Sunday best

Many types of patients are seen at Clinic. Some are here just for medication refills every two months to help keep their diabetes and hypertension in control. Others wait for months to finally see the dentist to have teeth pulled. Our surgeon has a full schedule by the first day of clinic and spends the remainder of his time operating. And then the providers see those patients whose conditions are not well-controlled, well children, and any medical issues patients might have.

In an era where people do their grocery shopping in pajamas, it is amazing to see the Haitians at clinic in what must their Sunday best. Women in knee length skirts and blouses, and little girls in frilly dresses with lacy socks. The patients wait for hours to be seen, dressed in their best clothes. and yet never fail to remember to say please and 'mesi'. Each child is gently reminded to say thank-you after they receive a toy. Every single patient always says good morning and good-bye even if they only sit with you a few minutes and all we can provide them with is vitamins and some Tylenol.

- Leena and April

Families provide love and care

Hospital admission is not really an option for our patients. One weak, a dehydrated woman was carried by her family to the clinic with a blood sugar too high to even register on our meter. She was treated with IV fluids and a small amount of diabetic medications in the clinic, and despite remaining ill and needing assistance to walk, she returned to clinic the following day for further fluids and treatment. After 4 liters of IV fluids and a few doses of diabetic medications, her blood sugar was significantly improved and she thanked us as she walked away, unassisted this time, with her home medications to control her disease. 
 
Despite the poverty in Haiti, it is amazing to see how well patients here are cared for by their family. A 2 year old child was brought to be seen who has hydrocephalus. It is a condition easily treated in the US via surgery, and yet here, that is not an option. He was brought in by his family to be evaluated by the pediatrician on a clean pillow so that he would be comfortable. Despite his large head, his hair was done in multiple braids, and his face and clothes were clean. It was evident he was well loved. 
 
After a relaxing Sunday at the beach, we are ready to start our second week at clinic. The crowds were already gathering as we drove home this evening outside the gates. 

- Leena & April

The disparity in care

Day 3 and 4 have proven to be easier than the first day. The routine of seeing patients and working through our interpreters is now more familiar. In talking to them, it is becoming easier to understand Creole and maybe even speak a few words. 
 
For two days now, a 5 year young lady has come to see us with a sickle cell pain crisis.  She lies there with tears in her eyes as you examine her and screams when you touch her ankles because she is in so much pain. Children in the US with sickle cell get treated with oxygen, IV fluids, and narcotics on demand - here we provide her with some antibiotics and Ibuprofen and a small amount of morphine to help ease the pain. Her mother has carried her to clinic for two days now and waits patiently while we treat her and will bring her back again tomorrow. Despite her tears, the young girl waves good bye as she leaves.
 
There have also been several patients with recent strokes. One man had a stroke two days before coming to clinic and could only get here with his brother supporting most of his weight as he was now paralyzed on his right side and could no longer speak. Another woman had a stroke two months ago -- while she had regained some use of her left side, she was still dependent upon a family member to help her walk. Both had severe hypertension and will be treated for that, but there is little else we can do to help their symptoms or prevent another stroke. In the US many stroke patients can get medicine to lessen the impact of a stroke while it is happening, as well as many tests and medications to significantly lessen the chance of another debilitating stroke. 
 
There is a huge disparity between the care in the US and what we can offer the Haitians here during our two week stay. And yet, the gratitude the Haitians show is humbling to our medical team for the little that we can do.
 
- Leena and April

First day of clinic

Our team leader arrived early at the gates of the clinic where throngs of Haitians were waiting to be seen by a provider. Many had been waiting for days in advance for our staff to arrive, cheering as we passed by them on the way into the clinic. 
 
The benches were quickly lined three deep to see the surgeon on his one day of clinic this trip. Of the dozens of patients seen, nearly 40 surgeries were scheduled for the remaining days of his visit. Small tumors that would have been caught early and easily removed in the US grow for years into large masses that can deform the body and require hours of surgery to correct. 
 
We were able to see a young girl who is being followed for congenital syphillis.  Despite the fact she has been treated and seen at three consecutive clinics now, there is little we can do to ease her discomfort from this easily curable condition. A simple blood test on her mother during pregnancy and a few days of penicillin would have prevented her painful illness. 
 
