cute haitian kids

pictures below were taken in the pediatric unit

street scenes from carrefour and port-au-prince

above port-au-prince

above: neighborhood near orphanage

haitian art



MSF

roads are beginning to flood d/t frequent rain


cute girl striking a pose for us

they have the best mangoes here! On the other hand the corn looks good but in reality is hard and chewy.




laundry day

this poor elderly lady didnt want to get her shoes wet so she walked barefoot through the rubble and puddles

last day in Haiti

friday morning we woke up early to say goodbye to part of our team that was on the early flight. Then we started to pack/organize our things and get ready to leave in the afternoon. We had a lot of goods that we hadnt given out during the week in fear of being identified as a "giver" and being mobbed.

We divided up our blow up mattresses, shoes, toys, flashlights, energy bars, clothes and suitcases according to the needs of these unfortunate individuals.
Nadine, a young girl found in the rubble - her parents assumed dead was given the most with a duffle bag filled with shoes, toys, food, soap.



Nadine pictured above

We gave things to two other families that lived in the same tent. They had lost their homes and possessions. The air mattresses and another pair of shoes were given out to a mother and daughter. When we they were in the hospital the daughter would sleep by her moms cot on a flattened out cardboard box on the floor and then fold up it up every morning. Her mom was handicapped due to a left leg amputation.

above: Kettly and her daughter

These people mentioned had all been 'discharged' from the hospital but had no other place to go so wound up in this huge tent donated by canadians with around 20 other people. It was like 40 feet from the entrance to our hospital.



Then we went to maternity/peds and gave them a suitcase full of linens and towels as well as prenatal vitamins. We couldn't leave without holding some of the cute babies! (more pictures to come)

We passed out our special gifts to the in-hospital patients: clothes, fans, protein bars, shoes, tents, a backpack filled with toys. And all the patients received a condoms, soap, and a handmade card.The ones for all the patients were kind of a random assortment of goodies but the items seemed to be appreciated. I also carried around a box of condoms that went by really fast. It was ridiculous watching some of the guys grab condoms; some would say "oh, I REALLY need a lot of these" others would stand there and only pick out the "huge" condoms. (little do they know that they are all the same size, yes I did compare the two). Anyways we did a pretty good job giving stuff out but left some toys and lots of condoms for the next group to give out as well.


As we were roaming the halls saying good bye to our patients the orthopedic doctor ran up and said he really needed our help with his clinic patients. I had a few hours to spare before we needed to leave for the airport, so I jumped right in. Gurpreet went to the ED was immediately asked to help out too.

Dr Nelson explained briefly to go into one room and remove sutures and then start seeing his patients. It sounded a lot easier than it actually was.
the suture removal took way too long. plus there wasnt adequate lighting so the guy with the portable xray machine had to use the overhead light to serve as a spotlight for me.

When I was finally done I went to see the next patient. I walked in the room and got a history via translator - It wasn't really clear to me what I was supposed to be talking to the patients about so I just kept making up questions until I got some sort of history that pertained to the ortho subject. I was charting when a huge drop of water fell on the paper I was writing on smudging the ink on the chart. I looked up to see a huge leak in the ceiling. no big surprise. it had been raining pretty frequently this week and the building was not in great condition.

I saw the next patient a cute 2 year old with both legs in a cast and a bridge connecting them. The baby began screaming her head off as soon as i walked in the room. awesome. I gave her some toys but she still didnt like me anywhere near her. Anyways, the parents were told by another dr. that the baby needed her legs to be lengthened as a result the dr. put this bulky cast on. The parents wanted to know if they could get boots to correct the problem instead. As soon as the ortho doc, Dr. Nelson, saw this he immediately grabbed the electric cutter to remove the cast. The feet/legs were normal. The child walked fine. the parents were relieved and expectingly confused. We dont know who put the cast on but it didnt happen at our hospital.

Then I assisted Dr. Nelson in applying an arm cast on another patient. While we were applying it the power went out. No surprise it had been happening on and off throughout the past couple of days it was funny how after a while you dont really notice/acknowledge it and just keep on going.

the next kid we saw had one leg that was longer - i guess he had a fixed fracture and the bone had healed in a way that made the leg a bit longer. The dr. prescribed the family to go to a shoemaker and get a shoe lift made. well they had never heard of a shoemaker before and didnt know of one in existence. This wasnt the first time a MD had instructed/prescribed something that ended up being impossible for the patient to follow. Some examples are: a pt needs to take hot baths - there are no baths and no hot water; they need to take meds 3x per day with meals - most haitians are only able to eat one time per day.

As I worked my way through the line I noted that almost 80% of the patients' injuries were related to the earthquake. Almost all of them had scars on their arms and legs that were caused by the debris and concrete from collapsing buildings that had collapsed during the earthquake. A mark that would always remind them of the devastation and traumatic experience on jan 12.






pediatricians arent pictured. Dr. Mark - ED MD, midwives, and part of the ukiah team


At 1pm gurpreet, emily, becky and I were all packed up and ready to go. A small crowd of people had gathered on the steps of the hospital to say their good byes. The volunteer pediatricians and ED doctor were there as well as the translators and kids that were living in the tents. It had been so great working with all of the volunteer medical staff. They were all wonderful people with huge hearts and amazing clinicians. We took group pictures and played with the kids. We could really feel the combined love and appreciation from everyone that was there. It was really sad to leave everyone.

