Ann, PT

It is almost time to head home from Haiti. We are staying only a week this time due to the constraints of limited vacation time to use and a son accompanying me who has a summer job. Last night we went to visit a patient that I met on my first visit to Haiti.

Anese lost her L leg below the knee after the earthquake. She was 6 and a half months pregnant at the time. After teaching her to walk with her prosthesis she told me she was going to name her baby “Ann”. When she had a son, I got a phone call asking me what to name him. I told her to name him “something that means grace” since that is what Ann means and she chose Isaac. I have been able to keep track of Anese & Isaac through my Haitian friend Billy who looks in on them for me and has helped to make arrangements for me so that I could pay for some of the cost of Isaac’s preschool.

I hired a driver to take my son Jesse, Billy and I to Anese’s home. For a couple of years after the earthquake she was living in the tent that we managed to find for her once she left the hospital after her amputation. We drove up some very steep and rutted roads past wandering goats, pigs, and chickens, people walking carrying loads on their heads, make shift “stores” by the side of the road, and many curious Haitian’s wondering about the car carrying a couple of white people into their neighborhood.

After being bounced around in the back seat for what seemed like a very long time after getting lost twice, the car finally stopped. We got out near a large red solid metal gate. On the other side of the gate we found a very simple structure made of plywood. We knocked on the door and I was immediately engulfed by a very big hug from Anese. She was smiling from ear to ear.

Her home had been upgraded from a tent by one of the many non-profit aid agencies still present in Haiti. It was the size of a large living room in the US. There is a single bare bulb hanging from the ceiling. There are no kitchen or bathroom facilities. Anese lives here with her son, Isaac, and her mother. She told me that her husband had left her. I asked if she was working and if not how she spent her days. Since Anese does not have any education and has a very visible disability, I was not surprised to learn that she was not able to find work. She said that she spends most of her days sitting. Isaac looks to be very healthy, and they both seem to be eating well. I am assuming this is due to one of the feeding programs run by an NGO or nongovernmental organization.

Anese showed me all of Isaac’s school pictures, report cards, and completed worksheets. We gave Isaac a very bouncy ball that we had brought for him and I gave Anese a little bit of money. I’m not sure how she is managing to pay for his school. I did notice that his report card said that he had missed many days of school. She told me through Billy that when she was not able to pay for his tuition he was sent home.

I was really happy to be able to see Anese and Isaac again, to see that they are both healthy, to know that she has managed to survive despite all of the challenges. I’m glad that she is no longer living in a tattered tent. I was also sad. Sad that she has to struggle, that she is unable to find work, that Isaac gets sent home from school.

I know that she has not done anything to deserve such a hard life. I can’t help but wonder why my life is so different from hers? What did I do to get so lucky? I don’t have any answers. I can’t fix all that I see here that needs fixing. I can only do the little bit that I can by sharing my professional skills in Haiti, by helping my children to understand that they too are very lucky, by helping to pay for some of the cost of Isaac’s school and by being a friend to Anese and Isaac as best I can from the US.

 

 

Ann, PT from Vermont....third trip in four years!

Back to Haiti for the third time in 4 years. Things that have not changed are the crazy driving conditions, the trash everywhere, the smiles when one says “Bonjou” to a Haitian when walking down the street, and the still present although less high and less frequent piles of rubble from the earthquake. It is actually hard to find a tent city and many of the tent communities seem to have been made more into neighborhoods with at least somewhat less flimsy structures.

The therapy clinic at Global Therapy is now within walking distance to the guesthouse where volunteers stay. The clinic had its grand opening last month. It is a large Green structure open on two sides (with sliding bars to keep out animals and thieves) with ceiling fans, parallel bars, a large therapy mat and one plinth. When we get to the clinic around nine every morning there are patients sitting outside waiting for us. They come first thing in the am and are seen in the order that they come. An appointment system was tried but the patients seem to like their own way of doing it. No one seems the least bit upset about having to wait. They all know that they will have their turn.

