Wow, this was a busy week...

 Lots to talk about today!  Happy Halloween to everyone.  You'll see towards the end of this that Haiti does celebrate Halloween.

This is Darline P.  She is working with Rick, one of the rehab techs, on leg strengthening exercises.  She broke her femur in a motorcycle accident.  They call them "motos" here.  She is not an earthquake victim, however, the earthquake, the very poor infrastructure and poor roadways, add to the risk of using a motorbike here.  The drivers are weaving through considerable traffic and often driving very fast. Darline has made wonderful progress in the month I have been working with her.  She is ready to start running and skipping, however, at this treatment, she did not have any shoes.  I have since found some tennis shoes for her in a shoe donation and hope to give them to her this week.

 I hope to spend some more time in each of my posts sharing some of the stories of the patients here.  The gentleman in the middle is Corlion.  He is a thoracic spinal cord injury.  We tease him that he is the godfather of the group.  To his left, "gouch" in Creole, is Remy. He is 17 years old. He has avascular necrosis in his left hip and is waiting for transportation to a hospital for potential surgery.  Surgery  is difficult to access here for many of the patients.  The organization I work for here actually has funds to help the patients pay for surgeries that they otherwise couldn't get.  The gentleman on the right ("dwot") is Artiste.  He is waiting for wounds on his residual limb to heal so he can use his prosthesis and return to his home.  We traveled to his home last week and found an area of land without any structure on it, tent or house, so he will need assistance from friends and family to try to build a home once he leaves. He's very strong and can do more on one leg than I can do with two!

This adorable guy is Beny.  Beny is a T-10 complete spinal cord injury from a car accident.  He is here for therapy for transfers, strength and balance activities and also needs considerable wound care.  He came to us with 2 large grade 4 gluteal wounds on his butt and hips.  That means that all the skin is gone and you can see the muscles and bones.  They are very clean and the nurses here are learning difficult wound care from the ex-patriot volunteer nurses, but he really needs a plastic surgeon to correct his situation.  He's very sweet, loves to smile and sing.

This is the team assembling oral rehydration packets to give to patients that are coming into the medical clinic with diarrhea symptoms.  We haven't confirmed any cholera cases here but they have been confirmed just north of here and seem to getting closer to Crois des Bouquet and Port-au-Prince.  We spent much of the week assisting the nurses and physicians with crowd control to help decrease the contact of any potenial cholera patients from the rest of the crowd.  I was the gate guard one morning and the people just stormed the place, nearly running over each other to get in.  Many of them try to use the sink that is for the toilet area of the separated potential cholera patients to wash their hair or clothes and, one time even, their dishes.

Game day again in the afternoon.  Outpatient therapy was put on hold last week but should resume this week with proper control for entrance and cleaning 
of equipment.






November 2 and 3 are actually a national holiday here so the medical clinic is closed Monday and Tuesday.  Plus, the OT, Erica who has been here for 3 months, left for Chicago today, so we took a quick trip to Jacmel, on the the southern coast of Haiti.  We traveled about 6 hours to get there Thursday and left to return on Saturday.  I work Monday and Tuesday to do the therapy sessions with the inpatients in the rehab hospital. (just like home, we still gotta work on the holiday). It was amazing to see some of the rural country though.  The mountains are breath-taking, as well as the narrow, curvy road that the driver is racing down.  It was like a 3 hour roller coaster ride.

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 The trip took us through Port-au-Prince and we were able to see some of the devastation from the earthquake.  It's actually difficult to take pictures because the people get very insulted when the white people are taking photos of their suffering. 

 This was a fishing boat at the beach.  I just loved the saying: "Man proposes, God decides"

 Sugar cane fields.  There are beautiful plantation building right next to these that are destroyed and crumbled then a tent city right next to that for the sugar cane workers.  It an amazing mix of growth, destruction, garbage, lots of people and beauty.  It's hard to even put into words.

 See...We went to a party for Halloween, however, the only costumes you find in a seminary are sheets!!
The following photos are some art, party pictures from the roof of the Chilean doctors house and the beautiful flowers here. just wanted to share these with you :)

all work this weekend...

