So for most of you following and reading our blog, you know that I (Jai) just went to Haiti. I know some of you do not have a facebook so I wanted to share the link to the pictures for you all to look at!
To ask me if it was what I expected is a loaded question... I luckily did not go there with much of any expectations so it was a sensory overload trying to take it all in as we rode through the cities. We landed in Port-Au-Prince, which is the poorest city in our hemisphere. With a population of around 3.7 million, and 230,000 killed in the 2010 earthquake, unemployment is at an all time high. People are still living in the "tent cities" set up for them from all the global organizations that came to help after the disaster. Corruption, religion, and politics all run very gray here. Riding through the city I am really just too shocked at what I am looking at to let the fear that I should be feeling set in. People with machetes everywhere, cops with hand guns and assault weapons with fingers ready on the trigger... really a different world. The smell of course is overwhelming with the "meat district" being the most nauseating. They have raw, cut meat out in the open sitting on a wooden table for people to purchase. Now I live with David and can handle a lot of bad smells, but this almost made me lose my cookies. Anyways back to the poverty... now I think it needs to be understood ahead of time that these people, although they are living in conditions we wouldn't let rabid animals or our worst enemies live in, they for the most part have no idea what could be possible. They are all busy living, life is fast and vibrant here, for them this is "the dream".... and they, unlike some of us, are busy LIVING IT!
Sanitation is of course non-existent. When you are a germaphobe this is not ideal. We did come up with the unofficial country motto... "When in doubt, whip it out!" These people would seriously just drop trow and go wherever they were and no matter how many people were around. Which makes me wonder what all "dust" we were actually breathing in! We would also see older women and kids naked taking baths on the side of the road in a watering hole for any old person to see. Anyways back to the sanitation since there is no formal system, trash is thrown everywhere. They burn plastic, and streets and ditches are lined with garbage. The stagnant water in the streets are a filmy, whitish mess that is foul smelling and full of mosquitoes. Livestock roams the streets, goats are tied to rocks in the middle of no-where without person in sight... it's an everyone knows that's so-and-so's goat kind of deal. Huge swine fill the ditches eating whatever other people have already picked over. People rummage through trash looking for something they can eat, use, or wear. Now you would think man they should just start a government ran organized system of handling waste products... yeah... no. The way it works in Haiti is everything has to be their idea, no matter how good the idea is and funding given from other countries the answer is no they will figure it out themselves. Which by the way they are not figuring it out because they like to overthrow their governmental heads and have mini "manifestations", or uprisings, in the streets.
Deforestation is another very big issue in Haiti. They have literally raped their mountains of beautiful vegetation to make their form of coal to be able to cook their food and to give them light at night. It's sad but at the same time they need to eat, and it truly is the big money maker here. Hideous concrete masses block out the beauty of the ocean that surrounds this poverty-stricken country. Looking at the view and thinking of home this would be prime multi-million dollar real estate, but here it is sprinkled with garbage and surrounded by bad smells and even worse scenery. The beauty here is under so much resignation. It is sad. I wish I could have taken a video of the driving here. To explain it is one thing but to see it is completely different. They have suggested sides you should drive on but that doesn't necessarily happen, the many motorcycles weave in and out of traffic and we saw up to 4 people on one dirt bike. Shockingly to me there would even be babies in the middle of two or three adults on the bike! This made me a nervous wreck! From Port-Au-Prince it took us 2.5 hours to drive 18 miles to Leogane. Trying to capture every image you desire is really just impossible. I had neck cramps and eye strain just trying to take in everything I was seeing.
