Canadian Medical Teams Helping Out in Haiti

Nepal Journal: failure is not something I am willing to accept.

Special guest blog by Dr. Nikhil Joshi, currently on the ground in Nepal for Team Broken Earth.

I’m in a car on the way to the Prime Ministers’ Residence.

I look out the window and consider everything that has happened so far. What started as a scouting mission for long term opportunities to help has become so much more. Many people are excited for the possibility of a collaborative project with Team Broken Earth. I think back to the key people that have taken me this far and have shown me so much of this impressive country. They’re the reason I’m on the way to meet with Prateek Pradhan, the Prime Minister’s chief press advisor.

This Harvard educated man speaks perfect English and we chat about the similarities between Boston and Newfoundland. We talk about St. Paddy’s Day and he lets me know that there is Guinness in Nepal and tells me where I can find some. In the course of our conversation, we have a candid discussion about the need for medical help. There is still a need for medical relief work in the country, he tells me, but it needs to able to reach the remote villages. We also talk about INGOs, aid and charity; topics which I’ve found to be challenging as I seek to reconcile good intentions with actual results. I’ve seen many well intentioned people and NGOs fail in Nepal and if Team Broken Earth is coming here for a long term project, failure is not something I am willing to accept.

I ask him what, in his opinion, is key to an NGO succeeding in Nepal? He tells me that the most important principles from the governments’ point of view are:

  • Local Support
  • Low administrative cost
  • Concentration and focus of aid

This all seems like common sense, but you may be surprised to learn that Nepal has over 40 000 NGOs and INGOs together. Many have been in the country since the 50’s and 60’s. If you are wondering how the country has so many NGOs and yet it seems like nothing is moving forward, then please know you’re not the only one pondering that. But I can’t solve the complex interrelationships, I am only concerned about whether Team Broken Earth can help and do so safely in country.

In many ways Nepal could be a growth point for our organization. Physical safety is all but assured from the people and the government; even at night, I feel pretty safe here. When we took a helicopter to a small village in the Sindu Palchuk district, I was amazed at how grateful people were for our mere presence. Even though they didn’t have enough food to eat they offered us lunch. The village was devastated by the earthquake, and it was clear that some villagers needed urgent medical attention, and probably had needed that attention at least a week ago.

After the interview with Mr. Pradhan is over, he thanks me for coming to this country and says that he wishes our organization the best of luck in establishing ourselves in Nepal. “The people of this country are grateful that the world cares for us” he tells me genuinely.

And in the end- isn’t that all we can ask for?

-Dr. N Joshi

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Nepal Journal: The importance of seeming local.

Special guest blog by Dr. Nikhil Joshi, currently on the ground in Nepal for Team Broken Earth.

I just came down from the village of Tukucha. The village is utterly destroyed. There is not a single standing structure. Women had wept holding me, men quietly stifled their grief. The devastation was heartbreaking and real. We had spent the day talking to local people to determine what their needs are and what they are going to be. Shelter seems high on everyone’s list with monsoon season quickly approaching. There was some food in the village but it was being rationed carefully.

On the way back to the car we pass a military truck which parks next to us and begins to unload and walk up to the village. There are three of us, myself, my local partner Shyam, and Patrick Boyhan, an American businessman interested in helping Nepal. The military is astounded to see Patrick, who is white, so far from the city. I start speaking to them excitedly, telling them I’ve heard about all the help they’ve given.

Something’s wrong.

They’re not looking at me the same way they are Patrick. Two of the men behind the commanding officer I’m speaking to have their hands on their guns. I keep on talking to the officer, trying to appear amiable, but the officer himself is speaking slowly and looking back between myself and Shyam. Shyam tells them that he’s known me for years, that I’m part of an organization who is looking to help. The officer brightens a bit, but his fellow soldiers keep their hands comfortably on their weapons. Patrick looks at the situation and blurts out “He’s a Canadian!” The officers laugh and the guards take their hands off their weapons and give me a hug. I wanted to ask them who they thought I was or why I could have been a threat, but instead I just accepted the hugs, grabbed Patrick and headed to the cab.

I feel I just aged a year.

The true importance this experience has given to me is the importance of seeming local. There are many NGO’s all over the world who strive to do good. Being integrated in the local community, having local partners, and being liked by the people you are helping are simple things that create a huge impact on the success of the endeavor. Life is not always about dollars and cents- sometimes getting work done in a developing country is less about what you have and more about how much you are loved. I was reminded of that as I came home from another long journey.

