COLUMBUS MEDICAL MISSION TEAM: SUMMARY FROM DR. JOE MILLER

April 20, 2014

Dear team members now and past, supporters and others who are interested,

Wow! We had another great trip, 67 total team members with 40 first week and 36 second week. Sorry, Edgard, for all the stress. We pushed the facility to its max. Donna, thanks for the use of your home. We had 8-10 there each week. We saw over 1000 patients in the clinic and ER and 110 procedures, mostly in the OR. The clinic and operating room were our initial focus but this has become much bigger than seeing patients. We are trying to create an infrastructure, physical plant, supplies, technology and most importantly, human resources that are self sustainable.

Patients waiting at the gate.

We brought over 5000 lbs of supplies and equipment. This included basically an ENT office set-up donated by Dr. Nila Novotny and John Novotny. This included an operating microscope, a flexible nasal/laryngoscope and light source and more. The microscope can double as a culpascope. We now have an ECG machine and it was utilized multiple times including a stress test this trip. Nila also spearheaded a book campaign for the nursing school and we brought thousands of dollars of books and posters, most of them in French (the professional language). These were used to set up a library at the hospital at Pierre Payen because of questionable viability of the nursing school. Also, thanks to Jeff Burg and Bryan LGH for providing us with urology fluids at the last minute.

Endoscopy equipment.

The first week there were seven in the "construction crew/ McGyvers" who started on the second floor of the guest house, along with moving wires, doing plumbing, trying to keep "the beast" (big autoclave) going and many other odd jobs. Second week crew of 2-3 (Adam PT vs construction) assisted by some Haitians put a roof over 90% of the second floor, set forms for the bathrooms and started on interior walls. This addition will be amazing. It will reduce the heat on the first floor and with the second floor being peaked and screened on all sides it will also stay cool. I stood up there Friday afternoon after the team left and the cool breeze was wonderful.

Working on the new 2nd floor.

The most amazing part of the trip was the educational piece. In November 2013, we taught a couple of classes to a handful of nurses and physicians that were well received. This trip we taught classes from 2:00-5:00 Monday-Thursday each week for all the nurses at OSAPO, Pierre Payen, some nursing students and resident physicians. Lunch was provided. We had over 50 attend each day and over 75 total people. They were given certificates at the end. It was very well received and will be a part of each trip in the future.

Mary giving her lecture.

We had very sick medical and surgical patients. One was a 24-year-old female with respiratory distress that we ended up intubating and anesthetizing all night followed by transport to Port-au-Prince to an ICU at Bernard Merz Hospital. She is still a mystery to them, is on the ventilator and was to get a tracheostomy. We had 2 patients that required transfusions from team members. Thanks to Naomi, Adam, Michele, Simeon and Melinda for your special contribution. Some of the surgeries were quite complex dealing with problems that would have been taken care of many years sooner if the patients were in a first world country. Unfortunately we saw way too many end-stage cancers and other medical/surgical problems that could be easily fixed in the USA but are disabling or killing the Haitian patients. This is always difficult to deal with for the group. We thank God for our many successes and care we provided. We pray we do no harm.

Kelsey, Dr. Leach and Dr. Miller early morning, after ventilating the asthmatic patient all night.

Transporting the patient to the van.

Pharmacy development, organization and inventory was another nice improvement. Having professional pharmacists both weeks on our teams was unbelievable compared to even a year ago (ask Shirley). Having an inventory and meds prescribed each time we go will be helpful. We can post for each team going down throughout the year which will help with planning.

Wichita State University (WSU) sent Mark Shaver, Audiologist Professor, with 2 students first week and Ngoyi Bukonda, Public Health Professor, with 3 students second week. Both groups worked on and off campus within their specialty and assisted the medical/surgical team.

Our audiology students, Megan and Kambra.

As usual we did have a few people get dehydrated needing IV fluids. But this is the first time we have had a team member get critically ill on a trip. Unfortunately, we needed to medivac (thank goodness for insurance) Dr. Deb Placek to Fort Lauderdale Friday after the rest of the team left that morning. Deb wants to thank all of you for your care and concern. Thank you to Namdar for staying with me to care for Deb and to Dr. Gardy for transporting us right onto the tarmac for the flight. As of April 20, Deb is still in the ICU in Holy Cross Hospital in Fort Lauderdale. She would appreciate your prayers.

Longstanding relationships, dreams and leadership are important in order to make Pierre Payen and the Victor Binkley Hospital sustainable. This trip, more than ever before, we began building relationships with the physicians practicing at Pierre Payen. Dr. Frank (Cuban OB/GYN), Dr. Nereyda (Cuban pediatrician), Dr. Bayord (physician in community clinic), Dr. La Vaud (physician in community clinic and director of the HIV program), Dr. Efrantz Toussaint and Dr. Christine (both social residents), Dr. Thomas (orthopedist from St. Marc) and Dr. Jovin (ENT from Port-au-Prince) all had meaningful interactions with the team. Growing these relationships is important. The dreams and leadership of Steve Mossburg of Project Help Haiti and the OSAPO leadership team of Dr. Gardy, Dr. Sterman Toussaint (congratulations new Daddy) and Ronald Toussaint are the driving force to not only sustainability, but a place of excellence. They are working on human resource development, plant development, program development and budget. Dave, Judy and I feel honored to be included in some of this visioning, development and planning.

Dr. Novotny and Dr. Jovin, ENT from Port au Prince with equipment donation.

Five years ago I had no association with Haiti and today after 12 trips to Haiti, 10 times taking teams, over 300 different team members, many Haitian friends and my Haitian brother (Dr. Gardy), Haiti has become my second home. I want to thank all of you for your support and commitment to not only helping the Haitian people but to your commitment in making Pierre Payen a self sustainable institution of excellent health care in Haiti. This will benefit Haiti more than any number of trips.

The next 2 trips are set for November 14-28, 2014 and tentatively April 10-24, 2015. I need feedback on the April date. November is set. Those of you that want to go, please let either Dave Ingram or me know.

God's servant,

Joe Miller