A Pediatrician’s First Experience in Haiti

Haiti Trip-May, 2015

by  Dr. Janet Schairer

This was my first trip to Haiti as well as my first international health experience. Nothing can really prepare you for what to expect. I think the first thing I noticed on the ride from the airport to our compound was the incredible poverty. The second thing was how friendly and joyful the children were when they learned we had arrived. We had a great time playing and dancing with the kids our first evening in Haiti. The kids truly touched my heart with their warm smiles and laughter.

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Warm welcome at Bod me Limbe village.

Providing healthcare to these children and their families was definitely a learning experience as well. One had to become comfortable with doing the best that you could, for as many as possible, with what supplies and resources were available.

Seeing patients in clinic

Seeing patients in clinic

One also had to depend on history and physical exams to make clinical decisions in the field as there are no X Rays, labs, or echo machines easily available.

Dr. Janet Schairer, part of the team from Jersey Shore Medical Center, at clinic

Dr. Janet Schairer, part of the team from Jersey Shore Medical Center, at clinic

Transporting a child to a local hospital, I saw pediatric units with old iron beds and cribs lined up in rows. There was no real place for families to visit comfortably so they could support their loved one. The grim reality also revealed itself in that if the patient can’t pay for his or her hospitalization or treatment, the care is not given. There is no obligation for the hospital to treat anyone who comes through the door.

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Visiting a hospital to follow up on a patient.

To me, living in the US where anyone can be seen at a hospital at anytime and many hospitals are becoming like 4 star hotels with administrators looking at patient surveys to improve the hospital experience to draw more patients in, this was shocking.

Fortunately, we were generally able to arrange for hospital care of our patients who needed it, but it left me wondering what would have happened if our team had not been there that week. Often the care could not happen as quickly as we are used to as well.

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Admitting a patient to one of our partner hospitals Haiti Hospital Appeal and discussing next steps.

For example, we sent a patient in heart failure to Haiti Hospital Appeal, one of the hospitals that partner with Hands Up for Haiti. They were able to stabilize her but she would need to be transported to another hospital in another town to actually get an echo. Although not every hospital in the US has every service either, transporting a child to another town for a medical service is a bigger problem in Haiti. Most families don’t have transportation or money for food or any lodging if they are away from home.

The days were long but the week short in Haiti. I think we made a difference in the lives of the children that we saw, if nothing more than to show them that we care.

With colleagues from Jersey Shore Medical Center, Pediatricians: Drs. Rose St. Fleur and Cathleen Balance

With colleagues from Jersey Shore Medical Center, Pediatricians: Drs. Rose St. Fleur and Cathleen Balance

Would I go again? Absolutely! The smiles on their faces are so worth it!P1010644


HUFH & Pace University School of Nursing Collaborate to Teach Neonatal Resuscitation Skills

COLLABORATION AT ITS BEST TO BENEFIT HAITI

On Tuesday May 19, Hands Up for Haiti collaborated with Promoting Health in Haiti to teach Neonatal Resuscitation skills and Helping Babies Breathe to visiting Haitian nurse practitioner students. The session, which was held at the Pace University Lienhard School of Nursing, was organized by Promoting Health in Haiti founder Carole Roye, Associate Dean and Professor. The 8 students were incredibly enthusiastic about learning Neonatal Resuscitation and Helping Babies Breathe. Many of them have already been to deliveries as well as cared for newborns and were eager to learn skills they could apply back home.

Dr. Rick Stafford Teaching Neonatal Resuscitation Skills

Dr. Rick Stafford Teaching Neonatal Resuscitation Skills

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Dr. Allison Platt and Dr. Wendy Marx in action.

According to Dr. Roye, the students were genuinely so appreciative. When she asked them if it was good, their response was “Much, much more than good!!”.  The knowledge and skills will be with them as they work in Haiti. In fact, these nurse practitioner students maydo a clinical rotation with HUFH in Haiti.

HUFH teachers included physicians Allison Platt, Wendy Marx, Rick Stafford, and Mary Ann LoFrumento, nurse Stephanie Korn, and student Samson Desamour. As Dr. Allison Platt said, “Personally, a truly wonderful experience and I look forward to working with these students next time I am in Haiti.”

