Dr. Tiffany Keenan (left), founder of Haiti Village Health
Tiffany Keenan: Dr. Keenan worked with us to ensure that everything went smoothly. Problems were addressed as a group and solutions proposed. Tiffany very much wants to continue working with Hands Up for Haiti on collaborative efforts to improve medical care in Cap Haitien and the surrounding communities. They will welcome future teams who wish to come and work at Bod me Limbe or at Shada Clinic which will now be under her supervision.
Dr. Brinvert: The young doctor now works there five days a week. Each day one of the students worked with him in the BML clinic. He taught all of us so much about practicing medicine in Haiti. He came to Mombe with us and acted as a consultant, rounding on each station and asking if we had questions. It was a real example of the collaboration that is possible between the Haitian doctors and our medical teams.
Dennrik Abrahan: A third year medical student who is at the University of Southern Florida and the current coordinator for HVH this year. He has been working with the staff to make sure these programs go as well as they can. Each night after dinner, we all met to discuss the day. Each person spoke about their role that day and what went right and what went wrong. Then everyone contributed with suggestions. The translators were included in these discussions. It was a really useful debriefing.
Staff: Santos is the manager who went out of his way to take care of our needs. Cholo is now the pharmacist and they are working on a detailed inventory for future missions and for their daily use in the clinic. and during our stay we also had Edward and Alysha who were helping to organize the program.
Each one of our students had to prepare in advance a topic to discuss with the group and after the debriefing, they took turns presenting to the group.
This included the Haitian staff and Dr. Brinvert. The topics covered were Malaria/Dengue; HIV- AIDS, Malnutrition, Parasites and Parasitic diseases, and Diarrheal Disease including Cholera. We had discussions that really took on a real life meaning. Especially informative was Dr. Keenan’s description of how they treated cholera in real life with limited resources.
The four medical students had just finished their third year at Touro Medical School in NY. They had had their pediatric rotation so were familiar with seeing patients in an out patient setting. It worked very well to have them see the patients with one of the doctors supervising. All charts and prescriptions were co signed (as per HVH policy) and interesting findings were demonstrated to all. The students all felt this experience was very valuable to them personally and professionally.
Hands Up for Haiti Resident
Viraj Chauhan was finishing her first year at Goryeb Children’s Hospital. This week counted as part of her Infectious Disease rotation. She saw patients independently and on one clinic day had a medical student to supervise. She felt she had more autonomy than in her residency experience and saw more patients in a day than in a week of outpatient clinics. When she returned she had to provide written reports and pictures to her Peds ID Attending who was quite impressed with how much infectious disease she had seen first hand.
Dr. Mary Ann Lofrumento, Team Leader Extraordinaire
Drive to Work
Because of the flooded condition of the roadways, we took a truck to the village of Monbin. The people of nearby Noman also came to this clinic.
The set up was the same but here we had a larger church that had better natural light. The pastor was very helpful in getting the people there and taking care of all of our needs including providing lunch for us. Because Mombin has a road in good condition leading to the village and there is more market activity, the children and parents in this village were healthier and in better nutritional shape. Even so, they had had few government programs for vaccination. Our team saw 117 children. Most had similar respiratory illnesses, and abdominal pain or stomache ache, some had ear infections, but less major infections of the skin and less scabies. We still saw a few cases of clinical malaria.
BOD ME LIMBE
Taking advantage of a day when the school was closed, we set up an outside clinic to see the children of Bod me Limbe and the two smaller surrounding villages.
We saw about 80 children. Again the children appeared healthy and well nourished for the most part. We saw less scabies than last year and even less tinea. Everyone received vaccinations who were scheduled to. More education needs to be done in the communities prior to vaccination blitz’s regarding the purpose of the vaccines, what diseases we are preventing, and the usual side effects. If parents understand this ahead of time, it will increase the numbers of children who will get immunized and make these programs more effective. Hands up for Haiti helped by having our nurses also work with the Agent Sante’s to educate them on how to prepare parents and the community for vaccination programs.
Vaccines were given by the Agent Sante’s under the supervision of Alysha, a public health nurse working at HVH, and Judy, our HUFH pediatric nurse. The vaccines were DPT, oral polio, and a Measles, Rubella combination. The vaccines for the day were picked up by Santos, HVH manager, in Limbe first thing in the morning. The challenges with the vaccines was keeping them cool and teaching the health workers how to properly prepare and administer the vaccines.
Our team saw over 100 children in Guiotant. The most common conditions we saw were infected skin lesions, stomache pain, respiratory symptoms such as cough and wheezing, pneumonia, and several cases of clinical malaria. We saw the common such as chicken pox and the exotic such as 6 year old Emerson St. Hillaire who has what appears to be an “ectopic Heart” , which would have been repaired in infancy in the United States.
The nurses tried to get accurate heights and weights and plot the weights on the government growth charts. Obvious cases of malnutrition were referred for further nutritional support. A program Medicine and Food for Kids using Medika Mumba, an RUTF food is being organized in Bod me Limbe with the help of Hands up for Haiti. We distributed a month’s supply of multivitamins to all the families.
The pharmacy was staffed by a student and a translator. And drugs were organized and then dispensed using peanut butter and jelly, and mixing suspensions in the empty vitamin bottles. Almost everyone received anti-parasite medication .
On both days, we set out early for our 45 minute hike to the village of Guiotant. We climbed up and down muddy hills and then walked on a long stretch of beach.
Before we got to the village we had to take small fishing boats across a river. This was quite an experience with bags of supplies and provided much amusement for the locals watching us get in and out of the boats.
We set up in the church, a small, poorly lit building, and used the pews for our stations. We had registration outside where Dennrik and Edward, another Haiti Village Health volunteer,, working with a translator and the local pastor took names and DOB and then found the previous records from the March immunization blitz if they had received vaccines.
A nursing station was set up near the door, Judy and Linda, our pediatric nurses, and the Agent Sante’s, local health workers being trained to run the clinics, did weights and heights, temperatures and blood pressures where needed. We used a regular scale and had the mother hold the child and then the nurses subtracted the mother’s weight. Heights were measured either against a wall or on a pad on the floor using a tape measure.
We had three consult stations for the three doctors. A medical student and a translator were assigned to each one. Every patient was seen by the students under the doctor’s supervision. If they were just here for vaccinations, we indicated which ones on their records and sent them to the Vaccination station. If they had a medical complaint, they were evaluated, and treated. Referrals were made for dental, surgical, and follow ups with Dr. Brinvert at the BML clinic. The patients were then sent to the Vaccination station before going to the Pharmacy station to get prescribed medications.
We arrived in CAP and were picked up by Dennrik Abrahan, medical student and coordinator for Haiti Village Health. . We traveled to Bod me Limbe, a two hour ride from Cap Haitien, in an open air Tap Tap. The students enjoyed seeing the countryside and greeting the people along the way.
The first thing we did after arriving at Bod me Limbe was to have a tour and get everyone settled in their rooms. Dennrik then held a meeting to discuss the plans for the week. We decided on rotating assignments for the medical students.
Then we organized our supplies and began sorting medications and preparing dosage bags for vitamins and antibiotics. It had been raining for several days and it looked like the rain was going to continue. The team is looking forward to starting our first day of clinic in Haiti.