SNACK TIME

On wednesday melanie and i made all of the bags of popcorn that we had (which was a lot) and distributed them to the patients and families. notice that we are using coffee filters bc we didnt have cups or paper towels/napkins. Brad, david and franz came to help us distribute and to share in the fun.


translator franz helps hand out popcorn




pictures by David PT (from davidwies.org)




SNAPSHOTS FROM A DAY IN HAITI ADVENTISTE HOPITAL



7am rounds with Dr. Nelson



"i dont sweat, i glisten"
pictured above is dina and claudia. I was in their room every day doing dressing changes. They are both hilarious people and made me laugh most of the time I was there. This is the day that I sang for them. They had been asking me all week so finally I did it on the last possible day. They humored me, but I think they regretted ever asking!

dina with her daughter, so cute!


Becky and Brad in the ED




TRIP TO THE ORPHANAGE


the palace

passing out coloring books to the girls at the orphanage

Today a group of us decided to go to the Adventist orphanage. Apparently, Patty a RN from UVMC that came with the last group is planning on adopting two girls from there. The orphanage was only 12.5 km away, but it ended up taking us around 2 hours to get there due to rush hour traffic. The ride was a bit scary: we got lost a few times, were involved in some near accidents, and got stopped by the UN soldiers. Nonetheless, we finally made it to the orphanage where we realized that the trouble getting there was totally worth it. The girls were all so adorable. They immediately attached themselves to us like glue. I even had a hard time going up stairs because there was about 5 of them that all wanted to be holding onto my arm, hand or leg in some way. The orphanage was well kept and clean. We gave them most of the presents that we had left over ( we had already gone around and given all the pedi pts toys as well as the kids in tents toys.) It was difficult to keep things fair.Each one got a coloring book, a handful of crayons, a stuffed animal and a toy. Melanie and crystal led a few songs and then then we asked the girls if they knew a song they could sing us. They said yes. when they started to sing their voices sounded so pure and innocent that it actually made tears well up in my eyes - I didnt even know what they were singing about, maybe it was the voices or the tempo but whatever it was it evoked a strong emotion of sadness and helplessness as I imagined what it would be like to grow up without parents and the sad stories that led them to become orphans. At the end the translator told me they were singing about the hardships that they have endured, the resiliency of their people and how God will always be with them. Afterwards we all sang a song together. They knew one english song and luckily we knew the same one. It was a religious song that I had heard many times growing up. Then we took a few pictures and they showed us around their rooms and had to leave. The stay may have been short but the moments we spent with those little girls is something I will not forget.
Outside the sun had just set and it was dusk. The night life began in port-au-prince. We passed many brightly colored tap-taps blaring the haitian music, people out in the market selling their goods by candlelight, other street vendors packing up to go home, a lot of people were on the move others were lingering about. It felt like everyone was out in the streets. The liviness of the streets contrasted greatly to the images of rubble that we passed, fires lit to burn endless piles of trash, and we passed the palace which was somewhat of an eery image as it sat there toppled over, abandoned and dark.
The trip back home was a lot shorter, thank goodness. At that point we were all hungry, tired sweaty and covered in dust from the drive. We pulled up to the hospital to find that some of the kids and translators had gathered to say good-bye to everyone. We took some pictures gave hugs and exchanged emails. A few of us headed down the street to grab a bite to eat. We didnt take a translator with us which made it difficult when it came to ordering vegetarian food. The restaurant was owned by a family. They were in the room with us watching the TV and chatting. They introduced their grandmother to us, she this tiny lady who was probably around 70, she came around and gave all of us kisses and hugs. It is a rarity to see someone that is as old as her. After our meal we said our goodbyes to the family like they had been old friends. It still is hard to believe that we are already leaving! Hopefully I will return with here no later than january when our UVMC team plans to come back for another month.

Gurpreet and I were planning on going out to eat and went down to the ED to grab Dr. Mark. We ended up staying for 3 hours because a kid was in sickle cell crisis and had desatted into the 70's when I found him. And then a man came in who was in a fight and had his lower lip bit off. Never a dull moment.

the picture is of the pediatricians and gurpreet and I with the child with sickle cell. stat orders for things like labs, xray, portable o2, and a 02 regulator that worked is not really a capability that we have here.
I am also drinking the "haitian juice" a special treat that the haitians make fresh every day - the translator that brought it was sure I would love it... It was.. interesting


