The Sewing Lesson – or Murphy’s Law in Action

By Celeste Theis, a social worker recently returned from the January 2015 mission to Haiti:

Our team of eleven, doctors, nurses, nutritionists, a social worker and an occupational therapist, and one volunteer from outside the health care world, came to Cap Haitien this past January on an HUFH pediatric mission. Some of us had been to Haiti with HUFH in 2014, when we met Maud Dugue, a Haitian businesswoman and the founder of Club Evangelize. Maud opened her home to the children in her neighborhood about 10 years ago; there she holds Saturday classes to teach the children basic academic skills. When we came in 2014, Maud graciously invited our team to her home to talk about her efforts to help the local kids. In addition to teaching academics, Maud sought out people who could teach the children marketable skills such as sewing, auto repair, and electronics. Dedicated to her children, Maud acquired funding to build a new school building just up the street from her home. Last year, the HUFH team walked to the new three story building; although still under construction, we knew it was going to be wonderful asset to the community.

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The team sets up the class.

That was our ah-hah moment: It was then that my friend and team member Alice and I hatched the idea to come back and conduct a sewing lesson for “Maud’s kids”. Alice and I both love to sew, and it seemed like a worthwhile skill to teach the kids. Our initial visit to Club Evangelize occurred on the last day of our visit to Haiti in 2014. But Alice and I were already pretty sure that we would return with HUFH the following year.

Once back at home, Alice and I put out the word to friends, co-workers, and anyone who would listen that we were seeking donations of sewing machines, fabric, thread, and various sewing supplies. We managed to collect 8 sewing machines and lots of fabric and supplies. These were shipped to Club Evangelize well in advance of our 2015 trip. I had been in email contact with Maud about the plan to visit her school for a morning to conduct a sewing lesson for the students. She was delighted, and informed me that there were many more students who were interested in learning to sew than we could reasonably teach in a few hours.

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Volunteer Lynn Perton helps a student.

 

In the months prior to our January 2015 trip, much had to be arranged: We had communicated with Maude that we felt we could work with about 25 kids in the time that we had to be at the school. Well in advance of our visit, sewing machines and supplies had to be shipped from here and picked up by our HUFH team when they arrived in Haiti. Maud would be responsible for getting the supplies unpacked and readied for the day we would arrive.

Meanwhile, Alice and I brainstormed to come up with a simple sewing project for the kids. We would teach them how to operate the machines, measure and cut the fabric, do some simple decorative stitching, and add some embellishments to make headbands. It would be quick, easy, fun – AND, most importantly, the kids could continue to make the headbands (and perhaps other projects) on their own after we left. The sewing machines and supplies had been donated to Club Evangelize and would remain there. Great plan, right?

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Celeste Theis teaches sewing skills.

Well….it’s Haiti. A couple of weeks before our trip, Maud informed me that her school does not have electricity. That was a basic erroneous assumption on my part. Although, in my defense, having visited the school last year while it was still under construction, it appeared that it would be a fairly modern, 3 story structure. But I did not realize that in Haiti, even a “modern” building used for a school may not have regular electricity. No problem. HUFH would rent a generator for the sewing lesson. All would be well.

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Nurse Elise Lentz threads the needles.

On the day of our visit to Club Evangelize, we arrived to find that none of the 13 boxes of supplies that we shipped had been unpacked (including the sewing machines). Our team of 11, along with our translators, got to work, unpacking the boxes, and arranging fabric and supplies on the tables. This was all happening while the kids were arriving. Our translators set up the generator to power the sewing machines. But when one of our translators, Sonnel, pulled the cord to start the generator, it broke off in his hand! Volunteer Dan Haskell, a master problem solver, set about to fix the generator with his bicycle cords. But would it work? Meanwhile new plan: make the headbands by hand.

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Volunteer Dan Haskell donates his bicycle cord to fix the generator.

The kids loved looking through the fabrics – all kinds of colors, prints, and textures. They selected their materials, and after a brief “how-to” demonstration, our HUFH team helped the kids to make the headbands. Many of the kids already knew how to thread hand needles and sew. But they were intrigued by those idle sewing machines sitting on the tables. Suddenly, we heard the generator start (thanks to the indomitable spirit and know-how of the HUFH team and translators): the sewing machines were functional! The kids loved trying out the machines (with lots of adult supervision).

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Lots of colors to choose from!

The day was a true example of Murphy’s Law in action (or, maybe just another day in Haiti). But by the time we were done, about 40 kids had made headbands. They had a great time, and so did we. The kids enjoyed putting their own stamp of personal style on their headbands.

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Occupational therapist, Janet Zrzemienski, shows a student how to work with the threads.

What we thought would be a simple and easy sewing lesson turned out to be an entire team effort involving all hands on deck, from getting things organized, to teaching the kids, to trouble-shooting the electrical problems. It’s an amazing thing to watch how a team of 11 people who have not previously worked together can gel as a team over the course of a couple of days and pull together to make things happen, whether it’s providing medical care, doing public education, or teaching kids to sew.

Final fitting!

 

After the sewing lesson, Maud led the kids in singing a few songs for us, we had lunch, and every child received a certificate for participating in the sewing lesson.

Lessons learned: You can’t take anything for granted (especially in Haiti), the HUFH team rises to any challenge, and kids are kids – they love to learn and be creative. It was a high point of the trip to be able to give them that opportunity.

The sewing machines and supplies remain at Maud’s school. She plans to install electricity at some point, and hopefully the sewing machines will be a great vehicle for creativity and learning marketable skills.

The kids proudly show off their sewing projects.

The kids proudly show off their sewing projects.

