Take... my... picture

We, the FOTCOH mission team, were on the long journey overland, returning home.

Through the dark night in a caravan of three lonely vans, traversing the southern Haitian peninsula, over rough and rocky roads and hairpin curves at speeds not to be discussed, we finally had descended the mountain and reached the city.

The scent and sights on that hot early morning were dire.

Let your imagination replace the description I choose not to portray, but please note a seemingly amazing observation.

Within the context of the incredible hardship, chaos and confusion, many citizens walked at a brisk pace, their heads held high, without visible signs of affliction or despondency.

Their clothes were fresh and neatly pressed, creating a visual anachronism with the decimated background infrastructure.

And, as we proceeded past the market, with its tight wall of humanity bustling around the produce, it too appearing restless, perched on old tarps and strewn on the street’s edge, we heard a voice.

It was clear, focused, somewhat staccato in delivery, but composed with an inflection seemingly not connected to the surrounding scene.

TAKE…MY…PICTURE.

Thus, as it were, we were reminded of the proverb, citing mankind’s overwhelming need, regardless of the circumstances, or epoch in the historical chain of events, to…” live life” …and forge forever forward with pride, with grace and unbending conviction.

- Dr. Charles Vergona

Reflecting, 'desire to do more'

It has been an adjustment returning to the U.S. after our short stay in Haiti. I miss the fresh mangoes, avocados and pineapples, the ocean, fresh lobster and wearing flip flops and tank tops to work. I miss the teamwork of the staff at FOTCOH, meeting the Haitian workers, patients and the co-habitating with an amazing group of strangers who became friends.
 
My first day back at work was quite a change from the previous week. I wanted to scream at the patient with dental pain, who complained at triage about waiting to be seen for an hr. I wanted to explain to them about the Haitians walking 6 hrs to be seen for a blood pressure of 300/200 and then sitting in the sun for 6 hrs after sleeping on a hard bench all night, while just complaining of a "little headache." Would that patient here understand? Probably not. How do you explain it all?

I feel like I gained so much during our short stay there. I am amazed by how calm, patient and grateful the Haitians are for the minimal assistance that we might have provided to them. It is such an overwhelming feeling and desire to want to do more for them. I realize how much more there is to do for others that just happened to be born in a country less fortunate than ours. What did I do to deserve being born in a country that has clean water, an overabundance of food, huge houses and even medical care? Nothing. But hopefully this experience will cause me to continually be aware of those with less and use what I have been given to help out.

- Carrie Stalter, APN

Reflecting, 'positive impression'

Reflecting upon my participation in the July 2010 medical mission, I feel a deep sense of humanitarianism and gratitude.

Our team meshed together so well that we were better able to meet and often exceed our patients' expectations.

For example, frequently we (some American volunteers) would walk past Haitian children and we would get lots of requests from children for "a dollar". Renee and I each introduced ourselves and spoke with a child about what would they do with the dollar if we gave them one. My child said he did not know.

Upon further discussion, we learned that these kids were starving. So for $1 each, Renee and I bought each child a full plate of dinner to fill their bellies. It made me feel like we connected with the children and made a positive impression on them.

Enough said, Gregg (Teitel, PharmD) !

Reflecting, 'no greater joy'

What impact does the medical team have upon the lives of our patients once we leave them in their abject poverty and with the medicines prescribed by us to go along with the counseling which we hoped was interpreted correctly? We will never know for sure because we are not there long enough to follow up the patients and their maladies. Some day, I hope, we will have trained Haitians as medical technicians-like the bare foot doctors of China-to follow these patients up until the next mission visit.

However, a few of the patients that we asked to come back for rechecks show up with a smile on their face, even if they still have pain but the pain is less and the heat from the affected site is gone. I am thinking here of the patient with the severe mastitis who was grateful, upon her return, of the treatment she had received; her husband was all smiles when I asked him how he felt she was doing.

