Sunday, January 24, 2010
Day of departure for Haiti
Bags were packed but I was not able to stay focused. Marshy my cat seemed to know that I was leaving for a trip, I sensed she was not too happy.
In the airport, I met Gale, the Founder and Director of PID and other members of the assessment team: Kerline, John, Jeremiah, Jenn and Susie; we would have a doctor (me) and two nurses (Jenn and Susie). There were 20 bags, plenty of supplies and Jet Blue was kind enough to give us a break on our bag allowance.
We arrived at Santo Domingo at 3:45 am. Many other people came to talk to Gale, I just assumed they were her field workers helping her to arrange the next stage of our journey. I stole a snooze on the bench while waiting. At the airport we were also joined by Ted whose mission was to figure out how to deliver free fuel to Haiti.
We loaded our bags onto a van and 2 cars heading to the Caribe Tours bus station. There were no UN planes to be seen. There were many locals and other relief teams all trying to get into Haiti. It was several hours before we finally scrambled onto the bus towards the border of Haiti. At the border we waited quite awhile to be processed. Then about an hour out of the border, the bus had a flat. We were lucky to be closed to a small tire shop and the tire was fixed before night fall.
It was dark by the time we reached the bus station. It was awhile before the taptap (local transport bus) came to get us escorted by a police car. The trip to the house we were going to stay was to take 20 minutes but we got lost in the dark but eventually stumbled into Kerline’s father’s house close to 9 pm. Auguste, Kerline’s father was very generous in offering his house for our use, her uncle next door also opened his home to us. We set up our tents and had a late dinner and went to sleep.
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Monday, January 25, 2010
Our first day in the clinic at Blanchard
We got up early to sort through our supplies: food, antibiotics and bandages, etc. to bring to the clinic. At 10 am we left for the clinic. We had to take a detour through a market since the bridge that was to take us to Blanchard was deemed unsafe. The van wound its way along the river where there seemed to be a settlement in the midst of piles of refuse, women washing their clothes with water from the river that looked gray. This scene reminded me very much of the the slum close to River Road in Nirobi, Kenya. The heat was intense and throngs of people were selling and buying.
On the way to the clinic, we saw some tents at the Agriculture Department and people were lining for food. across the street was a bank and the line there was quite long as well.
The road to the clinic was winding and dusty. There were quite a number of houses that were destroyed by the earthquake and make-shift tents were rigged up next to these houses.
We arrived at the clinic which looked unfinished but the clinic rooms were cheerful and I like the white tiles which made the rooms so much brighter. Immediately when we arrived we were asked to see an old woman with an old stroke and another recent stroke a few days ago and a set of twins. We really could not do too much for this lady but did get an IV started in the afternoon for some hydration while she was lying in the tent.
One of my very first patients was a grandmother with crushed injuries to her calf. She was seen at another clinic and had some stitches. She walked in with a walking stick fashioned from the branch of a coconut frond, accompanied by her daughter who lost two of her children, a 3 and a 6-year-olds. She began to cry when I asked her about it through my interpreter, Benite. They also lost their home and needed food. Her wound was quite ugly and I cleaned it as much as she would allow me.
There were many more patients to see and I lost track of how many we saw that day. Almost everyone that we asked had lost some loved ones, homes or their homes were too unsafe to live in. They lived outside their homes or what was left of them in make-shift tents made out of sheets, plastic sheets or cardboard. There was a tremendous amount of sadness weighing on the shoulders of these Haitians.
When I was in Africa, It struck me that the African people are very resilient and always seem happy in the face of adversity. The People of Haiti seem to display the same kind of resiliency that I observed in Africans. How people continue to have the desire to live in situations that look completely hopeless is beyond comprehension. They remind me of the Zimbabwean refugees I met in Musina, South Africa.
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Tuesday, January 26, 2010
Second day at Blanchard
I needed to continue my training for the Paris Marathon in April so I had to resort to running around the compound numerous times to make up to 5 miles. I got really tired of running in circles, frightening a mother hen and her chicks. This reminded me of the time when I ran in the village of Maseno in Kenya and stepped on a chick walking along my path with its mother. Miraculously the chick got up and walked away unscathed after some grumbling noises made by the mother hen.
