Well I'm going to bed. I'll update, with pictures, tomorrow.
Saturday, January 30, 2010
Saturday, January 30th--Easy day today, Port-au-Prince tomorrow
Today the second team came down...newbies...clinic was light, only about 150 patients. Tomorrow we are going into Port-au-Prince. I'm really of two minds about seeing the city. Edwens, Pastor Etienne Profete's son, got here today with team 2 and went into Port-au-Prince. He told me when he saw it he was overwhelmed.
Well I'm going to bed. I'll update, with pictures, tomorrow.
Well I'm going to bed. I'll update, with pictures, tomorrow.
Friday, January 29th--Fonds Parisien, Love a Child, Jimani
The internet was broken yesterday, so I couldn't post. We again saw many, many patients. One that sticks out to me is an 18 month old who had been sick last summer with a fever and had an "attack", which probably means a seizure. He was very sick, his mother said. Then he stopped walking, and he hasn't walked since. When I see him, he has contractures of his legs and hands. Seeing him, I think of all the opportunities he would have had, would still have, if he were in the US. We would have been immunized against the most common forms of meningtitis. If he got it anyway, he could have seen prompt and appropriate care. If he developed, as he has, problems arising from having meningitis, he would have recieved developmental evaluation and intervention. Each day we see between 200 to 400 patients.
Yesterday, I also see a 12 month old whose belly had swollen up at home and has been vomiting everything he eats. When I see him, his belly wasn't swollen, but he looks pretty punky, so I admit him to our mini-hopital for some IV fluids. He does pretty well overnight, and we were going to discharge him, then his belly blows up again, he is very lethargic. He develops a mass on the right side of his abdomen and passes a bloody stool. For those of you playing along at home, the answer is a condition called intussuseption, a condition where the small intestine telescopes into the large intestine. To fix it, you need radiology, and if that section of intestine starts to die, you need a surgeon.
So we call the USS Comfort, who say to take him to the LZ at the Love a Child field hospital and they will pick him up by chopper. We race there,and the chopper never comes.
We sit there for 3-4 hours trying to get the comfort to come, but they never do, so we pile into an ambulance for Jimani, Dominican Republic, where thankfully, there is a pediatric intensivist and a general surgeon.
Also thankfully, in this time, the intussuseption has reduced itself..
So we get to go home, but the border had closed, and the DR border guards were having none of it. Fortunately in our travels, we had met Jose Quinones, a special attache to the US Embassy from the Coast Guard who had all kinds of juice with those border guys, and he got us across, then took us home. On the way, he has to check out a group of orphans from a Haitian orpahnage who were being shepherded by a mission group who was now trying to go across the border without the right papers. It turns out, they need some medical care, and are not allowedto cross the border, so they will be coming to see us tomorrow.
Yesterday, I also see a 12 month old whose belly had swollen up at home and has been vomiting everything he eats. When I see him, his belly wasn't swollen, but he looks pretty punky, so I admit him to our mini-hopital for some IV fluids. He does pretty well overnight, and we were going to discharge him, then his belly blows up again, he is very lethargic. He develops a mass on the right side of his abdomen and passes a bloody stool. For those of you playing along at home, the answer is a condition called intussuseption, a condition where the small intestine telescopes into the large intestine. To fix it, you need radiology, and if that section of intestine starts to die, you need a surgeon.
So we get to go home, but the border had closed, and the DR border guards were having none of it. Fortunately in our travels, we had met Jose Quinones, a special attache to the US Embassy from the Coast Guard who had all kinds of juice with those border guys, and he got us across, then took us home. On the way, he has to check out a group of orphans from a Haitian orpahnage who were being shepherded by a mission group who was now trying to go across the border without the right papers. It turns out, they need some medical care, and are not allowedto cross the border, so they will be coming to see us tomorrow.
