Google+ WTN Haiti Partnership: March 2012

Tuesday, March 27, 2012

Pills R Us

One sees many things on the streets of Port au Prince, a crazy jumble of humanity and all manner of items for sale. One of our favorites is the man carrying a huge bucket, with an inverted cone of medications. The pills are packaged in blister packs, so the vendor has sheets and sheets of plastic blister packs in yellow, pink, blue, green, and white, even brown, displayed as a 4 foot tall cone shaped bulletin board, if you will. We never got close enough to read the names of the medications, but I imagine you can buy antibiotics, blood pressure medicine, cough and cold remedies, and probably things you never thought of. Also spotted on the streets for sale were stereo equipment, DVDs, handsome wooden furniture, plastic bins/buckets, mattresses, sugar cane (this comes in huge 4 foot lengths), fruit(melons of all kinds), bedframes, books, shoes, clothing including mens' suits, baby strollers. Its like Wal-Mart, but streetside. We spotted a baby stroller that we thought about buying, because we needed to make a seat for Margaret Vincent. Margaret is hydrocephalic, about 2 years old, and was left at St Vincents during one of our previous trips in 2009. See earlier posts about her story. She is one of the many handicapped orphans brought to the school by their parents. When I brought Dr Jeanne Jemison, a developmental pediatrician, to Haiti with me, my hope was that she would help me work with several particular students, and Margaret Vincent was one of them. Dr Jeanne examined Margaret, who spends her days in a crib upstairs at the school. She is well cared for, but severely handicapped so that she cannot sit up by herself, or even hold up her oversized head which looks too big for her small body. The matrons who care for her try to prop her up in a wheelchair, but she basically lays across the seat with her head hanging off one arm of the wheelchair, and her legs across the other arm of the chair. She holds her arms bent tightly at the elbows, but with stretching one can straightem her arms almost completely. She responds with a smile when you talk to her or stroke her face. Over the course of the week, Dr Jeanne, Clark (one of the CBU nurses) and I were scouting for adaptive materials to help this little girl. Dr Jeanne wanted to make some splints to help her hold her arms out straight, to keep them from becoming permanently contracted. In conversation with the school's orthopedic doctor, we found some plastic splint material we could use. How to form it so it would fit her arm, and not cut into her skin? Should we cover it with gauze, or leave it as is? We consulted an occupational therapist who happened to be staying at the same guest house. She recommended we leave the plastic uncovered, since it is manufactured with small holes in it, to allow the skin to breathe. We visited the school's brace shop, and spoke with the workers there who make braces and prosthetic appliances for the students, with simple tools and what looks like 1950s machinery. Dr Jeanne said the place reminded her of Campbell Clinic in the 1950s, where her father, an orthopedic surgeon, worked at one time. We had measured Margaret's arms and needed a splint 6 inches by 2 and 1/2 inches, for each arm. They cut the material for us. We worried about the sharp plastic corners. No problem, they said, and promptly rounded the corners with a lathe. So obvious! Our next treasure to find was an old car seat, actually gathering dust in a shed behind the guest house. The guest house is owned and operated by Healing Hands for Haiti, an organization which works on rehabilitating injured and disabled people! So they have lots of adaptive equipment, walkers, canes, etc, just lying around. Dr Jeanne spotted a car seat, the kind for an older child, with straps to hold Margaret sitting upright, and a back tall enough to support her entire trunk, much better than the wheelchair. Gail Buck, the proprietor of the guest house, kindly let me have the car seat for Margaret. All that remained was something to support her neck. Jeanne said what we needed was one of those airplane neck pillows that people travel with. Kristen graciously donated her pillow to the cause. The final result was magnificent. Margaret can now sit up in her car seat, strapped in so she does not fall out, with a pillow to support her head. She can see better and interact with the other children much better. She will be at less risk for skin pressure sores since she isnt lying in the crib all day. Dr Jeanne instructed the matrons carefully, through an interpreter, how to apply the splint with an Ace wrap, and to leave them on only at night. As Clark was working with Dr Jeanne to put all this together for Margaret, he made a comment (reported to me later) which will stay with me for a long time. He said that he thought that the reason he was put on this earth, was to care for children like Margaret.

