Monday, May 30, 2011

Fe Kon Sa

Saturday, May 28, 2011
   We started out the weekend with a quiet morning studying for Boards and adjusting to the Haitian humidity.  It's been fairly warm out, not excessively hot, but the humidity is brutal!  So we sat outside, tossed around information, and had a Diabetes inservice, courtesy of Dr. Lauren McCray, where we all had our blood sugars taken (ouch it hurt).  We also took some time to try and get some physical activity in by kicking a ball around on the driveway inside the house's gates, because we couldn't leave the compound until we'd had a tour.

We were antsy/eager to go out and about in Simone and do some exploring.  In the late afternoon, Marvin, one of the prosthetists working here from Nicaragua, took us on our tour of Simone.  We walked down to the river, where most of the people in town were doing their bathing, laundry, and cleaning their cars.  It's also the only fresh water source for many people.  We walked along the river and up into the hills and jungle.  Along the way, we came across dozens of cows and goats tied up along the paths.  Many of the people leave their livestock tied up outside during the day, and everyone knows who they belong to.  

After our little hike, we headed over to one of the local schools where they have a soccer field, as well as a basketball court and a volleyball court.  We spent much of the afternoon kicking a soccer ball and throwing a frisbee around with the local kids.  Mo showed them how it's done on the soccer field with Marvin.  Kara and Tricia headed up the frisbee movement.  We don't think they've ever played frisbee before, but they all caught on really fast.  They also got a kick out of our cameras and liked having their pictures taken then looking at them on the LCD screen.  They then proceeded to show us all up by showing us all of their acrobatic skills.  Pretty much every single kid could do cartwheels, backflips, back bends, walking handstands, and performing a variety of break-dancing moves. Tricia showed them the worm, which they got a kick out of.  They were also fascinated by Lauren's Vibram shoes.  One kid thought they were some kind of prosthetic, and didn't believe they were shoes until she pulled her heel out of one! They spent the rest of the time taking turns poking her toes.. 

After dinner,  Marvin taught us about a half dozen card tricks.  He's been here for about a year, and told us that most people know who he is, even if he doesn't know them.  He also says people think he practices some kind of black magic voodoo because of his card tricks.  Kara and Amanda spent a couple of hours playing cards with Kelly, who is Dr. June's cousin and has been teaching english at a local school, and Corky, who is one of the local translators.

Sunday, May 29, 2011
     This morning we woke up and got dressed up for church.  The church in Simone is some form of Protestant Christian church, we're not entirely sure what denomination.  We didn't get there until about 9:30.  By then, the service had been going on for over two hours already!  Within 15 minutes, the pews around us were filled with curious kids, tugging on our hair and peering at us around their friends while their parents scolded them for not paying attention to the sermon.  Naturally, because the service was in Creole, we couldn't understand a word, but we assume it was about God. It seemed like most of the town was at church. It was a great experience seeing their passion during worship.  After church, we came home, ate some lunch and started up some more studying. 

It had been overcast all morning, so we were concerned our plans to go to the beach were bust.  Luckily, Marvin came down shortly after lunch to tell us to suit up, so we changed and piled in the truck to head to Port Salut, a beach about an hour away.  We spent a good few hours on the beach, playing soccer with one of the local kids on the beach (we gave him a frisbee before we left), and swimming in the ocean, and, obviously, taking lots of pictures. We somehow all got bit by a clear wormy rolly polly parasite that we think was harmless because we spent an hour googling what it was and found 0 results (and we used every word possible "biting bug in salt water" "parasite with legs suction in ocean"..just a few of MANY searches.)  We finished up the afternoon sitting in the shade with some fresh french fries and a cold Coke (disclaimer: We promise we are working, we just have no pictures of the clinic.. yet!) 

We went to bed tired and excited to start our first day in the clinic. Vibrant church music with singing was still going on while we drifted off to sleep..

Monday, May 30, 2011
   Day 1 in the clinic!
The morning started out, shockingly, humid.  (It's really too bad sarcasm doesn't translate over the internet ;P )  It rained most of the night, so pretty much everything felt damp.  At about 8:30, we headed over the clinic, which is only about a 5 minute walk up a hill.  Marvin and Carmen, the prosthetists, accompanied us.  We met our 4 translators (Ronnie, Berto, Joe, and newbie Kelly), as well as Isaac, who functions as sort of a rehab aide.  Because of the weather, no patients had shown up yet, so we went on a tour of the hospital upstairs, and met the handful of patients we would see there.  Isaac brought 3 of the inpatients down to the clinic, and we got started. It was our "initiation" to being real PTs-no CI's and we made all our own decisions!!

Caseload, Day 1:  We saw a range of patients of all ages with mainly neurologic conditions, including several strokes, Guillan-Barre/Osmotic demyelination, cerebral palsy, and orthopedic conditions such as fractures, amputations, and mild genu varum (whom we discharged), as well as a patient with burns.    

The atmosphere of the clinic is busy but relaxed, and we get to set our own schedule. We were able to work with patients as long as we wanted, some up to an hour and a half. 

After clinic, we changed out of our scrubs and into shorts and did our (hopefully) daily walking circuit around Simone, with a "Bon Swa!" to everyone we passed, ending up back at the soccer field.  There was an official game going on between two local teams, so we messed around with some of the young kids on the sidelines, Twong showing off her "karate" moves (they thought she was Jackie Chan).  We then ran into Ronnie, one of our translators, who proceeded to hunt down a basketball for us to play with.  We played two on two, and he schooled us (We claim home court advantage).  Amanda sat on the sidelines with the kids taking pictures.  Lauren sat on a rock.  The end.

