Monday, July 18, 2011
Sunday, July 17, 2011
Port Salut and serious chillin'
Back from a gorgeous day over in Port Salut. The ride was nice, through the countryside and over the mountain to the southern coast of Haiti, a bit farther west than Les Cayes. We went to the same beach I celebrated my 40th birthday at last year. It's a beautiful beach, very shallow with great blues and greens and white sand. Had the lobster with frites again (because you don't mess with a good thing), and some of the local Prestige beer. Gotta love Haiti time--we ordered right when we got there at about 10:45 am and were told it would take 35 minutes. A little of 2.5 hours later, voila lunch!
What I learned today...part of the reason Port Salut is so pretty and developed (it even has a bit of a tourist trade with 3 hotels on the beach) is because this is where Aristide was from. He had a private airstrip so he could fly here for weekends when he was dictator. The UN now uses the airstrip for helicopters.
I swam a bunch, read a bit (thank you Kindle, for handling the sun so wonderfully), had some more beer, practiced my French with Harold (our driver), practiced my Spanish with Carmen, and otherwise had a great day. Also got to listen to the Women's World Cup final match in the car on the way home. I loved how the announcer was speaking French but when anything exciting would happen he would slip into Kreyol. Hee. From what I caught, it was exciting to the end. Too bad for the US, but at least it was a great game. I also loved driving past small, cinder block houses to see people all crowded at the doors and windows watching the game on the few TVs that people have hear, as well as hearing all the radios turned up with the game.
I'm a bit uncomfortable right now. I've got a bunch of bites from something (I don't think mosquitoes) and have added a bit of a sunburn on my shoulders and upper back. Whatever. It was a great day. I did take photos, so I will try to upload those later tonight!
What I learned today...part of the reason Port Salut is so pretty and developed (it even has a bit of a tourist trade with 3 hotels on the beach) is because this is where Aristide was from. He had a private airstrip so he could fly here for weekends when he was dictator. The UN now uses the airstrip for helicopters.
I swam a bunch, read a bit (thank you Kindle, for handling the sun so wonderfully), had some more beer, practiced my French with Harold (our driver), practiced my Spanish with Carmen, and otherwise had a great day. Also got to listen to the Women's World Cup final match in the car on the way home. I loved how the announcer was speaking French but when anything exciting would happen he would slip into Kreyol. Hee. From what I caught, it was exciting to the end. Too bad for the US, but at least it was a great game. I also loved driving past small, cinder block houses to see people all crowded at the doors and windows watching the game on the few TVs that people have hear, as well as hearing all the radios turned up with the game.
I'm a bit uncomfortable right now. I've got a bunch of bites from something (I don't think mosquitoes) and have added a bit of a sunburn on my shoulders and upper back. Whatever. It was a great day. I did take photos, so I will try to upload those later tonight!
Saturday, July 16, 2011
As Cholera Surges In Haiti, Aid Withers Away
I found the following story on the NPR iPhone App:
http://www.npr.org/blogs/health/2011/07/15/138161193/as-cholera-surges-in-haiti-aid-withers-away?sc=17&f=1001
by Richard Knox
- July 15, 2011
Cholera is back in Haiti.
Well, in truth, cholera hasn't gone away since it was introduced last October, possibly by infected U.N. peacekeepers from South Asia. And undoubtedly cholera will plague Haiti for many years to come because it's nearly impossible to eradicate from the environment.
But new numbers show an upsurge in cholera since the rainy season arrived this spring. Between April and June, the Haitian health ministry reports more than 86,000 new cholera cases – one-quarter of all the cholera reported since the beginning of the epidemic.
In 11 largely rural communities, Shots has learned, cases nearly quadrupled between April and June, from 3,932 to 14,425. Cholera hospitalizations in these areas went up nearly six-fold.
Meanwhile, health workers say the international support that came to Haiti's aid during the peak of the cholera epidemic last fall and winter has withered.
"We have a smaller pool of people responding and similar caseloads to what we were seeing the later part of last year," Cate Oswald of the medical aid group Partners in Health told Shots. "So we're working double- and triple-time with very limited resources. We're quickly going through dedicated cholera funds."
Speaking from Mirebalais, a town 40 miles northeast of Port-au-Prince, Oswald says the latest surge in cholera cases has been relatively invisible in the most remote towns and villages, sometimes inaccessible to cars or trucks.
"In areas where there are zero latrines and no effort to improve water hygiene, we're seeing caseloads as high as the early days," Oswald says. "When the rains come, as people defecate in the fields out of necessity, all this is running into rivers. So it's just this ongoing cycle."
Recently, Oswald says, she got a call from a health worker in Petite Montagne, a hamlet five hours by foot on a rutted mountainous road from the nearest clinic in the Boucan Carre region. The health worker reported 14 people who needed to get to a cholera treatment center immediately.
Untreated, cholera can kill within eight hours from overwhelming fluid loss. Timely treatment with rehydration is cheap and life-saving.
