Thursday, April 17, 2008

Beth's Post: Haiti Trip Day 2

April 4, Easter Sunday:

Slept in until 7am and put ourselves together for the day. After breakfast Willem, our host, and the two boys, Stephen (13) and David (9), drove us up the mountain to Gramothe, the site of the church, a school, and the medical clinic. It was an awesome ride up. We took 4 wheelers and Stephen (AKA Speed Demon) was my driver. The path up the mountain is rocky and uneven at the best points, apparently impassable at others, and we raced up it like it was Mother Nature's newest roller coaster. It was wild and an amazing amount of fun. Oh, and I was very glad I'd added leggings under my dress... Especially on the way down when we broke all the posted warnings and added a third passenger to our vehicle driven by someone under 16... Did I mention it was awesome?

Gramothe school.
Up at Gramothe Stephen gave us a tour of the campus. Britney pointed out how much it has changed since she visited 10 years ago. It's a pretty nice facility considering, but still a lot to be done there. We got a peek at the clinic we will be helping at this week. Pretty well stocked right now. As Beth said, a lot of medical and cleaning supplies have come into the country right now and there is enough hand sanitizer to bathe in. Not that this is bad, but right now it's a storage issue and will it still be here in 6 months? Anyway, back to events of the day...

Soon it was time for the Easter service to start. Of course it was all in Creole so we didn't understand any of it. I think I'm up to about 8 different languages I don't speak that I've attended services in, so nothing new for me. The music seemed to go on and on since all the songs were just strung together. I recognized one and a few others sounded familiar. I'm still not entirely sure what went on in the service, but we had Willem explain one part later because he was dancing during his sermon and that could not just be overlooked. At one point Willem brought me and Britney up to the stage to introduce us. He mentioned Britney has visited 10 years ago, but for me he just asked if I was married and then told the crowd that interested parties should speak to him. (Incidentally, I really think this is becoming a thing. All the married men in my life are trying to marry me off.) He claims he had 2 interested parties come up after the service, but I'm not convinced.

Britney talks with David while we wait for Willem to finish his meeting.
After the service Willem had a meeting so we hung out with the boys. It was definitely hot out in the sun. When the breeze came up it was nice, but otherwise it was brutal seeing as shade is hard to come by. Haiti has a huge problem with deforestation, which has affected many other things including shortening the rainy season and creating potential for drought. Anyway, after about an hour and a half we finally headed back down the mountain to lunch.

Sunday is traditionally a sabbath in Haiti so we just chilled for the afternoon. I tried to read a little and ended up taking a little nap instead, but was woken up by the arrival of more members of the team. It was kinda nice having the house to ourselves, but tomorrow more of the team arrives and the house will be packed to the gills. So the chill evening chatting and playing card games was nice. Tomorrow we head up to the clinic to get it all set up for the medical staff arriving tomorrow afternoon.

Beth's Post: Haiti Trip Day 3

April 5, Monday:

More organized than when we came in.
Started a little late this morning seeing as Willem was spending the day making trips back and forth from the airport bringing in the rest of the team and there wasn't too much we could do yet. Britney, Hannah (a team member from Mexico), and I spent the morning over at another guest house sorting out supplies for the clinic, the children's home, and other destinations. Many of the hotels and guest houses fell in the earthquake and the ones that didn't are jam packed with aid workers and others coming into the country for various programs. This led to various houses and other buildings being pressed into service as guest houses and bed and breakfasts for visiting workers. This house is one that MTM has been able to get access to and Beth said both houses have been packed since the earthquake. The house itself was very nice and would be considered quite fancy even in the US. Of course, down the street people are living in shacks, but that's Haiti. Our task there was to come into a stack of meds, equipment, and supplies from various sources (including a big load from Morocco which had info only in French and Arabic), figure out what they were, and arrange them into suitcases and bags to be transported to various locations. After sorting the meds we took the various toiletry products and made up "health bags" to be passed out at the clinic. We used up all the supplies, but I'm sure we will run out of them sooner rather than later.

More supplies waiting to be loaded.
When we got back to our house Beth went off with the newly arrived medical director, Marcia, to look over the equipment and meds and come up with a game plan for tomorrow. We spent the afternoon getting to know the new team members and feeling a little useless. After dinner the last group of people arrived and then we had orientation and discussed jobs and assignments for the next day. Britney will be working with children -- she has the fun task of covering them with cream to treat them for scabies. Yay! I will be working in the pharmacy, but breaking away as needed for whatever support the nurses and doctors need.

I'm looking forward to finally getting up to the clinic and getting to work. Should be an exhausting, but rewarding day. I'm pretty sure I'll know a lot more about medication and medicine in general by the end of the day...

