October 25th to 28th

After going through a number UN quarantine checkpoints we finally arrived at our base around 6pm. The base was at a beach house, which was owned by a member of one of the other NGO’s there and was in a town just outside of Saint Marc called Mont-Rouis. Upon arrival we were briefed on the de-contamination procedures and updated on the current situation at St. Nicolas hospital -it was made pretty clear that no one actually knew how many people had been affected by cholera or how well it had been controlled.

Our team was assigned the night shift and initially, they said they had no need for non-medical volunteers at the hospital (and that I would mainly be helping to decontaminate the vehicles and deliver medical supplies to the other hospitals) but I managed to weasel my way in using my kreole skills…

As soon as the door of the bus opened up the strong smell of bleach filled the air. To get into the hospital we had to walk over foam pads that had been soaked in bleach. Each ward of the hospital was in its own stand-alone building; most of them also had terraces both in front and behind. The majority of St Nicolas was dedicated to treating Cholera patients but the maternity ward and surgical ward were still open but separate from where the cholera patients were staying. 

It turned out that there was a lot for me to do there. There were over 250 patients my first night all of which either needed constant monitoring of IV’s or top ups on their oral re-hydration serum. I ended up spending most of my time there translating for the nurses and teaching the families of the patients and Haitian nurses about what we knew about Cholera and how to prevent it from spreading. (Kenley and I had quite a heartfelt conversation after my 1^st night in the hospital when I told him how his teaching me Kreyol had helped so many other people.)

Many of the patients had “cholera beds”, which were actually just army cots that had a hole cut out from the middle of the bed and a bucket underneath. The families of the patients do most of the personal care in the hospitals here, that includes bringing their own sheets and enough food for the duration of their stay as well as bathing and disposing of any bodily fluids. Cholera can kill a healthy person within 5 hours and is often not caught soon enough, so because of how serious the illness is and the fact that many of the people who were affected were from rural areas most of the families were unable to buy food by the 2^nd day.

For the patients that didn’t have any family of families with multiple members who were sick the quality of care was much less.  Myself and 2 of the other non medical volunteers took it upon ourselves to give those patients some extra attention and went around making sure everyone else also had enough blankets to cover themselves. I began giving many of the ones in critical condition hand and foot massages to help ease some of the pain and helped to bathe them to give the families a break.

One of the men I was tending to was all smiles and when asked how he was feeling he would always reply that he was doing well. It was apparent that he had other medical issue but it wasn’t until I was bathing him that I noticed his high temperature. It turned out that he had malaria as well as cholera. After he started his treatment for that his recovery became obvious and he was up and about and walking out by the third day.

On the way back from the hospital I would talk to David who was one of the other translators for the nurses, he told me about his view on healthcare and how to better understand the way the Haitian nurses approached the situation.

Over all it was incredibly challenging for me to be at the hospital. I struggled with the callous manor of the visiting nurses and the lack of dignity the patients were given. It was heart wrenching to see how arrogant the visiting nurses were towards the Haitian nurses.

 

One lady came in on my second night there that was in critical condition, the nurse was convinced that she wouldn’t make it through the night but by squeezing her iv bags and giving her antibiotics she managed to pull through. When she came in she looked so thin and lifeless but as she became hydrated her face and body completely changed shape and by the 3^rd day she looked beautiful and was once again able to drink on her own.

The difficulty with having visiting nurses is in the maintenance of the standard of care. By the 2^nd day the hospital had the set up a renal ward to help manage the patients who were having kidney problems due to an excess of water –meaning that some patients were given too much and nothing was documented or monitored so it went un noticed until they were showing signs of renal failure.

My last night in the hospital there were much fewer patients and many of the newly admitted were actually the family of the patients we had seen earlier in the week. After a long swim an a sleep I woke up around 6 to be picked up by David (on a motorcycle) to go to the market. It was nice to finally have that freedom from fear that was so much a part of the compound life and illuminated a whole other side to the Haitian culture. One of the local churches had music playing while a man spoke into a megaphone, he was talking about how to prevent cholera and explaining the symptoms. After the market we went for dinner and listened to Davids friend’s band play kompa music.

The outbreak had been down graded and many of the medicall teams were leaving so there was no need for Terry Charlie and I (2 other the other non medicals). We decided that we would spend Friday catching up on sleep (we all averaged about 3 hours a day that week) and to make tracks for PAP on Saturday.

October 19th to 25th

So, there's been a bit of a change of plans here. I ran into a few problems last week with some of the work I'd been doing at the orphanage and have now relocated to Port Au Prince.

My best explanation is that among other things,  I'd been asking too many questions about the compounds involvement and I was working with a UN organisation (UNICEF) which made a few people at the top very uncomfortable. Needless to say the director gave me an ultimatum...


