Posted on March 25th, 2010 No commentsGreetings from the Hopital. While we continue to see untreated earthquake related trauma from the Jan. 12 quake, we are functioning more like a hospital and less like a disaster response unit every day. We do still have approximately 40 patients outside in tents but, have the entire 2nd floor NE wing devoted to and filled with in-patients. The 1st floor SE wing is also filled with patients in our pre-op and two post-op rooms. At any point in time we are housing about 50 patients inside the main hospital and another 20 or so in the in-patient pediatrics and obstetrics wards in the polyclinic building. We continue to staff and support a very active 24x7 emergency room, as well as OB/GYN, Ortho, and Medicine clinics Monday - Friday. The operating room remains very busy averaging 15 surgical cases per day, 8 - 10 orthopedic/reconstructive, 2 - 3 OB, and the balance general surgical cases. The stream of volunteer medical staff continues to flow into the hospital here thanks to the efforts of our coordinating body at the LLU Global Health Institute.
On Wednesday morning seven of our translators–a group of handsome, strong young men–surprised us at our morning briefing by giving a heart-warming thank-you and tribute. They had it all planned and staged and even had made special wooden plaques that they gave to some of our long term volunteers. The plaques read, "Thank you for helping us in Haiti, together we move." The translators have been a God-send. They are always friendly and eager to help (and their help is much needed). Communication has been a big challenge, since the majority of volunteers speak neither french or creole fluently. Imagine 70 english-speaking volunteers trying to communicate with hundreds of patients, family members and the 100+ Haitian hospital staff on a daily basis–impossible without the devoted help of these really amazing guys.The O.R. translator team and Dr. ChandyThanks all around
Posted on March 19th, 2010 No commentsMy good friend Irene Naesse, a geography teacher at Orange Coast College (OCC) sent me the following email a little less than a month ago:
I am going to challenge my students to each bring in a coloring book and crayons to send to you in Haiti for the kids. I have about 300 students this semester....so that is a lot of crayolas!
Well about 10 days ago Irene delivered 4 Xerox copy-paper boxes full of coloring books and crayons to my house so my wife Laurel could bring them with her to Haiti this last weekend. While Laurel could not bring them all, she did pack a couple dozen books and crayon sets in with the medical supplies she carried in her luggage. The remaining coloring books and crayons will be carried in by other volunteers heading here over the next few months. Below are some pictures of the OCC coloring books bringing joy and healing to the kids of Haiti.
Merci beaucoup to Irene and the OCC Geography students.
Posted on March 17th, 2010 No commentsThe quality of the reconstructive surgical program we have today is a direct result of the collaboration with our partner CURE International. CURE is a christian organization that operates nearly a dozen teaching hospitals in developing nations around the world with a focus on surgical treatments for children with disabilities and deformities. Their experience in operating hospitals in the developing world and providing top quality care in challenging environments has been invaluable in our earthquake relief efforts. CURE has provided world renowned experts in reconstructive surgery to serve the needs of earthquake victims. We have developed a reputation in the country of Haiti as a tertiary referral center for a variety of complex orthopedic cases. CURE's Haiti Medical Director Dr. Scott Nelson is also a Loma Linda University School of Medicine clinical faculty and alum.
CURE has had an orthopedic program in Haiti for a number of years prior to January's earthquake. The existence of this program pre-quake benefited us greatly by providing in-country knowledge, experience, and resources. CURE has provided invaluable logistical and supply resources such as:
L - R Phil Hudson, Dr. Nelson, Loubins Labiche
- In-country logistics coordinator (Mr. Phil Hudson)
- Air and ground transportation
- Shelving units
- Orthopedic surgical equipment
- Surgical nursing staff from their Dominican hospital
- Multiple international volunteer teams
- Volunteer coordination (Erin, Heather, Robbie)
THANK YOU CURE INTERNATIONAL for all of your help here at the Hopital Adventiste!
