Sunday, March 14, 2010

With Deep Gratitude

Sunday, March 14, 2010
For all we have been given, I have returned home. There remains much to be done in Haiti. Hopefully these past 3 weeks have helped in some small way.

Will try to publish some pictures soon.

Thank you all for your support.


Friday, March 12, 2010

Still Here

Still Here

Friday, March 12, 2010
Forgot to mention for those of you who know her that the woman with the terrible facial deformity is still here. She showed up one time last week and again today. I gave her my sandals today along with some more money. Her feet are deformed and I don’t know if she can wear them, but maybe she can sell them for a few gourdes in the market.

We have dinner tonight with the Canadian therapy team at our house. One of the enjoyable aspects of working here is meeting volunteers from many places.

Right now I need to go say good bye to some of the patients.

See you in the USA. Judy

Invisible Loss

Invisible Loss

Thursday, March 11, 2010
Today as I chatted with the Swiss Director of the laboratory here, she told me of one of the many cases of invisible loss that will plague Haiti for years. A bright, hard working young man in the lab went to college and learned computer science. He returned to HAS and began working in the lab. To fully reach his potential, though, he needed some more work at the college level. He had simply run out of money and gone to work as his only option. The Lab Director encouraged him to begin saving little by little to return to college. She provided him with an inexpensive computer to further his studies. He was encouraged and did begin to save and it looked like he would be able to return to school. Somewhere along the way he must have enrolled and made a payment toward tuition. Then came the earthquake. The University is a pile of rubble. The young man’s savings are gone. He has no idea if he or hundreds of other students will ever receive their tuition back.

So this is one of many invisible losses. The press has focused much attention first on people trapped in the rubble, then on the loss of life and limbs as a result. Lost limbs are tangible. Many individuals and organizations, including Hanger Prosthetics, have come here and begun providing limbs to people who previously in Haiti would have had none. The only prosthetics operation in Port au Prince was destroyed in the quake. This is a wonderful thing. As a Physical Therapist, I am thrilled to see people walking again.

But the invisible losses may run deeper than we will ever know. I hope that the world stays interested in Haiti long enough to deal with these more complex problems.

See you in 2 days, Judy

Wednesday, March 10, 2010

Tough Bunch of Students

Tough Bunch of Students

Wednesday, March 10, 2010
Today was a LONG day for the Rehab Technician students. First they had a written exam. Then they had a practical exam--a make believe patient that they had to teach how to use crutches or a walker or a cane on level surfaces and on stairs. The nerve racking part for the students was that I was the patient.

I did this in the interest of fairness. Even without any intention of trying to help a fellow student or to blatantly cheat, it is easy for them to give subtle hints to one another when one of them is acting as the patient while the other is tested. When I am the patient, I can present in the same way for each case. It took over 30 minutes each to test the six of them so it was a very long morning, as this came after the written exam. I was POOPED afterward as this also takes intense concentration on my part to act the role of the patient and then remember what they are doing at the same time.

Over lunch, I totaled up their points and found that everyone passed. Beth and I spent the early afternoon doing an intensive review of the practical exam as this material will be very important in their practice.

It was after that that the amazing thing happened. It was 2:50 PM and I offered the students the option of quitting for the day and starting fresh on a new unit in the morning. I did give the caveat that we needed to completely finish that unit on Friday before I leave.

Now in the USA (I did not say this to them), I would have bet the farm that the students would have BOLTED out the door in somewhere less than 10 seconds. Not these students. They talked briefly among themselves, then clearly told me to commence. I am not sure about the French spelling of that, but it clearly translates to begin. Tough bunch.

Last night a group of 4 Canadians arrived, 3 PT’s and one OT. They were on the wards today and in the out-pt. area. We especially appreciated the arrival of the OT as there are several patients with hand injuries who need appropriate splints and no one here has that expertise.

Will try to get this posted before the water comes on for our evening shower. One of our pediatric patients has scabies and I am starting to itch. See you in 3 days.


Addendum: As I walked into the hospital to prepare to post, I heard the loud wailing of a family who has just lost someone in the Overnight Ward. Apparently the morgue has not been in use here for quite some time, so the body lies wrapped in a sheet on the bed or stretcher until arrangements have been made to take it away.

Four Days Remaining In the Clinic

Four Days Remaining In the Clinic

Monday, March 8, 2010
There are only 4 days remaining in the clinic for this 19 day trip. One day to travel here, thirteen days working so far, one day off. The last day we will travel home. The time has FLOWN by.