The town of Nuwakot is 4.5 hours from Kathmandu through frankly dangerous terrain. The roads were awful. There had been landslides the night before after a monsoon rain. One route was completely blocked so we had to back up and try another one. We travelled there to meet to a group called “Eek Eek Paila” (translated roughly to Step-by-step). This is a local group of about 11 Nepalese physicians and dentists of various subspecialty’s with 40 volunteers who travel to remote villages and offer medical care. They collect all the medications, dressings and minor instruments before arriving to the village. I spent a day with them, learning about their organization and speaking about Team Broken Earth. It’s interesting to me how many like-minded people there are around the world. So many people do genuinely care. I find it helps counter the daily negativity we see in the world. Knowing people want to do good is what makes this life brighter.

We were finally on the way home. We looked at the stretch of road before us. Terribly muddy road with half of the right side cracked off. The driver started the journey, but we quickly became stuck. Really stuck. A few local villagers came with some tools and tried to dig us out while toiling in the blistering sun. We were digging with our hands at one point and trying to make a plan together while not fully speaking the same languages. Eventually more people from the village came and we actually pushed the scorching hot car through the mud to the other side. We were so thankful to them. We attempted to give them gifts, but they accepted only our thanks. They said they knew that we had come all that way to help them and they were happy they could do something for us in return.

I’m in my room with a touch of heat stroke, drinking water underneath a fan. And despite the day’s difficulties, I remain happily optimistic about this world. Because some people just choose to care about it.

– Nikhil

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Nepal Journal: There was once nothing.

Special guest blog by Dr. Nikhil Joshi, currently on the ground in Nepal for Team Broken Earth.

I’m hyperventilating.

I need At least 10 translators. They need excellent English skills, and then have to be able to speak at least 3 of Nepal’s 40 or so dialects. They have to be available, affordable and willing to work the long hours our team will.

But that’s not all. I need space. I need clinic space, enough for at least 8 nurses and physicians. Separate rooms to allow people to be examined without loss of their dignity- which is something critically important to preserve as these people have gone through so much.

What about lab equipment? A laboratory tech? Clean disposal of needles? Supplies of dressings, antibiotics, anti-tuberculosis medications? The list goes on and on.

I sit down. I feel defeated. The day hasn’t even earnestly begun and I’m overwhelmed with the sheer complexity that comes when trying to start an endeavor of this magnitude.

But I remind myself that even Team Broken Earth had a beginning. Few people think about that now. We often focus on the excellent work multiple teams from across Canada have done. But before there were two story buildings and Haitian patients walking on rebuilt femurs, there was people like Dr. Furey sleeping on the floor in some random house as patients slept in nearby tents.

There was once nothing. And now Team Broken Earth has launched a multitude of teams and initiatives and are regarded as ‘local’ partners rather than sporadic visitors. The teaching our organization has done in treating patients with trauma was so popular and timely that it captured the gratitude of Haiti’s press and President. From a humble tent on the ground, there is now a stable two story building where people receive aid, are taught and can come for help. There is a foundation laid in the city that people can see. A place that says our commitment to the country is not transient, is not dependent on media coverage, but grounded in a shared vision and hope. Consistent work and focus over a long time will yield results.

Foundations. That is what I need to lay. I need to talk to people, as many people as I possibly can. I need to find who needs help and what help they need. I need to accept that I can’t help everyone but realize I can help someone. I just need to find other local partners whose core needs match our core competencies. I just need to find people who need help and those who can help us.

My mother taught me when I was young that if a problem seems too big to break it down and down into manageable pieces.

So today I’m going to try and find us some translators.

Wish me luck
-Nikhil Joshi

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Nepal Journal: Have you ever felt called?

Special guest blog by Dr. Nikhil Joshi currently on the ground in Nepal for Team Broken Earth.

It was April 25th. I had just gotten off the phone with my friends in Nepal. It was hours before the earthquake. I laughed to myself and went to sleep. In the morning I saw that I had missed another phone call several hours after we talked. I didn’t think much of it.

But then I saw the headlines the next morning. I urgently called back. Nothing. Every phone number I had, every email address, every social media account- nothing. Every second went by without an answer was agony. And then something just flicked on and I realized something.

We’re all called. We’re all called to live compassionate lives where we care about others. That’s what makes us strive in our own lives for a better world. And as a result, I was going to Nepal because I just had to.

The next lesson happened when I told Dr. Barter about my plans to go to Nepal and do some clinical work. He was supportive, but shared some perspective that he had gained in Haiti. “Trying to make a difference in Nepal seeing patients for a month is like trying to knock down a wall by kicking it with a pair of flip flops”. The ridiculousness of the imagery was jarring and accurate.