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A satisfying day is done: the visiting Haitian students with Dr. Carol Roye, Samson Desamour, Dr. Wendy Marx, and Dr. Mary Ann LoFrumento.

 


The “One”

Regina Clark, Co-Leader, March 2015

As this was not my first trip, I had some preconceived notions of what type of medical maladies I would encounter among such severely underserved Haitians, especially the children.  Commonly, for each volunteer there always seems to be one case that stands out as “The ONE’ among the hundreds we see and treat. I wondered if it would happen to me. Of course, it did.

I didn’t expect it to happen on the very first day, within the very first few hours no less. As with most trips, we start at Open Door Clinic run by Pastor Wiljean.

Open Door Clinic

Open Door Clinic

The day began in the usual fashion. I eagerly greeted the many patients quietly waiting for us.

Patiently waiting to be seen at clinic

Patiently waiting to be seen at clinic

About 7-8 patients in, a young girl of 8 or 9 came in with her mom. As the exchange of information began, I wondered what her chief complaint was. Her mom lifted her right arm up and pointed to something needing no explanation! I inwardly sucked in my breath at what I saw before me.

On her right axillary gland there protruded the largest abscess I ever saw! My heart broke for her and her mom. Several thoughts raced through my mind. What will the doctor (Dr. Harry Moskowitz) do aside from giving antibiotics? Do we have strong enough pain reliever to get her through a very painful procedure that awaited her as I took instructions to prepare for what we were about to do?

Without missing a beat Dr. Moskowitz asked for the necessary items to carry out an I and D! (Incision/Drainage). After we got set up for it, we instructed through our translator that the mom was to hold down the left arm tightly and be ready for a tough procedure. First thing needed was to numb the area. Unfortunately it required three very painful injections. I was so very sorry we had to inflict terrible pain to lessen the worst pain yet to come.  It was a little difficult staying focused rather than to dwell on how bad it was and how much pain this poor little girl was made to endure.

Predictably, it was extremely painful and the child screamed over and over.  Gauze in hand, the doctor applied pressure, willing the pus to drain out. At one point he placed his index finger inside the bigger growth to facilitate as much drainage as possible. Pain, tears, fluids flowing, I did my best to both assist by holding/replacing gauze pads and comforting the girl and her mom.

Once we finished, we instructed the mom to bring her back to us the next day seeking visible improvement via the antibiotics we gave her. She did indeed bring her and there was noticeable improvement! The best news? She got operated on later in the week. Sadly, she also tested positive for TB. I pray/hope she will be okay!


A Visit to Partners In Health

Lauren Blum, Team Member March 2015

It’s 5 am the morning after the end of a weeklong, successful volunteer mission trip with an amazing group of diverse and dedicated volunteers. The other volunteers are already home, and Dr. Jill Ratner and I and our Haitian medical team: Dr. Manol Isac, Dr. Dieula Toussaint, Dr. Billy Isac, and our in country coordinator, Tiruru, are setting out for the long drive to Mirebalais for a visit and meeting at the new Partner’s In Health Hospital, Hopital Universitaire de Mirebalais (HUM). As the sun rises we are offered exquisitely beautiful glimpses through the tropical forests to the “mountains beyond mountains.”  Mountains Beyond Mountains is the name of the book by Tracy Kidder about Paul Farmer, the visionary doctor who started Partners in Health and his work in Haiti, but also a Kreyol aphorism, a metaphor for the scope and complexity of the struggles in Haiti.

Our motivation for the visit is twofold. We are looking for a place we can refer the patients we see who need advanced and specialty care and currently unavailable in the North of Haiti, and we want to find out what services they offer. We also want to give our Haitian medical staff an opportunity to see the hospital and network with the medical staff so they can consult, refer, and take advantage of learning opportunities offered at the hospital.

We travel over 5 hours to get to Mirebalais, through the mountains, over windy, bumpy, dusty roads. Along the way I imagine a critically ill or injured patient having to travel the same route.

We arrive at a large, bright white, new hospital complex, but what I notice most are the huge crowds of people waiting in and around the complex with large bags of stuff: clothing, food, cooking supplies bedding. I realize many of these people have traveled long distances to get here, far from their homes, and are “camping” here as they wait to be seen or wait for family members to be discharged.