Only Susie and I ran the clinic, the rest of the crew went to Carrefour, the epicenter of the earthquake to assess the destruction and need. We decided to see 100 patients today and hoped that the triaging people would let us see the sicker patients first but it did not work out that way. Towards the end of the day, sicker patients who apparently had been waiting all day were finally noted by Gale and sent to the front to be seen. This created some small disturbance as temper flared because of the long wait for all concerned. We saw quite a number of malnourished kids, block injuries…
A young lady brought a baby who was the sole survivor of her family. Every one in her family perished in the collapsed home but her mother happened to send her to her next door neighbor for the afternoon. Was it fate? Another orphan added to the long list of orphans.
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Wednesday, January 27, 2010
New Clinic at Bon Repos
Last night was hot and humid. sleep did not come easily as the generator was on till 5 am. Some artists were busy painting sign for Ted’s fuel relief effort. when the generator finally went off, the rooster’s crowing could be heard. I got up then to venture out in the streets for my run.
A word about Ted’s fuel relief effort, he runs a non-profit organization that delivers free fuel to disaster areas to enable the delivery of food, shelter and water possible and to also allow NGO’s and non-NGOS to continue to function during period of fuel shortages since generators need fuel to run. This is no small contribution! His website is www.fuelrelieffund.org.
Gale and Kerline decided that we should have a clinic in Bon Repos where we were staying. We set up a temporary clinic in the warehouse next to Kerline’s house with some sheets rigged up in a corner for privacy. Susie and I saw patients while Jenn and Kerline did the triaging.
Even before we were ready, there were already patients waiting. My first patient was Samuel, a 16-year-old man who was hit in the left eye by a block. He was seen by Search and Rescue and received a cut in the upper eyelid and on the left cheek. I was the second medical person that he was seeing. When the dressing was removed, he had a lot of pus oozing from his eye, a lot of swelling and his vision was blurry. I was afraid that he also sustained a facial fracture that trapped one of his eye muscles. I removed his stitches and irrigated his eye as best I could, the lack of equipment made this job harder. I asked him to come back to Kerline’s house every day for me to change his dressing and check on his vision. There was a man with a gangrenous fifth digit and we sent him to a hospital, a woman with a broken collar bone and anther with a broken tibia in a cast and she ran out of pain medications. Eventually we had to turn away some patients.
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Thursday, January 28, 2010
Back to Blanchard and a visit to Port-au- Prince
Last night was a lovely night for sleeping. There was a cool breeze and the moon was almost full, it cast its light gently on the Mango trees and the lawn. The Big Dipper was visible but soon dawn obscured it.
I rose early to leave for Blanchard with Gale hoping to see the houses that were built by PID. However upon arrival at the clinic there were already a few patients waiting. I ended up starting clinic early. The dog Sebut came looking for food. He was scrawny and covered with skin sores. Susie and Jenn came around 9:30am and we saw patients all morning through the early afternoon and stopped around 2 pm. We worked without stopping and it cracked us up when a young boy who was not a patient came sauntering in as if he owned the place and walked right up to me and leaned against me and smiled. He had his picture taken and just as soon as we were done he nonchalantly walked away.
This afternoon, Gale, Kerline and Susie and I went to Port-du-Prince for the first time. We drove through Cite Soliel which we were told is a gangster town. In Port- du-Prince, everywhere we looked there were collapsed houses, rubbles and dust. Many streets remained impassable. At one point we were greeted with a strong stench. There were US soldiers guarding the streets. We visited the camp across from the National Palace. People went about their daily activities sleeping, cooking, bathing in these temporary shelters all in a very crowded condition. Some of them looked hot and miserable, I really can’t imagine being in such hopeless situation.
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Friday, January 29, 2010
The houses that PID built
Gale and I left early again this morning with Dawn, the woman from Texas who came with 1500 pounds of donations, mainly old clothing, shoes, ensures, depends, wipes, powder, lotions, toothpaste, soaps…
About 50 odd US soldiers came to the clinic, perhaps for security reason. It seemed that Gale requested their presence because of a minor disturbance earlier in the week. One of the soldiers carried a man with a nasty cut in his foot. It took me some time to clean and dress it. We had no tetanus vaccine to offer him. Bennet, my interpreter and I worked well together.
