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Archive for October, 2007

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Robendji Saurtilive clings to her mother as they wait for Robendji’s time for surgery. In the recovery ward at Hopital Universitaire de la Paix, a sense of community has formed among the mothers.Photos by Jennifer Browning.

By Jennifer Browning

PORT-AU-PRINCE–While the fans keep the air from being completely stale, the recovery room is still hot. This is where the waiting takes place. The mothers and caregivers sit here with their babies waiting for a nurse to come in and call their child’s name. And after surgery, this is where they wait for their baby to recover until it is time to go home.

Most recovery rooms are quiet, but as you walk down the hallway you can hear babies crying, mixed in with chatter, and sometimes the voices of mothers singing prayers. While other recovery rooms in Haiti offer observations of voluntary individual isolation, walk into the mother’s world of wait here and you will see that these mothers have created a sense of community.

Some of the mothers who were brought in through Healing Hands of Haiti attended a workshop offered by the organization. During the workshop, the organization informed the mothers how to care for their babies after surgery. So maybe a small bond was created through the workshop, but look into this room and you will see that this bond has grown.

While Rosaline’s little girl, Phoebe, was in surgery, Rosaline held Vigiline’s daughter, Semia, as if Semia were her own. It is a common scene here.

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Nurse liason Maguy Rochelin visits Bianca in the recovery ward. Maguy helps Project Medishare keep ties with organizations like Healing Hands of Haiti. Photo by Jennifer Browning.

By Jennifer Browning

PORT-AU-PRINCE–After living and working as a nurse for ten years in New York City, Maguy Rochelin decided to move back to Haiti. She now lives in Port-au-Prince.

“I love my country,” she said.

Two months ago, Maguy was hired as Project Medishare’s Nurse Liaison. She helps Medishare stay in touch with partnering organizations like Healing Hands for Haiti as well as Haiti’s Ministry of Health.

It’s been a memorable trip for Maguy. For the first time since nursing school, she scrubbed into surgery today.

“This morning when I went into surgery I was in another world,” Maguy said. “It was amazing what I saw this morning.”

Maguy was here when Dr. Ragheb came to Haiti to assess the children with hydrocephalus, but this is her first medical trip with the organization. She said that so far, working with Medishare is an incredible experience.

“I feel so happy because people are coming from The States to help my Haitian people,” she said. “To me it’s great, and I feel so good about it. I feel that I am doing something so worthwhile.”

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Bundled in blankets, Marie Celestine rests after her Ventricular Petroneal surgery. Marie was diagnosed with Hydrocephalus immediately after birth. Photo by Jennifer Browning.

By Jennifer Browning

PORT-AU-PRINCE–Hours before the surgical team would return, Marie Nesline Neika Celestine was born Saturday at 2 a.m. at Hopital Universitaire de la Paix. It was evident she had hydrocephalus.

This morning Marie had surgery where the surgeons performed a Ventricular Peritoneal. Different from Endoscopic Third Ventriculostomy (ETV), in this procedure a shunt is placed to reduce the amount of cerebral spinal fluid in the brain by draining it into the abdominal area.

Project Medishare’s Nurse Liason, Maguy Rochelin, said the baby has a better chance for a normal life since the condition was diagnosed at birth.

“That baby was so lucky to be born here on that day,” she said. “We were there at the right time. When I spoke to Dr. Ragheb, he said the earlier we take charge of the situation the better off it is for the child.”

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By Jennifer Browning

sammie_bernier.jpgPORT-AU-PRINCE–While the main concentration here in Port-au-Prince is to treat the children with hydrocephalus, it is hard to deny those with other issues.

Yesterday morning as Ann McNeil was on her way to visit the hydrocephalus children, a lady was waiting outside the recovery room with her two month old infant. Her child, Sammie Bernier, had spina bifida, a condition that in the United States is normally fixed immediately after birth. Spina bifida has caused a lump to form on the lower end of Sammie’s back. The lump contains spinal fluid, which has redirected a portion of the spinal cord to grow outside of the body.

While scheduling is tight to operate on the hydrocephalus children, the doctors were able to squeeze Sammie into the operating room schedule. The operation was successful, and the bump with the spinal fluid was reduced.

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Carolyn Domina brings Sammie Bernier back to her mother who was waiting in the recovery ward. At fourteen days old, Sammie went through surgery to treat her spina bifida. After her surgery, the infant was already showing signs of spinal fluid shifting which meant the baby would develop Hydrocephalus. The next day Sammie underwent another surgery where a shunt was placed in order to treat her hydrocephalus.Photos by Jennifer Browning.

