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Archive for December, 2008

By Jennifer Browning

haiti-invitation-2Hurricane victims in Haiti are being sent some financial relief thanks to those who attended and purchased items at the Coral Gables Congregational Church fundraiser REBUILD HAITI: MISSION POSSIBLE. The event which hosted both a live and silent auction raised $18,000.

The money raised from the event has been split evenly between Project Medishare, the Florida International Volunteer Corps (FAVACA), and the Lambi Fund of Haiti so that each organization receives $6000 to benefit their hurricane relief efforts. All proceeds will go to benefit the many people effected by a series of hurricanes that pummeled Haiti in August.

Thank you to all of those who attended and made our mission to help hurricane victims in Haiti’s Central Plateau.

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By Ronine Zamor*

Thomonde, HAITI–So far, my experience in Haiti has been both medically and culturally fulfilling. Being Haitian-American, I felt as if I would not be as shocked or surprised by this trip. However, it has been the complete opposite.

Because my family is from the city of Port-au-Prince, I have never been to the countryside, which is completely different. From the home visits to the clinics, people have been extremely friendly, welcoming, and patient. Today, we saw the most patients since we’ve arrived. We also saw a multitude of cases from scatoma to scabies to hypertrophic cardiomyopathy. Being able to help diagnose cases and present them to the physician is not something most first year students get to experience. As a first year medical student, we learn what looks normal and how to do physical exams on standardized patients. Today, I was able to see the abnormal such as people who are underweight but are still hypertensive.

On the way to the clinic today, we drove for almost an hour in what seemed to be the middle of nowhere. Everywhere we turned there were mountains, trees, and almost no people. When we reached the clinic, there were people already lined up. This just shows how badly the Haitian people are desperate to have medical care. The fact that they will walk miles up a mountain to see a doctor amazes me.

On our way back, we stopped at a cave. I never imagined that if I were to walk into a cave, it would be on a medical mission trip to Haiti. My experience today has shown how wonderful and beautiful this country is as well as its people. By being here, it has given me the motivation to continue to do more for my people, which is what I came here to do.

*Ronine Zamor is currently volunteering with Project Medishare’s mobile clinic team during his holiday break. The trip was organized through The University of Miami’s School of Medicine.

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Project Medishare recently received a $1.25 million grant through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The award, which focuses on HIV/AIDS prevention activities, is part of a $4.8 million grant to Cross International, a South Florida-based interdenominational Christian humanitarian agency.

“This grant is a solid foundation,” Dr. Fournier said, “on which to build awareness to prevent the spread of AIDS.”

This grant, which took effect December 1, on World AIDS Day, marks a milestone for Cross International, the organization overseeing the grant and achievement of its objective.

“This is the biggest single grant in the history of Cross, a real landmark in the seven years since we began serving the poor,” Cross President Jim Cavnar said. “The competition was tough, and the fact that we were chosen says a lot about our work and how much we have matured as a ministry.”

PEPFAR was established by President George W. Bush in 2003 to combat global HIV/AIDS. Cross was one of 19 non-profits to receive funding.

The grant’s goal is to encourage faith-based and local organizations to partner with the U.S. government’s global AIDS initiative. Cross International will work with Project Medishare and four mission partners to begin a comprehensive HIV/AIDS awareness and care program that targets teens, AIDS orphans and vulnerable children. The three-year project will reach an estimated 5,000 orphans and vulnerable children, providing them with care and medical services. Project Medishare will focus its work on one of Haiti’s poorest regions, the Central Plateau.

The ties between Project Medishare and Cross International have long been established, with Cross supporting a number of programs. Miller School and UM nursing students have traveled to Haiti to work hand in hand with local doctors and community nurses, providing access to preventive and curative health care to more than 6,000 children in the city of Thomonde. Cross has funded CT scans for the more than 60 children who undergo surgery each year to alleviate hydrocephalus.

Project Medishare is currently developing a factory to produce a nutritious, sustainable food source called Akamil. Once operational, Cross will be one of the first organizations to purchase Akamil to feed children in local schools.

“Partnering with Cross International,” Dr. Green said, “has proven to be successful in the past. We believe this money will allow us to expand AIDS awareness, educate the population and prevent its spread to future generations.”

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By Christopher Gibson

Thomonde, HAITI–Today was another mobile clinic day. Both the location and population were distinct from yesterday – the community was more remote with more agricultural activity, and the people primarily sought water from nearby rivers.

Their requests were also more basic. Yesterday, people asked for better constructed houses and more accessible healthcare; today people requested roads and, because they had none whatsoever, latrines topped the list. Nevertheless, we still encountered the same warm and embracing spirit from each and every patient.

One woman in her twenties was hurried into the OB-GYN clinic, interrupting another consultation. After a quick but thorough examination, she was found to be in the early stages of labor. All signs showed a healthy pregnancy, without complications. Her progression was slow, so the doctor suggested she stay the rest of the day for observation, with the intention that we would bring her to the hospital in town for her baby’s birth later in the day. We were surprised when she kindly refused the offer, citing that she had two children at home to care for while her husband was out of the country. She said she would simply have her child at home.

