PT’s from another volunteer organization join us. Four PT’s and no patients! We had them work with our in-patients and I re-organized the storeroom of donated supplies. It was kind of nice to have a relaxing day with a different pace than usual. Emmanuel one of the translators and I found boxes of new crutches, a bunch of canes which we desperately needed, many new hand and finger splints, shoulder supports and pressure cushion options for the bed- bound patients. I did not know any of that was available before as there are so many boxes just piled up of donations. Emmanuel saw one of the arm slings was of a different design as we were unpacking them. I put it on myself and explained to him how it would be useful for a patient. He smiled and said that one of JoAnn’s out-patients Emil had a problem with his shoulder just like I described and could use that sling. He is learning so much already! I told him he is a true PT in the making. Guibson brought us 6 ripe mangos today and I brought him peanut M&M's. We both thought the trade was terrific.
On the way home the car began to smoke from the engine and stopped in the middle of the road. Luckily it was right in front of a small store with a sign in English that said, “Auto Parts Supply.” The driver, a passerby and 2 men from the store stood over the engine and discussed things. It looked a lot like men in America. It takes a group to discuss engine or tool malfunctions and come to a consensus. It was decided that there was no oil, and this was confirmed when they were able to empty 4 quarts in before it was full. Then they began to add water to the hot radiator which immediately became a geyser spewing the hot liquid. JoAnn and I backed up and commented to each other that at least we knew better than to do that and we are not auto mechanics! Just when we had our doubts that we would ever get home, who pulls up behind us but our new friend Alix who lives at the guest house. He chauffeured us home in his car with AIRCONDITIONING!!!! It was lovely. Once again whatever we need here in Haiti just appears right in front of us.
We spent about an hour playing with a group of 8 boys hanging around the hospital today. They have learned they must stay away from the clinic while we are working during the day, but can come by after the patients have gone. JoAnn gave them a soccer ball and they had such fun playing in the hospital parking lot. None of them spoke English, but somehow we learned that they like the music of 50 Cent, Rhianna, Beyonce, Akon (they could sing his songs in English or Creole) and Michael Jackson (one little guy did an awesome moonwalk!) They like Jackie Chan movies and liked my imitation of his karate moves, James Bond, Spiderman, Batman and Shrek. Most of these boys do not have shoes, food or water but I guess they see American movies somewhere. We shared water with all of them and the kitchen has started feeding them the leftover food this week at lunchtime. They taught me all the body part names in Creole and I taught them the names in English. It seems the boys go out and roam the neighborhoods during the day and I assume the girls stay at home. Two of the boys had on Croc shoes. We see these all over Haiti on adults and children. I think it is because they last so long, but many of these Crocs have seen better days. I have started taking pictures of all the feet I find in them and thought I would send them to the Crocs company to let them know their product lives on even if the market for it in America has slowed significantly. Tomorrow we plan to sleep until noon if we can and just rest! Watch the Extreme Makeover show for us!

Friday, April 30, 2010


I was inspired by the people around me at the clinic today. This morning one of our translator/aides Guibson told us he encountered a woman trying to walk up the hill toward the hospital as he was walking to work. He noticed she was swaying and having trouble holding her balance and asked her what was wrong. (He is learning to evaluate a person’s gait already!) She told him she had not eaten in 2 days and did not feel well. He helped her to clinic and had her wait in a grassy area behind the hospital. After lunch, when the kitchen staff was cleaning up, he asked if he could help them scrape the baked rice from the large rice cooking pot. They were happy to turn the chore over to Guibson. He asked me if he could take some water from us and he used it to loosen the baked on rice and fill a plate for her with it. He scraped some bean sauce from a second pot and made her a plate of food. He then asked if he could fill an empty water bottle with more water and give it to her. We told him he overwhelmed us with his generosity toward her and he said that God and we, had been generous to him by providing him this new job. He felt he wanted to pass God’s blessings on. He told us he saves a portion of his pay each week for the future and uses a small portion to help those he finds who are in need each week. He told us he believes if you give to others it will come back to you. Some ideas are universal.
One of the children presented me with a hand woven bracelet that says, “I love Haiti” and thanked me for being there helping today. I told him I would accept the gift if he would allow me to present him with a gift tomorrow. He smiled from ear to ear and nodded “yes!” That smile and the light in his eyes just brightened my afternoon.
The head nurse who attended JoAnn’s inservice yesterday came by as I was working on Judeline’s hand and Judeline was obviously in pain. She stopped to talk with her and encourage her and then left and returned with a soft rubber ball for Judeline to work with. I was so happy to see one of the nursing staff being encouraging and also being willing to work with the therapists for the good of the patients. JoAnn’s program really seemed to have the desired effect of making us part of the team now!
What an amazing world it would be if everyone spent their days looking for those in need and then helping them, thanking others for their service, encouraging someone during a difficult time or just bringing your wide childish smile to a melting team of tired and hot therapists.