Some patients walk to get to us, some come in cars, or on tap taps- a sort of colorful community bus system- and many arrive via motorcycle with anywhere from 2-5 people on them, many times carrying babies or small children as well as people with hemiplegia due to stroke.

This is the most common reason that patients are seen at the clinic, followed by young children with disabilities, and least common people who were injured in the earthquake. I am primarily an orthopedic PT so the neurologic patients and small children are not the typical patients that I see. But having been a PT for 30 years in a variety of settings I still have things to offer them to help them to function better. After three days in the clinic I am spending a lot of time encouraging patients to try to use their hemiplegic arm and hand as much as possible. I saw a woman on Monday whose daughter and son were helping her to get dressed. After assessing her hand it was clear that she could do more. I had her pick up some small objects using a pinch grip. She had no idea that she was capable of this. Today when she came back she told me that she was able to put on her blouse and button it herself! It is these small victories, the charm of the Haitian people, the warmth of the family that runs the guest house, and most of all the chance to make a real difference in at least a few Haitians that keeps me coming back to Haiti. 

 
 

Haiti Cherie

Haiti Cherie: Graduate Student Spotlight Essay & Video detailing the Experience

Haiti Cherie

    They say, “Be the change you want to see in the world,” but where do you start?  Last month I read a research article that discussed service-learning experiences in third world countries for occupational therapists.  I immediately began researching opportunities on the internet, thinking to myself, ‘how can I make this happen’? I sent a few emails to the president of a non-profit rehabilitation clinic in Haiti and with an unrelenting aching desire to create more meaning in my life and make a difference in the lives of those that could give me nothing in return, I took a leap of faith.  Here is the story of my solo journey to Haiti.

 Pòtay, Fatra, Debri, Povrete

(Gates, Garbage, Rubble, Poverty)

    These were my first observations as we drove through streets ridden with potholes and without signs, speed limits, or stoplights.  The devastation from the 2010 Earthquake is still visibly apparent and the poverty is rampant.  I see children with extended bellies, hundreds of people selling food on street corners, and starving dogs pulling apart the trash that fills each street.  I arrive at the Clinic, a large tent with cloth tarps lining the wet and uneven terrain.  There is one table to see patients, a mat to treat children, a desk, and a few supplies in the corner on plastic shelves.  Here I meet the Haitian men (Andre and Frantzo) who run the clinic, as volunteer therapists from all over the world come and go.   

My first day at the clinic I was told that everyone will show up right when we open. Service is first-come first-serve and trying to initiate appointment times has proved futile in a culture that does not view time the same as most Western countries.  Andre the clinic manager and interpreter, begins by taking each patient’s blood pressure.  This is crucial in Haiti due to the prevalence of hypertension and high risk for stroke.  With only 10% of the country having running water and 50% having access to limited amounts of clean water as well as their excessive use of salt in their foods, their culture increases their risk factors.  I would learn over the next two weeks that the majority of the patients at the clinic were stroke survivors who wanted therapy to increase their independence.    

I would greet my patients “Bonjou, vini tanpri, kijan ou ye?” then explain the treatment we would be doing and talk with them in Creole as we worked.  Occasionally I would yell to Andre (who was often working with another patient) “Kijan ou di...safety” when I needed the translation of a word.  An hour and a half would pass and it felt like twenty minutes.  I was in my element.

Aside from the stroke patients, there were a few young children that came to the clinic for therapy also.  I would find toys from the sparse supplies to provide a rich and stimulating environment to engage their happy hearts.  We worked on increasing their abilities and before I knew it, two hours would pass.  Frantzo would say, “Okay, Amy, time for the next patient please.”  The family would thank me and wait for their ride.  Often using the most common form of transportation in Haiti, the motor-bike taxis.  One family would regularly sandwich the child between the driver and the woman and ride off without helmets to their destination.  I would wave goodbye in awe, as I envisioned all that could go wrong in that situation.  

