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Archive for November, 2007

snapshot-2007-11-22-23-24-56.jpgBy Karena Wienands

After another long day out in the field, the doctors, medical students and other affiliated health workers returned to the compound. Thanksgiving is not celebrated in Haiti, but the fabulous cooks had prepared two turkeys. Before the meal, everybody formed a circle around the dinner table and shared their personal “Thanks”. It was wonderful to hear one after the other thanking their Haitian patients, Medishare and its donors, for a life changing experience. Some of us have been so touched by the people they have come in contact with during this trip that they could not hold back their tears. The meal was exceptionally delicious and even though we were far from home and without families, our spirits were high. It is indeed, special to be amongst people who care deeply about the same cause. Not everybody committed to making a change in Haiti was able to sit at this table tonight. The people who made this trip possible through financial and medical contributions were in our thoughts and each one of us is thankful for the special gifts that allowed us to be here on this Thanksgiving Day.

* Karena Wienands is a Registered Nurse at Mt. Sinai Hospital.
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By Brian O. Gross (BOG)

Technically, caregivers do a physical examination of the patient, crunch the data, and report the results. Science is often seen as a cold, open-and-shut, just-the-facts discipline, but it’s interesting how delivering the news at a Medishare mobile clinic affects the messenger. Whether it’s the falling, disappointed expression of a patient who has just been told that there is nothing the mobile clinic can provide for them or the relieved face of a mother who has just learned that it’s normal for her infant to burp and vomit, my emotions this week have mirrored that of the patient.

After visiting four villages in four days, I’ve become more and more amazed by the loving spirit, compassion and warmth of the doctors and students on this trip, not to mention the response of the Haitian community in assisting one of its members. Today we saw a woman that had a fever of over 104: a distant cousin left the clinic to deliver the news to her husband, while several other people remained at the clinic to comfort the woman. Haitian resiliency will never cease to amaze me.

* Brian Gross is a former Peace Corps volunteer in Haiti and a translator for this trip.

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snapshot-2007-11-21-23-11-28.jpgBy Gabriele Denis

During Emory’s second day in clinic our first case in pediatrics was a two-year old male with right eye retinoblastoma/retro orbital mass. Based on research, it is a malignant tumor on the retina, the light-sensing part of the eye, and would be preventable if found early. While in this case the cancer is present in the child’s right eye, it can show up in both. In the US it is standard to test for the red-eye reflex at birth, and if a baby does not have this reflex, treatment is started immediately. It occurs most often in children five years and under. Caused by rapidly growing cells in the eye, retinoblastoma sometimes creates specialized cells that won’t stop reproducing. Eventually theses cells mature in the retina in the form of a tumor. These tumors may continue to grow, filling almost the entire vitreous humor (the jellylike substances the fills the eyeball). These tumors can also break off and migrate to the entire orbital space, and eventually outside to lymph nodes and other organs.

This child’s grandmother reported that the boy was healthy three months prior to the clinic visit. Today he presents with a large, infected, oozing right orbital mass. Parents first noted swelling of the right eye in September of 2007. The family took him to be evaluated at a referral hospital where he was treated with eye drops. At present he had no fever, headache, and reported to have good vision in his left eye. His developmental history is normal for his age (walking, talking, and feeding self). The doctor diagnosed him with bilateral cervical lymphadenopathy. The family stated that they did not want the child to die and they appeared to be very worried the boy’s survial.

“Miss se Bondye ki voye nou pou mwin, mwin lage pitit la nan min nou.” Miss God sent the team for me, the life of my child is in your hands, the grandmother said.

This translator linked the patient with one of Project Medishare’s health agents to follow up with Zanmi la Sante and the Bascom Palmer Eye Institute team which is expected to arrive in December. Dr. Desai Sachin instructed a nurse to teach the family how to manage the child’s wound until surgery is scheduled. The family was also given enough material and medication to prevent further infection.

* Gabriele Denis is Project Medishare’s Program Coordinator.

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By Maryam Hosseini

Today is Tuesday, the third day of our trip to Haiti with Emory Medishare. I was lucky enough to have the opportunity to join this incredible group of doctors, students, nurses, and social workers in Thomonde, Haiti. While yesterday was spent working in a clinic in the town, today went a little differently. Today’s clinic was actually to be in a school, and because some of the roads had washed out in the rain from the previous day, the drivers took a different route. Once we finally got to the school, we were greeted by at least 100 people of all ages, lined up to see us. We were told that they had been waiting patiently for us since 6am that morning. I was assigned to triage, and since the school did not have enough room to accommodate us, we set up shop along a wall, under shaded trees. It was incredible to talk to the men and women outside, with their own land and their elements surrounding us. While many of the people who came to see us were complaining of stomach aches, as GERD (acid reflux) is a common illness in at least Thomonde, we noticed that many of our patients had red, inflamed eyes. The sun is brutal and constant in Haiti and it can actually scar the retinas of the people because there are no sunglasses readily available. Cataracts are very common, and you could actually see visible white scars in the eyes of many of the older men and women. Headaches seemed to also be a common complaint, and for many patients, something as simple as glasses would easily remedy them. While for the most part, many of our patients were overall healthy, there were definitely consistent complaints that spoke of issues that may be endemic to the area, specifically GERD and eye problems. When Melissa and I come back here in March with Morehouse, we hope to bring sunglasses and maybe even a variety of reading glasses so that we can effectively treat and possibly prevent at least a couple of these issues.