Celeste Theis


Sharing Haiti- A School Responds to Help

On December 18, 2014 the Middle School Student Council at Wooster School in Danbury Connecticut ran a very successful Holiday Shopping Bazaar to support the work of Hands Up For Haiti. The volunteers who travel to Haiti with Hands Up for Haiti on our medical missions become our best ambassadors. Last October, Dr. Eliot Barsh, a pediatrician in the Mt. Kisco Medical Group went on his first mission with fellow pediatrician, Dr. Allison Platt.

Pediatrician Dr. Elliot Barsh seeing a young patient in Haiti

Pediatrician Dr. Elliot Barsh seeing a young patient in Haiti

It was a life changing trip for Dr. Barsh and he shared his amazing story with his whole family, and with Gaynor O’Neill, the Administrative Assistant to the Head of the Middle School, where his son, Jack is an eighth grader and his daughter Sue Ann is in the High School. Dr. Barsh’s wife, Pam Genet was key to helping the children, and teachers understand the extent of what her husband had done and seen in Haiti.

Dr. Barsh shares his experience in Haiti with the middle school class.

Dr. Barsh shares his experience in Haiti with the middle school class.

 

Wooster School is an independent day school that promotes the attributes of being “gentle, generous, truthful, kind, and brave”. To help reinforce these ideals for students the school seeks out charitable opportunities and ways to promote cross -cultural understanding. In her advisory role, Ms. O’Neill, shared with the Student Council her conversation with Dr.Barsh. As a result, the Student Council chose to donate the proceeds from the 2014 Wooster Holiday Bazaar to Hands Up For Haiti.

 

Dr. Barsh working in rural Haiti.

Dr. Barsh working in rural Haiti.

The Holiday Bazaar was set up in a hallway with six 8 foot tables displaying all of the donated merchandise plus a free wrapping station with moms in charge. More tables sold freshly made waffles with a choice of toppings, an industrial strength popcorn maker and a variety of flavors one could squeeze onto a freshly made snow-cone. Shoppers were the school’s student body, from kindergarten through 12th grade. The merchandise, popcorn, whipped cream, wrapping material and much more was donated by parents. Some moms left the school to shop for items that could quickly restock the tables. Not suprising, Pam was on the scene, from start of the project to finish.

 

Dr. Barsh and Dr. Ratner did presentations for the students on what life in Haiti is like, and showed the students the work done by the doctors, nurses, and other volunteers who 10 times a year travel on one week medical missions. The children watched the images of the slide presentation as Dr. Ratner described the poverty in Haiti and what the donated money would buy. The students understood that their fun time at the bazaar and the funds raised help pay for life saving malnutrition supplements for children who were severely malnourished and allowed the organization to buy equipment to teach newborn resuscitation to traditional birth attendants.

Pediatrician and President of Hands Up for Haiti, Dr. Jill Ratner demonstrates teaching Helping Babies Breathe techniques.

Pediatrician and President of Hands Up for Haiti, Dr. Jill Ratner demonstrates teaching Helping Babies Breathe techniques.

 

The entire school community of The Wooster School came together to create this successful event which raised over $1700. On February 13th the Student Council, with the entireMiddle School in attendance, presented a check to Dr. Jill Ratner, co-founder of Hands up for Haiti, for $1736.

The Student Council presents a check to Drs. Ratner and Barsh for Hands Up for Haiti.

The Student Council presents a check to Drs. Ratner and Barsh for Hands Up for Haiti.

For Drs. Barsh and Ratner it was an amazing and heartwarming example of the power of connections to help others and to highlight the mission of Hands Up for Haiti. The school has already begun to think about ways to brainstorm and partner with Hands Up for Haiti again next year. The children were really able to see that together they could really make a difference in the lives of children in Haiti. The experience of Haiti goes beyond the volunteer and the one week they spend on the ground. They carry it back to their families, and community.


A Most Challenging Mission-Part 4- Peacekeepers and Patients

by Mary Ann LoFrumento

“There is a place in the city where no one goes and the children are very sick.” So reported Francisco, a doctor on the medical staff of the UN Peacekeeping force in Haiti. Our friends at Haiti Hospital Appeal had introduced us. Francisco is an officer in the Chilean battalion, the UN force responsible for helping the people of Cap Haitien. We were sitting around a wide nondescript table in the officers’ building. It was the beginning of the rainy week and I was still worried about getting my team back to Cap Haitien. We were served expresso coffee, tea, and biscuits as Francesco explained the situation.

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Members of the Chilean peacekeeping force securing the streets in La Fossette

La Fossette is a slum area that borders the same river as Shada, on the other side of the bridge. As efforts to redevelop Cap Haitien begin, plans include building a new bridge to replace the ailing old one, and the homes and businesses in this area may be slated for removal in the next year. This has resulted in even more neglect from the city government. The commander explained that, “Even the police don’t go there. But we try to help the children who live there.” They needed our team and we needed places to work. But I was concerned about the danger. “No problem,” the commander added. They would provide our escort and security. We would provide the medicine. Where will we be able to hold the clinic?  “Don’t worry, we have a nightclub.” A nightclub in an unknown slum neighborhood where even the local police don’t go. “Please” Francesco said, “I have never seen such sick children.” I was thinking that I had lost my mind. But I assured them that if I could get my team back, we would hold the clinic on our last day. We shook hands and departed.

Getting organized. Dr. Mary Ann LoFrumento supervises the team setting up the stations.

So now it was Friday, the last day we would be working, and my team was excited to be going to a new location, one in which they were greatly needed. Some of our returning volunteers had experience working at our clinic in Shada. But in Shada, although it is also considered a dangerous area, Hands Up for Haiti is known and welcomed by the local community workers. The people know what we have done for the community and our Haitian health workers provide the women and children with ongoing medical care in Shada. Here in La Fossette, however, we were “blancs”, a term that refers not to the color of our skin, but to the fact that we were foreigners, unknown to the community, and with no evidence that we would return.

