It Takes a Village: Haiti Medical Mission Trip

I have recently returned from my second Medical Mission trip to Haiti this year and could not be more pleased with our team’s accomplishments! If you missed the blog about my first trip back in March, click here. This time we returned in late October saddened by the recent devastation of Hurricane Matthew in many areas of the South, yet grateful that our trip to the North would be able to proceed as planned. I am truly amazed at how this whole project came to be. From disappointing attempts to find a medical mission trip over the years to the first trip finding us through mutual connections…to a casual conversation in Haiti back in March about the hernia needs of the community and a chance meeting with a special needs outreach coordinator…all which lead to 14 people going in October to perform general surgeries, dental surgeries for children with disabilities, and minor surgical procedures in addition to treating a few acute situations and seeing some hundred general medical patients. Yet that’s only the beginning of what this trip meant for both our patients and the team.

This trip started well before we left Atlanta, GA with many hours dedicated to planning, organizing, and fundraising. This trip would not have been possible without the support of our friends and family who helped with our Consignment Sale and donated via our GoFundMe page (www.gofundme.com/GAPCaresHaiti). We also received monetary and supply donations from the Wellstar Foundation, Wellstar Kennestone and Paulding Hospitals, Northside Hospital, Covidien, Kimberly Clark, GE, and Heine. We purchased greatly discounted items and medications from organizations that collect supplies for use on medical missions: Medshare (www.medshare.org), MAP International (www.map.org), and AFYA Foundation (www.afyafoundation.org).

Our team formed mostly by word of mouth, many had never met before our first meeting and not everyone worked directly in surgery. Some were worried they would not be of use, which could not be further from the truth, though we didn’t know in what capacities until we arrived. The unknown of what to expect and inability to plan ahead made some of us uneasy. Many were concerned about the safety with regards to housing, access to clean water, and susceptibility to illness. One of our team members Serena Daly NP shared her pre-trip worries questioning herself as many others did, “Do I really want to do this? Can I get out of it at this point? Am I going to be safe? Are we going to have clean water and food?” I had been once before yet still lost a lot of sleep prior to the trip worrying about these same things. We tried to waylay their fears, but at the end it came down to trust and faith on all of our parts as we boarded our American Airlines flight to Cap Haitien. Ready or not, here we come: a general surgeon, a dental surgeon, a pediatric endocrinologist, an anesthesiologist, a psychologist, a nurse practitioner, 2 registered nurses, a dietician, a physician assistant, a surgical tech, a patient care tech, and 2 anesthetists, including 3 Haitians now living and practicing in the US.

Our first impression of Haiti, after the beautiful countryside as viewed from the airplane window, was the chaos of the small airport, disorganized baggage retrieval and subsequent haphazard searching, and lastly the shakedown by customs for exorbitant fees they just make up. Like the rest of Haiti, you are expected to negotiate and finally settle once both sides are thoroughly confused, annoyed, and exhausted. We boarded a school bus provided by Ecole St Barthelemy, the Montessori school where we would be housed and fed, which is supported by Bethlehem Ministry (www.bethlehemministry.org). Over the drive of about 45 minutes, our team got their first glimpses of life in Haiti as we left the busy city of Cap Haitien heading to the countryside of Terrier Rouge. Damon Denzin PA-C recalled “I was shocked by the amount of refuse in Cap Haitien,” while his wife Lucy Denzin reflected on “seeing a reality that was hard to accept.” Serena noted “the level of poverty that many of the Haitian people live in is hard to take in. It all just seems so unfair that so many Haitians have to live in the conditions they live in, while so many Americans have access to so many resources that they take for granted. And it’s all just because I was born here, and they were born there.” That was a common theme within our group over the trip.

Gratefully some of the fears were assuaged once we arrived at the school, described as “a stark contrast to the surrounding area--like an Oasis” by Damon, and impressed Lucy who said “the school, with its solid structure and clean school yard was a welcomed sight! The rooms, though spartan, were also clean, which was a welcome comfort.” We split up into our rooms to put our things down so we could eat quickly and start right away at the clinic which already had patients lined up to see us since early in the morning. “Arriving at the clinic, and seeing all of the Haitians waiting patiently for care, was humbling,” noted Lucy. The first day was a chaotic blur with patients, staff, and translators working together to get as many people seen as possible in a short amount of time so we could schedule surgeries to begin the next afternoon. Many had to return in the following days to be seen. In addition to seeing patients, our team members were under pressure to sterilize supplies and set up the rooms we would use for ORs which is not a normal function of the clinic.

Clinique Esperance et Vie (www.clinev.org), also under the umbrella of the Bethlehem Ministry NGO, has a wonderful team of doctors, nurses, and support staff to help the citizens of Terrier Rouge on a regular basis for a nominal fee. Yet when they hear that American doctors are coming (a nominal fee is also charged for our services that goes back to the clinic), they come out en masse for chronic conditions the clinic could have easily handled. This overburdened our team who expected to focus on identifying general surgery patients as indicated in our advertisement. We were able to get some semblance of order relying on our native speakers, but many of our providers became frustrated and saddened as the care we could provide was limited by language and cultural barriers as well as the availability of supplies, medications, testing, and follow up care. Our nurse Diana Ambroise could often be found yelling at patients in Creole, “you are going to die!” as they did not understand medications should be taken as prescribed, not skipped due to the inability to afford more, which sadly happens in the US too. Lucy recognized the need to work with the locals “to learn how and what to ask the Haitian patients so that we could get better information. We also need to consider their lifestyles and living situations. For example, telling them not to shower for 48 hours is meaningless for most of them since, due to lack of running water in their homes, they ‘bathe’ in the river or with water in basins.” Though Damon “expected the limitations of scarce resources,” he “enjoyed the challenge of trying to work out solutions with the resources we had available to us.” Most of all, the team was impressed by how kind, grateful, and strong the Haitian people were. Lucy noticed “there was barely a quiver of an eyelid when…injecting the lidocaine…It was amazing and humbling.” We were touched by many of the stories of the patients we met, including the 17 year old girl who had dropped out of school to care for a young relative whose parents had died. Lucy enjoyed meeting the single mom of 2 who waited patiently for days to have her children’s needs cared for, always with a smile on her face. She even told Lucy through a translator that she loved her. “We had established a special bond just through smiles and facial expressions over those three days,” Lucy acknowledged. Knowing these 2 strong, genuine, and kindhearted women, it must have been like looking in the mirror.