Here's a picture summary if you don't want to read the whole entry...

Juggling competition in the compound

We're SOOO excited to study for boards! not.
we had a diabetes in-service by Lauren
Kara intrigued by sharp objects
People getting water, bathing, and cleaning their cars
Cholera isolation and treatment center-the brown squares were "housing" for patients during the worst of the outbreak
beautiful view at the top of the hill we mounted

Epic palm tree on hill

Typical Simone housing
On our way to the soccer field

Marvin and Maureen juggling
Patty teaching the Haitian boy ultimate frisbee
From here on out, she will be known as bucket baby.
Kara teaching the kids how to throw a frisbee

Elite break dancing

group shot 

Road trip to the plaj
self explanatory
Tiki hut + Coca Cola = Haitian heaven 

Juggling on the beach with Joseph
Epic palm tree on beach

The beach!!

documentation station at lunch
Lauren and Tricia testing their PET cart skills. They realized they had none.
Lauren shoots one basket (it was all net) before retiring to her rock.
Kara and Mo losing to Tricia and Ronnie (mostly Ronnie)
Our new friends, who LOVE pictures! 
That's all folks!! Tune in later :)

Friday, May 27, 2011

M'pa konprann!

Phase 1: Getting to Port au Prince....

On our way to the airport, still fresh, clean and well rested!

So we started our trip with a four hour delay at O'Hare airport. We finally took off for Miami at 11:30 pm; arriving to Miami at 3:00 a.m. That left us about 2.5 hours of beauty rest on the floor of the airport.

miami airport: mo TRYING to catch some z's..

Lauren, conforming her body to the airport chairs, a travel pro

    Amanda, using her time wisely, reading her kindle

 Kara, ACTUALLY sleeping (what she does best)

Twong, not even attempting to sleep, studying for boards!

5:45a.m. board for Port au Prince!!
Obviously we all slept through this flight...
7:30 a.m. (or what feels like 7p.m. to us) ARRIVAL!!!!

After waiting in line at customs and picking up our bags (which miraculously all made it, intact), we left the airport and met up with Wilson and Fabian from Medical Teams International (MTI). We went straight from the airport to the University of Miami Medishare Hospital in Port au Prince to see a patient who had suffered a spinal cord injury 7 days ago. We got to see the ONLY ventilator-capable ICU in Haiti, which had 4 beds (and 4 vents). This patient we came to see had been in a car accident, and then was carried on foot to the hospital (which he arrived at 24 hours later), then was flown to the hospital in Port au Prince. His fracture (which is believed to be a jumped facet at C7), was not stabilized and he has since lost function; now only able to shrug his shoulders. 

After our hospital visit, we drove to the MTI team house in Port au Prince (which was incredible!). We spent the afternoon chatting with other volunteers, meeting the Port au Prince staff, eating some delicious food, and of course, napping. Then we all got to take one last, mosquito-free shower and slept in an airconditioned room, where we also caught some of the Bulls-Heat game. It was a lovely way to spoil ourselves before traveling to our next guesthouse (still nice, but not THIS nice...)

our quarters in Port-au Prince

The rooftop view from the guesthouse

Our new friend, Baron
Looking out over Port au Prince from the rooftop

Phase 2: Port au Prince to Les Cayes

We left Port au Prince by van at 9:30 a.m. for what we were told was a 4-5 hour drive (Haitian time). It took over 2 hours to get outside of Port au Prince due to the rush hour traffic jam that lasted all day. The pictures describe what we saw better than words can:

Rows and rows of beautiful artwork lining the streets
We saw a variety of housing situations, starting with the tents...
and shanties

To the concrete buildings. Slowly but surely, things are being rebuilt

The balancing act

A marketplace in Port au Prince
UN troops patrol the streets of the city

People selling yams, cabbage, and many different types of fruit
The traffic jam

The incredible scenery on the road to Les Cayes

Around 3:30 p.m. we arrived at Dokte June's house, which also serves as the MTI guesthouse in Simone, a "suburb" of Les Cayes.

Our feat of engineering-hanging 4 mosquito nets with one long piece of twine. 

Only after did we realize we could have just as easily tied them up separately!
Then we met with the orthotist, Ann, and the OT, Megha who have been working at the Advantage clinic for the past two weeks. They gave us a quick run-down of the patient list and filled us in on who we would be working with on Monday.  Then we had more delicious food and took a short walk to the hospital to deliver dinner to a patient. The hospital does not provide food or water for the patients, so they rely on their families to keep them fed, hydrated and clean. This patient, who we will work with throughout our time here, comes from a village far away from Cayes. He became ill with cholera, and survived the illness, however was left with neurologic deficits. He was originally diagnosed with Guillain Barre, however once he arrived at the Advantage clinic for rehab (he was originally being treated at the Medishare Port au Prince hospital) the therapists recognized that this was not a typical Guillain Barre presentation, and did a little research. It appears that he has Central pontine myelinolysis (also known as osmotic demyelination), which is caused by the rehydration process during cholera treatment. Good thing we have a fairly reliable internet connection so we could Google that one (I mean search PubMed for systematic reviews of randomized controlled trials...)! All in all, a great start to our trip. Now we're really looking forward to getting started in the clinic on Monday.

That's all for today; we will keep you all posted when we can!