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