Post-Haiti Reflection

"I alone cannot change the world, but I can cast a stone across the water to create many ripples." - Mother Teresa

We've been back from Haiti for two weeks tonight. We are all adjusting in our own way, but it's clear that everyone has been extremely supportive of one another. We have had two meetings already to reflect and discuss ways in which we might share our experiences with others. Some of us have already donated our time to give a talk to another service group on campus, Appalachia, in a couple of weeks.  Others plan to write articles about patient experiences we had in Haiti.

As we move forward through the semester, we will continue to carry the wonderful experiences we had in Haiti in our hearts.  (We've already started talking about a reunion trip a few years down the road!!)

To our friends and family, thank you for your continued support as we transition back.

Update from Port-Au-Prince

Hey everyone! We have been enjoying our last few days in PAP, Haiti. We spent some time at an orphanage and at Mother Teresa's establishment, which is a part- time orphanage and feeding center for malnourished children. Although very sad, it was another incredible experience for all of us. We hope you enjoyed Liz and Laura's previous post- we couldn't have explained the emotions of this trip better ourselves. Here are some pictures from our last few clinic days and this weekend.

January 12, 2013

Hello friends and family,

We are writing to you one day after the third anniversary of the earthquake that changed the face of Leogane and Port Au Prince.  We left a quieter-than-usual Leogane early yesterday morning and drove back to PAP in less traffic than we normally encounter.  Other than a slight decrease in the normal hustle and bustle of life in the streets of both cities, January 12th seemed like most other days to an outsider in Haiti.  Apart from appearances though, we knew that today was an exceptional day for the people of these communities.  Later in the day, on our way to the orphanage in Petionville,  we drove through the center of the capital city and saw the flags in the center of the city and in front of the US embassy flying at half mast.

As we have met and served patients in over a dozen mobile clinics over the course of the last three years, we are aware of how many times we have heard a complaint quantified by the phrase "before the earthquake" or "after the earthquake." This is a true testament to the weight of this event in the lives of the Haitian people.  Though this descriptor has not changed, we have noticed other differences over the last three years here.  On our first trip in 2011, fourteen months after the earthquake, we witnessed Haitian men filling wheelbarrows daily with rocks and rubble from the earthquake and clearing the debris piece by piece.  It is this mentality we have strived to adopt, helping to bring comfort and health to Haiti one patient at a time.

Laura and I are again humbled and amazed by the dedication and knowledge of the students and nursing colleagues on this trip.  We appreciate the help and support of the team of interpreters and staff and hosts at the Hopital St Croix.  Without them, we would accomplish nothing here.  We remain in awe of the sights and sounds of Haiti and we look forward to sharing our photos, videos and stories with you upon our return home.  Finally, we must thank the Boston College school of nursing, the BC community at large and our families and friends for all of the educational, emotional and financial support.  Words cannot explain what you have helped us to achieve this week.

Much love,
Liz D and Laura

Last Day in Leogane

             Hi everyone! Sorry for the delay in a blog post. Wifi is scarce, and although we are loving our experience here, we’ve been really busy, tired, and emotionally drained the last couple nights. On Thursday, we had another successful mobile clinic in a nearby town, and we were able to see around 200 patients.

            Throughout the week, one of our nurse practioners and a few of our undergrads have been visiting the local nursing school, FSIL, and teaching them pathophysiology classes. This school is the only Bachelors accredited nursing school in Haiti, and they were celebrating their eighth anniversary on Thursday. Due to the close relationship they formed this week with the BC girls who taught them, they invited us to their huge party last night. We were able to stop by their party for a few hours and were so grateful that they thought to include us in the celebration. The girls who chose to spend some of their days here teaching them want to give you all an update on their experience, and will post their own thoughts tomorrow on a separate blog post.

            Today was unfortunately our last day in the mobile clinic. The location was the most difficult to coordinate, as there was limited furniture and appropriate space for each clinical specialty. From the moment that we arrived, we all had to accommodate the patients awaiting care while also trying to determine how to make the best of our selected location. We were able to take a few minutes before the start of the day to gather in remembrance of the earthquake, which occurred three years ago tomorrow. We stood in a circle, hand-in-hand with our patients and translators with thoughts and prayers for all of those who lost their lives or were deeply affected by this tragedy.

