In March of 2016, I was blessed with the opportunity to participate in a medical mission trip to Haiti. As an anesthetist, I have always wanted to do something like this but was so nervous about it at the same time, I didn’t truly look very hard for opportunities. So instead one fell right into my lap. Just at a time when I needed to find my purpose as I was navigating through grief. A coworker was asked by an associate from a nearby town if he knew of any anesthesia interested as their usual providers were unable to go this year. That’s how my coworker and I got involved with the Athens Orthopedic Clinic’s Annual Haiti Mission Trip (www.athensorthopedicclinic.com). This amazing group has brought orthopedic surgeons, physician assistants, anesthesia providers, nurses, therapists, and radiology technicians down to a small town on the north side of the island called Terrier Rouge for a number of years. Over this time they have built up donated and purchased second-hand supplies, established a relationship with the clinic and school, and oiled this machine making the seemingly impossible possible.
The clinic we served is called Clinique Esperance et Vie (www.clinev.org), the Clinic of Hope and Life, built in 2009. Dr. Classaint Saintvil is the medical manager while Dr. Carmelle Lucien is the CEO. They join optometrist Dr. Jean-Paul Louben and dentist Dr. Joseph Osener as well as nurses, lab techs, housekeepers, watchman, and the glue that holds it all together, the wonderful logistics manager Richard Estimable who endured my endless questions and demands always with a smile on his face. Reverend Melissa Hamlin works tirelessly on the malnutrition outreach program. Unfortunately, the amazing people of this clinic have to work with extremely limited resources while the people of Haiti have very little ability to pay for the services they so desperately need.
We were housed and fed by the wonderful Father Bruno and his family at the Esperance et Vie School, Ecole St. Barthelemy, a Pre-K through 12th grade Montessori school (www.esperanceetvie.org), all made possible by Bethlehem Ministry (www.bethlehemministry.org). We stayed in modest dorm-like rooms with a few bunk beds and shared a bathroom complete with cold unpotable running water. Some rooms had air conditioning while ours did not, and they were cleaned daily. Considering our surroundings, we were living like royalty. The family cooked us three heaping buffets of local food every day, and gave us bottled water to drink along with tea, coffee, and fresh squeezed juice.
The trip began for us on Thursday evening when my friend and I worked diligently to fit our assigned supplies into our luggage. There was some cursing, some drinking, some MacGyvering, but somehow we did it. We enjoyed our Friday in Ft Lauderdale at Dania Beach, never ones to pass up an extra beach day. After meeting everyone just that (early!) Saturday morning, we began our week with a 6 am flight from Ft Lauderdale, FL to Cap Haitien, Haiti on the unknown IBC Airlines, no relation to the root beer unfortunately. We were off to a great start, losing only one person on the way to the airport. We all had our overstuffed luggage as full of supplies as we could and still be within a reasonable weight limit to actually leave the ground. If you don’t like being weighed publicly along with your luggage, IBC Airlines is not for you. Or if you like leaving on time. Or if you don’t want to be split off from your group while everyone is racing across the tarmac on foot. We arrived quickly in Cap Haitien and got through customs rather easily with this group having done it before and knowing what to expect, which is not always an easy feat. We covered ourselves in DEET and headed out to the open air truck for the ride through the bustling city out to the smaller community of Terrier Rouge. The streets were crowded with locals going about their day, some walking down the road with large items on their heads, others dodging traffic on their bikes, mothers and babies 5 deep on motorcycles, and even more hanging off the “tap-tap” trucks loaded down with riders (now do you see why Haitians desperately need orthopedic doctors?!) The crowded city soon became the calmer open countryside and eventually we turned onto the dirt roads of Terrier Rouge. We threw our stuff down, grabbed a quick lunch, and went straight to the clinic where over a hundred patients had been lined up since early morning, most arriving on foot. I was beyond overwhelmed to say the least, and grateful that my role as anesthesia was minimized as the rest of the crew hit the ground running assessing patients, shooting x-rays, and lining up our surgery patients to begin Monday.
We worked for 2 days finding, organizing, and checking our equipment. Some of it worked, some of it did not, some we would only know when we tried it on our first patient. We set up 2 “operating rooms” utilizing the few rooms with air conditioning while other members of the team prepared the surgical supplies. The first was surprisingly close to a real operating room with equipment this group has acquired second-hand over the years. The ancient anesthesia machine and mass spectrometer were actually familiar to me from my training 14 years prior, though they were used in our lab at the time, not on humans. The second OR was just a table and a nonworking stretcher, the anesthesia being provided with regional and IV techniques only. While running around sweating to gather supplies, I saw some amazing things over those first few days: an elderly lady whose lower body was paralyzed walking by moving her legs with her hands in a crouched down position (she has since been given a wheelchair), a sweet lady with a goiter as large as her head, and a mother holding her special needs child telling us of the recent passing of her other son with cerebral palsy. Sunday morning some of our group hiked up to the Citadelle Laferriere, the largest fortress in the Americas, while the rest of us went to the church service at the school. Sunday evening we came up with a game plan for the next day’s surgeries considering equipment, processing time, anesthetic technique, necessary NPO time, and likely arrival of the patient based on transportation. For a second night, I went to bed early yet did not sleep well.