The first day of clinic was eyeopening, but not unlike what we had expected. It was frustrating to see all of the medical conditions that we could not treat, and yet obvious the difference we had made on so many other patients. We were all surprised by how exhausted we were at the end of the day, but excited to get up and do it again tomorrow. 
 
- Leena & April

November team arrives

The first glimpse of Haiti came from the plane, with the coastline coming into view. Landing in Port-au-Prince was an entirely new exercise in chaos - somewhat like a busy day in the hospital and yet completely different. 
 
Sitting in the back of a truck going from one airport to another, our passing glimpse of the city was through the small windows, as we bumped along the road. And from the tiny plane as we flew across the island in under 20 minutes, we saw hundreds of shacks, nestled into the mountains along nearly unpassable roads, miles from each other. The contrast to the towering hotels 90 minutes away on Miami Beach was humbling.
 
Unpacking our supply bags brought to light both the extent of the generosity of the people who donated as well as the basic things that Haitians so require and we take for granted. A thousand toothbrushes, hundreds of bars of soap, dozens of bottles of children's vitamins were unpacked - and with it came the realization that all these supplies will likely run out before we had seen all the patients that needed care.
 
Tomorrow will bring the first day of clinic and with it, cheerful Haitians who line up outside the clinic's gate to be seen. 
 
Leena Kendhari, MD & April Miller, MD

- first-time volunteers

Paradise Lost (and Found)

Kenson Pierre, a 22 year old man from Laford, did not curse, cry, or yell as Dr. Nelson treated his infected hand. The only evidence of the terrible pain he experienced was a quiet high-pitched hum. A construction worker, M. Pierre reports having a block fall on his hand. Being unaware of FOTOCH and without enough money for Saint Michel Hospital, M. Pierre did not seek medical attention for three days. He came immediately upon hearing from a friend about our clinic.

Haitian law states that the owner of the property is financially responsible for employee injuries incurred on-site. For example FOTCOH purchased insurance for the Haitian workers who built the clinic. Unfortunately, it is very common for property owners to deny workers their rights, however. Fortunately for those with no other place to turn, FOTCOH is here and, as Dr. Nelson stated “We are very happy to take care of him”.

As I mentioned in previous entries, this was my first trip in Haiti. Therefore, all that I had known of Haiti came from books, articles, and our team leader Bob Hoy. Haiti as a paradox was a common theme in all I read and heard. The truth of their words was revealed to me each day.

Haiti is gorgeous and grotesque, neglected and exploited, chaotic and tranquil, foreign and familiar. The kind people, rich culture, and remaining natural beauty are evidence of her potential. The pillaged resources, unsurpassed poverty, and long history of political instability inspire hopelessness. While the children here are starving for food and attention, it is the friends who care for them that are truly fulfilled. Rue FOTCOH, a rocky path with a hibiscus canopy, is both a corridor to healthcare and microcosm of this country.

- Brendan Sullivan

There are no small roles, just small clients

Our clients come from far and wide and in all shapes and sizes. Likewise, the tasks needed to treat them are multivariate. A client’s primary concern maybe an acute condition but by the time they leave the clinic they may have been screened for diseases, educated on prevention, have a tooth pulled, given donations like clothes and baby formula, and have their prescriptions filled. For example, Jacky Louigene educates children on proper oral hygiene and the importance of fluoride.

It is easy to see why Yssale Louis, a 29 year old male from Peredo, is grateful for the care he received from Dr. Nelson. M. Louis reports hitting his head on a rock while on a mountain with his goat. Dr. Nelson treated the wound and stitched him up believing that a skull fracture had not occurred.

- BS

"Shelter from the Storm"

“Come in,” she said “I’ll give you shelter from the storm.”

An afternoon thunderstorm did not stop work Monday. Despite poor weather and having only one provider, it was business as usual. Our experienced nursing staff was able to handle an increase in responsibility. Our clients moved into the small pharmacy waiting room to avoid the rain. In short, flexibility and hard work got the job done.

Of course, business as usual is anything but uneventful. Dr. Nelson saw a child with infected scabies. Given the severity of the condition, he recommended the child be treated at Saint Michel Hospital in Jacmel.

- BS

Haitian staff lauded

All who have had the opportunity to work with Jacmeliens can attest to their talent, compassion, and charm. Their dedication to the FOTCOH mission is not questioned and their importance to this organization cannot be overstated. Tasks big and small are completed thoroughly and enthusiastically by Haitians who have been a part of the FOTCOH family for years.