Nurse Youselene, Translator Sondra, confer with Doctor Francisco.

Nurse Youselene, Translator Sondra, confer with Doctor Francisco.

We left our vans, surrounded by an escort of soldiers armed with machine guns, pistols, and machetes. This was not the usual way we engage a community and I confess I was uneasy with the plans. But the day went on without any problems. The team was so good at setting up an outreach now, it only took a few minutes to set up in the brightly colored “nightclub” which was really an open air pavillion. The bar transformed into the pharmacy and the tables became our stations. The people were respectful and appreciative and our team saw about 120 children.

A dehydrated infant is rushed through triage.

Nurses waste no time treating a child with pneumonia.

Nurses waste no time treating a child with pneumonia.

 

 

 

 

 

 

 

 

A few infants were quite sick. One two month old with Down’s Syndrome was in congestive heart failure, probably from an undiagnosed congenital heart defect. We treated the baby with emergency medications and then sent the baby to our contacts in Justinien Hospital and Sacre Cour in Milot.

Nurse Judy McAvoy lovingly attends to an infant with Down’s Syndrome who is in heart failure.

Were the children any worse than the children we see in Shada? I do not think so. But this experience made even more clear to me that how Hands Up for Haiti approaches medical care is the right way to do this. In La Fossette, we were faced with an emergency situation and we helped, but this is not the ideal. In contrast, by engaging the community in Shada as we have, we continue to earn the trust of the people who live there. The community health workers, like Madame Bwa and our clinic administrator Miguel Ange, work to ensure that the sickest patients are seen and that there is follow up. We support a doctor and nurse for the clinic when we are not there and we provide for education on prenatal care, nutrition and even sexual education. We are invested in the community and feel a part of the community. In LaFossette, we were visitors.

Dr.Hemant Kairam makes sure this child is treated for an infection.

Dr.Hemant Kairam makes sure this child is treated for an infection.

Dr. Mathieu, one of our Haitian physicians connecting with a little patient.

 

 

 

 

 

 

 

 

 

 

The UN forces in Haiti, called MINUSTAH, have been criticized by some as not helping and possibly hurting Haiti after the earthquake. I can’t comment on all the forces, but this battalion from Chile wanted only to help and it was an honor to work with them.  It is also clear that relying on the peacekeeping force to provide the only medical care for this community makes no sense at all. This is hit and run medicine and not in line with the goals of sustainable health care. The members of the Chilean battalion are compassionate and really care, but this is where the city government and the Ministry of Health need to step in, as they did in Shada after we rebuilt the clinic.

Working together. Members of the Chilean force: including head of security, Jaguar, nurse Fernandez and Dr. Francisco Garcia and Dr. LoFrumento.

Our challenging mission had come to an end, but a lot of work remains to be done. The initial days of rain and flooding had been replaced by sunshine and hope. Going forward, Hands Up for Haiti will continue to advocate for and work towards a better system of health care for all Cap Haitien neighborhoods, including La Fossette. We will continue to support our clinic in Shada, where we can create sustainable programs to serve the women and children of some of the poorest neighborhoods.

Thinking back on the whole experience, I believe we were successful because of the strong connections with our Haitian colleagues and our partners on the ground, working together, learning together, and healing together.

Our team with the members of the Chilean peacekeeping force.

Our team with the members of the Chilean peacekeeping force.

Photographs by Audrey DeWys


A Most Challenging Mission-Part 3 –Helping Two Sides of the City.

By Mary Ann LoFrumento MD

It had finally stopped raining and the floodwaters were receding from the city and the countryside. As team leader, I breathed a sigh of relief. We had held one large pediatric outreach clinic the day before but the week was only half over and we needed to find more locations. We reached out through the Cap Haitien Health Network, an organization linking many of the health related groups working in Northern Haiti. Within a few hours, we had two locations identified in desperate need of medical care.

 

Team arrives at Ft. Bourgeois clinic.

Team arrives at Ft. Bourgeois clinic.

Both were small clinics, so we decided to divide the team and our medical supplies. Dr. Hemant Kairam and Dr. Ann Engelland led the team to Ft. Bourgeois, a struggling medical clinic on the road to the Royal Caribbean port of Labadee. The doctor in charge of the clinic, Dr. Renaud Gerve, was glad to see the team and immediately mobilized the community.

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Community Volunteer announces that there will be a clinic for children today.

The team now knew how to set up a pediatric clinic in any location and immediately went to work. Within a few minutes, they had a triage team and registration, two to three stations with a doctor, nurse and translator, and  a pharmacy.

Volunteer Julianna Piccirilli weighs an infant.

Volunteer Julianna Piccirilli weighs an infant.

Dr. Roma Bhuta helps a young girl as a curious crowd develops.

Dr. Roma Bhuta helps a young girl as a curious crowd develops.

Respiratory illnesses are commonly seen, especially if a baby has underlying condition such as asthma. Often these sensitive lungs are irritated by smoke from poorly ventilated cooking areas in small homes. Our team educates the families after treating the children on how to avoid these attacks.

A baby who is having trouble breathing is treated with a bronchodilator and a makeshift aerochamber to help distribute the medication.

A baby who is having trouble breathing is treated with a bronchodilator and a makeshift aerochamber to help distribute the medication.

After treatment, a much happier baby.

After treatment, a much happier baby.

 

 

 

 

 

 

 

 

 

Over the day, the team saw about 90 children and left medical supplies and medications for the clinic at Ft. Bourgeois. Dr. Gerve was so grateful and sent a message to the Cap Haitien Network, reporting that the Hands Up for Haiti team came after the flooding and helped reopened our clinic. “We are so grateful.”

