Report of Trip by Support for Haitian Helping Haitians

Report, trip to Haiti

Support for Haitians Helping Haitians

January 27-February 8

Carlyle Schlabach MD and Chad Bates EMT-B

Chad Bates and I traveled to Haiti to investigate

opportunities to support Haitian physicians and

nurses who are helping Haitians and improving

health care. We met with Haitian physicians and

nurses, spoke with North Americans who are

working with Haitian health care, visited Haitian

health care facilities, and attended several

conferences.

The trip was very successful in meeting our goals. We were able to ask questions, get

good advice and identify potential partners. We presented ideas for collaborating with

Haitian physicians and nurses to bring Comprehensive Advanced Life Support and/or

Advanced Life Support in Obstetrics courses to northern Haiti. We are now ready to

present a plan for collaborative projects between North American and Haitian health

care workers.

What we learned:

1. Dr. Ernst Robert Jasmin, Director of Health for North

Haiti, has placed Maternal health care and Emergency

health care as priorities for North Haiti. He supports our

idea of training programs in Obstetrics and Emergency

Medicine for physicians and nurses in North Haiti.

2 Many Haitian physicians expressed interest in

assisting with or receiving training in Comprehensive

Advanced Life Support (CALS) and/or Advanced Life

Support Obstetrics (ALSO). Some physicians

expressed interest in becoming CALS and/or ALSO

trainers.

3. Drs. Khalil Turennne and Dr. Martine Dorsainvil

suggested that CALS would be the first priority for

training at Hospital Justinien in Cap Haitian. Physicians

and nurses seeing emergency patients would benefit

from the knowledge, practice and confidence that would come with receiving the CALS

course.

4. Dr. Galit Sacajiu, director of the Haiti Medical Education Project (HME), is interested

in incorporating our training initiative into her organization.

5. Some groups have already begun to provide emergency medical education in North

Haiti.

6. Many facilities have times when medicines and lab supplies run out. Many facilities

have difficulty in keeping medical equipment repaired.

7. Some facilities have difficulty in access to anesthesiologists, nurse anesthetists, x

ray technicians, and other support services.

8. Medical teams from outside Haiti who do surgery or clinical medical work can be of

help. One facility would like to have North American surgeons do surgery in partnership

with Haitian physicians in order to have sharing of surgical expertise. However, visiting

medical teams can cause problems. There may be problems with continuity of care. For

example, surgical patients may suffer complications after surgeons have left or patients

may run out of medicines after physicians start them on treatments for chronic

conditions such as hypertension and diabetes.

9. Some Haitian health care workers are seeking help in organizing emergency care in

their facilities and in the region.

10. There are clinics in underserved

areas in and around Cap Haitian that

would benefit from financial

assistance to help them expand their

services.

11. Community health evangelism is

an innovative holistic approach to

improving conditions in communities

with needs. It is a grassroots

approach that identifies and

mobilizes already existing resources

and organizes communities for

mutual support and empowerment.

What we propose:

1. A Comprehensive Advanced Life Support (CALS) class for physicians and nurses in

North Haiti to be held at Hospital Justinian within one year. This would be a

collaborative effort between North American and Haitian physicians and nurses and

would include training in CALS and training of trainers. The class would be an addition

to the Haiti Medical Education project directed by Dr. Galit Sacajiu.

2. Possible expansion of training to include Advanced Life Support Obstetrics (ALSO),

and to take training to other sites in North Haiti.

3. Exploring ways to collaborate with other groups in emergency medicine training.

4. Discussing with key informants ways to make basic medicines, medical supplies and

equipment more reliable and constant in Haitian health care facilities.

5. Discussing ways of increasing the availability of medical support personal such as

anesthetists and x ray technicians.

6. When possible, linking donors with clinics and hospitals in areas of greatest need

and accountability.

7. Participating in joint efforts to increase the organization of emergency services in

North Haiti.

8. Sharing about Community Health Evangelism, its availability, principles and process.

9. Fund raising in order to provide free training with food provided at a comfortable

setting, and to help pay for equipment, drivers, translators and short-term assistance.

We will encourage trainers to pay their own expenses or to arrange their own financial

support.

10. Changing the name of this project to "Mache ak Ayisyen ede Ayisyen: Walking with

Haitians Helping Haitians." This will help to communicate that our project is about

developing relationships that encourage Haitian health care workers.

