At the Miami airport we met Philadelphia pediatrician Lily Higgens and her son Sean.  Sean is a high school senior with an interest in pursuing a career in medicine (after a stint playing college lacrosse if all goes well).  This was the first trip to Haiti for these wonderful volunteers. In Miami we were also met by Randy Lee, a Haiti Clinic regular, who was on a mission within a mission.  In his spare time Randy had written a computer program to produce the first version of an electronic medical record for Haiti Clinic. The plan was for Randy to perform a pilot test of his system during the weekend clinic. The 4 Dell laptop computers that he brought in his check in baggage definitely raised some eyebrows amongst the security team at the airport. Randy disavows membership in the techie brotherhood, but the 4 Dell laptops and his gleaming Iphone 4G suggested otherwise.

Our arrival and journey through the Port au Prince airport was the least chaotic in recorded human history. Our stalwart Haitian partner Robinson Fritzner was on hand to meet our group and escort volunteers and luggage to the Coconut Villa Hotel. Emergency department doctor Steve Griffith and nurse Laura Sharpe were waiting for us and these two terrific volunteers rounded out our 9 person medical team.

We headed to the clinic with the plan to get organized and prepare to see patients bright and early on Saturday. The only glitch was that our organizationally challenged team leader had not informed Robinson of our intentions and we found over 100 patients patiently waiting for our arrival. Not wanting to disappoint the patients and our Haitian partners, we quickly changed into patient care mode and jumped right in to treating patients. Dr. Garcon, the Haitian physician we help support at Mission Ranch, was already seeing patients and worked alongside our team for the remainder of the afternoon. After we finished seeing patients I was able to have a quick meeting with Dr. Garcon to ask him about unmet needs at the clinic and to update him on the new computer charting system.

We then headed back to the Coconut Villa for a jump in the pool, cold Prestige beer, and dinner. The news topic of the evening was the anticipated decision of the Haitian Election committee to rule on whether the Haitian hip-hop superstar Wyclef Jean would be allowed to compete in the elections to run for President of Haiti. The worry was that if his bid was denied, his supporters in Citi Soleil would respond with angry demonstrations that would destabilize the security situation and keep our team confined to the hotel. By morning we learned that in fact his candidacy was rejected, yet things seemed calm and we continued with our original plan.

Several of our team members deserve special mention. Patricia Oetting (pronounced Etting, the o is silent) made it a point to engage and connect with virtually every human being we encountered during our stay in Haiti. Her animated and bustling interactions with others were quite amazing to observe. Her talkative and sociable nature allows her to make new friends easily and she also was able to rekindle friendships from her many past visits to Haiti.

Maggie Remy did just about everything this trip. Besides her tireless work in the clinic, she translated for our team, ordered our meals at Coconut Villa, and fiercely negotiated prices for our Haitian art souvenirs on our behalf.  Alas, if not for the residency requirement, Maggie would be my choice to run for the Presidency of Haiti.

The work in the clinic was, as always, very intense and demanding. Our team saw over 600 patients during our 2 ½ days of clinic. No rest breaks were taken because a long line of patients were always waiting on a series of benches that snaked outside the clinic and across to an adjacent building. We saw multitudes of patients with routine, but untreated problems. Scabies and a variety of parasites are endemic in Cite Soleil and these conditions add to the misery of children, who are disproportionately affected.  High blood pressure is extremely common, often monstrously high, and patients typically report that they have run out of their blood pressure medication, so access to care is quite limited. We also saw acute emergencies such as septic joints, pre-eclampsia, and dehydration/hypotension. We successfully referred and transported several of these patients to the hospital and the Medishare program. We saw very many children, actually our pediatrician, Lily Higgens, was responsible for providing this care and she did an outstanding job.

The tales of woe elicited from our patients were heartrending. We saw young mothers, likely suffering from AIDS, who had no money to buy formula for their malnourished child. We saw patients who lost their entire families in the earthquake and were simply lost. The magnitude of the hardship that surrounds our clinic overwhelms a medical response. One gets the sense that without fundamental changes this wretched slum will remain home to generations of impoverished children with limited prospects for a better life.

The discussion on the trip home after these clinics always comes back to our frustration with the feeling that our efforts represent a “band-aid” for a patient who really needs a major intervention. So this leads to the next natural question that we will need to answer as Haiti Clinic evolves. What can we do to help address the underlying structural problems that have created such a disastrous medical crisis for the people in Cite Soleil?

Photos from this trip can be seen here.

Amphibian Stunt Tank is a fully improvised performance featuring one actor, Matt Higgins (Centralia, Burn Manhattan, Shock of the Funny) coached by Matt Mitler (Dzieci), and one
musician, Stuart Bogie (FELA! Antibalas, Superhuman Happiness, TV On The Radio,
and many more).

Participate in GrowNYC’s interactive recycling demo before the show, then watch as
everyday NYC discards and audience proposals inspire a spontaneous
comic trip.

Read the full article here.

Our clinic consisted of one pediatrician; Dr. Kevin, two podiatrists; Cathy and Nick, one nurse practitioner; Rosaire, one OB/GYN Doctor; Shelley, a nurse; Patricia,  a paramedic; Gayl, a medical assistant; Annie, and three non-clinicians; Kim, Charlie and Antoine, who worked pharmacy or translated. This was a very diverse group with a wide range of talents.

Dr. Shelley, our OB/GYN was clearly the busiest of the practitioners as we sent all the vaginal problems to her room. She is also energetic, friendly and a blast to be around. The pediatrician was wonderful, kind and sorely needed on every trip.  So many children were seen, and we had at least two children who were critically ill, two of which were sent to local hospitals on Sunday. (More on recently discovered resources later). The need for an intraosseous needle became apparent as we had two infants in profound hypovolemic shock that needed rapid infusion of fluids. As it was, infusion was accomplished via femoral butterfly stick, but this is not an optimal situation. An infant ambu bag and oxygen would be good also.  We are at the point where IV fluids would add so much to badly dehydrated patients, especially the elderly and infants/children.  Hopefully we can soon add this to our treatment modality.

