PAYPAL

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

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

10/21/10
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

10/9/10:
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 – paintings, sculptors, tin work, macramé, etc. What was most interesting, though, was the fact that the attendees were primarily the elite – a switch from who we see at the hospital. Everyone was clean, well dressed and with nice cars – a 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.

Donna