Thursday, January 28, 2010
Wednesday 1/28/10 Haitian Christian Mission
One thing I forgot to say yesterday is that the rest of the team, the ones that stayed home, saw 300 patients. Today everyone stayed. Word has gotten around about our presence here. This morning, the first patients started arriving at about 2 am. By 6 am, the porch was full. At 8 am, when we started, we had to open up the church next door as a triage area because there were 300 people there already. The day was crazy busy. We did not have enough translators, so most of the day I worked without one. Guesly worked in the same room as me, so I had him when I got stuck, but my Creole has improved to the point that I can get through most visits alone. Just imagine your doctor with a 3 year old's vocabulary, and you begin to understand what a challenge it is for them to go through, seeing me. There is an awful lot of pneumonia and asthma like illness in the patients who are coming from Port-au-Prince. it's probably due to all the dust from the Earthquake, speaking of which,I felt my first real deal earthquake today' People around here are very jumpy about the aftershocks. It was a 4.1, enough to shake a little, but no damage. With all the medicine that was donated by the hospitals or bought from money donated to us, we are definitely able to handle sicker patients, and do a better job than the last time I was here. 9 hours and 522 patients later, we were finished.
Well,most of us were finished. we are developing a census of inpatients that need tending overnight, so our nurses are rotating shifts to care for them 24 hours a day. The nurses working nights are still up and working the next day after maybe a couple hours of rest.
Well,most of us were finished. we are developing a census of inpatients that need tending overnight, so our nurses are rotating shifts to care for them 24 hours a day. The nurses working nights are still up and working the next day after maybe a couple hours of rest.
Wednesday, January 27, 2010
Jimani, dominican Rebublic, Tuesday, 1/26/10
View Larger Map
This hospital started as a medical mission clinic/OR, not as a hospital. It had apparently seen little use untilthe earthquake hit and it was cimmissioned as a hospital. The old orphanage, the building to the left in the map, serves as the less critical area as well as ER/triage. The building to the right (marked with A) is where the OR's and ICU is. In the first several days of opening, hundreds of operations were done. Today, I got to see it when it has calmed down a bit. The first thing that struck me was the number of amputations. It is one thing to hear of amputations being done, and another to goto the children's rooms and see them laid out for me 3 at a time.
My first patient was a 2 1/2 month old baby girl named Noreus. She was found ubder the rubble of a seven story building in Port-au-Princem shieded by the body of her mother and several other adults.
Her aunt had taken her to several Aid stations over the days and all had not been able to see her. Noreus was only taking water, about 4 ozz. per day for several days. When she got to Jimani, she was glazed over, dehysrated, and feverish. She would not wake up or eat. She also had a bad lacerationon her thigh and a very large, infected pressure sore on her right buttock.
*****WARNING*****
Below is a graphic,disturbing image of her injury
This morning she is alert and happy. Her thigh wound is closed. Her buttock wound is open, with dressings applied. The wound is very deep. Her right leg will not move on it's own. She has no reflexes in that leg.
This hospital at the edge of the Dominican republic has alot to teach us about this disaster. First, that effort to save lives, even in difficult situations, can be effective. The people running and staffing the hopital at Jimani have been managng an extremely chaotic situation and still attending to the needs of many people, way more than the original purpose of the building. On the other hand, I can also see some of the waste that goes into this kind of relief effort. The side of the building of the hospital was overflowing with supplies. Boxes were stacked so high that the bottom rows were getting crushed. No one there knows exactly what they have out there. There is a central problem with medical aid efforts like this. Who comes to help? For better or worse, it's the "Rock Stars" of medicine, the lightning rods for attention--the doctors and nurses. Doctors, tend to think of themselves as a self -contained show. We don't see that our efforts depend on someone to organize our stuff, to keep the instruments sterile, to make sense of all the medications. We recognize that we need nurses, of course. They are our hands and legs, but we underestimate the need for them, too. Seeing how things are here convinces me that I should have brought with me 2 nurses, a pharmacist, someone from central supply, someone from housekeeping,and a physical therapist.
Which brings me to something else I figured out, seeing all the amputees, I realized that this will be an amputee generation in Haiti, and disability will be common. The time to intervene will be in the next few weeks to months. The next wave of aid workers needs to be Physical Therapists, Occupational Therapists, and Prosthetists. These people are hoing to stop dying of their injuries and start trying to live with their disabilities. The news crews are going to go soon, but the need will not dry up.