Nurse Alicia Benton convinces a little girl to take her medication with the help of some peanut butter.

Nurse Alicia Benton convinces a little girl to take her medication with the help of some peanut butter.

The pharmacy team busy ay work.

The pharmacy team busy ay work.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Meanwhile all the way on the other side of the city, team number two visited a small clinic run by one amazing nurse in the Madeleine area of Cap Haitien. Converted from a home to a clinic with the pharmacy in the garage, she sees patients in this underserved neighborhood a few days a week. When not working here, Nurse Carole sees patients at another HUFH location at Jolitrou, a clinic in a rural area where we have one of our malnutrition programs.

Nurse Carole in her pharmacy.

Nurse Carole in her pharmacy.

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Nurses Judy McAvoy and Valerie White unpack supplies in the “dining room”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A highlight of this clinic was the lab technician who sets up a small lab complete with microscope to run some simple lab tests. Pediatric resident, Priya Soni, who plans to do a Pediatric Infectious Disease fellowship after she graduates in June, was thrilled to be able to do hands on lab work to identify pathogens. As a Global Health educator, it was so gratifying to see the excitement of my residents being able to do field work.

Dr. Priya Soni takes a turn looking at a specimen.

Dr. Priya Soni takes a turn looking at a specimen.

The whole team wants to see. Nurses Hope Bechard and Valerie White take a turn.

The whole team wants to see. Nurses Hope Bechard and Valerie White take a turn as Drs. Priya and Blair Germain look on.

 

 

 

 

 

 

 

 

 

This smaller team saw about 4o children that day, but an important connection was made. Nurse Carole who no longer needs the home decided to rent the space to Hands Up for Haiti as an office with enough space to store supplies.

The team was now ready for anything and feeling very good about their ability to set up and run a pediatric clinic anywhere. Tomorrow, our last day to see patients, would provide yet another challenge: Next part: Mission with the UN Peacekeepers.


A Most Challenging Mission-Part Two- Heartbreak in Shada

by Mary Ann LoFrumento MD

It had been raining for days in Cap Haitien and the city and surrounding areas were suffering from serious flooding. The community of Shada, one of the worst slum areas of the city, was particularly hard hit. Many families who live in poorly built huts by the river lost all of their belongings; some lost their homes. Most tragically, three children were killed and their mother injured when flood waters crushed the wall of their home while they were sleeping. There were fears of a new cholera outbreak due to the contaminated water and lack of sanitation in the area. Things were so bad that it even prompted a visit from the President of Haiti, Michael Martelly, who arrived with government relief trucks of clean water and food.

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Shada area immediately after the floods.

Our pediatric team had been in Cap Haitien for most of this rain that never seemed to take a break. It had finally stopped raining and the floodwaters were receding from the city and the countryside. We were working on a plan for our team when I had a call from Miguel Ange, the administrator of our HUFH clinic in Shada. The clinic had been badly flooded by the river.

Some of our lost medications

Some of our lost medications

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Photos of the HUFH clinic in Shada taken by Miguel Ange, right after the flood

The HUFH clinic in Shada provides the only medical care for the people who live in the poorest slums of Cap Haitien. Hands Up for Haiti renovated the clinic building in 2011 and patients are seen two to three days a week by the clinic staff. It is also the location of our malnutrition program for both pregnant women and for children identified as severely malnourished who are treated with a peanut based supplement called Medika Mamba, supplied by our partner Medicine and Food for Kids. Every HUFH team that visits Cap Haitien holds a clinic there, seeing 60-80 children. This had been the plan for our team as well.

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During a previous HUFH team visit to Shada clinic.

I needed to go and investigate the damage. But we had to wait a few days as it was not safe to go there until the waters receded and the government and UN peacekeepers had provided some emergency supplies. Nurse Judy McAvoy and I planned to go with our Haitian staff and report back, but the team voted to go with us. We ventured into a nightmare of muddy streets piled with the destroyed belongings of families who had lost everything in this devastation. Mattresses and clothing were hanging to dry everywhere, yet a few children still kicked a battered soccer ball around the boulevard.

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Saving what could be saved.

I entered the back room in the Shada clinic with Administrator Miguel Ange. I looked at the walls, paint peeling off, and saw the marks where the water level had risen four feet into the building. The shelves in the pharmacy were empty except for the top two shelves. Medications and medical supplies were lost, as well as a supply of the Medika Mamba. Equipment was damaged. Some of the paper records were too wet to save.  Out of sight of my team, I felt tears come into my eyes as I surveyed all the damage.

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Miguel Ange shows me the clinic after a day of cleaning.

Miguel Ange is a proud and resilient man. He has been running the Shada clinic for Hands Up for Haiti for three years now. He had just been working all day to clean out the water in the clinic that had surged over the banks of the “boulevard” after days of unrelenting rains pounded the city of Cap Haitien. When he saw I was upset, he put his hand on my shoulder and simply said, “Don’t worry, Dokte Mary Ann, we will fix everything.” The strength and resilience of the Haitien people cannot be overestimated. I nodded and said, “HUFH will help you.” Before heading out, I gave him some emergency funds for the immediate clean up, and told him HUFH would help to rebuild the clinic better and stronger.

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Drying out what we could.

The team was a bit shaken by what they had seen. The poverty of Shada can be overwhelming, although things had been improving with the USAID project a few years ago to build a boulevard to replace the fields of muddy sewage that had been there before. A swing set and park area had been created. Now that swing set was battered and broken.

The team leaves Shada.

The team leaves Shada.

Some of our lost medical supplies.

Some of our lost medical supplies.