Posted on March 15th, 2010 No commentsMaranatha International is here with us at the hospital providing assistance in a couple of different ways. Back in early February Maranatha contacted LLU about the possibility of sending in some volunteers to provide boots on the ground assistance with our work at the hospital. On February 19th six Maranatha volunteers arrived at the hospital for a full six week stay to serve in anyway we needed them to. These six people have been the force behind the amazing transformation of our central supply from the piles of boxes and bags to the well organized HAH Depot Central.BeforeAfterL - R Marcello Martinez, Bob Chase, Ashleigh Cohen, Dan Patchin,Myrlene Honore (not pictured Marilyn Patchin)In addition to their work in the Depot Central, each of these volunteers has contributed in his or her own special way around the hospital. Ashleigh has served as our base camp manager and also doubles as a social worker helping to find orphans homes and debriefing volunteers on their departure dates. Myrlene has filled many gaps due to her Haitian background and language skills. Bob has used his carpentry skills to build a number of custom shelves in various rooms around the hospital. Marcello has taken on the responsibility for maintaining the oxygen supply in all departments of the hospital managing 16 D and E size bottles and 20 large M tanks. And Dan has served as the Supply Unit Leader for the operations committee.1 Day Church StructuresMaranatha has also sent in a team to build us 5 of their 1 Day Church Structures to be used anyway we see fit. The first of these has just been completed and is planned to be volunteer housing. Structures number 2 and 3 will be done shortly and will be used as volunteer housing and out patient pediatrics. 4 and 5 will go up next week and will provide shelter for urgent care/triage and an ER expansion.
Posted on March 11th, 2010 No commentsBy Dr. NelsonDisaster relief is typically one of the most inefficient uses of the donor’s dollar. Think about it. Premiums are paid to purchase last minute items, overnight deliveries are made, volunteers are buying last minute air tickets, and extra funds are used for security and support of volunteers in a situation where there is no infrastructure. Due to lack of communication, urgency, and constantly changing needs, heaps of materials arrive that are not always needed. We experienced all of this. (BTW the breast implants and total knee replacement parts that were sent down were not needed at any point during the disaster relief) When the relief efforts are over many of the expensive pieces of donated equipment sit idle, deteriorate or are scavenged. This is not to be critical, many of these factors are uncontrollable and the job has got to be done. It is just the nature of the situation.At the Hopital Adventiste we are doing a lot more than just disaster relief and because of this, your donations will have much more than just a transient effect. For a short period of time we were buried under the heaps of stuff that was generously provided. But, thanks to Dan and Marilyn Patchin from
as well as many other Haitian and American volunteers it is now well organized and we are working efficiently with the needed supplies to offer a top quality level of care to those we serve. The donor’s dollar is also multiplying as we take advantage of synergistic collaborations with other organizations who are interested in our vision for a long term program with the highest of standards. We were very fortunate to receive an autoclave from Hope Force International as well as a portable digital x-ray machine from Americares (see photos). Portland, ORWe thank these organizations for their generosity as well as each and every one of our donors who have generously given. Some of the ongoing weekly expenses that we are currently supporting are:
One time capital expenses include:
- Diesel $3000 for electricity
- Oxygen $600
- Transport of equipment and supplies $500
- X-ray film and envelopes $750
- Housekeeping, maintenance, & repair supplies $1000
- Lab supplies $500
In addition, payroll is about $42,000USD per month. All our services are currently offered for free. Without an income source this is not easy to come by, but we must pay our employees as they re integrate back into the workforce.We want to again thank all of you who have contributed. The challenges ahead are great. But with God’s guidance and power we continue to give our all and not get discouraged.
