In front of our hotel

friends from the hotel

Saying goodbye to Myrlande and Bonite

Our driver

In a search for some related material today, I came across Anderson Cooper’s recent report: “3 Months Later: What does “Better” mean for Haiti?” It’s a fairly appropriate answer for a question I was asking myself during our entire trip.  Even more important is, what will “better” look like 3 months from now?

http://ac360.blogs.cnn.com/2010/04/09/three-months-later-what-does-%E2%80%98better%E2%80%99-mean-for-haiti/

Below, I’ve interspersed photos of the destruction with some of the most hopeful photos and images of Haiti that we saw on our trip.

Port au Prince

Port au Prince

.

Beach

Port au Prince

Port au Prince

.

.

.

Crack in the road

.

Tent City

.

.

Bonite cuts the ribbon with the Cutco French Chef knife

Myrlande's plans for the future clinic

.

.

.

Remember, you can help the clinic become a reality.  Donate today.

Myrlande directs Susan, Noah, and Heather on packing distribution kits

.

Baby supplies were in high demand in the tent cities, which is understandable.  Imagine changing and caring for multiple babies on the dirt floor of a makeshift tent, in extreme heat, with no place to launder cloth diapers, no wipes, and no baby food.  Susan and Heather worked hard at getting the kits ready for us in time.

Susan and Heather display packed baby supply kits

Everyone took turns helping to fill ziplock bags of rice and other food.

Lindsay Musser and Susan Saunders help pack distribution kits

Carl Drew helps to fill bags of rice

Andy takes his turn filling rice bags

.

Noah and Kenndhy display full bags of rice for the distribution

We loaded up the truck with boxes and bags of supplies and food to distribute and drove up the road to the tent city near our hotel.   This was a tent city we passed every day on our way to the clinic.

Noah and young friends from the tent city

.

.

.

.

.

.

.

.

.

.

Susan takes notes for Myrlande and helps fill out charts

Reginald came in with a foot laceration, Susan helped with his charts and forms

Susan helps prepare Reginald's foot for the dressing

Noah steps in to help Myrlande bandage Reginald's foot

Feeling better

The next part of this post is for those of you who are Cutco fans.  Check out what Myrlande used to fix our dinner that night.  Yep, that’s right. Cutco in Haiti.

.

.

.

Next post: Distribution in one of Jacmel’s tent cities

Three huge trucks like this one full of boxes pulled up to Christ Love Center

The unloading efforts were massive.

.

.

Think of how exciting it is to receive a package you’ve been waiting for in the mail.  Then multiply that into 3 huge trucks the size of a house full of boxes.  Understandably, the delivery was cause for great excitement.  The workers’ response was celebratory and playful: assembly lines formed to move the boxes quickly and the young men were practically singing as they unloaded and organized.  Boxes without breakable contents were merrily tossed and caught, and there was lots of laughter.  The energy of the whole group was palatable. Andy and I were struck by the enthusiasm and energy.  This crew of thirty or so young men could get massive amounts of work done with the right organization.  Haiti is full of natural resources, but its best resource is unarguably its brilliant and irrepressible youth.

.

The woman responsible for all this is named Isabelle.  She lives in Connecticut and has been able to convince her entire town to adopt Jacmel.  They focus on the town as a “sister” or “partner” town and have plans for building a school in the near future.  The trucks hold 1200 boxes of supplies, and all are from Isabelle’s connections.  What if more US towns would adopt Haitian towns like Jacmel?

Isabelle

The Cutco crew joined in to help.

Heather and Susan help unload the boxes

Susan and Andy

.

Andy and Noah enjoy the playful attitude of the staff

Susan and one of the hired unloaders

.

Noah helps unload the trucks

Susan and Heather help unload

.

.

.

.

With the help of the Cutco team, we were able to unload more than 1200 boxes of clothing, gatorade, food, and emergency supplies into the CLC for storage and later distribution.  A later post will show the distribution of some supplies in a nearby tent city in Jacmel.

Next post: more clinic work

On Day 4 one of the last patients in the clinic presented our most serious case yet.  His advanced asthma attack was nearly overlooked because his mother was so quiet.  ”Eskize mwen,” she said to Heather (“Excuse me” in Creole) and with a wave of her hand, she motioned toward the little boy in her arms who was having trouble breathing–since last evening!

I’ll never forget how easy it would have been to miss that silent, limp little body in his mother’s arms.  Thank goodness Heather was insistent that Myrlande take a look.  The little boy’s eyes were half-shut and beginning to roll back in his head, and his little belly heaved quickly with breath after helpless breath.

Asthma case on Day 4

“Lele” (the boy’s nickname) needed a nebulizer immediately, and it instantly became VERY clear how important our organizing work in the clinic storeroom had been.

.

