Medical student finds time for some futbol after a chaotic day

By Arjun Parasher

The morning came earlier than expected for most of us. But after breakfast and a round of Haitian coffee, we were all eager to arrive at the mobile clinic site and finally see the Haiti that awaited us.

After setting up our respective stations, the day began with a chaotic start: in a new surrounding with limited, if any, understanding of the language, a line of pediatric patients awaited us in triage.  After finally settling in to the routine, the students and physicians provided care in a remarkably efficient manner.  From diagnosing tuberculosis and malaria to treating glaucoma, the physicians with the help of excellent and patient translators were able to provide high quality care to over 200 Haitians secluded away from the normal mechanism of care.

We returned to Thomonde to visit the recently constructed hospital, which truly is an incredible institution of human service.  Soon after we arrived at the Project Medishare, I spotted a few children playing soccer with a half-deflated ball just outside the gates.  After watching them for a few moments, I asked to join and attempted to keep up with 5 to 10 year old kids.  After finding out how skillful these kids were the hard way in front of the newly drawn crowd of spectators, I ran back for the remnants of dinner.

We had a long, productive discussion about ways to improve our work in the days to come.  After deciding to increase our coverage of women’s health and redesigning our triage organization, we began the nightly task of packing drugs.  Finishing our task, we sat around the pavilion, relaxing with our colleagues.

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University of Miami returns to Thomonde

By Paru Mehta

Today we arrived in Haiti.  As we flew into the Port Au Prince airport, there was a band playing traditional Haitian music.  It was a nice way to be introduced into the Haitian culture.  The airport was very clean, organized, and most importantly it was air-conditioned.  The carried to Thomonde was long.  It began on a deceivingly smooth road, but after about an hour, we saw some very rocky and bumpy roads.  After a few stops, we landed in Thomonde.  The Medishare headquarters are great.  They accommodate us very well.  Unfortunately, when we came, it began to pour, so we were bombarded with bugs that felt like they were the size of hummingbirds while Dr. Fournier gave us some background information on Medishare.  We packed many medicines and then we just relaxed, chatted and read books.  I am very excited about the week ahead of us.

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Medishare volunteers experience Rara band performance

By Jennifer Browning

Most of our posts here talk about the people Project Medishare and its volunteers help, but through showing you the lives and the needs of the Haitian people, rarely do we delve into the beautiful rich culture this tiny country offers.

With Haiti being predominately Catholic, Lent and Easter offer a huge spectacle throughout the land. As I was leaving Port-au-Prince winding down through Petionville, a suburb of the capital, there was a processional of people dressed in white parading through the streets. Later waiting in the airport,  I was able to see the Petionville processional on television which lead the crowd towards a Catholic Church in the neighborhood where there was a reenactment of the Easter story.

While the students from George Washington and Morehouse medical school’s were up in Thomonde a Rara band parading through the streets stopped in front of Project Medishare’s office. Former Project Medishare intern, Samira Sami who traveled with the group wrote up a nice account of the experience over on Haiti Innovation’s website. Sami points out how vibrant the celebration is in color, rhythm and song, but more importantly how Haiti’s culture is full of life and strength.

Check out Samira’s post on Haiti Innovation here.

*Photos contributed by Cristina Catlett. Catlett is an Emergency Room physician from George Washington University.

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Art in the making in the pre-op room

Waiting to go in for his hernia surgery, Widmayer Nordé draws pictures next to his decorated glove balloon recovery nurse Renaye Mansfield blew up for him.  Photo by Jennifer Browning.

By Jennifer Browning

Port-au-Prince, HAITI–Whether it is minutes or hours, the wait always seems long when waiting for surgery. After getting him dressed for surgery, recovery nurse Renaye Mansfield took a couple of surgical gloves and blew them up for 11-year-old Widmayer Nordé. Widmayer took a pen and drew a face on the makeshift balloons. Widmayer is scheduled for hernia surgery today.

Keeping the kids occupied critical care recovery nurse Janet Shanley lets the kids play with surgical hats and masks.  Photo by Jennifer Browning.