 

 

 

 

 

 

 

 

 

Sometimes, working in Haiti can break your heart. It is a country filled with proud people who want to better their lives, despite forces that are often beyond their control. In Global Health work, we can make progress, but we also suffer setbacks. It is one of the lessons the team learned during this challenging week. For me personally, it was hard to see our little clinic in such bad shape, but I was heartened by Miguel Ange’s resolve to repair it. I knew our teams would return to Shada, but now the focus was on this team and where we could work during the rest of our week.

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Children play near the river in Shada.

SHADA UPDATE: A few weeks later, the reports from the clinic are that the walls have been repainted and new shelves built. The tile floor and roof were in good shape. Some of the equipment could still be used. And Medicine and Food for Kids was working with HUFH to do the needed repairs. HUFH is looking into obtaining secure cases to hold supplies and protect them from water damage. Structural changes for the building might help secure the walls and doors from future floods. The doctors are back seeing patients and the malnutrition program is up and running again. If you wish to make a contribution for the “Make Shada Stronger” campaign    CLICK HERE     and select Shada

 

 

 


A Most Challenging Mission- Part One- The Rains Came




by Dr. Mary Ann LoFrumento

This was my seventh Global Health trip to Haiti, and I felt very confident leading this team of fourteen doctors, nurses and volunteers. We had been planning for months and preparing for weeks. The plan was to arrive in Cap Haitien and then head west to the remote fishing region of Bas Limbe  to run pediatric outreach clinics in the local villages. We would end the week back in Cap Haitien seeing patients in our clinic in the Shada slums. Nurse Judy McAvoy and I were experienced leaders and everyone was excited to be taking part in this mission.  We were ready, but nature had other plans for our team.

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The team arrives at the village of Bod me Limbe and Haiti Village Health

Our team arrived to a city saturated by days of rain.  The forecast was unclear when we arrived, and the team piled into the waiting van for the two hour drive to the village of Bod me Limbe on the coast.  Rain intensified along the way and travel became increasingly more difficult. The group of volunteers and Haitien translators arrived safely but soon realized that the plans for pediatric outreach were in doubt. Located right by the sea, waters had flooded the beach, the schoolyard, and was making travel by foot for the local families impossible. At the guest house at Haiti Village Halth, everyone dried off and enjoyed a dinner of steamed rice and chicken as Volunteer coordinator Thermitus Jean gave everyone lessons in Creole. The team then unpacked supplies and medications and prayed that the rain would stop.

Flooded schoolyard adjacent to the clinic at Bod me Limbe.

Flooded schoolyard adjacent to the clinic at Bod me Limbe.

I had stayed behind in Cap Haitien with nurse Judy McAvoy to pick up photographer Audrey DeWys who was arriving separately. Judy and I were joined by Hope Bechard, a nurse from Canada who was staying in Haiti for three months as an intern for Hands Up for Haiti working on several projects. But the weather was forcing cancellations of flights and suddenly we found ourselves huddled down with our partners at Haiti Hospital Appeal in their volunteer village and separated from the rest of the team for two anxious days. We made ourselves useful by seeing patients at the neonatal unit and the Maison de Benediction school for children with disabilities. But the rain continued day and night and we began to worry about reuniting with the rest of the team.

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Nurse Judy McAvoy plays with one of the little ones at Maison de Benediction.

Thanks to the leadership of experienced pediatricians, Drs Hemant Kairam and Ann Engelland, the team was in good hands as new volunteers, both pediatric residents and nurses dealt with the disappointment of not being able to carry out their mission in the flooded area. By Tuesday the rains had lightened enough that they were able to put together an outreach in the Haiti Village Health clinic on the property. They saw as many children as possible and then packed up what they could and boarded a van to return to Cap Haitien.

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Patients lining up at the Haiti Village Health clinic.

I had made the difficult decision to evacuate the team before roads became impassable. I knew this meant we would not be able to hold pediatric clinics in the villages that were expecting us. Conditions had worsened, however, and the safety of the team was the priority.  Taking advantage of low tide, the team traveled back in the rain and took up shelter at the Volunteer Village. The Haiti Hospital Appeal staff went out of their way to make us feel comfortable. Never had a meal of grilled cheese and soup tasted so good.

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Dr. Mary Ann LoFrumento meets with the reunited team.

Clothes and spirits were dampened, but by Wednesday morning, prayers were answered and the skies appeared to clear. It looked like the rains were finally ending. Photographer Audrey captured our smiles as we took the team photo.

November team

Standing l to r: Kathy Lee RN, Juliana Piccirilli, Ann Engelland MD, Priya Soni MD, Amanda Slanina RN, Judy McAvoy RN,Hemant Kairam MD, Hope Bechard RN, Mary Ann LoFrumento MD, front kneeling: Roma Bhuto MD, Valerie White RN, Blair Germain MD, Alicia Benton RN

But what to do with the team? We had fourteen people ready to work and we needed clinics in new locations. We conferred with our partners in Cap Haitien. First stop, an orphanage about a half hour away called Helping Haitian Angels. They also served the community surrounding the orphanage and school which had no access to medical care. Community leaders went into the village and announced that our team was coming. Before we knew it a crowd had formed with mothers, fathers and many babies and children.

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Patients arrive to our first clinic.

We knew what to do, and the team sprang into action setting up six stations, each with a doctor, nurse, and translator. Triage was run by volunteer, Julianna Picciarelli who is studying to be a medical assistant and nurse Amanda Slanina from Canada. Children were weighed, measured, temperatures were taken and the sickest children were put at the front of the line.

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Volunteer Julianna Piccirilli and Nurse Amanda Slanina check in and triage the first patients

Finally, the team was doing what they came here to do. Our biggest challenge that day was what to do for a family with a severely malnourished child who was known to have untreated tuberculosis. All the children were at risk as well as the parents. We would need to access some help from the Cap Haitien Network and the Ministry of Health to get them the needed medications and treatment supervision. Without this, the entire family, as well as other villagers could become exposed to TB, a true public health emergency. Our in country team helped to coordinate the plan. At the end of the day, the team may have been tired, but they were all smiles as we finally got to work. Now what to do next?

