To all our dear friends and family,

 

I want to give a diary/memento of some of our work in Haiti.  We appreciate so deeply your loving support, good wishes and prayers.  I am deeply humbled by our experiences.  We were blessed far beyond our expectations and feel that we accomplished more than we could have ever hoped for - though it is less than a drop in the ocean of the needs of our beloved Haitian friends.  We are all safely home, but our hearts are still in Haiti - I wish I could have stayed indefinitely - it was hard to go where there was so much need - but we had used all our resources and needed to come home.  We will never forget.  Many of us were permanently changed by what we saw and experienced there.

 

Wed 10 - With our 38 (50#) crates we left from Detroit in a snowstorm.  We met some of our group in Miami, and stayed the night there - we had to store the 38 bins as the airlines would not check them through.

 

Thurs 11 - Arrived in Santo Domingo (Dominican Republic) and met up with our last team member - 3 doctors, 4 nurses, 1 PA, 1 EMT, 1 physical therapist, 2 pharmacy workers.  The airport waved us through passport and customs without even looking at our documents when they found we were doctors going to Haiti.  Were met by Bobby of GCOM (a wonderful man who was raised in House of Blessings orphanage near PAP where we were staying).  We had a couple of vans - but there was not enough room for all the bins of supplies, so ended up having to spend the night in Santo Domingo and renting a small bus the next day. 

 

Fri 12 - We left at 6 AM, making the seven hour drive to PAP.  Again at the Haitian border we were waived through without stopping for passport clearance.   There is a shocking change in landscape at the Haitian border.  Sadly all the trees have been cut down to pay off debts to the French (after the slave revolt in 1809) and to burn wood for cooking.  It is dry, dusty and barren compared to the lushness of the DR.  In PAP we drove directly up the mountain to our little orphanage (15 miles but another hour and a half due to road and traffic conditions).  We made this drive twice a day the entire time we stayed there - but it was nearly impossible to find somewhere safe to stay in PAP.  The orphanage was built by an American and housed currently 14 orphans of all ages.  They and the staff welcomed us into their little home.  We picked places to sleep - some in tents outside, some in bunk beds in the orphan's rooms, some on the floor - and I chose to sleep on the 2nd flood patio.  We spent several hours organizing our massive amounts of supplies and medications and packing for the next day.

Most nights we had an orientation/debriefing meeting which sometimes included airing our frustrations and a song and prayer.  We slept OK except for the dog fights in the garbage, the crowing roosters, the hard floor, and the cold nights (the temp dropped precipitously at sundown in the mountain).  

 

Sat 13 - We packed 25 people plus about 10 bins into the Tap-Tap (an indescribable sort of truck that is the endemic form of public transportation in PAP), leaving around 6:30AM.  We drove the hour and a half down an incredibly rough dirt road into PAP - where we had our first glimpses of flattened houses and buildings and smaller "tent" cities.  Many tent cities consisted merely of sheets hung up over poles, or cardboard boxes.  Every little encampment had a sign saying "We need food, water, medical care". 

Many tent cities had not received any assistance since the earthquake (which the Haitians call "the event" or "that thing that happened").  We headed for a small hospital in the Pernier district (a 15 minute drive from the hard hit downtown area).  The hospital was called Censhop.  As soon as we drove up some doctors came out and warmly greeted us.  They had received no international help or medications since the Event and were absolutely thrilled to see us.  This hospital was built 8 years ago by Dr. Casimir from his own money that he got by selling a piece of land.  It is a non-profit hospital that until a few months ago was getting some support from the government, but that had dried up.  They serve an area of 100,000 people with 12 part time doctors and a handful of nurses.  Their pharmacy was not much bigger or more well stocked than my medicine cabinet at home, and they had no surgical equipment.  After the Event they saw 5000 people, 500 of whom had to be shipped to other hospitals for major surgeries.   It is by Haitian standards a nice facility with multiple bathrooms, patient rooms, waiting areas.  Many rooms were not being used since they had no way to care for the patients.  We set up our pharmacy, triage area, and began seeing patients - seeing 150 patients that first day.  Some were very ill, some were mildly ill - but all were appreciative.  We saw some severe malaria cases, diarrheal illnesses, and severe uncontrolled asthmatics, as well as many hernias we were unable to operate due to a lack of an autoclave. 