Many patients poured in over the weekend and there are beds lining the hallway. Housing is being renovated for the many amputees and their families who will be coming here to receive a prosthesis

Sunday, March 7, 2010

Little Jobs That Belong to No One

Little Jobs That Belong to No One

Sunday, March 7, 2010
After a leisurely morning of sleeping late, coffee, and quiche for breakfast, Beth and I went to the wards and saw 16 patients. We found quite a few new people on the wards and in the overnight ward (kind of an ER/ staging area for new admits). Tomorrow will be very busy for everyone.

After lunch we returned to the classroom area with cleaning supplies in hand to do one of those little jobs that belongs to no one. The same cabinet that was used last summer to support the white board used in class has been moved to the new classroom in the hospital this year. It was dusty and crusted with what looked like maybe dried soft drinks or coffee or splatters of whatever. It has been that way since last summer. So we scrubbed and cleaned it. We used the wire that we purchased in the market yesterday to hang up 2 anatomy teaching posters that were gathering dust in the closet and certainly not helping the students. We cleaned out the bookshelf and put small supplies in a container. We wiped down the crutches and walker and cane used for teaching. All these little jobs belonged to no one, so we decided to be the someone who did them today. Hopefully the students will feel good about the refreshed look of their classroom. They are always diligent about dusting off the table before they put their books and papers there each day.

We are being relentlessly pursued by people trying to sell us souvenirs, and a couple of people just flat out begging for money. There were about 5 beggars sitting on the ground on the walkway into the hospital this morning. So far, no evidence of the woman with the terrible facial deformity who also begged for money over the many years I have been here. I think that she may be gone.

After two really good nights of sleep I am ready to tackle our last week.

Until later, Judy

Saturday, March 6, 2010

Enjoying a Cool, Quiet Day Off

Enjoying a cool, quiet day off

Saturday late afternoon, March 6, 2010
What a wonderful cool day this has been, the coolest I have ever experienced in Haiti. The sun has been behind the clouds all day and it is pleasant both inside and out. Beth and I pleaded for a day off today which was graciously given after 11 days without a break. This is nothing to brag about, as some of those here have had no real time off since the earthquake.

We slept in until 7:30, had a leisurely breakfast of sweet Haitian oatmeal, bread with cheese spread (Bongu!), some very watery watermelon and coffee. After that we packed up like good Girl Scouts and headed out for Verette. We actually were not that sure how to get to Verette, but we decided to chance it, knowing that we would probably find volunteer guides along the way and it is only 3 miles. So off we went. At a turn in the road, we asked directions in our best Kreyol and continued on the path we had taken, although a little worried that the directions had seemed more complicated than just ‘follow this road.’ After a while we stumbled upon the Deschapelles community clinic and were invited inside for a tour by 2 hospital employees who were there and saw us looking through the fence. As we left, I asked again in my best Kreyol if we were going the right direction and found that we were not. I paid a small guide fee to be led to the correct road. We ended up walking back to where we started, then down the ‘corridor’ through town to the main road. We were actually looking for the dirt path, but this did not seem to be working out, so we set off down the road. Along the way, we had picked up another ‘guide’ who wanted to sell us baskets. He tagged along on the promise that we would look later. We were eventually able to cut across a field and pick up the dirt path where there were only honking motorcycles to dodge, rather than tap taps and trucks.

The market was wall to wall people with narrow passages between the tables and other wares spread on the ground. We found cookies, tomatoes, and some thin wire to use as string; 3 of the 4 things we were looking for. One woman was very disappointed when we did not buy her tomatoes because she did not have enough change for our 50 gourdes note for a 5 gourdes purchase. Perhaps she hoped we would just give her the whole bill, but she did not try to chase us when we walked away so she probably did have less than 50 gourdes with her (about $1.25). Overpaying may have been the right thing to do, but if others had noticed, we would have been swamped.

One of the best things about coming to Haiti is that your usual roles are often turned upside down, always a good experience for getting out of your rut. I thought that I had given up academics 8 years ago, but here I find myself doing classroom teaching again for the Rehab Tech students. Then at the end of the week, I the former teacher was asked to return to helping on the wards and Beth, always a clinical person, was asked to take over the teaching. We made the switch and Beth spent Friday teaching about the gait cycle while I returned to the wards for patient care, including several pediatric patients who are far out of my regular realm of work.