Thursday, April 29, 2010


Two days of amazing meetings! JoAnn and I went to the Haitian government Injury and Rehab group meeting yesterday and talked with colleagues I had met 3 weeks ago, as well as meeting several new and exciting people. After I spoke about our clinic, one of the participants introduced herself as a representative of the US aid program who was in Haiti for 2 weeks on a fact finding mission. She was looking for places where congressional money could be spent to further rehab services in Haiti now. She looked at me and mouthed, “We need to talk!” We met after the official meeting, told her our story, and she has agreed to come tour our clinic! Access to some congressional funds would be awesome. We also met with a PT who runs a program at Albert Schweitzer Hospital who had much advice on starting a Rehab Tech school to begin to train local Haitians to take over the clinic eventually. Lastly, the wife of one of the heads of Healing Hands for Haiti was there and said she was in the country to be with her husband and did not feel very useful as her specialty was business not medicine. We told her we would love to have her advice as we know nothing about business, but appear to have started one! She may be able to come to the guest house to meet with us this weekend. So many wonderful contacts and offers of help.
Today I found a volunteer to drive me to the Petionville Club where Sean Penn’s group is serving the now 50,000 living in a tent city there. I met with the medical director and chief ortho doctor and Sean himself came to sit next to me to listen in on the conversation and my description of our new clinic and services we can provide. (He has a great smile!) Another of my, “How did I get here?” moments in Haiti.

Anise and Isaac are both doing very well and Isaac is growing stronger each day. I found a donated portable baby crib and stroller in the back of the storage area at the hospital and we presented them to her yesterday as gifts. They are planning to leave soon. I would like to write they are going home, but unfortunately they have no home to return to. She is still unsure where they will live once she is discharged, but at least little Isaac will have a bed to sleep in.
Joslyn, who had a severe stroke passed away this morning. It was a blessing as her body had been failing over the past 2 weeks and her bedsores multiplying. It is an interesting ritual here when a patient dies. All the family gathers outside and they accompany the men with a stretcher who go in to pick up the body. They parade out wailing and crying and talking to the deceased about how much they will miss her and how sad they are. We have watched this several times and the intensity of it is always interesting to me. Funerals and death in the US are such quiet affairs. Here their grief is cried out loudly. Something about that seems healthier for the grieving process.
JoAnn presented a great inservice to the nursing staff today on body mechanics and the prevention of bedsores. The nurses here have been very wary of us since day one, but today went a long way toward breaking down that barrier and moving toward working as a team. They seemed genuinely interested in learning how to prevent back injuries for themselves and how to move patients more easily. Once JoAnn got them all involved in practicing on each other, there was much laughter and some real teaching going on. We told them we were here to help them however we can and I am hoping they will now feel comfortable enough to ask.
So many wonderful things going on that it is almost possible to forget how unbearably hot it is. Tomorrow is to be 101 with a heat index of 114. With no AC or even fans to move the hot air, it is tough. JoAnn and I have taken to walking past the ER and ICU as often as possible as there is AC in those rooms and some of it slips under the closed doors and out the side edges. We often find we need to consult on a patient as we are passing by and must stand there a few minutes to talk!
I am encouraged this can all come together and believe we can truly create a sustainable clinic here in Petionville. Things continue to appear in front of us just as we need them, so I know God is still busy. I am trying to keep up and not melt in the process!

Tuesday, April 27, 2010


Today was filled with many “Only in Haiti” moments.
I went to walk with Anise this morning and found little Isaac lying beside her and nursing. (Yeah!) He was dressed in 2 layers of t-shirts, with thick sock booties on his feet and a blanket over him. I was hot just looking at the little guy, as it was like a sauna in their hospital room. I suggested we at least remove the booties, but Anise would have none of it. She showed me today how to squeeze his nose to make it grow in a more pointy shape as wide flat noses are not considered attractive in Haiti. I suggested that maybe she was hurting his little nose and that I did not think that would actually change the shape, but she looked at me like I was just clueless. I can’t say I’ve ever seen any nose re-shaping take place anywhere before. Thankfully, Isaac is nursing more and seems to be stronger. They will most likely have to leave in a few days and I hope Isaac can grow just a bit more before they need to leave. I held him for over an hour this afternoon and marveled at what survival against the odds looks like. He is only about 5 pounds but has a head full of hair and the sweetest disposition.
I watched a 9 year old pull a double-edged straight razor blade out of his pocket and begin to carve a piece of wood into a top. I asked him if he was worried he might cut his finger and he showed me where he had done just that in the past. You don’t see too many kids in my neighborhood playing with razor blades.
At lunchtime today I watched two large pigs sprint up the hill beside me, and 2 baby goats graze on the scrub grass. I watched people carry chickens home holding them by their feet upside down and swinging them as they walked.
We had to eat lunch in shifts today as the kitchen had plenty of rice and beans but limited plates and spoons. And, JoAnn and I were so thrilled today to find a place before lunch to actually wash our hands with soap and water. We found a garden hose attached to a spigot near our clinic! Hand sanitizer only goes so far with the grime we deal with daily. Somehow there is black stuff under all my nails by noon everyday and I wear gloves often! Every sink we could find in the hospital is broken or without water including by the nurses station and in all the patient rooms. We keep wondering where (or if?) the staff wash their hands. Running water, even non-potable water is a luxury here.
While waiting for our ride home this evening, I asked Guibson, one of the translators what he was planning to cook for dinner. He looked at me in a confused way and answered, “I cooked and ate this morning before I arrived for work and I ate lunch here at the hospital.” Only in Haiti are 2 meals a day considered fortunate.
I have to keep telling myself to stop thinking like an American. We just take so much for granted.