Tuesday, January 26, 2010
Landed
On the ground in Miami. There is so much to process from this trip. I'll add pictures to previous blogs and add some details tomorrow.
Thankful
I just took a shower. Here at the Mission we have no hot water. The hot water side of the taps are not even hooked up.
I am no fan of cold water, except for drinking. I won't go swimming in a pool that is less than 85 degrees. I don't take sold showers. But I took one this morning. As I was feeling, not really sorry for myself, but somewhere along the lines of not happy, I thought of all the people, thousands of people just miles away who also didn't have hot water. Nor did they have running water. Nor did they have clean water, even to drink. For days, months, years, a aifetime, maybe. So now as I'm sitting here, dry, in fresh clothes. I am comfortable. I smell good. I realize that even here, I have it cush. I will eat today. I will drink clean, safe water. I am protected. So while, when I get home, I am not going to start taking cold showers, nor will I be swimming in 80 degree water, I can maybe be thankful for what I have.
All right, gotta go, I have an 8:00 tee time. And, can you believe it, no golf carts. At least we have caddys.
I am no fan of cold water, except for drinking. I won't go swimming in a pool that is less than 85 degrees. I don't take sold showers. But I took one this morning. As I was feeling, not really sorry for myself, but somewhere along the lines of not happy, I thought of all the people, thousands of people just miles away who also didn't have hot water. Nor did they have running water. Nor did they have clean water, even to drink. For days, months, years, a aifetime, maybe. So now as I'm sitting here, dry, in fresh clothes. I am comfortable. I smell good. I realize that even here, I have it cush. I will eat today. I will drink clean, safe water. I am protected. So while, when I get home, I am not going to start taking cold showers, nor will I be swimming in 80 degree water, I can maybe be thankful for what I have.
All right, gotta go, I have an 8:00 tee time. And, can you believe it, no golf carts. At least we have caddys.
Monday, January 25, 2010
First Day in Haiti--The Border is Wide open
For everyone worried about our safety, here in Fonds, things are about the same as they were a few months ago, very calm. No soccer today, maybe tomorrow.
2:14 am Sunday--Santo Domingo
We are packed up and waiting for the bus to drive up to Fond-Parisien. We just had Hot showers, the last in a while. Customs was a breeze in L'aeropeurto. We found out, as expected, that in Santo Domingo everything is more expensive than usual, everyone is trying to chisel their piece out of the massive increase in traffic. The price is never the price, and the price is cheaper si se habla espanol. Anyway, off through the mountains. The first group made it through the Haitian border and customs and is in Fond, organizing what they have so far. Our group has a massive amount of stuff.
Sunday, January 24, 2010
Welcome to Miami
We are safely I'm Miami. Most of the other group that's ahead of us in Santo Domingo has left for Fond. Guesly is staying back to wait for us. We will be stating the night in Santo Domingo since we found out the border closes at 6 pm. Well, part of the night. We'll get up at 2 and drive for the border to be in Fond tomorrow.
On the way
Driving to the airport now. Guesly's flight has just left Miami. We will catch up with him tomorrow, I mean later today.
Saturday, January 23, 2010
Packing
We have way more stuff here than we have space to take it. I would gladly pay $200 extra for the airline to allow me to take everything.
Where we are Going
We are going to the Haitian Christian Mission in Fond Parisien. The map from google maps:
View Larger Map
The pointer is on the main building which houses the clinic in the lower level and living quarters in the upper. The large building to the left is the Church. Behind those two buildings, you can see the school buildings separated by a concrete courtyard. The building off to the right is the new OB/Gyn clinic/hospital/OR.
View Larger Map
The pointer is on the main building which houses the clinic in the lower level and living quarters in the upper. The large building to the left is the Church. Behind those two buildings, you can see the school buildings separated by a concrete courtyard. The building off to the right is the new OB/Gyn clinic/hospital/OR.