We learned from Shaun, the PT on site, that one little boy who eagerly works with us in return for a balloon and piece of hard candy each day was trapped in the rubble for SEVEN DAYS. I do not know how his little body survived and certainly wonder if I could keep my sanity that long. One of his eyes is badly infected and looks as if it may not be saved. His right hand has a nerve injury from the multiple tissue tears on his arm and is stiff and paralyzed. It will probably remain that way. His opposite foot is floppy, also due to nerve damage and lack of muscle control. He doesn’t seem to notice and has learned the rule that exercise comes before a treat. He never complains when we stretch his stiff wrist and hand; a bad sign that there is no sensation present. So he will probably go through life with one eye, one working hand, and one normal foot. But he is alive!

Amputees continue to flood into the hospital for closure of their open wounds, care for infections, and skin grafts for amputations that were done under terrible conditions. Several patients who are healed have already received prosthetic limbs, a miracle in Haiti. I hope that the international support that is making this possible throughout Haiti will continue throughout their lifetime. As the news moves on, Haiti may be easy to forget.

Beth and I will see the patients in the hospital tomorrow who need Physical Therapy, then the Haitian staff will return on Monday. There are so many rehab patients here now that plans are underway to provide some consistent weekend coverage. There are several PT’s and OT’s lined up to come and help with the extra load over the next few weeks, but more are needed. Those with experience in the developing world and skills with trauma victims and amputees are the most needed. A knowledge of French will also go a long way toward preparing you to speak basic Kreyol, and all the educated professionals in the hospital speak French. Medical rounds are now held in French as the majority of the Medical Staff is Haitian, with translation into English for us dumb one language speaking Americans!

I’ll see you in a week. Will try to post again before then.


Thursday, March 4, 2010

Half Way

Half Way

Wednesday evening, March 3, 2010
I felt a little more energetic today after crashing very early last night with an overwhelming case of fatigue. Getting pretty tired now, but happy to get at least brief access to the net.

Tomorrow is an exam for the students, so I will see if I have imparted any information. Unfortunately the exam if mostly straight forward memorization, so the true test of what they have learned will not come until later in the clinic.

We had questions and answers today to review for the test and during part of that time, I had the students formulate and pose questions to each other. Afterward I asked them if they had ever done that kind of thing before. They had not. They are accustomed to passively waiting for the instructor.

Just tried to get back to net to send this and access is gone. Will try again tomorrow. They are hard to get, but I enjoy your emails. Please keep sending! If you are adding comments to the blog, please send me a copy by email, as I am unable to access the commnets.


Wednesday, March 3, 2010

Teaching Again

Tuesday evening, March 2, 2010
Yesterday I began teaching again in the Rehabilitation Technician Training Program. There are 6 Haitian students, including one who is an RN who I have worked with here for many years. As during last summer, the purpose of this program run jointly by Hospital Albert Schweitzer, Health Volunteers Overseas, and Friends of HAS is to train basic rehabilitation technicians to work in the community. There couldn’t be a better time for this with Haiti overflowing with injured disabled individuals in need of rehabilitation.

The teaching goes very slowly, as it is all done through a translator who tries very hard, but struggles with his English. The small room at the hospital is open on 2 sides with full screens, but still hot and dusty. It is noisy and uncomfortable, but it is progress in terms of availability of rehabilitation!

My understanding is that in Haiti, most education, at least before college, is primarily by rote. Students are given material to memorize and there is always a correct answer. In the Technician program, many of the students are being asked for the first time to put together ideas, work with their hands to learn, and to come to conclusions. Learning to do this is incredibly difficult and this afternoon was especially slow. Beth helped me with the lab today and we slowly, slowly coached the students through a simple list of questions to assess 3 ‘fake’ wounds that we had drawn on my legs.

The kids remain the best and the saddest part of working here. They run through the hospital , often naked except for their bandages, yelling “BLAN, BLAN” when they see us and begging for a balloon. They are also the saddest as many of them have injuries that will never completely resolve. Fortunately, right now, they don’t know that and they live in the moment.

Web access has become almost impossible so I do not know when this will be posted. I have to admit that I am getting very tired as I have worked nonstop in the hospital and/or teaching since arriving here last Tuesday. Beth and I have decided to ask for one day off from seeing patients this weekend.

Hope I can send this to you before I return home! Judy

Sunday, February 28, 2010

Come Thou Fount of Many Blessings

Come Thou Fount of Many Blessings

Sunday evening, Feb. 28, 2010
As Beth and I treated patients in the hospital this morning, we listened to the sounds of a large group of people wandering from one area to another singing hymns and then praying for the patients in the room. Patients and visitors joined in and added to the joyful noise. The one hymn that I recognized was Come Thou Fount of Many Blessings, one of my favorites. If ever there was a time and place that needed a fount of blessings, it is now in Haiti.

