Our group of 7 landed in Port au Prince on Saturday, January 12, 2013. We had 2 physicians (internist and pediatrician), a Haitian-American nurse, a Haitian-American emergency medical technician, a Haitian-American social worker and two social workers-pharmacy technicians. We had worked together before, although not as a team of 7.
Our hosts drove us to Residence Filariose, operated by the University of Notre Dame, and named for the treatment of filariasis, in Leogane, the epicenter of the January 2010 earthquake. On Sunday, we made final preparations to teach the 2-day Public Health Assistant (PHA) course, assembling instruction booklets and medical equipment and dividing our team into 2 teaching classes. We also prepared baggies of medications for the 3 medical clinics.
On Monday and Tuesday January 14, 15, we taught two groups of young adults in grades 11, 12, and 13 the PHA class. There were equal numbers of young men and women, by design. We held the classes in two different rooms in the Hopital Sainte Croix (Hospital) in Leogane. The classrooms were very warm, with little or no air flow, and the students were cramped for space…just like classrooms always are in Haiti. After an introduction regarding healthcare
professionalism and patient confidentiality, the class consisted of two ½ days of didactic instruction regarding diseases in Haiti and two ½ days of practical training involving universal precautions, vital signs, wound care, bandaging, splinting, slings, and medical technology applications. The students learned how to use the individual lancets to obtain a drop of blood which could be used for multiple tests. We taught how to use a glucose meter, malaria test kit, and automated blood pressure devices. We disposed of used contaminated lancets and other materials in red plastic (hazard) containers.
The common diseases in Haiti that we discussed in the class were athlete’s foot, head lice, eczema, mosquito-borne infections such as malaria, dengue fever, filariasis, and yellow fever, plus water borne infections such as diarrhea and worms. We circulated samples of antifungal cream, bottles of Rid or Nix, and tubes of hydrocortisone cream as props to support the teaching. The students asked many questions about all the topics, but they were particularly interested in AIDS and STDs. We also taught a 45-minute segment on dental hygiene, using a large toothbrush and huge set of teeth for props.
At the conclusion of the second day, the students attended a graduation ceremony and received a certificate as a Public Health Assistant and received a goodie bag with some donated supplies such as Tylenol, Band-Aids, sticky pads, a toothbrush and toothpaste, and hand cream. Of note, many Haitians seem to prefer a toothbrush and toothpaste rather than candy or gum.
On Wednesday, we travelled to the rural community of Baussan, about 5 miles outside Leogane, and saw about 100 patients. We proudly wore the red “Henry Schein Cares” shirts for this clinic from our corporate donor, Henry Schein, Inc. There were about 10 community members present when we arrived in the morning, but word spread quickly that a medical team would see patients, and soon many people populated a courtyard area.
We rearranged some chairs and tables in a large meeting hall, partitioning off 2 exam rooms, and setting up 2 pharmacy supply tables.
We repeated the same mobile clinics on Thursday in Novilos, and on Friday in Carrefour Croix, both about 5 miles outside Leogane, but in different directions. We saw a total of 310 patients in the 3 days. In each of these communities, some people had been seen at the Hopital Sainte Croix within the past year or two for either an acute condition, such as a fever, or a chronic condition such as hypertension or diabetes.
Of the common disease problems we encountered, hypertension, arthritis, various scrapes, cuts, and burns are common, while symptoms of headache, backache, and stomach ache are nearly universal. Hypertension is endemic due to genetic predisposition and possibly related to salt intake. There is little variety in the food available to most Haitians, so salt and hot sauces are prized to flavor food. Diabetes was also common, much more so than one might expect given the paucity of sweets and food in general. We performed ear and eye examinations with donated equipment. Most Haitians do not have glasses for worsening vision, but are grateful to have any pair of reading glasses or distance glasses. One lady noted that she could no longer thread a needle to sew because she could not see the hole in the needle….so she had a daughter do it for her.
We left any remaining medications and supplies in the Residence Filariose for the next medical mission group.
Some of the notable patients we saw included a 61-year old man who accidentally punctured his left eye with a stick of sugar cane, a 4-year old boy with apparent deafness and no obvious middle ear infection, a 30-year old lady with a nasty 10-inch open burn wound on her left leg for which she had not received any medical attention in 5 days. We used donated equipment and low cost supplies to care for these and the other patients. We tried to arrange follow-up care at the Hopital Sainte Croix for these special patients.
Some of the lessons we learned, or re-learned were that people who live in poverty appreciate anything that others can do for them, or with them. But the real meaningful gifts are the time spent with them, and anything we share that might make their lives better, such as lessons about public health measures.
Our thanks for making our trip possible go to the University of Notre Dame and the Residence Filariose, Henry Schein, Inc., Blessings International, and Medical Missionaries, Inc.
Silver Spring Team (Maryland, USA)
Denise DeConcini, M.D., Myrian Louis-Charles, R.N., Dominique Parker, Emergency Medical Technician, Rodney (The Rod) Kerby (social worker and math teacher), Bob Ramin (social worker, nonprofit organization director, and pharmacy technician), Marie Osborne (social worker and pharmacy technician), Steven Osborne, M.D.