After all the patients had been treated for the day, I would head back to the home where I stayed for the two weeks.  There I would find a traditional Haitian dinner prepared for me.  Often I went upstairs and talked with the Haitian host family I stayed with.  We’d share stories about our days and lives while sipping guava juice (some nights mixing it with Haitian Rhum) and laughing all the while!  Then, I’d take a cold shower, write in my journal, do homework by headlamp and read under the mosquito net before falling asleep.

On the weekends I was able to see many different parts of Haiti.  I went to two church services at a local nursing home that were entirely in French.  Where a limber 90 year old man asked me “Etes-vous tombe du ciel?” -Have you fallen from the sky?  I also attended an annual community art festival that had booths set up for Haitian artists to display their crafts.  I bought a couple necklaces that were made of recycled materials by Haitian women working to support their families.  Each woman’s story was attached and I was deeply moved by them.  This initiative empowers women as entrepreneurs and I will be selling their jewelry for them here in the states over the next few months.

I continued to explore the festival with Caroline, the head of the family I stayed with.  Caroline is the owner and director of a private Pre-K through 9th grade school.  I had read that most educated individuals leave Haiti after obtaining their education.  I asked Caroline why she stayed, to which she replied, “Here I am a leader, in America, I would just be a number.”  She is extremely intelligent, a wonderful host and a true inspiration.

Caroline’s kind and witty husband Henri was also a great host.  On my last weekend in Haiti, we toured the only neurotrauma hospital in the country.  Here I met with one of the three neurosurgeons in the country and also with Matt, a physical therapist that manages a program at the hospital called “Project Stitch.”  This project teaches spinal cord patients and amputees how to sew to make a living for their families, while also trying to dispel the outdated and oppressing notions of disability.  On the tour, we walked into the four bed E.R. to see doctors working hard to stop the bleeding of a woman that was missing half of her face from a motor-taxi accident, with pools of blood and rags all around, there were no curtains separating her from the other patients.  The tour continued where we saw the only adult ICU in the country, which had five beds, the only CT scanner and the only acute spinal cord injury ward in the country, which had eight beds.  Seeing the progress Matt has made was refreshing, but the disparities in access and quality of healthcare as compared to the states is undeniably unjust.

Reflection

The thing about Haiti is, even though these people didn’t have money or things to give me in return, what they gave me was worth far greater.  A people that have known violence, devastation, lack of justice, and extreme poverty, gave me their smiles, their gratitude, their hard work, sweat and faith, and have further propelled my passion for occupational therapy and social justice.  The major similarity between occupational therapy and the development of third world countries is that you must empower people to help themselves, you cannot do the work for them.  Traditional charity fails these countries and that is why we must invest in the people, so that they can help themselves.

With treatment focused on the client and the creativity allowed to help empower each patient reach any goal they find personally meaningful; I instinctively knew that a career in occupational therapy was the right path for me.  Haiti has taught me that I can use my skills to help others feel successful as they pursue goals and opportunities that they might not have believed they could achieve prior to therapy.  I have learned the importance of recognizing and celebrating the little victories with each client and that through occupational therapy and regardless of cultural differences, I am able to instill hope where disability or illness may have depleted it.  

This has been the most rewarding experience I have ever been blessed with.  I have learned so much about myself as well as having gained greater insight into my therapeutic style.  I have a new enlightened perspective on what it means to be brave, by watching all these resilient individuals push through the circumstances they have been dealt, as they strive for a better tomorrow.  Each day was an opportunity to learn and I tried to be open to and absorb as much of the culture and life lessons as I could.  This experience has helped me realize that the burdens in my life back in the states are rather trivial as compared to the daily struggle people face elsewhere in the world.  This new perspective and the cultural competency I gained is not something that can be learned in a book.