This story reminded us of a 15-month-old girl we saw yesterday. It only took a few moments to realize that she was not as mentally developed as one would expect someone of her age to be. She was unable to hold up her head on her own, was constantly drooling, and yet was the happiest, most delightful child. Her mother told us she had been born at home, breach, and had never before been seen by a doctor. The family seemed joyful and content, but we found ourselves wondering how her situation might be different had she been born under the care and expertise of a hospital staff.
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By Jennifer Burzawa

Time can get away from you. Over the recent Thanksgiving holiday, I went back to Thomonde, Haiti with Project Medishare for the first time in seven years.

Seven years.

I can’t believe it has been that long. I last went as a second-year medical student with the University of Miami, not too long after Project Medishare began. Since that time, a lot has changed in my own life. I was eager to see how much Haiti and Project Medishare have changed as well.

On my first trip in 2001, the Medishare compound was still being completed. In fact, we had an inauguration ceremony for the pavilion during that trip. We held our clinics right there where we slept. In fact, there wasn’t even enough space in the original compound to accommodate all of us. About half of the group had to stay in various homes of people in the community. The medicines we had to work with were only those that we brought ourselves. The closest hospital was Cange. There were no doctors in Thomonde other than those that came with us on our brief trips. University of Miami was the only medical school that was involved with Medishare at that time.

pre-e-haiti-ptThings have definitely changed since then. I suspect that some of these changes, at least from my view, may in part be due to the fact that I have changed schools that I went with. Within the Miami contingent, Project Medishare has now become fully incorporated into the university’s new Global Institute.

Outside of UM, Medishare has expanded. One of my medical school classmates brought his interest in Project medishare to Emory where he completed his residency. Now within Atlanta, Medishare has expanded to Morehouse. And now there are three or four additional schools that have their own trips.

Each of these schools now has different agendas. The Emory portion is focusing on mobile clinics in the more underserved regions of Casse. In contrast, when I was a student, most of our work focused in the heart of Thomonde. However, on my second trip, we did two days of mobile clinic in a more remote village. The people there told us they had not seen a medical-related person in 2 years. Now even in the remote regions of Casse, Medishare and Z’anmie Lasante among other organizations have community health agents that visit these communities on a regular basis. At least 50 percent of the expectant women I saw had been seen in some medical capacity at least once before during their pregnancy.
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By Megan Gray

Thomonde, HAITI-Waking up to roosters crowing and strong fresh Haitian Blue coffee, we gathered medications we had packed the night before to begin our second full day with Project Medishare. Yesterday, we toured sections of Thomonde with the agents de santé, who introduced us to individual families within the community and gave us a sense of the lifestyle of Thomonde.

Today, we first caravaned to the nearby Akamil Nutrition Facility, which is still under construction but plans to provide a nutritious weaning food to combat the malnutrition that commonly occurs in the transition from breastfeeding to solid foods. We then drove to a nearby school, empty for Christmas vacation, to set up a mobile health clinic. We divided ourselves into a medicine room, ob-gyn room, pediatric room, and a triage room, trying to maintain a decent number of translators and medical personnel for the patients at each station.

Triage was initially swamped with patients, but became much smoother after we found our rhythm. The first patient to arrive at the medicine station was also our sickest, presenting with fever, headaches, lower back pain, diarrhea, and nausea over the past three days. We suspected typho-malaria and treated her with empiric therapy but kept her in the medicine room to follow up on her second dose of chloroquine and to ensure her condition did not deteriorate.

Predominantly, adult patients had gastritis and vision problems, including pterygium and glaucoma. We made a note for future trips to ensure to bring enough sunglasses and eyeglasses down with us, as patients really appreciated the glasses they received.

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By Beth Melia

Thomonde, HAITI-On our first full day in Thomonde, we conducted home visits with Project Medishare’s community health workers. They showed us their daily routine of checking up on patients, which gave us an opportunity to see the regular Haitian home-life and learn the basic medical needs of rural Haitians.

Highlights of the day included learning how the sugarcane is processed here in Haiti, seeing patients with unusual cardiac conditions, and appreciating the overwhelming hospitality of the Haitian people. We were openly welcomed into their homes, and warmly embraced.

Many of our reflections of the day have centered on the differences in access to healthcare and technology between our own country and Haiti. The exams and labs that we are dependent upon in the US are inaccessible here in Haiti, and thus treatment requires stronger clinical skills. Noticing this reinforces the importance of thorough clinical training as we approach our third year of medical school.

The stark contrast in differential diagnosis and in care giving call for more creativity in treatment courses and reinforces the importance of collaboration with community healthcare workers. It was clear from our visit today that the community healthcare workers are integral in making this system work. Their impact is far-reaching and goes well beyond a simple check-up. Not only are these workers the most informed about the individual healthcare needs of their community, but their rapport with the community allows them to promote basic health education such as nutrition and personal hygiene. This simple concept of health promotion via community healthcare workers could enhance medical care even in our own country. We are excited about conducting mobile health clinics over the next three days, and are curious to see what ailments will be the most prevalent. We hope and know that as we do so we will gain a greater appreciation for the Haitian people and culture.

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