Day 3: L'Hopital Bernard Mevs, Port-au-Prince, Haiti
April/16/2012 05:20 PM
Susanne had a rough night last night. Let's just say that the first night in a state of delirium, she accidentally brushed her teeth with the tap water. Having realized this on Sunday morning, she started a dose of Cipro but didn't read the fine print. Avoid dairy. So unbeknownst to me she was in and out of our bunk bed (she's on top, I took Ambien) to visit the toilet which barely flushes. She has been a trouper in spite of being slightly under the weather.
Our day got started seeing the inpatients in med/surg and pediatrics. Then we headed over to the clinic. Patients line up at the crack of dawn to get in line to be seen for clinics. There is a wound clinic (they saw over 40 patients today), an ortho clinic and a rehab clinic.
It took us a while to get into a rhythm as to how to make ourselves most useful. It's a fine balance between wanting to bust in and get busy and at the same time, not step on the toes of the Haitians who are being trained to do the work on an ongoing basis.
There is a rehab tech in the clinic named Sammy who is actually quite good for not having any formal training. The clinic is chaotic (similar to Lumiere), but after a few hours we caught on to the system and did a variety of pediatric neuro rehab (failure to thrive, CP and hydrocephalus). These parents have their hands full as you can well imagine. The parents are very involved, with both parents contributing to the care of the child.
We also saw a variety of ortho trauma follow-ups. Since the ER is inundated all day and night with moped/motorcycle/car accidents, there is an unsightly amount of people walking around with intricate external fixator devices on multiple body parts. The problem is that they may have a fixator device at the lower leg but, through a lack of communication, somehow the patient is under the impression that they are not allowed to move any joint from the pelvis down. So, in addition to having a problem with ankle/foot motion, they have a knee flexion contracture and severe muscle wasting throughout the lower extremity. We spent much of our time retraining joints far superior or inferior to the actual injury.
After clinic we were asked to assist in the spinal cord area. As previously mentioned, there are eight patients in this room. Some of them have severe decubitus ulcers (large enough to put a fist through) and it is getting challenging to find a position for them to rest in which won't start up another decubitus. The degree of severe decubitus ulcers is really upsetting to the three of us. Several of these patients are so badly infected that the smell emanating from them is difficult to stomach. And to be honest, they really have no future. One woman would be best with an amputation at the pelvis but I'm not sure how one lives like this. Nick is really struggling with this aspect of the trip.
We did have a lot of fun working with a young man named Jean Eddy (pictured at right, with Nick). He suffered a compression fracture T11/12 which resulted in an incomplete spinal injury. He is highly motivated to work with us and we dug in to our early PT brains to recall spinal cord rehab protocols. It was a very fulfilling session for all of us. Jean Eddy matched our intensity and we all had a good work out. Tomorrow we hope to move a table outside to the shade and give him more opportunity to really whack us with overhead ball tossing crunches.
All in all it was a good busy day. As I write Susanne is serenading me with sweet little burps but as she stated, best that they are coming out of this end. In between floating around to various wards and clinics, there is a local "artisan" who claims to be making threaded bracelets which say "Haiti". One for $5, three for $10. He drives a hard bargain and so far Nick and I have failed to persuade him to do 6 for $15. He responds with "let me tell you". Nick suspects that he learned this technique of street side bartering from watching Hollywood drug dealing movies.
We are going to "clean up" for dinner at the UN. This will be a highlight as the food situation here is quite different from Lumiere. When they said bring your own eating utensils and bowls, I failed to take that seriously. Big mistake... They provide no cups dishes, silverware or napkins. I guess because we are literally sleeping and staying on the hospital grounds, anything provided disappears and Project Medishare at some point decided to stop trying to keep with supplying disappearing inventory. So I am using and reusing the plastic fork and spoon which Eric provided at the last minute in the car to the airport. I understand their predicament but wished they had really spelled it out to us more clearly in the "what to bring list" because you are totally screwed if you don't!
Also, it would have been helpful to know that when the UN is closed (Sunday), there simply isn't any dinner provided. We had quite a collection of shared snack treats. I so want to thank my friend Peter from Clif Bar who sent us with over 400 Clif bar samples. They are a hit!
All for now.
The Three Stooges
Our day got started seeing the inpatients in med/surg and pediatrics. Then we headed over to the clinic. Patients line up at the crack of dawn to get in line to be seen for clinics. There is a wound clinic (they saw over 40 patients today), an ortho clinic and a rehab clinic.
It took us a while to get into a rhythm as to how to make ourselves most useful. It's a fine balance between wanting to bust in and get busy and at the same time, not step on the toes of the Haitians who are being trained to do the work on an ongoing basis.
There is a rehab tech in the clinic named Sammy who is actually quite good for not having any formal training. The clinic is chaotic (similar to Lumiere), but after a few hours we caught on to the system and did a variety of pediatric neuro rehab (failure to thrive, CP and hydrocephalus). These parents have their hands full as you can well imagine. The parents are very involved, with both parents contributing to the care of the child.
We also saw a variety of ortho trauma follow-ups. Since the ER is inundated all day and night with moped/motorcycle/car accidents, there is an unsightly amount of people walking around with intricate external fixator devices on multiple body parts. The problem is that they may have a fixator device at the lower leg but, through a lack of communication, somehow the patient is under the impression that they are not allowed to move any joint from the pelvis down. So, in addition to having a problem with ankle/foot motion, they have a knee flexion contracture and severe muscle wasting throughout the lower extremity. We spent much of our time retraining joints far superior or inferior to the actual injury.
After clinic we were asked to assist in the spinal cord area. As previously mentioned, there are eight patients in this room. Some of them have severe decubitus ulcers (large enough to put a fist through) and it is getting challenging to find a position for them to rest in which won't start up another decubitus. The degree of severe decubitus ulcers is really upsetting to the three of us. Several of these patients are so badly infected that the smell emanating from them is difficult to stomach. And to be honest, they really have no future. One woman would be best with an amputation at the pelvis but I'm not sure how one lives like this. Nick is really struggling with this aspect of the trip.
All in all it was a good busy day. As I write Susanne is serenading me with sweet little burps but as she stated, best that they are coming out of this end. In between floating around to various wards and clinics, there is a local "artisan" who claims to be making threaded bracelets which say "Haiti". One for $5, three for $10. He drives a hard bargain and so far Nick and I have failed to persuade him to do 6 for $15. He responds with "let me tell you". Nick suspects that he learned this technique of street side bartering from watching Hollywood drug dealing movies.
We are going to "clean up" for dinner at the UN. This will be a highlight as the food situation here is quite different from Lumiere. When they said bring your own eating utensils and bowls, I failed to take that seriously. Big mistake... They provide no cups dishes, silverware or napkins. I guess because we are literally sleeping and staying on the hospital grounds, anything provided disappears and Project Medishare at some point decided to stop trying to keep with supplying disappearing inventory. So I am using and reusing the plastic fork and spoon which Eric provided at the last minute in the car to the airport. I understand their predicament but wished they had really spelled it out to us more clearly in the "what to bring list" because you are totally screwed if you don't!
Also, it would have been helpful to know that when the UN is closed (Sunday), there simply isn't any dinner provided. We had quite a collection of shared snack treats. I so want to thank my friend Peter from Clif Bar who sent us with over 400 Clif bar samples. They are a hit!
All for now.
The Three Stooges
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