 

Memorable cases - a 50 year old man who nearly died of acute asthma our ER doc was able to save, a man shaking severely from malaria, a dehydrated baby.

Memorable people - Jean (a 20 year old man who had taught English until his school collapsed) showed up at the hospital to see if he could translate for us.  He worked with us all day and we learned his story.  Not only had his school been demolished and many of his students killed - but his entire family was dead - mother, father, sister, brothers and some cousins.  He was the only one left.  He was sleeping on the ground with no shelter in a park, heard we were at the hospital and came to try to help.  I hugged him and expressed my sorrow.  He said he was grateful to God to be alive.  We offered to sponsor him in the US if he can find a way to get a visa and Peter gave him some money to try to get a visa.  He was so sweet. 

 

Memorable scenes - a grocery store completely flattened - great slabs of cement and rubble - hundreds of bodies still buried and the smell of decaying flesh.  A feeling of being in a morgue - yet the city streets pulsating with life everywhere around - pigs and dogs rooting in the rubble - street markets with fresh produce everywhere - mounds of burning trash in every street - dust and rubble everywhere. 

 

The drive back up to the orphanage was somber, we arrived at 7 PM, they fed us and we felt so lucky to have food and water, cold showers for some.

 

Sunday 14 - We divided into two teams.  Half stayed in the mountain to run local clinics (after church - Haitians are very devout and in fact were in the middle of a national 3 day fast for the dead and injured).  The other half went back to the hospital where we set up our pharmacy again - today news had spread there were American doctors and we saw 200 people (plus 120 in the mountain).  Many churches were flattened and 90% of the schools were unusable, yet people were worshipping everywhere.  The remaining churches were packed to the brim (they say Haiti is 50% protestant, 40% catholic, 10% other - and 100% voodoo).  All the Tap Taps are painted brightly like circus trucks with slogans such as "Jesus Saves"  "Thanks be to God"  - all in Creole of course. 

 

Memorable patient - a 19 year old young lady with a rectal abscess that had to be surgically drained.  She was so shy we had to put the male translator in the bathroom and we shouted back and forth during the procedure. 

Memorable scenes - Haitians everywhere dressed and clean in their Sunday finery - looking much better than us hot, sweaty Americans - with little water, no homes, most of their belongings gone. 

 

Monday 15 - Again divided into two teams as the mountain clinic was overwhelmed with need.  Today the mountain team saw 240 patients, and the hospital team nearly 200.  We were mostly seeing non acute things.  The worst of the earthquake victims were being cared for in the field and city hospitals that had surgical capacities, although we saw quite a bit of wound infections, lacerations, and a lot of uncontrolled asthma - partly because of the dust but also because there is no preventative medical care for the asthmatics in Haiti.  Our surgeon was frustrated by a number of surgical cases we had to refer due to lack of an autoclave.  Dr. Casimir told me he had a large crate of medical equipment tied up in the port but they could not get it out because they wanted $2000 and the hospital simply did not have it.  They were paying their doctors $300 a month and their nurses $100.  The cost of living in PAP is high.  Gasoline is $7 a gallon.  We gave vitamins with iron because nearly everyone was anemic due to poor nutrition and untreated tropical diseases.   At this point having seen around 900 patients things were becoming a bit of a blur.  Our surgeon and nurse anesthetic went to Quisqueya (a school that had become a command center for dispensing medical teams to various hospitals).  They ended up doing some surgeries and wound debridements and dressing changes. 

 

Memorable scenes - blocks of women and children waiting in line for the World Food Organization trucks.  ID badges are only issues to women, as they are known to also feed the children and they don't fight in the hours long lines.  The result of this is mostly beneficial but some of the men went hungry if they did not have women feeding them and anger towards women sometimes broke out. 