"What Ladder"

Speaking of 12 women in one room, (see earlier post), a few of us had the pleasure of sleeping on the top bunk. The first few nights we were divided between two rooms, and the "older women" (that would be me, Amy, Sue, Karen and Jeanne) had our own room, lower bunks thank you. That is until Jeanne moved in the middle of the night one night, attempting to get away from the snoring. (names kept confidential to protect the innocent). She caused a brief upset by climbing onto the top bunk above Sue,who naturally was not expecting someone to climb into the bed above her in the middle of the night. At any rate, the weekend brought another group from Boston to the guest house, so all the Tennessee folks had to pile into one room, which meant some had to take top bunks. Sue, being the fearless leader from CBU, volunteered. Of course she didnt think about being one of the SHORTEST women, which made climbing onto the top bunk particularly challenging. One night I had already climbed into bed, settled in under the mosquito net, and was about passed out when I heard several loud "ooomphs" from just above me. This was the end of the week, as I said, so ordinary things take on a humorous note due to fatigue and mental exhaustion. I started giggling and couldnt stop. Then someone said to Sue, "You know there's a ladder!". This was our last night in the room and Sue had been struggling into that top bunk for 3 nights. Tee Hee

An Unlimited Supply of...

AKA Things We Will No Longer Take for Granted I polled our team members at the end of our week in Haiti, asking what they thought they would never again take for granted when they returned to their lives in the US. Here is the list: Soap in the Bathroom Clean water out of the tap, for brushing teeth ( as opposed to walking down the hall to the purified water cooler, usually done AFTER you are standing at the sink, with a full mouth of toothpaste, then realize you dont have any water to rinse your mouth with) Flushing toilets (Siennas personal favorite) Toilet paper in the bathroom Paper to dry your hands on. (common bathroom themes apparent) Hot showers Cold Diet Coke LUNCH! ( this vote from Brianna. Lunch each day was whatever we brought to the school in backpacks, usually bags of peanuts and granola bars. By Friday the pickings were pretty slim) Reliable electricity Clean streets A dresser to put your clothes in ( with 12 women in one room at the guest house, it felt like summer camp) The children at St Vincents have all their clothes in suitcases. The only personal space they have is their bunk bed. The ability to hear, and to see, and to walk normally. To communicate with the people around you. To connect easily with friends and family by cell phone. Texting has become second nature for many of us. The phone at the guest house could be used to call the States, but only the speaker phone worked. So calls home were not exactly private! "Hey ?Baby! I love you" followed by embarrassed grins from the team member in Haiti, knowing he was in a room full of 6-10 other people, all listening. Lastly, all the married folk agreed that the love of a supportive spouse gave them the energy and support needed to make this trip, to face the uncertainties of traveling in Haiti and the tragedies abundant all around us Thank you to all those who made it possible for us to be in Haiti. We appreciate you now more than ever.

Monday, March 26, 2012

Amazing grace

Amazing, Amazing

This is the word Dr. Susan Nelson used to describe St. Vincent’s School and Orphanage and the children in Haiti. A facility she has been serving since 2008 through the West Tennessee Haiti Partnership.

True – the school is amazing, given the lack of resources available to them. True - the children are amazing given their unique situations.

From the onset, the first ten minutes at the school I would have described the environment, children and staff as not Amazing but Amazing Grace.

The blind, deaf, mentally and physically impaired children are the epitome of amazing grace. The blind children lock arms and walk throughout the small compound, keeping one another safe. They smile, laugh, play and sing or play the violin without the aide of their eyes. The deaf children guide the blind, push those confined to wheelchairs to class or the clinic, and express the desires of a child via sign language and smiles. The smiles – the dance of joy when a 5 year old deaf child tries on the pink crocs and dances!! The smiles as the children color, paint, make jewelry, or play ball with others. The little boy that was a resident of St. Vincent’s that had shoes but wanted shoes for his two friends, day students at St. Vincent’s that did not have shoes. These two boys, his friends, lived with their families – he did not have a traditional family but rather the family at St. Vincent’s. An orphan concerned for his shoeless friends- Amazing Grace.

