Monday, March 8, 2010

Day 9

Slept in a bit and Nick drove Omanes' (corrected spelling) van to Sunday morning fellowship meeting. Then had dinner there with our ministers and missionaries and also Irving and Sandra West and their son Barry who arrived yesterday from Virginia. (Sandra was a friend of Marilyn's when we lived in Washington DC 30 yrs ago. She says Tammie looks just like her mom did back then.)

Omanes took the rest of our bunch on a big sight-seeing tour through PauP. We brought the Wests and our ministers & missionaries back to J/P HRO to see the place.

One of our Haitian friends, Samdy Genese, was crushed in the same home her family members were killed in. All of the scrapes are healed but her arm still hurt. She hadn't seen a doctor yet. We x-rayed it and showed that the bone is healing well. She had a little leather lace-up wrist thing which wasn't holding it still enough, so we got her a splint. She's a teacher and is still working so needs to use her arm.

Some of our team left for home today and the rest of us will leave tomorrow.

There's a bit of a party atmosphere here...Domino's Pizza delivers! Omanes will pick us up at 7 AM to go to the airport. Next post will be from the states.

Howard

Sunday, March 7, 2010

Howard à Ayiti - Jour 8

Rick, Kim, Deb V., Arne, and Debbie C. all went to Citi Solei. No Army escorts, but everything went well. It has to be one of the most dismal and depressing places on earth, I’m told. They saw 260 patients in a private school compound and came back feeling good.

Bruce, Sarah, Tammie, Nick and I all went with Omenes to our church convention grounds in Cabaret. We visited the town’s government clinic. One doctor, 70 patients per day, minimal support from the government, no medicines, and 2 surgical instruments in his whole clinic. I took him 3 large boxes of supplies…much appreciated. Got a shopping list from him and filled three more boxes tonight which I will send out tomorrow with Dan. Tammie and Sarah gave out some toys to the kids at the grounds. I don’t think they had ever played baseball…this is not the Dominican.

Then Nick, Bruce and I helped pour the floor on one of our friends homes. It was partially completed when the quake knocked most of it down. They cleaned up all the old blocks and started over. I helped fill the cement mixer with sand and gravel, Nick and Bruce drove wheelbarrows of cement. They did the complete floor in about 5 hours. This is the 4th house they have done in the past few weeks.

Cabaret was hit less hard than PauP or Leoganes. Only about 1 in 10 concrete buildings are down. I think it might be because many in that area have metal roofs with wooden rafters. Concrete roofs are too heavy for the pillars.

We noticed on the way home that the streets in many areas of the city are much cleaner…all the rubble and garbage swept. Collected and piled at the end of the street to be picked up with a front-end loader. Omenes left his van here tonight and we will drive it to Sunday morning fellowship meeting in the morning. He has to pay to keep it in a protected place every night, so this saved him a few dollars.

Tonight we had another delivery. This one the baby came OK, but the placenta didn’t. Had to eventually sedate her and then attempt to remove the placenta manually. I think she had placenta acreta, and we sent her to Dr. Agenor’s hospital to get a D and C.

All for now................Howard

http://picasaweb.google.com/howardleibrand/HaitiDay8#

Saturday, March 6, 2010

Haiti Day 7

Rained all night and didn’t clear this morning as it has before.  Steady drizzle.  Canceled Strike Team today due to the rain, and everyone worked here in the clinic.  NYC medics left today, and new people are trickling in.  Two new nurses from Vermont. Bio-surveillance officer Jim Wilson who works for/runs a non-profit company called Praecipio (warning)… http://haitirewired.wired.com/profiles/blogs/haiti-epidemic-advisory-system He is here to evaluate the actuality and potential for infectious disease.  It’s rather interesting that Rick and I have been saying all week that what we are doing is rather unimportant compared to the Public Health prevention aspects.

Another baby today, didn’t do so well.  Full term but came out not breathing and had to be resuscitated.  We were unable to intubate her and the weather was too bad to fly.  Rick went with her in the back of an Army ambulance.  She is now intubated and in an incubator at the UM Hospital. Doing well.

