Voices from the clinic

Following the work of the Friends of the Children of Haiti

 

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This grassroots organization changes — and saves — lives in a place of staggering need, bringing critical medical care and hope for a healthy future.

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September 2011

 

What makes the weariness worthwhile

Team_in_jacmel_airport

The September team paused in the new Jacmel, Haiti, airport for a team photo before heading back home.

If we look a bit weary compared to the photo taken at the Miami airport before boarding the plane to Haiti, it could have something to do with the hard work this team put out.

We saw 2,214 patients during the 8 days of clinic - sometimes in 100-degree heat.

That means that 2,214 Haitian people are more healthy, more comfortable, and perhaps even more hopeful tonight.
 
That makes it all worthwhile.
 
--Kathy Neil & Sharon Hoy

Comment (1)
Posted by Leigh 
 

In Haiti, surgery is a gift

Surgery. In the United States it's a basic concept. If you need surgery, you get it.
 
In Haiti, surgery is a gift.
 
Many need it, but few can afford it. Because of FOTCOH, many Haitians who cannot afford surgery, have been able to receive it.
 
I went to the the outpatient surgery center in Jacmel with our Dr. Garron Lukas to see how surgeries are conducted in Haiti. Dr. Lukas is a dedicated FOTCOH volunteer, who has completed 32 surgeries in the 2 weeks we have been in Haiti. He has participated in many FOTCOH clinics.
 
I was a little taken aback when I saw the conditions of the operating room in Jacmel. As I stood in the operating room for the first time, the lights went out for a few seconds. I was told that this was something I should expect.
 
There were no surgical technicians to assist during surgery as we have in the US.  Patients have no type of monitoring of their vital signs once they have received anesthesia.  It all seemed very primitive to me. 
 
However, every surgery I witnessed went as planned, without complications. Breast tumor biopsies/removals, hernia repairs, and gallbladder removals are just a few of the surgeries that patients in Haiti are able to undergo thanks to the efforts of FOTCOH and Dr. Lukas.
 
Following the 3 cases we had for the day, we went to St. Michele Hospital. This is the only hospital in Jacmel. I couldn't believe my eyes. Patients are not seen unless they have the money up front. If they don't have enough money (which is a large number of patients), they are kicked out and told to come back when they have enough money, regardless of the urgency of the situation. 
 
Furthermore, the families of patients are expected to take care of their loved one while they are in the hospital. This includes food, water, and just general care. Nurses will stop by every so often to check vital signs. 
 
The hospital is one floor, and has a couple different buildings stacked next to each other for each specialty, such as pediatrics and internal medicine. In each room, there are 2 rows of beds lining the walls with patients and their families sharing one bed.
 
It was very hot, and there was no air-conditioning. I didn't even see a bathroom during my brief tour. I couldn't believe that this was the place people come to when they are sick.
 
It made me realize how important the FOTCOH clinic is to these people to help them afford healthcare.
 
--Michelle Zubair, University of Illinois College of Medicine

Comments (2)
Posted by Leigh 
 

What a difference Medika Mamba makes!

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A highlight of the trip to Haiti with FOTCOH this year was seeing our sponsored child, Mise Guerline, looking healthy and strong.

Last September she was identified as severely malnourished and put on the Medika Mamba (Creole for medicine peanutbutter) program to help her gain weight and regain her health.

The Medika Mamba program began with FOTCOH 2 years ago in response to the large number of malnourished children coming to the clinic.

A high-protein peanut base is combined with vitamins to make a food supplement for the
children. Usually a difference is seen in 9 weeks, but occasionally the children are continued for an additional 9 weeks. It costs FOTCOH $80 for a 9-week series to provide this supplement.

What a difference Medika Mamba has made in the life of Mise Guerline and many other Haitian children!!!

Today Mise Guerline is a healthy almost 4-year-old who will begin school in October!
Thank you, FOTCOH!

--Dr. Bill and Kathy Neil

Comments (0)
Posted by Leigh 
 

Managing medication for 2,000+ patients

 750,000 pills go out to 2,000+ patients during the two-week clinic.

Keeping all of this straight are the Pharmacy workers, including pharmacists, a nurse who works in pharmacy as a technician, Haitian interpreters who explain the medication to the patients and Haitian pill counters. 

That is just the official list of the Pharmacy team. In addition to this, almost all of the other volunteers from the USA help with pill counting and medication dispensing some time during the two weeks.

Glamorous, it is not. No lives being saved from the brink, no life-threatening tumors being removed, etc. Just getting the right medication to the right patient with the best possible instruction for safely taking it.
This is a bit more complicated than it may seem. You see, our patients only come to see us every two months. For those under continuous care for their hypertension, diabetes or epilepsy, the Pharmacy must set them up with a 70-day supply of pills.  For some patients, this can mean taking home nearly 1,000 pills! 

