Archive for Haiti

Cap-Haïtien: Reflection & Return

Every clinical rotation provides its own unique challenges, lessons, and professional growth. However, our time in Cap-Haïtien met these marks tenfold. The calling of our profession is to serve, and while the people we worked with expressed their gratitude for our thorough assessments and treatments, we each gained far more from the Haitian people than we were able to provide. The complexity of healthcare in Haiti cannot be experienced fully in two weeks or expressed in a single blog post. For those of us who have never lived without clean water or consistent electricity, even immersion is not enough to develop true sympathy. We witnessed resilience, heartache, suffering, and joy that doesn’t conform into to words.

Our final day in Haiti was spent on an idyllic beach on the northernmost coast. We all welcomed the reprieve to process our time together, discuss the things we had seen and felt, and soak up of the beauty of Haiti.

– Christine Higgins, FNP & CNM Candidate

 

Cap-Haïtien: Service & Sickness

Sunday, we donned our “Sunday best” and loaded into the tap-tap. We were headed to L’Église Baptise de l’Espoir to attend services with the children from the orphanage. It was wonderful to see the community come together. They were very welcoming to us and shook all of our hands. The service was in Creole which was interesting, but they had Bible verses on the wall and pamphlets in English, which helped us follow along. The service lasted about 2.5 hours, but Dr. Bussenius informed us services can often last up to 4-5 hours!  After church, we dropped off the kids from the orphanage and worked on school assignments.  It was a relaxing day and nice to catch up on work, until…

Monday morning, we woke up ready to set up clinic at the airport. Our day was soon delayed when poor Nicole woke up vomiting. As soon as her first dose of Phenergan was given we headed to the airport. For the next few hours we provided care to the staff at the Cap-Haïtien airport. On this day, we saw about 50 patients. Since it was a smaller population we are able to go to the pool and relax after our clinic. Throughout our afternoon a few more of us began to get sick. This was no surprise to us after doing a little research from the CDC. We found “Protozoal pathogens generally have an incubation period of 1-2 weeks and rarely present in the first few days of travel”. According to guidelines, the sick began taking Flagyl and azithromycin. After dinner, we all crowded in Nicole’s room and took care of her. If you have to be sick when away from home, it’s best to be with nurses!

– Kathryn DeVillers, PNP-AC Candidate & Madison Olkes, FNP Candidate

Cap-Haïtien: Clinics & Culture

Over the next few days, we had many kinds of adventures in our new environment. Each of our clinic sites boasted unique patients, surroundings, and experiences. From the rural mountainside to the private inner-city clinic, we have treated numerous infants, children, and adults principally for infectious etiologies including scabies, giardia, nematodes, and helminths. One unique case that required additional facilitation from the Lillian Carter Center was a young man with pronounced elephantiasis secondary to lymphatic filariasis. He will be traveling the length of Haiti to see a specialist on the Southern Coast.

We have begun to understand the challenges of continuity of care within the Haitian healthcare system. For example, we have continued to monitor the care of the child transferred to the local hospital where is he being worked up for both HIV and TB. With the help of Eternal Hope in Haiti, he will continue to receive care, regardless of ability to pay.

Several of our FNP students had a crash course in the management of sexually transmitted infections and family planning; multiple young women were seen back to back with concerns about reproductive health. The team was able to provide them with extensive education regarding barrier protection and availability of multiple forms of birth control, including Depo-Provera and Nexplanon, at the nearby women’s health clinic.

We have valued our hours off as well. Traversing the Iron Market, where all the locals purchase their clothing, housewares, produce, and meat – sometimes while it is still alive! – was a view into Haitian culture that few foreigners can experience. Haggling at the souvenir markets gave us the opportunity to test our burgeoning Creole. The Citadel, a massive fortress built in the early 1800’s that overlooks the city, provided stunning views of the surrounding mountains and an insight into the complex history of the Haitian government.

– Christine Higgins, FNP & CNM Candidate

Cap-Haïtien: Arrival & Adventures

Note: Wi-Fi in Northern Haiti has been spotty due to frequent storms and power outages. We are thrilled to belatedly share our adventures!

Our day began Monday morning in Atlanta. We caught an early flight to Miami. After a short layover and some Cuban sandwiches, we continued to our final destination: Cap-Haïtien, located on the Northern Coast of Haiti.

We deplaned on the tarmac and jostled our way into the crowded immigration line. Looking for our baggage… we found that it was directly in front of us in the single roomed international airport.

Breezing through the Customs Officers’ inspections, we went outside to meet our fearless leader Dr. Bussenius. We were whisked away in the tap-tap, the double-wide, open bed truck that would remain our sole source of transportation. Wilnick, our constant companion and Haitian guide, rode with us through the bustling city and up the steep hill to arrive at the lovely Mont Joli Hotel.

We made our way down the flowered path to our rooms. After dinner, we settled in for the night excited to begin our immersion clinical experience.