In the late afternoon John took me for a tour of the PID houses. A group of children were calling “Blanche”, and it finally dawned on me that they were calling any foreigners “Blanche” just as the children in Africa calling out “Mzungu”. The PID house is a two-room house with a small front and backyard equiped with electricity. A lean to was built by the owner to serve as a kitchen. All the 40 houses built by PID withstood the earthquake. The children were busy at the well pumping water.
Samuel came in the evening to get his dressing changed. His vision seemed worse and his conjunctiva was red and we had no antibiotics. The fact that he had double vision made me think that his eye muscles were not moving freely. I advised him to visit the Israeli Hospital as I did not wish for him to lose his eye sight.
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Saturday, January 30, 2010
Visit to Carrefour, the epicenter of the earthquake
I was on schedule for a 15 mile run but Gale told us that we would be leaving between 8 and 9 am. This time I ran past the border of Bon Repos and ended up in more deserted area but there were still areas of garbage and rubbles even beyond the town border. I only managed to do a 10-mile run. Running in Haiti was not easy, the air is very polluted and the dust is dense, I was sure it wasn’t very healthy.
We left around 11 am! Susie left early this am with a 9 month-old baby, the parents wanted her to take the baby to the US to be away from the chaotic situation in Haiti. I wasn’t sure it was a good idea to separate a nursing baby from her mother.
On the way to Carrefour, we saw tents set up in the medium strip of the road, hardly any space for the children to play. Gale spoke to the director of an orphanage, 56 of the 150 children died in the earthquake, she and her husband buried these 56 children in two separate graves in the back yard. Now the orphans slept in big tents on the street.
We saw the empty house that would serve as our new clinic at Carrefour. It was fairly big and seemed quite suitable for our needs. We hope to start our first session next Wednesday.
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Sunday, January 31, 2010
Looking for a place to set up Bon Repos Clinic
Today we went to visit Dr. Margaret Blaise’s Clinic, a pediatrician who was enthusiastic about giving a space for us in her clinic once a week to run a clinic for the people at Bon Repos. Her house was damaged by the earthquake and she was living in the clinic. She barely escaped being crushed by the water tower that would have landed on her and her car as she pulled away from the parking space just before the earthquake hit.
In the afternoon Kerline and I visited the school that was damaged by the earthquake, its space was to be used by her women who were to go to school after hours. We went across the street to visit the camp that housed some of the inhabitants who lost their homes. It was very hot and no one was at the camp. There were a couple of people with broken limbs in cast sitting in a car and wishing that they had some pain medications. We went back and found some for them.
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Monday, February 1, 2010
The man with no shoes
Last week, the soldiers brought a man with a big gash on his foot for me to see. He was bare feet and stepped on a piece of glass. When I took a breather that morning, I happened to look out the back door, I saw a man working at digging a trench for the wall of the clinic using a pick axe, he was bare feet. Each time the pick axe landed on the ground, it seemed it was inches from his feet. I tried to look for a pair of old shoes from the donation from Texas but only found over sized shoes. John brought him in and explained to him that the doctor did not want him to go about bare feet. We finally were able to find him a pair of old shoes with a hole in one of them. With a pair of socks and his shoes, he was happy.
Today I brought the pair of shoes that Ted picked up from the Caribe bus left behind by one of the relief persons. These I gave to him and gave his old pair to his friend who was wearing a pair of shoes with huge holes on the sides. Many more workers showed me that they did not have shoes but were wearing slippers. Unfortunately I had no more shoes to give to them.
I was the only person left now to run the clinic at Blanchard. The woman with the crushed injury returned to have her dressing changed, she almost fainted. A woman with twins returned with worsening mastitis and another with jaundice with a belly that grew large over a short period that I feared that she had something ominous. All I could do was to ask her to go to the nearest hospital. A man came in with a crushed finger and a partially avulsed nail from a hammer injury.