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We are greeted warmly by Delight and Jack, two doctors from Vermont and Jill’s contacts for our visit. They spend months at a time volunteering at the hospital. Jack is a neonatologist and Delight is a pediatrician. Together they have helped to set up the NICU here, and have written a protocol manual for the pediatricians in the outpatient clinic. We are introduced to Vanessa, who gives us a tour of the hospital.

We learn that the hospital in Mirebalais, which opened in 2012, was in its planning stages even before the earthquake, but on a smaller scale. It was greatly expanded upon after the earthquake to be a major tertiary care center because of it’s proximity to Port au Prince but also to areas in central Haiti and because it is not on a fault line.

The hospital has been carefully thought out in terms of the placement of various departments. For example, the women’s health and pediatric outpatient department are separated from the general outpatient department. Labor/Delivery is directly across from the Operating Room entrance.

The roof is covered with solar panels, which generate enough electricity to power the entire complex. There are UV lights and a ventilation/fan system in the waiting areas to minimize spread of contagions. They commissioned Haitian artisans to create metal work for the large window grates in each waiting area that represent the services offered. The waiting areas are filled to the brim: every chair is filled and others are waiting on the floor.

We are all impressed at the array of services that are offered, both inpatient and outpatient. The outpatient program offers women and children’s health care, which includes cervical cancer screening, gynecology, obstetrics, and pediatrics. Specialty outpatient services include ENT, nephrology, mental health, and urology. Dermatology was recently added. There is an ER, one CAT scanner, EEG, a lab, a pharmacy, and a seizure clinic.

Inpatient services include general surgery, women, men, children wards and an 18 bed NICU (compressed air and C-pap!). An ICU is opening soon and will have 2 pediatric beds.

Consulting services are available on a schedule depending on when foreign teams are here: neurology and neurologic surgery. (Through a collaboration with Emory a sixth year resident comes regularly.), cardiology (the Haiti Cardiac Alliance organizes teams from the US and Canada and PIH is looking for other cardiologists to come), a pediatric craniofacial team (Smile Train and another). Pediatric surgery will be added in 3-6 months.  They currently do not do any open-heart surgery. Referrals are made to other area programs for services not offered or unavailable at the time, such as radiation therapy, for which patients are sent to the Dominican Republic. Chemotherapy is offered, most commonly for breast cancer, Lymphoma, and cervical cancer.   Children’s cancers are referred to St. Damien’s in PAP. Other collaborations exist with Schweitzer Hospital.

They cap their outpatient caseload to 800 patients a day, seen by 18 Haitian doctors and Haitian residents. The hospital mainly serves outpatients in the inner catchment area, which was not specifically defined because of the hospital’s policy of turning no one away. Referrals and inpatient cases come from even farther away.

Here is the most amazing feature of all: the fee for services for all patients is a 50 gourdes registration fee (about 1 US dollar). This includes EVERYTHING. Soup to nuts: labs, treatment, and medication.  If you have breast cancer it includes diagnostic procedures, surgery, chemotherapy, as well as the cost of receiving radiation in the DR…everything! If a patient needs a service not offered at HUM, they will pay to transport the patient to another facility in Haiti or the DR, and sometimes beyond, and give a stipend to the family to cover expenses as well as the treatment. Is this sustainable? Vanessa, our tour guide was not optimistic and touched on the financial difficulties the hospital is having. But if you’ve read Mountains Beyond Mountains, or are familiar with Paul Farmer, you will understand that free comprehensive care for the poor is the focal point of his philosophy and vision, as well as addressing other issues related to the problem, such as malnutrition. He and PIH work tirelessly to raise funds.

In our meeting after the tour, Frankie Lucien, coordinator of services and referrals, stressed the importance of communication in referral of specialty patients and asked that we use their referral form and specialty contact list to communicate our referrals to ensure that patients don’t fall through the cracks, wait unnecessarily, or arrive on a day when the specialty service is not offered. It would be ideal if referring medical NGO’s would cover the cost of the transport of their patients, but PIH will also cover transportation and have an arrangement with Haiti Air Ambulance and area hospitals to transport patients to HUM.