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Renaud Elysee kisses her son Prince a few hours before he went into surgery. Eight-month-old Prince was diagnosed with hydrocephalus four months ago.  Photo by Jennifer Browning.

By Jennifer Browning

PORT-AU-PRINCE–Eight-month-old Prince began having seizures three months ago so his mother took him to the doctor. He was examined and his mother was told that he was fine. A month later his mother started noticing that his head seemed to be a bit larger than his body. Prince was taken back to see the doctor and he was eventually diagnosed with hydrocephalus.

Prince’s father said that money wasn’t the reason his son’s condition wasn’t treated right away. The issue was a getting a visa to send Prince to the United States for Endoscopic Third Ventriculostomy (ETV) surgery. While there are neurological surgeons in Haiti, none of them perform ETV, mainly due to lack of funding in the country so in order to have the procedure performed parents have to take their children out of the country.

Thanks to the partnership here between Healing Hands, Haiti’s Ministry of Health, and Project Medishare, Prince had his surgery today.

“I feel relieved that [the surgery] is over,” the Renaud Elysee, the child’s mother said. “Now that my son is out of surgery, I feel a load has been lifted.”

Prince cried most of the morning because he was hungry due to the food restrictions required for surgery. His surgery was successful, but it wasn’t until he was able to eat that Prince settled down and stopped crying.

“He’s feeling better now that he has eaten,” she said.

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Pediatric neurological surgeon Dr. Jeff Blount stops by the recovery ward to check on a few of the hydrocephalus patients like Bianca. This is Dr. Blount’s first visit to Haiti. Photo by Jennifer Browning.

By Jennifer Browning

PORT-AU-PRINCE—As dark clouds hovered above threatening rain, the team gathered outside for breakfast at 6 a.m. With twelve surgeries scheduled today, it was necessary to get an early start.

Before beginning the operations, the surgeons stopped by the recovery room to check on the children they had operated on the previous day. Only one child, Coby, showed signs of possible complications, as the morning progressed Coby seemed to improve.

Once the status of the children from yesterday’s round of surgery, the surgeons will begin again.

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Dr. Karl Valcourt places an IV access into Coby’s arm. Coby was operated on the previous day, so the IV access was placed for hemodynamic stabilization. Dr. Valcourt works as a pediatric intensive care doctor at Children’s Medical Center of Medical College of Georgia in Augusta. Photo by Jennifer Browning.

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Esperancia Simon was abondoned in Les Cayes, about a five hour drive from Port-au-Prince. After her Endoscopic Third Ventriculostomy, Baby Hope will have a chance to live a relatively normal life. Photos by Jennifer Browning.

By Jennifer Browning

PORT-AU-PRINCE—Almost 120 miles away in a town called Les Cayes, a carpet bag was placed on a doorstep. When the owner of the house discovered the bag, it wasn’t until the bag started moving that she discovered its contents contained a little girl who obviously had hydrocephalus.

Whole Harvest Mission in Les Cayes made sure Esperancia (whbaby_hope02.jpgich means “to hope for” in French) was taken to a doctor. The local pediatrician estimates the little girl is five to six months old. Whole Harvest Mission got in touch with Healing Hands for Haiti to inquire about surgery for the baby’s condition. After a series of emails, Dr. Ragheb received word of Esperancia along with the baby’s X-rays. Her hydrocephalus was diagnosed as severe.

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By Jennifer Browning

PORT-AU-PRINCE–Hermance Fenelon’s favorite thing about her daughter Bianca is her smile.

bianca02.jpg“She is an interesting child,” Hermance said. “She rarely cries and she is always smiling, making faces….she likes to blow kisses…”

A year ago, early one morning, Hermance walked outside her house and found a two-month-old Bianca. The baby’s mother had left her behind possibly in hopes that someone else would care for her. Hermance, whose own two children are already grown adults, took Bianca to social services and began to fill out the paperwork for adoption and named the child.

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By Jennifer Browning

hopital_de_la-paix.jpgPORT-AU-PRINCE–The team traveled to the Hopital Universitaire de la Paix at 8 a.m. Much was to be done in preparation for today’s surgeries. Everyone participated in getting ready for the day. Mothers washed their babies’ hair so that their heads were clean for surgery, nurses took temperatures, identification bracelets were placed on the children, and final assessments were made.

Upon arriving to the hospital today, the nursing staff found that one of the children scheduled for surgery had found crackers. Surgical patients aren’t to have food eight hours before surgery. Fortunately, another child who had not eaten recently was found, so the planned surgeries will be able to stay on schedule. Surgical team coordinator said this situation isn’t unusual.