Everyone who comes to our clinic is given an age-appropriate vitamin. Mothers come to the clinic and receive vitamins for themselves, their children and their unborn children. The women who are, or might become pregnant are given extra folic acid to reduce the chance of birth defects. We give a different kind of multivitamin to patients during three different age periods in their lives.
Keeping this all working takes planning long before we come down to Haiti, to make sure that we have enough of each vitamin.
 Medication is the point of the spear for FOTCOH’s mission in Haiti. It allows our doctors and nurses to treat and prevent conditions in a village in Haiti about the size of Marilla, NY, or Goodfield, IL.

We address conditions that would not even occur in the USA because of a healthcare system that all of us take for granted. Yesterday we saw a teenager with mildly crippling Rickett’s disease of the bones. When she was an infant, her mother did not have access to prenatal care, vitamins and good nutrition. The result is an otherwise healthy and pretty girl crippled for the rest of her life.     

Our ability to provide this volume and quantity of high quality medication is due to your support of FOTCOH. The pride we take in what we do could not be real without your donations. Though you cannot be here physically, your are here in spirit as we carry out our mission. 

There are many churches (as well as other organizations) that support the mission of FOTCOH. I want to acknowledge my home church, Annunciation Church of Elma, NY, whose generous support has enabled us to provide 250 courses of infant vitamins, thus giving 250 babies a better chance at a healthy future.                   

This year, thanks to an educational grant to FOTCOH, we have begun a new phase of Pharmacy practice at our rural clinic. Through the efforts of Eric Behrens, an outstanding, professional DVD was produced to address medication compliance.
As is typical for FOTCOH efforts, joy and love went into the filming, audio-recording and production of this message. We jury-rigged a daytime movie theater on the back porch of the clinic, complete with projector and Bose surround-sound speakers.  (Only the best for our patients!) We now show this 5-minute video to our patients during their visit to the clinic. 
Plans for the future include purchasing a wide-screen monitor for better viewing and production of at least two more 5-minute messages to educate patients on the proper use of asthma inhalers and dietary and lifestyle modifications for the diabetic patient.
--Mark Ludwig

 

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Comment (1)
Posted by Leigh 
 

Beauty is in the eye of the beholder

As a first-timer here at the FOTCOH clinic, I thought I knew a bit of what to expect, since I’d seen many pictures and heard many stories about FOTCOH from friends who had participated in the previous trips.

 

When we arrived on Monday I was impressed with the beauty of the surroundings, especially as seen from the third floor balcony:  lush greenery and trees, mountains nearby and others in the distance, ocean waves breaking on the rocky shore and a beautiful moon reflecting off the water.

 

As the clinic opened, it wasn’t a surprise for me to see the many people waiting on several sets of benches on the premises.  However when I ventured out beyond the clinic gate, I was overwhelmed to see so many more people waiting to be chosen to receive some medical help.  Many had been there since before the clinic opened and had no guarantee that they would be selected.  It was hard to accept that amongst all the beauty of this area, there was so much pain and suffering.  It was impossible to hold back my tears.

 

But there was more to be seen.  The patients were warmly greeted by the various volunteers throughout the clinic process;  children were coaxed into smiles and even laughter as their vital signs were measured; patients encountered compassionate nurses and doctors as they shared their health concerns; young mothers received help so they could successfully breast feed their tiny babies; people experienced relief by working with a physical therapist or having a decayed tooth removed; minor surgical procedures were performed on the spot and others were able to have surgery offsite; patients left the clinic with vitamins and any other medication that was necessary and available.  Some were even delighted to leave with new shoes.  And all left with the satisfaction of knowing that the clinic would be in operation again in two more months.

 

So yes, the pain and suffering continue to exist in close proximity to the beautiful Haitian setting.  But if you look closer you’ll see another kind of beauty:  On a daily basis, about 250 – 300 people have experienced compassion, healing and hope from the FOTCOH clinic and its volunteers.  It’s been an eye-opening experience and a blessing to be a support person for this mission and to witness beauty at its best.

 

--J.F. (non-medical volunteer)

Comment (1)
Posted by Leigh 
 

Small gift, big impact

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Day 4 in Haiti. Today felt like the hottest day since we have been here.  I was working at the front in charge of handing out patients their dossiers (medical records). The sweat was dripping down my face. Even standing in the shade didn't help.  

Each patient waiting for me to hand them their dossier greeted me with a friendly smile. They appreciated my efforts to talk to them in Creole. I greeted each patient with "Komon ou ye? (How are you?)." Regardless of how sick they were, almost everyone replied with "Pa pi mal (not too bad)."

Then I saw this woman. She was covered in sweat. I could tell that this woman had a harder journey than most.  She looked exhausted, but relieved that she had made it to the clinic. She was carrying a little boy who was also dripping sweat and looked miserable.

I looked at her dossier and saw that they were from Cap Rouge. Cap Rouge is a little village that you cannot travel to via motor vehicle. This lady had to travel across a mountain by foot, and once she got to the bottom, she could take the tap-tap. The tap-tap is a truck that runs as a local shuttle service. It picks up passengers who then tap the truck when they want to get off.