At this point all the doctors on our team had gone back to the states and Myrlande was the only nurse on duty.  Myrlande called Dr. Robert to confirm the diagnosis-the boy needed the nebulizer to be set up, a shot of Epinephrine, and other care all simultaneously–and since we had just packed up the medicine to prepare the CLC for other use that afternoon, someone had to find the medication–quickly–while Myrlande found and set up the nebulizer.

Andy, Myrlande, and I tore through boxes with an urgency I’ve never used before.  When Myrlande finally found the nebulizer she scrawled “Epinephrine” on a piece of paper and said, “Find this! It’s in a little vial on one of these shelves!”

Despite the careful labeling we had done earlier, there simply wasn’t enough room for all medication to be clearly placed and accessible at all times, especially when we had to pack up and move quickly every time we finished a clinic in the borrowed space.  Myrlande rushed out to the patio to care for Lele, leaving Andy and I to find the vial.  As we scrambled through shelves of bottles, wishing we were medically trained, Andy glanced at me with wide eyes.  “What if we don’t find this?” He asked, first with his eyes and then out loud.

I swallowed and continued scanning the bottles, struck by the significance of a tiny little misplaced bottle.  The fragility of human life, so easily forgotten in the States, was made prominent daily in the Hatian experience.

Andy comforts Lele in Creole

.

.

One of the most urgent decisions was whether to continue to treat the boy in the clinic setting or to take him to the Jacmel hospital.  In the US, this would have been an easy decision: in Jacmel, it was not.  It was hard not to think about Myrlande’s story of the electrician who had died of the wrong injection at the hospital.  The boy was not stabilizing properly: if we took the time to move him to the earthquake-ravaged hospital, would his condition worsen on the way?

Finally Myrlande found the Epinephrine, and, on the phone with Dr. Robert to ensure accurate dosage, administered the medication.  It took about 6 calls and 3 phones to get through to the US, by the way.  Life can so often hinge on the simplest of technologies!

.

.

For a while, the boy seemed to stabilize, and Myrlande talked to his mother about the importance of bringing him in for care immediately next time.  Had he been treated the night before, his case would have been much less serious.  As he gripped the little inhaler we’d given him, I couldn’t help thinking of how many kids in the states use those on a daily basis, and how most of them have had the chance for more education on asthma than was available to this mother of seven!

.

After a few minutes, though, Lele was unstable again.  Myrlande put him back on the nebulizer.

.

Final decision: take Lele to Jacmel.  Perhaps the hospital would be able to do more for him. Noah carried the boy to the CLC Jeep.

.

Our driver and Myrlande pulled away with Lele and Carl in the car, and all the rest of us could do was hope.

.

Jacmel needs this new hospital.

Cutco team at the Christ Love Center in St Cyr, location of temporary clinic

Although direct medical attention, is, of course, the most urgent need, any doctor we talk to agrees that one of the most challenging elements of working in temporary emergency relief clinics is the ORGANIZATION of medical supplies.   Angel Wings has received generous donations from various organizations and individuals, but currently can only store supplies in Christ Love Center.  Those same supplies have to be boxed up and moved when the medical teams run a clinic in Port au Prince, only to be packed up again and taken to Jacmel.   The Cutco team committed to organizing 3 rooms of medical supplies in Christ Love Center, clearing the way for medical personnel to work efficiently.

Storage Room 1, BEFORE:

Storage Room 1, BEFORE

Storage Room 1, DURING:

Heather Drew, Noah & Susan Saunders organize supplies

Noah Saunders and Andy Jeanty move boxes

Storage Room 2, AFTER

Storage Room 1 AFTER

Storage Room 2, BEFORE

Storage room 3 BEFORE

Storage Room 3, AFTER

Storage Room 3 AFTER

Heather Drew organizes pills in Angel Wings' mobile pharmacy

Angel Wings volunteers can also help directly in organizing patients for the doctors to see. “Triage” is a medical term for deciding which patients’ needs are the most serious and need to be attended to first. Non-medical personnel don’t make triage decisions, but they can walk patients through a questionnaire that allows the doctors to make the right decisions.

Carl and Heather Drew help with triage

In emergency relief situations, non-medical volunteers can also do simple tasks like count pills for patients under a doctor’s direction.

Susan Saunders counts pills

Getting these kinds of simple tasks finished allows the doctors to focus on seeing patients.  The Angel Wings team of Drs. Chris Le and Robert Abello saw about 100 more patients.

.

This patient was actually first seen at the Tent City clinic: Dr. Robert asked him to come back so we could do a small surgery with only local anesthetic.  He bore the pain quite bravely.

.

.

Again, the local volunteers you see in the background were able to get firsthand medical experience.  Were there a full hospital, these two might have a place to help them pursue a medical career after possibly attending school in the Dominican Republic.

.

.

.

.

Carl Drew, with EMT training, was able to help the doctors with basic checkups.

Next post: an emergency again highlights the need for full hospital services in Jacmel.