- Water main $4000
- Translator honorarium (30 people x 6 weeks) $2700
- Shelving $5000
- Generator parts $1000
- Repair of perimeter wall $5000
Posted on March 9th, 2010 1 comment
I feel like I run around all day. Either I’m trying to discharge post-partum patients home, running to the lab with fresh blood samples to make sure we get stat labs, trying to keep the blood pressure down on our pre-eclamptic patient, or our blood pressure up on our malaria patient, or simply translating between the american nurses and haitian nurses. Actually I shouldn’t say simply…it’s incredibly exhausting after awhile! I’m tired today. Yesterday I had the most awesome day. I guess each day just varies. Its quite the challenge to get the Americans to work alongside the Haitian nurses, when they don’t speak the same language. Talking with some of the nurses they were saying they feel really sidelined when all the americans are speaking in english etc. And I don’t blame them…it would be hard for me too if a large group of people came into my workplace and spoke in another language I didn’t understand, and tried to boss me around as if I didn’t know anything. So that’s one of our goals here, to teach the haitian staff to provide top quality care, and to be able to leave this whole thing in their hands when we leave. I hope we’re doing a good job of that, but its definitely not easy. It’s hard when we don’t even understand the system here, and as soon as we grasp on to how things work, another group rotates through, trying to run things a little differently. It’s definitely helpful that we’re here, we only have three ob/gyn doctors here and they take call it seems every night, so we’re for sure taking a load off them. But sometimes its frustrating.
We had a pre-eclamptic patient come in today. After watching what happened to the pre-eclamptic last week who abrupted and lost her baby, I was pretty nervous for this one. The nursing care here is sketchy, and sometimes vitals are taken merely once throughout the night….which can be dangerous, especially when her blood pressures were 220/160 this afternoon. We started her on Magnesium Sulfate, and gave her Hydralazine for the bp…it slowly came down but we were monitoring her very closely this afternoon. I’m somewhat concerned about what will happen during the night shift…
Anyway I’m having so much fun with these girls I’ve made friends with! They’ve been too kind to me…they keep bringing me gifts! Yesterday they brought me three, ripe, juicy mangos. I was in heaven! Today they brought me ice cream. And this evening they forced me to sit down, and braided my hair! It was so fun, my head hurts like crazy but its still fun They also keep trying to force other food on me. I try to refuse, but they get very mad when I refuse. I feel like I should be giving them stuff, not taking things from them. But they keep saying its the least they can do to thank me for my friendship. I don’t really feel like my friendship is that important, but it’s nice to know they appreciate it I guess.
I’m loving just hanging out with all of the people here. Looking back in life, one of the best things I ever did was learn french and spanish. It’s been soo useful! I spent a couple of hours this weekend hanging out with a large group of teenagers, just learning Creole. They get so excited when I put a new sentence together! Then during the whole evening, they ask me about California, and what it’s like to live there. They said they heard we have earthquakes too. They were surprised to find out that I’ve experienced multiple earthquakes, and that they don’t scare me. For them, this was their first earthquake ever. Many people had never heard of such a thing, and had no idea what was going on. They said a lot of people got scared and ran into their homes rather than out into the streets.
That evening as my friend Neerla was leaving, I asked her if she was going home. She looked at me and laughed! She was like, ‘Sarah, I don’t have a home! Remember?’ Oops. I can’t even imagine what it’s like to not have a home to go to in the evening. I’m even spoiled here, sleeping in a sleeping bag on a cot in a busy hallway. One of the nurses I’m working with was telling me how when it rains, she stands up all night, hiding under some sort of shelter, and gets no sleep. Then she has to come into work the next morning, without any sleep. And she, just like so many of the patients and other hospital staff, have no idea how long they’ll be without shelter.
But despite the sadness, most often at the end of the day I feel happy. And from what I can tell, so do they. I’m forever in awe of all of the people here, and I feel so thankful to have made so many beautiful friendships in such a short stay.
Posted on March 8th, 2010 No commentsWelcome to the Hopital
Greetings on a beautiful bright and sunny morning here in Haiti. After a quiet weekend of overcast skies, fog, and rain, Monday morning has brought us a cloudless sky and beautiful sunshine. While we continue to face many challenges around the hospital, significant progress is being made and I would like to highlight a few of those areas with some pics.Patients waiting in the main hallway on a not so mad MondayDepot Central d'HaitiPharmacy stock roomTent distribution for discharged patientsThank you all for your prayers and support.