Over the course of a few days, Dr Fritz Jean-Pierre was able to operate on 7 children and 6 adults who needed general surgery though we had to send some away due to lack of time. He along with Damon Denzin PA-C helped 16 patients by removing small masses and scar tissue. Damon also surgically treated an infection and closed a wound for a motorcycle accident patient. Our dental surgery patients came from Footprints of the Son (www.footprintsoftheson.org), an organization that helps families with special needs children and provides an opportunity for education that would not be possible otherwise. Dr David Kurtzman was able to operate on 7 children leaving them with healthy teeth and beautiful smiles. Dr Tanicia Jean-Pierre treated children with asthma and saved the life of a newborn with a dangerous fever. Though an anesthesiologist by day, Dr Eric Fishman treated medical patients, including the diagnosis of a life threatening condition. Stephanie Puleo PhD was surprised to see a stack of charts requiring her mental health background. Lucy learned how to sterilize equipment and assist in minor procedures, all new to a dietician and practice administrator. RNs Diana and Donna, NP Serena, and CST Sarah fell into their familiar roles in the pre-op, OR, and recovery room though not much about the situation and surroundings was familiar and they quickly adapted. And like the rest of the team, they also found themselves doing other jobs that were not their usual. Jean used his knowledge of French Creole to translate, his gentle nature to calm babies, and his words of wisdom to inspire our group. Lindsay and I provided anesthesia for surgery and lead our team the best we knew how. A big difference on this trip from the last for me was to be in a leadership role. In addition to the weight of doing anesthesia in a third world setting, which was quite enough in and of itself, I was now responsible for our team members, paying the translators and clinic staff, and most importantly to some, making sure the team had some beer to enjoy in the evenings. I fielded questions I usually did not know the answers to and felt quite useless when the team looked at me for guidance. They quickly realized they were on their own and as such excelled in their roles, teaching and learning along the way, to get the job done.

There were also many non-clinic moments that completed this trip. Beginning Monday, we were greeted by the school children as we walked to the clinic. To see their joy reflected as they held our hands, touched our belongings, and looked at themselves on our phones was truly a blessing that kept our team going. They loved having their portraits drawn by Dr Kurtzman and looking over school books with Lucy. Damon described the kids as “amazing” being “struck by their smiles and curiosity.” Lucy also connected with a young boy of about 10 in the village who helped her when she took a wrong turn and introduced her to his entire family. She will look upon the photo she took of them fondly as a reminder of “the welcoming nature of the Haitian people.” We worked very long days, often falling asleep immediately after our cold showers and rice and bean dinners. We finally relaxed on our fourth night there by dancing on the rooftop of the school while marveling at the clarity of the stars. On our fifth night after concluding our clinic duties, we drove through a few remote villages, had some beer on the beach, and visited a local bar. Our last 2 days were spent at a different beach to celebrate our efforts as a team and relax after the physically, mentally, and emotionally challenging days.

As the trip started long before we arrived, it does not end once we come home. Serena reflected “I’m proud of the work we did and of how many people we were able to help,” but noted the difficulty in that “we worked so hard while we were there, and there is still so much left to do!” Dr Fishman shared “The hardest part of this week is the realization that while we might have made a significant difference in a few people’s lives, there were many, many more of whom we could not cure.” He concluded that having to work in “less than ideal circumstances, and without the equipment and infrastructure we are used to” helped enhance our skills as practitioners and unite us as a team because “most importantly, we had each other to rely on. This was an amazing, passionate, hard-working, and talented group of people with whom I would go anywhere in the world with again.” Damon said “this is likely the first of many trips to Haiti for us,” while his wife Lucy “inquired about several children and/or families who could use support.” So the beautiful chain of giving back will continue long beyond this week in Haiti. There has been so much interest generated that some members of our team will be returning in March of 2017. If anyone would like to join on that or other future trips, please contact us at GAPC.Cares@gmail.com. We also greatly appreciate any financial support at www.paypal.me/GAPCares and www.gofundme.com/GAPCaresHaiti. You can follow us on Facebook at www.facebook.com/GAPCares. The area where we stayed only 2 short weeks ago is now being devastated by flooding. Please consider helping by visiting the websites for Bethlehem Ministry, Clinique Esperance et Vie, and Footprints of the Son listed above. I would be remiss if I didn’t mention the other group of wonderful doctors, nurses, and students from Mars Hill University in Asheville, NC who shared the accommodations with us and provided medical care to the remote villages when they weren’t helping us in the clinic. The people of Haiti have many representatives of the US to be grateful for after this week. It takes a village…

BE THE CHANGE YOU WISH TO SEE IN THE WORLD –Mahatma Ghandi