Monday, April 26, 2010


Well, President Preval must have payed his bill to Hugo Chavez because the gas shortage is over today. Good for the people I guess, but bad for us because the traffic is back again. It was nice for a few days to not have to sit in bumper to bumper standstills twice a day.
The children made the day wonderful today. Early this morning a mother brought a 3 year old little boy named Clifford to our clinic. He lost his left leg above the knee and she had brought him to the hospital because of a tiny blister on his stump. People in Haiti have no idea what therapy is or that it is available so she never considered any service other than having his stump checked. I taught her how to place a special sock on his stump to help shape it for a future prosthesis and pump some of the swelling out of it and she caught on so quickly and was so happy to be able to help him. I got out several pairs of children's crutches but they were all too big for him! We finally took one set apart and rebuilt them to fit. They were red and yellow and he was so delighted when I put them on his arms. He must have watched others walking with crutches as he seemed to know just what to do. He put them out in front of him one at a time and then took a little hop. In just a minute or two he was hopping all over the clinic and little beads of sweat were rolling down his face. Having not walked for months now, he must have been so tired, but did not want to stop! We asked mom to bring him back in 2 days and hope to be able to refer him to a group that fits children with prosthetic limbs. If I did nothing else here this week, giving him back the ability to move on his own made me feel so good!
Then I went to see Isaac today and he is so much better! The little limp boy I held just 2 days ago has been replaced by a stronger one who moves his arms and legs often and tries to hold up his head when I lift him. Anise says she feeds him often now and I am so happy she finally understood how important that is. Her milk supply has increased and I know Isaac is now getting the quantity he needs. When she and I went for a walk she told her husband to watch him closely and be sure no mosquitoes bit him. I told her mom's in Haiti have so much more to worry about than in America and that she was doing such a great job. We talked about breastfeeding more today, sore nipples and c-sections. To the translator's credit,he never faltered or was too embarrassed!
JoAnn and I are trying to relax at the guest house this evening but the frogs are so noisy. They do not sound like frogs back home, but more like a group of drunken ducks quacking and laughing. It is not a rhythmic sound but more chaotic and bizarre. Last night a small red and blue colored frog fell out of a tree onto our balcony and scared JoAnn enough that the owner of the guest house heard her screams and came running to see what was wrong! We found the frog dead this afternoon and I had to peel his suction cup legs off the tile floor. Something else to add to our list of things that you will experience only in Haiti.

Jo Ann

This is my first entry on our blog and I happily dedicate it to...the professor and Mary Ann!(you know who you are)
It's hard to believe that my first experience in Haiti was on April 5th and that by my return on April 23rd I felt like I had come home. Even the airport no longer provokes anxiety!
This is unlike anything I have ever done before and I can honestly say it is the highlight of my 30 year career as a P.T.
I'm sure Donna has written about the little boy we saw this morning with an amputation from the earthquake. We had the gift of giving him his first pair of crutches and watching him stand and take his first steps!Can anything really top that?
I watch what a few weeks of therapy can do and see the difference of a life lived independently vs. dreams forever lost.I have never questioned my career choice,but somewhere between the hospital administrators,productivity ratings,billing and insurance company's I forgot the joy of doing what we do best...treating patients.
I hope others will take advantage of this opportunity for Haiti and for yourself.
Time for sleep now so I'll be ready for more fun tomorrow!
(Jeff, sorry for any errors...but you are not here to edit for me!)