Nothing dries out, mud everywhere, can't imagine living here under a sheet and 4 sticks.

Thursday, March 4, 2010

Day 6

Omenes drove Wade, Nick and me to Leoganes to deliver supplies and make some contacts for IMAT. CMAT (Canadian Medical Assistance Team) has been there since the first week. They did 47 amputations and numerous other procedures in that little tent. They are a group of ER doctors out of Vancouver Island and elsewhere across Canada. IMAT had a team with them earlier. They are in a compound with UNICEF, OCHA, and the UN. Leoganes is one of the hardest hit areas, both economically pre-quake and from the quake. Almost every concrete structure we saw was down or severely damaged. The quake was a great equalizer…everybody in a stick and tin house still has a stick and tin house, and now they have food and water and a job. All of the large aid organizations have hired teams of people to clean the streets, improve drainage, haul off garbage, and start to clean up the rubble. Each organization has different color shirt, like sports teams. Everybody is busy.

We stopped at the National Palace and took pictures from the 2004 Tower…built by President Aristede to celebrate 200 years of independence. It remains unfinished, as does the work of independence. Lots of traffic.

Delivered another baby today. Saw a kid with typical Kwashiorkor: thin limbs, big belly, large eyes and developmental delay from nutritional deficiency. Old grandma and blind grandpa are trying to raise him and his 2 older siblings after their parent and most of the extended family were killed. Wonder why grandpa’s BP was up a little and his heart skipped beats. Treated a lady tonight who spilled tea on her leg.

The strike team today went to City Solei, the poorest slum in this hemisphere. Lots of very bad gang influence there in past, but very polite people, many who had never seen a doctor. 6 Tylenol cost 3 days’ wages, so that is why many come to see us. Many “merci’s” later, they left a place worse than any Dante described.

Scott’s turn for an IV today. Patient confidentiality would prevent me from telling you he had bad diarrhea. Everyone else seems to be doing well.

It rained really hard last night. The big tent has a leak right over my face so I had to put the rain fly back on. I can’t imagine what the camps must be like. Some people have full tents, but some just have tarps and sheets over poles. And the water must flow right on through. Ox-Fam and others are working on drainage issues. (Ox-Fam, originally Oxford Famine Relief out of England. Now many branches in many nations providing many types of relief in many areas.)

Howard

http://picasaweb.google.com/howardleibrand/HaitiDay6#

(Update 05-Mar-2010) Dad's in a few of these pics as well:
http://picasaweb.google.com/DANLHENRY56/Feb25#

Wednesday, March 3, 2010

Day #5

I was on-call through the night but it was quiet. The morning started off with two quick normal spontaneous vaginal deliveries. One little boy with a comically proud and happy daddy. One little girl whose mommy was so pleased to get a girl. The only one who wasn’t happy was Rick who said I stole his delivery. The nurse asked me to check the patient because she wanted to push. Rick said, “Nah, she’s only 6 cm. I just checked her.” The baby was crowning before I could get my gloves on, and popped out seconds later. Stole his delivery, huh, the nerve of that guy.

Sad cases…teenage girl with a non-healing right forearm fracture, open wound healing OK, but needs an operation they won’t be able to do here for months. Young man with a nervous breakdown because many of his family were killed and then a brother was shot a couple of days ago. Young boy with a sickle cell crisis…we could fix him. Baby with hydrocephalus, vomiting, decreased level of consciousness, needs a shunt that they can’t do here. UM has a neurosurgeon, but may have to send her out of country. Kid with chickenpox who is now not infectious who was living with her family in our isolation tent. Time to go “home”…thought the tent was theirs to keep but have to go back to their tarp. Etc., etc., etc.

Another group (Sarah, Scott, Alex and Arne) went out to some orphanages with the NYC Medics to do clinics for the kids. One of the “orphanages” was a broken down building with a tarp over it. The other was a lean-to tarp spread along the side of a leaning wall between parked cars. Sarah says “I could quit my job and take care of all 25 of those kids.”

