Moderator EMEDPA Posted May 7, 2009 Author Moderator Share Posted May 7, 2009 Hey, set up a blog so we can monitor your day to day experience. You prob won't have satellite internet like we set up in Pak.:o I think I'm going to be in an internet free zone the whole time...will post some pix when I get back though.... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 15, 2009 Author Moderator Share Posted June 15, 2009 just got back from haiti last night after 9 days. we were in a rural part of the western mountains of haiti in the town of leon. see video link from youtube above in a prior post if you are new to the topic. very humbling experience. folks would walk 11 hrs to see us and wait in line patiently for 4-6 more hrs. 4 providers(me, a peds np, and 2 docs) saw over 700 pts while we were there. we were supported by several nurses, medics, and college kids who played gopher for us. highpoints: delivered a baby with heavy meconium, suctioned, resuscitated, baby did fine. many surgical referals to port au prince hospital for stuff that really needed to get done like big hernias, breast ca, tumors in airway, cataracts, etc. tx a pregnant woman with syphillis, pyelo, anemia, and malnutition. she should do ok. there is very little birth control in haiti as it is predominately catholic. no barrier methods at all. 8 kids is not uncommon. some women sneak off to port au prince every 3 mo for a depo shot. less HIV than I expected but folks who get it can go downhill fast due to conditions there. started lots of folks on bp meds for truly outrageous pressures(296/210 was highest). the world health organization only recommends tx for > 180/110. anything less they tx with salt restriction and lifestyle change. tx lots of new dm folks with metformin. we had a really good lab/tech that could do chemistries, cbc, malaria, syphillis, hiv, ua, ucg we started lots of folks on iron and vitamins for anemia. lowest hb seen by one of my colleagues: 1.3. she walked 11 miles to get there. took a while as you might imagine. lowpoints: end stage HIV pt, 35 yrs old, new dx, weight around 60 lbs, with anemia, malnutrition, pneumonia, dehydration, etc we resuscitated and started some meds. don't expect he will make it. 23 yr old guy fell from tree. paraplegic from t10 down. nothing to do there except teach family to self cath and avoid bedsores. 8 mo old baby at 8 lbs. brought in dry, malnorished, hypothermic with undetectably low blood sugar. initially responded very well to resuscitation but died several hrs later. biggest eye opener. file this under "common things occur commonly". 40 yr old woman, family carried from 4 hrs away following syncope x 2 hrs. totally unresponsive with muscular contraction of jaw and no movement of extremities. we thought maybe she had acute tetanus. worked her up for everything. all labs nl following resuscitation she sits up and says" I still feel drunk from all that moonshine last night....." lots of hunger/malnutrition there as you might expect. we ran a feeding program every day with a meal of rice/beans. we also gave away bags of rice/beans for at home. speaking of home there is no homelessness in haiti. folks take in strangers who have nowhere to stay. the word for homeless there translates as "people who live with other people". the haitians are kind, gentle, and patient. it was a very rewarding experience that I hope to continue every year. our group runs 4 trips/yr in june(x2)/oct/feb and we are able to provide pts with enough donated meds to last them until the next team arrives. pix below left to right. st paul parish where we lived. power 4 hrs/day from generator. cold water showers. basic, simple meals. the air terminal at jeremie which we flew to from port au prince. the clinic. the lab. my section of the clinic with critical bed in far corner. stpaulparish.bmp airportterminal.bmp clinicleon.bmp lab.bmp office.bmp Link to comment Share on other sites More sharing options...