I have been altered at my core, truly inspired, and deeply empowered to help others on a global scale.  I give my endless gratitude to the patients at the clinic and my Haitian family.  As well as a big thank you to my family in the states for their support and love on my journey!  We show the world who we are through our actions and not merely our words.  I encourage everyone to take a leap of faith and see where it takes them, because“ You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face.  You must do the thing which you think you cannot do.” -Eleanor Roosevelt

 

Link to the movie I made:

https://www.youtube.com/watch?v=4xNLAHYrCjA

Hotter than Haiti...Janet Papenfuss, ST

(The following is excerpted from an article written by Janet Papenfuss on her trip to Haiti doing speech therapy.  The full article and photos can be found in the Franciscan Sisters of Perpetual Adoration quarterly newsletter published the week of October 21, 2013.)

Serving people in a Third World Country through Peace Corps volunteering has been on my "bucket list" long before the term "bucket list" was ever coined.  Since the age of 18 (yes, that makes it a 40-year old dream), I have felt the call to do things, and to go places out of my comfort zone, and to try to make a difference in the lives of those less fortunate-and by doing so, to make a difference (or even changes) in my own life. So you can imagine my excitement when I stumbled upon an article in one of my professional journals requesting speech therapy volunteers to go to Haiti for Global Therapy Group, an organization founded by an amazing physical therapist, Donna Hutchins, following the 2010 earthquake.

The founding of this group is a story in and of itself (I invite you to visit the Global Therapy Group website and click on "Donna's Story").

After reading the story, I laughed, cried, and literally jumped up and down.  By the end of the day, I contacted Donna, filled out all the paperwork, committed to a month of service, booked a flight, and arranged for all the immunizations   I'd need.  By the next day, I had arranged for a house and animal sitter.  I had recently renewed my passport and had just received my tax refund, so that went to fund the trip.   I also discovered that, by some small miracle, my home mortgage was actually paid a month ahead!  Now how did THAT happen?

Things came together so quickly and easily that I knew deeply it was God's plan for me.

The feeling I carried inside me up until the day I left was so uplifting and positive that I felt like I was floating or being carried by Holy Hands throughout my days.  Even when my family, friends, and the U.S. Embassy website reminded me that Haiti is a very dangerous Third World Country, I was not deterred- not even a little bit.  The clear message was that this is what I am supposed to do, and if something negative happens to me there, that also is God's plan for me.  Before I left, a woman I knew only slightly couldn't believe I was traveling to Haiti alone, and offered to go with me and stay for three days just to make sure I was in a safe place.  She is a nurse and had been there multiple times.  Again, proof of Divine providence.

I like to think I made a difference in some of the Haitian lives I touched, but as is so often the case, I was touched so much more by the people I came into contact with.  I have never been around a more patient people.  Since we could not get the concept of "appointment times" across, the people who came to our clinic would wait to be seen, sometimes for hours in the heat.  There was no such thing as a waiting room, much less a sign stating, "If you haven't been seen in 15 minutes... , " as we have in our clinics here.

There is a pride and dignity of appearance that is important to Haitians, no matter their impoverished living conditions.  In spite of the heat, rubble, dust, and garbage in the streets, our Haitian patients arrived clean and in clean clothes, and some of the little girls in what appeared to be communion dresses.  If when waiting the children became dirty while playing or eating a snack, their mothers had a change of clothes for them before they came into the clinic.  I mention this because it seems so incongruous to me-most people do not have running water, much less a wash machine, and even the wealthier people do not have hot water (my host family included).   Shoeshine boys and "car washes" (hoses attached to a barrel of water) are seen every hundred feet or so along the streets or roads, in the middle of dust and rubble.  It seemed a pointless endeavor, but for the Haitians, is very important, and somehow they arrived at their destinations clean and put together.  I, on the other hand, could never quite look as good.

I know that this was not simply something to cross off my bucket list, because I'm going back.  I'll be carrying this bucket with me until I can't carry it anymore! 

Orevwa, bèl Ayiti

Goodbye, beautiful Haiti

How do you leave a place like Haiti? How do you leave a land filled with such beautiful people who have taught you so much and inspired you in so many ways? I’m sitting here reflecting and wondering how I’m ever going to return to reality. There have been so many moments where thoughts of Haiti would make my eyes well up with tears. It was only two weeks and yet I know I will never be the same again. I am eternally grateful to the people I met for all that they have taught me about humility, compassion, life and love. 

