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.