I wanted to do something for this lady. When I looked down at her feet, I realized I could. I saw that
her shoes were worn out. I couldn't believe that she had made the journey by foot with the shoes that she was wearing. 

This lady needed a new pair of shoes. That was the least we could do to make her journey back to Cap Rouge a little easier, so I made it my mission to make sure she got a new pair of shoes today.

I came back to talk to her later in the day, and she was so grateful for her new shoes. It was such a rewarding feeling to see her smile and to see that I had taken a part in making her life just a little bit easier.

At that moment, I forgot about the sweltering heat and the pesky bugs around us. And it was also at that moment that I was reminded of how big of an impact FOTCOH has on the lives of so many people that desperately need help.

-- Michelle Zubair

Comments (6)
Posted by Leigh 
 

Day 3: More challenges

It was our third clinic day and I started out in the lab/wound-care room in a whirlwind with 2 nebulizer treatments, and then this middle-aged man with diabetes and both lower legs covered in scaly loose skin from his very poor circulation.

We were able to soak them and pretty thoroughly clean up the skin, applied an antiseptic cream and give him enough supplies to take care of them a bit on his own.

It is difficult to find a comfortable way to think about seeing so very many with desperate problems and obstacles and the individual cases that you think you are helping.

There was an elderly woman brought in by wheelbarrow "ambulance" who had collapsed outside the compound and was completely unresponsive. They tried 2 nebulizer treatments and she woke up and was able to leave the clinic under her own power -- that may well have not been the case if she hadn't gotten treatment.

I've been able to provide a back manipulation and some therapeutic massage that has seemed to help;  to give someone a crutch who had only a stick for support.

It has to counter things like the 3 women that came in with large breast tumors from cancer in as many days for whom we have no help other than some pain medication.

One picture I'm including is of a young woman with the little guy in tow trying to support herself on only a stick with a severe limp. She had a badly sprained her ankle (maybe fractured?).

We applied some ice that I confiscated from our drink supply, tried a little gentle exercise, gave her an ankle support and a new pair of shoes (which you can see in the picture).

I almost forgot to give her a child's-size crutch that she could use like a cane. She reported her ankle didn't feel much better and I sympathized, but she was grateful for the little crutch.

Another picture is of the doctors' area where they see patients. Yes, it's all out there on a patio, but believe me, the light, the shade makes it a much more pleasant than an airless, dim room in this balmy climate.

I'm starting my list of things I want to bring if/when (??!!??) I come back.

--Bill Granger, M.D.

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Comments (2)
Posted by Leigh 
 

Some of our patients

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Comment (1)
Posted by Leigh 
 

And yet, resilience remains

Day 2 of Clinic was a success. About 270 patients were seen, but many more remain to be seen.
 
Today I had the pleasure of learning more about life in Haiti from one of translators named Tanis.
 
Tanis is a very bright and pleasant 28-year-old man with big dreams. He is currently attending college to work in the field of computer programing. He is also the secretary of a local Haitian organization that deals with education, agriculture and health issues.
 
He is a very big fan of Gospel music and a devoted Christian. He enjoys playing football (aka soccer) and basketball. He has aspirations to travel the world, but loves his country.
 
As we sat in the shade waiting for patients, he helped me learn phrases in Creole and I helped him with pronunciations of English words in his Creole-to-English dictionary.
 
As we continued to converse, he told me how life in Haiti has changed drastically since the earthquake: "January 12...I'll never forget that day. It is the most important day in Haiti's history."
 
He recounts exactly where he was and what he was doing. He looks at me solemnly and tells me how he is blessed that he and his family were unharmed, but he lost many friends in that tragedy. He has even more friends who lost everything they owned that day.
 
He told me that Haiti has a long way to go to get back on its feet. But that Haitians are a resilient people who will not let this tragedy break them.
 
They continue to have hope and live life with a positive outlook, although their surrounding circumstances are anything but that.
 
--M.Z.   

Comments (0)
Posted by Leigh 
 

Hope for many, heartbreak for some

320. That's the number of patients seen at the clinic today. 
 
It was a tough day.
 
Probably one of the most heartbreaking stories was that of an 18-year-old girl who was recovering from severe burn injuries to both of her arms from a fire in February. The girl came today because as her skin has been healing, it has formed contractures (thickening and tightening of the burn scars).
 
These have severely limited the mobility of her arms to the point that she can not fully extend either arm. The farthest her arms will extend is about 60 degrees. She was hoping to have surgery to help.
 
However, due to the limited resources, doing this procedure in Haiti creates a high likelihood of complications and the risks outweigh the benefits. As the translator explained this to her, her eyes swelled with tears that she quickly wiped away. I cannot imagine what this must be like for her.
 
I felt crushed by the news, so I cannot begin to understand how she must have felt.
 
Although there are hundreds of patients that we help every day, it is every bit as heartbreaking when we see those patients that we cannot help; for whom we cannot provide the cure or answer they were hoping to find.

--Michelle Zubair

 
 

Comments (3)
Posted by Leigh