Sunday, November 11, 2012

With overflowing gratitude

I returned home from Haiti 4 days ago. These past 4 days have flown by quickly as I readjust to everyday life. My gratitude is renewed for EVERYTHING we have been given, starting with clean water out of the tap every morning. The shock of commercial Christmas ads all over the television, radio and in the stores is wearing off. Thank you all for your support. I hope that some of you who have not may one day make the journey to Haiti.

Saturday, November 3, 2012

What is the same?

Because this blog posts the most recent submission first, please do not read this item without also reading the previous post—What is new? They are intended to be read together. Faded discolored Mickey Mouse sheets that once provided happy comfort for a child most likely in the USA now cover the bed of a severely ill Haitian woman. Our cast offs flow into this country, often given away by various foreign organizations and groups. While this seems generous at first glance, it deprives local Haitians of the opportunity to make and sell these goods. Our cheap used American clothing has almost eliminated the job of tailoring here. Reduce/Reuse/Recycle. The first is the most important. We may recycle here for the Haitians to reuse our goods of all kinds, but the very BEST solution is to REDUCE our usage and let these people make and sell what they need locally. There is still trash scattered almost everywhere and even bright young Haitians drop their wrappers and bottles on the ground. Clean water remains a challenge and the threat of cholera still hovers. Cholera was not a problem here until foreigners came in large numbers to ‘help.’ The climate still makes my soul weary by the end of the day. Productivity and afternoon heat are almost mutually exclusive, something that go go go Americans struggle to grasp; some never do especially those who bluster through a short term stay. Many people offer to help, but not for long. Sustained commitment is needed the most.

What is new?

The next 2 posts will be a collection of images and thoughts—What is new? What is the same? I will start with what is new? On the wards, there are 2 large new metal sinks with foot pedals to control the water! There has also been liquid soap in the dispenser on most days. This is a huge step forward for hand hygiene. There are no paper towels, or towels period on the wards for staff. So previously after turning on the faucet with your dirty hands, you had to touch it again with your clean hands to turn it off. Now the water turns on and off with a foot pedal! I carry a washcloth in my pocket to dry; the Haitians swing their hands to air dry. The Internal Medicine doctors now stand outside the closed door to the TB isolation area to discuss those patients on rounds, rather than in the rooms. There is no mechanism for airborne isolation in an open air hospital and the only difference in the TB rooms is a fan that weakly pulls air out into the courtyard. Usually it is turned off. Standing outside is a small precaution that may make a difference for people with frequent exposure to TB patients. The Haitian Physical Therapist here pulled up images from a scan done elsewhere on a patient on her iPhone to show to the MD treating the patient. With no information from the original hospital that treated him, this was a wealth of information. When I gave one of the Rehabilitation Technicians working with me on the ward several suggestions about what to do with a patient, he chose family training first! Exactly as I would hope that any American student or young clinician would do in the same situation. The Haitian Physical Therapist and Technicians are freely giving away the squeeze balls and small squeezable airplanes that I brought here to use for hand exercises. In the past, these items tended to be hoarded in a place where so many have so little. Multiple out-patients are being seen in the PT department at one time. They have 4 treatment tables in an area set up for them that also now includes parallel bars. We started with one portable treatment table on the back porch of the wards. One of the Rehabilitation Technicians asked a question of the visiting blan MD in morning conference, displaying a tremendous increase in confidence. There is a small hotel now in Deschapelles! We had a grand tour this morning and it is quite comfortable. It is providing much needed jobs and may decrease the burden on campus of visitors who only want to visit briefly and are not providing services to the hospital. The Rehabilitation staff and administration displayed excellent flexibility in rescheduling the planned time for the seminar that I presented when the situation called for a change. The old deserted Club Med on the beach has been remodeled and reopened as Club Indigo that I enjoyed last weekend. It provides rest and recreation for the mind and body of those working here and much needed JOBS. I could almost become a Republican here when it comes to pushing the importance of economic growth—but not quite. Remember to VOTE on Tuesday. I voted early before leaving with thanks to my friends from DAI who provided the info on how to do so. Hanger Prosthetics which opened shop at Hospital Albert Schweitzer after the earthquake providing limbs for amputees post quake is now also making orthotic (brace) devices of all kinds and sending their staff to teach the Haitians how to do so. By setting up shop, I do not mean that Hanger is making money here. They have made a HUGE humanitarian gift of materials and personnel to HAS Haiti. The hospital has a new CEO whose energy seems boundless, matched only by the Swiss Medical Director, Dr. Sylvia Ernst. She has an extremely kind, but firm realistic grasp of the situation here.

Thursday, November 1, 2012

Continuing Education in Haiti

Today I began the first half of the continuing education program on stroke originally planned for last Saturday. (Flexibility of mind and spirit is an absolute necessity in Haiti.) There were 12 Rehabilitation Technicians in attendance from the 3 classes that I have helped to teach in 2009, 10 and 11, as well as the Haitian Physical Therapist in charge of the department. They were a GREAT group--just what any instructor would want. They listened, asked questions, and participated in the activities that I had planned. This was all done through a translator making their patience even more admirable. We all had a good laugh with the 2 Techs who agreed to take part in the demonstration of dysarthria (weakness of the muscles producing speech). Both techs stuffed 6 pieces of hard candy in their mouths, then they tried to rapidly repeat a sentence in Kreyol. The effect was quite amusing in these healthy young people, but served the purpose of demonstrating the difficulty that may be experienced by their patients. No patients were scheduled during the 4 hours of the program, but just by chance one out patient came in after missing his appointment last week. He was suffering from a stroke and his treatment served as an excellent demonstration of many of the things I had been talking about. As we debriefed afterward, the students had been quite attentive to the problems that he presented. Tomorrow brings the second half of the session and I am in need of some down time to restore my sagging energy level. These bright young people answering questions make the work well worth it. More about the campus and hospital this weekend.