Marie Carmel, the 46 year-old wheelchair bound cook, unofficial matriarch, and life-time resident of St. Vincent’s. Marie was dropped off at St. Vincent’s when she was a baby, almost 47 years ago: her birthday is April 26th. She has no knowledge of her family, yet she smiles and enjoys the children and her place of honor at St. Vincent’s. Each day she sits in the breezy place, in her wheelchair watching the children – overseeing the activities of the children, the courtyard and orphanage - Amazing Grace.

There is Jo Jo, the artist in residence. John Joseph, the rock star – he is limbless yet creates masterpieces with the use of an bandage to his right “nub” or his mouth. He signs with his nubs, eyebrows, lips, and face…he communicates with the deaf children, he translates English to Creole or Creole to English. He is the unofficial patriarch of St. Vincent’s, a 50 year resident. He does not know his birth family – yet he knows the story of each child at St. Vincent’s. He smiles, laughs, jokes and makes light of his lack of extremities. He never complains – Amazing Grace.

There is Margaret. The hydrocephalic toddler abandoned in November of 2010. She is fed, always dressed appropriately with even a ribbon occasionally in her hair. She does not speak. She does not walk and yet she responds to the touch of her caregivers. She responds to the physical therapy provided to prevent her arms and legs from contracting. This innocent, helpless child is loved by her caregivers: given to St. Vincent’s by a caring family member, who could not provide for her-Amazing Grace.

There is Pere (Father) Sadoni, the Priest and administrator of St. Vincent’s. A quiet young man in his early 30’s. He manages not only the orphanage and school but a church. He is guarded almost shy but so tender when you see him touch a child. He is devoted to the children, both residences and day-students. He uses the resources made available to make a difference in the lives of all the children. He allows a teenage boy to stay at St. Vincent’s and attend high school because he has no where to go. This boy lost his mother, the cook, and his younger brother in the earthquake. He could see them, he could hear them, he could give them water and food for three days but could not get them out of the rubble and they died. He plays his guitar and sings. He is not bitter or angry or troubled at the world but has moved forward. He provides comfort to the blind and deaf children and adults at the orphanage. He assures Father Sadoni he will work hard to be a good student – Amazing Grace.

Seven nurses enrolled at Christian Brothers University in the RN to BSN program and myself, their teacher were witnesses to the Amazing Grace of St. Vincent’s School and Orphanage in Port au’ Prince, Haiti. For five, short incredible days, we left our comfortable homes and families to travel to St. Vincent’s. The students assessed and documented the height, weight, arm circumference, and heart and lung sounds of 208 children in four – six hour days. They played with these children. They colored with the blind and deaf. They painted the nails, combed the hair and made beaded necklaces. They held them. They cradled them in their arms and loved them. These seven nurses immersed themselves with the children and staff of St. Vincent’s – Amazing Grace.

This was designed as a student clinical experience, a “mission trip” to provide health care to Haiti. However it reality, it was a human experience where the children and adults of St. Vincent gave far more to us, the CBU community then we did to them through their Amazing Grace.

Sue Trzynka, Ph.D., RN

Friday, March 16, 2012

End of week note

We saw all 200+ kids plus ~50 adult staff members. Diagnosed tuberculosis in one patient, found two kids with heart problems, others with routine skin problems, minor respiratory complaints, lots of MAL TET (headache) and back ache. My Kreyol is getting better but still have great trouble comprehending. The kids laugh at me. We handed out >200 hygiene kits (soap, toothbrush, toothpaste, comb, wash cloth) and all the crocs.
Tomorrow we go to the beach for some much needed relaxation.
Will try to send you a quick note tomorrow. I am very content and pleased with our trip and our amazing group of nurses from CBU.

Already making plans for next November


Thursday, March 15, 2012

Playing the power game

Every time I get started on a blog post, the power goes out. I will have to write more when I get back to Memphis. Please know that all the ibuprofen and tylenol donations were much appreciated by many of our adult patients. Many of the teenage girls are grateful for ibuprofen for menstrual cramps and migraine headaches.
We are all safe and working very hard.