What do they need? Training for their Haitian staff but especially for their nurses in using equipment like IV pumps and other equipment. A commitment of at least 2 weeks is ideal. They have many visiting medical teams working with their Haitian doctors from the US and elsewhere, but can always use more. And more funding, of course!

Frankie Lucien was excited to learn about the existence of the Cap Haitian Health Network from Jill and promises were made to share contact information about that as well as contact information for all of our Haitian in-country medical staff. They will provide us with the contact information for all of their specialty areas for referral of patients along with their referral form.

It was an extremely productive and important visit for everyone. Health care in Haiti will improve when there is better communication with one another and coordination of services. Everyone needs to work together. Training of Haitian doctors, nurses, and healthcare workers is key.

It was another hot, dusty 4-hour drive to PAP. Dieula, while generally quiet and introspective, was bubbling over with excitement and enthusiasm as we discussed our visit at HUM over dinner that evening. What also was evident was her pride in knowing that a hospital like this existed in Haiti. She was already dreaming and scheming of the possibilities this meant for her in terms of learning opportunities, her patients, and the people of Haiti.

 


Memory – A Mother and Daughter Share Their Reflections

The Daughter: MEMORY

Memory is a very important part of your life. Without memory, one would not be able to remember life experiences, the names of the people they love, those who they impacted, or were impacted by.

Another important thing in life is the act of compassion which can be seen in selfless action and trying to help another person to one’s full extent.

Volunteer Lauren Burnette on her first day at clinic.

Volunteer Lauren Burnette on her first day at clinic.

The doctors that came to volunteer with Hands up for Haiti combine both of these things to create an impact far larger than one would expect. A couple of weeks before I left to go to Haiti, I decided I would go onto the website and read all the stories about patients seen: one of the stories was about a teenage girl who was having hallucinations and was brought to the clinic seeking help. One of the doctors who treated this girl was Dr. Jill Ratner and what they did was have her go see a team of psychiatrists who could help her and give her the medication she needed. Even though the doctors from Hands Up for Haiti couldn’t do anything themselves, they used their compassion and all their resources to help this girl get what she needed.

The next time Dr. Ratner went on a trip, the girl visited her and was doing much better because of the visit to the psychiatrist that Dr. Ratner helped make happen.

She came to visit when we were at Blue Hills treating patients. While doing triage, I spotted her outside and realized that I recognized her from the website and thought back to the moving article I read about this girl’s story. When Dr. Ratner saw her you could see the happiness on both of their faces. This shows how important memory and compassion are in many lives. Because Dr. Ratner was so compassionate with this girl, neither one of them could forget each other. Also, the help Dr. Ratner gave this girl, impacted and changed her life so much that the memory of her visit with Hands Up for Haiti, especially with Dr. Ratner, would never go away. Watching the reunion was amazing and moving.

Dr. Jill Ratner, HUFH President and Trip Leader, at Clinic

Dr. Jill Ratner, HUFH President and Trip Leader, at Clinic

Dr. Ratner impacted this girl’s life and changed it for the better through doing anything she could for her mental health. Seeing the impact Dr. Ratner made on the life of this girl helped me to realize the kind of pediatrician I want to be in the future and the impact I want to make on the lives of others.

Lauren Burnette- Sophomore in High School Aspires to be a Pediatrician 

 

Her Mother’s Reflections:

This week was incredible! I have wanted to go on a medical mission for sometime now. I didn’t know it would be so spectacular. Having my two teenage daughters with me to experience Haiti together was life changing.

The poverty in Haiti is quite evident, but I didn’t expect how primitive the medical system would be. I saw many patients at various locations and worked with limited supplies. Many adults suffered from high blood pressure, pain “all over” and vaginal

Volunteer Physician Dr. Carol Ann Killian at clinic.

Volunteer Physician Dr. Carol Ann Killian at clinic.

yeast infections. The children had itching from scabies, fungal rashes, diarrhea from worms, cough, “stomach” pains, and malnutrition. The Haitians wait their turns very patiently and appreciate whatever help we can provide.

We were a very large group of 20 doctors, nurses, and students. It was amazing how we all worked so well together. We all learned from each other how to provide the best care possible with such limited supplies. Everyone was always willing to help in anyway possible.

