Highlights include a 19 year old with a ~15% total body burn early first week. We debrided him daily initially. One of our nurses who works in the burn OR at St. E's in Lincoln called the St. E's burn unit for supplies. They generously sent what we needed. Her son (past team member), picked them up and drove them to Omaha in a snow storm so the second week team could bring them the next morning. The special dressings were amazing. By the time we left, it appeared he would need minimal to no grafting. The Haitian nursing and physician staff had been instructed by team members on how to use these dressings. Dr. Toussaint will be available if/or when grafting will be necessary. WOW - team work coordinated both in Haiti and back home. There were enough dressings for probably 3 more patients and now the Haitian staff has been educated on how to use them.
We were asked by a Haitian physician to see a new patient he had admitted with respiratory distress, a 9 year old who was lethargic and severe respiratory distress. We took him to the OR and set up for an emergency tracheostomy. Once everything and everyone was in place, anesthesia, ENT and family medicine saw our first epiglotitis. With significant difficulty they got a 4.5 ET tube in place instead of a tracheostomy. He remained intubated in the big OR overnight (with nursing at his side and physician close by) and in the small OR the next day till extubated about 6:00pm. With IV antibiotics, IV steroids and the grace of God he was able to leave the hospital 6 days later. Though we had many years of experience, we saw our first case of epiglotitis, a disease we used to fear in the US. This disease is almost non existent in the US now due to vaccines.
A major jaw tumor removed in a 50 year old man, multiple hysterectomies, radical prostatectomy for prostate cancer, breast lumps, lipomas and other masses removed, nasally surgeries, urethral strictures and many more surgeries were done. Medically we saw 100's of cases. Three excellent family medicine residents, a family medicine PA and a PA student covered the clinic which was a great gift to me. The surgeons and I were available as needed.
We had many successes but unfortunately there were all too many times we could not change the course of things in Haiti such as a 17 year old boy with end stage hepatocellular carcinoma. We were unable to resuscitate a 34 year old woman stab wound victim. Unfortunately we see where culture, poverty and lack of availability of technology and limited resources limit our ability to help. What I did see was a team that always cared even to the point of tears at times. Having two team members to lead devotions most mornings helped remind us why we were there, to serve.
PT and OT and a new twist, chiropractic, were invaluable from the ambulation of patients to back pain to hypo and hypertonic infants to burns and more. Students and non-medical personnel filled in everywhere from the gate and crowd control to inventory to washing instruments to working in each of the areas.
An added duty this time was running the pharmacy. The residents, PA and an ICU nurse with a student and other assistants gave out over thousand (maybe 2000) prescriptions. We inventoried medical supplies in all the areas and will set up a way for groups to access the inventory. The new meds were added and we kept track of the meds given out for the pharmacy inventory. With all the scripts it was greatly depleted in many areas.
One of the greatest successes was working side by side with the Haitian nurses and physicians. The family medicine residents put on an afternoon of education for the younger Haitian physicians and the Hatian nursing staff that was excellent and well received. 6 days we sent at least 2 people to the nursing school in St. Marc to teach and answer questions. The second week Dr. Sterman Toussaint was the general surgeon all week and Dr. Optaint (OB/GYN) did Ultrasound Monday and surgery Wednesday. Dr. Lavouwe is the director of the HIV program and worked with us on several cases. Every patient seen in the clinic was screened for HIV. Dr. Lavouwe will also follow up with the burn patient. In the pre-op/post-op area the nursing staffs worked well together.
A veteran team member and master electrician arrived a week before we did and he rewired the OR and central supply from 2 wire to 3 wire. We are now grounded. He remained the first week and was joined by a mechanical engineer, civil engineer and a 6 trip veteran. The four of them in conjunction with Steve Mossburg, director of Project Help Haiti for Church of God, started planning for structural improvements including a second story on the hospital, second story and new kitchen on the guest house, solar energy and other electrical and mechanical needs on the compound. They also did many fix it jobs, cleaned out old junk, built shelves and benches and more over the two weeks. A faculty member from Wichita State University volunteered to write an energy grant for the solar energy.
Every trip offers new successes, opportunities and challenges. God has blessed us with a way to serve our brothers and sisters in Haiti. To the team, hopefully it was a fulfilling experience. Hopefully you will come again or tell your friends so the network continues to expand. To those of you that contributed in so many ways, thanks and we would appreciate your continued support. The goal is to make Pierre Payen Hospital and Clinic self-sustainable and completely staffed and operated by Haitians. Each trip by each team should work toward this goal. Since earthquake, many positive changes have happened both structurally, operationally and with equipment. Many times this week I thought of Dr. Victor Binkley who started this over 35 years ago. I think he would be smiling.
The picture below is Giana with some Haitian nursing students.