Teamwork does make sense. Individual efforts while laudable become infinitely more powerful when amplified by the energy of likeminded people. That’s how it felt to be in the cafeteria with Drs Furey and Pridham. It took 3 minutes for me to make up my mind to be part of Team Broken Earth’s efforts in Nepal.

The goal is simple, to find out what the situation is on the ground in Kathmandu and the surrounding countryside. To see what people need, who is offering it to them, and ask is there a way Team Broken Earth can be of service to Nepal and its people in the long term.

Team Broken Earth’s core strengths lies in the fact that it is an organization comprised of hundreds of compassionate members with unique skills and stories. And those people all share something in common: a calling. An indescribable feeling that tells us that hope isn’t dead, that altruism is noble and that caring about the world isn’t an exercise in futility but an action befitting humanity.

And so I’m on this flight heading in to Kathmandu. I have no idea what I’ll find when I land. I don’t know what’s happened to my home away from home, I have no clue what the air feels like or what is the humanitarian situation on the ground. I just know that whenever I feel overwhelmed by the enormity of these problems, I tell myself that I’m not alone because many others also feel called. And we’ll find a way through this together.

-Dr. Nikhil Joshi

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Where do you find the energy?

Where do you find the energy? Do you hit the gym a lot? Eat right? Do you have a good sleep schedule? Have you hit the sweet spot for a proper work/life balance? Are you happy? Where? Where does your energy come from? Sure, it can be any of those things. They’re all positive. But the best energy out there comes from one simple source… people.

We are hitting our peak here. Everyone’s firing on all cylinders. The OR has been so busy seeing case after case. Everyone’s working together.  And we have been privileged to have residents from two teaching programs in Haiti working with us all week. That kind of hands-on education will go a long way.

Pauline and Linda have been flat out in the ER today too for what seems like a busier day than usual.

The teaching has been extensive. Jackie secured brand new training mannequins for this trip and they have been in constant use.

Anesthesia and Dr. Sampson have done resident teaching rounds every morning.  Dr. Boone talked on general surgery diseases to med students. Dr. Smith did a casting session.  Dr. Martin and Dr. Cashin travelled to another hospital at 6:30 AM to teach.

These are the people that create the energy that drives Team Broken Earth. Their commitment, their never-say-stop attitudes. That’s the fuel.

It’s hump day today. Can’t believe how quick the week is going. But mid week is when you always could do with a boost. Today, that boost was the arrival of a container from home.  Sponsored by Rotary St. John’s and facilitated by Canadian Medical Supplies. We can’t thank you enough for this. It’s like Christmas for healthcare fans… it contained badly needed monitors for the ICU and a new intra-operative X-ray machine.

Second wind is achieved all round. Bring on the rest of the week.

– Andrew

Ps. Tell me: where do you find your energy?

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The place where typical does not exist.

A lot of people have asked me what a typical day in Haiti is like. The answer always evades me. There’s nothing ordinary about this place. Some nights, it’s as quiet as a church. Other nights, you can hear a gun shot in the distance and you’re quickly reminded that this is not a vacation, no matter how much you love the heat versus the snow back home. This is Haiti. Anything typical was buried here long ago.

The team worked hard all day.  And after seeing over 60 patients yesterday, it was now time to operate. The OR staff saved two lives today…one from a gunshot wound with injuries to multiple veins. The whole team clicked into action… from Carlos in the ER to Lisa, our radiologist.  Then straight to the OR where it is like symphony, every one working as one. And today that concert was conducted by Dr. Pridham and Dr. Boone.

In the very room next door, separated by a window that opens, the resident team of Dr. Smith and Dr. Decker were amputating an arm of a 16 year-old boy with cancer. The procedure saved his life.

Emily, our physiotherapist, was busy in the spinal care unit working with para and quadriplegics. And then there’s the real fuel of the machine. The nurses.  I have always said they can do a lot without us. But we can’t do anything with out them. Here and at home, I have so much respect for them. So much to thank them for.

The flow of patients never stops. And it’s heartbreaking to see the faces on the ones that are turned away at the gate because the hospital is at capacity.

A typical day in Haiti.

I hope some day that will exist.

-Andrew

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When the groove is good.

Each update made me more and more excited. Sometimes pictures are just not enough. We are building something. It feels like we’re taking something back from the earthquake’s devastation. Putting a foundation down. Literally, a foundation. A footprint that says Team Broken Earth and our amazing supporters like Columbus are here in Haiti to stay. This new building represents such a big part of our aspirations here.