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Saying goodbye to some new friends.


The Story of Jennie- The Challenge of Mental Illness in Haiti

 

She walked into the busy clinic, a thin, quiet teenage girl who seemed frightened and reserved. Her name was Jennie and she had been brought to the clinic by her adoptive mother who heard that a Hands Up for Haiti team would be visiting the small clinic known as Shaddai in the area of Cap Haitien known as Blue Hills.

Our small group of doctors and nurses had never been to this clinic before and we were busy seeing patients, of all ages, when the nurse brought Jennie and her mother over to see me. She explained to me through our translators, that over the last several weeks, Jennie had become more withdrawn and was seeing things. She would wake up from her sleep shouting and disoriented. Other times she would be unable to speak, or run into the streets unclothed. Her mother informed me that she had been an abandoned child that she and her husband had taken in.

Many children in Haiti are abandoned when their family sees no way to feed and clothe them, or provide the medical care they need, They do this in hopes of someone caring for them. And often, despite such wide spread poverty, another family does take them in and will do their best to care for the child in need. This was Jennie’s story. There was some information that Jennie’s natural mother had had mental illness. Jennie had been fine until five weeks ago when the bizarre behavior occurred.

Nurse Chancerrie welcomes the team to the Shadii clinic

Nurse Chancerrie welcomes the team to the Shadii clinic

It was the first time that a Hands Up for Haiti team had come to work at the Shaddai Clinic. I met the nurse, Channecie Gabelius at the Cap Haitien Health Network meeting in October of 2013. She told me about the clinic that she and her husband, a Pastor ran in a community of Cap Haitien called Blue Hills. She was hoping that a team from Hands Up for Haiti would come and work with her at her clinic.

Following the meeting our medical director, Dr. Dieula Toussaint was able to make arrangements for a site visit. Based on Dieula’s visit, we were able to discern that the clinic was a small facility operating out of Channecie’s home. Dieula recommended that our team be limited to five people.

So given that this would be the first visit for a HUFH team at this location, Dieula and I went as the doctors, bringing Amy Welsh, a Canadian nursing student, Celine Grae, an American EMT and Marg Nap, an experienced Canadian nurse. We arrived at the clinic after being escorted from the center of the town to a small road to a crowd assembled outside of a house with a veranda. The crowd consisted of small children, and elderly adults, and everything in between. Dieula and I set up two stations in the living room, Marg was set up on the veranda in a small enclosed area to triage patients, and Celine and Amy set up our supplies and pharmacy. Our team included our two translators, Peterson, and Sandra.

(L-R)Dr. Dieula Touissant, EMT Celine Grae, Dr. Jill Ratner, Nurses Channecie Gabelius of Blue Hills and Marg Nap from Canada, Nursing Student Amy Walsh, Translators Simon Peterson and Sondra

(L-R)Dr. Dieula Touissant, EMT Celine Grae, Dr. Jill Ratner, Nurses Channecie Gabelius of Blue Hills and Marg Nap from Canada, Nursing Student Amy Walsh, Translators Simon Peterson and Sondra

I sat on a couch with a small wooden table in front of me- and despite the rush of children who needed to be seen, I knew that Jennie needed to be my first priority. Psychiatric care in Haiti is sporadic at best and very difficult to find for most families in need. My instinct told me this was a child who had experienced trauma in her life, might have a predisposition for mental illness, and her family had witnessed an abrupt decline in her functioning. In the US this would have called for a full neurologic evaluation, blood tests, CAT scan and EEG, which more than likely would be normal and she would be seen by a Psychiatrist.

But here I was in a living room in Haiti, with my translator and a mother, and a desperate teenager. She clearly understood everything I said to her, although she could not speak, she nodded and let me know how she was feeling. The best I could do on that day was be kind and reassuring, treat her for infections that might cause encephalopathy, and think about how I could get her for diagnostic and therapeutic treatment. The family was so appreciative of us being caring and kind. We took their contact information and I left feeling helpless to aid this girl for whom reality and hallucinations were indistinguishable.

After that day, Josette , a family practitioner on the trip, and I discussed this girl. Josette, having more of a psychiatric background from her practice, felt strongly that Jennie was having a first psychotic break, and could be helped by medication. I contacted Ted Kaplan, the head of the Cap Haitien Health Network, and he was able to refer me to a team who comes twice a year to Ounaminthe to teach local doctors how to treat psychiatric disorders and sees patients. They were returning in three weeks! Ounaminthe is about an hour’s drive from Blue Hills.

I was able to contact Dr. Jim Druckenbrod back in the United States and Chaneccie brought Jennie to see him with funds provided by HUFH. She was evaluated and begun on life changing medication. Channecie writes to me regularly to let me know of her progress., “Jennie is so much better! Her family says she is eating and drinking normally and seems more like herself. Merci Dr. Jill, Parents of Jennie embrace you. “According to the reports, Jennie speaks, is no longer tortured by hallucinations and has returned to normal activities and school.

Jennie and her parents return to the clinic.

Jennie and her parents return to the clinic.

What is more the team led by Dr. Jim Druckenbrod is sharing their clinical protocols with us and is interested in collaborating in any way possible. This means that subsequent patients can benefit, and that we, and our Haitian colleagues can feel more comfortable treating a broader range of conditions.

We will return to Blue Hills and I will hug Channecie and see Jennie again on my next trip. I didn’t do much for Jennie except listen, empathize and find someone and someway to help her. These little victories and successes are the true delights of being a physician and working together to be able to coordinate care with other dedicated individuals and organizations. Without contacts, and relationships, none of this would happen. Hands Up for Haiti and its association with the Cap Haitien Health Network made this girl’s future optimistic again.