The podiatrists, a brother and sister, stepped up and adapted to seeing any patient we sent to them.  They had at least 3 festering I&D cases that were taken care of beautifully.  They were a fantastic addition to the group. Our nurse practitioner saw anyone we sent to her, but gratefully is very experienced with geriatrics, so that helped immensely. The paramedic was the trip leader and was available in all areas as care provider, pharmacist, and director of fun and logistical issues.  It really helped to be able to “float” and address issues as they arose.  The medical assistant was Creole speaking and acted as interpreter for the OB/GYN, which gave us a female element to the exams, and she was also able to give injections.  She is a great girl, very adaptable and possesses good clinical skills. Her husband, also Creole speaking, was used as an interpreter and also worked in the outside tent helping with triage and directing patients.  A great asset to us!  The other two non clinical participants (Charlie and Kim) kicked butt in the pharmacy. And of course, our wonderful Patricia, global nurse extraordinaire, worked her magic seeing patients and making everyone comfortable.

To see photos from this trip, click here.

Date: June 15, 2010
Time: 5:30 – 8:30pm
Royal Ballroom 1533 US Hwy #1 Suite 9
Vero Beach, FL 32960

Put on your Hottest Salsa Dress and Dancin’ Shoes for this Party with a
Purpose! Join the Chicks to honor and support this very worthy organization at the
Royal Ballroom for “Dancin’ with the Docs” hosted by Dr. Gerald
Pierone, board member of Haiti Clinic and founder of Facial Rejuvenation Florida.

The full Interview with Dr. Shelly Chvotzkin in the Gloucester County Times can be read here.

Dr. Dirk Parvus and 13 volunteers made the trek to Mission Ranch in the Boston area of Port-au-Prince in mid-April.  This team treated 900 patients during their stay and photos of their visit can be seen here. 

This is an excerpt from Dr. Parvus’ notes from the trip:

We went to the clinic on Friday afternoon and set up 6 provider stations manned by 3 doctors and 4 nurses and saw 180+ patients.  Jayne, a Medical Assistant, directed patients to and from the pharmacy and helped moms rehydrate their babies.  My nephew, Clinton, and son, Matt, set up a dental clinic in the little room next to the Pharmacy and were an immediate hit with a long line waiting all weekend.  He pulled about 50 teeth.  We went home via the Visa Lodge (swimming, beer, pizza, and internet) to our guest house and were picked up at 8am the next morning.  By 2pm on Saturday, we had seen 300 patients and, for the first time ever, actually ran out of patients so we packed up and had an afternoon and evening at the Visa Lodge where we met up with friends for dinner.  Due to the high demand for dental services, Clinton stayed behind and so did Ruth, Chuck, and Rose to organize the Pharmacy.  By 2pm on Sunday, we had seen 411 patients before we started to pack up for our 6pm flight back to Miami.  Our Haitian partners were superb, the four security men were pleasant, unobtrusive, kept an eye on us at all times, and maintained excellent crowd control.  Robinson kept his finger on the clinic’s pulse by continually monitoring and facilitating.

Most Common Diagnoses:
Pain (unspecified)
Vaginitis
URI/Cough
Conjunctivitis
Heartburn
Worms

Thank you so much to all the volunteers and Haitian partners that made this clinic so successful!

Greetings Friends of Haiti Clinic!

Just back from a clinic in Cité Soleil. I would like to share with you what we experienced.

10 of us (4 doctors, 3 nurses, 2 non medical volunteers and 1 EMT) carried 21 bags of medications and supplies. We flew Air France from Miami to Port au Prince. We arrived at 1pm and were working in the clinic 2 hours later. We not only staffed our clinic at Mission Ranch, but opened a “satellite” clinic in Soutane, which is an even poorer neighborhood about 1/2 mile down the road.

The new clinic consists of an army tent pitched on a vacant lot. The area appears to be built on a garbage dump. There is raw sewage and excrement everywhere. Pigs and goats hunt for food. People live in tin shacks, with mud floors. There is no running water, electricity or toilets. I have never seen such devastating poverty.

We opened to standing room only crowds. Most people there never see a doctor. Many children had the orange hair and distended abdomens of kwashiorkor–severe protein deficiency. They walked barefoot in places I did not even want to go in my trail running shoes.

We treated many sorts of infections: parasites, fungal and bacterial. We treated these with the thousands of medications we purchased with the money you sent.

We saw many with infections that we were not able to treat: AIDS, tuberculosis and malaria. We are planning tests and procedures so that we will be able to diagnose and treat these scourges.

We saw many with chronic diseases: hypertension, diabetes, and arthritis. We now employ a Haitian doctors who will be able to test and treat these patients on a daily basis at our clinic.
The weather was hot but the rains held off. (for now)

We were able to treat 1170 people, but there are thousands more who need our help. We plan monthly clinics. Each clinic costs about $7,000 which includes the medications we buy at a steep discount, car and driver, Haitian health workers, security, etc. but does not include the costs of air transportation, food and hotels for the 10 volunteers, who pay their own way)

We want to buy several lap top computers to make the clinics run more efficiently and to help us with inventory control in the pharmacies.

Depressing?–yes
Frustrating?–yes
But also energizing. All of us left with the desire to return and improve.
We have so much work ahead. All of this requires money. We so much appreciate your contributions. I hope we can count on your continued support. Visit our website Haiticlinic.org and our Facebook page for updates.
Thank you

Neil Heskel MD
President, Haiti Clinic