I also reflect back upon the one month old baby who came to me the last day of our mission. When I saw him he reminded me of the prisoners of war or the many who were wasting away in the German concentration camps. This baby had not lived long enough and he was already dying. How sad it seemed to me. The mother, mentally retarded did not know how to breastfeed; the gramma, upset with the extra burden on her life, did not know how to instruct the mother on how to feed the baby adequately. The bay weighted only 4 pounds but amazingly enough, he moved all his extremities, he tracked with his gaze and later on we saw how he was able to latch on to the nipple of the formula bottle offered by Ann Spika, our maternal and infant feeding educator. How helpful she was!

After all the training and education that Ann carried out with the baby’s mother and the gramma, it was heartening to see the mother breast feeding the child in the correct position and the baby latched on and suckling correctly. I would like to think that this baby has a better chance at surviving now than he did before we took care of him and his family.

Lastly, I think back about the father who came with his 2-month-old baby who was vomiting, whatever formula he had purchased, and the mother had left 3 days before because she felt that her milk was making the child sick. We were able to offer a different formula that agreed with the child’s digestive system as well as a few diapers and some clothes for this dedicated father. Words alone cannot express the look of anguish initially, swapped by a look of appreciation, as he left that day.

So I think that we do make a difference in the people that we treat. But we also make a big difference upon our own lives; for there is no greater joy than that which we feel when we provide services to others for the fee of a smile or heartening “mesi”.

- Dr. Jaime Cercone

Taina, mending well

Taina Mentor, 5, was treated by FOTCOH in January for a severe crush injury to her left hand caused by the earthquake - that also killed her parents.

FOTCOH’s surgeon was able to save Taina’s hand from amputation then, but the prognosis was not certain that she would have use of her hand.

Six months later Taina’s hand is still very tender, but mending well with improved mobility, thanks to FOTCOH’s continuing care.

Taina’s “Aunt Judy” is raising Tiana now with her husband who is a police officer in Jacmel.

“Life will never be the same for her,” says Aunt Judy. “Financially, it’s much harder now too.” But Judy also says that Taina loves school, and most of all, “coloring.” 

When asked, Taina says she would like to be a painter or a doctor when she grows-up.

My conscience at the door

There he was, appearing like the mist, by the side of the FOTCOH clinic door.

We succeeded in seeing the last patient comprising that long line of local Haitian citizens seeking the only medical care practically available to them.

With a special rare type of smile, combining grace and dignity, this young teen spoke one word in a soft polite tone…”tennies”?

As staff was scurrying to move to the task of inventory for the next mission date, I too scurried, but to the laboratory technician, keeper of donations and specialist regarding a soft touch with children.

No footwear whatsoever remained. However, true to form, she located other items for this special youngster.

I then finally realized that I could find some gift in my suitcase for our new friend.

Up to the FOTCOH dorm section and down I came.

Then, I searched for him, but life doesn’t wait for us to ponder.

The earlier feeling of accomplishment had now transformed to two shades of melancholy.

When, pray tell, will I learn that the right hand works while the left must stand ready … “to give the gift that makes the children smile”.

- Dr. Charles Vergona

Our Trachoma patient

The little girl was easy to pick out in the crowd. She was in her mother’s arms and her right eye was swollen shut - the size of a golf ball. She has an infection called Trachoma.

Infectious Trachoma is a common infection in poor countries like Haiti and can lead to blindness if not treated. It is commonly transmitted in areas of poor sanitation (lack of clean water) and also by flies.

As with most diseases in developing countries, women and children are at greater risk, and with Trachoma, the disease is most common in pre-school age children.  

Luckily, her cornea was not affected yet and hopefully with antibiotic treatment she will not loose any of her eyesight. It is already a difficult life for the children in this country, let alone with blindness.

As she clung to her mother for comfort, I prayed that her eye would heal without any loss of sight.

- Sue Behrens, APN   

The prime of life

Twenty two years of age, most would agree, are among the prime years of our lives, characterized by vigor, enthusiasm and more.

