My Third Trip to Haiti

By Erica Bromberg

I recently returned from my third trip to Haiti. This time, I went on a pediatric mission. There were 14 people on the trip and the group consisted of students, pediatricians, nurse practitioners, nurses, nutritionists, social workers, and a professional photographer. As with my previous two trips, this mission was nothing short of amazing. This was my first trip without my mom, but our team leader was my childhood pediatrician and Hands Up For Haiti’s president, Jill Ratner. Jill was an unbelievable team leader. There were quite a few “young” people on this trip – Jenna, a sophomore at Cornell, Chava, a nursing student at Pace who is my age, and Pete and Pat, two social workers. Not to mention the amazing Haitian translators we work with every trip. I was so excited to see them again. The pediatric mission was great for me to learn about basic medicine. I will never forget what Albendazole is used to treat! (worms).

Upon arriving in Port au Prince last Sunday, we were informed that not all of our luggage, mine included, would be able to continue with us to Cap Haitian that evening and would be sent out on the first flight the next morning. I then saw that my suitcase had been locked with the spare lock I had on one of the zippers (and I did not have the key with me!). Fortunately, we were able to take all of the luggage with us and upon arriving at Open Door we were able to break the lock open. We spent the evening setting up our bug netting and we ate Ma Pas’s amazing home cooked dinner.

Day 1

We were spending the first few days seeing patients in the clinic at Open Door. The first morning we were awakened by the usual roosters at 4am. We started clinic around 8:30am and worked until the early afternoon. I helped the doctors with scribing, getting medications from the different rooms, and I got to rub Permethrin cream on a baby with scabies – my first time administering treatment to a patient by myself!

The worst case of the day was a two year old with a rectal prolapse that was so bad she couldn’t sit down. I will spare the details. The child was in such hysterics our only solution was to temporarily tape her rear end closed and advise that she returns to the clinic in two days if it does not improve. Another baby had a face covered in impetigo. In addition to medical treatment for the infection, the nebulizer was used to soothe his face as temporary relief. The team was excited to see the baby the next day and how much his face had already improved!

After clinic we went over to the orphanage. We saw the kids playing on the swingset. As usual, they were craving attention and would not let go of our hands. After the orphanage we walked down the road to see a well that had been built. A 12 year old Haitian boy walked with me the entire time, chatting in English. He told me he loved me and also asked for money to keep going to school. I told him I did not have money on me but that he should stay in school as long as he could and how important it is that he gets an education.

Day 2
On Tuesday the team split up – half of us went to do outreach in a local village and the other half stayed at Open Door clinic. Outreach was performed in a local church. There was nothing in the church except for a few tables and chairs. We made do with what we had and set up different “office stations” for the doctors to work. We examined 45 patients in total. I saw a young girl with tinea on her scalp. It had caused a large bump on her head. A young boy had an accident with a machete about two weeks ago. The tip of his finger, which was falling off, had been stitched up about two weeks ago, but the stitches were all frayed and infected and his finger was gangrene. We attempted to clean the finger and put some gauze over it, but the baby needed to go to the hospital immediately to have part of his finger removed.  The patient who had the largest impact on me was an 18 month old who was so malnourished he was about the size of a six month old. The mother said he was enrolled in medika mamba, the local malnutrition program (mamba is peanut butter in Creole), and not gaining any weight from it. It was clear to us that the mother had some issues of her own. She seemed unresponsive to our comments and suggestions and very removed from the situation. The nutritionists tried to speak with her one on one to get the message through to the mother that her child would die if he did not gain weight. We gave the mother money to take a tap tap to the hospital and told her that we were going to check on her the next day to confirm that she went to the hospital. We later learned that she did not go to the hospital, as she believed she did not have enough money to then take a tap tap home from the hospital. The whole situation was very saddening.