To put it simply, he wanted me to break off the relationship I had developed with Madame Lucien, put an end to my contact with UNICEF and limit my activities at the compound which would only allow me to go to the guesthouse and clinic (meaning I would no longer be able to see Kenley or even go down to the orphanage on site).

I'll write more on that later, but after careful consideration I opted to leave the compound...

On the way to PAP

I arrived yesterday at Grassroots United which is a Burners Without Borders project in Port Au Prince. They've got a really sustainable approach to aid work which includes distributing medical supplies, sustainable buildings & power (they've got an Earthship here! ) and a tool sharing program.  The base itself is powered sustainably, has compost toilets and reuses everything including grey water :) Early last week they had put a call out for any medical people in the area to come help with the Cholera outbreak so today I'll be going to St. Marc to help out here for my last week in Haiti.

My new home

It was pretty tough leaving everyone behind at the compound but they were all so understanding and helpful. One of my friends came in to PAP to drop me off  to make sure it was safe and to see where to pick me up next weekend as a few of them are planning on coming in to take me to a local beach.

When I arrived, I got stuck in and made friends with the security guards using my, now fairly intelligible, Kreyol.  After we made dinner I was all set for my bucket shower but when the rain kicked in I settled for an open shower in my bathing suit instead :) and not long after that I retired to my tent to fall asleep to the sound of our chickens and the generators next door.

Earthship

This morning, we had a meeting about all the projects they have on the go right now and the action plan for the outbreak in case it comes closer (which includes sending teams out to the tent cities to educate people on preventing spread and digging emergency latrines). It was incredible to see how organised and efficient they are and how much they're able to get done with such a small team!  Quite a change from the compound where it seems to take months to get anything done and (possibly for that very reason) there seems to be a total lack of people who are keen to see it thorough to the end. 

At the moment, I'm not too sure what the set up will be in St Marc but if I can, I'll be sure to update you guys on the situation there as much as possible.

Bucket showers!

Being in Haiti has taught me so much about the drawbacks of idle donations -its so difficult to stand back and watch these huge NGO's pour money into luxury housing and beach excursions for the visiting groups.  If you're looking do donate and want to find a trustworthy organisation to donate to then its these guys. I can can vouch for them and their work &  I have no doubt that you can rest assured the money you give will be going where they really need it. (www.grassrootsunited.org)

Also, if any of you think you might be able to come help and can afford a week or two to come down then now is the time! They really need nurses & emt's for the outbreak but if you're committed and keen to help then there is plenty of need on the preventative education programs and other projects they have.

sending lots of love
xx

October 4th to 18th

Sorry for the delay in posting this!!

I spent the rest of Sunday hiking up the hills behind the mission- it was really nice to get out and to something active for a change!  The walk up was really beautiful and on our way we met a few people who lived in the hills either tending to livestock or to their crops. Thankfully my Creole good enough now to communicate and show a little confidence too … apparently its voodoo territory up there :)

First thing Monday morning Madame Lucien came into the prosthetics clinic holding Kelly (the boy I made the brace for). His breathing was very shallow and quick, his face was almost white and his body was limp. She casually told me he was sick and handed him to me with a smirk… I ran him up the hill to our emergency room where I was met by Eimear who got him hooked up to the monitor and started him on a nebulizer.

Kelly was on the verge of respiratory arrest when he came in and wasn’t stable until the afternoon but thankfully he came round and because we had a couple of really competent prosthetists in at the beginning of the week I was able to sit in as his mum for the day (as Madame Lucien had actually only come in for her diabetes tests and left immediately after that without saying a word).  It turns out Kelly had pneumonia which was thought to be because of an infection in his chest that had gone on too long -unfortunately that same morning a baby who was about 6 months old (but looked like a new born) came in with the same symptoms and didn’t make it.

Needless to say it was a tough day for all of us and when Kelly was able to leave the clinic I took him down to the lab where he slept until we finished work about 6. After that I quickly grabbed dinner at the guesthouse with Kelly, Andrew and Eimear then headed down to the patient tent for the night to stay with two of our prosthetic patients who were spending the next couple nights there. Petit-Frere and Rosemie are both 24 but were too scared to stay alone so we just hung out, they plated my hair and taught me a few words and in the morning we did some yoga together :)

The rest of the week didn’t go as well as we had hoped due to some problems with the new prosthetist who had been retired for over 10 years and was indifferent to the standard of care we were trying to uphold. We were scheduled to fit 4 new patients that week but all 4 left without their legs due to poor fit and other major concerns with socket alignment. I think all of us were relieved when he decided that he wouldn’t be staying the month, especially poor David as the prothetist had been force feeding him beef jerky all week (which David told me tasted like socks haha)

Things at the orphanage have been bitter sweet lately as Madame Lucien has expressed that she trusts Kenley and me so the mission has been encouraging us to go (which means we get vehicles easily) but it also puts us in a really fragile position; we had a bit of an issue last week when one of the young translators had asked a few of the children some questions about food and hygiene. Unfortunately, that got back to Madame Lucien and she was pretty upset about the whole thing.