While seasoned FOTCOHers report that Wednesday was a typical day at the clinic, for first-timers like myself and Jan Sickbert (from rural Argenta, Illinois) each day is a full of new experiences. Jan reports being humbled by the patience of our patients. Many wait all day and night to be seen. It was a great shock to me to see people camping over night outside the stone wall which surrounds FOTCOH HQ. 

Thankfully Pharmacist Bob Hoy shows nightly movies for neighborhood children and those waiting for tomorrow’s clinic. “Cinema Bob” aired “Charlotte’s Web” tonight.

- BS

Wi, nou kapab! (yes, we can)

A twenty-four year old mother from Peredo (near Marigot) brought her three
month old ill son to be seen early Tuesday morning. Dr. Garron Lukas diagnosed the child with Scalded Skin Syndrome, which he believes developed from a staph infection. The mother reports that it started with a small blister on the child’s chest and spread quickly over the past five days. Due to the severity of the infection, the mother and child were driven to Saint Michael Hospital in Jacmel by M. Boyer. Once at the hospital it likely that child will be given IV fluids and antibacterial medicine. As for a prognosis, Dr. Lukas explains “It all depends on how the child responds to the treatment." Fortunately, Dr.  Frantzo Nelson, a Haitian Physician, works here and Saint Michael pediatric ward. We hope he will provide us with good news in the coming days.
 
Shellie Coleman reports, an sick infant seen in May has returned much improved! A fifteen month old boy named Wilder gain 8 pounds. When seen in May, the infant was vomiting and had diarrhea. The infant was given a poor prognosis as he was lethargic and had no appetite. Now Wilder is active, eating, and playing. What a pleasant surprise!
           
Jean Flander Cheri is a nine year old boy from Jacmel who arrived with an abscess on his cheek. Jean’s bravery impressed all whom witnessed his operation. He's a "fo' gason" (strong boy).
 
Having had a busy day, some FOTCOHers enjoyed a relaxing swim at a nearby beach.
 
Bob Hoy’s Cinema is a neighborhood attraction.
 
“I am really excited about the exceptional numbers," says FOTCOH CEO Dick Hammond. "Bob Hoy is happy too. But it is going to be more difficult everyday
to keep up."

- Brendan Sullivan

http://www.youtube.com/watch?v=dk8rYSdJCYg

September team reporting for duty!

We have arrived and the clinic is running. My name is Brendan and this is my
first trip to Haiti. My job is to assist the medical staff and blog. Keep checking back for information and pictures.

 Having no prior experience gives me the confidence to state that this is the best FOTCOH team of which I have been apart. Each member is personable and professional. I feel very fortunate for the opportunity to serve with people for whom the years of experience have not diminished their enthusiasm.
 
I heard that our team is smaller than we had hope. This fact has not diminished our spirit. While I wish there were more staff to provide the sorely needed help, I am looking forward to forming friendships with a close-knit group.
 
I have had my eyes wide-open since we departed from Miami early Monday morning. I was fortunate enough to get a window seat for both the flight from Miami to Port-au-Prince and from Port-au-Prince to Jacmel. I was mesmerized by the spectacular aerial view of rural Haiti. I was dumbfounded by the Jacmel airport that was little more than a concrete runway. To be fair, it is under construction.
 
FOTCOH HQ is fully function thanks in part to the help of local Haitians. It is a pleasure to work along side people invested in the betterment of their community. In addition to assisting the medical staff, they have taken on the responsibility of teaching me Haitian Creole (or kreyòl ayisyen).
 
Pharmacist Bob Hoy remarked, “For the first day [Tuesday 9/7/09] ran very smoothly”. Other experienced FOTCOHers report being pleased with the quantity and quality of care being provided by a small number of volunteers. Even the weather is more pleasant than anticipated.

- Brendan Sullivan

See related video: http://www.youtube.com/watch?v=fjlZXxRk3LU

Until September

It has been almost a week since the July team has returned from Haiti. As we are getting back into our daily routines in the US, each one of us is heavily reflecting on our time in Haiti and the patients that we cared for.  Our team saw 2463 patients in the two weeks we were there; our youngest patient was a newborn and our oldest was an 89 year old gentleman!      
 