jmj11 Posted June 15, 2009 Share Posted June 15, 2009 just got back from haiti last night after 9 days. we were in a rural part of the western mountains of haiti in the town of leon. see video link from youtube above in a prior post if you are new to the topic. very humbling experience. folks would walk 11 hrs to see us and wait in line patiently for 4-6 more hrs. 4 providsers(me, a peds np, and 2 docs) saw over 700 pts while we were there. we were suppoorted by several nurses, medics, and college kids who played gopher for us.highpoints: delivered a baby with heavy meconium, suctioned, resuscitated, baby did fine. many surgical referals to port au prince hospital for stuff that really needed to get done like big hernias, breast ca, tumors in airway, cataracts, etc. tx a pregnant woman with syphillis, pyelo, anemia, and malnutition. she should do ok. there is very little birth control in haiti as it is predominately catholic. no barrier methods at all. 8 kids is not uncommon. some women sneak off to port au prince every 3 mo for a depo shot. less HIV than I expected but folks who get it can go downhill fast due to conditions. started lots of folks on bp meds for truly outrageous pressures(296/210 was highest). the world health organization only recommends tx for > 180/110. anything less they tx with salt restriction and lifestyle change. tx lots of new dm folks with metformin. we had a really good lab/tech that could do chemistries, cbc, malaria, syphillis, hiv, ua, ucg we started lots of folks on iron and vitamins for anemia. lowest hb seen by one of my colleagues: 1.3. she walked 11 miles to get there. took a while as you might imagine. lowpoints: end stage HIV pt 35 yrs old, new dx, weight around 60 lbs, with anemia, malnutrition, pneumonia, dehydration, etc we resuscitated and started some meds. don't expect he will make it. 23 yr old guy fell from tree. paraplegic from t10 down. nothing to do there except teach family to self cath and avoid bedsores. 8 mo old baby at 8 lbs. brought in dry, malnorished, hypothermic with undetectably low blood sugar. initially responded very well to resuscitation but died several hrs later. biggest eye opener. file this under "common things occur commonly". 40 yr old family carried from 4 hrs away following syncope x 2 hrs. totally unresponsive with muscular contraction of jaw and no movement of extremities. we thought maybe she had acute tetanus. worked her up for everything. all labs nl following resuscitation she sits up and says" I still free drunk from all that moonshine last night....." lots of hunger/malnutrition there as you might expect. we ran a feeding program every day with a meal of rice/beans. we also gave away bags of rice/beans for at home. speaking of home there is no homelessness in haiti. folks take in strangers who have nowhere to stay. the word for homeless there translates as "people who live with other people". the haitians are kind, gentle, and patient. it was a very rewarding experience that I hope to continue every year. our group runs 4 trips/yr in june(x2)/oct/feb and we are able to provide pts with enough donated meds to last them until the next team arrives. pix below left to right. st paul parish where we lived. power 4 hrs/day from generator. cold water showers. basic, simple meals. the air terminal at jeremie which we flew to from port au prince. the clinic. the lab. my section of the clinic with critical bed in far corner. Can't wait to read your story above (and hear more later) but I have to run. I'll be back. Link to comment Share on other sites More sharing options...
jmj11 Posted June 15, 2009 Share Posted June 15, 2009 Great story. Wish I could have been there. I may be taking my first student to Nepal in Oct. Have a student, have a place and group to work with. However, while I was dealing with one group of the BODs, someone else filled our slots. Now it is a wait and see. I will know by the end of June. Link to comment Share on other sites More sharing options...
primadonna22274 Posted June 16, 2009 Share Posted June 16, 2009 Sounds like a wonderful experience E. Glad you're home safe and thanks for sharing. One of these days I'll get to do something like that too! Link to comment Share on other sites More sharing options...
dreamin2baPA Posted June 17, 2009 Share Posted June 17, 2009 Sounds good E! My FIL has been working missions for > 30 yrs. Wife has been there and I am getting ready. Welcome home. Thank you for giving. Waiting to hear more. m Link to comment Share on other sites More sharing options...