We had so many patients that Benite had to see some of the less sick patients and Woodman was my interpreter for the rest of the afternoon.
The clothes that Dawn donated from Texas were too large for any of the Haitians to wear. Instead Gale had them cut up and sewn into blankets.
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Tuesday, February 2, 2010
Another busy day in Blanchard
Another day alone in the Blanchard Clinic. There was no shortage of patients although we were running out of medications. A child came with periorbital cellulitis but we had no antibiotics suitable for children. There was no sterile water to reconstitute ceftriaxone for an intramuscular injection. I finally gave her a dose of cephalexin dissolving a capsule in some clean water and she was to return for an injection tomorrow.
There seemed to be endless string of patients and the day was rather exhausting with us running out of water and no lunch. This reminded me of my time in the rural area of Mtwara, Tanzania when it just went through a severe drought and there was a lack of food. When I first whipped out my sandwich on my first day at the Ligula Hospital ground, I was soon surrounded by children and adults watching me eating my lunch. I gave up lunch for the duration of my stay, only eating two meals a day.
In the evening, Samuel came and brought his x-ray that he had at the Israel Hospital. He had a facial fracture, probably an inferior orbital fracture that entrapped one of his eye muscles thus causing him to have double vision. The doctor would call him when they had a plastic surgeon in their hospital. I do hope he will regain normal vision soon.
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Wednesday, February 3, 2010
The arrival of the first relief team
I was the only one left from the Assessment team besides Ted, the fuel relief person.
Last night the first relief team arrived with about 11 members, including an orthopedic physician, an ER doctor, a Haitian pediatrician, a med-ped doctor and several physician assistants.
Today we started with sorting through the supplies brought by this team. The nice bonus was we had Jim, a professional cook with us and for the first time, we had real breakfast.
We planned to run two new clinics: one in Carrefour and another in Bon Repos. With fresh supplies we had a late start. On our way we saw UN and US soldiers distributing sacks of rice to crowds of people waiting under the hot sun. We drove through the market that sent off stench of rotten vegetables and fruits, slums in the midst of garbage, waterways choked with garbage and cans, streets filled with trash and rubbles. These were unthinkable places for us to live but they were hogs’ heaven. Indeed hogs were happily feasting in the waterways.
Because of traffic jam, it took us two hours to arrive at our new clinic in Carrefour. The first team only had to walk to their clinic in Bon Repos. When we arrived at the Carrefour Clinic, there was already a crowd waiting at the entrance. We took an hour to set up our clinic and supplies and began to see patients after a quick bite of PB & J.
The patients at Carrefour were patients with chronic medical conditions requiring long term follow-ups. Many had run out of medications and could not see their doctors because of the earthquake. Almost all the patients I saw did not know what they were taking, in any case we had limited number of medications, substitution was the rule. Soon we were told by the people running the pharmacy that we were out of many medications. We ended our clinic at 4:30 pm, having to turn away many more, promising them that we would return.
On our way home, we passed through Port-au-Prince. At dusk, the devastation was surreal. Burning of trash and tires added to the sad state of affair of Haiti, the environmental disaster that it is already in.
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Thursday, February 4, 2010
Carrefour Clinic: Our second day
Despite our good intention of an early schedule we seldom left on time. In order to follow the early schedule I got up earlier each day, around 5:30 am to prepare for my run and I continued to dedicate myself to my training. Haiti must be one of the worst places for running. The sidewalk is narrow and I had to dodge pedestrians, vendors, buses, trucks, cars parked on the sidewalk, hog, goats and chickens and I had to be careful of potholes.
Before we could go to our clinic in Carrefour, we had to drive to Blanchard to pick up our pharmacist, lab technician, interpreters and supplies, in particular medications. This probably would be my last time seeing the Blanchard clinic and the children. We bumped into heavy traffic on the coastal road and Marcelin directed Papi, our driver to go through Port-au-Prince. Seeing streets after streets of destroyed buildings in broad day light hit home for the first time. I cried for the first time, finding it difficult to imagine myself in their shoes. We wound through the garbage choked waterways and by the time we arrived, many patients were already waiting for us.