Who we met with:

Baraka Clinic, Ferrier

Dr. Nirla Nelson

Cap Haitien Health Network:

Maudelin Mesadieu MD, Country Director

Djailcovsky Aimable

Clinique du diabète, Haut-Limbe

Dr. Emmaneul Mareus

Clinic ORLO, Petionville

Brigitte Hudicourt, MD

Clinique Communautar El Rapha, Cap

Haitien

Dr. Pedro Jn Pierre

Cooperative Baptist Fellowship, Haut-Limbe

Nancy B. James, RN

Stephen W. James, MD

Empower and Advance, Fort Liberte

Ayesha Khan, MD, MPH

GE Health Solutions

Francoise Juste, RN MA

Global Therapy Group, Petionville

Donna Hutchinson, PT

Haiti Hospital Appeal, Cap Haitien

Carrwyn Hill, CEO

Dr. Paul Toussaint, Medical Director

Haiti Medical Education Project

Barbara Ley Toffler, PhD., Director Nursing Education

Galit M. Sacajiu MD MPH, President and Medical Education Director

Hopital Bon Samaritain, Limbe

Dr. Nichael Armand

Hopital Justinien, Cap Haitien

Khalil Turenne MD

Marine Dorsainvil MD

Hopital St. Jean, Limbe

Dr. Calixte

Hopital Sacre Coeur, Milot

Harold Previl MD, CEO

Kombit Sante, Cap Haitien

Nathan Nickerson, DrPH, Executive Director

Tezita Negussie MPH, MSW

Mama Baby Haiti, near Cap Haitien

Santo Choute, Haiti Operations Director

Medical Ambassadors International

Bibliana Mac Leod, MD, Regional Coordinator

Osse St. Juste, Area Coordinator

Meds & Food For Kids, near Cap Haitien

Patricia Wolff, MD Executive Director

N a Sonje Foundation, near Petionville

Carla Bluntschli

Ministere de la Sante Publique et de la Population

Dr. Ernst Robert Jasmin, Director of Health Department, North department

Unite de Lutte Pour La Sante, Fort Bourgeois

Maudelin Mesadieu MD

Thank you for your interest in the project, "Mache

ak Ayisyen ede Ayisyen: Walking with Haitians

Helping Haitians." I hope to send an update and

ask for your comments and advice once a month.

Carlyle Schlabach MD

Change of email address

Hi all

Please note my email address has changed.  Please contact me at hannahlouissaint@gmail.com.

For Haiti Village Health enquiries please continue to contact me at hannah.haitivillagehealth@gmail.com.

Many thanks

Hannah Louissaint (nee Steadman)

Change of email address

Hi all

Please note this is my new personal email address.  I will no longer be checking my hannahsteadman@hotmail.com or hannahsteadmanhaiti@gmail.com accounts.

For conversations relating to Haiti Village Health, please continue to use hannah.haitivillagehealth@gmail.com.

Many thanks

Hannah Louissaint (nee Steadman)

Ounaminthe visit

Today, Covsky and I met Dr. John Nelson, Canadien metabolic specialist and Medical Director at Univers Medical Center in Ounaminthe. Got my first look inside very impressive facility that was still busy at 5 PM today.  

The lab does several chemistry tests, including nbil (for neonatal jaundice), in addition to standard hematocrit centrifuges, manual cbc by microscope (QBC machine needs repair), antibody tests for malaria (and syphillis).  They have a functioning, nicely equipped x-ray suite and dental treatment room.  Very nicely stocked and organized pharmacy is pictured.

Dr. Nelson is pictured in their 24 hours Urgencie room.  While it was empty during my visit, the clinic was still busy after 5 PM.

We also saw the progress at the Medical Center at Danita's Children, also in Ounaminthe.  It was beautiful to see it.  Pictured is their modern looking pharmacy through smoky glass. They are seeking an x-ray machine for their dedicated x-ray room. They have a nice recreational therapy room for children with disabilities. 

Thanks to Karris for the impromptu tour and great display of Spanish and Kreyol!

From:

http://www.krzystek.eu/searchid.php

Network Meet and Mingle meeting of March 6

In addition to a good turnout of new and old Network members, we had the treat of hosting professional photographer Wayne Chinnock at our informal "Meet and Mingle" meeting on March 6.  Wayne worked with our partner Haiti Help Med in the south and with some other organizations in other parts of Haiti before coming up and spending the week with Hands Up for Haiti.

I have posted all the pictures to our Facebook group "Cap Haitien Health Network", but have included a couple highlights here.  As we usually do at these meetings, everyone had a chance to introduce themselves and their organization before breaking off to discuss things with each other. 

There are many other images of Wayne's experience in Haiti on his (Wayne E. Chinnock) and the Network's Facebook pages.

Visit to Perches

We made a brief stop in Perches on Feb. 8 after our clinic in Danda.  We had Dr. Mesadieu, who does mobile clinics there, Dr. Eugene, Dr. Ally Joseph, Juline from the Network Support Team, Pastor Elima Etienne from Danda, and some of the visiting students from the nursing and surgical tech school from Lorain Community College in Ohio, with Joseph and Jean Brunel, interpreters, all in Dr. Eugene's truck.

The Network recently connected with the Haitian Baptist Church of Orlando which it turned out has connections, through their pastor, in Perches.  Pastor Antoine Fils-Aime is from there, and has directed his church to assist the village in a long term, broad way.  They are building a new church, which will have a clinic.  They bring a team with medical and other volunteers to the village at least once a year.  Patrick Delice and Jean Leblanc are part of the HABCO Haiti mission leadership team that I met in Orlando.

I was surprise that Perches was a little larger, better organized, and nicer than expected for a village that does not show up on most maps.  It is in the northeast department, not too far from Grand Bassin, which is a central larger village south of Terrier Rouge.