Sorry no pictures this time!!  We learned of an outbreak of cholera in the central plateau on Friday night.  I'm sure you all have seen the news and are wondering about me.  Saturday and Sunday, we spent the days cleaning out a storage room to use as an isolation  room for suspected cholera patients.  They will be assessed and given fluids and lots of education to attempt to decrease further transmission.  We assembled soap and hand sanitizer packets and some bags of home-made electrolyte mix.  It was a BIG job to move hundreds of boxes, identify and inventory the supplies we have to do IV hydration and medical treatment.  I learned a lot of nursing terms and a considerable amount about planning for an event like this. 

I just want to comfort all of you that we have lots of protective supplies here and access to the treatment needed should any of us get sick.  Truly, I moved at least 20 boxes each of gloves, masks,soap and hand sanitizer, some of them twice :) There are 5 confirmed cases in Port-au-Prince, none confirmed in Croix des Bouquet, which is where I live.

I will continue to update the blog as I am able.  Keep the prayers coming for the staff here and the Haitian people. 

This week, we were privileged to have a 3 team pediatric specialty group. Overall, it has been difficult to see a lot of the disabled children because we are so busy with the 14 patients that live here and many adult outpatients.  We saw many new children and both family members and the technicians were trained on several techniques to use with disabled children. 

This is Gail, physiotherapist from Toronto, training Kensley's mama on help him learn to sit up.

 This is Michelob. He is 8 years old and has spastic quadriplegic cerebral palsy.  The woman standing behind him is actually his aunt.  His mother died in the earthquake in January.  Here is Haiti, a disabled child doesn't go to school.  School is quite expensive and they feel that any physical disability also equals an inability to learn and contribute to society.  Many of them get dropped off at orphanages because the families can't handle to burden. I haven't had a chance to get to an orphanage yet but I plan to soon. 

 This is Gail with Michelob.  The gentleman in the back is our interpreter Mike.  He was educated in the USA, but has returned to Haiti to work for the medical non-government organizations here.  The two most lucrative jobs here for a Haitian are providing transportation and communication for the many NGO volunteers.

This is Rick, a rehab technician, working with Laura, the Canadian OT and Vladensky.  The rehab techs are actually the most important part of our team because they carry out the therapists plan of care and continue care even if there is no therapist here. 

 These are the 4 wonderful ladies that prepare our food, 3 meals a day: breakfast at 7am, lunch at 12:30pm and dinner at 7pm.  Clinic is often closed by 3 pm and the longest hours of the day are from 3 until 7 pm, when the bell rings.  They are also the hottest!!

This is a picture of the doctors from Chile that  volunteer here for a year.  Of course, the white woman is Kathy, nurse extraordinaire, who unfortunately left us on Wednesday to back home.  She was very excited and I was very sad :(

This is Kathy with an orthopedic ankle patient, Jocelyn.  She was in a cast for 5 months because she was either not given the right instructions or lost her instructions and did not know when to return to see the doctor regarding the care for her ankle fracture.  There was easily an inch of old skin wrapped around her foot and ankle after the cast was removed so Kathy was helping her with skin care before her PT sessions with me.  There is no hot water here so Kathy would use an electric teapot to heat water and add some cold water for a warm water foot soak.  Something very few Haitians ever get to experience.  Jocelyn loves Kathy's foot scrubs and then comes to me for pain and torture (PT). 

Traveling challenges

Traveling in Haiti is very difficult.  The roads are so bad and  there are so many people.  Thursday we went to Visa Lodge for team dinner.  We traveled 7 miles to this restaurant and it took over 90 minutes.  Cars are packed on top of each other and people are packed on top of each other in the cars.  As we closer to the Haitian election, the organization I'm working for will be setting new security measures where we can only travel certain times of the day, we will have curfews and only be able to travel to approved places.

 Visa Lodge for a team dinner.  The people on the right are the doctors and a dentist from Chile that we spend a lot of time with.

 Because of the new security measures and as a goodbye trip for our nurse, Kathy and our OT, Clare who are leaving this week, we went to the Dominican Republic this last weekend.  We took a truck from our compound to the border, aka. frontier.  From there we road on the back of motorcycles to a town called Jimani.  In Jimani, we had hoped to get on a bus, but instead we found a man with a van that would drive us to Barahona, on the coast and pick us up on Sunday.  This picture is a National Park in the DR.  Quiet beautiful.  The whole trip was 70 miles and it took us 4.5 hours to get there and then the same to get back.

The Beach :)

 Very rocky but beautiful.  The mountain rivers actually empty into the ocean so the water is cold on top and warm underneath.  It was wonderful!