brookspa Posted June 17, 2009 Share Posted June 17, 2009 contact univ of ND PA program. they send a group of students/instructors there each yeay. Mary ann Laxen is the program director and has a long history of mission work in the area and around the world. good luck. also check the state dept and the CIA web site the lattter is the best for threat assesment. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 15, 2010 Author Moderator Share Posted June 15, 2010 just got back late last night from another 9 day trip to Haiti after 20 hrs in transit. this was to the same place I went last june to staff a rural mountain health clinic with members of various DMAT teams. our team was 2 em docs, 2 nurses, 3 pa's, an np, an emt-I, a social worker, a tropical medicine MPH, and a lab tech. highpoints of the trip included a delivery by one of our female pa's of a preterm infant who was born in significant distress and successfully resuscitated( including mouth to mouth-yuck- and chest compressions by one of our em docs), an "away team clinic"( I feel like commander riker from star trek the next generation..."#1, take an away team to the planet"....) run by me, another pa, 1 nurse, and a lab tech at a smaller village a 1 hr hike away from our primary clinic site. we saw 52 pts in 4 hrs including a critically dehydrated and anemic infant who would have died if we had not been there that day. at the main clinic we also saw 2 critically ill pts with chf, an open tib/fib fx after a truck rollover, several cases of syphillis, only 1 HIV + pt this trip( my pt actually, covered with tinea corporis from the neck down...had to be immunocompromised.....), sewveral pts with malaria, a pt with probable pertusis, several pts with significant anemia in the range of 5-8 hemoglobin, many cases of std's including a guy with 7 wives...., a uroseptic pt with obstructive/postrenal failure secondary to prostatitis who actually did very well with abx after placement of a suprapubic catheter by one of the em docs. we were blessed to be led by 2 incredible em docs. one was from the first class of a prominent em residency in the 70's and another is the ems medical director for a large west coast city. our team leader is a captain in the us public health service. we had some serious discussions about my joining the usphs....he thinks he might be able to get me in as a Lt. commander....something to think about....it was a great team across the board. I hope to continue doing this every yr. I will post some pix in the next few days. p.s. I found another scorpion in my bed....outside the mosquito net.... Link to comment Share on other sites More sharing options...
ajnelson Posted June 15, 2010 Share Posted June 15, 2010 Sounds awesome E! Too many things prevented me from doing anything this year so far, but going to make this a priority for me next year (and hopefully yearly). Link to comment Share on other sites More sharing options...
jmj11 Posted June 15, 2010 Share Posted June 15, 2010 Great work! I have to say it hits a jealous part of me. I wish I could have been there. Looking forward to seeing the photos. We were a little worried about you when no one had heard from you recently. Link to comment Share on other sites More sharing options...
DelusionalEnthusiasm Posted June 15, 2010 Share Posted June 15, 2010 I've been down there twice and seen a lot of those things you've mentioned so far. One of my friends who was down there before the earthquake got stung by one of those scorpions and had full body paresthesia for several hours. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 17, 2010 Author Moderator Share Posted June 17, 2010 pix #1right to leftriver crossing for away teamlab at away clinic: ua/ucg/hb/glu/hiv/malariadowntown leonHaitian wheelchairsaway clinic site at local school Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 17, 2010 Author Moderator Share Posted June 17, 2010 pix#2 right to lefttypical diet(fried/salted....avg bp> 160/90...many> 220/110)bed with nettingfolks outside clinic waiting to be seenmy "office" on the patio of the clinic Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 17, 2010 Author Moderator Share Posted June 17, 2010 pix #3 the shoe story.... so my regular shoes are nice leather dealies...I was getting ready to leave for the away team and someone who had been there before says"take my sandals so you can keep your shoes dry...it's an easy walk" so after the first mile the strap tore off on my l sandal...no big deal...tape...which lasted another mile or so....ok, coban....lasted 50 yards....so barefoot for the last mile or so including the last river crossing and the trail pictured here....I got to be a "barefoot dr" Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 17, 2010 Author Moderator Share Posted June 17, 2010 pix #4 typical transport...one of these flipped while we were there...not pretty view from the second floor of the rectory where we stayed in leon Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 17, 2010 Author Moderator Share Posted June 17, 2010 pix #5 world cup soccer leon style: church pews and only tv in town(the priest's) big scalp tumor...refered for surgical eval.... Link to comment Share on other sites More sharing options...