BethEllsworth, my PT colleague at Parkland, arrived safely last night after a gut wrenching ride over the mountain road in the dark and pouring rain. The drivers here think nothing of passing on a blind mountain curve, honking their horn and flashing their lights as they go. Two goats may have been sacrificed along the way; the driver did not stop to check. Travel here is not for the faint hearted! We celebrated the end of the journey with some good Haitian rum.

Tomorrow I begin teaching in the Rehabilitation Technician Training Program, as I did last summer. I will, once again, teach the unit on Skin, Wounds, and Burns. Thank goodness for Parkland! It is a very appropriate unit to be teaching now, as the hospital is loaded with trauma victims with terrible wounds, many requiring repeat surgeries, skin grafts, and muscle flaps. And, as they have often noted in the news, MOST of the amputees will need at least 2 surgeries, as the first was so often done under terrible conditions leaving an open wound that must be treated before a prosthesis becomes an option.

As Beth and I went through the wards today and worked with the patients, I told her that she could have my favorite today--a small boy with multiple fractures, wounds, and nerve injuries who has a smile that lights up the room. Exercise is often painful, but he never complains beyond twisting his face into a terrible grimace of pain. I know that many of you warned me not to bring home any children, but he is a temptation! He has only his sister here caring for him, so I am not sure what home situation he has to go back to.

Hope you are all doing well. All the donations that you made for the hospital will be well used.

A deman, Judy

Saturday, February 27, 2010



Saturday afternoon, Feb. 27, 2010
I do think that some cosmic force in the universe is trying to tell me to let go of my American obsession with time. First the bag with the alarm clock was lost. Then the bag was returned with the alarm clock (and 2 bars of soap, go figure) missing. This morning I set my watch alarm for 6:30. I awoke at 6:15, looked at my watch and rolled back over for a 15 minute snooze. When I next awoke, my watch read 12:00 AM! My theory is that the alarm went off and I did not hear it. This must have short circuited the watch. So, I am trying to ease up on worrying about time, especially units (that last a private joke for the Parkland folks).

I started late today around 8:30 but stayed until 2:00 seeing 14 patients. I was definitely flying without a net! The Haitian PT staff does not work today and I had no translator. The patients were amazingly patient and cooperative with my very limited Texas version of Haitian Kreyol.

After my halting greeting in Kreyol, one sweet young woman this morning asked me if I spoke English. She then told me that she was learning it in school and wanted to practice. We completed the entire treatment in English and she taught me how to say ‘wait on me’ in Kreyol and to understand when the patients are saying that back to me!

To the delight of his family, I sat up a head injury patient today who is beginning to wake up and come around much to everyone’s amazement. He is still confused and quite a handful, but does not seem to have any paralysis and may end up doing quite well. This is especially amazing given that there are no CT or MRI scanners here and no access to Neurosurgery. Head injury patients are only given supportive care and if there is continued bleeding inside their head, they expire in a few days. This patient will, hopefully, be one of the exceptions who lives to be rehabilitated.

It was cool this morning for Haiti (tepid for Dallas), then muggy this afternoon and now pouring rain. After work I took a long muddy walk down the ‘corridor’ looking for drinks and snacks. I was a one person parade especially to the children who called out BLAN as I walked by. One of the experiences that Haiti brings is the knowledge that you are always on display. You can never “blend in.” Coupled with that is the constant sensory stimulation--sights, sounds, heat, humidity, odors, vehicles speeding by honking their horn, people constantly flowing past. It is impossible to fully describe or capture other than to BE here.

Just got word that Beth Ellsworth has been picked up at the airport and is on her way. Can’t wait for her to get here and have Rum waiting (found that on the walk today)!

Will get this sent off to be posted; access goes down in 15 minutes.

A deman, Judy

Friday, February 26, 2010

Despair and Joy

Haiti Blog 2010

Despair and Joy

Thursday Evening, Feb. 25, 2010
The day on the wards began with the wailing despair of a Mother who had just lost her small child to malnutrition. Death here is noisy and public. Families in a hospital at home are given privacy; here everyone sees and hears the agony of the loss. The small body was moved to the hallway on a low cot and covered with a blue plastic tarp. Later in the day a family member (the father?) gathered up the child and carried him away, still wrapped in the blue cover.