I will never forget all the people on my trip, The Haitian doctors and nurses, the fantastic translators, the appreciative Haitian people, and all the beautiful children with their bright white smiles and gleaming eyes!

I look forward to my next mission with Hands Up for Haiti.

Carol Ann Killian, M.D., Emergency Medicine

Working Together: Nurse Martha Renteria, Dr. Steve Margulis, Nurse Chava Pollak, In-Country Medical Director Dr. Dieula Toussaint, Dr. Carol Ann Killian, and In-Country Nurse Youseline  Pierre-Louis

Working Together: Nurse Martha Renteria, Dr. Steve Margulis, Nurse Chava Pollak, In-Country Medical Director Dr. Dieula Toussaint, Dr. Carol Ann Killian, and Haitian Nurse Youseline Pierre-Louis

 


Bringing “Helping Babies Survive” to Haiti: Giving every newborn a chance to live.

By Dr. Jill Ratner, President and Co-Founder, HUFH. Trip Leader, March 2015

On this most recent trip to Haiti, we delivered our first Master Training in Essential Newborn Care: Helping Babies Survive.

We had planned for thirty doctors, nurses and nursing students to come for our full day seminar to introduce the AAP program that teaches newborn care after birth, focusing on decreasing infant mortality after birth. This is the companion program to Helping Babies Breathe, which teaches life saving newborn resuscitation.

Most of the group had attended the previous day’s HBB session.

I was afraid they would have been saturated with information before we ever began, but in fact they arrived earlier than the day before and seemed eager to begin.

Setting Up

Setting Up

I had trained at the AAP initial roll out of the program in November and was very excited to see this program in the field. Fortunately, my team included neonatologists, neonatal nurses, pediatricians, and a pediatric nurse practioner, who were able to familiarize themselves with the program before the course.

Thirty-Nine professionals arrived and quickly organized themselves around the tables and chairs set up. Madame Bwa, a lay midwife, who is in her 70’s and has been delivering babies since age 12, joined these young doctors and nurses, and added her enthusiasm and experience to the day.

After an opening song that asked for a successful day, we began the training.

Like HBB, telling a story is central to the course, known as HBS, Helping Babies Survive. I asked everyone in the room to close their eyes and picture a baby that had just been born and was healthy. The baby breast fed well, stayed warm on the mother and was discharged home with the mother having a good idea of how to keep the baby healthy. Then, I asked them to close their eyes and picture a baby that was born healthy. The mother received no help; the provider came back 6 hours later to send them home, to find the baby was dead. We then proceeded with the course to see how we could transform that story.

Dr. Lauren Blum and translator Franz Toussaint working in small groups.

Dr. Lauren Blum and translator Franz Toussaint working in small groups.

We discussed the timeline of breast feeding, giving initial treatments to the baby to prevent infection and bleeding, and classifying the baby to determine the need for further care based on physical exam, weight of the baby, feeding and respiration.

Each aspect of the teaching was followed by acting out the parts of the mother who had just delivered the baby and the provider giving the necessary instruction in newborn care. Everyone participated and switched roles. The room was filled with the entire group practicing their skills in communicating the information they had learned to the “mother”. This form of simulation is a major teaching tool of these courses, designed to reinforce learning and to emphasize the skills of communication.

Dr. Leah Greenspan Hodor teaching.

Dr. Leah Greenspan Hodor, a neonatologist, teaching.

We proceeded to discuss the need for prevention of hypothermia, the baby getting cold. The need for immediate skin-to-skin contact, breast-feeding in the first one hour of life, and extended skin-to-skin contact for the small baby was reviewed.

The audience was so engaged, and much of the information was very new to them.

We learned that in Haiti, Vitamin K, which prevents newborn bleeding, is often not given. Some of that is due to unavailability, but much of this is due to the under-recognition of the need. We informed the group, that it is estimated that in resource poor areas, 20% of mothers are deficient in vitamin K to a level where the baby is at risk to bleed internally.

We discussed universal eye care and cord care to prevent infection.