The Partners in Health clinic in Boucan Carre had been aware of a cholera outbreak in Petite Montagne because dehydrated patients had been arriving by stretcher, carried for hours by family members over the rutted road. In the past two weeks, the group realized it had to get more help to the mountain town.
"Petite Montagne has needed help for months," Oswald says. "But when we realized how many people are being infected in this new wave, we said there's no way we can't do this."
It took a day and a half to mobilize supplies and workers and walk them to Petite Montagne.
In responding to cholera, time equals lives saved. So Partners in Health recently purchased 120 cell phones for about $10,000 and is distributing them to its far-flung community health workers.
The phones have been programmed (in Creole) to allow easy input of cholera cases and deaths, how much oral rehydration and intravenous fluid packs are on hand, where trucks are needed to take the most severely ill to treatment centers, and how much water-purifying tablets and bars of soap are available.
"As the rains have come, it's been incredibly hard to get this data," Oswald says. The cellphones will help speed the response and give the Haitian ministry of health a better picture of what's happening in rural areas.
Meanwhile, debate is still grinding on about whether to deploy cholera vaccine to reduce the accumulating numbers of cases and deaths. So far Haiti has counted nearly 380,000 cases and more than 5,500 deaths since mid-October.
Earlier this month, a meeting of vaccine advisers to the Pan American Health Organization in Buenos Aires recommended small-scale projects in Haiti to vaccinate against cholera in "underserved urban and rural areas."
Last December, a high-level meeting of the Pan American Health Organization in Washington concluded that large-scale cholera vaccination should be considered in Haiti.
But the Haitian government, worried about civil unrest among people who couldn't get vaccine, turned down one manufacturer's offer to donate tens of thousands of its vaccine. And this month, PAHO's expert advisers worried about competition between vaccination against cholera and other diseases.
Meanwhile, health workers are trying to cope, anticipating that cholera caseloads will continue to increase.
"August and September are the peak hurricane months, and we notoriously have very heavy rains in that time," Oswald says. "So we're preparing ourselves. We're putting cholera treatment centers under tin roofs with plywood walls and concrete floors instead of tarps and tents. We know cholera is not going away." [Copyright 2011 National Public Radio]
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Rewarding Saturday
Last night was crazy! It rained so hard for hours and hours and hours, complete with thunder and lightening! I thought at first that the sound of the rain was being magnified by the tin roof, then remembered there's a whole other floor above the one I'm staying on. And then I looked outside...I've never seen rain like this. I can't imagine what a terror a hurricane must be here! It had stopped by this morning, and the sun is out and by now nearly everything (including the dirt roads) is dry.
Today we all decided to donate some of our time to the Sisters of Charity orphanage in Les Cayes. Marvin and Carmen casted a bunch of kids for braces and orthotics they will have their 2 apprentices work on this week, while Taryn, Ed, and I treated some of the kids with disabilities and showed the regular caregivers some techniques they could use with these kids. I don't even know how many kids I saw in the 2 hours we were there (5 maybe), but it was great. I've done zero pediatric PT outside of my course in school and the more post-op ortho stuff we would get at the hospital every now and again (scoliosis surgery, fractures), but found I remember more than I thought and put my neuro skills, NDT in particular, to good use. Two of the kids I saw were also blind, which was extra difficult because playing games is very much complicated by the language barrier, their development problems, and no vision. I did get smiles from everyone of them, even the last little girl who was so complex I nearly gave up.
We also got a tour from Sister Guadalupe. The center has health care and hospice for adults with HIV/AIDS and advanced Tb. The whole second floor is for pediatrics, which 4 classrooms, 2 activity rooms, a quiet dark room, a sensory integration room, a treatment room, dorms for boys and girls, and a mini-hospital room for the sickest children. It was a bit overwhelming, many of these children were abandoned because of their problems or are orphans because of the earthquake. They do have some normally developing orphans who are up for adoption. Five of these kids were having a French lesson and sang us a welcome song and practiced their English. Four of them are awaiting adoption in the US, so practicing the little bit of English was important to Sister so they can at least understand something when they go with their new parents. She said the earthquake has made adoption by US families much easier, and for that she is grateful. [PS Kristin--no, I didn't ask about taking any of them home with me, but it was a great temptation!]
This is the same order of nuns as Mother Teresa, and I can see the similarities. The three sisters we met were all sharply intelligent, spoke multiple languages (Kreyol, French, English, Spanish), and clearly loved their work. They admitted to being overwhelmed and challenged by having to make decisions about which child might get what (braces, therapy, more schooling), but clearly had the best interests of all the children in mind. It was both heartbreaking and inspiring, all at the same time. I think we may go back next Saturday to deliver the braces and work with the kids a bit more, and I really hope we do.
We decided that since tomorrow the cooks are off, we would delay our trip to the beach until then. That way we can have a great fish and/or lobster lunch. We plan on leaving early (before 9 am) for Port Salut, which is about a 45 minute drive. If the weather's anything like today, it should be great...high 90s with about 90% humidity and a few high clouds.