Beth's Post: Haiti Trip Day 4

April 6, Tuesday:

You can fall off, but don't let the suitcases.
Today started bright and early. I was up and moving even before my 6:30 am alarm went off. After breakfast we all quickly got our stuff together and prepared to head up to Gramothe. First we had to haul a bunch of suitcases and boxes full of supplies out to the trucks and then we piled on top of them. If going up the mountain on an ATV was wild, on the back of an open truck was even more so. The places to hold on were few and far between and I got hit in the head with branches more than a couple times. I'm really impressed by the drivers.

When we arrived at the clinic there was a long line already waiting for us. Some of them might have been waiting over night even. It took us a little while to assess the state of the clinic, organize the bulk of the new supplies, and set up the work stations. The pharmacy and supply cabinet were chaos. The medical directer said it was once well organized, but the current state was anything but. Nancy, the pharmacist, and I were threatening to spend the night at the clinic rearranging the stores. At that point there wasn't too much we could do.

Supply closet. Good luck finding anything.
Soon the clinic was open and prescriptions were pouring in. Starting off I knew little about the drugs and nothing about the shorthand coming in on the prescription pads. I know way more now. Nancy was very patient with me and answered my many questions about what the various drugs were used for. This might seem mere curiosity, which did play a factor initially, but it was also highly relevant as we frequently needed to make substitutions for prescribed drugs we didn't have or to use up other ones that are older and need to be handed out first. Pretty quickly I learned the most commonly prescribed drugs and what they were to treat (high blood pressure, antibiotics, pain killers, etc). After only one day I can quickly count out the necessary strength and amount of medication with a pharmacist's knife, fill a pill bag, and translate the doctors instructions into Creole (qd prn=1 chak pa jou, pou doule= 1 a day, for pain). At the beginning of the day I had to ask Nancy about every item, but by the end I filled most of them only pausing to check with her on substitutions or quantity.

When it came time for the lunch break everyone else headed up to the school cafeteria, but Nancy and I still had prescriptions and patients waiting. We finished most of them before finally being chased up the hill to our lunch. After quickly consuming our sack lunches it was back down. By then Nancy felt a little more comfortable with where to find things and we took the few minutes before new scripts came in to reorganize our work space and make it more efficient. I definitely think the second part of the day went more smoothly as a result.

All in all it passed really quickly. I feel like I didn't get much hands on time with the people since we were pretty much frantically running around a small closet and handing things to the translator to pass out the window. That said, I really enjoyed the day. Once I figured out the basics and got to know my co-workers I felt pretty comfortable in my role. By the end of the week I might be heading to pharmacy school... Marcia said it was a pretty big turn out for the first day, so I'm interested to see what it will be like tomorrow. The patient count was around 200 people and there were more waiting when we closed down for the day.

Nancy trying to figure out what these meds are.

Beth's Post: Haiti Trip Day 5

April 7, Wednesday:

This is the MIDDLE of the line greeting us as we pulled up.
This morning was quite similar to yesterday morning minus the suitcase hauling. When we made it up the mountain to Gramothe there was a huge line waiting again. Britney said she could see the line from down at the guest house. It's intimidating pulling up to a line like that and knowing some will be sent home to return later and others can't be helped at all. We got to work a lot faster since we were starting off a lot more organized.

As far as the pharmacy went, it was more of the same today. Being more organized meant more down time which was in turn utilized for reorganization. Hopefully by the end of the week the pharmacy will be easier to navigate. I spent a bunch of time rummaging around the supply closet digging out hidden meds and things that needed to be used up first. I think there's enough antibiotic ointment to cover all of Haiti, but there are other things we don't have at all.

Getting out of the pharmacy a little today meant a little more exposure to the patients, but I'm still feeling a lack of hands on time. On one pop out of the pill box I noticed Haylee searching for formula for a teeny little baby I'd seen come by the pharmacy window. Apparently the baby hadn't eaten for sometime since the mother has some kind of mental problems and won't breastfeed. Haylee was trying to get him to eat, but he wouldn't suckle for more than a few moments. I pointed out that he probably isn't even sure how since he's obviously not eating much at home. Eventually he worked up some steam and she got the bottle down him, but it's hard to know what will happen from there.