Posted on March 7th, 2010 No comments
Tonight at the National Auxiliary Mission Vespers Daniel Westerdahl and I presented the progress going on in Haiti and why our class is so excited about helping the “least of these.” We are enthusiastic about how God has led us to adopt what is becoming a pivotal hospital in Haiti during the current hardship they are undergoing and for years to come. Afterwards the National Auxiliary presented our class with a check for five thousand dollars. We have raised around seventy-five thousand dollars out of our goal of one hundred thousand dollars by graduation. Although initially we worked with GHI and AHI in raising funds for the earthquake relief effort, we are now returning to accomplish the endowment fund. Please help see success in accomplishing our goal!
Posted on March 5th, 2010 1 comment
I spent all afternoon treating vaginal infections. Let me tell you, even though I’m going into Ob/Gyn, doing the whiff test is still not my favorite activity. But these vaginal infections are a sign of what kind of conditions the people of Haiti are living in right now. I’m not sure how often they have a chance to bathe themselves, or where they would anyway. If they’re lucky, they’re living in a tent. If they’re lucky. If not, they’re outside, under a tree, by a wall, next to the road, or wherever they can find shelter from the rain. That’s why its impossible to discharge them sometimes, because here at the hospital they have shelter, safety, and food. Who would want to leave?
Martine is another woman we’ve been working with all week. She has one son who is 13 years old, but since then she’s had 5 other pregnancies that she’s lost. Now, at 29 weeks pregnant, she didn’t want to lose this baby again. But with chronic hypertension and superimposed preeclampsia, she was a difficult case. We started her on Magnesium and gave her betamethasone x 2 for fetal lung maturity, but unfortunately her blood pressures remained uncontrolled. This morning, at 5:30, she began to have severe abdominal pain with vaginal bleeding….her placenta was abrupting. She was taken to the OR for a c-section, and a beautiful baby boy was delivered with apgars of 1 and 5, but after bagging him for 2 hours, he was finally left to die at peace. It was an emotional day. We questioned ourselves, what we could have done differently. We questioned the system here, about why things happened the way they did. We organized teaching with the nurses on how to manage hypertension in pregnancy. But it still hurt to see Martine holding her limp baby boy in her arms, sobbing. Nothing we could do now would change that.
I made some friends with some of the young haitian girls today. They’ve kind of latched onto me, craving attention and care. They work here, helping to organize the gynecology clinic and translate. They work for free, it’s completely voluntary. But they do it because they feel safe here. Stephanie, an 18 year old girl, said she likes to come to the hospital because she can forget what it’s like off campus. She can laugh, enjoy her friends, be distracted from what has happened to her world outside. She’s living on the streets, with her mom and 3 younger siblings. She said she was fortunate that none of her family died in the earthquake, but she said it shook her personally so much that the sunday afterwards she gave her life back to God. These Haitians seem to have an amazing faith in God. Each morning, we can hear them singing outside. When the women are in labor, they’re singing songs. It’s like they’ve been through so much tragedy in their lives that God is the only constant thing. It was interesting, they were surprised to find out that I was Adventist, even though we’re working in an Adventist hospital. They thought that no white people were adventist. That might be because a lot of the relief workers here are from all over, very few are actually adventist. But I think it’s also because we have such a different culture. They’re very open about their spirituality, and their faith. I think I have a lot to learn from them.
Yesterday afternoon we went to a small orphanage nearby, and gave hundreds of tetanus and typhoid vaccines. The children lined up nervously, waiting to be shot. We rewarded them with stuffed animals after braving the two shots. After finishing with all of the orphans, people from the street started showing up, asking to receive vaccines. We gave out as many vaccines as we had syringes, but there were still more people waiting. We’re continuing the vaccine campaign each day.