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General surgeries for the day

Handing over her contact information Project Medishare’s Nurse Liaison Maguy Rochelin is pleased that she can make an appointment for Ambrose Widzar. In accordance with The Smile Train grant the doctors from the University of Miami will return to Port-au-Prince two more times this year to perform cleft surgeries. Photo by Jennifer Browning.

By Jennifer Browning

Port-au-Prince, HAITI–While the patients scheduled today will be general surgeries, Project Medishare’s nurse liaison, Maguy Rochelin is scheduling cleft palate patients for another round of surgeries when the doctors return in June.

Motioning her to come closer a little girl hugged Maguy and gave her a kiss on the cheek before she and her mother left the clinic. Ambrose Judhly Widzar, 5, came today to see about her cleft palate being repaired. Three years ago Widzar traveled to from Port-au-Prince to Cap Haitian to have her cleft lip repaired. Ambrose’s mother was happy that he daughter would be able to have her surgery closer to home.
But not everyone is fortunate enough to live close to the surgical site in Port-au-Prince, many times more efficient travel is to take a tap-tap but even this modest transportation isn’t affordable to everyone.

Elise St. Pierre came with her parents today to see about repairing her cleft lip. They live in Degan near Carrefour. The family woke up at 1 a.m. to walk to Port-au-Prince to be here this morning after hearing about the surgical program on the radio a few days before. Since general surgeries are already scheduled for today.

Although the St. Pierre family will have to come back when doctors return for the second round of cleft surgeries, the family said they are thankful for The Smile Train who provided the grant which will allow their daughter to have surgery.

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Taking time to heal

After spending the night in recovery at Santé Bernard Mevs, Lise Marielle is comforted by her father. Lise had her first cleft lip surgery in Cange when she was 9 months old. Yesterday she had her palate repaired by Dr. Sam McDonald who is here with the University of Miami Department of Plastic Surgery. The UM Department of Plastic Surgery was able to perform these surgeries thanks to a grant provided by The Smile Train. Photos by Jennifer Browning.

By Jennifer Browning

Port-au-Prince, HAITI–During this morning’s rounds, Dr. McDonald stopped by the pediatric recovery room to check on the patients from yesterday. On the list was little Lise. Cuddling up comfortably with her father, she was a bit sore from her palette surgery the previous afternoon, but otherwise Lise was doing well.

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Stories from the surgical room: Dorine Mesidor

During morning consultations a volunteer medical resident from the University of Miami observes Dorine Mesidor’s scar from an electrical burn she received three years ago. Below: Nervous about going into surgery, Dorine was given a mirror to play with while she waits. Photos by Jennifer Browning.

By Jennifer Browning

Port-au-Prince, HAITI–Infants discover their world by sticking things in their mouth, but sometimes this isn’t the best way to learn. Three years ago Dorine Mesidor was playing with an electrical cord that was plugged into an outlet. Curiously, she placed the cord in her mouth. Unfortunately part of the cord was not protecting all the wiring inside and Dorine suffered an electrical shock which caused a burn on the corner of her mouth. Dorine arrived with her mother yesterday to see the doctors after she had heard about the team working at Bernard Mevs.

After today the University of Miami Department of Plastic Surgery team will have performed 23 cleft palate surgeries. After two cleft lip surgeries this morning, the remainder of the surgeries for today and tomorrow will be general surgeries.

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Mobile medical clinic in the central plateau

By Jennifer Kim & Monica Vohra

Pareidon, HAITI–Today we journeyed down the bumpy road to Pareidon, a village in close proximity to Casse. After the hour and a half ride, we got to the town church and set up our four clinics: pediatrics, adult, obstetrics, and vision. Many eager eyes were awaiting our arrival. Throughout the day each clinic saw a variety of diseases.

Ivorie Stanley (first year MPH student) and Lattisha Rowe (first year medical student) test for iron deficiency. Photo by Jennifer Kim.

In the pediatric clinic, a 5-month-old baby was brought in and was suspected to have both whooping cough and tuberculosis. The baby continuously coughed during the examination. The mother said that the father had been coughing and loosing weight recently. During physical examination, the baby’s skin turgor was not optimal and the baby had a fever. Unfortunately, we did not have a test to confirm TB but we were able to refer the baby to the hospital in Casse for confirmation and treatment.

