Monday, February 28, 2011

Ann in Haiti---Week Two

It is the beginning of our second week in Haiti. Time is going so fast! I can’t believe that we will be headed home in just three more days! Friday was a special day. One of the patients who I worked with last year came for a visit. Anese was 6 months pregnant with her first child when the earthquake hit last January. Although she lost her L leg below the knee, she did not lose her baby. Isaac was born last April 14th. When I met Anese she was 8 months pregnant. She had had her leg amputated and had just been fitted for her first prosthesis by a prosthetic team visiting from the US. She was very determined and was never too tired to work with me. She asked me if she would be able to climb mountains with her new leg. I assured her that she would be able to do most anything if she was willing to work hard. In no time at all she had mastered walking with two crutches on level surfaces, then the stairs. By the time I left she was able to walk on level surfaces and stairs with only one crutch. Despite her determination, there were many obstacles for Anese. It was not just that she had lost her leg. It was that she had lost her leg, was 8 months pregnant, had no shoes, and had no home. When I met her, her entire family was staying in her hospital room because they had no tent and no place else to go. I managed to find her a pair of shoes to wear so we could walk outside. When we left Haiti, we managed to find a 2-person tent to give to her. One day when we were practicing walking, I asked Anese what she was going to name her baby. I was very flattered when she told me that her baby would be named “Ann” after me. I asked her what she would name the baby if it was a boy. She assured me that, “It will be a girl”.
When it was time for me to go home last year, it was hard to say goodbye. I felt a connection with her and this baby! I last spoke with Anese last April when one of the translators I had worked with called me from Haitian Community Hospital. He had gone there to work and found that Anese had had a baby boy! She asked him to call me so that I could name the baby since he could not be named “Ann”. I told Anese through the translator that she had been through so much with this baby and that I thought she should choose his name. She insisted that I was to name him. I was not sure what to do, so I told her “Ann means grace. Choose a name that means grace”. The baby was named Isaac. When Cholera hit Haiti, another of the translators tracked Anese down and was able to give me the news that she and baby Isaac were OK and had not gotten ill.
Friday, Anese and Isaac came to the clinic to visit. Anese had a new socket for her prosthesis and was walking with one crutch. We gave her some new socks to help her prosthesis to fit better as her leg had shrunk more. I showed her an exercise to do to help her not to limp. Then we spent time visiting and took turns holding baby Isaac. Anese told me that I was his godmother and that my daughter Maria who is here in Haiti with me was his sister. She asked me when I would be able to come back for his baptism. I told her that I thought that she would need to baptize him and that I would be there in spirit. Isaac and Anese looked wonderfully healthy! He is beginning to walk when someone holds onto his hands. Anese was very happy when I gave him some shoes that I had brought and two little outfits. (What is a godmother to do but bring gifts for her godchild?).
I asked Anese where she was living. She told me that she and her husband and baby Isaac were still living in a tent city in the tent that we had given her. She told me that neither she nor her husband were working. I asked how they were managing to eat with no money. She told me that friends, family and her church helped them. She asked me for money to buy formula and diapers. I gave her the 10 dollars that I had brought to the clinic with me that day.
I don’t know if I will ever see Anese or Isaac again. They don’t have a mailing address. I have a phone # for her, but since I don’t speak Creole, talking on the phone is not a really viable way to keep in touch. Clearly, the biggest mountain that Anese and so many of the people here still need to climb is the huge mountain of poverty, lack of work, and lack of resources. It can seem so discouraging. Even though I have been here twice, supported by lots of good people at home who have donated to pay for the cost of coming, and bringing equipment with me each time I come, it does not seem to be enough. I have so many resources in this life. Coming to Haiti makes me realize that even more and gives me even greater gratitude for those gifts. It also makes me want to do more for Anese and all of the people who I have worked with here. Despite at times feeling overwhelmed by all there is to do in Haiti and being unsure of the best ways to help. I am so grateful to have had the opportunity to use my skills to benefit people here. I am also grateful for the opportunity that my daughter Maria has had to be here with me, to appreciate all of the gifts that she has been given, and to experience the joy of sharing the gifts that she brings to the world in being herself and in caring about others.

