Tag Archives: nurses

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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Homeward bound

As the minutes wind down on another trip everyone is exhausted, hot and in desperate need of a real shower! What a week though. Every time I think I’m getting used to this, Haiti proves me wrong. These medical missions are always fulfilling, busy and emotional for us all.  But above all, they are so rewarding.

The ER staff has been busy and the nurses have been covering different shifts, helping each other out.  That’s true teamwork.

The peds unit is always the hardest but again the nurses came through, pushed through some hard shifts and rose to a level above what anyone could expect.

The ICU once again was over flowing with the sickest patients in Haiti but our resident doctor, Dr. Stone, got it done in style.

We had a birthday today.  Our physio, Susan Baird. Not going to say how old but she is spending it in Haiti with the team. That’s commitment!

Perhaps the person who needs the biggest break is Dr. Dick Barter.  He has been down here for almost three weeks.  You would never say it.  His spirits are always high and his work ethic pushes us all to be a little better. Dick’s commitment to the people of Haiti is something we should all be truly proud of.

My 3 year-old son cried this morning when he woke because I wasn’t home.  Someday I hope he will understand. But for now it is a sign, not just for me but for all the hardworking members of our team. We need to get home.  We may be headed north but our hearts are big enough that a piece stays in Haiti.

Thank you all for reading and sending your kind words of support. It truly energizes us all.

– Andrew

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The harsh reality of rural Haiti

To spend a day at Port-au-Prince’s Bernard Mevs hospital is to see people suffering the worst of the worst – things like enormous tumors, horrible strokes, malnourishment to the extreme.

But a day in the northern village of Bord de Mer Limbe is to see where the worst takes root. It’s a place without running water, without electricity, without paved roads. Set against the ocean, it’s a place where prior to the earthquake, 14% of the population lacked adequate sanitation. Nothing has improved.

This is where Team Broken Earth’s rural team started their clinical work in Haiti. They reopened for a day the shuttered clinic at the village’s edge. By the time the gates swung open at 8 am, 50 or so adults were lined up at front. An impromptu market of a dozen sellers set up at the gates, peddling drinks and fried plantains.

The team divvied up the available clinic space. Two paramedics triaged patients at the front, dietitians worked in the open-air courtyard and the physicians split the exam rooms – two physicians to a room. That meant two physicians, two translators and two patients in each small examining room.

TBE’s rural team treats patients who lack regular access to any healthcare provider. Their goal is preventative, aiming to halt the progress of problems that are prevalent at places like Bernard Mevs.

Dietitian Jen Woods used photos and measuring cups to demonstrate to her patients how much they should be eating, and what, in order to ward off malnourishment, which leaves the region’s children extremely prone to infections.

Among adults, hypertension is prevalent. Villagers don’t have access to a doctor or nurse who could check their blood pressure regularly. Even if they did, there are very limited medications available. I saw the region’s makeshift pharmacy one afternoon. It’s a beat-up jeep driven by four men who illegally sell pharmaceutical drugs, real and fake, from their vehicle. They advertise by calling out to villagers through a tin loudspeaker strapped to the roof of the jeep. “Do you have a belly ache? Do you have a headache? We have pills!” they shout.

James Rourke, Dean of Medicine at Memorial University, said patients in Port-au-Prince have much more access to medicine than those in rural areas. “There, at least, they can get cheap medicines on the street.”

Even when medications are available, there’s little monitoring of blood pressure in Haiti, resulting in what Dr. Rourke called the “tragedy of untreated hypertension.”

“That was brought home to me on my last visit to Port-au-Prince. At Bernard Mevs, we saw 45 and 50 year olds with strokes. Our goal here is to give people medication to control hypertension and prevent strokes, and give them medication at a cost they can afford.”

– Christina

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First, do not harm.

First, do not harm. A saying I’ve heard countless times. Today, I saw firsthand how difficult that can be.