Cutco team at Christ Love Center with Bonite Affriany and several Angel Wings staff

The hospital is located at the main entrance into Jacmel, about seven to ten minutes from Christ Love Center in St. Cyr.

Hospital at Jacmel

During our dinner conversation, Myrlande mentioned the lack of ambulance service in Jacmel.  Below you see the only ambulance in the city.  The man standing beside the disabled vehicle is an administrative office employee named Robinson.

Robinson, an administrative employee at the hospital stands beside Jacmel's only ambulance

Jacmel's ambulance

The earthquake only compounded an already dismal lack of resources and equipment. After the quake, most of the buildings on the hospital ground have been declared unsafe.  Robinson’s desk has been placed outside, and he admits patients and does all his administrative work from here in the open air, with only a canopy to shade him from the weather.

Robinson's "office"

Robinson gave us a tour of the hospital grounds, which is composed of different buildings for each ward.  This building used to be the maternity ward, and was actually brand new just before the earthquake.

Collapsed maternity ward of the Jacmel hospital

Collapsed maternity ward at the Jacmel hospital

Myrland tours the collapsed maternity wing of the Jacmel hospital

With virtually all the buildings of the hospital condemned and unusable, all the patients are being treated and kept in tents.  (This one was donated by the UN.)  There is no way to tell how soon a building will be available since there is currently not even any talk of construction of new facilities…much like the Tent Cities, these “temporary” conditions might not actually be very “temporary” unless someone steps in to help.

Temporary patient area

Back of the maternity ward. Lindsay Musser, Myrlande Affriany, Carl Drew, and Robinson.

Robinson shows us the back of the hospital where the river has eroded a significant amount of the hospital grounds.  If a retaining wall is not built soon, the foundations of the current buildings could be threatened.

Polluted riverbed behind the Jacmel hospital

.

Even the most basic things are in short supply.  Here Robinson shows us cloth rag diapers drying in the sun outside the children’s ward.

Diapers drying outside the children's ward

Diapers drying outside the children's ward

The earthquake devastated almost every building the hospital has, making patient care extremely difficult.

Combined women's and men's ward

.

In summary, hospital care was extremely limited before the earthquake, and now it is almost non-existent. Until a full hospital can be built by Angel Wings, the organization is limited to using Bonite Affriany’s facility (Christ Love Center in St Cyr)  to house the temporary clinics.  Until they have a permanent building, clinical care is also only available quarterly, when Angel Wings is able to supply medical teams from the United States.  Our next post shows what Cutco reps were able to do in the temporary clinic at St Cyr.

Tent City resident

The Tent City was a walled-in area packed with people and tents of all sizes and shapes.  The UN and Venezuela’s presence was made obvious by the presence of huge trucks (see photo below), but many nations flags and well-wishes were emblazoned across donated tents.

Despite all the showing of international support, however, many families were still in makeshift pole-and-blanket tents or tiny palm-leaf huts barely large enough to lie down in.

Tent City Residents

Tent City residents

.

.

So many of the Tent City residents are little children.  Many of them are going days at a time without food, and yet still eager to play and interact.  As we walked through the tent city, mobs of children would form, each hanging on to a visitor’s finger or our shirts.

Noah in the Port au Prince Tent City

Injuries from the earthquake also compound the discomfort of living in the Tent City.  Imagine having your leg in a cast and sleeping on a dirt floor in a tent that didn’t even keep the rain out, no indoor plumbing and no bed.

And no hospital anywhere nearby.

.

We set up the clinic in an empty schoolhouse.  (Schools are currently closed until further notice because in Haiti children have to pay around $30 a month to attend, and right now so few people can afford to send their children that most schools have closed!)

Patients go through Triage with the Angel Wings staff…

Triage with Amors

…and afterward are allowed to see a doctor.

Woman with "frozen" joint

Dr. Christian Le talks with a woman who complained of not being able to bend her elbow.  It took a while to find out that her arm had been crushed in the earthquake, then casted, infected, and re-casted—straight.  Once the joint heals in that position, the tendons are tightly contracted and it’s very difficult and painful process for a patient in that situation to re-gain mobility of the joint.

She’ll have some painful rehabilitating to do if she wants to work again.

.

Many of our patients are infants.  The baby below was only 4 days old.

.

Cases of jaundice were also common.  This case was likely Malaria and fortunately, we had medications to treat the patient.

Jaundice case

Remember the man with the crutches we saw in the Tent City?  He came into the clinic clutching a beat-up manilla envelope containing his X-rays.  He must have waited for over 2 hours to see us.

.

Another benefit to the Angel Wings clinic is the hands-on training the local staff get.  Many of them are Haitian medical or nursing students.  Good thing–this country could certainly use more medical personnel.

Dr. Bob teaches Kenndhy how to read this X-ray

Angel Wings serviced about 40 patients that day, and then had to return to Jacmel.  A permanent clinic in Port au Prince is desperately needed.

Noah, Susan and some new friends

Heather and a Tent City resident