Elderly are rare to see but they exist. The life expectancy is 62 with a median age of 21, excess mortality is due to HIV/AIDS with approximately 120,000 people currently living with these diseases. They also have a high infant mortality rate at 52/1000 births resulting in mortality. 19% of the children under 5 are underweight. On a similar note cats are rare to see here because they get eaten! On the patient charts they have estimated ages because many of them are not sure of how old they are. Prenatal care is rare but there are many organizations that go to Haiti and volunteer strictly just for OB to help these women get the care they need, and to better the unborn child and mothers chances of surviving post-partum. Finally arriving at the hospital it is almost dark and the streets of Haiti at night is literally the last place in the world I want to be. I would rather roam the dark alleyways of Detroit or Memphis than be out or stranded anywhere in Haiti. Arrival at the hospital was... shocking to say the least. First off you should know there are huge concrete walls that surround it with barbed wire, sort of like a prison... but then again I have also never been so happy to see tall barbed wire walls in all of my life (oh and to be inside them)! For the record for all of you health care complainers out there (and I was one), we really have absolutely nothing to complain about. This was our first night arriving and I am going to be honest I almost broke down and cried and was seriously asking myself what have I gotten into. I now look back and know this was one of the best decisions I have ever made in my life. I needed this and these people needed us. We are so spoiled in America and tend to focus too much on me, me, me and not enough on those in need!
First night done and woke up to roosters it was pretty cool. We did not have any surgeries planned for Sunday so we had a little "field trip" planned to go to Jacmel. The ride there was beautiful and I had no idea how mountainous Haiti was. Jacmel is a complete polar opposite from Port-Au-Prince and I am so glad I got to see it. Still poverty but beautiful and cleaner. The whole city was gearing up for Haitian Defile Kanaval, which is their version of Mardi Gras. There were bands, music, costume rehearsals in the streets, stadiums being built, and very elaborate artwork throughout the city. Day two of this trip I had already taken 210 pictures... note to self: more conditioner and more memory cards. Side note if you take pictures of Haitians they want money for it so I had to do the pictures in stealth mode. We stopped off in a beach in Jacmel, which was beautiful it actually reminded me a little of the other side of the island (Dominican Republic). Here I tried coconut milk straight from a coconut and I did not enjoy it. I tried some fresh caught grilled mongoose (which is what they call lobster) and it was spicy and pretty alright! Today was church and on our ride back we saw all the ladies dressed so pretty in their nicest clothes. In spite of all the filth these girls can get their whites blindingly white... I need their secret!
Finally surgery... what we're here to do. We were here to take out thyroids. The Haitians have a problem developing big thyroid goiters, for the most part because they lack iodine. Here in America we get it from our iodized salt, and there you would think they would get it from seafood but unfortunately many cannot afford this food, or lack the resources to go out and catch it. For those that don't work in surgery some of this might be difficult to understand, but here we go. They have flies in the OR, back home when we saw a fly we had to call a manager, someone calls her manager, we're required to break down our case, kill the fly, go re-set up the case and start all over. Why all this over a fly... well if the fly lands on any of our sterile material or God-forbid an open wound all hell could reap havoc on the patient's body. But here eh it's a fly, it happens. Like I said night and day from the US. My instruments we washed off in the same sink we washed our hands in for surgery, but hey when life gives you lemons... you deal. At home when the case is over we rip off our surgical attire and throw it away, here if that gown's not too bloody they want it back to autoclave for the next case. Crazy/unheard of and even harder to give into because it goes against everything that is right and safe back home. However if we didn't do it we were looked at like wasteful Americans. Hopefully someday some sort of JACHO will get in there and clean'er up. Another crazy practice here, the next person waiting for surgery sits right outside the OR in their gowns waiting, where they can see the other surgeries going on.... you know just waiting and watching surgery (no big deal) HA! Going to visit our patients post op was very different too. There are up to 10 people per room recovering, with flies and mosquitoes flying around everywhere. The next day Dr. Roe and I went and checked on our Thyroidectomy patient and she was doing great and was so grateful which made it all worth it, and it was so nice to see that they are happy that we are here.