The need for early breast-feeding and the need to support and encourage all mothers in breast-feeding was our next major topic. Although everyone in the room realized that breast-feeding was important, many of the participants expressed the belief that many women don’t make milk, and wanted to ask about alternative feedings such as formula. Our energy quickly focused on communicating that all should breast feed and that milk production will be improved by feeding and that supply will increase if the baby sucks appropriately at the breast. We discussed the latch, problems with breast-feeding, and milk expression and cup feeding for the small infant with a poor suck. If we had done nothing else this day but discuss these issues it would have been worth the visit to Haiti.

Learning to take temperature. Dr. Leah Greenspan Hodor and a group of health care professionals.

Learning to take temperature. Dr. Leah Greenspan Hodor and a group of health care professionals.

In the afternoon we proceeded to discuss “danger signs” recognition of jaundice and infection in the newborn, recognition of low body temperature

and seizures and the need to treat for infection, and transfer the baby to the hospital. We talked about teaching this course to traditional birth attendants and ways the course might be modified based on their abilities to perform tasks such as intramuscular injections of antibiotics. We all agreed that teaching the “danger signs” were most important so that the TBAs could get the baby to the health care center for further care.

The course was incredibly well received, and clearly passed on additional medical knowledge to the providers in attendance. We are all very excited for the materials being translated into French, as since the course is brand new, all materials are in English, with great illustrations.

Dr. Roosevelt, one of our Haitian colleagues, thanking HUFH for the HBS course.

Dr. Roosevelt, one of our Haitian colleagues, thanking HUFH for the HBS course.

In the end of the day, this was my most satisfying part of the trip. Being able to empower local doctors and nurses with knowledge of newborn care, identify ways we can provide them with the tools they need, and emphasize the development of communication skills they can utilize with their patients to me was crucial to our mission here in Haiti.

As an organization, I believe this course should be repeated on any trip that a facilitator is present, as I believe we will impact newborn mortality significantly with the exchange of this information

 

 

 


One Moment of Compassion-Two Hearts Respond

The Physician:

The most poignant moment of the this trip for me came when I toured the public hospital. I was with another physician, a nurse, and a student. As we toured, we saw how much could be done with so little. The parents were at the bedside helping with care. The moment came when we entered the pediatric unit where there was a severely developmentally delayed malnourished child moaning in a crib. The nurse in charge told us she was a “foundling” or an abandoned child. Three weeks previously the child had been brought to the hospital with cholera. After she recovered, the family did not come back to claim her. The nurse took over her care, paying for the medication and spending time with her. I took the student over to this child to touch her and pat her to comfort her. As he placed his hand on her chest, she wrapped her arm around his and stopped moaning. As we moved on, in our tour, I looked back to the student unable to leave the child. He couldn’t tear himself away knowing that the simple act of human touch was what she needed. I believe at that moment, I saw a man decide on his life’s work. I know that the student will never look at life the same, I know for certain the same is true for me.

 Janel Hino:  Neonatologist, Holy Cross Hospital Maryland; March 2015

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The Student:

Whenever someone asks about spring break, they want the highlights. The best part, the funniest story, the craziest adventure. Never before have I struggled with coming up with an answer. I pick one of my favorite stories, and I enjoy rehearsing this story again and again for anyone who asks.

Trying to explain my trip to Haiti was on an entirely new level. And it was not for a lack of stories. Quite the opposite, honestly. I have funny stories of times with my Haitian futbol buddy Mento. I have the amazing story of being given the privilege to triage 100 patients on my first full day in Haiti. I have inspiring stories of the doctors and nurses and volunteers I was so blessed to work with, and the friendships I made that will have an impact on me for the rest of my life.

I share these clips of stories because I wish to make it very clear that this spring break was without a doubt the best possible trip I could have asked for. I laughed, cried, laughed so hard I started crying, and found myself and my identity among some of the most incredible people I have been given the chance to meet on this earth.

Every second I spent in Haiti, I knew where I belonged, and I knew exactly what I was called to do in life.

And I could stop my story there. Sometimes, while telling this story to friends, I have. But that’s not where Haiti’s impact on my life stopped. Far from it.

There is a reason that Hands Up for Haiti was created. Medical infrastructure, infrastructure as an entirety, is desperately needed in Haiti. Hands Up for Haiti, in conjunction with a variety of organizations such as HHA, have made incredible improvements in the last decade. Not only is direct medical care provided, but a wide array of classes, ranging from blood pressure courses to neonatal care, have ensured that the practice of medicine will continue to grow and improve within the Haitian medical community consistently.