Gurpreet and Mel doing a dressing change on Staille



The kids from the tents lining up to get presents

Throughout this entire trip there has been a common conversational topic among the volunteers: how can we really help 'heal' Haiti. I often wonder the type of impact that we are making here and what things will be like once we are gone. The nurses seem to be educated poorly and I find to hard to say that quality healthcare is being given here. As I mentioned in an earlier post, they don't even have the supplies they need. A majority of the patient care work in this hospital is done by the patients' families. They help feed their loved one, bathe them, clean out their bedpans, and change their linens. scheduled meds are often skipped or forgotten about because the ordered meds cannot be found. the nurses stations are cluttered, disorganized. It is a very frusterating work environment and even more unsettling that no one is trying to change it and things will probably continue to be this way.
In the big picture the issues in the hospital are a result of poor structure, a structure that resembles the broken government of this country. Even this week we heard talk of riots breaking out at other hospitals bc the current president is planning to transfer power to another person instead of doing a democratic election. But even if another president is elected, the long history of corruption makes me believe that there is little or no hope that we can rely on the government to help their own people. The people here are loving, kind, and wonderful - but they lack the right resources and organization to help rebuild their community. And if Haiti is relying on NGOs and donations to rebuild itself, the process is going to be even slower because resources are running out.
So what are we accomplishing by being here? The week that I have been here, it feels like most of my actions address the problems at hand; like putting a boo-boo bandaid on a busting pipe ( or whatever that expression is). There is no real sustainable plan for these people, not in this hospital, and not in the country. everyone just keeps coming in and trying to help fix the piece that is broken and then leaves. The people deserve so much more than that. They are the most loving, kind, sweet population of people that I have taken care of.

Throughout this trip we are learning to become very flexible, adapt to new situations, and think outside of the box. Their is a lack of everything here - proper equipment, organization, support services, nursing staff which means that we are often thinking outside of the box and taking on many different roles in order to provide the proper care to our patients. Gurpreet has been doing all the EKG's for us and performed a "poor mans stress test" - where she took the patient for a walk outside instead of in a controlled room with a treadmill and heart monitor, Becky has been giving breathing tx among many other things, the PT's are in charge of wound care and managing the patients on the floor as well as occasional discharge planners/case managers, my nurse manager Brad stood and ventilated a patient for like 3 hours because we dont have any ventilators. We have been supplementing missing equipment with anything that will work, I have been asked to triage, pre-op, wound care, and ED nursing - most of which are all pretty new/unfamiliar roles to me. So the environment allows us to experience a lot of new roles and skills and learn how to work with what we've got.

below are some more pictures. I wish I could write more but we have to start our morning rounds.

Its about 12:30 am here and I am having a hard time winding down. Gurpreet, Becky, Shaun and I just returned from playing "santa" to the kids in the hospital. We created little goodie bags with coloring books, crayons, pixie sticks and toys and then placed them by each sleeping child so that they could have a suprise when they woke up!

This morning we woke up early to do rounds with the orthopedic surgeon. Afterwards we had planned to begin doing wound care on the patients but the triage tent was so busy that Gupreet and I were asked to help down there. Dr. Turner and Emily had a long line of people waiting to be seen. I was told to take vitals and triage but after an hour and a half I was drenched in sweat and began to feel overwhelmed as I realized there was no end in sight. Not to mention I still had a lot of dressings to change! I decided to ditch the triage tent and do wound care with Brad. Wound care has been taking a lot less time because we did a mini "LEAN" project on our supplies bin. There are still a few complicated wounds, one patient takes an an hour + no matter how much we prepare for it, but for the most part we have a good workflow. I am even proficient enough in my creole that I find I dont need my translator to be with me during the dressing changes!
After lunch the wound care team was helping the ED. There was plenty for everyone to do - lab draws, giving meds, starting IVs in dehydrated people, and if nothing else there is always someone who cant find a supply they need and needs a "gofor" There is a definite lack of organization here with the supplies. It is immensly frusterating. Gurpreet was involved with some complex cases today as well as being stuck with entertaining 4 nursing students and teaching the lab about the necessity for correct lab supplies in the ED. I had tried earlier with an interpreter but gave up because not even my interpreter understood me. Becky is just doing great things in the ED and is the go-to girl in that department.
We also went out to eat tonight at a local restaurant. We had a few beers and shared our "war" stories of the day as we munched on fried plantains and piccoleas (sp?). It was nice to get away after a long crazy day. We had this young 24 year old mother with the skull fracture was a very sad case. She was assualted by a baseball bat last night and sustained severe head injuries. She has no family or relatives that we know of and the only one who came with her is her employer. She was transferred from Doctors without Borders, and after more than 6 hours spent trying to save this girl which included measures such as cooling her core body temp, inserting our only central line in the hospital in her, intubating her, giving her IV meds and IV fluid and more it was decided that there was no hope for her after a consult call was made to a neuro surgeon and the MD director advised letting her go. The whole situation is just extremely unfortunate and sad. But even in the best hospital we couldnt of saved her.

OK well I have to get at least a few hours of shut eye before tomorrow.

I will try and post pictures later. It might take some time because my laptop is the only thing with a built in cardreader and its dead. (i didnt bring the charger)

good night :)

pictures from the first day