Thursday, June 30, 2011

For those of you asking me about signs of progress

Many of you have asked me if there has been any progress in Haiti since the earthquake. I can say with certainty that there has been progress in Physical Therapy at Hospital Albert Schweitzer. When I came here in 2000, the space allotted to PT was a small corner spot in the Nursing Director’s office. Over the next few years, PT gained a closet to hold supplies and a moveable table that was placed out on the porch to see out-patients. Then, in the summer of 2009 there was finally an actual room for Physical Therapy. Now 2 years later, there is an even larger space that has been divided off from the courtyard and includes a storage area for supplies.

In 2000, I was asked to bring crutches and did so in 11 long boxes. During the next few years, the people at HAS made due with a number of different experiments in crutch provision including some bulky wooden ones made on site, forearm crutches rather than axillary (very hard for fracture patients to use), and many times crutches were in very short supply. When I was here 6 weeks after the earthquake, we had to put together mismatched pairs to send the patients home. Now the storage room holds many pairs of new crutches, both wooden and aluminum still in the packaging.

The storeroom also holds many other supplies that in the past were donated periodically, then would run out. There are extra wheelchairs--one of the hardest items to find for a patient 10 years ago.

So all the international attention has done some good. There is physical evidence of progress in place.

The most important progress, though, is in the staff. In 2000, there was one part time volunteer Swiss Physical Therapist here, along with her husband who was on the staff as a pediatrician. Before she left, she trained Mary Jane Carraway, an American RN and also a volunteer, to do basic physical therapy treatments. For many years, Mary Jane did an excellent job of providing access to basic physical therapy care, along with the help of visiting volunteer PT’s. Before Mary Jane left, she trained 2 Haitian RN’s to take over the Physical Therapy service and they did so until 2009. In January, 2009, the Rehabilitation Technician Training Program that had formerly been in Port-au-Prince moved to Hospital Albert Schweitzer. Then in the fall of 2009, a Haitian Physical Therapist was hired to run the Physical Therapy service. Finally! Physical Therapy had officially arrived at HAS. In January, 2010, 3 of the Rehabilitation Technician graduates also joined the staff, just in time for the earthquake. Today the Haitian Physical Therapist Director of the Dept. continues to work with a staff of 3 techs and many visiting PT’s teaching in the Rehab Tech training program.

The resources that many of you have given have been put to good use. There can be progress in Haiti.

Tuesday, June 28, 2011

The rain

Yesterday afternoon we had an incredible thunderstorm. Huge streaks of lightening, crashing thunder, wind blowing and the temperature dropping within minutes. A tropical thunderstorm is a powerful reminder that Mother Nature is in charge and we are at her mercy. After 3 nights of wonderful storms, there has been none yet today. The difference is very uncomfortably noticeable. It is hot, steamy, a difficult night to sleep after 3 very comfortable ones. The mosquitos are out in force tonight; no rain storm to wash them away. The tropics, Haiti.

I washed the lettuce in chlorox

If a waitress in Dallas told you this as she served your salad, I am guessing that most of you would get up and leave. Those are the words, though, that our cook said to us (more of less in translation from Kreyol) as she served us a small salad for lunch yesterday. With the outbreak of cholera in this immediate area, all fresh foods are suspect. The tomatoes have had a chlorox wash, too. Maybe my teeth will be whiter by the time I leave . . . . . . . .

The Classroom

The classroom for the RTTP students has changed again this year and is now in the building shared by administration and the malnutrition ward. Unfortunately, it shares a common wall with the malnutrition ward, so the sound of babies crying is a frequent accompaniment to the general noise of people talking and chairs and beds being scraped across the floor. The room has windows on one entire side with worn out screens, one ceiling fan slowly turning and little air circulating. By mid-afternoon it is an oven, as are most places in the hospital and the houses, too.

Despite this, the 6 students this year are asking a lot of questions as we study wound and burn care and are doing their best to stay alert in the heat. By 2:30 to 3:00 we all give up. The students go home and I go on to other experiences.

There are so many other experiences that I am not sure which ones to share. So will do some short pieces and you can decide which ones sound interesting enough to read.

Monday, June 27, 2011

Inside the cholera ward

You can't really grasp the scope of the outbreak until you go inside. The old gift shop, a relatively small building with several rooms that are windowless, is crammed full of cots for patients suffering from cholera; 168 as of this morning. The cots are almost too close together to walk between. As with the hospital, family members crowd around to provide all the general care for the patients. Only purely medical tasks--IV's, injections, medications are done by the staff. Keeping the patient clean, changing the diaper is the job of the family. In addition to the building, there are 6 white UNICEF tents, also full of patients. The sickest patients, though, are in the building, including two tiny rooms with babies and toddlers. Patients wait outside to be evaluated and possibly admitted. Some have an IV running while they wait.