Couple who came at the last minute. The kids were sent home with scabies meds.
We were ahead of the game for most of the day until the last half hour when all the complicated prescriptions came in at once. We were getting a little stressed by that point. It's quite a bit of pressure too because by the time the patients got to us they'd been waiting out in the sun all day and you just want to get the drugs together as fast as you can and send them home. Just as we were finishing the last prescription and heading out the door at around 4:30pm a couple with a baby and a little girl came up. The girls both had scabies so we dug out some cream and sent them home with it with instructions on how to apply it. Willem said the couple said that they might make it home by midnight if they walked very fast. It's heart breaking to think that as many as 200 other people were turned away in the morning. That said, we did help 191 patients in the clinic and over 80 in the eye clinic. Back at the house Willem said there's even more need right now because there used to be doctors all over Haiti, but now many have left Haiti because of the earthquake. It's difficult to even know where to start.

Haylee holding the IV.
On arriving home we went to check on Betsie, one of the nurses, who had gone home sick in the middle of the day. Apparently she had been vomiting all afternoon after arriving back at the house. This is definitely a good time to be surrounded by medical professionals. After some consultation, Marcia and Nancy headed back to the clinic on an ATV to get supplies so they could start her on an IV. When they got back everyone took a turn at trying to get it going, but after about 4 sticks they decided that she was too dehydrated for even that. After some medication she was finally able to get down some fluids and we let her rest and went down to dinner.

The evening hasn't been too exciting. Pretty much just hanging out and swapping photos. I feel a little aimless today. I don't even want to think about the fact that I'll be leaving soon. My heart and mind are still up at the clinic. Rolling around in my mind are thoughts of all the things the supply closet does and doesn't need. Mostly I feel inadequate. I can't understand how anyone, especially a medical professional, wouldn't want to be here now doing this.

Beth's Post: Haiti Trip Day 6

April 8th, Thursday:

Apparently there was an aftershock last night measuring in at 6.1. Unfortunately I missed it. I'm really pretty bummed. I've never felt an earthquake before.

Scabies treatment.
Same game this morning: stumble out of bed, dress, eat, and pile in the trucks. About the same length line to greet us. Today I decided to get out of the pharmacy so I could have more human contact. I ended up serving as scribe for Marcia. Basically my job consisted of taking notes on symptoms and recording the diagnosis and treatment. The whole process is rather tag team since we're working through a translator and trying to push through the patients as efficiently as possible. You quickly notice the same basic complaints over and over: reflux and hearburn, worms, scabies, fungus, etc. Since Marcia is the medical director she frequently got called away to consult with others or to deal with various other issues. While Marcia was running around we (a nurse, myself, and our translator, Robert) would get down the symptoms and prepare the treatment for the obvious complaints (vitamins, tums, skin cream, etc). Marcia would make the final diagnosis or, for the simple patients, sign off on our assessment. Robert is pretty experienced which made things go pretty smoothly.

She smiled a lot, except for when I tried to take a photo.
Since Marcia was focusing on children we saw a lot of babies throughout the day. Some were as healthy as you could expect in their enviroment and others were pathetically underweight or covered with scabies. One healthy looking baby came in with a cold and Marcia noticed a firm spot on her arm. The mother got a little worried when we were looking at it but Marcia asked a few questions and discovered she had recently been vaccinated. While the translater explaned that this is a normal reaction I pulled out my arm and showed her the spot from my last Hep shot. The mother felt my arm and then smiled, clearly reassured.

The next station had a two month old baby brought in to be given up for adoption. The mother is 16 and is living with her grandfather who insisted that the baby be given away. I heard it all secondhand, but apparently the girl got told off by everyone within earshot when it was discovered that she had the baby's bonnet ties wrapped tightly around her neck. In the end they counseled her on breast feeding and sent her home for the time being until the baby is a little older. Hopefully the grandfather will change his mind. If not they will probably be back.

Back at home we found Betsie doing a lot better. She'll be back to work in the clinic tomorrow.

Final tally for the day was 192 patients in the clinic and 85 in the eye clinic. Tomorrow is the last day for the clinic and my last full day in Haiti. I'm pretty sure the end of the day will be heartbreaking, but it helps to know that the next clinic won't be too far away.

Beth's Post: Haiti Trip Day 7

April 9, Friday

This morning started off a little earlier as the vendors were supposed to arrive at 6:30am so that we could buy our souvenirs before breakfast. They ended up being significantly late so we all hurried around trying to get a good deal. The whole process was complicated by the fact that we only had large bills and the three vendors didn't have change. It was interesting to saw the least. Finally we rushed into the house and shoved some food down our faces (at least I did) as we ran out the door to hop onto the truck.

I spent the day scribing for Marcia again. Yesterday the flavor of the day was babies, while today we saw a lot more adults. Most of the morning was rather frustrating. It seemed to be one thing after another and Marcia was continually being called away. Progress seemed slow, especially with the added pressure of it being the last day of the clinic. However, after lunch we were finally able to pick up momentum and by the end of the day things were more fluid.