I wish I could write more but it will have to wait.... Power acting funny.....THIS IS HAITI!


Crocs for St. Vincent

Hello everyone!   This is just an update to let everyone know that In the recent St Marys School and Holy Communion church event, over 200 pairs of brand new Crocs were donated to St. Vincent's!  Outdoors Inc donated over 26 pairs.  Excellent job and many thanks to all who donated.  Photos below.

In Which There is a Flood

Last night there was a storm. Oh what a storm. I am reminded of the story in Winnie the Pooh about the "Floody Place" in the Hundred Acre Wood, where Pooh and Piglet find their houses being washed away. Fortunately, our guest house is much sturdier, but we had a river running down the driveway into the gutter that runs underneath the house. Apparently the bedroom downstairs had 6 inches of water running through it, so the Haitian staff had to sleep upstairs for the night. The house has a tin roof, so the storm began as a quiet chatter. At its peak, we had to yell at each other over the din. I suppose it rains like that in Memphis as well, but the experience last night was amazing. We stood in the doorway to the guest house, watching the torrents of water fall from the sky and astounded at the force of it. Sleep was not an option at that point. I tried to get on the internet to blog about it, but was not surprised when no internet connection was available. I was surprised we had power at all.
Eventually it slowed down to a continuous thrumming on the roof, and with earplugs and Benadryl I managed to fall asleep.
Yesterday in clinic the nurses saw another large section of the St Vincent's students; we have seen 135 to date. Our goal is to do wellness assessments on all 250 children by the end of the week. We saw another child with an impressive heart murmur yesterday; this one is a followup from my last visit in November 2011. When I saw her then, I asked Jean Robert for help. He works at the school and speaks English well and always helps us with our many questions. In a previous blog post from years ago I wrote that the answer to every question is "Ask Jean Robert". At any rate, he told the mother to bring me any records she had for the child, which produced a copy of an echocardiogram report! One never knows what you might get by asking! The echo report was from 2009, and written in french, but valuable nonetheless. I could make out most of the french, but the numbers about gradients and ventricular size were beyond my family doctor knowledge base. I brought that echo report home to Memphis and faxed it to Dr Nancy Chase, a pediatric cardiologist. She explained to me the details of the measurements, and actually thought the defect was not critical and could be monitored at this point. She suggested we get an EKG to determine whether the child has RVH (Right Ventricular Hypertrophy). The EKG is easier to get and cheaper than an echocardiogram, and could give us an indication of how the heart is functioning at this point. Of course, "easier" is a relative term in Haiti. We don't have EKG equipment at St Vincent's. Getting one requires a visit to the hospital or to a local cardiologist, both of which are next to impossible for this child. Nonetheless I talked with the mother yesterday, using my broken Kreyol with Jean Robert to translate. I told her we had good news, that the child likely does NOT need surgery, and that I would talk with Pere Sadoni about if/how to get an EKG done to give us some updated information about how the child's heart is functioning now. So basically this was a cardiac consult, extended over 4 months and across an ocean (literally and figuratively speaking).
Other noteworthy events yesterday included a story Dr Jemison told me about trying to evaluate a child with "poor appetite". The nurses are assessing every child, and if they find one who appears to be sick or who has a significant complaint, they send them to one of the pediatric providers which includes me or Dr Jemison. So she had a child who was reported by the teacher as having "poor appetite". Her physical exam was normal. The key to evaluating children is often the history, which is difficult with a 7 year old child anyway, so it is always important to talk to the parents. Dr Jemison asked to see the child's mother when she came to pick her up from school, so she could get more information about any problems with eating. She described the situation to me this way: The child is deaf. The teacher is deaf. The parent is hearing, but speaks Kreyol. The parent does not sign. Dr Jemison does not speak Kreyol, and is using an interpreter. She can speak to the parent through the interpreter, but the parent cannot communicate with the teacher. How does one get an accurate history in this setting? The other factor is Haitian politeness. Haitians will often tell you "yes" to your questions, because they are being polite and they tell you what they think you want to hear.
So, where was I? Oh yes, the history taking with no one able to communicate. The teacher says the child has poor appetite. The parent says the child eats everything on her plate. I think Dr Jemison concluded maybe the child does not like the lunch food at St Vincent's, or for some mysterious reason does not eat at school. At least that's the best she can gather from all parties involved. The situation highlights many of the barriers faced every day by the teachers and students at St Vincent's. How does a deaf teacher who sig

