Saturday, April 24, 2010

Wanted: Joe Martin... International Criminal...

Getting through US Customs in Miami was a breeze for most of us...

Apparently, Dr. Joe had quite a different experience, as his name appeared on the Department of Homeland Security's "watch list!"

Two and a half hours later... he rejoined the United States... We'll let him tell the story though...

Back From Haiti

It was quite a week of sweat, hard work, adventure, sweat, camaraderie, sweat, innovation and medicine. I said in my first blog how I was interested in learning and practicing medicine that was low technology and back to the basics. Well, I got my wish in spades.

My first day I had 20 minutes of training and then I was on my own. There were approximately 110 patients in the hospital and in the general medicine tent I was suddenly responsible for about 25 of them. I quickly figured out that if I wanted to do something that is usually a quick job in the US -such as grabbing a glucometer to check a diabetics blood sugar that it was not so easy. Typically the equipment needed was not available or no one knew where it was in the mass of people and chaos. I had to just figure it out. Innovation, intuition and basic training was the key to treating the patients.

A person with swollen legs, crackly lungs, an altered level of consciousness, labored breathing would be diagnosed as probable congestive heart failure and treated as such. We did not have an X-ray, or EKG for diagnosis and for 2 days we did not have a lab for blood analysis. If the treatment was effective then we continued it. If a patient needed to be propped up in a sitting position we made a wedge under the mattress with cardboard and tape.

Another thing that really struck me was the important need for people with all types of skills. We could not have done it without the PT's who got people moving again, and the pharmacists who sorted the mountains of donated medications and knew what to substitute when an ordered med was unavailable. The Lab people were back to microscopes and pipetting with reagents, no million dollar blood analysis devices.

We really needed non-medical staff who found or organized equipment, fixed broken cots, found donated coffee makers (important) and more.

The patients were physically tough, enduring major injuries without complaint and minimal care or pain medications. We did what we could and it was worthwhile week of hard work, sweat, giving, sweat, new friendships, sweat and helping the Haitian people recover.

Bob Parker, RN

Friday, April 23, 2010

Haiti in my rearview mirror

Early in the week the time stretched out towards alot of effort and hot tired times. I wrote in my journal about staying here mentally and being present where I was, which was a tad unattractive on the surface. Tonight I am celebrating my time here,and what I have seen and learned. It's like no meditative lesson you've ever seen on the menu. Haiti is full of love while mindful of its pain and more receptive to an embrace than the evening news may suggest. The people are us. The plane ride out will be as full of remembrance and sentiment as the plane ride in had made me flinch a bit. Cheers to Haiti, strong culture, strong people, place to come and think and do..

Dr. Joe, Ortho

Flaggite by way of San Diego, or: fun fact: hatians clean themselves as well as you do in your shower with a bucket and 1/100 of the water you use.

Iv'e seen things in my life that have given me pause before, but rarely so much in on particular place. Haiti is such a wonderful, colorful place, with so many happy people, despite the many factors stacked against it. In truth, I've never had a patient population so grateful for the care they were given. I've never had patients thank me so much, or ones that have touched my heart to this degree. The families of my patients were unlike almost any of those I've had in the states, feeding, bathing, clothing my patients (linens and baths were done by families.) Though many times we had no supplies (try going a day with only three pairs of gloves for three patients, no running water, the constant threat of losing power, eqipment that breaks when it's absolutely critcial, running out of a essential meds, no lab, no x-ray, no ct or MRI, no 12 lead, etc) and fought terribly oppresive heat, dehydration and humidty, somehow I managed to give the best care of my life (I gave a patient a foot rub and she told me that no one had ever touched her feet before!!!).
Somehow over the course of the week I found myself in the PICU, the NICU, and Peds every second I had to spare. The real future of Haiti, the children, absolutely broke my heart. We face death and code situations every day in the hospital at home, but it's a rareity to lose a child. Though we lost people in the ICU, the picu deaths in partiuclar and there were....a lot, were very very hard. For me, the PICU was just the start of a thousand first for me. I had never seen a dead child before this trip. I had never been there for the death of a child before this trip. In two years of working at a major city trauma ICU, I had never lost a patient of MINE to anunexpected code. Bluntly put, those parts, they sucked, and I won't soon forget them. For every one of those moments though was two of sheer happiness. Feeding an infant so small and malnourished they were smaller than my hand. The day our cerebral malaria pt fianally woke up and spoke to her 10 year old daughter who slept on the wooden and dirt floor next to her every night. The massive tent city just outside port-au-prince, with one single solitary makeshift kite flying gleefully over it, oblivious to the abject poverty and stuggles below it... These are the images I will take home with me, the ones of hope, the ones of need. Haiti faces so many socioeconomic challanges on it way to deveoplement. The paitents I helped, the amazing voulanteers I worked with, the families of the ones who died this week, and the awesome kids, they still need help. Haiti will never make it without the Hatians doing the majorty of the recovery themselves, but they need healthy bodies to do it. Please consider donating to project medishare. God knows they need the supplies. But try coming down here and putting in your own time. It my not change your life, but it will change someone elses.'