* Maryam Hosseini is a second year medical student at Morehouse School of Medicine.

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By Rick Spurlock

The mornings can be tough in Haiti, usually the fault of the preceding evenings festivities or the roosters that seem to start crowing as soon as you close your eyes. But this is not another day for an ER physician from Atlanta. This being my 10th trip to Haiti for either a medical or surgical trip with Project Medishare, I feel, whether true or not that this is another experience with which to treasure and store away forever. The same themes tend to ring true in the mornings on every trip, “damn this coffee is great,” “this fruit is so fresh,” and “wow too much Prestige last night.” The energizing chatter of the group, 30 of us this time, is intoxicating as we prepare to head out to our mobile clinic site. There is so much diversity and so many people with different life experiences. Each with different reasons for coming on this trip. It is a great team…one of the best I have been with. snapshot-2007-11-19-23-31-33.jpg

The stark reality of our beautiful world, and one that stands out when you come here is what our capabilities are in America compared to the potential, yet lacking, capabilities here. We have done well on this trip, proudly we march in our 4-wheeled vehicles to our site with ultrasound capability, urinalysis dipsticks, hemoglobinometers, palm pilots and a ton of meds literally…and whatever else we could truck up this forsaken road. We have some of the most brilliant minds in medicine here. People trained by the best and brightest of our planet with experiences ranging from Harvard to Liberia and of course Miami and Emory. We have a large part of medicine “covered” on our trip: OB/GYN, Pediatrics, Infectious Disease, and Emergency Medicine, but still we are lacking. Unable to predict the patients needs and ability to function in a setting with which we are used to in the States, we are reduced to the level of those who practiced medicine centuries prior. Truly it is an honor to be a part of such a noble group of people.

The capabilities we have in America versus those in rural Haiti are polar, but the work with the Department of Health, Project Medishare, Partners In Health, and others in the central plateau will hopefully begin to close these gaps. At the end of the day today, we saved some lives, made others better, learned much and had a lot of fun.

* Rick Spurlock is the co-founder of Emory Medishare and an ER physician.

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By Claude Bruny

I was born and raised in Haiti but I’ve never experienced doing a clinic before. Upon arrival I felt like we were anticipated. We were greeted with what seemed like a thousand smiles.snapshot-2007-11-19-22-46-17.jpg

 

I was asked to help translate in the pediatrics side of the clinic. It seemed like a simple enough mission, since I was born speaking the language. What I didn’t realize was how few we native speakers were. The most interesting part was when I had to be in two to three places at once while maintaining perpetual hope in the patient’s eyes. I was asked to survey the patients on their household conditions. It came to my ignorant surprise how many people did not have a toilet to use nor did they know their age or the age of their offspring.

 

So many kids suffered from stomachaches, chest colds, anemia, and abdominal pains. Once I translated to the parents that we would prescribe their child medicine and they would be given the medication, it looked like we had just told them that poverty was a thing of the past. I replayed the moment over and over in my head and the feeling, of doing something that matters so much, never dwindled. We then mounted our caravan made of 7 SUV’s and with passing waves and smiles from the locals, we “rocked” our way back down the impossible mountain.

 

* Claude Bruny is a Haitian-American translator for this medical trip.

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By Nayla Khoury

It felt like we were walking into summer again as we descended the steps of the airplane and onto the tarmac. “Hopefully, living in Atlanta, you are used to this heat,” Arabelle said to me. “Some people pass out, you know.”

The five-hour car ride gave us a peek of Haiti. We leaned into the windows of ournov18_image.jpg Pathfinders, catching glimpses of narrow roads leading off the windy track. There was much construction, or unfinished work, or ruins- we weren’t sure what. Robbie explained that Haitians are taxed less on a building if its “under construction,” which may explain why many buildings were half painted. There is much to find out.

This is my first time to Haiti so all I know is what I have seen from the bumpy car ride. I was surprised by how rural it was, even the capital city, though this should have been expected. Much of the land looked unpopulated. I was surprised seeing cactus living side-by-side with palm trees, and by a family of pigs and piglets squealing on the side of the road (they are so cute!). Driving through Cange, I was amazed at how Paul Farmer’s clinic, Zanmi Lasante, towered over the surrounding village. This is not my first trip in a developing country, but I was nevertheless surprised by the shacks these Haitians may call home, by the glimmers of light bulbs shining through thatched roofs, and by the breathtaking views of nature that these residents enjoy.

It was just a glimpse, an appetizer of sorts. I wanted to stop at every village, to run down the windy paths and find out where they lead. I can’t wait for the rest of the week. I am hungry for more.

*Nayla Khoury is a first year medical student at Emory University School of Medicine.

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