I’ve been back in the US for a day now, and the transition has definitely been difficult. It’s been hard to have all the comforts and luxuries of home after seeing the struggles and poverty of people who deserve so much more. I do hope that my time in Haiti will help me to be grateful for the opportunities that I do have, whether it is the opportunity  to travel, to eat out, drive, or even to turn on the faucet for water.

Staring out the window during my flight from Haiti… in a somehow perfectly timed moment… I looked out an saw a beautiful picture. I was watching the sun set on the horizon, with a layer of soft clouds that seemed to go on without end. If I could imagine heaven and what it might look like, this would have been it. 

It was an incredible sight. For me personally, it was a gentle reminder of the reassurance and hope that despite our suffering and struggles here on earth… it is all temporary. There is an eternal hope that extends far beyond what we see in the here and now. “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.”  What a beautiful hope. 

A special thank you to all of you for reading and for supporting me in this journey. It means the world to me that I can share this experience with you. Now that I have seen what I’ve seen and learned what I’ve learned… I feel like I owe it to the people of Haiti to continue sharing their story and   think about how I can continue to help now that I’m home.

I have seen the adversity and struggles of the Haitian people and it has inspired me to think about my own life and how I am supposed to respond. Something that I’ve learned is that everyone has their own personal challenges; for many Haitians, it is a daily struggle to survive… it is anything but easy and comfortable. And perhaps for us… our circumstances have made it so that the challenge is not to be comfortable and complacent with how things are. Maybe our challenge is to fight for justice and equality in our world so that everyone can have a chance to live… to not let our abundance and fortune cause us to forget that happiness is made so much fuller if it includes everyone and not just some. 

I recently read an inspiring speech from the World Bank Group President, Jim Yong Kim. Here is an excerpt:

Injustice will not vanish “inevitably.” Injustice, said Dr. King, must be “rooted out by strong, persistent and determined action” spurred by “the urgency of the moment.”

As we set goals for our organization, goals for our collective effort to better serve the poor and vulnerable, we should reflect on Dr. King’s example.

We set goals precisely because nothing is inevitable. We set goals to challenge external obstacles—but also to defy our own inertia. We set goals to keep ourselves alert to the “urgency of the moment,” to push constantly beyond our own limits. We set goals to keep ourselves from falling into either fatalism or complacency—both deadly enemies of the poor.

If we act today, if we work relentlessly toward these goals of ending extreme poverty and boosting shared prosperity, we have the opportunity to create a world for our children which is defined not by stark inequities but by soaring opportunities. A sustainable world where all households have access to clean energy. A world where everyone has enough to eat. A world where no one dies from preventable diseases.

A world free of poverty.

It is the world we all want for ourselves, for our children, our grandchildren, and all future generations.

As Dr. King said, “the time is always ripe to do right.”  The opportunity is squarely in front of us.  We can and we must seize the arc of history and bend it toward justice. 

Thank for you for sharing this journey with me! I hope the beauty of the Haitian people has touched your life as much as it has touched mine.  

Michelle, PT The Last Day

Day 12: Therapy + Health Update

Yesterday was my last day in the clinic. I can’t believe how fast time has passed and am amazed at how much of an impact my patients have made on me in such a short amount of time. Most of them were stroke patients so it was nice to use things I learned at home to help. Therapy is a new concept for people here, even though it is desperately needed. There were so many small children that came in for various reasons - developmental delays, cerebral palsy, burns, club feet… it’s sad to think how few services there are for them. And for the stroke patients - it’s just crazy when I think about how much we have at home compared to here. Not only are there very few therapists here, but patients rarely have access to things like custom splints or braces, shoulder support, imaging, medication, ultrasound, mirrors, Kinesiotape, Bosu balls, special creams, ice packs, wheelchairs (or choice of wheelchair color, like we have at home), walkers, canes, proper shoes, etc. Sometimes I do wonder if what we have at home is maybe even too excessive when I think about the patients here and how many don’t even have the basic supplies they need. One of the stroke patients arrived at the clinic on a motorcycle. Her husband basically just lifted her up and onto the motorcycle. This would be practically illegal at home! But people here are creative, resourceful and determined. I’ve seen a man with a crippled leg, trekking up the hill with a pair crutches. I’ve also seen an amputee pushing his wheelchair up the steep hill.

