http://picasaweb.google.com/howardleibrand/NickSHaitiPics#
http://picasaweb.google.com/howardleibrand/BruceWandlerSHaitiPics#
Thursday, March 11, 2010
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
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#
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.
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#
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#
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#
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!
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!
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