Thankfully there are some really good things that have come out of all our work there.

Last week I went into Port Au Prince to meet with the director of the residential school for children with disabilities so that we could have Stanley (a boy from Good Sam who is deaf) transferred there. When we arrived they requested we do a test to see how much he could hear. The test was actually just them ringing a bell very loudly behind him and seeing if he responded in any way- not the standard way of doing it but effective none-the-less :) 

I’ve decided put my other projects on hold for the moment as most of them depend on other people and won’t be taking shape for sometime. Instead, I’ve been spending heaps of time teaching Kenley (the boy I’ve sponsored) about sustainability and how to start spreading it in his community, which I visited last week.

 

More to come soon…. 

How to talk with a monster

So sorry that its been a while since my last post!

I've been having Creole lessons almost every night now which has been great but by the time I get back up to the house at night the internet connection is terrible from the storms we've been having.

I'll hopefully have a big update posted by the weekend but for now here's a little lesson from David on how to talk with a monster...

September 26th to October 4th

It's been quite a busy week for me here, I've got just under a month to go so any spare time I have is spent either out of the compound doing work at the orphanage or on the computer trying to get support from different NGO's on my projects.

A Tap Tap

I've been working on getting a Prosthetics and Orthotics association started here in Haiti with the hopes that it might help to standardize patient care and encourage the clinics to pool their resources.  Hopefully this will also enable them to work more effectively (within their means) and help them to take a more holistic approach to patient care.


On Friday I took David and Nonu into PAP to see another Prosthetics & Orthotics Clinic to do a bit of networking as well as see the clinic's multidisciplinary approach to rehabilitation in action. The clinic is owned by Handicap International but after the earthquake destroyed the building that Healing Hand for Haiti was in they collaborated and have now expanded their care to have 3 full time physio therapists as well as a couple permanent Prosthtetic/Orthotic clinicians and technicians.

After a tour of their huge facility I sat down with one of the coordinators to talk about my idea. Much like us, his biggest concern was that small clinics (like ours) have been working far beyond our means and due to the short term 'vacationing' prosthetists and lack of follow up care there has been a lot of unnecessary suffering for the patients we've seen.  Thankfully, he's full support of creating an association in Haiti and is going to help in any way he can... after a vacation of course.



So far I've called on the head of the International Society for Prosthetics and Orthotics (ISPO) for support and have drafted up forms for all of the clinics to fill in so we can gain a better understanding of our individual efforts and use the information to help develop a general measure for the standard of care clinics should be providing. I think the biggest challenge will be convincing all the clinics to join as many of them have their own (business and religious) interests in mind rather than that of the patients.

Port Au Prince

Yesterday was the first day of the mobile clinic I've started for Good Sam orphanage :) it was a prime week to start as I had 2 doctors 3 nurses and 3 paramedics! We managed to give every child a vitamin shot and started up charts for everyone (including staff members) so that we can keep up to date records of them and track any chronic illness or neglect concerns. Some of the logistics are still be be discussed as the coordinator of the compound isn't keen on helping out with it but I think I've managed to get enough of the long term staff on board to make fortnightly or even weekly visits even after I'm gone. My only concern now is in providing long term acute care for the kids and educating the staff on how to identify serious illnesses before they've gone too far.


I've also been working away on my report for UNICEF and have since discovered that in 2008 there was a flood at Good Sam where at least 20 of the children were killed when the river that runs behind the orphanage knocked down the wall in the chapel and swept them down stream. For a few months after that  Madame Lucien and the remaining orphans were moved into a building here but after a few months she had had enough and moved them all back to the same place. Needless to say she's well known around here so I've been able to add a few more eye witness accounts to my report... there's still lots to be done though.

I retrieved Jhonny,who is a little boy from Good Sam, in the ambulance on Tuesday because of two severely infected ulcers on his face about the size of a quarter.

I've also learned that orphanages here are run more like businesses and because she owns it and started it herself its highly unlikely that we will have much luck getting it shut down (especially because she is known to have contacts with the Haitian government and has paid them off in the past to get out of trouble). As frustrating as that is I have no choice but to accept it and try to find ways we can work with her to get the result we want. After all its not about her, but about the kids :)  The best option, I think, is to take advantage of the fact that she has registered the orphanage with UNICEF (which for her means that she NGO's will support her) and use that to enforce standards of care as well as monitor their incoming donations... who knows, it might even turn out to be a better option than just shutting it down- this project might help to educate the surrounding community on child protection and make it easier for other orphanages to get the support they need as well! 

Other than that things are going well, my Creole lessons are going great (I've learned how to hassle the David and Nonu now) and test has been postponed until the 14th :)

much love
xx