Re-entry

Morning Rises over Deschapelles

Bonswa all - Many, many thanks for all your prayers and words of support during the last 3 weeks. I arrived home around 10pm Saturday night and am slowly working my head around getting myself back into the Western World. It was a wonderful and challenging 3 weeks. There were many opportunities to teach which felt really good and sustainable. I taught rehab techniques to nurses in the northern town of Cap Haitian the first week, and split the second 2 weeks between teaching in the rehab technician training program at HAS and working with the Hanger team in the amputee rehab program. There is some amazing work being done there - http://www.hanger.com/Pages/JayTewHaitiBlog.aspx for more details. The patients are incredible, they are so strong and so determined and do so well in spite of every wall they are up against. The tech students are eager and hard working and we had a lot of fun teaching the pediatric portion of the course. There are lots of joys and lots of obstacles and lots of work still to be done. It was bittersweet to head home to all the creature comforts we know here. Life is so green and lush it almost hurts my eyes. Thank you for all your prayers, please keep them coming as the work is only beginning. It is wonderful to see the Haitian people starting to take on some of their own solutions but there is much training that needs to be done. Thank you to each one of you who made this trip possible - through donations, prayers and support. Those who are able to go are only able to do so because of the support of those who stay behind.
Bonwet - mesi anpil. Lauren

"May God bless you with the foolishness to think you can make a difference in the world,
so that you will do the things which others tell you can not be done."

Inhale, exhale repeat

A transition in my work this week as I am spending most of my te at the rehab tech program at the hospital, helping out at Hanger if I can but that is getting harder to do. We are working on teaching play techniques for children with disabilities. It's quite an amazing program but there is a lot to cover in a short period of time. There's a lot of everything to teach, accomplish, try to guide and improve. Sometimes it feels so daunting and it's all you can do to remember to breathe.

Arielle's new leg

We started our Friday by walking some of our to-be graduates from Lascale, a previous TB solarium which is now used to house up to 30 patients and one family member each, to the clinic. The walk takes an able bodies person a good 15 minutes over uneven terrain, crossing a small ravine and up and down hills. The strength, endurance and balance of these people is really amazing. Some of them are single amputees, others are bilateral. They are so excited to be able to do the walk and it does some amazing things for their confidence. Arielle and her mom came in the afternoon for their fitting. Mom has been fit with a new support for her leg and Arielle got to tale her first steps. She's got some work to do as her rei
sidual limb has some scarring and a bit if a contracture but her smile lights up the room. That us why we do this work. Regardless of political struggles and red tape we are making a difference in peoples lives. The next step of the challenge is to train more Haitians how to do this kind of work. I've had one of the rehab techs from the hospital with me most of the week trying to fill Jim
with as much information as I can. Sustainability is the key to lasting change...

There are no coincidences in HaIti

it has become ever more clear to me that we are all connected here. When we were up at Cap last
week we met some staff from food for the poor who told us of a 6 year old who had lost her leg in the earthquake, mom has a partial amputation from a car accident years ago. They had been transported from PAP to Cap for medical care and they wanted to know what we could do about getting her a limb. After working with the incredible Hanger program on Monday I asked around and it was pretty clear they could meet her needs. Food for the poor helped with the 5 hour travel costs and both she and mom arrived this afternoon. They were both casted and will be fit with prosthesis ToMORROW! She is georgeous, a very bright girl and I can't wait to see her face
tomorrow... The lab is busy but well organized and I'm happy to be of help. More definite plans for next week have yet to be firmly established soooooo. Love too all, Lauren