 

Tuesday 16 - Half of team to the hospital - half to our first tent city.  The mobile people arrived first in Las Vegas (large tent cities all have names and numbers - and the UN keeps track of how many people are there.  Las Vegas was a tent city of 4012.  A US army detachment was there with a first lieutenant who told us he was heading up an investigation into 14 rapes that had occurred there recently.  There was a Doctors Without Borders hospital relatively close so we headed to a larger tent city with 7,000 and set up under a canopy.  I was impressed to see the women schooling the children and we shared the space with the school.  We again saw around 200 patients, treating multiple infections - including a leg osteomyelitis (bone infection).  We were afraid of tetanus - most of the population has not been immunized and many hospitals have already had people die of this dreaded and difficult to treat disease.  We had no tetanus vaccination with us and were unable to locate any.  Between the two teams we again saw around 400 patients.  A Hiatian nurse who lived in a nearby tent city saw us and brought her nursing license over and asked if she could help us.  I think her name was Mireille.  She didn't speak much English, she was awesome and helped the pharmacy people (Kyle and Peter).  She had no job because her hospital was destroyed (like most of the rest of the city - one of the worst things was noone had a job and they were all subsisting on handouts).  She came and helped us every day.

 

Wednesday 17 - The whole team set up in a larger tent city in one of the roughest downtown areas, next to the city Soleil (the notorious slum area where 4 and 5 year olds carry guns to protect themselves).  This was definitely a harsher environment, we treated lots of sexually transmitted diseases and some really nasty infections that needed surgical drainage in addition to the usual.  Part of our team set up just to clean and dress wounds.  I spent the day driving around PAP with Dr. Casimir trying to buy medications (we went to 4 different pharmacies to get some of what we were running out of).  We also tried to find an Autoclave (or a pressure cooker) to sterilize instruments - but there were no department stores - everything was demolished - in a city of 2 million - we couldn't find anything to sterilize.  I offered to pay the $2000 to get the crate out of the port and we found a bank but they would not take my charge card so Dr. Casimir borrowed the money from his friend and I agreed to pay it back as soon as the bank president OK's the transaction.  We then took the check to the Port - only to find that  they wanted an additional $1500.  That is how things work in PAP.  We took the $2000 back and I decided to work on the problem from another angle. 

 

It took us most of the day to locate Davidson because some of the men had taken him in hopes of extracting money from us.  I told them we would be back with the US army if they didn't produce him by 2 PM.  We eventually found him, talked to a blind older brother who confirmed he lived with his aunt in a cardboard tent with 10 children she was raising.  We were able to find the place he lived - and it made the other tent cities look like upper middle class.  There were literally thousands of box and sheet tents packed in next to each other - it was incredibly crowded, noisy and demoralising.  His aunt introduced us to his siblings and cousins she was taking care of, we told her we respected her, told Davidson not to run off (his parents had died of tuberculosis when he was 2) and left her with some supplies - which probably got distributed among all her neighbors.  We offered to take Davidson to an orphanage but both the boy and his aunt declined. 

 

Most memorable patient - a 5 year old girl with congenital cataracts, almost blind.  Her mother told us she had been all over Haiti looking for a doctor to help her but they said nothing could be done.  She had the most beautiful blind eyes.  We took her contact information and told her we would see what we could do.  She expressed great fear we would take her daughter from her, but we reassured her we would not.

 

Wednesday evening the doctors and nurses decided to stay at Quisqueya and go out to hospitals the next day, the rest of the team went back up the mountain.  At the Quisqueya meeting I told the staff about our little hospital and they agreed to start sending medical teams the next day.  I also told them about our problems with the medical crate - they got a look of fire in their eyes and assigned someone to look into it the next day.  We slept in a tent, no roosters but the traffic and horn blares went on all night.  It rained pretty hard and we got sort of wet.  We worried about all the people in tents and boxes, and heard there were many floods.  Rainy season starts in a month.