The Haitian staff and a few foreign MD's and RN's who have come to help are exhausted. MD's and RN's with experience in the developing world are needed NOW. Contact information may be found on the Hospital Albert Schweitzer website.

The housekeeping crew in gloves and rubber boots work endlessly to keep the floors clean of the worst contamination. Despite best efforts, trash piles up outside--empty bottles, used gloves. The soles of our shoes are sprayed with chlorox as we leave. Incredible.

More later about the first day of teaching, the students and the hospital.

Sunday, June 26, 2011

So much to tell . . .

Back in Haiti for less than 24 hours and already so much to tell. Had the easiest time ever at the airport--short line for immigration, almost efficient. Porter found my bags immediately. Out the door and down the walkway to look for the Hospital Albert Schweitzer driver. That is when the adventure began. Was happy to see a Haitian man holding a Hospital Albert Schweitzer sign who quickly grabbed my luggage cart and we took off through the parking lot, soon joined by another "helper." A short way out, I looked closely enough to see that the man with the sign had an airport badge and was therefore NOT the HAS driver. As we got further and further away from the airport, I finally demanded that they STOP until I could see the real HAS driver; otherwise, I was returning to the enclosed airport exit area. After much negotiating, one helper going ahead to supposedly find the driver and a couple of false starts, a van slowly began to pull toward us. It turned out to be the HAS van. Adventure #1 completed.

We bumped over to the HAS Port-au-Prince office a short distance away, at times almost swimming through pouring water (see previous entry). If we had stalled in one of those lakes of brown water, I'm not sure if I could have forced myself to step out and walk away. Fortuntely, the ancient well worn van seemed to be able to swim and we arrived at the office. We picked up 6 more riders, then headed out Highway 1 on a long, hot journey.

Adventure #2: It began to rain, then pour. Beautiful streaks of lightening across the sky. People running for cover, motorcycles struggling and stopping where there was shelter. "We went on. The discouraging part came as we went through several towns in the rain. Water poured down hillsides into the street carrying along great globs of garbage, including glass bottles of all sorts. How any vehicle could swim through what we did without cutting open a tire, I do not know. But we drove on. We made it to Deschapelles.

As we pulled up by the hospital, the large while UNICEF tents holding cholera patients came into view. The old gift shop has now become the cholera ward since a fresh outbreak with the start of the rainy season. It is overflowing; hence the tents. My house mate who has been here for several months tells me that the Haitian staff are becoming worn down by the influx of these patients--with very limited facilities for their treatment and general ignornace in the population about how to prevent transmission. Lots of handwashing this visit. Filtered water with chlorine. Indoor and outdoor shoes. And hopefully good luck . . . .

Speaking of my housemate--I was delighted to met Kim, an American PT who is here working with the new PT Dept on administrative organization, as well as public health and other issues related to the disabled. She has much interesting knowledge to share and we are already trading insights and thoughts on all things Haiti.

Adventure #3: At 7:30 this morning, Kim led us up the side if a nearby mountain to a wonderful morning view of the Artibonite Valley. Looking down at nature, it is hard not to believe that there cannot be hope for Haiti.

Finally caught a shower at noon; running water only 3 hours per day (6-7 AM, 12-1 PM and 6-7 PM). Now unpacking many supplies, planning for class tomorrow with the Rehabilitation Technician Training Program students and preparing to take a look around campus and the hospital. Bottom line, it feels very good to be here. I am glad to be back in Haiti.

Saturday, June 25, 2011

Back in Haiti!!

Smoothest time ever at the airport. Now at the HAS office in Port picking up others for the hot dusty ride. The van already made it through wheel deep I assume sewer water. Taking Off. Too bumPy for more.

Sunday, June 19, 2011

Mother Nature is trying to help get me ready for Haiti

Yesterday it was 104 degrees in Dallas, hotter than Port-au-Prince. Predicted high for Dallas today is 102 degrees; Port-au-Prince 95 degrees. Seems a little strange that I'll be going to Haiti to cool off!

Sunday, June 5, 2011

Getting ready

Just got back from Target buying bug lotion, cheap pack of washcloths and all manner of supplies. Now at the Apple store getting the ancient iBook ready to go. Leaving on June 26 for 3 weeks.