Friday, January 22, 2010
Trip Information
1. It is important that the group has a master list of all the medical supplies and medications. That way when you get to the Dominican Republic you will know what else you want to purchase there. I learned from a missionary there that it is very easy to buy medical supplies in the Dominican Republic. Many stores even take credit cards or you can get pesos from an ATM. (Let me tell you, it is not like that in Haiti. J) Narcotics are the only things you need a prescription for. So please send a list of all the medical supplies and medications you are bringing to Eva at evamaria14@yahoo.com. She will be compiling the list. You cannot take expired medications.
2. In case you have not already checked into this it is recommended that you get the following vaccinations before travelling to Haiti: Typhoid, Hepatitis A, and Tetanus. You should begin taking a malaria prophylaxis right away.
3. Please send me, through this e-mail, emergency contact information. Give me someone’s name, phone number(s) and e-mail address. The Oregon group is bringing two satellite phones and there is a computer with internet at the mission compound, but I’d let your families know communication back and forth still may be limited. Feel free to give my e-mail address and cell phone number ( 503-302-1822 503-302-1822) to family members.
4. Groups normally give HCM $30 a day per person to cover food, transportation and translator costs so upon arriving in Fonds-Parisien, you all will give the directors $250/person totaling $4000. Additional money will be needed to cover ground transportation costs and purchases in the Dominican Republic. This doesn’t need to come out of your own pocket. Bring whatever donations you have received.
5. Each passenger can bring two checked bags up to 62 inches (length+width+height) weighing no more than 50 lbs, and one carry-on up to 45 inches (length+width+height) weighing up to 40 lbs. You can also bring a personal item, ie. backpack. Often teams use military style duffle bags as their checked luggage because they are light, flexible and can be brought back more easily.
6. Here is a suggested packing list:
· Clothes for 10 days-- humid weather in upper 80's. Scrubs or long pants for working. Shorts are acceptable for men when not working. Usually the mission asks that women wear skirts when not wearing scrubs, but I’d say this is a special circumstance being so last minute. Knee length and sleeveless shirts are fine.
· Tennis shoes for walking
· Flip flops--if preferred when not walking far
· Toiletries--keep in mind carry-on fluid restrictions (2 oz. or less, pass through security in it's own ziploc)
· Towel
· 2 rolls toilet paper
· Bug spray
· 1 roll paper towels
· 2 boxes 1-gallon ziploc bags
· 3 boxes sandwich ziploc bags
· Wet wipes
· Hand sanitizer
· Stethescope, otoscope, and other medical equipment (Don’t assume anything you need will be there.)
· Sunglasses
· Hat
· Sunscreen
· Reusable water bottle
· Protein bars/other ready to eat food (can be purchased in the DR also)
· Consider mosquito net
· Malaria prophylaxis
· Pepto-bismal tablets (plan on 2 BID for traveler's diarrhea prophylaxis)
· Passport
· 4 photocopies of passport--1 for each bag, 1 for team leader.
· A set of clothes for church, nothing fancy, a nice shirt will do
7. Here is the list of the group members:
1. Guesly Dessieux, Family practice dessieuxg@yahoo.com
2. Doug Boudreau, Pediatrician boudreau@mail.crmc.org
3. Paul Neumann, Family practice doctor.neumann@gmail.com
4. Dean Yeager, Family practice Tami@meritel.net
5. Charles A. Woodridge, Pediatrician quas68@yahoo.com
6. Lori Borella, Anesthesiologist Lborella@santiamhospital.com
7. Sabine Dessieux, FNP sabine1079@hotmail.com
8. Adam Maurer, Paramedic Amaurer@santiamhospital.com
9. Juanita Culver , RN Jculver@santiamhospital.com
10. Genny Baldwin, RN Gbaldwin@santiamhospital.com
11. Debbie Turrell , RN dturrell@santiamhospital.com
12. Clark Yoder, RN, operating room Cyoder@santiamhospital.com
13. Eva Brogan, RN, operating room evamarie14@yahoo.com
14. Amanda Gutwein, RN algutwein@liberty.edu
15. Amy Hilt, RN AHilt001@yahoo.com
16. Debbie Sands, LPN, Pediatric nurse—Jefferson City docsands@embarqmail.com
17. Mary Deeken, MD, Pediatrician--Jefferson City, MO deekeneven@aol.com
2. In case you have not already checked into this it is recommended that you get the following vaccinations before travelling to Haiti: Typhoid, Hepatitis A, and Tetanus. You should begin taking a malaria prophylaxis right away.