“This is pretty common,” surgical team coordinator Ann McNeil said. “Parents try to keep the child from eating before surgery and then a kid finds crackers, so we have to reschedule. In that case there isn’t much you can do.”

name_braclets_caption1.jpgSurgical trips like these take careful planning and preparation. McNeil explained that the team tries not to rely on the partnering hospital in Haiti to have the appropriate equipment. So the team thoroughly packs everything from surgical instruments, anesthesia, and antibiotics to identification bracelets, thermometers, measuring strips, and catheters. An inventory is also created in case such information needs to be provided for Customs or the Ministry of Health in Haiti. But despite careful planning, sometimes delays are inevitable when working in a developing country.

organizing_boxes02.jpgWith the surgical team landing in Port-au-Prince by 8:15 a.m. today, the plan was to get the remaining equipment through Customs be at the hospital by 11 a.m. But an unexpected delay in Customs kept the group from making their planned deadline. After waiting three hours to get through Customs with the remaining medical equipment, the group finally made it to la Paix.

The team’s arrival was a hectic one. There were scrubs to change into, more boxes to unpack, and an anesthesia and an oxygen machine to hook up. Apparently, the oxygen machine had the wrong adapter for the oxygen tank being provided. Surgery couldn’t begin until this was fixed. With the help of the hospital director, an adapter was found and the first surgery finally began at 2 p.m. with Coby John Lundy.

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Dr. Sanjiv Bhatia discusses x-rays of one of the children he will perform surgery on with Dr. John Ragheb and the rest of the surgical team. Photos by Jennifer Browning.

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By Jennifer Browning

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PORT-AU-PRINCE–The rain poured at 4 a.m. as three Project Medishare volunteers drove to Miami International Airport for their 7:10 flight to Haiti. There was much to do before 14 more members of the surgical team arrived on Saturday and this early flight was just the beginning.

As part of Project Medishare’s Specialty Surgery Program Miami Children’s Hospital neurosurgeons and nurses are volunteering this weekend in Haiti’s capitol to perform surgeries for those children who have been diagnosed with hydrocephalus, a congenital disease that affects 2 out of every 1000 births. For this surgical trip, Project Medishare has partnered with Haiti’s Ministry of Health and Healing Hands, the only organization in Haiti that deals with the disabled.

In most places, hydrocephalus is diagnosed shortly after birth, a somewhat simple operation allows a child a greater chance at a normal life. Unfortunately, this is rare in Haiti; instead when undetected, the cerebrospinal fluid (CSF) that flows normally through a healthy baby is blocked or unabsorbed. When this happens, the fluid creates pressure on the brain causing swelling, severe damage and eventually death.

Cranial MeasurementTwenty-three children will be operated on in the next three days. In preparation for these surgeries, Surgical Trip Organizer Ann McNeil along with Carolyn Domina and Sharon Udy-Janczuk met with Haitian nurses who will be assisting in post-operative care. Then there were the logistics to look after: setting up cribs, making sure the operating room was ready, finding out how and where the instruments would be sterilized, and making sure the boxes of equipment were properly placed. Afterwards, surgery candidates heads were measured to detect any growth since the team’s assessment in September.

Tomorrow the surgical team arrives in Port-au-Prince on the 8:15 a.m. flight. By noon they will begin the surgeries scheduled for the afternoon. Six children will have vetriculostomy surgery performed by the surgical team lead by pediatric neurosurgeons Dr. Ragheb and Dr. Bhatia. The procedure allows for the cerebrospinal fluid to escape relieving pressure on the child’s brain.

The procedure does not reduce the size of the child’s head, but the head will stop getting larger. Eventually, the child grows and the abnormal large appearance of the head isn’t noticeable anymore.

The key to the hydrocephalus situation in places like Haiti is detection. The children with larger heads, who have suffered from the condition longer, have more developmental delays. If hyrdrocephalus is diagnosed early and is not complicated by other medical conditions (such as meningitis) then the developmental delays are less. These children can eventually go on to school and be productive members of society and that is one of the many hopes and goals Project Medishare has during this surgical trip.

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Carolyn Domina hands out care packages containing shampoo, soap and a toy for the children who will be going into surgery to treat their hydrocephalus. Domina works at Miami Children’s Hospital as the Perioperative Director when she isn’t volunteering her time in Haiti. This is Domina’s fourth trip to the country. Photos by Jennifer Browning.

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