Monday, March 19, 2012

Haiti March 2012

Caribbean Sea

Once again we are fluently rising up into the lower stratosphere overlooking urban decay interspersed with tents and a few shiny new roofs. A glass of orange juice is served and a few peaceful moments ensue as we cross over the tropical blues and greens of the Caribbean Sea… This is the second of three consecutive Sabbath mornings looking out across this dynamic tapestry of creation - a sacred time more inspiring than most church services.


Who went on the trip?

Maria (MD anesthesia) and Lucia (RN) from the Dominican Republic

Dr. Paley - The most experienced limb deformity surgeon in the world

Dr. Dror Paley and team

Dr. Craig Robbins – Jackson MS

Wendy Wong – LLU resident

Dr. Tan keeping cool during a case and her sister Josephine on R

Shirley Tan MD anesthesia and Jennifer Barker CRNA – LLU

Rose PA Arrowhead Regional Medical Ctr

Luis – Stryker Spine

Josephine Wong RN

A film crew from Journey Films who are producing a documentary about Adventist international healthcare outreach

Also visit from Dr. Dick Hart and Dr. Elie Honore early in the week to evaluate progress and host the film crew

Are things getting better down there?

This is a complex question. Progress is being made at the hospital. A housing project for long term volunteers is almost finished. Workers are vigorously working on the private ward remodel and doing a high quality job. New fixtures are being mounted and the walls are being chiseled out to accommodate new plumbing which will correct the hot water circuit which was previously connected to the toilets. This project was made possible by an $85,000 grant from the AIMS foundation and should help to create a source of revenue at the hospital.

Workers remodel private wing

The earthquake destruction around the city is less evident but the grinding poverty and ubiquitous trash make the new visitor still ask if it was really this bad before the earthquake.

We were fortunate to have constant electricity this trip but the importance of having a constant water supply at the hospital is still lacking, sometimes requiring volunteers to limit their fluid intake and pee on banana trees and the back fence.

Who is in charge of the orthopaedic program?

Francel Alexis MD is the local full time orthopaedic surgeon who we are so fortunate to have. His pleasant demeanor and reliability are assets that allow us to do complex cases with the confidence that the patients will have good follow up.

We are still looking for a full time foreign surgeon to help lead the surgical program and coordinate international resources and educational programs.

How is all the equipment down there?

This is my first visit since Terry Dietrich left last November so I was expecting some chaos and disorganization, but Jean Joel our local ortho tech has done a remarkable job at keeping things organized. I was pleasantly surprised to see that the organizational scheme that we set up 2 years ago is still continuing to function

Dr. Craig Robbins uses Stryker cordless power drill recently donated

Before my arrival Francel had warned me that the C-arm was not working as there was a problem with the interconnect cable between the workstation and the C-arm. This is a $2320 replacement part which we were able to obtain and when I installed it the day we arrived x-ray function was restored. Unfortunately, 2 days later the monitor began flickering and the machine would not boot up. After 3 phone calls to GE headquarters in Salt Lake City where there are some technicians sympathetic to our cause, we were able to do some calibrations and get the system functioning again.

Where do you sleep there?

This time we bunked up in one of the new modular buildings out in front. I actually prefer my previous location on the porch with my cot, but perhaps some will be comforted by the air conditioning and hot showers that are now available for visitors.

How many cases did you do?

Thirty-nine. But it actually does not really matter because what is most important is the relationships we fostered and the quality of care that was given. On Friday we finished early and enjoyed a dinner with 40 of the employees at Hotel Auberge hosted by Josephine and Shirley. This was a real treat for many of the employees who rarely if ever are able to enjoy something like this.

Employee luncheon at Hotel L'Auberge

Nursing students review patient records

What kind of patients did you treat?

Ronald a 22 year old with severe R leg bowing

Spatial Frame placed for gradual computer driven deformity correction

Walking down the hall on Monday morning is a strong motivator for our continued commitment to this program. Children and adults of all ages were waiting for the clinic. Some had clubbed feet, some had severe limb deformities and others could not walk. They waited patiently. One by one we saw them and made treatment plans. The weeks seemed it would be overwhelming, but thanks to the expertise of Dr. Paley as well as a strong team effort from all members we were able to treat a wide variety of exotic cases. A couple of orphans brought by Annie an American woman who runs an orphanage were cancelled on our last trip. We scheduled them as our first cases this time and it was great to have Dr. Paley to operate on these difficult cases. We operated on a number of patients with clubfeet and other challenging limb deformities. The week ended with an operation for a T8 burst fracture in a man who had been in a bicycle accident.

Dr. Paley pre operative planning for a case of arthrogryposis with severe knee flexion contractures

R clubfoot in a 32 year old woman

What is the vision of for the future?

There is so much need and so much potential. I certainly do not have the answers but I have realized there are at least three key factors essential for the success of mission hospitals. These are:

  • Excellent services
  • Focus on caring for the poor
  • Sharing the love of God

There is no reason to do anything with mediocrity. This is essential for maintaining support from volunteers, donors, and patients with and without resources. We can never forget that the main reason to have a hospital is to care for those that are most in need. Profit is important only for the sustainability of offering our services to the underserved. And sharing the love of God extends our finite abilities to move forward with courage and boldness to accomplish formidable tasks.