242smithbob Posted June 17, 2010 Share Posted June 17, 2010 schmitte120 is there right now - due back on Friday - He's been 12+ time. Mountians ar the safest place the people are wonderful. I'd PM schmittie120 and see what the conditions are right now. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 17, 2010 Author Moderator Share Posted June 17, 2010 having been to Haiti 3 times in the last yr I feel safer there than many places in the u.s. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 16, 2011 Author Moderator Share Posted February 16, 2011 just got back from Haiti. went to the same clinic again with dmat for 9 days. we saw 1000-1200 folks or so including 15 or so with critical illness or injury(cholera, malaria, PE, typhoid, critical anemia(hb=2.9), meningitis, status sz, liver failure with hyperkalemia, arterial bleed after machete vs wrist, cva etc), 100 or so with moderate illness and 900 or so with nl ambulatory complaints. broke my personal record for pts seen in 1 day(100 in 6 hrs-it's amazing how fast you can go with 3 sentance charts; c/c h/a, exam nl, tx tylenol). port au prince doesn't look much better than a week after the earthquake. much of the rubble remains on the street. 80% of those who lost their homes in the earthquake are still living in IDP(internally displaced persons) tent cities. glad I went back. will continue to go every yr. Link to comment Share on other sites More sharing options...
bradtPA Posted February 16, 2011 Share Posted February 16, 2011 Was wondering where you had been:). Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted February 16, 2011 Share Posted February 16, 2011 What an experience, Emed. I look forward to joining you in the years to come. Link to comment Share on other sites More sharing options...
SCHMITTIE120 Posted February 26, 2011 Share Posted February 26, 2011 just got back from Haiti. went to the same clinic again with dmat for 9 days.we saw 1000-1200 folks or so including 15 or so with critical illness or injury(cholera, malaria, PE, typhoid, critical anemia(hb=2.9), meningitis, status sz, liver failure with hyperkalemia, arterial bleed after machete vs wrist, cva etc), 100 or so with moderate illness and 900 or so with nl ambulatory complaints. broke my personal record for pts seen in 1 day(100 in 6 hrs-it's amazing how fast you can go with 3 sentance charts; c/c h/a, exam nl, tx tylenol). port au prince doesn't look much better than a week after the earthquake. much of the rubble remains on the street. 80% of those who lost their homes in the earthquake are still living in IDP(internally displaced persons) tent cities. glad I went back. will continue to go every yr. EMEDPA, Where are you going these days. I have been going to Haiti (mostly Baie D'Orange Sud-Est, Leogone, PAP and Jacmel) for around 6 years (15 trips or so). I am always trying to network with people who are interested in going to Haiti to do medical work. If you are interested I could give you some names of people (including PAs that are there full time) to network with. Love the stories, keep up the awesome work! Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 16, 2011 Share Posted March 16, 2011 Hoping to join DMAT when I grad or some point in my career Link to comment Share on other sites More sharing options...
1ORTHOPA Posted March 17, 2011 Share Posted March 17, 2011 The hand specialist and one of the other orthopods from my new job just got back from there a couple of weeks ago. They were showing me some pretty crazy pics of some pretty awful injuries. They were there for a week and their team did roughly 40 surgeries, minor and major cases. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 28, 2013 Author Moderator Share Posted August 28, 2013 Just invited back to Haiti for a trip in the spring to a new site more remote and "austere" than our typical site. this will be roughing it with tents, no running water, etc. small team. 2 docs, 1 np, me, 1 rn, 1 lab tech, and 1 team leader who will double as pharmacist. 4 hr drive by 4x4 from our typical site which is already considered "rural" by Haiti standards. very excited to have been invited. this is considered an "exploratory mission" as there has never been a western medical team in this area before. The plan is to see just how feasible it is to run a remote clinic with just a handful of people and the supplies that fit in 1 jeep. Link to comment Share on other sites More sharing options...
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