Thursday, February 24, 2011

Ann in Haiti--- Day Three

It was our third day in the clinic today. Bridgitte walked with her walker with a platform attachment 20 feet with only contact guard! She also put her brakes and footrests on and off by herself. Her daughter said that she needed minimal help to transfer. Bridget was very excited that we gave her the walker to take home! Progress!
Doing PT here can be a bit frustrating at times. Yesterday I worked with a man who had had a proximal Tib/fib fracture stabilized with an external fixate. He had -20 degrees of ankle DF, a lot of soft tissue scarring, and edema. After some edema massage, joint mobilization, passive stretching, wrapping with an ace wrap, giving him a night splint and gait training to try to keep his heel down as long as possible during stance, he went to see the orthopedic surgeon. He came back afterwards saying that the doctor said that he needed a different type of ace wrap. Since we did not have any other ace wraps, we decided to walk into the hospital and talk with the doctor, and see what he had in mind. The doctor wanted a wrap that went around the patient’s ankle to keep him from externally rotating. I explained to the Dr. that I felt he was turning his foot out due to his lack of DF Range of motion, which we are working on, and that I was not sure that wrapping the ace differently would help much. The Dr. was very pleasant, but insisted that wrapping would help. So the pt and I walked back to the clinic, and I wrapped the ankle again…. Clearly, the surgeon did not have much exposure to PT and was not used to working with another professional who might have expertise that was different from his. But, he welcomed me to come and see some patients with him on Friday. Maybe we can educate him about what a PT has to offer just by the exposure!
There is a definite need for PT here, but the patients and Dr.’s do not always realize what we have to offer because they have had little exposure. There was no history of rehab in Haiti until the earthquake when professionals from around the world came to help. Since then, however many of the patients hurt in the earthquake seem to have disappeared. The host at the guesthouse where we are staying says that many are just coping as best they cannot realizing that PT could help them more and that it is available. The more that we are here helping people to get better and helping surgeons to have better outcomes, the more the word will spread. Ultimately, there is a need to train rehab professionals in Haiti.
Tomorrow is another day! I am planning to show up and see patients with the orthopedic surgeon being very diplomatic in my suggestions!--- Ann

Tuesday, February 22, 2011

Return to Haiti ---Ann, PT

After eleven months, I am back in Haiti. It is so wonderful to be here. Despite all of the chaos of getting around every day, there is something about this place that calls one back. I find things much improved in some ways and much the same in others. There are noticeable improvements in the airport. It was much less chaotic getting in, getting luggage, and meeting our ride. We had one bag that did not arrive. We were pleased to find that there actually was a procedure for tracking where it was and getting it back (which hopefully will happen tomorrow!). It did take me almost an hour to stand in line and fill out the paperwork; but still, our hosts tell us that we can actually expect to get our bag! There is much less rubble everywhere than a year ago. The hospital where we are working is now almost empty of patients. There have been repairs to the roof, and there are few foreigners to be seen.
What has not changed is that there continue to be people in need of basic healthcare. This morning we worked with a patient whose blood pressure was 200/105 at rest. She had BP medication but had not taken it in three days. It is not clear if this was due to lack of money to buy the medication or lack of understanding of its importance. Another patient who had diabetes complained about feeling dizzy. I asked her when she had last taken her blood sugar. She told me that she had done it the day before and that it was 250. She had insulin in her bag, but clearly did not understand the basics of monitoring her blood sugar and adjusting her insulin based on what it was.
I spent a fair amount of time this morning working with a patient, “Bridget”, who had had a stroke. Her daughter was also there for physical therapy because of back pain caused by transferring her mother. It became clear quickly that Bridget was capable of a more active role in caring for herself than she was currently performing. By the end of the morning, she was able to put her wheelchair brakes and footrests on and off by herself and had begun to propel her wheelchair with her unaffected arm and leg. We then spent time teaching her daughter how to transfer Bridget without compromising her back, and to encourage her mother to do as much as possible for herself. Hopefully some of this teaching will “stick”. I know, from my time here a year ago, that the culture of illness/injury here is that the ill person is passive and to be cared for. Changing such attitudes in both patients and families is not an easy or quick process. Never the less I have hope for Bridget as she seemed eager to do more for herself and quite proud of her ability to begin to walk with a walker and platform attachment.
There is much to be done in Haiti and it can seem overwhelming at times. When I am working with patients like Bridget and her daughter, I take solace in knowing that for these two people there is something that I can do to help to make their lives a bit better. Tomorrow is another day! There are many “Bridgets” here in Haiti who can benefit from the work of Global Therapy Group and the skills that I have to share. ---- Ann