One of Sean Penn’s friends is a gourmet chef who usually cooks for traveling rock bands. Now he is volunteering for us. He went to the Dominican and picked up fresh produce and seafood. He made seafood fettuccine which was excellent. Then we helped unload about 4 tons of rice, water, and Malta. Malta is a local drink of carbonated molasses, not as good as Mountain Dew but more calories for the Haitian people. The rice comes in ten 3 pound sacks bundled together in plastic…much easier to distribute than a 50# sack of rice. Distributed by Global DIRT (Disaster, Immediate Response Team). They work a little off the radar, bypassing some red tape, using dump trucks and unmarked cargo box trucks, and working at night. They try to avoid the big crowds that interfere with distribution in other situations. They travel only at night and try to deliver inside locked compounds.

Howard

http://picasaweb.google.com/howardleibrand/HaitiDay5#

Tuesday, March 2, 2010

Day 4 Update from Howard

Arne, Kim and I went with the Army to a remote site clinic. They goal of these is to provide some medical care to people in tent camps who have no access otherwise. Today's site was down between the airport and the port. Hot. We set up shop under the cantilevered second story of a private school. It is cracked but still standing. You can bet I had an escape route planned. Hot. Five of us saw 230 patients in 3 1/2 hours. Most just wanted some over-the-counter meds and to know somebody cared. Others had legitimate medical problems, infections and wound checks. Hot.

The ride to-and-fro was interesting...about 6 Hummers in a row with lotsa guns. Much demolition going on. A few jack-hammers, but mostly strong backs and sledge hammers. Break up the concrete from around the re-bar and haul it to the street in a wheelbarrow, make a big pile and someone with a front-end loader and dump truck carries it off. A rubble causeway extends out into the bay and dump trucks can be seen making the "island" bigger and bigger. Ships are bringing in more and more heavy equipment. Some buildings are being demolished in a more American way and some lots are already ready for utilities and reconstruction. The American presence is shifting more from disaster response to assistance with rebuilding. Many Haitians are going to end up with livable wage construction jobs (if that pesky 1/10th of 1 percent doesn't somehow shave a big hunk off the top).

The medical role is also changing from Trauma Care to Refugee medicine and ensuring the premises of good Public Health are met...namely, to keep the poop out of the water. WHO/CDC are also watching closely for any signs of infectious disease outbreaks. Medicine is transitioning from tents to hard-side temporary facilities, then eventually to permanent neighborhood clinics and new hospitals.

Wade continues to improve our basic sanitation and is having a great time interacting with big names in refugee health. Bruce, Rick and our great team of nurses and techs not only saw some very sick patients in the clinic, but also cleaned the place up wonderfully. Scott continues to wheel and deal with locals, military and international organizations to trade and borrow the things we need most. The archbishop cardinal somebody of Boston was here (black is a hot clothing color).

Howard

Pics from Day 3 & 4 are also up:
http://picasaweb.google.com/howardleibrand/HaitiDay34#

Monday, March 1, 2010

Update and pictures from Howard

Day #1

Long day. Fourteen hours of flights and then a day of mostly waiting at the airport for baggage, flights and rides to the Petionville J/P HRO compound. Dan was a reliable breath of fresh air when he interrupted his busy day to meet us and make sure our arrival was smooth. We were able to make arrangements for Bruce and Nick to do their real jobs at the UM hospital. Sarah and I were invited also. Several of the group were able to spend some time in the clinic seeing tent city folks. Just walking down the street we see pathology that would never be seen in the states…the result of untreated parasites, trauma, etc. Many, many supplies have arrived here and it is a huge job cataloging, sorting, and storing all of them. J/P HRO won’t need much that I brought, so will be able to donate to Cabaret and Leoganes. The rains have started and this camp would have been a terrible muddy mess except J/P was able to obtain a 50X100 tent out of the Dominican Republic with a plywood pallet floor. Nearly dry. Even here in their country we have it sooo much better than them. The rest of the team arrives tomorrow. Dan will pick us up at 8 for Sunday morning fellowship meeting in Port-au-Prince followed by lunch with friends.