 We met a great guide who helped us get to the beaches and to these beautiful water falls that we swam and played in for an hour.

There are two nurses working with us, Kathy, on the far left and Suzanne, next to me.  Kathy is 62 years old and she's amazing.  She's retired, fluent in Spanish and volunteers all over the world, in multiple types of medical settings.  She keeps up with us like a young woman!! 

This week we have a pediatric specialty team here this week from Toronto, Canada so my next post will have pictures of all the kids we are seeing here.  I know you all don't believe it, but I do actually work here :)

Ahh...the weekend.

 On Friday afternoons, we have a bowling group.  It is very serious and high level competition :-)  The patients play arms versus legs so some of them can throw the ball and others have to kick it.  The woman in the first picture is David, pronounced Dah-veed. She is 73 and lost her leg above her knee in the earthquake.  She is using a prosthetic but also walks quite well with the walker and 1 leg.  73 is actually quite old in Haiti.  Most Haitians pass away before the age of 70.  They also don't keep very good track of their ages, so we "think" she is 73. 

 The above picture is Delcame You-Youte.  She had a severe femur fracture with multiple injuries.  She has several metal plates and screws in her thigh.  They struggle with this concept of internal fixation and are very afraid of "breaking"  the metal in their bodies so they avoid using the joint.  She's the one I gave the shoes to.

This is a common shop in Haiti.  There are several types of stores along certain roads, called the Market.  Their form of a shopping mall.  


This is a tent city.  There are several companies here putting up tents and also 1 room plywood houses with tin roofs that will be used as permanent housing.  

Don't feel too bad for me though!  We went out for dinner on Friday night at a really posh restaurant with a swimming pool and we met another American here that's work for the Animal Humane society.  He lives here and has a car and can drive like a Haitian.  So we were able to get to the beach on Saturday.  It was so fun!   Lots of SPF!

Tough days...

 This is the view of the mountains from the compound I'm living in.  This is rainy season so there skies are rarely clear to really see the mountains.  One of my friends and coworkers showed me how to climb to the top of the water tower where the view is better so I hope to take the chance to get some photos on a clearer day some time soon.

Wednesday was a tough day. I cried for the first time here.  I know it won't be the last.  We had to send a woman away who was very ill but needed medical care beyond what this facility can provide.  It took 4

                                                      family members to carry her out of the backseat of a car. They so desperately needed help and we had to send them to the general hospital, not knowing if the family would actually take her because of the cost.  She had severe heart failure with swollen legs, very short of breath, unable to even sit.  I went on my first "home" visit to take a patient who started going into withdrawal from alcohol, wasn't eating and threw up on me in the am PT session.  He lives behind a wall by the main street, where his wife and family sell various items under a tin roof held up by 2 branches.  He sleeps on some blankets behind the cement wall under a fabric canopy and a family member carries him to the public bathroom.  He has already lost one leg and just had toes amputated on the other foot.  Sorry, I didn't take pictures of that, but I rode in a truck with 8 other Haitians into an unknown part of town and didn't want to risk it getting stolen.  Anyways....

Today it rained in the morning and the heavy rains flood the streets so many of our outpatients didn't come.  That gave us some more time with the inpatients.  This picture is of a woman named Osinette.  She lost her leg in the earthquake.  She now has a great prosthetic and we are getting her ready to go home and back to work.  She makes money by selling fruit and items on the street so she has to carry baskets on her head and get up and down off the ground.  You can see how straight her basket is and how crooked mine is.  I dropped mine 3 times and hers never wobbled a bit!!  They will carry as much as 5 gallons of water on their heads at times.  That's 40# and I couldn't hardly hold up the 5#.  By the way, this is the new neck rehab protocol for my patients when I get back :-)

This is Clare, showing off how good she is at holding her basket and moving around.  I need much more practice! 

We got a shipment of shoes that the main OT, Erica, brought in and I was able to give a patient a pair of shoes today and she was SO HAPPY, ear to ear grin, because she got a used pair of tennis shoes.  Makes you think, doesn't it?

My first days at work...