Nonetheless, so much more can be done, and needs to be done. The most essential needs ranging from clean water to food to housing are at times very scarce. Awareness and support for the developmentally disabled is almost nonexistent, and education is lost because of the desperate attempts of families to simply satisfy their most basic physiological needs.

Through malnutrition cases and severe cases of viral and bacterial infection, I finally became aware of the severe costs endured when these needs are not met. This realization reached its pinnacle in a moment, during a visit to Justinian Hospital, one of the more major public hospitals near Cap Haitian.

Physicians and nurses at Justinian had not been paid by the government in over eight months. When we arrived, the hospital was stressed far over its capacity with only a fraction of the staff actually in attendance. Nonetheless, the Haitian doctors present were gracious enough to give us a tour of the grounds.

While in the pediatric unit, I saw a number of very ill children. One of these children, in the far right corner of the room, stopped me dead in my tracks. I actually saw this girl before the doctors and nurses I was with, but I was too stunned to formulate words, much less a sentence. Lindsay, one of the team nurses, and Janel, a doctor on our team, asked me if I saw the young child, and I could only nod.

This young, beautiful girl was six years old, but she looked about 3 or maybe 4. Her arms and legs were essentially skin and bones, and every one of her ribs protruded from her chest. Janel almost instinctuively rubbed the girl’s chest, speaking to her and trying to ease her of some of the pain she was enduring. As Janel did this, we learned this girl was found nearly three weeks ago.

Abandoned. In a home. By her family. Left essentially to die.

So malnutritioned that neurological damage had taken a serious toll on her mind and her body.

At that point I think the only way to describe my emotions was a general sense of feeling numb. I couldn’t really find a way to process everything I had heard and everything I saw in front of me. I didn’t know what to say, and I had no idea what to do.

At this point Carol Ann, another team doctor, asked me if I wanted to try to comfort the girl, to grab her hand, rub her shoulder. As I tried my best to comfort this girl, my mind spun as I felt each of her ribs, and thought about the countless list of gifts I take for granted each day of my life. I tried to smile, and spoke the little bit of Creole I had picked up that week, and this young girl seemed to truly feel, even appreciate my presence.

After some time, Lindsay gently told me we were asked to move to the next part of the hospital by the Haitian doctors. I wished this young girl an escape from her pain, but just simply wasn’t sure what else to do. I lifted my hand off the girl, and as I stood up, she lifted her hands, wrapping her fingers around my index finger.

An act of compassion. Amidst her pain, the cruelty in her life, the obstacles that lay in her way, she grabbed my hand and held me. It took every bit of me to not break down that moment in that hospital, and as I reminisce on that moment I can’t help but do just that. That beautiful young girl, whose name wasn’t known and whose name I will never know, changed my life. Made me feel the incredible power of humanity and compassion in a way I never had before.

That humanity is existent is so many men and women around me. The doctors and nurses that worked tirelessly in that hospital despite not being paid, the nurse who found and brought this young girl into the hospital through her own support, the absolutely incredible team I was so blessed to join.

And most importantly,

The entire organization of Hands Up for Haiti. What is stands for. Who it’s made of. What it fights for.

A world that runs on compassion.

Bobby Nolan: College Student, United States Naval Academy, March 2015

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Hands Up for Haiti Meets LitWorld

Last Tuesday in Port-au-Prince, HUFH enjoyed a wonderful visit with Nadine and the LitClub, a program run by LitWorld for Haitian youth. Dr Jill Ratner, HUFH founder, Dr Manol Isac, our Haitian executive director, and Lauren Blum, a pediatric nurse practitioner and active HUFH volunteer, presented on early care of the newborn and the importance of breast feeding.

Dr. Jill Ratner (left), Dr. Manol Isaac, our in-country Executive Director (center kneeling), and volunteer Lauren Blum at LitWorld

Dr. Jill Ratner (left), Dr. Manol Isaac, our in-country Executive Director (center kneeling), and volunteer Lauren Blum (second from right) at LitWorld

The attendees then asked any health related questions anonymously, writing them down; Jill, Lauren, and Manol drew the questions from a box! As Lauren exclaimed: We were there 3 hours!! They asked such great questions.