Dr. Mesadieu introduced us to the nurse in charge of the Dispensaire of Perches (currently the only healthcare there), named Paul Marie Lourdes.  She is pictured with Dr. Mesadieu.  Coincidentally, he and her husband also have a connection with Fort Bourgeois, way back near Cap Haitien, where Dr. Mesadieu has his ULS clinic.  We also met the other nurse of the dispensaire.

The dispensaire has an exam room, a central main room, and a pharmacy with just a handful of meds on part of one shelf.  

They have a separate semipermanent cholera tent, an education area, and a latrine.

They would welcome visiting volunteers and mobile clinic teams to help them.

On the way out, we stopped at the guest house that the HABCO members stay, and met the owner.  It was a very nice house with nice grounds, and they were receiving visitors just coming in for Kanaval.

We look forward to working with Perches and HABCO as participants in the Network.  

Lecture at Justinien

I was happy to be invited to speak on a pediatric topic at the conference room of Justinien Hospital on Wednesday, Feb. 6.  The talk was organized by Patricia Sedlak, RN, professor at Lorain Community College in Ohio, and Yanick from the the North Haiti Nurses Association.  Continuing Education Credits for nurses with American licenses were arranged, too.  The pediatric residents and some other doctors from surgery and anesthesia also attended, as well as Pat's visiting nursing and surgical tech students.  The room was PACKED, at least 60 people, I would estimate.

The talk was entitled "Essential Physical Assessment in Pediatrics, or, Why a examination must be done for a sick child".  The power point presentation, with some pretty clear photos I was able to gather, is posted on the files section of the Network's Yahoo group, if you are interested.  The talk was very practical and clinical, emphasizing how the findings completely change your management, so if you haven't examined for them, you can easily be doing the wrong management for your patient.  I also was able to demonstrate ausculation, ear, and throat exams through the projector and demonstration.  I also brought a digital camera integrated otoscope which didn't work great but did show some of the picture of a normal ear to the audience.

I had some nursing students try to look in one of the visiting volunteers ears to demonstrate that technique.  I think it is especially important to Haitian nurses who often practice along in village dispensaire's.  One of the first students scratched the volunteers ear with the ear speculum; after that I could show the next students what blood in the ear canal looked like (but I abandoned having them using the otoscope solo--I told them to practice on ear other).  

A lively discussion followed the talk.  We have the help of young surgeon , who turned out to be the best medical English-Creole interpreter in the room.  I also had the great help of psychologist Dr. Joseph Saintus who interpreted the bulk of the presentation.

I haven't done something like this for a while, and it was always with a much more dry research bend, so it was different, and pretty fun, and I think gave the audience something to think about, and something to practice!

Haiti Village Health Medical Team

I spent a week in January working with Haiti Village Health's medical volunteer team providing paediatric outreach clinics.

The team was made up of 3 doctors, 3 nurses, 5 nursing students and non medical support staff.  We saw a total of 375 patients across the region of Bas Limbe, Ladadee and Shada.

We treated a lot of children for worms, scabies, tinia and malaria.  We also provided a lot of education for the patients and their mothers during the consultation, on general hygiene, how to prevent malaria and cholera, and ways to improve their level of nutrition.


This pie chart shows the overall ratio of diagnoses throughout the week:

The team, many of whom had been to the region this time last year, commented on how the overall health of the children had improved since they last came.  We saw many more 'well children', than previous years, which was positively reinforced to the parents.

We also provided education session for the youth of Bod Me Limbe and Labadee on sexual education.  We talked about how to protect against STDs and the team answered questions asked by the young people.  The team also helped the community of Bod Me Limbe to do a beach clean-up.

I personally think its a great idea that medical teams come to the north of Haiti to provide consultations for people who have poor access to healthcare, and to provide education on health promotion and disease prevention to these communities.

Report from MSPP Nord Director: Une prise en charge adequate realisee en urgence a Justinien

(google translate of message below:

 

I share with you these photos taken during surgery for thoracoabdominal wound on a youth, pierced by an iron bar.

It has just been extracted without complication.

Despite various constraints, providers of HUJ perform amazing feats every day that deserve also be rented. Major efforts are currently being made ​​to change the face of HUJ and make it a public institution model.

Stay close to us and support these efforts. )

Bonjour,

 

Je partage avec vous ces photos prises lors d'une intervention pour une plaie thoraco-abdominale, sur un jeune, transpercé par une barre de fer. 

 

Il vient d'etre exéaté sans complication.

 

Malgre les contraintes diverses, les prestataires de l'HUJ réalisent chaque jour des exploits extraordinaires qui meritent aussi d'etre loués. De gros efforts sont en train d'etre faits pour changer le visage de l'HUJ et faire de lui un etablissement public modèle.

 

Restez proches de nous et soutenez ces efforts.

 

Dr Ernst-Robert Jasmin
Directeur DSN

MSPP/HAITI

Rue 18 Boulevard, Cap-Haitien, Haiti                                 
Tel :  3721-1935