Sunday, April 25, 2010


Were Baaaaack! JoAnn and I returned to Haiti just 8 days after we left. Walking through the airport we kept saying to ourselves, “Didn’t we just do this?” Upon exiting the airport, our driver was not waiting for us as planned. But directly in front of me was Ruben, a nice man who we paid to assist us the last time we arrived and our driver was not there. His eyes lit up when he saw me and he came and gave me a big hug and the kiss on cheek that is the traditional Haitian/French greeting. He waited with us again, and when it was obvious our driver was not just simply late, he offered the use of his cell phone. I tried to give him $1 for his service and he refused saying, “We are friends now. No, No.” While waiting for the driver he kept asking me in a roundabout way if I was coming back and if people from the US could bring things. Much gets lost in translation here as the Haitian people do not like to directly ask for favors. I have learned to just cut to the chase and ask “What is it you need?” His answer was, “a tent.” He said he and his siblings sleep on the ground and as he put it, “When it rains hard on you, it wakes you up and you cannot fall back to sleep.” It rains almost nightly here now as it is the rainy season and he said they are all very tired. JoAnn decided to bring a few tarps with her this trip, “just in case” and she gave one to him. The smile on his face reached from ear to ear. I now know we will have permanent friend and helper at the airport for years to come!

Walking through the hospital and into our clinic felt so much like coming home. The last 2 teams have grown the clinic and its services greatly in this short time and all the patients have progressed so well. Seeing Judeline donning her own prosthesis and walking herself to the outdoor clinic took my breath away. Alex, Emmanuel and Guibson our translators are now much more than that. They are true therapy aides and have embraced their new jobs with such passion. I taught Guibson what the phrase, “You have really stepped up your game!” means and he told me he has tried so hard to do just that. I told them all when I left that this could be more than just a translator job for them if they were interested, but I do not think they fully understood the opportunity available at that time. Over the past 2 weeks they have come to understand what could be. They asked the last team for books to learn more about the body and have begun memorizing the names of the major bones already. JoAnn and I brought them each a basic anatomy book and presented it to them yesterday. They were so pleased! What made my heart sing was hearing them describe that before we arrived they did not know that “therapy” existed. They have watched us work with Judeline since day one when she cried continually and refused to even sit up in bed on her own. “In just 3 weeks she is walking!” They said. They told us they see therapy as like a miracle and they love the idea of being part of making that miracle happen for patients. “It makes you feel so good inside to help people like this!” Alex told me. “That’s why we love our jobs.” I replied. They really get it now and they are hooked! They love being a part of this and tell us they eventually want to become therapists like us.

Saturday was a tough one emotionally. We said good-bye to Janean, Heather and Kirsten in the early morning and then walked into the hospital to learn that Luc Pierre had been discharged! The last X-ray from 3 days ago showed his lower leg bones displaced again despite the external fixator and it appeared the lower leg was still infected. He told the surgeon he really did not want his leg amputated so they told him to go home and return in 22 days! 22? Why not 7 or 100? We do not believe he will even be alive in 22 days with a displaced lower leg bone and an infection and can you imagine the pain he will suffer in that time. Emmanuel went to his chart and found his phone number for us, but there was no answer. Alex and Emmanuel told us they were touched by the tears in our eyes and could not understand why the Haitian doctors did not care about Luc the way we did. Like I said, they get it now!
Later in the day, I went to walk with Anise and found her sitting in the main hospital lobby. We walked to our outdoor clinic and she sat to rest while we worked on Judeline’s hand. When I realized it had been at least 2 ½ hours since I found her, I asked if she wanted to walk back to her room as it must be time for Isaac to eat. When we got there she did not seem to have any interest in feeding him. When I asked her when the last time she nursed him was she answered, “I feed him when he cries.” I asked her if I could hold him and picked up this limp and flaccid little baby. He still has an IV drip, but did not seem to have the energy to cry or even move his arms. I did not see any rooting reflex or apparent desire to feed and realized this baby was failing. Through the translator I came to realize that Anise thought the IV was feeding Isaac and she did not need to nurse often. This is her first baby and it appears no instruction is happening from the nursing staff at the hospital. I told her Isaac needs to eat at least every 2 hours and that the IV was doing very little for him. She and her husband seemed very surprised and I am not sure fully believed me. I tried to teach her that her milk was what would make him grow strong and her husband told me he was concerned that Isaac had lost weight since he was born. I spent much time teaching but we are never sure what gets through and what is lost in translation. I am praying often for Isaac and hope he can hold on until Monday and we can teach even more then. JoAnn and I decided we need to have a conversation with Josiane about options and the need for more aggressive breastfeeding instruction with the new moms. Judy sent several new outfits and an adorable hat as a gift for Isaac and we need to make sure he grows big and strong so he can fit into them!
It is so hard not to bring our expectations of American standards of medical care down here to Haiti but watching a 70 year old man suffer and die in severe pain, or a newborn baby die should not happen anywhere. Prevention of suffering and healthy babies must be the minimal standard anywhere in a civilized world.