            Despite the emotions and chaos of the day, we really pulled together as a team and got the most out of our last day in the clinic. Although we were upset that it was our last clinical day here, we each had patients and experiences today that made us realize what a difference we have made. 

            One patient that stood out to many of us was actually a lady who originally was not going to go to the clinic because she “didn’t have the money,” although she was due in four days with her 6^th child. Our videographer, Liz, and photographer, Lexey, were exploring a bit outside of the clinic to get some good footage, when they found Margalie looking very pregnant and in pain. The translator that was with them helped them convince Margalie to come back, telling her we would pay for her to be seen. We were able to do an exam to determine that she was 3 cm dilated, listen to the baby’s heartbeat with a Doppler, and estimate the position of the baby. We gave her a birthing kit and educated her on the safest way to deliver her baby at home. We came to find out she had five other kids and was already struggling to provide for them every day. We came together as a team and gave her whatever we could: a little bit of money, granola bars, onesies, t-shirts for her older kids, etc. She told our translator, “I am so thankful to all of you for doing this for me. I didn’t have enough money to come here earlier, but it was God’s will for me to meet you today. Thank you.” A few of us then walked her home, only to discover that her “home” was an area smaller than a one-car garage, walled in by bed sheets and tin. She allowed us to see the inside of her home, which was neatly organized and well-kept, but clearly not big enough for her seven, soon to be eight, person family. This was such a reality check for us, especially walking away from her house realizing that some closets are larger than her house for an eight- person family.

            Overall, it was an incredible, moving way to end our week in Leogane. Tomorrow, we set out for Port-Au-Prince early in the morning, where we will visit another orphanage. On Sunday we will be able to go to Mother Teresa’s Church for mass and to help feed children in need through the nutrition clinic there. Tomorrow is sure to be a difficult day for all because it is the third anniversary of the Earthquake. We will have much better wifi in Port-Au-Prince, so we will be able to upload more photos and stories tomorrow night or Sunday.

Love,

Lindsay & Erin

A Memorable Day

Today we went to our furthest clinic location up in the mountains of Leogane. It took us approximately 40 minutes to get to the base of the mountain from Hospital Ste Croix, and another hour to make our way up the unpaved, rocky, narrow mountain roads to a village at the top. The scenery was unlike anything we had ever seen before, and we enjoyed our journey when we didn’t get too close to the steep ledges on the side of the road.

On the way up, a few of us were discussing our expectations for the day. We couldn’t decide if we would see patients who were incredibly sick because they had severely limited access to healthcare on the mountain, or if we would see healthier people enjoying the natural resources of the area. As it turns out, we did in fact see both ends of the spectrum at our mobile clinic.

Once we finally arrived at our site, patients were already in line to receive medical care.  Because of the long drive, we were behind our usual clinic schedule and we knew that we would have to leave an hour earlier in order to make it home by dark. Therefore, we quickly made decisions about the physical layout of each station and began seeing patients.

Every patient that comes to our clinic is unique and has their own story to tell, and the following will stay with us through our nursing careers. Somewhere around lunchtime, a mom with her four children came into the clinic. At first they all appeared to be here for another well child check up. Minutes into the exam, it was clear that this was not the case. One of the children was an adopted six-year-old boy who lost both of his parents in the earthquake three years ago. He presented as the ‘classic’ malnourished child although his beautiful brown eyes, long eyelashes, and apparent need for love and affection were so much more memorable. Liz, our videographer and a mother of one of our NPs, said it best: “I have three kids. I never worried about feeding them”. Similarly, we all shared the same sentiment, which allowed the entire team to come together. We opened our fanny packs, and gave them whatever we had to help. The family walked away with thirty dollars, granola bars, peanut butter sandwiches, and their prescribed medication. The language barrier was replaced by tears, smiles, and mutual gratitude.

Because everyone has spent the last two days getting accustomed to our clinic routine, many of us felt that today was the most emotionally draining for a number of reasons. It’s easy to get caught up in the logistics of triaging, assessing, and diagnosing over 150 patients a day. Day 3 in the clinic was the first day we were able to step back from the process itself and take a look at the patient or family as a whole. We are just getting used to the logistics of our clinical day, yet we also realized tonight that we are over halfway through our journey. We have each begun thinking about our transition home and the difficulty that will come with trying to apply our experience in Haiti to life in Boston.  This transition will not be easy, but we will have each other for support and we are so thankful to the people of Haiti for entrusting their lives with us. We look forward to sharing these lessons with our friends and family back home. 