Work in Deschappelles

On to the next phase of things. I have started this week working with the Hanger lab and clinic established at Albert Schweitzer. The lab in quite an amazing setup and they have done angreat job organizing an amazing amount of supplies and meterials. The clinic is very busy, Monday in particular. Once patients have been assessed for a new limb, they are brought back a week later for delivery and can stay for 5 days to 2 weeks for training and daily therapy. The patients are amazing - tons of double amputees and they are so excited to get back on their feet. We often have to slow them down to not overdo it. As usual there are concerns about sustainability, but we have had a tech with us for better parts of the week for ongoing training. Should be tired enough to sleep like a rock but that always eludes me here- I am greatful for access to the HAS pool to blow off steam with my 5:30am swim. Hope to collaborate to bring a young girl and her
mom welearned about in Cap down for assessment this week. Whonsays anything happens by chance? Going to try to get some sleep. Love to all, Lauren

Next adventures

I woke up this morning early to the sound of the birds qacking their good morning and it got me thinking of how thankful I was for such a great group of individuals who gave of their lives and talents this week. It has been my great honor to lead such an amazing and compassonate group of people. I hope they never underestimate what an impact you each have had. Reentry is always a bit of a shock and my small advice on re-entry is to take each moment for what it is. Keep evrything in the perspective of it's environment. We had a great reunion last night complete with troubedor band and dancing and today we parted ways. The rest of team CT headed home and I started the journey up to the Albert Schweitzer hospital for 2 weeks of teaching in their rehab tech program and working with their amputee clinic. I'll keep adding my thoughts as they come. For now in the words of someone really smart "may God grant you the foolishness to think you can make a difference in the world so you will do the things that others tell you can't be done. You have many great days ahead of you. "

A small cornerstone

Lauren and I are sitting here at the Cap Haitian airport waiting to return to PAP. I keep thinking of how fast the last few days have gone. It seems as though our journey hasn't even started! This morning was another successful day for our nurses and their confidence in patient care has grown. It is evident by the way they interact with their patients, listening closely and looking intently as their patients practice using a step or performing their exercises. They seem to have a good understanding about the things we have taught them and that fact alone will carry them far. I am excited at the possibility of more therapists coming in a few weeks and providing more education. The unteachable things though, the things that are essential in life..showing compassion and having an open heart, well our nurses have a solid foundation in those areas. It has been a huge honor to be in the presences of not only our nurses and translator but the Cap Haitian people as well. I am grateful for the moments they allowed us to share with them. Our days may have passed quickly but are not easily forgotten. Whether it be brainstorming ways for a patient who had a stroke to learn to dress themselves again, teaching a beautiful dancer whose leg was crushed from the quake to stand if only briefly, or educating a young mother on the importance of gently encouraging her baby to move her badly burned and scarred leg and arm, it has all been so humbling for me to watch these nurses bloom into their own. I know I haven't even begun to process this whole amazing experience, but here's to helping lay a small cornerstone.

Victoria

Burning the Midnight Oil

Tom stayed up all night last night making the two prosthetic legs he casted yesterday. He arrived at Hopitai Espoir with legs in hand only to discover that the resin did not set properly. It was a different resin than he was used to and it did not work with carbon, so they had to be redone with fiberglass. Not all is lost though, as Tom was able to fit the prosthetics and ensure that they fit properly, so he can be confident tomorrow. He arrived back at HHH early afternoon and is still working on them - no sleep yet! One of the neighbors complained about his sawing last night though (around 2 or 3 am), so he will be forced to bed tonight! He has made good progress though and should have them ready before we leave tomorrow morning. Oh Dave, you are missed!

Two of the hydrocephalus children seemed in distress yesterday, so arrangements were made for them to go to Project Medishare today as they had a neurosurgeon available to look at the kids today. Hence, Hydrocephalus clinic was cancelled, to be completed tomorrow. Annelle and Marielle went to the clinic this morning and let the two mothers know that they would be going for an examination to check on some symptoms that the nurses were worried about. Annelle and Marielle accompanied the mothers and children to the Medishare field hospital, where on examination the neurosurgeon decided to put external drains in until the shunt surgeries could be scheduled and completed. Annelle and Marielle were able to observe the surgeries and see the resulting improvement in the children. It was a good thing that they went today as the staff at Medishare thought one of the girls would not have lived through the weekend without intervention. A good day for doing good today.