Before I leave, I'd like to send out a special thanks to all of those who helped me this week, and those other volunteers who I was fortunate enough to spend time with. You brought me through the frequent hell that is life here with your smiles, your insights, and your love for your professions. Additionally, the Seattle team... You make me want to quit adults, move the the northwest, and work a PICU. I will miss you terribly.


Michael L.

The end.

I am writing on the last night I will be in Haiti. A whole week has gone by and I can't believe how fast and amazing my time here has been. While here I have felt the whole range of emotion which for me is not usual. I started my week in the ICU and after two days moved to the med surg tent where I stayed for the rest of the week. Each day I was overwhelmed with the needs of the pts, the heat, stress, pain and crazyness that was common place there. I can't say enough for the staff I worked with.It was a honor to be able to work along side for a whole week the same people. The nurses who ran their buts off. The doctors who gave the most caring, attentive and best care anyone could be expected to do with the resources they had. I have made friends and will miss them. The pts and family have truely bless me and I will not soon forget their faces or ability to make me smile. I have many stories I could tell but not the energy to tell. Only to say I didn't for one moment regret coming here and hope and pray this will not be the last time I am able to be apart of this type of experience.

Ben

The Last Day

It was quite difficult getting up this morning (even though my entire body was sticky and sweaty from this humidity); this week has been the most work I have ever made it through...over 100 hours of work...and some people worked 24 hour shifts (like Mike being the only ICU nurse the first 2 days who then transitioned to a PICU nurse today when we were slammed). Today was a difficult day with an emergent peds trauma that we quickly rushed to the OR where I was trying to hang a dopamine and epi drip with no pump and only a pen and paper to do the calculation(thanks Erica! Calculators are yet another item taken for granted!) Right when I was done with the drip I heard Mike tell me that they needed a PICU nurse to start an IV on a new code so I rushed back on over (...we need PICU nurses here!) As I was leaving the OR, I saw one of our amazing doctors-Tom- trying his best to help this child as he was pulling his own blood out to give him as he was actively bleeding and we had no blood available (we only had two units that we had already used). Everyone here cares so much and has been doing everything that they can to help. It is so different here then it is in the states...if a doctor was trying to save a life by giving a child his own blood because there was nothing else available in the U.S., I'll bet that he would be sued...here the families know that everything is done to help and with a good heart. I have enjoyed working here with families that are grateful that all you can do is give them a cot right next to 15 other kids and their families crammed in a small 12'x25' portion of a large tent that is boiling hot/humid where as in the U.S. the patients/parents will complain that you only have apple and orange juice but not cranberry. I have been very honored to be a part of this as difficult as it was. I have learned not to waste anything (even if it is a buritrol that is missing a peice or is not compatible with anything....Ray can turn it in to a spaceship so "don't throw anything away!" he told me.....which by the way last night he and Derek ended up opening the wine bottle with a spinal needle into the cork and pushing air into it with a 30 cc syringe). I can't beleive it's the last day...thanks to everyone who has been a support to us. It really makes a difference here in Haiti. There are so many children that would have died from simple dehydration and yet they have a chance. And not only on the medical aspect but just the basic care to humans (love and compassion). Today a child told one of our workers "I love you and want you to be my dad" (her dad died in the earthquake)...that was heart wrenching. Anyways I am so excited for home but I know I will miss it here as soon as our flight leaves. Thanks again!

Tara-PICU RN

Thursday, April 22, 2010

Adventiste 'Ospital...