 

Thursday 18 - 5 of us went to a large hospital where they were treating amputees, and other post traumatic surgical patients.  The hospital was partially destroyed and all the patients were in tents outside the building, but they were doing the surgeries inside the OR's.  The surgeon and ER doc did a lot of wound debridements, flap revisions and other surgical cases.  The nurses worked in triage and ER and came back telling us our team was better organized and supplied than the hospital ER.  I made the mistake of agreeing to run a street clinic outside the city.  I had to collect my own medications and supplies - and while I was in the medication tent overheard an eye doctor asking for medications.  He agreed to treat our little blind girl, and we contacted her and had her go with her mom to the University General Hospital where the eye team was for two days.  We hope she got her surgery.  My street clinic was incredibly disorganized and poorly run and the nurse midwife who was in charge did not seem interested in actually seeing patients and giving appropriate treatment.  She spent most of the time praying with the patients and measuring pregnant women's bellies.  I saw about 70 patients on my own and had to dispense my own medications.  I opened and drained an osteomyelitis, treated a lot of malaria and sent one very sick infant (who clearly was multiply infected with either HIV or malaria or both) to the hospital.  I tried to get the nurse to help me and train her how to identify and treat malaria but she was clearly uninterested.  I did not get back to the compound until 7:30 and decided to go back up to the orphanage that night. 

 

The remainder of our team that day ran some wound care clinics and street clinics and drove through some of the hard hit areas - they visited the Presidential Palace (collapsed) and a Baptist mission that had a small Haitian museum and zoo.

 

Most memorable patient -   My translator in the street clinic was a lovely young woman named Ruth.  She was a school teacher.  Her school and 23 of her students were destroyed.  During the event Ruth was on the 3rd floor of her house and her two sisters were on the bottom floor.  They both died.  She had a look of horror in her eyes when she told how they looked when they were dug out with their heads pushed down  their necks.  "I will never forget it - never!" she said.  She showed me the remains of her house.  I hugged her but there was little I could say.  She did not cry.  She told me all her school books, personal papers and money were gone.  I cannot forget her. 

One of my other patients told me her two children were dead in the quake.  I prayed with her.  It was all I could do.  In a city of 2 million - one out of 10 dead, one out of 4 seriously injured, nearly everyone homeless - it is not possible to truly grasp the magnitude of this tragedy. 

 

Friday 19 - Our surgeon and ER doc continued treating surgical patients through Quisqueya.  The remainder of our team ran a short tent clinic in Davidson's city.  We saw 100 patients in an hour and a half, including a young boy with a rectal abscess, and a 15 day old pair of identical twin girls - they were so little and so beautiful.  Getting diapers was a terrible problem and many babies had sores.  Some of the moms had diminished milk supply since the Event and were feeding their babies with food that was too harsh for their little systems and they were getting diarrhea.  We did a lot of education.  The tent city of 5000 begged us to stay longer but we were almost out of medications, and had other commitments.  The head of another 1500 person tent city came over and begged us to go there, said they had had no care.  We were sorrowful, but it was our last day and we had things we had to finish up and it was already 2 PM.  We tried to leave boxes of wound care supplies, tylenol and food snacks - but right at the end a doctor and some workers from Partners in Health came over and tried to confiscate the supplies from the tent city leaders.  An ugly fight ensued with shoving, jerking and yelling.  I tried to intervene but no one listened to me!  Some marines were watching from outside the city but did not come in.  Finally I just hopped on the Tap Tap and we left them there to work it out themselves.  Violence in the tent cities is a growing problem - frustration, desperation, lack of work - there have been gun shot and knife fights and rape - but these are isolated incidences and most of the people are patient, resilient and kindly.

 

We then drove to the Hospital.  When we got there to our great joy there was a huge 18wheeler with an immense crate full of medical supplies on the back.  Our Quisqueya people had got on the phone to the Haitian president and got the port to deliver the supplies - and no money changed hands.  The hospital president came bounding down the stairs and there were tears of joy on his cheeks - he kissed and hugged me again and again.  It was one of the most joyous moments I have ever had.  Included in the shipment were operating tables and lights, TWO autoclaves, anesthesia machines, many ultrasound machines, computers and copiers, hospital beds, and stacks of ancillary supplies - a three page single spaced list.  Dr. Casimir said we had added 10 years to his life.  I introduced our little Haitian nurse to  Dr. Casimir and gave her my highest recommendation.  He did a two minute job interview on the spot (which we have on video in Creole), then hired her based on my recommendation.  She starts Monday.  We dopped off the 10 remaining crates full of supplies and medications we had brought from the states - leaving this little hospital with the ability to treat all the things we had treated, plus perform surgeries.  We had the blessing of helping to transform this little starving and dying hospital into a well stocked and energetic hospital, able to provide at least basic medical care to the people in their district.  Dr. Casimir plied our whole team with coca cola and fruit drinks.  We were sorry to have to say goodbye but it was getting late.