Sorry, no pictures this time.  I haven't had my camera out since Sunday.  On Monday, I was working by myself, the other 2 OT's were both gone.  There are 3 staff here specifically designated as rehabilitation technicians.  A huge part of the therapist's job here is to train the techs to perform therapy tasks because there are months and weeks at a time that the facility doesn't have a therapist here.  They don't do new evals or take new patients but they do continue the care until the patient can go home or a therapist comes to help with discharging. It's so different!

I wasn't as affected by the heat so much this weekend, but wearing scrubs and seeing patients in the gym just makes my sweat  like crazy! Most of the staff say that they were that way initially too, then it got easier.  I am truly overwhelmed here by the level of injuries and the pace of patient care but am swimming along in the rapids and still keeping my head afloat :)  The 2 OT's and I have a month together to get some processes figured out to improve the system and help with the flow, then I'm on my own for about 2 weeks before the next therapist arrives.

I am learning lots of Creole and will soon start formal lessons. The patients are very patient with my attempts to learn their language. Actually, I think alot of Creole words sound very funny with my Minnesota accent.  They usually laugh at me, then gently correct me. They are very hard workers.  So far, if I walk away from the patient I'm working with to go help someone else,  I don't even have to tell them to do something, they just start exercising on there own.   There are many patients that wait a long time to see the therapist and they rarely don't show up on the day of their appointments.  I'm going to be spoiled when I return to the states and probably less tolerant to the no call/no show game.

Anyways that's all for today.  Thanks to everyone for all their supportive comments and prayers.  Lots of Love!!

Hitchhiking in Haiti...

Hi!  So today we went on an adventure to find a pool at a local "hostel/hotel"  that the doctors from Chile that work here had heard about.  We got a ride to the gas station and then hitched a ride on the big flatbed truck.  The driver wouldn't take money.  Then we had to walk along a path right past a Haitian wedding.  All eyes were on us for a time, not the bride and groom!  Amazing that I've managed to find a pool within 48 hours of my arrival here, huh?  And the Haitian beer was only 2 American dollars!  They fed us fish, rice and beans, avocado salad and a very spicy type of coleslaw.  We swam,talked, drank and ate for about 5 hours.  Then we had to find a "tap-tap" which is like a taxi.  Its a small truck with large, high topper painted bright colors.  We squeezed on here with several other Haitians to ride back to the gas station.  The girl in the photo with me in my new friend Clare, an OT that is volunteering here. We had a fun day and now I've been informed that I actually do have to work tomorrow and the vacation is over!  I'm so ready to meet the patients and get started doing what I came here to do. 

Getting settled...

 This is the courtyard just outside of my room.  Lots of tropical plants and flowers, along with lots of bugs, spiders and lizards :)  It is about 93 degrees today and the Haitian people tell me that this is cold for them! The compound is made of cement, with 1 story and there is a wall with a gate around it.  We had to ask for special permission to come home at 10:30 Friday night from the birthday party because the guard locks the gate at 9 pm each night. The Haitian people actually go to sleep early and get up early.  I found out that many of the patients won't even come to therapy at 3 or 4 pm because that is when the rest, like a siesta, they call it "kabicha". 

 This is my room, I actually will post another picture from other side, as I moved there today after my roommate left to return home.  The bed was fairly comfortable, but I was also very, very tired.

 This is the dining hall.  I thought it was monks that were here, but it is nuns.  Actually, this is where they vacation.  They are all very sweet and speak Spanish.  Lots of different languages are spoken here.  Monday, I will start taking Creole lessons!

This is the therapy gym.  I was quite surprised at how large it is.  People have donated so much equipment that the OT, Claire and I, spent the morning opening boxes and organizing things so we have access to what we need.  Until last week, the other OT here was seeing 14 inpatients and 8-10 outpatients BY HERSELF!  Here, we are considered "physiotherapistes" and PT/OT treat any type of patient and condition.  No separation of arms and legs, or fine and gross motor. Interesting!  Well, off to the water tower to take pictures of the mountains:) 

Arrival!

I got to Port au Prince at 3:15. The time is the same here.  We went to a super market and I bought bread and peanut butter.  I rode in a truck with some team members: the nurse, the medical director and the clinic director.
It took us an hour to travel 8 miles!  .The roads are terrible and the drivers are very aggressive.  Lots of honking and nasty looks and language ( not that I could understand) We are going to a party for a birthday tonight. Yes, I guess there is beer here:) I am exhausted but riding on adrenaline.  I will post pictures tomorrow.  It is hot and humid and lots of mosquitoes!