Course Completed!

Course Completed!


Our Stories: The Ophthalmology Team In Action

glasses

To save a life is to save the world. An ancient saying, it perfectly captures how our actions impact the people of Haiti. Here is one such story, related by Dr. Beth Bromberg, who recently returned from her annual ophthalmology trip.

About a year and a half ago, Pastor Wiljean, who runs the Open Door clinic and orphanage we’ve partnered with in Limonade, asked me to see a woman in her 30’s whom he knew from his church. She was in NY and had been diagnosed with a benign brain tumor which was affecting numerous nerves in her brain that affect eye and lid movement.

After examining her, I sent her to Westchester Medical Center for surgery and they arranged radiation after surgery for her in Florida, where she had family. About six-months later, she came to see me when I was in Haiti, but her symptoms had not yet improved. Last month, she returned to the eye clinic again while our eye team was in Haiti and her condition was significantly better! It was a very happy moment for all of us!

(From l to r) Nurse Ann, Engineer Gerald, Optometrist ,  Dr, Beth Bromberg, Dr.  , Optometrist , Dr. Mitch Stein

(From l to r) Nurse Ann Giuli, Engineer Jean Moise, Optometrist Michael Yellen , Dr. Beth Bromberg, Volunteer Erin Halman , Optometrist Lori Rothman, Dr. Mitch Stein

The February Ophthalmology trip was a huge success in many other ways as well. Dr. Beth Bromberg and Dr. Mitch Stein led a team of veteran doctors, optometrists, and an engineer, as well as first-time nurse and a student.

Dr. Mitch Stein examines a patient with the team observing.

Dr. Mitch Stein examines a patient with the team observing.

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Optometrist Michael Yellen checking eye pressure at Caracol.

Dr. Bromberg donated two machines to the eye clinic in Cap Haitien, and the team taught their proper use and maintenance, and how to interpret results. One is a Visual Field analyzer which is very important in the evaluation of glaucoma, retinal and neurological eye disorders, the other an optic nerve analyzer used to follow glaucoma progression and to detect changes in the nerve before the changes are noticeable on the visual field test.

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Volunteer Erin Halman using the autorefractor at Open Door to determine the patient’s approximate glass prescription.

 

Both of these machines will allow the doctors to show the patients how glaucoma is affecting their nerve and their vision. It is usually a painless loss of vision and the patients do not understand that when they notice the loss of vision it is too late to help.

 

 

The team performed outreach at 2 new places: Caracol, which, for those of you who know translator Guindi, is his home town, and to Blue Hills near Cap Haitien. The team was able to dispense glasses to patient’s in need and screen for cataracts, glaucoma and other vision threatening diseases.

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Engineer Jean Moise repairing a sophisticated piece of equipment.

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Nurse Ann Giuli hugs a happy patient at Caracol.

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Optometrist Lori Rothman performing a refraction for glasses.

 

 

 

 


NEW PROJECT UNDERWAY: Sponsor a Nurse

Nurse Hope Bechard works to help a sick child during a pediatric clinic in Haiti.

Nurse Hope Bechard works to help a sick child during a pediatric clinic in Haiti.

Bringing a Nurse’s Training and Compassion to Communities in Need

We all know how important health care is to a local community, especially those in developing countries like Haiti. During her 9 weeks in Haiti late last year, Hope Bechard, R.N., a Canadian volunteer and HUFH board member, was able to observe firsthand how much of a difference having a nurse in a community can make.

Working with the nurses on the cervical cancer screening program.

Working with the nurses on the cervical cancer screening program.

With a shortage of trained health care professionals in Haiti, a skilled nurse can make a big difference.. A nurse can provide vital health education, help run our malnutrition programs, do assessments and prescribe some medications in areas without a physician available. Recognizing this need, HUFH is beginning a project called Sponsor a Nurse. Sponsoring a nurse is very similar to sponsoring a child. For $150.00 a month a nurse can empower her community and keep them healthy!

 

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FOR MORE INFORMATION, or TO MAKE A GENERAL DONATION, or one IN MEMORY OF or IN HONOR OF ANOTHER, please click SPONSOR A NURSE HERE.