Tag Archives: ER

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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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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It’s like it’s a flooding river.

“Help me! My baby fell off a tap-tap and his leg is broken!”

The story – a common one in Haiti – is, this time, not real.

The “baby” is a plastic mannequin of a toddler wearing navy blue sweatpants three sizes too big and missing an arm; his “mother,” a tall blond Canadian pediatric nurse. The “nurses” hurrying to help are Haitian nursing students demonstrating how they’d respond when a mother arrives in emergency with her injured child.

Though the story line is make-believe, the benefits are real – Haitian nurses will be better trained to deal with this kind of emergency when it happens because they’re learning through hands-on simulation training.

This kind of teaching is the key reason that Team Broken Earth’s nurses and doctors come to Port-au-Prince.

Four years ago, when Team Broken Earth was founded in the aftermath of the earthquake, Haitians needed surgeons, doctors, nurses and physiotherapists from other countries to fill the enormous gaps in the beleaguered Haitian medical system.

But, today, efforts are increasingly focused on building the local medical system local healthcare workers. For Team Broken Earth, that’s meant a shift from practicing medicine here to teaching it.

Over the last four days, Canadian nurses and doctors have taught nursing students and nurses, medical students, surgery residents and local physicians. Sometimes, they squeeze into tiny single rooms on the hospital ground, or take students across the street to the vacated building across the street. They’ve taught outside under tents, in hot sweaty ORs and in the frenzy of tbe emergency department.

Suzanne Westcott, a nurse who has been down to Haiti three times with Team Broken Earth, said she’s spend more hours teaching on this trip than any before. This last one has been the most rewarding – “and it’s because of the teaching.”

“I feel like I’m not just filling a role; I’m really giving back. It’s like it’s a flooding river. When you come here just to do clinical work, you’re plugging a hole somewhere. But when you teach, I feel like you slow down the flood.”

– Christina

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The Daily Dose of the Unfathomable

This is a place where the unfathomable is often the everyday.

This morning, we woke to news that a five-day-old baby died in the pediatric ICU during the night. He was a tiny thing who was supposed to be one of the first surgical patients of the day. One of our docs put his head in his hands and cried in frustration after the discovery.

Later, a 10-year-old boy with an amputated leg arrived, brought by his adoptive mother. Through a translator, one of the surgeons asked the mother how her son lost his leg. She explained that the boy’s birth mother dumped the boy out a yard soon after he was born. Pigs gnawed much of the baby’s leg off before he was rescued by a woman who later adopted him.

Perhaps most telling, the translator passed on this information without reaction, like it’s a story he’s heard before.

Children are abandoned at this hospital every month. Abandoned or orphaned babies are easily to pick out in the row of cribs in the pediatric ICU. They’re covered in flies because they don’t have parents there to fan bugs away from their faces.

I don’t mean to give the impression that all the stories are sad here at Hospital Bernard Mevs. They’re not. Earlier this week, Team Broken Earth met a five-year-old girl who arrived dressed in a princess dress. She can’t attend school because of her clubfeet. She grinned proudly for docs as she demonstrated her “walk” – a system of shuffling along on her knees. An operation will give her the opportunity to walk for the first time in her life. With that, perhaps she has a chance for an education.

Today, I saw the country’s new air ambulance service, which is funded privately by a former helicopter pilot in Florida. An air ambulance is an unusual luxury for a country like Haiti where babies die from lack of basic nutrition. But the air ambulance service is creating the first comprehensive network of hospitals and medical services in the country. Unfathomable though it is, no such list existed before.

This afternoon, our Team Broken Earth crew delivered bags of donated goods to volunteers from a Haitian orphanage, Tytoo Gardens. We met the orphanage team last year after several of their kids came to Bernard Mevs for evaluation by Team Broken Earth. This year, we brought toys, clothes and soccer balls, along with necessities like medications, soaps and toothbrushes for the orphanage.

Tonight, at their seaside compound, I know 30 or so kids are experiencing a new kind of unfathomable. That makes this all worth it.

– Christina

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As Long as We Have We…

Sometimes you have to stop and look at the people you’ve surrounded yourself with and count yourself as lucky that you get to work in their presence. I believe nurses are amazing people. I’m lucky to work with some of the best here.  The team started today with a bang.  The OR was buzzing immediately, Orla and Tina have barley had time to recharge but they find the energy somewhere.  Rochelle and Michael in the peds unit started with Leigh Anne and Natalie resuscitating a baby. Always tough to see for a parent, for anyone really. Little fighter pulled through.

You can always count on Jackie Connelly to be in the ring. Jackie continues to be the glue for the team… coach, mentor, supporter, soldier… she’s working hard in the ICU and putting out fires all around us. Our nurses are all cut from that cloth. The emerge nurses are working together even when they are off. It’s a solid lesson in teamwork for all of us

Scott Wilson an adult ER doc thought he was running a pediatric unit with three very sick babies at one point! That changed very quickly with a three-person polytrauma car accident and an adult code all at one time.   Four acute sick patients in a three-bed unit. I’d like to say that’s abnormal, far from it.

Trying to keep up on our mandate of making education an important part of what we do here. Last night I met with the Dean of the local medical school and we are going to try and set up regular telemedicine lectures for his students and teachers. I like to think of it as investing in Haiti’s own team for Broken Earth.

Been long days here so far. Lots done. Lots more to do. I hear it’s been cold back home. Thinking about the kids. The support at home. The support at work. You got to surround yourself with a team. That’s how you do it. My kids love the Grinch. There’s a great line at the end… “as long as we have we.”

– Andrew

 

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