http://picasaweb.google.com/howardleibrand/HaitiDay1#

Day #2

Up the steepest, narrowest staircase to the top of the rock. Little earthquake damage because it’s on the rock. Small meeting in a hot little room, but very touching to be with those we’ve come to know through pictures and emails. Dan told the “Where I was when the earth shook” stories of several. He was in the lower floor of the convention building and physically couldn’t run out because the ground was moving too much. The roof fell in on one lady and her two young kids. She was trapped but they crawled out to get help. All were in the meeting. Another family lived upstairs and rented out the basement. The top floor stayed intact and the bottom floor was crushed. They just last week dug the bodies out. Several of the friends family are staying at the at the batch, including some orphans from extended families. They have also been cooking for other families living in tents. We went there for lunch. Bruce examined Caridad’s foot and the graft isn’t doing well. He put on a special dressing and will follow it up.

Came back to camp and saw some patients including a baby with diarrhea and dehydration. Not even moving until the Army medic got an IV in him and Vickie cuddled him and fed him Pedialyte with a syringe for 4 hours. He’s now asking for a drink. Didn’t have scheduled clinic…Sunday is a day of rest in Haiti. Raining again tonight. Tomorrow we help run the German clinic in the tent camp…their doctors left yesterday and the new crew comes in Tuesday.

http://picasaweb.google.com/howardleibrand/HaitiDay2#

Day #3

Spent the day in the clinics. Bruce and Nick originally went down to the Miami Hospital and worked for the morning but the hospital is now fully staffed so they came back. Rick and Nick and Kim worked in the German clinic in the tent camp. Alex worked mainly triage sorting those who really needed to be seen. Everybody else worked in the main clinic/hospital seeing the usual vomiting, diarrhea, dehydration, and healing wounds. Rick delivered a baby tonight!! Everything seems to be coming together better. They even gave me the Internet password tonight!

Sunday, February 28, 2010

Beth's update from Nick

Nick called me this afternoon about 4:35pm. He sounded great! He said the group is staying in a 60 x 100 tent that was just put up a day or 2 before they arrived. They have NO phone service in their group...but some nice lady let them borrow a phone with free minutes until tomorrow with a special phone that she had. They heard that there is a phone that you can purchase somewhere that only costs $20 with minutes for the company that works in Haiti...so they are going to attempt that! Maybe tomorrow! They do not have computer/internet because it is all password locked and nobody can get through....so the girls have managed to find some U.S. Military computer that allowed them some access!! (at least that is where Nick thought they were able to connect from) Leave it to the girls!

I will start with the ride from the airport. They had so much stuff and people to try and stuff in ONE Land Rover that Nick and Bruce (Surgeon from Auburn, WA) rode on the roof of the truck. He then commented that there are no laws in Haiti and so you can drive any way, direction, and speed you want. If someone comes your direction then you stop and honk at them! So, you can imagine their ride from the airport!

Nick said that as soon as he arrived into camp he helped Bruce with a surgery on the back of someone's neck...he was really excited about it. Then he got to treat a little boy that had something in his eye: he washed it, put some antibiotic lotion in it and put a patch over it. Those were the only two people he told about.

He was very excited about going to a church meeting this morning. They were picked up by Dan Henry, a minister in the area, and again he rode clear in the back on flip down seats with Howard L. He said it was a really neat drive, through alleys and trees. There were a total of about 20 people in an 8x8 room...the largest of the 3 rooms in the home.

They were told that Haitians don't do much on Sundays. So, it was a slower paced day today. They were told that Mondays are swamped. I think that Nick was looking forward to that! He thought that he was going to be possibly working in the University of Miami tent hospital tomorrow. He was told that the x-ray people had left there and they were in need for someone to be there. But, he says they will have a meeting either tonight or in the morning telling them where they will go for the day on Monday.