Dr. Jill Ratner

 

 

 


Hands Up for Haiti Opens “Our Door” for Pastor Wiljean and His Family

Hands Up for Haiti volunteers welcome the Pastor and his family

Hands Up for Haiti volunteers welcome the Pastor and his family

Almost every Hands Up for Haiti volunteer who has traveled to northern Haiti has been welcomed at Open Door in Bois de Lance. In fact, this clinic was the site of the very first medical mission in 2010 when the founding team went to Haiti after the devastating earthquake. They were welcomed at that time by Pastor Wiljean Compere and his wife Jannine, an amazing cook, known to all as MaPas. Over the past four years, the Open Door community and the Wiljean family, have hosted multiple Hands Up for Haiti teams as they worked in collaboration with the Haitian medical staff to support and expand the medical clinic, provide health care to the children at the Open Door Orphanage, hold health education workshops for the school age children and teens, and donate books and computers to the school library.

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Hands Up for Haiti team at Open Door last January.

This August it was our turn to welcome Pastor Wiljean Compere and his family as they traveled to the United States for a visit. Pastor, MaPas and their two teenagers, Jennie and Jerry, came to New York after traveling to Orlando and visiting Disneyworld. Dr. Jill Ratner, President of Hands Up for Haiti, and her husband Joel Rosenberg hosted the Compere family at their home, where they were reunited with Samson Desamour, who was excited to see his Pastor and show him where he has been living while going to school here in the United States.

First stop was Mt Kisco Medical Group, to meet and thank all the staff, especially at the pediatric practice where Dr. Jill, Dr. Allison Platt, and nurse Judy McAvoy, who have helped Hands Up for Haiti support Open Door throughout the years. It was an opportunity for staff members who have heard so much about our Haitian friends to actually meet them. For others, such as RN Kathy Lee and Alicia Benton who will be traveling to Haiti in November with Hands Up for Haiti it was an exciting chance to make connections.

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AT Mt. Kisco Medical Group, having lunch with members of the Pediatric Department.

A special moment was meeting Dr. Kevin Riley, OB-GYN, who although he has never traveled to Haiti, has helped save lives by donating the ultrasound machine used at Open Door to help women have safer pregnancies. Dr. Steven Maruliese who hopes to travel to Haiti in 2015 was instrumental in the Compere’s medical care, as well Dr. Oren Kahn, who, like many of the physicians and staff at the Mount Kisco Medical Group has supported HUFH over the last four years. Dr. Warren Bromberg was reunited with the Compere’s in the office as well. Ms. Doreen Semel, patient coordinator, and Sonia Young, public relations for MKMG was able to meet the Comperes and coordinated the appointments.

That evening Dr. Ratner and her husband held a potluck dinner for the Hands Up for Haiti community to celebrate the Pastor and his family. They were overwhelmed by the joyous welcome they received from countless volunteers who came from New York, Connecticut, and New Jersey to see the Pastor and his family. Board member, Amy Parkin, observed to MaPas, “Almost every person here tonight has been a guest in your home.”

Executive Director, Lamar Parkin and President Dr. Jill Ratner with

Executive Director, Lamar Parkin and President Dr. Jill Ratner with “MaPas” Madam Jannine Compere

For some volunteers, like Judy McAvoy, it was a chance to introduce family members to the Pastor. When she introduced her husband Jim, MaPas hugged him like family. Joel Rosenberg, Dr. Jill’s husband and major supporter of Hands Up for Haiti, has heard about the Pastor for years, “It really was wonderful to be able to finally meet.” Others, like pediatrician and frequent trip leader, Dr. Allison Platt, brought their children who hung around the piano as Samson, Jerry and Jennie sang Gospel songs from their church.

Board member and team leader, Judy McAVoy with her husband Jim.

Board member and team leader, Judy McAVoy with her husband Jim.

Guests included Joel Seligman, CEO of Northern Westchester Hospital, and his wife Joyce. Mr. Seligman traveled to Haiti with Hands Up for Haiti last year and spent time at Open Door working side by side with the doctors and nurses caring for the hundreds of children who come for medical care. During his visit, he formed a special bond with the Pastor after learning of all the needs for the people in his community.

Joel Seligman and his wife Joyce share stories with the Pastor Wiljean

Joel Seligman and his wife Joyce share stories with the Pastor Wiljean

Joining in conversations over dessert, Ophthalmologist Dr. Beth Bromberg and her husband, Urologist Dr. Warren Bromberg, were both happy to catch up with the Pastor. Dr. Beth and her eye team, including Dr. Mitch Stein, have made arrangements for ongoing ophthalmology care for patients from the Bois de Lance community with the help of Pastor Wiljean.

Jennie and Jerry share their music.

Jennie and Jerry share their music.

It was a beautiful evening and a wonderful summer celebration for the volunteers of Hands Up for Haiti and a chance to welcome a very special family to the United States.

Dr. Ratner said, “ It is like a collision of two worlds, a world in Haiti and a world at home and how these two worlds meet is a beautiful thing. It makes the universe feel a little smaller. “

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CHERISH THE SMALL VICTORIES – A Baby and a Grandmother Return

By Dr. Jill Ratner

It was our last day of clinic at Open Door in Bois de Lance, a rural farming community where Hands up for Haiti has supported a medical clinic for the past three years. I was called into the examining room where one of our pediatric nurse practioners, Lauren Blum, was seeing patients. She was seeing a grandmother with a very underweight one month old. The baby’s mother had died and the funeral had been the day before.  The mother had been hospitalized two weeks after giving birth with an infection. The infant had not been nursed in two weeks. The family was doing the best they could- giving the baby juice and tea.