In Haiti, there is no health insurance or disability payment system so when a person gets hurt, it makes such a huge impact on their work and livelihood. They tried an appointment system at our clinic but it didn’t work out (traffic, especially after rain, can be very difficult) so oftentimes, people just have to sit and wait for therapy. 

The people in Haiti need so much more. Basic health education and disease prevention is desperately needed. In 2009, statistics showed that Haiti had one nurse and 3 doctors for every 10,000 people. Only 10% of Haitians have running water and 80% lack adequate sanitation. During a rainstorm here one day, I saw people outside collecting water with buckets. Oftentimes, people have to walk long distances to get drinking water - sometimes small children go early before school… sometimes mothers go and return with water-filled buckets on their head. Every minute spent getting water is a minute not spent in school or at work; people may miss class or work if they have stomach pains, diarrhea or dehydration. I read in an article that for one lady, her test for clean water is this: “If it is clean, nothing will happen. When the water is not clean, my children get diarrhea.” I can’t even imagine not being able to turn on a faucet to get water or wash my hands, or having to spend my days walking for water. We are definitely very, very lucky.

I know there is so much potential for Haiti, but they still have a long ways to go. I’m encouraged whenever I read about the progress that is being made - improved sanitation, more people getting vaccinated, more cholera awareness, etc. If you want to learn more about the water crisis around the world, check out this short 3-minute YouTube video or visit the Charity:Water website:

Water Changes Everything

Charity: Water

Michelle, PT in Haiti

thoughts & lessons from Port-au-Prince, Haiti

Day 3

I’m sitting in my room right now and it’s raining like crazy outside. Sounds of thunder roll in once in awhile… but it’s kind of a nice, calming feeling. It’s rainy season here in Haiti which means more mosquitoes and more humidity! Luckily, it was sunny and dry the whole day.

Today was a great day in the clinic. I saw 5 patients today - most of them were stroke patients. It’s sad to think how little follow-up care there is for people who have had a stroke, especially since it requires life-long rehab. At home, the continuum of care is so comprehensive but here, people just take whatever little they can get. It’s really cool to see how much of an impact this little clinic has made in the past 3 years though, and also really neat to hear about all the volunteers who have come from all around the world to help.

One story in particular that I wanted to share: today I got the chance to work with Franz, a patient who had a stroke about 2 years ago. Andrew said he was a very hard worker and really motivated, coming to the clinic twice a week for therapy. He is also the owner of a nice local bakery. Anyways, we went through our treatment and it was a nice change of pace because I found out he spoke English in addition to French and Haitian Creole so we were able to have a conversation. I asked him how he learned English and he told me how he had spent some time in the US Army as well as in NYC to study accounting. Not only that, he was also trained as a pilot and a baker. He was such a nice man and Andrew was right - a hard worker and positive guy, despite his limitations. At the end of his treatment, he had someone send us some pastries - such a wonderful guy!

Reflecting back on today, I am really encouraged when I think about Franz. He was clearly very accomplished and had much to be proud of - fluent in three languages, serving in the Army, trained as a baker, pilot and accountant… But just working with him in the clinic today - I would have never known because he just acted like a normal, down-to-earth guy, joking and laughing… giving 110% during our therapy today. He had such a positive attitude and the dedication he had was inspiring.

I was reminded today of the resilience and strength of the human spirit. I was reminded also that in the end… no matter where we’ve come from, what language we speak, what we’ve accomplished or not accomplished, or our abilities or disabilities… there is always some capacity in which we have the opportunity to inspire and encourage one another. Franz did that for me today. It never ceases to amaze me how much I continue to learn from my patients every day.