Love,

Erin & Lindsay

 

Pictures from the last three days!!

Our first view of busy Port-Au-Prince on our way from the airport to Leogane (which is 18 miles from Port-Au-Prince).

 Our accomdations for the week in Leogane. We stay on the 2nd floor, and the hospital is located on the 1st floor.

 Some cuties we found at the American-run orphanage we visited on our first day!

 Destruction from the earthquake 3 years ago we saw during our walking tour in Leogane

 An example of a home along the streets of Leogane

Some boys smiling for the camera at the orphanage!

A beautiful sunset on our walking tour

 Excited and ready to go on our first day at the mobile clinics!

(Triage) Erin assessing and interviewing patients with Richardson, one of our interpreters.

 Someone got a hold of Lindsay's stethoscope!

 (Triage) Lindsay and Erin taking vital signs and interviewing a patient.

(Triage) Sandra assessing a distended abdomen in triage on day 2.

 (Triage) Kirsten gathering more information from her patient

(Nurse Practioners) Sophie interviewing a family

 (Nurse Practioners) Laura listening to lung sounds.

 (Nurse practioners) Julia discussing her treatment plan with the patient through an interpreter.

 (Nurse practioners) Caitlin prescribing some medications and explaining the proper dosages.

 (Pharmacy)  Hard at work on day 2!

(Pharmacy) Spencer educating a patient on her proper dosages and treatment.

(Pharmacy) Treating another child with Scabies- one of our favorite cuties of the day!

 Our fearless leader, Donna, striking a pose at clinic location on day 2!

 Local children playing and posing for us at our scenic location!

Amazing sunset after a long day of work at the mobile clinic. (This was taken just minutes before we all went swimming in our scrubs!) :)

Some of the undergrads taking advantage of beautiful scenery at the clinic.

Day 3!

Today we started our mobile clinic! Donna made arrangements for us to be in the towns of Leogane that neededd the most medical attention and would benefit most from our care. Each town has a community health worker who spreads the news that we are coming. This person, also known as the "Agent sante," finds good locations for us to set up our clinic.
       We began our new routine for the next five days today. Each day we wake up before 7, grab a quick breakfast, load the truck with our bags which are organized by category of medical care (GI, respiratory, cardiac, etc), and drive out to the site. We spent probably 45 minutes unloading and setting up for the day. We divide our setup into a few different areas. First we have triage, where four undergrads admit each patient that comes to the clinic. This includes obtaining a medical history, taking vital signs, and performing urine dipstick tests, malaria tests, and pregnancy tests when necessary. Next, the patients go to the nurse practioners, who interview them further about major problems, diagnose them, and prescribe the appropriate medications. Then the patients go to our makeshift pharmacy run by four undergrads. Here, the students dispense all the proper prescribed  to each patient while reiterating the appropriate way to take the medications. Each patient also receives a toothbrush and toothpaste, while infants get onsesies. Even pregnant women receive birthing kits to facilitate their own delivery, as access to clinics and other healthcare resources are limited in this region. There were also two private exam rooms for patients-- one for dental procedures and the other for pelvic examinations. Our dentist, Dr. Emmanuel, is a Haitian doctor who assists in our clinics each year. He performs a number of tooth extractions each day, as many of our patients complain of horrible toothaches and rotting teeth (often due to the sticks of sugar cane that they snack on). In the pelvic examination room, women receive pap smears and are evaluated for STDs as needed. Patients also receive breast examinations, and pregnant women can listen to their baby's heart beat on the Doppler monitor! 

Today was amazing yet exhausting day for everyone. We were able to evaluate, diagnose, and treat approximately 175 patients in a short 8 hours! At our clinic, we saw a wide variety of individuals with different medical needs. From the difficulty of seeing patients who are terminally ill and beyond our help to witnessing a moms smile upon hearing her baby's heartbeat for the first time, the day was  full of emotions for us.

We look forward to another day in our mobile clinic! Be on the lookout for some pictures on the blog sometime tomorrow.

Love,
Erin & Lindsay :)