 

We did a quick run to the Baptist mission, took a tour of the hospital where there were a lot of amputees and bad wounds, saw the museum and did a little street shopping - the Haitians are fantastic artists. 

 

Our team had been there a week -  Kyle and Peter had spent most of the time in the pharmacy or mobile pharmacy (back of the truck) - dispensing over 4000 prescriptions to the almost 2500 patients we had seen.  Some of us had not showered.  Our PA Bruce got dehydrated and our CRNA Randy pumped him full of IV fluid, the next day Randy dislocated his shoulder and Bruce popped it back into place and despite his pain he stayed and did as much he could - two nurses (OK I won't tell their names) got some diarrheal illness.  We were all sleep deprived.  Don our surgeon and Monica our ER doc made an impressive OR team, Kathy and Katie were masters of triage, Rocephin shots, IV fluids, and generalized nursing care, Liz bless her heart extended our providers by seeing patients - she particularly enjoyed treating the pregnant women, Phoenix rotated between the pharmacy, triage, wound care and taking care of children, Mary also did wound care, triage and loved the orphans (she is a PT and should return and help with rehab of some of the amputees in the future).  Additionally we were joined by 3 young men and 1 young lady from UTAH who were truly awesome and did everything and more we asked them, two young men from Chicago (great at crowd control), and Martha and her mother Ellen (70+) who were the hardest working and greatest hearted people you could ever meet. 

 

We made a lot of connections, learned so much, tried to help a little.  Mostly we learned to love Haiti and the Haitian people.  Ronald (our main translator and team leader) was truly amazing.  He was studying to be a pastor, but his school was destroyed along with 37 of his classmates.  He ran home to find his two sisters trapped in the rubble of their home.  He spent hours digging them out by himself because everyone else was digging out their own family members, but thankfully they were both survivors.  We love him so much. 

 

What we learned about the Haitian people is - they are resilient, they are tough, they are hard working, they are intelligent, they are creative, they are beautiful, they have great hearts - they have tremendous potential.  Our hope and prayer is that out of this terrible Event a new Haiti can arise - one that allows the amazing Haitian people to develop their abilities, to govern themselves, to make a place that is safe, welcoming, prosperous, full of opportunity for all. 

 

Sat 20 - Left our little orphanage at 6 AM, spent a couple of hours trying to get to the airport in PAP (which thankfully had opened up the day before), finally ended up walking the last mile or so to the airport because the UN had blocked all the access.  We saw soldiers and teams from all over the world - US army/air force - blue helments of the UN - Canada, Germany, Swiss, Israel, France, Cuba, even Pakistan had soldiers and medical teams in Haiti.  We were scanned and patted down twice at the airport - the plane left on time.  A medical emergency midflight turned out to be a Haitian woman with - an acute asthma attack.  We managed to stabilize her despite the fact she refused an IV (she said it would kill her), refused to use the oxygen, and even refused to use the inhaler as much as we wanted her to.  When we landed they hauled her off to the hospital.  I'm telling you - Haitians are tough!

 

Although we are happy to be home - our hearts are still in Haiti.  We hope to make an ongoing partnership with the hospital to help them provide improved care to their 100,000 Haitians.  We hope to return soon and often.  We hope the international community can assist the Haitians with helping hands, but not try to solve their problems - only the Haitians can solve their problems. 

 

Thank you all so very much for your amazing support - we could not have done it without every one of you.  We will be making a blog with more stories and pictures and videos of our trip, we will keep you updated.

 

Bless you all

 

Susan and Team