At the end of the day I sat in the PT Dept making notes and listened to the loud joyful sound of a small child singing his heart out in the nearby public shower. Cold water, no privacy, no problem. He was having a great time; the true Zen path of fully engaging in and enjoying the moment.

Around 5:00 we had a wonderful tropical downpour that cooled everything off nicely. Today was HOT, humid and dusty so the rain was much needed. I snuck in a little nap while it was going on, also enjoying a Zen moment.

I don’t know if it rained in Port au Prince, but if it did, I imagine that all the people crammed into tent cities and broken homes are suffering greatly. I cannot claim too much credit for helping with the ‘dire conditions in Haiti’, as overall it is quite comfortable here. The water is off now until 6:00 AM tomorrow, but we have electricity and a fan in the bedroom. The showers are cold, but it feels really good to get clean. I found some decent packaged cookies in the market place today and there are plenty of soft drinks. No beer, but there is some rum. On the whole, nothing to complain about.

Supplies are pouring into Haiti, but there is never enough. All of the walkers in the PT Dept are broken, and we have one elderly patient who I don’t think is going to be able to manage crutches. I watched a patient leave the dept yesterday with one crutch on the right side and her left arm draped over a family member, hobbling along non-weight bearing on one leg. When I asked the Rehab Techs why the patient did not have a second crutch, they told me she had a wrist fracture. So she needed a platform crutch, which we do not have. Before I left Parkland, I looked longingly at a well worn rolling patient cart in the hallway that was headed for the trash heap. That old cart would be a shining star here in Haiti! If only we could get it here along with thousands of other lightly used pieces of bulky equipment that are so desperately needed here. Single use items in the US are reused many times here and passed from patient to patient. In our eagerness to prevent the spread of infection, I am afraid that we waste a HUGE amount of perfectly good supplies in the US. There has to be a middle ground of patient safety vs. reasonable reuse.

Small moments continue to be the most rewarding. Late this afternoon I did some stretching on a little girl with burns on her chest and the front of her right leg. She laughed and called me ‘blan’ (blanc in French, whilch translates to foreigner in Haiti). When I tried to put her on her stomach to stretch her hip, it was too much and she sobbed and cried. So I pulled out a pink balloon and blew it up for her. Tears changed to smiles and she batted this simplest of toys around and played with her Mother.

Running out of steam so will close. I will probably not get this posted until tomorrow evening.

A demen, Judy

Wednesday, February 24, 2010


Feb 24, 2010
Arrived safely yesterday after bumpy flight. Ride to campus was mostly in the dark--very surreal with candles and small fires along the way and one larger fire on the mountaintop. Crashed into bed after late dinner, as we did not get on campus until 8:30. Medical rounds at 7:00 AM as usual. Saw patients all dayTuesday and today along with the Techs. Many earthquake victims with amputations, wounds, fractures, burns, usually more than one diagnosis.
Net access terrible so writing this in bullets and will hope it goes through!

The hospital is flooded with patients, estimated about 120 now for a facility made for 80 beds. Immediately after the quake, there were 800 people here waiting to be treated.

It is HOT, but not as bad as summer. Bad news--NO beer in the entire country. UN bought it all. Going to go out and look for some rum.

Fascinating lunch yesterday with multi national planning group for rehabilitation in Haiti. There is a prosthetist here at HAS and people are actually getting legs! It took an earthquake with thousands of deaths to awaken the world to Haiti. Surely there should have been another way to do it . . . . .

The experience of working with the patients is exhilerating and exhausting as usual. This AM on rounds the MD'S were examining the leg wound on a young woman while I watched from beside her at the bed. As she groaned and tried not to cry out, she reached for my hand and squeezed it. Then when the pain became worse, she let go and grabbed my arm. No words to express that kind of connection.
Judy sends an email saying she is OK and communicating even by email is difficult. She hopes to post on the blog soon.
John Daniel

Saturday, February 20, 2010

Getting the computer set to return to HAS. This is the PT Dept. that will be waiting!

Saturday, February 6, 2010

Trying to get a flight

Still trying to get a flight to get back to HAS to help out with the many patients recovering there and to teach in the Rehabilitation Technician Training program. One commercial flight was cancelled. Two charters for medical professionals did not fit the schedule. Trying again for a commercial flight, but no one knows if they will actually take off. The airport in Port au Prince is badly damaged.
In the meantime, gathering supplies especially ace wraps for amputees.
Stay tuned.