7:00 AM: I feel more confident going into clinical today. I did so many blood pressures yesterday and got really good at them so I’m excited about doing them again.
10:00 AM: We started the clinical with a song and prayer led by the pastor’s wife. The singing was so beautiful! I know religion is a big aspect of the Haitian culture and being a part of the prayer really made me feel like I was a part of their family.
12:00 PM: I’ve forgotten how hard it is to do interviews. I’m asking the patient questions to figure out what the problem is but I miss basic ones that Dr. T picks up on right away. She’s amazing!!! She can ask 3 questions and immediately figure out what the problem is versus me who has spent an hour with the patient and still hasn’t gotten to the bottom line haha. Her level of expertise only comes with time and I’m excited for the day that I can hopefully do what she does and as amazingly as she does it too.
6:00 PM: I am back home and today was a great day. I learned so much from Dr. T and saw the kindest patients again today. I saw Dr. T put her hand on a patient’s chest and say, “I would say that his temperature is 100.5” haha. The best part was that she wasn’t kidding. She said, “When you’ve been doing this as long as I have you don’t need a thermometer anymore”. She also loves saying what is going to happen then once it comes true replies with “Who said it? Not me!” hahahahaha. She’s the best. I worked with Elissa today. Taylor and Peyton were also doing assessments with me. It’s soamazing seeing how much they have grown as nurses and I am so proud to call not only my group but the entire class my friends and future colleagues.
I wasn’t sure what to expect from our first clinical day. Once we arrived at the site, we were given a tour of the area and began to set up for the clinic. The students were divided into 3 groups based on their clinical focus. One group was responsible for taking vital signs for each patient and determining their chief complaint while the other two groups were tasked with doing a full physical assessment on either adult or pediatric patients.
Before arriving in Cap Haitien, our cohort fundraised for the clinic and the orphanage by selling stethoscope name beads to students and faculty of the Nell Hodgson Woodruff School of Nursing. In just this first clinical day, we saw the impact that the money we raised had on this population. We distributed 50 meals to patients who were malnourished and reported not eating that day. Children with growth delays due to malnourishment were given ensure to promote growth and development.
One of the most memorable patients of the day was a 5-day-old baby who was completely lethargic. It was discovered that the mother had been feeding the baby watered down tea because a witch doctor instructed her not to breastfeed. Therefore, the baby was not receiving the nutrients he required that would have been provided by breast milk. Luckily, we had some formula on hand and were able to teach the mother how to mix the formula and feed the baby properly. Formula is an expensive commodity, so some of the money raised was used to buy her formula to feed the baby.
Towards the end of our day, a mother came in with her two young girls who were diagnosed with scabies and a fungal infection. The fungus was growing over their entire bodies and the younger girl had lesions on her head from the fungus. A classmate and I bathed the girls, scrubbing the younger girl’s head with a toothbrush, and treated them with an antifungal cream. After dressing both girls in new clothes, we held them and gave them lollipops. Both girls had the most beautiful smiles and were happy to be clean. We sent them home with the antifungal treatment and 2 new sets of clean clothes. The impact that our actions had on this population in need was apparent to us after just one day in the clinic and we all were excited for the remainder of our experience.
Today we got the opportunity to do a few different site visits to better understand the culture and lifestyle of the Haitian people. We took an open air truck which allowed us to really experience the sights and smells as we drove to our first stop, The University of Haiti Campus Henry Christophe located in Limonade. While there we visited several classrooms, the library and got to see the work of the art students and speak to the faculty of the music program. It was interesting to compare the similarities and differences between the university and universities in the United States. One big difference is the lack of an online system to share grade information; so instead, all student grades are posted publicly on bulletin boards outside the classrooms.
After touring the university, we headed back in the open air van to visit a local hospital, Fort St. Michel. It was shocking to see at first as it was very different from what you imagine when you hear the word hospital; it was mostly outdoors, with small treatment rooms for separate needs, such as tuberculosis, a dental clinic, and different areas for pediatrics and adults. Although it may be so different from what we are used to here, it was also inspiring to see how the Haitians do the best they can to take care of sick individuals. There were easily over 100 patients waiting to be seen and the director of the hospital informed us of the many free services provided to locals. I really appreciated the opportunity to visit these different sites and get information directly from local residents of Haiti because even if I return to visit Haiti again, it is unlikely I will have the chance to go on similar visits.