On our first clinic day, we awoke bright and early, excited to get to work.  We piled into the truck and started off through town.  We were surprised to find that Cap Haitien has a rush hour to rival Atlanta’s!

After we got past the traffic, we stopped at the women’s hospital and dropped off two of our students to work for the day.  The rest continued, past the sugarcane fields, down a long county road line with grazing cattle and goats.  Nearing the end of the drive, we were greeted by many people, young and old, walking down the dirt road towards the Eternal Hope Orphanage.  We stopped briefly at the metal gate, which was let open by a guard.  The truck drove through and the gate quickly closed again.

We hopped off the truck and began setting up the clinic in the shady courtyard of the orphanage.  Several members of the team went outside of the gates and began triaging pediatric and adult patients.

Our busy outdoor clinic buzzed with activity as adult and pediatric patients were seen and treated at several different stations. A child was found to be so ill that he needed to be taken to a nearby hospital; two students accompanied him along with our trusted driver, Luken.

With supplies running low, we finished up clinic in the early evening.  We saw 300 patients, more than had ever been seen on a single day.  We headed back to the hotel, tired but happy at the end of a full day.

-Michele Carranza, ENP Candidate

Men Nan Men and Church Service

We spent the last two days with complete immersion into the Haitian culture. We started Saturday morning at Complexe Educatif Men Nan Men which is a multi-lingual school funded by Foundation For Peace in pursuit of teaching English, Spanish, French, and computer classes for less than $4 to the student. The students were quite curious and eager in asking questions about the American culture and our perspective of Haiti.

        

Christine (left) and Ektaa (right) conducting English classes.

Later in the afternoon, we set up a clinic in the schoolyard where we saw about 80 students. What was unique about this experience was that some of the students helped in translating; they were very ecstatic to practice speaking the English they have been learning for the past few months.

Nicole gathering patient history.

We attended a Haitian church service on Sunday morning at Pastor Valentin’s church. We were greeted by a very friendly community and participated in singing and dancing at the church that was led by only children. It was great to see how involved the children were in putting this event together.

Our leader, Helen, thanking the church members for a warm welcome.

Shortly after the service, we were guided by the Foundation For Peace staff to tour the local community. We took a bit of a scenic hike through many fields to a small village where church members live. They were living in quite unfortunate circumstances where a small hut would be home to at least 8 people. Despite their living conditions, the people of the community welcomed us with open arms.

  

Day 2 and 3 Care in the Community

Days two and three were a whirlwind, as we embarked upon an adventure in the villages of Kwa Kok and Jaquet. Within two days we were able to see greater than 200 patients. Making diagnosis were drastically altered by the norms of the Haitian culture and prevalences of diseases in the community such as malaria, dehydration, typhoid, parasites, and nutritional deficiencies.

  

 

 

 

 

 

 

 

We were able to gather information from our patients with the help of our hardworking interpreters, who worked hard at gathering appropriate patient history. They also went above and beyond about educating us on Haitian culture.

The eve of both clinical days were spent sorting and labeling medications appropriate for our patient population. In comparison to the US when treating our patients we were often unable to use first line treatment, we were required to be creative with our medication choices.

Despite the overwhelming amount of patients seen we were able to work well as a team and meet the needs of our patients.

  

 

Moulin Sur Mer and Tabarre

After seeing hundreds of patients this week, we spent our day off with some R&R at Moulin Sur Mer. It was a beautiful beach with clear, blue waters and soft waves. Later that evening, the Foundation For Peace organized a Creole class to help us better communicate with the patients we were seeing.

Relaxing and bonding at Moulin Sur Mer

The patient population we saw that day was quite different from those earlier in the week. They were more educated and some even spoke English. The kids were more playful and eager to ask questions. A lot of the care we provided was surrounded around patient education and prophylactic treatment.

Joya discussing adolescent growth

The day was filled with a great amount of teamwork as the Pastor of the church, Pastor Valentin, was present the whole day to keep things organized. Pastor Valentin’s sister, who is a NICU nurse in Haiti, was also present to help triage and assess vital signs.

Our amazing team for the day

We were fortunate to work on a team with many hard workers that came together to provide optimal patient outcomes!

Day 1: Eben-ezer Hospital

Our day started off bright and early where we were greeted by the Foundation For Peace staff with breakfast. Shortly after we boarded our bus to visit Elbenizer Hospital for our first patient encounter in Haiti.

This is a local hospital that sees patients outpatient of a variety of ages, has a lab, operating room, an emergency room with 1 bed, and a few about 10-15 inpatient beds.

Our team split up to work with the Haitian doctors and nurses to efficiently treat a room full of patients.This was our first day working with Creole translators and providing care which had it’s difficulties taking a history. We also were introduced to diseases that are common among Haitian populations and learned how they present and how to treat.

After enjoying another delicious Haitian meal, our evening concluded with packing and sorting supplies for our next day’s clinic.