Dione Occeanad (first year medical student) translating for Rick Spurlock (ER physician) during adult patient consultation. Photo by Jennifer Kim. 

Most of the patients that visited the adult clinic complained of a “hot” heart. After examination we noted that heartburn is very common in the Haitian community. It was treated with cimetidine and amoxicillin. Later that evening during our debriefing the Haitian Medishare physician confirmed that most heartburn is caused by H. Pylori.

Several pregnant women visited the OB clinic eager to make sure they were having a healthy pregnancy. Unfortunately, in one case we had a patient who had miscarried. There was no doubt the patient was overwhelmed with grief upon hearing the physician’s diagnosis. One of the students was able to console her and it was that simple gesture that gave her the strength to accept what she had heard. This particular experience was touching because it really showed us that our presence makes a difference.

Patients were referred to the eye clinic for further examination to address visual acuity and other concerns. It was interesting to see that most of the patients did not exhibit issues of myopia and several suffered from itchy and burning eyes. In one specific case, a 3-year-old child had an eccentric pupil that was not responsive to light. Interestingly this usually presents as a congenital defect, however the mother indicated that the child developed it one year ago. The patient was referred to the local hospital for further examination.
*Jennifer Kim and Monica Vohra are both first year students at Morehouse School of Medicine

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A chance to follow-up

Critical care recovery nurse Janet Shanley tickles Lise Marielle to get her to smile. Today will be Lise’s second surgery by Dr. Sam McDonald who will repair Lise’s palate. Photos by Jennifer Browning.

By Jennifer Browning

Port-au-Prince, HAITI–Taking the bumpy, winding road up to the Partner’s In Health Hospital in Cange is one of the things Rebecca Dasy remembers when she took her niece, Lise Anna Marielle to get her cleft lip surgery.

Rebecca helped her sister look into surgery in Port-au-Prince for Lise who not only needed her lip repaired but also her palate which was gaping, but in 2004 there was only one doctor who could perform this type of surgery in Haiti’s capital. This doctor’s cost was $4000. And that was only to repair Lise’s lip.

So Rebecca learned about a group of American surgeons who had traveled to Cange to perform cleft lip and palette surgeries. Lise was only 9 months old when Dr. McDonald performed cleft lip surgery on her in June 2004.

Lise is almost five years old now. Her aunt found out about the doctors returning to Port-au-Prince due to a grant provided by The Smile Train and brought Lise to Bernard Mevs to get a follow up surgery to repair Lise’s cleft palette.

Rebecca was thankful when Lise went into surgery today. She was also a bit relieved to see that the same surgeon was operating on her niece. While Project Medishare makes a major effort to see that patients have opportunities for follow-up, it is rare that a doctor donating his time in the operating room gets to meet a patient for the second time.

“I saw him walk into the room,” Rebecca said, “and I immediately remembered him as the doctor who operated on her in Cange.”

Lise’s operation was successful, and her aunt is thankful for Project Medishare and for the grant that The Smile Train provided to make this surgical trip possible.

“Your organization,” Rebecca said. “and other organizations who join you to finance this program are blessed.”

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Mirror of hope

Jeff St. Elois, 8, looks into a mirror for the first time since his surgery yesterday. A grant provided by The Smile Train to the University of Miami Department of Plastic Surgery made this week’s cleft surgeries like St. Elois’ possible. Photos by Jennifer Browning.

By Jennifer Browning

Port-au-Prince, HAITI–Following the rising sun the surgical team arrived at the hospital at 7 a.m. Before beginning consultations and prepping patients for today’s surgeries, doctors checked on their patients from the day before. Clevil Nesilomme was one of the first.

Clevil was handed a 5×7 mirror so could see the results of his surgery the night before. Although he was swollen from surgery, his lip was repaired. Clevil glanced back and forth from the mirror to the doctors standing before him. His eyes began to water and despite the pain from the swelling; he tried to force a smile. Clevil said he couldn’t believe the difference the doctors had made.

“It is a Godsend that you are here,” he said.

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