Today at lunch I walked around the tent camps here on the hospital campus, taking pictures. At first I felt somewhat bad, because I didn’t want to just take pictures of their suffering. But these people were so joyful to have their pictures taken, I didn’t feel like I was documenting any suffering at all! One woman had just had surgery on her leg, and she laid on her bed with arms wide open and the biggest smile on her face. I can’t wait to post her picture up. Other amputees gladly had their picture taken. I saw countless young children running around very skillfully on crutches, with big smiles on their faces. Life here goes on, day by day.
I have so much to learn from the people here. I only hope I can give them back a piece of what they’re giving to me.
Posted on March 3rd, 2010 No comments
Her name is Juliette. She’s 38, in her 7th pregnancy, but delivering her 3rd child. She has two older boys at home, 7 and 3. Her husband died in January in the earthquake. She says they were at home, and a wall fell on him. So she’s raising 2 kids on her own, and now with another one on its way. We examine her, and she’s 7 cm dilated. We take her to the delivery room, prepare for a fast delivery since she’s a multiparous woman, and sit there and wait. 15 minutes, 30, an hour, and soon 3 hours go by. She’s not making any progress. We repeatedly check her, and the exam is difficult. Its hard to tell what’s vaginal wall, what’s cervix, and what’s the baby’s head. Thats when we realize….it wasn’t the baby’s head. The ’suture’ line, was the baby’s bottom. The fontanelle was the baby’s rectum. We had a breech position on our hands.
So in the states, to begin with, most people would have some sort of prenatal care, with an ultrasound (there isn’t a single ultrasound around), and the breech position would be known about far in advance. And then, some people are comfortable with breech deliveries, but most prefer to do c-section. The doctor I was working with said she ‘doesn’t do’ breech deliveries. But at the same time this was going on, there was a lady who had hemoperitoneum needing to go straight to the OR, since 2 weeks ago she had had surgery for an ectopic pregnancy, and somehow a sponge was left in her abdomen. All of the other OR rooms were full, so we were left with this breech on our hands. Thankfully, there was a midwife, Terry, around who felt comfortable doing breech deliveries, and she came just at the exact moment that Juliette let out that final scream, meaning it was imminent. Terry delivered the baby’s bottom, then the legs, the torso, the arms, but the head had a hard time coming out. It hadn’t had the time to reshape to the form of the mother’s pelvis since he was breech. But Terry reached up under the baby’s chin, put two fingers in his mouth, and pulled the baby down and out. We laid him on Juliette’s stomach, and she shrieked that sigh of relief, realizing that her agony was over. The baby was limp, and didn’t seem to be breathing however. We bagged him with some oxygen, and soon after he came to. Apgars were 3 and 9.
I sat down and delivered the placenta, which didn’t need much help whatsoever. But since Juliette had been in labor for so long, the uterus was having a hard time clamping down, and kept bleeding. I gave some extra Pitocin, and we also gave some Cytotec to help her. She kept bleeding for quite awhile. I kept checking her vitals to make sure her blood pressure was stable. We had her feed her baby to get the natural pitocin going. And soon there after, her uterus was feeling much more firm, and she was bleeding a lot less.
Then next to her, we had a pre-eclamptic patient whose blood pressures had been 190/110 all afternoon. And in the other room a 7 month pregnant woman with malaria, a woman with a fetal demise of 4 months, and a woman progressing in labor at 6 cm. Waiting in the hallway we had a woman with cellulitis of the breast, being treated with IV antibiotics, and a group of women waiting to be triaged.
So that was my second day in L&D. I have so many other thoughts about being here, about the people, the hospital, the needs, the problems, the beauty etc. But basically what I’ve seen so far, each and every person is a victim of the earthquake. They’re all struggling. We’re having a hard time discharging patients, because they have nowhere to go. The ortho patients especially, since many of them are newly amputees. Haiti isn’t wheelchair accessible. Many are living in the tents here on campus. Others don’t have anywhere to go. And even if they do have a tent, their hygiene is way sub-par. Yesterday in gyn clinic we treated at least 20 vaginal infections. We figure they just don’t have the means to clean themselves properly.
Ok enough for today, I’m sure there will be more to come…