Wednesday is another field trip day since the surgeon Dr. Roe was training was scheduled to do surgery across town with other doctors. This was my favorite field trip. We went to Petite-Riviere-de-Nippes and Miragoane. We visited a well-oiled medical clinic which was beautifully landscaped, and again barbed and gated. The clinic is about to build OR's and if they do I told Dr. Roe I would actually go back there because they have TV, A/C, and you can sit outside and play with goats! At the clinic they have an area outside where the patients wait to be seen, they have a computer filing system, and nice rooms and equipment to see patients. After this we went to visit a school that Dr. Young, the anesthesiologist that went with us, has helped get up and running. This school holds all grades and lets the children stay until they finish, up to the age of 23, if it takes them longer than that they have to be transferred to a different school. The children were adorable and all uniformed. Next stop lunch.... After lunch at a hotel and my first time trying Guinea hen (not terrible), we went to a Catholic church that had suffered destruction from the earthquake. You could tell this place was amazing prior to. Funny story while we were waiting to get into the church we ran into our first thyroid patient where Dr. Roe saw her post-follow up in the streets and took her bandage off and asked her how she felt... which was fine, then she got on the back of a motorcycle and rode off home... WILD! If that was me I would still be on the couch whining to David to please bring me a milkshake, pain medication, and a back massage. If I said it once I will say it a thousand times these women are hardcore. Their pain tolerance is impressive.
Thursday and Friday were jammed packed with back to back surgeries with barely time for food, which is fine I didn't eat much of anything presented to me anyways. We got finished around 6:30 Friday and our last case developed a huge hematoma waking up from anesthesia. She had to be re-intubated before her airway collapsed from the blood. Roe and I got in there, check everything out and nothing but clots to scoop and suction out, no active bleeders. Roe blamed it on the rest of the group members that visited the voodoo guy that morning (we didn't go but definitely had to clean up the damage) haha. We checked on her before leaving Saturday and she was great, could talk, no hoarseness or any complaints... thank God! Side note: while the others was at the voodoo place they saw a dead body in full rigamortous there. The widow could not afford a proper burial and she took him to the voodoo man who will take care of the body.... not sure how... I don't believe anyone had the gumption to ask. Finally after a week we gather up enough courage to venture out at night with our trusted Haitian driver and visited an amazing French chef's restaurant in the middle of nowhere (I mean we literally drove over a creek and through a field to get there). I have no idea how he stays in business but the food was amazing. Three courses, one with red wine, one with white wine, then it ended with coffee and ice cream. Delicious! Probably the most calories I consumed collectively while I was there. On the way back to the hospital I realize just how incredibly dark Haiti is. There is not copious amounts of light pollution that we are used to... the night is NIGHT!! So dark my eyes were working in overtime.
While we were here we stayed in Leogane, and one of the problems they are having here is lymphatic Filariasis which is spread from person to person by mosquitoes. People with the disease can suffer from lymphedema and elephantiasis and in men, swelling of the scrotum, also known as a hydrocele. There was a Urologist from Notre Dame that was there while we were who took care of about 25 hydocele patients. I know there is so much more that I probably should talk about but that is all that is coming to me at the moment. There is a link to the pictures on facebook where you can see all the pictures. Warning: some are graphic (surgeries, nudity) sorry ahead of time but I thought it was important to document all that I could.
Overall I am so glad that I went on this trip. There are some really great people in Haiti that I got to meet and there are a lot of programs being set up and going on to help the Haitian people provide a brighter future for themselves and others. There are amazing parts of this country and I am so glad I got to see both the good and the bad. These people are rising up from a terrible catastrophe that has struck their nation and it is going to take time, money, and a whole lot of volunteers to help them rise up. Whether church or medical I totally recommend going if you get the chance on one of these trips. This was a really rewarding experience for me and we got to help people that really needed it, it also helped me realize how fortunate we truly are. So back on day one I questioned what I had gotten myself into.... well on day seven I knew two things: 1. I needed this trip and 2. I wouldn't trade this experience for anything in the world.
Thank you for reading.
Here is the link to the pictures:
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