The orphanage got a double dose of PT today with Barbara and Dana working with the kids. They brought more hygiene kits over to help make sure those kids have good teeth! At the HHH clinic Lori and Cara worked their way through the patient list while Liz did some chart organizing and prepared for Hydrocephalus clinic graduation tomorrow. The mom's all get a back pack kit that contains shoes, a hygiene kit, and a toy for the kids. When clinic was over Cara continued with chart organization and Lori and Liz went to the store to stock up on some things for our reunion tomorrow night. We are making dessert for the staff here as well as for us, and we hired a local band to keep us entertained. Should be a nice evening after a long week's work.

Over at the Medishare tent today the AC was back on, thank goodness. There is a need for Tom and Dave to come and help with some braces, so hopefully they will make it out there tomorrow afternoon. Dawn brought over more resting foot braces today to help with foot drop, help prevent contractures, etc. Also some sterile gloves for the OR. All much appreciated. After the fire earlier this week, the OR is back in operation, and the ICU has moved back into that tent as well. The pediatric and adult patients are still all in one tent though, and it has been a tough week on the staff and patients alike. Every day at lunch time, one of the Interpreters breaks into song and most of the patients and families participate. It is quite a lovely sight and sound to witness. Several patients went home this week which on one hand is good. But many of them are going home to tents that have no furniture, and in wheelchairs in a country where there is no such thing as accessibility. One patient that is to go home tomorrow, a young man with a spinal cord injury, his family lost their home in the earthquake and sending him home means to the streets. Project Medishare is discharging him with a tent for him and his family to live in.

We continue to face new challenges daily such as when the discharge plan has to include a tent for shelter. Many wonderful people make these solutions possible here in Haiti, many organizations, and many generous people around the world who donate supplies, money and time. It is a pleasure and a privilege to be a part of that.

Much less duct tape

In fact I am thrilled today I haven't open the roll we brought up north at all! Some of my other trips have felt like true bandaids to the system so it is a wonderful change to work on a project that seems so empowering to the people here. We went back to the public hospital again today and our students directed much of the follow up treatments. Just about broke my heart when each patient or family asked when we'd be back. We've decided that the students have enough of the basics to see a few of the outpatients they already have worked with next week but they are certainly not prepared to be in the hospital or see any new patients without guidance. The hope is that the next volunteers will be here in 2 weeks. Looking back over our teaching log I'm axes at how much we've been able to cover, albeit cursorily. They have managed to absorb quite a lot. They work together so beautifully, it's quite amazing to see. Did some really fun labs this afternoon for gait training and strengthening. They had themselves in hysterics with the theraband but were really starting to figue more of it out for themselves. seems wierd to start thinking about packing up tonight. We will teach until 1 tomorrow and then fly back to PAP. Will be really fun to have a team reunion tomorrow night back at the guesthouse. Rumor is there are festivities being planned. We have been able to stay in touch mostly, and it sounds like all is going ok even if not always according to plan. Thanks four your prayers. Mesi anpil, Bon nwet. Lauren

Nothing is a coincidence...

Oh those of us who say that chance brings us the opportunities that come our way have clearly never been to Haiti. How else do you meet an amazing group of 17 people willing to give of their time and thei incredible talent for the benefit of others. It's incredible the paths of those we cross as we head along this journey. What small seeds we plant and what those small seeds
may become with a little faith and hope. The nurses did such a great job today, actually were able to direct the treatments for the 3 patients we had seen on Monday. They are so bright and eager and their faces
as they work together to figure something out is just priceless. It feels so hard to know that we have only started to equip them. We have given them some basic tools but there is so much more for them to learn. It is the part of 3rd world work where you have to have faith that theor will be others to follow. To let go of the control that you need to be able to see the next step. Just have faith that it is there...
Grateful to you all always, Lauren

If you have faith as small as a mustard seed, you can say to the mountain 'move from here to there.'. Nothing will be impossible to you.
Matthew 17:20

A Hot day in Haiti

Today has been the hottest day yet here in Port au Prince. The work goes on though, and the team made it through until sundown without needing IV fluids!

