Haiti first impressions

We arrived and got through customs quickly - not much concern for what you are bringing in here. Once outside (hot, humid, 80's, I'm loving it), the haggling begins. Forty to fifty men trying to get you to use their vehicle. We had a prearranged van for all 10 of us. Luggage on top strapped down. The chain link fence separating Haiti from the airport has young boys begging you to give them money. Once outside the airport the rule of the road is the bigger the car and the louder the horn ==> the right of way. Horns are used like doorbells to announce your presence. Constant honking the whole way. A few streets away from the airport we were in a congested area. Lots of people on streets, many approaching the van. One person in our van saw the shadow of a person up on top of our van, pulling at the ropes. We all got a little concerned...ok very concerned. The bus driver then explained we had a hired person on top of van "to keep luggage tied". That was a HUGE relief.

As you ride through Port-au-Prince there is no sign that things have been cleaned up other than the streets are cleared, mostly. Building after building toppled and tents set up around the rubble. People live literally on top of one another. Existing structures are attached, 6x6' and stack up from street back to who knows where. So before earthquake, the people living in this area were already living on top of one another. No privacy. Areas with tent camps have the tents attached to one another... Again, 6x6, stacked together.

What did catch my eye is the interesting tin used for entry ways and garage doors. The kind of tin with imprints that I would like to arrange to ship home and use somewhere in my 9x9 house! The tin and iron grates are decorative.

What's most decorative are the tap tap buses. Painted, decorated, usually religiously themed but not always. The owners of the buses compete with design to be the best tap tap bus. This guarantees more ridership. People pile on, and I mean pile. The highlight was catching up to the Barack Obama tap tap bus. My favorite!

The damage from the earthquake was visible through the first 90 minutes of our ride. Now we weren't driving fast but even still, the damage was far-reaching.

At one point we started driving through the country, very lush, reminds me of Costa Rica. Every few miles you ride in to a little bazaar with street side vendors. I could not convince them to let me out and look around for hidden treasures. Dogs run along the road and cars/buses honk at them. That's the only warning they get so unfortunately I got to see the tap tap bus ahead of us hit a dog and kill it.........

We drove to the southwest area of the island called Calles. We were met by the group leader Sheila. The van would never make it up the steep winding road to hospital.

Everyone out, loaded luggage in to jeep, and all but me climbed on TOP of jeep to ride up the mountain. I rode in jeep next to Sheila. She has lived here for almost 3 years. I really like her spirit. That’s me behind the jeep in the photo below.

guest house arrival

The guest house is quite livable. Five bedrooms, 3 baths sometimes with running water (cold). We have two house staff who cooked a great dinner. I passed on the goat but otherwise liked the rice, beans, cole slaw, tomatoes, chicken, plantain and coconut cookie.
view from reservoir

After dinner we went to hospital to round on all 50 patients and a few in ER. Rooms have 6-8 patients plus family. It is not unusual for a family member to sleep under the bed of a loved one to care for them.

Wow diabetes – not the American variety from poor diet and obesity. These people are thin. Diabetic ulcers that don't heal and after several failed attempts to debride, end up with amputations. All ages, men and woman.

Trauma fractures from vehicle accidents. Motorcycle (the no helmet varieties) with head trauma as an added bonus. Lots of badly displaced fractures, some open through the skin. Pins, plates, bone traction with weights hanging off bed. BEDREST for 4 plus weeks. A PT nightmare. No get em up and move them day 1. Severe deconditioning, atrophy, and yes, decubiti... more bad healing. Every patient here has been referred to me to design a program. Noah will be doing some tendon releases to free up contractures caused by immobility. The patients are comfortable for the most part. Not a lot of pain meds here. Lots of smiles. One boy here for a displaced tibia fracture from a bad soccer play, is adorable. He will have surgery Monday to fixate his fracture and then he's all mine. Most like my current population!!!

The hardest case was a young girl 2-3, with a fractured radius. Taken to an herbalist who wrapped her arm too tight and resulted in a compartment syndrome. She is in pain. Huge tears and crying when her bandages were removed...and she cried too. Big tears, fear in her eyes, screaming from pain. Surgery for her. Many beanie babies and toys are coming to her. She is beautiful.... and her mother very present.

On walk back to house, I spotted a beautiful toad/frog... I knew Eric was with me!!! Others went to look for tarantulas in the rocks. I passed on that...

All for now.....
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Haiti Medical Trip