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Not to have a mother to nurse an infant in Haiti is an ominous thing- formula is sometimes available in the city, but it is very expensive for the typical Haitian family. Lauren and I looked at each other. We contemplated having the grandmother make a substitute formula using boiled water, sugar and salts. And then another thought occurred to us- perhaps there was another mother in the village willing to nurse the baby along with her own child.

We queried the grandmother, whose face lit up as she told us that the mother’s cousin was sitting outside with her six month old. The cousin came in and was so excited to nurse this small, undernourished child of her cousin. No one in the family thought that the milk she was making would also be good for a baby this young. We gave them lots of support that day for her to be the wet nurse for this poor infant.  We spent time reviewing that breastmilk was the best possible food for the baby and that no solid foods, tea or juice should be given. We made sure to give the cousin prenatal vitamins and we gave her advice about her own diet. I wrote down the baby’s weight and height that day, and handed it to the grandmother. We arranged for her to be followed by the nurse and doctor seeing children in our malnutrition program that normally begins at six months of age.  The baby was to be seen the following week.

We left feeling good that maybe that child had a chance of getting appropriate nutrition, and that maybe our intervention would make a difference.

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I returned to the clinic nine months later. On my last day at the clinic, an old woman came in with an alert child, whowas small and somewhat thin, but healthy. I didn’t really recognize them at first. The day was busy and I saw many children that day.  In the woman’s hand was the note with the weight and height that I have given her nine months earlier. I looked at the woman. She looked at me. We both had a moment of recognition. It was the same grandmother. The baby had survived andwas doing well. We hugged and both became tearful. I knew her story and she was touched that I remembered. I grabbed Lauren who was on this trip as well. Wayne our team member and photographer also remembered her and the story. We were bonded by our shared experience on that sad day months before; the day this woman buried her own daughter and brought her grandchild to the clinic. We knew her pain and we acknowledged her triumph of keeping this child alive.

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It can feel overwhelming at times to work in Haiti. We see so many people who need medical help and sometimes it is too late to help save a life. In this case, it was the simple knowledge we provided that breast milk could be given to the newborn by someone else that saved this baby’s life. It is these moments of small victories that reinforce what we are doing; moments when we return and see that life is better for those we were able to touch and help.


TIME TO REFLECT- Interview with Obstetrician and Gynecologist Dr. Michael Shaw

By Dr. Jill Ratner

Four months after Dr. Michael Shaw returned from his first trip to Haiti and his first experience delivering health care in a resource limited country, we sat down to talk. Even though Dr. Shaw is a seasoned Obstetrician/Gynecologist and has done extensive volunteer work with Planned Parenthood, he admitted that nothing had prepared him for what he saw in Haiti. And as with many of our volunteers, sometimes you need some time to process the experience.

He spent his week working in the clinic at Open Door Ministry alongside trip leader and pediatrician, Dr. Allison Platt, and then focusing on his core mission: teaching life saving colposcopy and cervical cancer screening at the Justinien Hospital, the main teaching hospital in Cap Haitien. To do this he would conduct training classes and make rounds on patients with Ob/Gyn Attending, Dr. LeConte and his house staff.

Cervical Cancer is the leading cause of cancer death for women in Haiti and it strikes them in their 30’s and 40’s.

This program was first brought to Cap Haitien by another Hands Up for Haiti volunteer, Dr. Sue Malley who managed to get the first cryoprecipitate machine and screening done two years ago. (link to previous blog)

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“There is no comparison with working in a clinic or office in the United States and the conditions in which you see patients in Haiti- the heat, the lack of equipment, nothing is clean despite all efforts- you can’t be ready for that”.  Despite that, he commented that the cases he saw in the hospital were extremely well managed, and the outcomes were going to be good. The patients were suffering from complicated medical problems such as uterine perforation after an abortion and severe pre-eclampsia of pregnancy. Despite the environment of crowding,  lack of basic hygiene control, and incessant flies in the hospital, patients were receiving good care.

Dr. Shaw felt that cervical cancer screening with colposcopy and “see and treat” protocol was definitely the “way to go” in this setting, especially since obtaining routine Pap smears is not possible for the millions of women at risk.  He felt that there were women with pre -cancerous or cancerous lesions that he treated and he was sure that they will have good outcomes because of this.  “The equipment is old, difficult to focus and needs upgrading”. One of Dr. Shaw’s goals will be to try to obtain a new culposcope and cryoprecipitate machine for the program.

Although Dr. Shaw recognized that doctors were trying their best to deliver good care, he did feel there was much need for increased sensitivity to the rights of patients for respect and privacy even in this setting. It is a different culture and “The lack of drapes during exams, the lack of privacy was really hard for me to see.”

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As far as Hands Up for Haiti was concerned, Dr. Shaw had nothing but superlatives. “I always felt safe and the trip leader was “tremendous”. “From the moment I stepped off the plane, until returning home, our Haitian team was always there and escorting us through sometimes tricky situations”.

As for most of our medical volunteers, the first trip is always the hardest. “It was difficult being without the support of my family and other Ob-GYN colleagues. I am not ready to go back…..yet. When I do go back, I think the way to go will be with an experienced operating nurse, and maybe even an anesthesiologist. I would be willing to continue to work on the cervical cancer screening and on the operating room protocols and techniques with the Haitian doctors and nurses.”
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There were bright moments as well. “One of the highlights of the trip for me was watching Allison treat the children from the orphanage. The children were so grateful for the attention and care. It was emotional and heartbreaking all at the same time”.

In the meantime, Dr. Shaw is continuing to support Hands Up for Haiti and its work, and will be actively seeking improved equipment that will make treatment options even better.

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