Susan Neslon
March 15, 2012

Wednesday, March 14, 2012

Morning after first day in Haiti

It is now 6 AM and I am at the computer, not something I usually do at this time of day. But last night the internet was down so this morning is my chance to send news home. I am sitting in a darkened guest house, everyone else is still asleep. I am usually an early riser anyway, but in Haiti the monkey birds have been awake for hours and are calling to each other in the background. Monkey birds, aptly named for their strange screeching calls, are much louder than the roosters, who also crow all night. I grew up believing roosters only crow at sunrise! Ear plugs and benadryl are the only way I can sleep when I am here. I am usually keyed up with excitement anyway.
We arrived safely on Monday evening, all 15 team members minus 4 of our bags. Of course, one of the bags had the paschal candle we brought to Pere Sadoni from Memphis. The struggle to find a bag that would accomodate a 36 inch candle is a story in itself. But thanks to Preston Johnson we found a sturdy canvas garment bag that would serve.
Yesterday morning (Tuesday) Pere Sadoni took me to the airport to get our bags. The lady at the airport told me,in her lilting Kreyol accented english, "We are very sorry, but your bags will come tomorrow". I went away telling Pere Sadoni about the scene in the Wizard of Oz when Dorothy is told, "GO AWAY, AND COME BACK TOMORROW". Of course he has never seen this movie, but we laughed about it. As we were walking down the LONG covered walkway away from the airport, someone came running after us to tell us they found our bags after all! So we found all 4 bags that were missing, including the bag with the candle. I told Pere Sadoni, "Well, we got to see the Wizard after all."
We returned to St Vincent's where the rest of our team had set up clinic and were seeing the children. We saw 50 students yesterday and did wellness assessments, while Dr Jemison and Amy Chanin, physician assistant, saw about a dozen sick children. Mostly minor stuff, like sore throats and a cough or two. One child who complained of "poor appetite" was found by Dr Jemison to have a significant heart murmur and other signs of heart disease. A conversation with the mother told us that the child has seen a doctor about this and needs "further testing" which the mother cannot afford. Many unanswered questions, like whether the child could see a cardiologist if funds were provided, what exactly is the heart defect (which could be determined with an echocardiogram or ultrasound of the heart), what kind of followup could the child have in Haiti, etc. I will ask Pere Sadoni today more about if/how some of the children could see a cardiologist and how to make that happen, or if it is even possible.
I wish I had time to write more but breakfast is served and coffee is waiting. Wonderful, delicious Haitian coffee. I don't even drink coffee in the states, but in Haiti it is a treat and an accent to begin the day.
Many thanks to all of you who prayed for our safe travels here. We left Memphis 2 hours late, and with only a 50 minute connection in Miami I just knew we would be spending the night in Miami. I told God, "If you want us in Haiti today, you're going to have to make it happen, because there is NO WAY we are going to make that connection in Miami." Well, here we are. Bon se bon (God is good)

Monday, March 12, 2012

The trip was long and connections were tight

First news at 9PM Monday night:

We arrived safely. Missing 4 bags, including the canvas garment bag with the candle! my two bags and Laura's 2 bags missing. But they should arrive on the next plane, tomorrow morning at 9:20 AM.

Long day, no meals until we arrived at the guest house and were fed a delicious Haitian Meal. Even Laura ate rice and chicken!

All tired now and calling home to tell family we are OK.

Cool temperature when we arrived, nice breeze and beautiful sunset
Happy to be in Haiti, all excited about tomorrow and seeing the kids.

Good night