3. Please send me, through this e-mail, emergency contact information. Give me someone’s name, phone number(s) and e-mail address. The Oregon group is bringing two satellite phones and there is a computer with internet at the mission compound, but I’d let your families know communication back and forth still may be limited. Feel free to give my e-mail address and cell phone number ( 503-302-1822 503-302-1822) to family members.
4. Groups normally give HCM $30 a day per person to cover food, transportation and translator costs so upon arriving in Fonds-Parisien, you all will give the directors $250/person totaling $4000. Additional money will be needed to cover ground transportation costs and purchases in the Dominican Republic. This doesn’t need to come out of your own pocket. Bring whatever donations you have received.
5. Each passenger can bring two checked bags up to 62 inches (length+width+height) weighing no more than 50 lbs, and one carry-on up to 45 inches (length+width+height) weighing up to 40 lbs. You can also bring a personal item, ie. backpack. Often teams use military style duffle bags as their checked luggage because they are light, flexible and can be brought back more easily.
6. Here is a suggested packing list:
· Clothes for 10 days-- humid weather in upper 80's. Scrubs or long pants for working. Shorts are acceptable for men when not working. Usually the mission asks that women wear skirts when not wearing scrubs, but I’d say this is a special circumstance being so last minute. Knee length and sleeveless shirts are fine.
· Tennis shoes for walking
· Flip flops--if preferred when not walking far
· Toiletries--keep in mind carry-on fluid restrictions (2 oz. or less, pass through security in it's own ziploc)
· Towel
· 2 rolls toilet paper
· Bug spray
· 1 roll paper towels
· 2 boxes 1-gallon ziploc bags
· 3 boxes sandwich ziploc bags
· Wet wipes
· Hand sanitizer
· Stethescope, otoscope, and other medical equipment (Don’t assume anything you need will be there.)
· Sunglasses
· Hat
· Sunscreen
· Reusable water bottle
· Protein bars/other ready to eat food (can be purchased in the DR also)
· Consider mosquito net
· Malaria prophylaxis
· Pepto-bismal tablets (plan on 2 BID for traveler's diarrhea prophylaxis)
· Passport
· 4 photocopies of passport--1 for each bag, 1 for team leader.
· A set of clothes for church, nothing fancy, a nice shirt will do
7. Here is the list of the group members:
1. Guesly Dessieux, Family practice dessieuxg@yahoo.com
2. Doug Boudreau, Pediatrician boudreau@mail.crmc.org
3. Paul Neumann, Family practice doctor.neumann@gmail.com
4. Dean Yeager, Family practice Tami@meritel.net
5. Charles A. Woodridge, Pediatrician quas68@yahoo.com
6. Lori Borella, Anesthesiologist Lborella@santiamhospital.com
7. Sabine Dessieux, FNP sabine1079@hotmail.com
8. Adam Maurer, Paramedic Amaurer@santiamhospital.com
9. Juanita Culver , RN Jculver@santiamhospital.com
10. Genny Baldwin, RN Gbaldwin@santiamhospital.com
11. Debbie Turrell , RN dturrell@santiamhospital.com
12. Clark Yoder, RN, operating room Cyoder@santiamhospital.com
13. Eva Brogan, RN, operating room evamarie14@yahoo.com
14. Amanda Gutwein, RN algutwein@liberty.edu
15. Amy Hilt, RN AHilt001@yahoo.com
16. Debbie Sands, LPN, Pediatric nurse—Jefferson City docsands@embarqmail.com
17. Mary Deeken, MD, Pediatrician--Jefferson City, MO deekeneven@aol.com
Friday, January 15, 2010
Welcome to the Haiti Medical Mission Trip Blog
Hi all, I created this Blog to help keep you informed of the latest plans for the Mission Trip, which is still a long way from being realized. You are welcome to post your own comments and questions, as well. Thanks for all your help and support with this mission.
Doug Boudreau
Doug Boudreau
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