I arrived in Port-au-Prince yesterday, travelling with two Calgary-based plastic surgeons, Christiaan Schrag and Duncan Nickerson. They’ve taken the week off from their busy practices to join Team Broken Earth. They’ve left young families to come down to Haiti. They’ll deal with anything that comes through the door for them over the next five days — burns, tumours, neglected injuries from the earthquake. Mostly, though, they’re coming for one 30-year-old single mother with a disfiguring, debilitating benign tumour that’s bulging out of her jaw. A solid rock mass as big as a large cantaloupe, the tumour has swallowed up everything between her neck and her lower lip. She can’t eat properly, making her noticeably skinny even for Haiti.

Back in May, a Haitian plastic surgeon emailed her photo to Dr. Nickerson to ask his advice. Sadly, there wasn’t anything to be done here in Haiti that could improve the quality of her life.

That could’ve been where the story ended. But the Calgary surgeons couldn’t get this case out of their heads.

For months, they worked with a Haitian surgeon, a surgical prosthesis manufacturer and an engineer to develop a plan. They created models of her jaw based on CT images from Haiti. They laid out an intricate plan for an operation in which they would use parts of the woman’s right fibula to reconstruct her jawbone.

The case was booked for Tuesday, today. Working with the Haitian surgeon, they planned to start at 8 am and work all day. The local staff called a camera crew to cover the story. It was the first time this type of extensive jaw reconstruction using a fibula graft would be done in Haiti.

We discussed this case over and over on the 24-hour trip here — the risks, the benefits, the what ifs, all the possible scenarios.

Almost all. Sometimes, Haiti throws you curveballs. When we arrived yesterday afternoon, the surgeons learned there was a new twist — the woman was HIV positive. She started antiviral medications in July but only intermittently. All this had been missed in the pre-op evaluations.

Even last night, the surgeons believed they might still go ahead with the case. The deciding factor was this morning’s CD4+ count, a blood test that would show the strength of the woman’s immune system and her ability to fight infection. It came back below 200 — woefully short of the cutoff the surgeons had set out.

Perhaps back in Calgary with a fully supported ICU, a specialized team to monitor the patient and a higher CD4+ count, they would have done it. Perhaps. But not in Haiti.

You could see how much it bothered the surgeons — they’d had so much hope to change the life of this woman who washes clothes for a living. But now the surgery is so risky that, ethically, it was a not an option.

“First, do not harm,” said Dr. Nickerson.

The patient took the news stoically, a word I hear over and over to describe people here. Sometimes it seems as they’ve seen so much hardship that they’re immune to new sources of pain. Or perhaps her stoicism is from the tumour itself. Maybe she’s even lost ability to show any emotion on her face.

So went our first 24 hours.

– Christina

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Mission End, Part 2: Long road home

It’s been a long week in Port-au-Prince. I am super excited to get home and see Allison, my kids and take a long, long shower. 

We have only a few hours left here and it truly has been another amazing experience. The team just gelled as they always do in these crazy circumstances, and all were working in unison. We really are larger than the sum of our parts.

In a weird way it is tough to leave.  I will miss the sounds, the smells, the patients and our new team family.  Everyone always asks why do you go back?  That’s why. The patients who need our help. The amazing people so eager and willing to give it.  

It’s been non-stop here. Last night I met with senior doctors in Haiti last night to ensure as many participants as possible get the benefit of the teaching we are offering.  That’s so important for the medical infrastructure here. And today, I had a great opportunity to secure some space to store materials and help our good friends at Project Stitch.  Jo and Scott are incredibly dedicated to giving these often forgotten patients their lives back. To treat them with the dignity they deserve. It is an honour to be a part of it.  

Meanwhile on the compound, there have been three multiple-injured patients come in over night and all hands are on deck once again, sprinting to the finish line.

In a bizarre twist, we saw a man who got shot in the head… wait for it… TWO DAYS AGO… and walked into hospital asking to be assessed.  The X-ray showed a bullet in his skull… like I said in a previous blog, this place never ceases to surprise you.

We have all worked so hard and are all exhausted but excited to get home to family and friends. Passing the baton to the Dalhousie team next. I have no doubt they’ll be amazing.

Many of you have sent such amazing notes of support for the team. I can’t tell you how much we appreciate it and how it lifts us up to do more for the people of Haiti. Thank you so much for that. Please keep it up. It truly does help.

From 33 degrees in Port-au-Prince to 1 degree in St. John’s, see you all soon.

– Andrew

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