Dr. "Joe" and I went to the "Adventisite 'Ospital today..." we spent about 6 hours there, I was the only "OR Nurse" there! Nurses are needed desperately! Not only at Medishare, but in the surrounding hospitals!

Took a 1.5 hour tour thru the city of PaP to get there... truly unbelievable! I took a tour in February vicariously... thru those in my team that got out into the city... Today... first hand... Not much has changed! Tent cities everywhere, a lot of destruction and devastation...

Our driver took side streets to "avoid" traffic... the emergency blinkers were on, which actually commands some respect from the Haitian people... along with a few well placed blasts on the car's horn...From Adventiste... we took two patients back with us to Medishare... Try cramming 7 people into an SUV designed to carry 5... add a long spine/back board, personal belongings, hang two IV's, and keep a Styrofoam container lid on as one speeds 40+ mph thru PaP becuase the windows are down and it is much cooler than trying the A/C...

Sry... not a lot of pics...


Ray

Wednesday, April 21, 2010

Baseball anyone?

This evening, after a very long and stressful day in the OR, several of us (techs, nurses, surgeons) were sitting around and were talking and decompressing. The topic of conversation somehow came around to Whiffle Ball...

That led to a piece of webril being unwound, wadded up, and then encased in a thin layer of duct tape...

Which of course led to an excursion to our supply tent, which we found an unusable piece of aluminum (part of the end support brace for a cot), some cotton batting (there are thousands of rolls...), then the idea to use up some of the fiberglass splinting/casting material we have (a gazillon rolls of...), add a small roll of coban to the end... and what do you have.... a baseball bat!

By 4:30 pm we were in the field at the western end of camp... bases set... pitching and batting practice done... when we had the first ever, official baseball game, lasting only two innings, in Port Au Prince, at the Project Medishare camp! We even had a few people watching and cheering for us!

Tomorrow is the second day in our season, and we have quite the roster of individuals who want to play!

A little diversion... a little piece of home... a little fun...

Gotta keep it all in perspective! ;)


Ray

Inexperienced

There are no words for the inadequacy I felt today. By 730 AM we had two teams at the gate triaging people trying to send only the most severe acute cases we could to the ER. They gave us antibiotics, otc pain relievers, and many other assorted medications and told us to only send back what we couldn't fix at the front. We saw people who had cancer and had to turn them away because of a lack of proper equipment. Yet each one was thankful for being able to get some sort of medical care for their problems. Thank God for the flagstaff team everyone has been a rock star helping out in everyway possible. Definitely the trip of a lifetime

Nate
Where do I start...this trip has been the most work, in the most extreme conditions, but yet at the same time the most fun and exciting time I have ever had working as a nurse (and many other occupations that I would never be able to do in the states). The heartache here has been more than you could fathom but the strength among the Haitians even more. I have learned so much from my experience here and it is not even half way through. As I arrived at the Port au prince airport and watched people as I went through the custom process that was set up, I thought to myself 'everyone here that I am observing probably is thinking about a lost loved one as they work'. We arrived at the Medishare tent hospital and has a brief tour. I was immediately sent to work in the PICU where I have had more experience in the first two days than I have had the last few years as a nurse. The need here is tremendous and I begin to feel overwhelmed at times but I remember that if everyone helps just one person then that makes this an entirely different world. The Haitains and volunteers that are here are amazing. We have all become support for each other in emotional times of loss and sorrow and through that have been truly blessed. Volunteering your skills and love to people is the best thing that I have ever done...AND I have learned how to be an engineer for just about anything I need with whats available...oh and also that propel doesn't have any sodium in it so don't chug it when you are working nonstop in a tent in Haiti when the ac is turned off and you are sweating constantly or else you will feel dizzy and need to get an IV by one of your fellow nurses. Ok now I need to help Derek and Ray figure out how to open the bottle of Furia Merlot with the few resources consisting of two can openers and a rubber mallet.....there are also some small pebbles on the ground. Thanks for all of your support!

-Tara Cecil @2300

Totally worth it!!

The time we spend here in haiti is short, but the experiences last a lifetime.

Ray and I were the only O.R. crew for two days, during that time we did 23 cases ranging from Femoral external fixators to c-sections. On Monday we welcomed a O.R. trained nurse and an ortho scrub tech, however during the next two days the scrub tech was not around the facility. He was able to go abroad with the surgeon he came with to do cases at other facilities in the port-au- prince area. This left myself as the ONLY scrub tech in the Medishare hospital. Pretty busy!!