We made a quick stop by the Les Cayes wharf, which sadly is covered in garbage. There's what could be a cute little beach that is about 10 feet (yes, 10 FEET) deep with washed up garbage of all kinds. Then, before coming back home for lunch we stopped by the market to get a few local beers to go with dinner. The gentleman at the market was hilarious. He kept wanting to practice his Spanish with Marvin and Carmen (they are from Nicaragua), even carefully announcing the total in Spanish.
If you'd like to support my trip here, please click the link to the right. I can still take donations, and would love your support!
Today we all decided to donate some of our time to the Sisters of Charity orphanage in Les Cayes. Marvin and Carmen casted a bunch of kids for braces and orthotics they will have their 2 apprentices work on this week, while Taryn, Ed, and I treated some of the kids with disabilities and showed the regular caregivers some techniques they could use with these kids. I don't even know how many kids I saw in the 2 hours we were there (5 maybe), but it was great. I've done zero pediatric PT outside of my course in school and the more post-op ortho stuff we would get at the hospital every now and again (scoliosis surgery, fractures), but found I remember more than I thought and put my neuro skills, NDT in particular, to good use. Two of the kids I saw were also blind, which was extra difficult because playing games is very much complicated by the language barrier, their development problems, and no vision. I did get smiles from everyone of them, even the last little girl who was so complex I nearly gave up.
We also got a tour from Sister Guadalupe. The center has health care and hospice for adults with HIV/AIDS and advanced Tb. The whole second floor is for pediatrics, which 4 classrooms, 2 activity rooms, a quiet dark room, a sensory integration room, a treatment room, dorms for boys and girls, and a mini-hospital room for the sickest children. It was a bit overwhelming, many of these children were abandoned because of their problems or are orphans because of the earthquake. They do have some normally developing orphans who are up for adoption. Five of these kids were having a French lesson and sang us a welcome song and practiced their English. Four of them are awaiting adoption in the US, so practicing the little bit of English was important to Sister so they can at least understand something when they go with their new parents. She said the earthquake has made adoption by US families much easier, and for that she is grateful. [PS Kristin--no, I didn't ask about taking any of them home with me, but it was a great temptation!]
This is the same order of nuns as Mother Teresa, and I can see the similarities. The three sisters we met were all sharply intelligent, spoke multiple languages (Kreyol, French, English, Spanish), and clearly loved their work. They admitted to being overwhelmed and challenged by having to make decisions about which child might get what (braces, therapy, more schooling), but clearly had the best interests of all the children in mind. It was both heartbreaking and inspiring, all at the same time. I think we may go back next Saturday to deliver the braces and work with the kids a bit more, and I really hope we do.
We decided that since tomorrow the cooks are off, we would delay our trip to the beach until then. That way we can have a great fish and/or lobster lunch. We plan on leaving early (before 9 am) for Port Salut, which is about a 45 minute drive. If the weather's anything like today, it should be great...high 90s with about 90% humidity and a few high clouds.
We made a quick stop by the Les Cayes wharf, which sadly is covered in garbage. There's what could be a cute little beach that is about 10 feet (yes, 10 FEET) deep with washed up garbage of all kinds. Then, before coming back home for lunch we stopped by the market to get a few local beers to go with dinner. The gentleman at the market was hilarious. He kept wanting to practice his Spanish with Marvin and Carmen (they are from Nicaragua), even carefully announcing the total in Spanish.
If you'd like to support my trip here, please click the link to the right. I can still take donations, and would love your support!
Friday, July 15, 2011
First day on a Friday is good!
First working day in Haiti went really well. The other two PTs here, who just got married 3 weeks ago, are awesome! Just that right attitude to jump in there and go for it, tempered with a healthy dose of respect for another culture. I am looking forward to what could be a great 2 weeks!
Saw some familiar faces today, mostly staff at the clinic. There were 2 patients from last year. One was here today for a prosthetic adjustment with the prothetists, but recognized me right off and gave me a big hug. The other was one of my favorite patients who was unfortunately back with an amputation to his remaining foot that hasn't been healing well. He was the older gentleman who made me practice my French who had a poorly healing tibial amputation last year. Diabetes is terrible at home, but here with the less than hygienic living arrangements and dust or mud everywhere outside, it is even worse.
Growth area for me today-- treated a sweet girl with what I presume was CP. Even got her to count and name colors for me by the end of the session, which was great as she was a bit afraid of the 'blanc' when we started.
I am also pleased (probably way too pleased) to announce that I seem to have remembered a bunch of my PT Kreyol/French from last year! We've got translators, but I do like being able to ask simple questions and give simple directions on my own.
Marvin and Carmen, the two prothetists here, took us for a short hike around the village, out to the river, and by the local market this afternoon. I had forgotten how miserable the heat and humidity are, but think I'm almost used to sweating constantly again. Hiking in it was awful, but the great views of the mountains and the interested stares of the locals help take my mind off the heat.
It's been a wonderful 41st birthday here in Haiti!
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