After getting our bearings in Haiti, it was time to begin preparation for researching the population around us as well as preparing for the upcoming clinical days. We set out from the resort towards town to meet with Dr. Twilla Haynes and Elizabeth Woods. On our journey down the mountain, we were able to view the culture around us and how it impacted each of our senses. The sights of brightly colored buildings and vibrant social scenes easily caught our gaze. The sounds of music, laughter, and continuous honking became the soundtrack of our trips to town. The smells were dependent on our location in town. You could smell a range of things such as beach air or food cooked by local vendors. The taste of the air around us was a mixture of humidity and dirt stirred up from the streets by taptaps weaving in and out of the traffic.
Once we arrived at the Mont Joli, we were able to acclimate ourselves to the supplies needed for the clinic days. Dr. Twilla went through each “tackle box” thoroughly and explained to us where it would be located on clinical days. These tackle boxes contained medications and supplies needed to treat patients for various issues such as scabies, diabetes, and hypertension. This orientation to our supplies helped put our first day jitters somewhat at ease as we prepared to serve the people of Haiti.
This was the perfect day before diving fully into our long clinical days. It was a day of relaxation on a private island in beautiful Haiti. We took a taxi boat to get to the island, passing beautiful scenery such as the mountains. The waters were crystal clear and the sound of the roaming waters was refreshing. To top off the beautiful day, we got to indulge in freshly caught seafood, perfectly seasoned with Haitian spices.
What a great day! We woke up early, had breakfast at the hotel and then travelled by bus to the Citadel. It was amazing to drive through the different towns on the way. So many different smells and scenes than we are used to: children getting washed by there mothers in outdoor wash basins, the trash along the coastline with goats and pigs intermixed, the women carrying heavy loads on their heads with perfect posture and balance, and the tap-taps, motorbikes and other vehicles going in every which way. We slowly made our way out to the rural area that surrounds the citadel and the scene changed to open fields peppered with palm trees, with cows grazing. We quickly learned that Haiti is a beautiful country with a diverse landscape. Once we finally arrived at the Citadel we climbed on all climbed on horses and rode up the mountain. It was wonderful to see the view from the trail as the horses carried us. When we got to the top we were given a guided tour all around the grounds and throughout the structure. We learned that the Citadel was built to help protect Haiti from any possible French invasion, because at the time Haiti had recently earned its independence. We also heard the folklore of how Henri Christophe, Haiti’s president, committed suicide by shooting himself with a silver bullet and that his remains are buried somewhere on the Citadel grounds. After the tour most of us walked back down the mountain where we loaded back into the van and headed to the Sans-Souci Palace. This was a magnificent structure that housed Henri Christoph and his wife, Marie-Louise. We walked over the grounds and took pictures. It was a marvelous day and a wonderful experience to see the local people of Cap Haitian and to learn more of the history of beautiful Haiti!
On Thursday, June 26th, eleven (11) intrepid nursing students from the Emory School of Nursing’s Distance Accelerated BSN program embarked upon a two week immersive population health clinical practicum in Cap-Haitien, Haiti. After a short 1-1/2 hour flight from Miami, our first glimpse of Haiti was from above, eagerly peering through the airplane windows. Striking was the turquoise colored water that was so clear it allowed unobstructed views deep beneath the ocean’s surface. Then, starkly contrasting nature’s splendor, the cityscape began to come into view showing dense clustering of buildings and people. Clouds of smoke dotted the landscape which we later witnessed was from the burning pile of trash. Our plane continued its descent and soon we were on the ground, the plane filling with the applause of passengers aboard. Upon landing and deplaning, we were warmly welcomed and greeted by a local Haitian band. With traditional music playing, we made our way through passport control and collected our bags from baggage claim which contained many medical supplies and donations that students brought with them, including collectively ~20 lbs of suckers for the pediatric population (adults, too) that we would be serving during this clinical rotation. Once outside the airport, we boarded our bus and began our trek to the hotel, the Cormier La Plage. Our population health assessment began in earnest as we viewed the street scenes. We observed massive traffic, mostly of motorcycles and automobiles, racing and swerving with no stoplights, signs or speed limits, all avoiding the dips and broken pavement. The buildings seemed to be in various states of decay/repair, affected by earthquakes, hurricanes and overpopulation which have affected the island. The greatest contrast, against the backdrop of the beauty of Haiti, were the waste disposal issues, trash covering the beach and roadways and the acrid smell of burning trash filled our nostrils.
We arrived safely at the Cormier La Plage, we were again struck by the beauty of Haiti – the waves crashing on the beach, palm trees swaying and bright blue skies. We had made it! As we settled into our rooms and unpacked, we met for a debriefing of our first impressions and an overview of our itinerary. As we arrived safely at the Cormier La Plage, we were again struck by the beauty of Haiti – the waves crashing on the beach, palm trees swaying and bright blue skies. We had made it! As we settled into our rooms and unpacked, we met for a debriefing of our first impressions and an overview of our itinerary, ready for an experience of a lifetime.