Tonight I was waiting line for some dinner when a STAT C-section came in, so much for dinner!! within 5 minutes I had scrubbed in and pulled instruments, I had never even met the surgeon. Talk about pressure!! I was literally sweating bullets. The patient was fine and the baby was a beautiful boy!! SUCCESS!!

That is why I do what I do.........miracles happen every day

I LOVE MY JOB.


D

Tuesday, April 20, 2010

Wednesday April 21, 2001

It is very late Tuesday/early Wednesday morning here in Haiti...

We have been very busy, all of our team has been working hard and going above and beyond! The "rainy" season has definitely begun! Almost two nights in a row now, fairly late, but significant rainfall! No flooding per-se, as trenches have been dug around the compound to shed the rainwater into pits... that are subsequently pumped out into non-critical/less chance of flooding areas... Hot during the day... Hot and humid in the afternoon! The early evening breeze around 6pm is a welcome diversion!

Mosquitoes abound in the early evening... 40% DEET is a must!

I checked in on a former patient this evening (from our previous trip in February), the first chance I had... he is still here and maintaining, in good spirits and is hopeful... Which is a miracle in and of itself If you are prayerful... please include "Jean" in them... I am sure God knows who he is...

I can only speak for myself, but in three days, Derek and I have done about 30 cases in the OR... crazy! As the only two people with OR experience... we were thrust into Ortho, OB/GYN, ENT, General, and Neuro cases...

Please bear in mind... there are limited resources here and we are opening an "Ophthalmology Pack" to get a couple of sterile gowns, a back table cover, a few sponges, and a drape or two... in order to do an Ex-Lap! Of course we add as able... maybe a pack of Laps or two, instruments as available, a bovie...

However, I will let others explain their experiences! Last night and today was particularly rough for all of us... Let their posts tell the story...


Ray

Some pics...





Sunday, April 18, 2010

Day #1

Well, we have been in Haiti now for about 36 hours. I am working in the Med-Surg adult tent along with 4-5 other nurses. It's been many years since I have done staff nursing but you just have to dig in to get the work done. My fellow RNs are an incredible bunch which makes the working environment much more enjoyable. I am looking forward to an incredible experience here over the next week. I hope that my contributions will aid the Haitian people in some small way.

Beth

Thoughts on being the only one of two

Well here we are back in Haiti......WOW what a difference, this place is totally updated and ready for the rains. We have walkways, we have tents over the eating area. The supply tent is like a WalMart...... AMAZING!!!
The only thing I see being a problem so far is the fact that Ray and I are the ONLY Operating Room trained personnel. That means we are responsible for EVERYTHING surgical. Saturday we had to jump right in and bust it out!! We did. We managed to do 6 surgeries ranging from a femur fracture to a c-section. It really put my critical thinking to the test. I love it.

We are on call 24-7, so I'd better go.

Peace--D

Sunday, April 18, 2010

Well we made it to Haiti!

Finally found some time to get on the internet and post! For those that were here in February... a lot has changed! My comment was, "this place is like the Hilton compared to when we were here before!" So much has changed, wooden sidewalks between tents, gravel everywhere else, drainage ditches, etc! I will try to upload pics in the next day or so...

Our team just dove right in! Amazingly most have adapted and are fitting right in... The ED is still open, but not the Triage area... Peds ICU has expanded, Adult ICU has been moved out into the PEDS tent area... there is now a 4 bed PACU where Adult ICU was... Med/Surg is pretty much the same... the Ortho Tent across from the Wound Care tent is now Physical Therapy... they have put up another small tent and are actually teaching school/day care... and the supply tent, unbelievable what they have done!!! Like a Super WalMart now!

All in all, I am amazed at the organization and upgrades that have taken place! But, we are in Haiti... and tonight the decision was made to turn of the A/C to conserve electricity... it seams the diesel fuel is in shortage in Haiti, and to keep electricity running, the A/C was shut off (it consumes 80% of the power...) So we will be able to keep the lights on, the internet up, and the ventilators running for an extra day or so without A/C, otherwise, it would all be gone by tomorrow morning!