I can’t help but draw similarities between the new building and our teams. Both started from an idea and have grown so far beyond what we expected or hoped.

Our team is now composed of over 500 people from across the country.  The building – a discussion with our good friend and tireless supporter, Brendan Paddick – is now up to the second floor.

The team is a cohesive working unit.  The building is now a design of working support structures all leaning on each other for support. The team will make an ever-lasting effect on patients… the building, on the face of Haiti.

The teams continue to grow as will the new infrastructure for this country. We can all be proud of that.

Of course it’s business as usual here. Well, Haiti’s version of usual, which means non-stop. The new ER doctor, Brook Saunders, has received his baptism by fire. The surgical team has not stopped with a full day of clinic in two hospitals.

It was good to watch as Dr. Rideout consulted with new patients. They all offered the smiles he’d soon make perfect. And that in turn made us all smile.

– Andrew

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One too many mornings…

This is all too familiar. Early, early rise. Drive to the airport in the dark. The cold still biting. The city’s still asleep. The airport lit up like a greenhouse.

This can be the toughest part sometimes… times when I am not so psyched about the trip. To be honest, sometimes I am just exhausted. Dead tired. Worn down. Sometimes, it’s because of the bureaucratic weight of the teams and the organization and keeping everything in motion. Sometimes it’s just too many balls in the air and the tension of making sure nothing drops. Sometimes, I just want a break. Order a pizza. Binge-watch the latest season of House of Cards. Sleep late.

It’s bright inside the airport. Start seeing the familiar faces. The smiles are big. Even bigger are the smiles of the flight agents checking us in. They know all about the team and love to see us coming. There are hugs and coffee and laughs. There’s an energy. An indescribable excitement building with each team member arriving. And that is it. That’s the turning point. It’s the team. It’s the immediate sense of the team that makes those previous feelings fade instantly. Kevin Spacey will have to wait.

Another 30 people. Another 30 families and loved ones, giving up their vacation time to help. That gets me every time! Even though some of the trips become routine, standing here in the airport, watching people make this sacrifice, well, it’s humbling.

I’m a lucky guy. I’m blessed by the energy and support of my own family, who give more than I will ever know. I am inspired by each and every team member, and I’m overwhelmed with a feeling of humility from the support we have received from people across the country. I feel a responsibility to not let them down. To honour their generosity.

I know that there is a lot to do. A lot to accomplish. I know that there are lives to change… patients and our own. I’m ready. Let’s get this mission going!

– Andrew

PS. We all read your Tweets and posts and messages of support. That’s what fuels us for a week in Haiti. Thank you for that and please keep them coming!

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Bangladesh, Day 3

Thanks to all who sent well wishes and thoughts on yesterday’s post. It really does mean a lot to me and re-energizes me in so many ways.

Today was better.

We visited Dhaka which has approximately 15 million people so it was a dense day, dense in every sense of the word.

We travelled throughout Dhaka to the older part of the city to visit a SAJIDA hospital. It was without a doubt one of the more interesting drives I have taken. There were more rickshaws and other forms of transportation than I could have dreamed existed.  On the way home, it took us 2-3 hours to travel a short distance through what I can only describe as an ocean of people, not waves, or groups, but constant people side by side, rickshaw by rickshaw for kilometres.

When we got to the hospital, we had several presentations and discussed with how Broken Earth and SAJIDA could collaborate.   They have the equipment and skills, but need more education and support. I think that is where we could help. They average 3-4 C-sections per day, but need more training in infant resuscitation, a course we could teach them. Then they can pass on that knowledge.

Following that we ran a busy clinic with the help of local doctors and nurses.  It was incredibly rewarding to work along side such remarkable people, to work with, and learn from them.

From the clinic into the operating room, where Dr. Rideout helped change the fate of child who may otherwise have gone through life with just three fingers.

We met one patient yesterday who was born with no legs and only two fingers on one hand.  He lives in rural Bangladesh, and despite his perceived disability, he is a successful farmer (farming the land himself), husband and father.   He was so thankful to see us, he demanded to visit with us tonight to sing us a song of appreciation.

In many ways this place is different than Haiti, but the human spirit, hope and determination to help those in need is a universal tenet, it just gets clouded sometimes.

Speaking of Haiti, I was extremely saddened to hear of the loss in Haiti yesterday. 18 people killed, celebrating Carnival, our thoughts and prayers are with our Haitian families and friends.

Best,

Andrew

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Contact us at info@brokenearth.ca