Whether you go only once to Haiti, or if you are lucky enough to go more than once, Haiti will always be a part of you. It is a country with many problems and needs, but it is also a beautiful country with compassionate people who welcome you with open arms.  Our Haitian patients are a reminder why we got into health care and why we volunteer to help others.  As Nixon stated in an earlier entry, we are “all ONE people.”  Until our volunteer colleagues return in September, our thoughts and prayers will be with Haiti and our patients for continued health and peace.
 
Sue Behrens, Team Leader July 09     

Heartfelt thanks -- and surprise gifts!

As the last patient left today, there was a unanimous feeling of sadness in everyone's heart. We all knew that the time had come to go our separate ways and start saying our goodbyes. All this time, the relationships between our translators and us had grown strong; maybe even stronger than we had expected.

Nixon, one of the translators, gathered the majority of the FOTCOH volunteers underneath the balcony for a few words, and to our surprise, a gift. He shared heartfelt words of how much he and the other translators appreciated the love and compassion we showed them and the patients. "God did not create Haitian and American people; He created human beings, and we are all ONE people!" Nixon went on to pray for our health; our families back home and for us to continue to come back to the FOTCOH clinic.

After the prayer, they unveiled our gifts that lay on the table in front of us; all different, unique paintings for each and every FOTCOH volunteer ! We will treasure the memories, the gifts, the laughs, the tears and the smiles from everyone in Haiti in our hearts forever !

Sue Waltrip, RN

Only 8 days old

Claireus arrived at the clinic 2 days ago weighing 4 pounds; he was only 8 days old.  His mother had died shortly after child birth of Toxemia.  According to his Aunt, his mother was 9 months pregnant when she delivered Claireus; she said he was “small” at birth.  The family was only feeding him “sweet tea” since his birth.  Claireus was very ill; he had a temperature of 102.3, poor reflexes, no cry and was severely dehydrated. 

We started an IV on him and gave him fluids as well as an IV antibiotic.  It took some work, but we were finally able to get him to take formula.  We sent him home with medications, formula, and instructions to the family to bring him back each day for the rest of the clinic. 

When he arrived the second day he no longer had a temperature, was more alert and had an audible cry.  He was still dehydrated, but better.  We started an IV again for additional fluids and antibiotics.     

Today was our last day of clinic and our third day for seeing Claireus. He has improved each day. Today, his eyes were open and he was looking around. We encouraged his aunt, who was breast feeding her own child, to breast feed Claireus and give him the formula we supplied her with.  The Aunt says that she understands that Clarius will not survive unless she “raises him as her own”; she already has 4 children.  He still has a long way to go, but we really do believe that Claireus would have died, had he not received care here at the FOTCOH clinic over these past three days.

just a band-aid...

I first met Venicile and her two children in January of this year. Venicile and her one-year-old daughter tested positive for HIV then; her 3-year-old daughter tested negative. We referred her and her one-year-old daughter to the HIV clinic in Jacmel.

Today Venicile came to the clinic with her 3-year-old daughter. She told me her other daughter was in the hospital in Jacmel with fever and she did not think she was going to live. They both are being treated at the HIV clinic in Jacmel, and receive antiviral medication daily. They go to the clinic once a month for check ups and to receive their medications; they have not missed any appointments since they started their therapy earlier this year. Venicile said she feels better since being started on antiviral medication, however, her one-year-old daughter has not gotten better. She becomes very quiet when she speaks about her daughter who is ill in the hospital. Venicile said that the father of her children also has tested positive for HIV and that she was no longer with him. She told me she was kicked out of the house she was living in by the others living there because she and her one daughter have HIV. She now lives in the streets of Jacmel begging for food. She told me she has trouble sleeping at night.

Her 3-year-old daughter Chilove is severely malnourished. She crawls, sits up by herself, holds on to things, but cannot walk. Her belly is very large and I am treating her for worms. When I handed her a peanut butter cracker, she grabbed it out of my hand. She continued to eat everything I handed her. I made a package of food and clothing for Venicile and Chilove and gave them some money for additional food. This small gesture was just a band-aid for their social situation. As I watched them leave I was emotionally drained and overwhelmed with the health care and social needs of this country and the people here that I have come to dearly love.