He said that they have plenty to eat. They had brought all their own meals, but there has been oatmeal for morning that someone gets up and makes. So far he hasn't needed to eat his freeze dried chicken teriyaki and rice! He said that the rice and beans with creole sauce that they serve at night was amazing!

They are possibly going back out to the church convention grounds on Thursday or on Saturday, he didn't know which, to set up a little clinic there for those local people.

He can't wait to bring home the pictures!

Beth Ross

A call from Howard & Tammie

I just got a call from Howard & Tammie. They are all fine. They were using someone's AT&T phone in the group (Vickie's) and said that today is the last day it will be free. They're going to try to figure something else out phone-wise. Tammie & Sarah have borrowed someone's computer and that's working. Howard hasn't been able to get his laptop online, but he thinks he will be able to now that he has some time to work on it.

Tammie wanted to hang up to call Blake, but we figured out that he'd probably be in gospel meeting. Hopefully she can later!

Howard has written a post for his blog and has taken lots of pictures, so Scott or I will get those on his blog and emailed out, as soon as he sends them to us.

Dan Henry (one of our missionaries who has been in Haiti for a number of years) took Howard, Tammie, Sarah, Nick, Bruce, and Vickie to Sunday morning fellowship meeting with our Haitian friends this morning. After that he took them to the home where some other Haitian friends had also gathered for their morning meeting. There they met Dan's nephews and lots of others.

Tammie said she got cold last night and got up and put more clothes on. But during the day it's hot, and in meeting this morning it was REALLY hot!

It sounds like they have their own little sleeping tents inside of a big huge tent. It was very noisy on the phone because of the background noise there, and I had trouble hearing them and they me.

They're all tired. Maybe they can get caught up on some sleep tonight!

None of this is earth-shattering news (there's been enough of that, lately!), but it's just good to hear SOMETHING! Beth also heard from Nick, so we'll post that shortly as well.

Marilyn

Update from Sarah last night

"Just wanted to let you know that I made it here safely. It's been a VERY long day & I'm ready to go to bed. We met Sean Penn today & talked to him. We are with the organization that he's set up. So that was kinda cool! I helped treat a couple people today but we spent a lot of time organizing the 'pharmacy' that they have."

Friday, February 26, 2010

More Departure Pics

Nick Ross with all his belongings for 10 days:




Wade Bessett & Debora Chavarria (both from Skagit County Health Dept) leaving for the airport to take a later flight tonight:

Departure pics

 


Howard & Nick, Haiti-bound:

 


Update 5:10pm PST: They're on the plane in Seattle! They travel all night via LA, Miami and arrive in Haiti at 8:35 AM tomorrow.

Tuesday, February 23, 2010

Almost Ready

Thanks for all of your support. Just a few more days. Here is the group:

Nick Ross: Imaging Technician, Mount Vernon
Scott Jackson: ER Technician, Oak Harbor
Debora Chavaria: Public Health Nurse, Anacortes
Vickie Newell: ER Technician, Sedro-Woolley
Howard Leibrand: ER Doctor, Mount Vernon
Deb Vestey: ER Nurse, Mount Vernon
Kimberly Webster: ER Nurse, Mount Vernon
Wade Bessett: Environmental Health, Anacortes
Alex Bennett: L & D Nurse, Shoreline
Rick Smith: ER PA, Bellingham
Sarah MacDougall: NICU Nurse, Bellevue
Bruce Wandler: Surgeon, Auburn
Tamara Leibrand Schluter: Nursing Student, Spokane
Arne Hedlin: ER Tech, Nursing Student, LaConner

We will be traveling into Port-au-Prince (PaP) via several commercial flights on Saturday 2/27 and Sunday 2/28. IMAT has been a great help in getting this all together. The majority of us will be at J/P HRO compound in Pap. Some alternate sites include the University of Miami tent hospital at the PaP Airport and and a Canadian site in Leoganes, west of PaP. I hope to have at least one clinic in the town of Cabaret where our annual church convention in Haiti is located. Bruce, Nick, Tammie, Sarah and I hope to meet with our church friends for Sunday morning fellowship meeting in PaP.