Tom and Dave made a new leg for an amputee yesterday, and fitted numerous braces for the folks at Hospitai Espoir. The dynamic duo split up today as Dave set out for St. Boniface to aid in meeting the needs there. Hence, Erin and Rebecca welcomed a familiar face this afternoon. The best news though is that since Dave was joining them midweek, Rebecca and Erin were able to let him know if there were any supplies they needed and give him an idea of what would be needed from him. Dave set out for the 4+ hr drive with what was needed, good team work.

Tom went solo today to Hospitai Espoir. Yesterday he and Dave met a kindhearted woman from MA who has just returned to Haiti with 4 children who suffered from severe burns during the earthquake in January. She found a sponsor in the US to fly the children to the Shriner's Hospitals in Springfield and Boston MA and has now returned to bring them home. When she met Dave and Tom yesterday, she drummed up some work for them, so Tom had a very busy afternoon. He casted two gentlemen, both with BKA, for prostheses. He has a busy night ahead of him as well because it takes 4 hrs per prosthetic to complete fabrication and he has to go back tomorrow to deliver them. He really misses Dave! It is pretty awesome to be able to give someone a new leg the same day or within 24 hrs. There is some fantastic work going on there.

Hydrocephalus clinic was in full swing today as Liz and Annelle worked very hard to prepare the mothers for the upcoming surgeries for their children. The moms learned range of motion and how to care for the incisions post-op, and tomorrow they will be tested on what they learned. Last night the team made some rattles out of supplies on hand to give the kids some auditory stimulation. Great work ladies!

Yesterday Barbara and Marielle finished up at Holy Angel (Melissa's Hope) orphanage. They came back asking for a walker for a little girl who had outgrown hers and was having back pain from being hunched over. While nothing here fit her size, that surely won't stop this crew - Tom cut down a walker with his power saw, and the walker will get delivered to her sometime this week. Barbara visited a new orphanage - Notre Maison - today with Cara. With the heat today they report the children are napping on the tile floor instead of their beds just to keep a little cooler. They were able to spend their time treating the children who needed OT and PT services as well as help lift their spirits with some donated toys. They brought smiles all around.

Dana, Lori and Marielle held down the fort at the Healing Hands clinic today. There was a steady flow of patients and their impact is notable. There are many medical needs with Marielle identifying many patients with hypertension and showing some symptoms of diabetes. She and Annelle have been able to identify other needs as well these past few days, such as doses of medicine that are too low to be effective. They are engaging the staff here to made changes where needed and provide some education for ongoing care. Dana and Lori are continuing to treat the crush injuries, with some carryover for the patients who were here Monday and Tuesday, and providing new evaluation and treatment planning for those who were new today. Their services are much needed and much appreciated.

The A/C went out at the Project Medishare tent today, which is already very warm as the tent heats up during the day. By mid day 4 nurses were in need of IV fluids, and everyone was being extra careful to drink lots of fluids. Despite the heat patients were willing to work today, maybe because it was cooler outside and for some of them who are able to be out of bed therapy is a good option to cool down. Dawn brought some leg straps for the spinal cord injury patients as well as some abdominal binders. We also had some pressure relief foot splints to bring, badly needed by many patients with heel ulcers. Project Medishare had none of these items in stock so it was Christmas in May today.

To sum up the spirit of the team, we are all seeing and doing many new things. We are diving into our skillsets and doing everything we can to meet whatever need arises. We are often asked, are you this kind of nurse, OT, PT? And the answer is "Today I am" and we figure it out.

Listen to the mustn'ts...

