A Short Walk - January 20

Trying to write this every night after being on your feet for most of the day is a challenge. It would be more manageable if it could actually be posted to the Internet. None the less I will try to collect a few reflection and highlights for each day.

We are supposed to leave at 7am but it is closer to 7:30 before all the interpretors arrive and the truck is packed. One interpretor reported that his bicycle had a flat tire, I tend to believe him. Once everything is pack we are off. It is 40 minute drive to where the trucks have to stop. From there we have 30 minute hike to St. Terese. In true Haitian form it is describe to us as a flat hike in the mountains. Fortunately we have a fleet of donkeys reserved to bring the drugs equipment. With a dental clinic this is no small feat.

Our 30 minute hike is closer to 40 minutes over rolling and twisting terrain. The sky is clear and the temperature is comfortable, so we set off while the equipment is loaded on the donkeys. There are a few small homes along the way. You can also see terraced farm land on the hill sides. St. Terese is a cluster of buildings behind a gate; a church, a school and some homes. The back of the village opens to a cliff over looking the Gulf of Gonave, which gives Haiti its “C” shape.

The first discovery is that the metal case, with the dental instruments did not arrive. They hoped to see 30 patients each day, now we have to wait. The dentists walk back to the drop off point and wait for the truck to return. The missing case was left under a seat and the trucks were part way down the mountain before it was discovered. With the case found the dental clinic opens.

We set-up triage under a tree in the main court yard. The medical team and the pharmacy set-up in two small rooms separated by a curtain. It is actually more like two sheets than a curtain. Next to us is a long narrow building that has three or four classrooms. This is the main school building, the church building also serves as a classroom. The dental clinic is set-up under a tent at the back of the village, overlooking the gulf and the coast.

The biggest challenge we face today is that we will need to stop seeing patients, close the pharmacy, and the dental clinic soon enough to hike back to the vehicles before dark. In all I believe we saw about 190 patients, 30 or so went to the dental clinic. The medical team wrapped up operations by about 4 pm. Due to the late start the dental clinic took longer to finish, so it was about 4:50 by the time the last of us start the hike back to the drop off point.

Below is a short video from the end of the school. The students all gather outside the main building and sing, the national anthem or a pledge.

Here is a selection of photos from our day at St. Terese.

First Clinic --Monday January 19

Monday's clinic was at the hospital. We set up behind the chapel, with the dentist at one end and the medical team at the other. The pharmacy set up operation inside the chapel, with the pick up counter at the side door. It started slowly got a major crush between 1 and 2 as we scheduled lunch breaks. For the most part the day went well. Although we took advantage of having the drug and supply room back at the guest house handy. We will have to do better when we go on the road the next two days.

We started the day with our three practitioners, by mid morning three Haitian doctors had joined us. While this enabled us to see additional patients, it had the unfortunate side effect of overloading the pharmacy as the day proceeded. We would learn from this by the end of the week, when we held the second clinic at the hospital.

Let me back up and spend a few moments describing the members of our team and the roles we played in running a clinic. Our practitioners are Dr. Chuck Sternbergh, Barb Kell, a nurse practitioner and Dr. Sandy Varghese in her third year pediatric residency. Each has a translator to work with while seeing patients. Patients start the day by signing in and paying a small fee of 25 goudes, that's about 60 cents. Once registered the patients are first seen by Ruth Ann Honneycut, who takes their temperature. Children are then weighed by the CNP health worker. Next stop is at the triage table, with nurses Dawn Rubin and Mary Sutton. Here their blood pressure and pulse are taken. Then working with an interrupter the basic reason for their visit to the clinic is recorded. Patients are then sent to the medical team or the dental team.

The dental clinic is staffed by two active dentists, Alan Crisman and Chuck Holt. Working with them are Jack Danner, as an assistant and Mary Thurmond working the the back table. At most clinics they are joined by Charlie Belcher, a retired dentist, who pitches in to keep things moving.

In the pharmacy you will find Jane Carney and Martha Sternburgh. Working with them is long time translator Mario. That leaves Bob Ried and Mike Thurmond, who coordinate the movement of patients, run errands for others and pitch in with an extra hand when needed.

Several students from the nursing school in Leogane came by about 10 to lend a hand. They helped with screening the patients, an extra set of hands in the dental clinic and with scabies treatments. For those who are not medical scabies is a bug that infects the skin and results in crusty sores, which can cover the whole body. The treatment is to apply an ointment over the whole body to kill the bugs. Since the bug can be in the clothing, we also provide a complete change of clothes for children that are treated. Then we provide follow up drugs and give the parents instructions to wash all the clothes and bed linens in hot water.

The doors opened at 8 am, although I am not sure when the waiting line outside the hospital started to form. At first the people came in at slow but steady pace. As the morning progressed the number people waiting to be seen by triage approached 30 to 40. Throw in a mix children, dental patients and a few vendors, selling snacks and drinks, and you can appreciate the atmosphere. The clinic was open from just after 8 until about 4 that afternoon. In that time the team saw 257 medical and 32 dental patients. That is about 32 patients per hour. At the end of the day the backup is at the pharmacy, since patients from all the doctors and some dental patients all go through the pharmacy before their visit is complete. With only Jane and Martha in the pharmacy it can be a challenge to keep up. By the end of the day others on the team lend a hand to keep things moving. Even so it can require an hour after the last patient is seen for the pharmacy to complete their day. All in all it was a good day.

Here is a selection of Photos from the Monday clinic.