But to our Haitian friend, T. K., with incapacitating electrical burns of both hands, life has become a journey into the unknown.

Indeed, in nations where job opportunities are scarce, young men must often leave the familiar loving care of their family and travel to another country, as in this case, for life sustaining employment.

TK, unprotected by our OSHA type oversight, workman's compensation, and medical assistance lies on a stretcher in our clinic, while we surgically remove the dead skin from his gapping, crippling wounds.

His courage, lack of despondency, and gratitude create an atmosphere of respect, admiration, and awe.

The silent acceptance of life’s tragedies seems more prevalent in nations where children must mature preciously.

What can we do to evoke positive change in struggling nations, and what can we teach our children regarding the sanctity of the word…gratitude.

-Dr. Charles Vergona

'Mesi'

Viktor is an older man that came to the clinic with nodular enlargements all over his body.

His hands, legs, nose, face and even his lips were covered with odd, raised lesions. With minimally testing available to us here, we could only try to rule out what disease he might have. 

Tertiary syphilis or Kaposi’s sarcoma was our first two options, but they were ruled out by blood tests that he was able to have done at a local clinic.

We researched a few other diseases and he did have some symptoms leading to leprosy. A tissue biopsy would have been the best way to diagnose this man, but even that isn’t available nearby.

He came back 3 times that week and we treated him the best that we could, but without all the necessary resources, we had to leave him without really knowing what was going on.

He still came to us everyday with a huge smile and left with a “mesi.” 

Maybe someday we will be able to provide more for this man who was so grateful.

- Carrie Stalter, APN

Nicole's story

Today at triage I met a 13-year-old girl named Nicole Pierre.

Her skin was covered in a terrible fungal rash and she was malnourished.  She came to the triage chair alone.

Once the provider evaluated her we found her aunt outside the clinic waiting for her.

We found out Nicole lost her father in the earthquake and her mother died 3 months ago of epilepsy. She now lives with her 24-year-old aunt who doesn’t have children of her own.

Nicole has never been to school. Haitian children are only able to attend school if their family can pay for a uniform for them.

I decided to help Nicole through a sponsorship program FOTCOH has to help children. She will then be able to attend school.

It again helped me to realize how blessed I am for the opportunities my own children have that we often take for granted.

- Renee Humphrey, RN

Through his eyes

It was the opening day of the FOTCOH clinic mission, and my eyes where drawn to him instantly.

How could one overlook that quaint round straw derby, perched on that sweet toothless smile, all of which where imbued in an aura of grace and gentleness?

Announcing his age of one hundred plus, anyone would be drawn to his words of wisdom.

Then, as he took first, then a second pair of glasses from a box of donated eye glasses, (finally choosing the round light framed pair), I realized that those spectacles were mine.
 
A surreal sensation, of comfort and gratitude, struck me…that I, through my glasses was seeing the world through …his…eyes, as he did, through mine.

It’ no secret: Giving, in any dimension, is and always has been, better…than Receiving.

--Dr. Charles Vergona

No greater love

 A middle aged Haitian Grandmother typified yet stood out from the long line of local inhabitants seeking medical care on a very sultry summer morning.

You might have difficulty guessing her age, as we did, due to a life of arduous daily chores and major extended family responsibilities.

She presented early in the day, for she camped outside the clinic gate the previous night.

We attended the young child continuously parked in her arms, with the understanding that the Mother of the ill child was herself incapable by physical or other afflictions to be present, and to render care and rearing of the little one and her many siblings for the long term.

By afternoon, still present, due to the variety of tests and treatments needed for both of them, we noticed and subsequently confirmed by translation, that the brave ill woman, thoroughly perspired, had not eaten nor drank all day, for what little she had, she offered to the equally ill child.