Stay tuned! Unless the power goes out before we get resupplied with diesel fuel....


Ray

Saturday, April 17, 2010

Take Two

Here we sit at MIA, waiting to board the Vision Air flight to Port-au-Prince. I really can't believe my luck, I have been afforded the opportunity to take the trip of a lifetime TWICE. I am blessed to have the support of my family and co-workers in the effort to get me where I am today.

THANK YOU. Without your help I could not do this.

The crowd here is very diverse. I enjoy watching the families departing to Cuba, The Dominican Republic, and all points south. Style is everything to these guys, I could people watch all day;)

Anywho.... We gotta get on the plane.

Peace, D

Saturday, April 17th


Well it's 3:30am in Flagstaff... and we are about to board our VisionAir flight for Haiti! Just like last time, we really don't know what type of internet access we will have. So please stay tuned!

A diverse group indeed!

Updates will be posted as possible. Again, thanks to everyone that has, and is continuing to support us!

Friday, April 16, 2010

Preparing to go!

I was told that a good portion of the feedback received about previous blogs (not mine) were questions such as: "What did it feel like?", "What were your fears?", " How did you prepare?"
So I will detail a few of my thoughts before departing tomorrow.

I received an email about the April 17th trip, on about the same day I had given notice to leave my previous nursing job at FMC. It just clicked in my mind... "I want to go to Haiti." It was perfect timing to be temporarily unemployed with the world and all of its possibilities before me... I signed up the same day!

I have had a long interest in working internationally as a nurse, and this was a good opportunity to realize that dream. I have traveled widely and have been to about 35 countries, so I felt comfortable about stepping into the unknown. I have learned through countless travels, that the majority of the people of the world, are good, friendly and helpful. I did not worry that the people of Haiti would be any different.

Actually, my biggest fear is... the constant heat and humidity! I hate high humidity, but I will deal with it, I chose to go... so I won't whine.

My last feeling that I cover here, has been my interest in learning and practicing medicine that is low technology and yet, requires critical thinking and innovation to give care. Much of the world has little of the high technology that we use to practice medicine in the US. Many people are suffering in Haiti tonight without a Tylenol to ease their pain, or even safe water to drink.

Bob Parker, RN

Thursday, April 15, 2010

Thursday - April 15, 2010

I know of one person from our team that should be arriving in Miami within the next hour! They left Flagstaff around noon today, about the same time I did, but they flew, I drove! I had a few things to accomplish before I departed...

I am now sitting here at Phoenix Sky Harbor Airport waiting to board my "red-eye" to Miami... I will arrive around 9:30am local time on Friday.

The vast majority of our team will be arriving in Miami throughout the day on Friday, the last, very late on Friday night. We are scheduled to depart from Miami to Port Au Prince, Haiti on Saturday at 7:00am local time... that means a 3:00am wake up to allow for preparation, travel, check-in, TSA, boarding, etc...

Once again, we do not know what the internet connectivity will be once we get there. In February it was poor and intermittent. We will attempt to post to the blog and upload pictures as much as possible, but it may be limited until we return on the 24th.

It will be interesting to see the changes that have taken place. Likewise, I am curious about the things that haven't changed... the people, conditions, and other things...

I have been charged with a few missions... checking on certain people and patients... I will make this a priority to report on, if we have the ability!


Ray

Sunday, April 11, 2010

Less than a week to go...

It is now Sunday, April 11th... in less than 6 days another team from Flagstaff will be starting the journey to get to Haiti!

Please keep us in your prayers!

Thursday, April 1, 2010

Friendships...

I am totally amazed that over 140 people got on an airplane in Miami and flew to Haiti one day...

That day, unless you knew your group and the people in it, everyone else were complete strangers. A week later...

Most of those same 140+ people got back on an airplane in Haiti and flew to Miami...

Almost everyone knew each other. We had shared time with, worked with, or had been involved/in contact with almost everyone that went! Disparate groups, shared a common experience, got to know one another, made contacts, and are continuing the friendships to this day! From the "micro," our Team... to the "macro," all that were on the flight... to the "global," those that were in Haiti when we were, including a quite a few Haitians!

As Flagstaff prepares to return to Haiti, with two separate teams to return in April and May...

Let us all hope that the same will occur again!

For those on FaceBook...

Search for and join the group:

Flagstaff for Haiti