A Day to Prepare - January 19th

Sunday morning and we actually slept late for Haiti! Usually it is early to bed and early to rise, but for some reason I slept until 6:45. With breakfast at 8 that is late. It also helped that Mary and I are downstairs in the quarters formerly used by the guest coordinator. There hasn't been one of these in awhile and with the hospital closed there isn't a need for one. The manager of the Children's Nutrition Program (CNP) sees to the needs of the visiting team.


After breakfast we went to the 8 am church service. The church is located at the back of the compound. You could say we arrived late but many others arrived after us. I think you could say we were at the early service or perhaps we just left before the service really got into high gear. The music is delightful, but none of use knew enough Creole to understand the sermon or prayers.




Most of the day was spent organizing drugs and equipment for the medical clinics which start tomorrow. With dentists on the trip equipment takes on a new meaning. Portable tables and chairs are stored at the hospital for use by each team. There are also a lot of dental instruments to be cleaned and organized. Some instruments stay here but a large number are brought by each dentist. Our team includes two active dentists and a retired dentist who will be pressed into service.

On the lighter side we found time to go to a local soccer match. I had seen the stadium before but this was the first time a match occurred while I was here. Like the church service the crowd drifted in slowly. By late in the first half the stands were 80 to 90 percent full. There we also a goodly number of folks on the walls and the adjoining buildings. Sort of like the apartment buildings around Wrigley field. The match was entertaining. At half time armed guards came out to talk with the officials. There were even vendors selling beer in the stands. Unfortunately the home team, which played well, made one mistake and lost the match one to nothing.


















Some of the others met up with Jimmy Parison, brother of Gary, and went to visit with the family. He walked with them back to the compound, so I got to talk with him briefly. Here is a family that has found success on many levels, which is a miracle in itself.

A real high light of the day occurred when American Airlines called to let us know that the missing bag had been found. We should get it sometime on Monday. Not too bad under the circumstances.

Just before dinner several of walk around the corner from the hospital to visit a local artist at his home/studio. Typical of most Haitian art work it is quit colorful. Since it was near dark we had to view the art on his walls by flashlight. While we were visiting soe of his younger neighboors came out to check on his unique visitors.











Not entirely sure what is going on with the power this evening. We thought we had EDH (that is Haitian power) earlier but there has been lots of audible switch throwing in the last ten minutes and the power is coming and going. With no power during the day the only chance to recharge things is at night. Which may be in question.

What ever our power issues are the music from the street party, which started again at dark is going strong again tonight.


Well I need to wrap this up. Breakfast is at 7am and we plan to start seeing patients at 8. The Monday clinic will be at the hospital so we plan to see patients until 4 pm. It has been advertised by word of mouth and on the St. Croix radio station; which is still operating.

Arrival - Saturday January 17, 2009

Let's start with what may have been obvious already, access to the Internet is limited. The immediate cause is that Hopital St Croix is not functional. The building is here but the supporting staff is limited. One has the impression that things only happen on request. This is a change from four years ago, when the hospital was functional. More on this later.

Our morning started early but we were late. We didn't reach the airport until 4:30 am. Given that our flight was departing at 6:00 this was close. But we got everything checked, got through security (with a 2lb jar of strawberry preserves), and even had time for coffee and a breakfast snack before boarding the plane. Good thing we left out of gate T.

Our flight arrived pretty much on schedule in Port-a-Prince. New travel documents are in French and Creole, i.e. no English. We are met before customs by Mr. Murratt . Who whisks us through customs and on to baggage claim. We wait, while his staff collects the bags. We came with 34 bags this trip. After much delay it is determined that one bag did not arrive. We can only hope that it is enjoying an extended stay in Miami and might join us before long. Due to restrictions on checked baggage, we all had to check a variety of our personal belongings. The missing bag has most of the clothing and toiletries for two ladies in our group.

So here we are in Leogane. At the end of the day we have unpacked the drugs, medical and dental supplies. We brought 34 bags or about 1,500 pounds of drugs and supplies for our team to use this week. Withour a current inventory of the drugs on hand we choose to bring a wide array of medicine and spplies for the dental clinic. Tomorrow we will attempt to go to church, there is some question about the time of the service. But before the day is complete a number of our party drop in on a salsa dance club!

It is one more of the interesting contrasts that make up Haiti. In a country where the the average income is only $300/year, there are still people with disposable income. Even in Haiti there is a need for a break from the routine.

While the hospital is closed; the street outside the gate at the guest house is the hopping place to be. Music, dancing, horns and the underlying current of conversation fill the air and the street at 10 PM. I suspect it will continue for some time.

Don't know when I will get to post this but we will see.

Let me conclude with a short video clip taken from the back of our Land Rover while driving through Port-a-Prince on our way to Leogane.

An Epilog Blog

In my post before departing for Haiti I indicated that my ability to post reports would be dependent on Internet access. Well it turns out that the hospital and guest house are currently without access to the Internet. So I will now post some thoughts I recorded while on our recent trip but was unable to post from Haiti. While they are not live I hope they will still be of interest and lead to a better understanding of the situation in Haiti.

January 2009

I am about to return to Haiti after four years. We are once again traveling to Leogane and the ground of the Hopital St. Croix. Going with a group organized by Chuck and Martha Sternbergh from Rivermont Presbyterian in Chattanooga, Tennessee, we will be working with the Children's Nutrition Program. Much has changed at the hospital in the past four years. The mere fact that we will be doing medical clinics at the hospital says a lot, more at that another time.

Yet much remains the same. The work of the Children's Nutrition Program and many other organizations continues to bring hope to the people of Haiti. We leave early on the 17th of January for a week. Hopefully I will be able to post information and photos to this blog that will give you a little better understanding of the Haitian people and the challenges they face.