In the afternoon, we walked up Prayer Mountain. The view was gorgeous and it felt great to be walking around outside. We were joined by some of the village children. That night, the boys (Samson, Guindy, Sonel and Peterson) took us over to the church and played music for us. We danced around and formed a big conga line.

Day 3
Wednesday the team switched roles from the previous day, so I spent our third day in the clinic at Open Door. I worked in triage, helping to weigh and measure the kids. The biggest case of the day was putting sutures in the forehead of a girl who was accidentally hit by a rock. She was very scared at the sight of her blood and screaming uncontrollably. It didn’t help that we did not have the right size needle.

I gave a community lecture on why babies are born with birth defects. There are many myths and superstitions in Haiti so my goal was to dispel the myths. I spoke about a few different syndromes, gave advice on nutrition for the mother while pregnant and the consequences of drinking or smoking while pregnant. I did not receive many questions from the attendees, but I was glad when a mother said she was planning on getting pregnant again and happy to have this new information.

Day 4
Thursday morning we packed up our bags, as we were staying at a hotel in Cap Haitien the rest of the trip. Half of the team went to Grand Riviere while the other half went to Limonade. I was part of the group traveling to Grand Riviere, however we never ended up in Grand Riviere – over halfway through our tap tap ride we were stopped by a roadblock. People had placed tree trunks in the middle of the road as a protest to get the government’s attention. They wanted the roads to be fixed. We were able to get through the first roadblock, but we were stopped about five minutes later and had to turn around. We couldn’t return via the road we had come from, so we had to find an alternate route and ended up driving through rivers and streams. It was quite the adventure.

We joined the rest of the team in Limonade. 60 patients were seen in total, only about two of whom were healthy. The most malnourished children were seen here out of any other clinic day on the trip. I assisted Lauren, a Pediatric Nurse Practitioner, with getting medications for patients. We saw a three year old who was so malnourished he weight 13 lbs and was the size of a two month old baby. He couldn’t walk and his cry was so weak it was barely audible.

The malnourished three year old and his 19 year old mother:

Day 5
On Friday I went to Shada with half of the team and the other half went to Labadee. Shada is one of the poorest slums in Cap Haitien. The houses look like shells of concrete and there is trash everywhere. I was looking forward to working in the clinic at Shada, as I had never been there before. The clinic was extremely small but we worked very efficiently. Much to my surprise, we barely saw any malnourished children. Many of the children were already enrolled in a malnutrition program. Most patients had UTI’s, scabies, or other infections requiring antibiotics. One 16 year old boy, who showed up to the clinic alone, was extremely thin and had very concentrated urine. It was unclear whether he had typhoid.

After clinic, we walked down the street to the local market. It had tons of paintings, sculptures, bracelets, wooden bowls, etc. I definitely could have found something to buy, but the shop owners were very relentless and intimidating and I was not up for bargaining. Friday afternoon we went to a healthcare networking event at a nearby hotel. The hotel sat atop a mountain and we had a gorgeous view of Cap Haitien. That evening we had dinner as a team at another nearby hotel, Cristophe.

Day 6
Our last morning in Haiti most of the team went on a site visit to a Hatian woman’s home. We originally planned on having working sessions and discussions with the children, but due to miscommunications none of the children were there that day so the team went to scope out the space for future visits. The woman’s main mission is to “evangelize” the children in Haiti. The team saw the program brochure before traveling to her home and it was very religion oriented. However, upon visiting the gorgeous home and speaking with the woman, the team realized the main mission of the program was to promote education among the children. It was definitely a worthwhile site visit and the group would love to work with the children on future trips.

Instead of going on the site visit, Chava, Jenna and I accompanied Samson on a ride back to Open Door. We walked across the street to Deula’s home and Samson had a man climb a tree and cut down coconuts for us! We drank the coconut water. On the way back to Cap Haitien Chava went on a short motorcycle ride with Samson.

For our last night in Haiti, we took a walk down the street from our hotel and went to dinner at a local restaurant. It was a great end to a great week.