Up with the roosters at 3 am on Monday, I got ready early for some quiet reflection time. I was praying for the wellbeing of our trusting patients and the guidance of our skilled clinicians when a double rainbow appeared over the school’s soccer field as if coming right out of the clinic. Message received. And what tends to follow beautiful rainbows…torrential downpours. Onward we walked to the clinic along the muddy road while the goats huddled in doorways of the nearby tiny homes.
Monday was also the first day we were greeted by the school children. Droves of the cutest kids of all ages in their perfectly pressed uniforms, little boys with their tiny backpacks and little girls with their hairbows and ruffled socks. It is an honor to attend this school, and these children, some from homes with no running water and dirt floors, looked immaculate. For some, the school lunch is the only decent meal they will eat that day, and the families do everything they can to keep their children in school recognizing the importance. These kids adore us as much as we do them, touching us and our things, some of which they have never seen before, but mostly they love taking pictures with us and then climbing over each other to see them immediately. Unlike American children, these kids don’t have cell phones or even mirrors. We have a language barrier, but the commonality of kindness, compassion, and humanity speaks for us all.
Skimming over the surgery part, we did 26 procedures in 2 and a half days including removal of painful mismatched hardware, application of an ex-fix, pinning of fractured bones, and a number of mass excisions which all came back negative from the lab in the US. Hundreds more patients were seen over the 5 days in the clinic and treated or advised appropriately. All of the OR cases went very well, and I finally unclenched my butt cheeks allowing music in the OR. It was an odd feeling not to chart anything, so I did anyways, in order to give a report to the “recovery room,” aka closet, on the other side of the courtyard. Our patients’ families joined them there and many were taken home on motorcycle soon after their surgeries. I was so impressed by the teamwork and hustle from our whole crew, the clinic staff and translators, and the patients and their families, better than any US hospital setting I have ever seen. Monday night was a late night, operating by flashlight, but Tuesday we finished at a reasonable time and took a sunset stroll through the town of Terrier Rouge. Aside from being excessively poor, it was like any town on a nice evening with kids playing in the street and neighbors greeting each other in doorways. This area has just received electricity in the past couple of years, which means at night they have a bare lightbulb in the middle of their small home to share. By Wednesday night I could finally relax though next time I will bring wine as the local Prestige beer is not my thing.
Thursday morning we said goodbye to the Bruno family and the school children of Esperance et Vie. Parting was sad but we were proud of the work we had done and off to relax for a few days at the beach! We drove back through Cap Haitien exploring the artist market and buying a few goodies to take back home. I was saddened to see the beaches and river littered with garbage. Then we traversed the unmaintained winding mountain roads where motorcyclists go to play chicken, and just when we thought we were never going to make it there alive, the beautiful beach of Cormier Plage appeared like an oasis. We enjoyed more delicious food, cold drinks, relaxing on the beach, reading in the hammock, and just being grateful for what we have in our lives and what we had accomplished through hard work and caring to benefit the people of Haiti. When you give back, you will always get more in return.
We were so inspired by the need of the kind and grateful people of Terrier Rouge that we are going back in a few short months (www.gofundme.com/GAPCaresHaiti). Using the template designed over many years of trial and error by the Athens Orthopedic Clinic team, we are bringing a group of highly motivated clinicians from the Wellstar System serving the metro-Atlanta area, led by GAPCares, Georgia Anesthesiologists’ community outreach committee (www.gasdocs.com). Our team consists of a general surgeon, reconstructive surgeon, dental surgeon, cardiologist, anesthesiologist, pediatrician, mental health specialist, physician assistants, nurses, and techs, some of which are originally from Haiti. Not only will we be providing services at Clinique Esperance et Vie, but also with another wonderful local organization there, Footprints of the Son (www.footprintsoftheson.org.). Heather and her husband Dasmin provide support and education to families with special needs children through their outreach, respite, and give back programs. This is especially important in Haiti where disabilities are not well understood, add burden to an already tough life, and are seen as curses and referred to voodoo doctors, very common in this area. We are excited about serving the community of Terrier Rouge again, and I can’t wait to share that story with you too! After we recover at the beach.