The team intervened with hydration and nourishment, and as we watched the gentle patient lady drink, large beads of moisture on her forehead, we remembered that proverbial phrase:

There is No Greater Love than that of a Mother… perhaps, of course, than that of a …Grandmother.

-- Dr. Charles Vergona

Healing wounds unseen

Ferouge Jean, of Jacmel, has anxiety and nightmares caused by the earthquake.

“It’s classic PTSD [Post Traumatic Stress Disorder],” says Katie Hanlon, P.A., who examined the 17-year-old girl at the FOTCOH clinic.

Six-months ago, the massive 7.0 magnitude earthquake devastated Haiti, killing more than 200,000 people and leaving more than 1 million homeless.

Many like Jean are experiencing psychological effects from the disaster that may have taken months to develop.

Others, like Eustache Josuee’, 62, of Cyvadier, are finding it difficult to cope with the loss of a loved-one. Josuee has been despondent, often sobbing spontaneously, since his 32-year-old daughter fell victim to the quake.

Josuee’ has been victimized too, by those trying profit from the tragedy, when people he paid to dig in the rubble for his daughter just fled, without making any attempt to dig for her rescue.

We have been treating Josuee’ for hypertension, which has likely been causing dizziness, his chief complaint upon arrival at the clinic. We’ve also been treating him for abdominal pain.

“But what he really needs is counseling,” says Hanlon.

Fortunately, we have just learned of a possible referral option in Jacmel that will be providing group therapy at a camp for those affected by the earthquake.

Hopefully, our patients such as Jean and Josuee’, will find some comfort and peace.

A sole survivor perseveres

Eleonord Jean was just sitting in her house in Jacmel six months ago when the “tranblemannte” (earthquake) hit Haiti.

Her two-story house had been constructed the traditional way, made of concrete blocks and cement, but with little steel reinforcement. So when the massive 7.0 magnitude quake struck, the house collapsed on Jean and her family who were all inside.

Jean was buried under the rubble for two days before being rescued, having sustained severe injuries on her right side.

All other (five) members of her family had been crushed to death by the house’s structure that had “pancaked” on top of them.

Before the quake, Jean, 54, used to work as a “machan” in the local market selling clothing.

Now, her walk is unsteady and she wears a sling to support her right arm that has no feeling, leaving her unable to work.

Now, she lives in a tent with her sister-in-law, which sits on the site where her house stood before the “tranblemannte."

Haunting memories and a remarkable recovery

I was on the January medical team, which arrived 6 days after the earthquake.

As I prepared for this trip, I wondered what it was going to be like 6 months later, the patients, the country; I couldn’t wait to get back to Haiti.

Rosena was born January 13, 2010…one day after the earthquake hit Haiti. I evaluated her in January when she was barely a week old. At that time she was almost 8 pounds.

Today Rosena and her mother came to the clinic to be seen. I was thrilled to see Rosena was doing well. Her mother is breastfeeding her, and she is now 13 pounds.

Even though Rosena was born at a stressful time, I remember how worried her mother was in January. She is a post-earthquake success story that made me feel so much better for our patients.

Then I was reminded of the devastation the earthquake caused. We had an women who lost all 7 of her children in the earthquake.

She arrived to our triage area, tearful and very quiet. She is now living with family members and is still haunted by the deadly earthquake in January.

One of the last patients of the day was an 8-year-old girl that I took care of when she was only 9 months old. Jenie had skin TB that affected her neck, face and left ear, her skin and ear was literally eaten away by the disease.

I transported her to the Missionaries of Charity in Jacmel because we thought she was going to die.

However, Jenie responded to the TB therapy and did survive. She has the deformities and scarring from what the TB did to her 8 years ago, but she now has a beautiful smile.

I was amazed that her mother remembered me, as she pulled out a photo of Jenie when she was 9 months old with the severe results of what the TB had done to her daughter.

It was a great way to end the day, knowing that FOTCOH has done so much over the years for patients in our community, and that we continue to provide this service to our patients.

- Sue Behrens, APN