Listen to the mustn'ts child listen to the donts listen to the cants the wouldnts and the cants. Listen to it all my child then listen close to me. Anything can happen child anything can be. Shel Silverstein

We spent the morning at the Justinian hospital. Patients were presented to us by the chief of orthopedics Dr. Pierre-Louis. He selected 6 that were ready for therapy but many others in the orthopedic ward also looked in need. The nurses are good students and are catching on to how to take a history, assess movement. There are so mnay complexities that are so hard to explain though our translator George is great! The hospital is overwhelming in it's need. Many patients still in traction using wood for weight. Lots of children mixed in as well. There seems to be an inconsistent system for how patients are mobilized and unneccessary contractures develop. We spent a productive afternoon in the clinic saw one patient and spent a lot of time teaching - basics of assessment, rom and muscular assessment as well as bony structures and movements. The students are eager to learn and practiced on one another for the returning patients tomorrow. We met ip with some photo journalists from food for the poor this evening to compare notes about our adventures. Bonswa, Lauren

Try this again

Third time must be the charm right? A little less straightforward to blog from a phone but we'll do our best. The team reorganized all our supplies sunday morning and decided into smaller teams. Agnes and Louise went to Jacmel; Katie, Erin and Rebecca went via nondirect route to St Bonaface in Fonds DES Blancs, Victoria and Lauren got on a puddlejumper to Cap Haitian and the rest of the team planned to split between the orphanages, teaching hydrocephalus school to families of potential surgical candidates, working at the Kay kapab clinic and the medishare tent hospital. All best laid plans which may or may not actually go according to plan. We have a great team of flexible, creative and enthusiastic people so I think there's nothing we can't handle.

Victoria and I feel very privalged to be part of the Justinian rehab project aimed at bringing therapy services to the largest public hospital in Cap. They've set up a nice space and hired 3 enthusiatic nurses who want to learn but have a lot to learn as well. Taught a lot of basics today- taking a history, basic muscle and rom assessment and then saw some patients with them to start the teaching. Tomorrow we will go to the orthopedic ward at the hospital. Met up with the Canadian team to compare notes tonight.

Continue to keep us all in your thoughts and prayers. Lauren

Weathering the Storm and a Small Earthquake

Sunday the team sorted through the supplies that were donated or purchased with donations. These supplies make such a big difference, and the smallest things are appreciated here. We will have some pictures to post as well as the week goes on so you can see what great value your support brings to the people here. Some team members departed from Port Au Prince to other parts of Haiti for their assignments for the week. Agnes and Louise went to Jacmel; Katie, Erin and Rebecca went via nondirect route to St Bonaface in Fonds DES Blancs, Victoria and Lauren got on a puddlejumper to Cap Haitian and the rest of the team planned to split between the orphanages, teaching hydrocephalus school to families of potential surgical candidates, working at the Kay kapab clinic and the medishare tent hospital.

Today the entire team went to work in orphanages, hospitals and clinics around Haiti. There was an intense storm in Port Au Prince last night and during the day today there was either an earthquake or an aftershock which was upsetting to the local population as it has been a month since the last aftershock.

The O & P team, Tom and Dave, were busy fitting braces and prostheses in a local hospital. The Healing Hands clinic, staffed by Lori, Cara, Dana and Liz, was busy treating a variety of crush injuries. They felt the aftershock this afternoon and were working with patients at the time. All turned out well though. Dawn spent the day at the Project Medishare tent, where the team there was recovering from a fire last night caused by a lightening strike during last night's storm. Patients had to be evacuated from one of the tents, but the Project Medishare team did a great job of maintaining order and by mid-day today things had settled down. Lori, Annelle, Cara, Dana and Liz also spent some time this afternoon making kits of stickers to give out to the children of Haiti. The families are tight units here and frequently accompany the patients whether in the hospital or in a clinic. Hence, there are many children about needing some entertainment. Barbara and Marielle visited an orphanage and when Barbara and Cara return tomorrow, they are taking some toys, a portable crib, and some hygiene kits that the orphanage really needs. The traffic has been challenging and it took them 2 hrs to return today. We heard from Katie, Erin and Rebecca who report that St Bonaface is an excellent facility and were able to give Dave some information to prepare for his visit there later this week.

Hopefully more to come on Lauren, Victoria, Louise and Agnes in the coming days.

Monday morning. Well team Ct is off to the races. Devided All

Team CT has arrived