Sunday, October 30, 2011

Haiti 2.0

Thoughts on a second trip to Haiti, September 2011

A trip to Haiti, or any developing country, for that matter will quickly help put your life in perspective and help you appreciate all those little things that make life tick back home.  Take a moment from the second day of my most recent trip, for example.  It’s an almost absurd scene watching an expensive 1000-pound fluoroscopy x-ray unit being unloaded off the back of a truck by hand.  No heavy equipment, no crane, and no dolly for that matter.  It’s been a great challenge and success story to get to this point after the machine was generously donated by (our local) Poudre Valley Hospital, money was raised for the logistics of shipping a half-ton, unwieldy machine to Haiti. I’m reminded that nothing is easy here.  But it also makes things we might not think twice about extra special to the Haitians. Consider that after the unloading of the unit the locals carried off every last bit of packing material and cardboard to be used in their homes.

We’d hoped the x-ray machine would help us complete an Orthopedic mission dreamed up by my friend Jana Gottino and me where we would help earthquake victims with follow-up they needed after the initial medical teams came and left. We started this trip with high hopes and expectations but tempered them, knowing they can lead to disappointment when you are heading to Haiti.  We put together a team of 13 people from Colorado with an orthopedist, a pediatrician, nurses, an engineer, a massage therapist, a photographer and great support staff. I was overwhelmed when I asked PVH if they knew where to get a hold of old x-ray equipment and they donated a fluoroscopy unit. Since so much work went into trying to get the unit shipped to Haiti, it was discouraging when we showed up there and it had not arrived. Team spirit soared when it arrived the next day, only one day late! 

When I left for this second trip to Haitian Christian Mission in Fond Parisien I wondered if anything in Haiti would have improved since my June 2010 trip, but I was pleasantly surprised by at least a few things. Some of the earthquake rubble in Port au Prince was indeed cleaned up. New villages are being built for people from the tent cities and one even had gardens in front of each structure and a playground.

But because much of the initial influx of aid immediately following the earthquake has now waned some conditions are now unfortunately worse. This time the electricity was off for hours at a time daily. The kids were not allowed to attend school the weeks we were there because of a “presidential mandate” even though it is a private school and they get no public funding. Cholera, just introduced in the last year, has now killed over 30,000 Haitians.

Despite all of this, this trip was even more rewarding than my previous trip because of our fantastic team dynamics and the feeling that we were able to accomplish some of what we set out to do. Our goal was to do small surgeries with low risk so as to help without doing more harm like causing secondary infections.

Even though our focus was these minor surgeries, Haitians come from far away with every conceivable malady.  One of the most memorable parts of my trip was an obstetrical case. A pregnant woman showed up with the baby’s umbilical cord exposed below the baby’s head. This is an obstetrical emergency because it will quickly cause fetal death from cord compression. John, our pediatrician held the head off of the cord and we were able to hear that the baby still had a heartbeat. We decided to start a Cesearan section on the mother. The 2 anesthesia providers, the pediatrician and I have attended hundreds of those surgeries but none of us had ever performed the surgery alone. We worked well as a team in less than ideal conditions with the electricity out and the wrong instruments and had a good outcome with a healthy mom and baby.  This experience exemplifies what it is like to practice medicine in Haiti where excessive bureaucracy and malpractice fear are removed and we can focus solely on the question of whether or not we can help a person with only the people and limited tools available.

However, the high points are contrasted with equally low ones. For example, I’ll never forget when a lifeless young woman was carried in with diarrhea and fever. She was so dehydrated from her cholera that we could not even get a blood pressure to register on her and she was the closest living thing to death I’ve ever seen looking like a skeleton with sunken black eyes. This is an image that will stick with me forever.

The most lasting and powerful gifts from my trip are my relationships with the Haitian interpreters. HCM provides the mission teams with interpreters who have grown up attending their schools. These people are brilliant young men and women who speak multiple languages and have even learned impressive amounts of medicine from visiting physicians. They are so eager to learn but they have exhausted the Haitian educational system and even if they could get higher education they might not find employment in a country where few people can work.

It’s hard to understand but I’m comforted by the belief that there is good in the world and that the human spirit can overcome hardships if we simply work together and know that things can change. It’s humbling and inspiring to see these interpreters have such positive attitudes and strong faith despite their lack of opportunity and lot in life.

My trips remind me not to take my shelter, my clean water, my electricity, my food, my opportunities and even my education for granted. I feel blessed to have what I have and all that I have learned from the Haitian people.


jengod said...

Wow, an umbilical cord prolapse! So glad the mom and baby both survived with your help. And thank you for sharing your experiences and observations. I was just thinking today how we take our own situations for granted as the "default" when in fact we really are living uniquely textured lives. Hugs to you and Dean and the kids.

Jack G. said...

Dear Doc Susie,

I’m very proud to be the Uncle of someone who devotes time and energy to adventures like your trip to Haiti. Amazing. Thank you and thanks for the blog.
Some memories from my less important adventures….
You mentioned watching a very modern medical machine being unloaded without any modern mechanical assistance. In Indonesia, many years ago, I was similarly bewildered as I watched very heavy and very delicate satellite ground equipment being unloaded, entirely by hand, at our control station south of Jakarta.
You mentioned a few things that are better in Haiti and the warmth and ability of the people. On our recent [luxury] trip to China we were amazed by the relatively high standard of living. Materially, the nation, or at least its big cities, is very modern and “Western.” The people of China accomplished this modernization without foreign assistance (or meddling). A few people in China are now quite wealthy and most people in China are now being fed. When I was growing up we were told that in the 21st century that the people of China and India would be starving.
You also indicated how thankful you are for things we take for granted in the U.S. Again this resonated with our recent experiences in China. China is doing well, but the typical American is still much better off than the typical Chinese—both materially and in personal freedoms.

Fondest regards,

uncle jack

Mark said...

Great post Susie! Looking forward to visiting Colorado again sometime.