This 6 month old baby weighed 9.4 pounds.
We had a baby today that was 6 months old and only 9.4 pounds. He had a horrible case of scabies and the mother said he didn't eat well. You could definitely tell; he was amazingly tiny. We had a few very old women who were rather cute and we also had several people complaining of aches and pains as a result of the earthquake.

The final count for the day was 204 in the clinic and 90 in the eye clinic. Overall we saw 718 in the clinic and 350 in the eye clinic. That seems like a lot of people, and at the same time not nearly enough.

Towards the end of the day it started looking very definitively like rain. Once we'd finished the last patient, we ran around like crazy trying to finish up the cleaning so we could make it home before the rain. We did, but just barely.

It was with great melancholy that I packed up my things in preparation for our flight tomorrow. When I left for Haiti I didn't know exactly what it would be like or what I would be doing. I think I can safely say it exceeded my imagination in every way. What exactly it means for the future is as of yet unclear. I know I would love to return to Haiti and do more of the same if not something even more in line with my experience and skills.

Beth's Post: Haiti Trip Days -1, 0 & 1

April 1, Thursday:

Got up early to go to the medical center for my last Hepatitis shot before the trip. From there I headed off to work for a full 8 hour shift. It was a crappy day at work for many, many reasons, which did not make the time move any faster. A couple people told me to "put things in perspective". I found this highly unhelpful as true perspective said that I could be elsewhere doing more significant things... Finally got home and pulled an all-nighter finishing up the packing and cleaning my house.

April 2, Friday:

Headed to the airport just before 4am having already been awake for over 20 hours. Had to wait through a massive line for full service help at the check in, all the while not even knowing if it would help. Finally got to the front of the line and they did indeed connect the two legs of my journey, but the lady still tried to charge me a baggage fee until I pointed out that the flight was international. She wasn't overly helpful. Security was frustrating. They took away the "expert traveler" line in favor of one long queue. I had to wait forever behind a huge group of people who couldn't find their butt with both hands until I finally made it up to the front and passed through in 30 seconds. I had significantly less carry-on than usual which certainly expedited things. Got to the gate with only a little time before boarding so didn't get breakfast as I'd planned. Tried to sleep on the plane, but only dozed slightly as the guy next to me insisted on holding his newspaper all the way open the whole flight and repeatedly knocked into me as a result. Was very, very glad to arrive at O'Hare.

Hopped the El to downtown Chicago. The line had some delays which made it take longer than I'd hoped. Should have done some planning for lunch. Ended up just wandering around a while until found a place I could tolerate. Stopped in at a nearby Walgreens for some last minute stuff. Headed back to the airport and waited there for Britney to arrive. Boarded the flight to Ft. Lauderdale. Much better seatmates this time and an aisle seat. Didn't even try to sleep, but read instead. Had a conversation with my neighbor that wasn't tedious, which was a surprise.

Arrived around 11pm. Had to pick up my suitcase, but Britney didn't, which was weird. The airport had a bunch of "old time" faux store fronts so we picked a likely one that was a little sheltered and set up camp. It was a little like being a homeless person stuck in a Victorian theme park. The situation was not conducive to sleep and, on top of that, throughout the "night" there was a succession of noisy cleaning machines, a screaming child, and a lady screaming at her boyfriend over her cell phone.

April 3, Saturday

Set the alarm for 5am, but gave up on sleep around 4:40am. Tried to freshen up in the nearby (thankfully, spacious) bathroom and made myself as presentable as possible. Rechecked my suitcase and passed pretty quickly through security. Flight was less crowded than the others and went smoothly. Arrived in Haiti and passed through immigration. The baggage clam was pretty chaotic. My bag was one of the last to arrive which was a little worrying. Was met by our hostess, Beth, and then headed off to the guest house. By this point I had been traveling over 24 hours and awake about 48 except for some light dozing.

A taptap in front of a building with earthquake damage.
As we were driving I tried to look around a bit and ended up making myself car sick. In general it reminded me a lot of what I remember from the Dominican Republic. Did see some nasty earthquake damage right next door to buildings which are apparently perfectly sound. Passed by some tent cities as well, although not much to be seen there from the street. Wound through the crazy traffic and finally arrived at the guest house. Met Beth's kids and chatted with her. After lunch Britney and I took a little nap. Woke up in time for dinner and then a movie with Beth, a couple of her friends, and eventually the kids. Had a dessert made from sweet potatoes (very good) and then back to the guest house for the night.

View from guest house balcony.