My very first patient was a 20-year-old woman with a very high fever for 2 weeks and 3 days of diarrhea. She had a very stiff neck and I could not tell if she had cerebral malaria, bacterial meningitis or typhoid fever. Our malaria testing kit was not working. We gave her some advil to lower her fever and she was sent down to a local doctor down the street who was able to test her for typhoid fever which she turned out to have. We had to turn away a couple of children, one of whom told me he passed 7 worms; we ran out of worm medications. Before the day was over, we were out of many medications.
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Friday, February 5, 2010
The patients of Carrefour and the boy who passed 7 worms
Day 3 at Carrefour, There must be a hundred or more patients lining outside the clinic.
John and Rick asked me to see a youngster with what looked like Madura feet. We had no anti-fungal medications for him. We added this to our wish list.
The boy who passed 7 worms came back with his tall sister, we had some albendazole for them. At the end of the visit he very calmly told Benite that his mother died yesterday. We learned that their mother had been ill before the earthquake but she had crushed injuries and whether this quickened her demise, we would never know. It just struck me how calm and accepting this little boy of the fate doled out to him… Benite and I just cried over this. I had nothing for him but an energy bar brought a little smile on the faces of these two children.
A young man came to see us for a urinary tract infection and several skin sores. He made laugh when he told us that he was in the shower when the earthquake occurred and he came running out only to find that his house was collapsing and he jumped onto the next house which fell as well and he proceeded to jump onto the next house, finally running out in the street, stark naked.
We had a nightmarish ride home, detouring many times because of horrendous traffic jam. Papi was a saint, patiently driving us around making plenty of U-turns. He almost missed our exit to our home, it was easy to do so because the streets were quite dark and we took close to 3 hours to come home!
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Saturday, February 6, 2010
The woman who had not eaten for 4 days
After my short run, as usual we did not leave on time. I took the opportunity to take down my tent and pack my sleeping bag, getting things ready to depart early tomorrow morning. I felt sorry that I was about to leave. I was fortunate to be given the opportunity to come down here to help and I hope I did.
Day four of our clinic at Carrefour. Marcelin’s family cooked food for the patients today. It was rice and beans with chicken.
In the afternoon we saw an old woman who complained of pain under her breast bone. Over the last few days we saw plenty of patients with the same complaint. It dawned on me that she must be having hunger pangs since her pain was gone after she ate her lunch. Before today her last meal was 4 days ago. Gabeson, my interpreter felt so sorry for her that he fetched several energy bars and a bottle of water, the woman took them gratefully and packed them in her little bag. There must be so many out there hungry and thirsty.
Gale told us that in less than 2 weeks that we were there, we saw 1331 patients, not counting the people that showed up on our door steps to be seen in the mornings and evenings that we were home.
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Sunday, February 7, 2010
Last day in Haiti
Got up around 5:15 am to get ready to go to the bus station. Poussant came early and I said good-bye to August, Jeanne, Jack and Jim. Gale was still sleeping, I think. We walked by Ted sleeping on the front path.
There was already a queue when we arrived at 6:15 am. Along the way in Delmar, we saw the many destroyed homes including a police station where over 200 police officers were killed. There were numerous tent cities sprouted all over the cities.
The bus wound its way through a market and it took about two hours to get to the border. Unfortunately there we were stuck for close to 3 hours at the border crossing. We were finally on our way to the DR which seemed to be a lot cleaner than Haiti. I spent a night in a hotel.
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Monday, February 8, 2010
The morning by the Caribbean Sea
To my surprise my run this morning took me to the Caribbean Sea, it was the nicest run I had since I came down here.
Please continue to visit my website for the Paris Marathon: http://pages.teamintraining.org/ma/paris10/klaiop
I’ll be back to my comfortable home but I’ll take my memories of Haiti with me. There are numerous people who have very little and are confronting hardship every day of their lives. I’ll also remember people such as Gale who works tirelessly and selflessly to better the lives of these people. Do visit the website of Partners in Development: pidonline.org and Ted, the fuel relief person who has a website, http://fuelrelieffund.org.
To view Kwan Kew Lai’s blog in full, click here.