HAITI 2015: Our 2nd School and 5th Medical Mission Team - Summary Report

by Nick Candee

Mesi anpil / Thanks so much to all our friends and family that accompanied us on this educational and medical mission!  From the hand-crafted cloth bags, through donations for our ton ofmedicaments, dental supplies, the sorted and scrubbed pill bottles, and more. Thanks too to Zoll Medical for donation of an AED / Automatic External Defibrillator for Hopital St Croix.

Our team of 22 volunteers adapted to the challenges of operating in Haiti, as we worked in three zones:

v  Mobile medical clinics via Hopital St. Croix and the agentes sante / health agents: we saw about 1,185 patients (vs our record 1,030 patients last year). This is a very conservative estimate. Most of our team worked in the mobile clinics.

v  Developing a relationship with FSIL, the nursing school of the Episcopal University of Haiti; six team mates stayed at FSIL’s gleaming new guest house, and five were guest lecturers with the school:; Michelle Gillig RN on ER nursing; Gloria Korta MD on OB/GYN Caroline Larson OT on occupational therapy Marissa Seligman on pharmacology Dan Seligman DPM on podiatry.

v  Developing a relationship with Ecole St Croix, with the head of school Mr. Emmanuel, and head of lower school, Mr. Manuel; Carol Hokana, Barbara Foot, Elizabeth Foot, and Tom Mitchell were guest teachers in the English classes. Nick and team met with Mr. Emmanuel to endeavor to determine how to mobilize volunteers in the future for specific projects.

Villages and Number of Patients we treated that day (note family members are sometimes added after intake, so numbers are approximate, and conservative).

v  St Mathieu, 175 patients – Monday

v  Sarbousse, 260 patients – Tuesday

v  Fayette, 235 patients – Wednesday

v  Trouin, 240 patients – Thursday

v  K-Moncil, 275 patients – Friday

Total for the week: 1,185 patients treated – with some softness around those numbers.

A few patient cases:

Sad news: 18 month old Rose Nerlie, whom we met one year ago with an eye tumor, a retinoblastoma, died earlier this winter. A year ago we did get her and her mom to the best pediatrics hospital in Port au Prince; a spinal tap determined that the cancer was metastatic … so she received chemotherapy and de-bulking surgery to improve the quality of her life in the days left to her.

Glad news! Nancye Mims found the boy Alexandre with strabismus (crossed-eyes) in Trouin. Via eye specialist surgeons and the local priest, a team is working on surgery for this youngster so he can enter school. Kindly see Carol Hokana’s earlier report.

In Trouin Dr. Alex saw a 9 month old girl suffering from severe malnutrition and mild dehydration; the mother and child were referred to CNP / Children’s’ Nutrition Program.

On our last day in K-Moncil, two patients were so acutely ill that our team organized transportation to Hospital Ste Croix (there is presently no EMS in the region, nor a fire department).

Our last day in K-Moncil was surprisingly our busiest – in contrast to this village last year, where the clinic ended by 2 PM.

We then returned to Hopital St Croix, and bid farewell to our Haitian colleagues: the medical / dental team of Dr Alex Le Brun, Dr Emmanuel Bastien and his wife as dental assistant, and Kathiana and Kesnelda, our two nursing students from FSIL nursing school. We were delighted to see our nurse colleague from prior years, Rosaline Telfort now working in HSC Outpatient Dept., but keen to rejoin us next year (thanks Virginia Harrington). And we bid farewell to our 14 translators, many veterans of clinics past with us, our three reliable drivers, our team of 5 cooks, and the housekeeping team headed by the ever- positive Mme. Bellevue. And of course our beloved volunteer guest house managers, Dr Bob and Robin Sloane of Fort Worth, TX.

SUMMARY:

We are thankful for all the love that came with us on this trip, and thankful for the kind cooperation of our Haitian team as well as the patience of our Haitian patients.  We are thankful for the many skills our 22 teammates provided, from providers such as Dokte Reid Boswell MD who addressed issues in tropical medicine, to Henry Marks who pitched in on the eye clinic, to Jason Kinchen who joined us in the role of our spiritual advisor and chaplain – both for the team and for our patients; a prayer with our Haitian brothers and sisters is intangible but integrated our efforts in physical healing.

On Saturday 14 March 16 of our team returned home. Six of us (Linda Brown, Nick Candee, Mary Candee, Nancye Mims, Carol Hollingshead and Bill Saunders) remained to tour Haiti for a week, to discover a country outside the mobile medical clinics. Let us know if you’d like to hear the stories about what we found!

We continue to support our medical and school partners here throughout the year – and your financial and prayer support is treasured as we look forward to our sixth year of partnership here. 

Kindly note we anticipate additional reflections from some of our 22 volunteers

FINDING ALEXANDRE: a report on accompaniment

by Nancye Mims

 “You have to write a blog about finding Alexandre,” says Dr. Linda, as we walk into the Hopital St. Croix guesthouse after Thursday’s clinic in Trouin. I say “yes, of course, I plan to,” but I know that the words will be slow to come.

After a year of tracking down this child, hundreds of e-mails with providers, clergy, and volunteers, phone calls with a driver and a close, but ultimately unsuccessful attempt to have him seen by an ophthalmologist, we have found Alexandre.

Last March, 2014, on a Thursday, second-to-last day of our medical mission, an adorable five-year old, with a sweet smile, greeted us as we arrived in the mountain village of Trouin, pronounced “Twen.” When we stepped out of our vehicle, he was right there chewing on an old plastic bottle. We noticed immediately that his eyes were crossed; it was unclear how well he could see. I asked him his name, “Kijan ou rele?” “Alexandre,” he replied

Various team members spent time with him that day, and though I was tucked away in the pharmacy, I couldn’t get him off my mind.  Having seen a lot of poverty and suffering that week, his relatively minor condition hit me hard. How could something so easily and routinely fixed in the United States, go untreated in Haiti? As we left that afternoon, we were told he could not go to school because of his crossed eyes.

On the ride home, I was at first filled with grief, but then as we descended the mountain I began to feel determination welling up inside me. 

Colleagues and family say I am stubborn, determined, and just plain hard headed. Most recently my supervisor, described this quality euphemistically as “tenacious.” When it comes to the well being of family and friends, I don’t like to take “no” for an answer. So, right then and there, on that Thursday evening in March of 2014, I knew that I could not and would not let this stand.

By April, I found my way to an ophthalmology organization that treats people in the developing world, including Haiti. The doctor was willing to see Alexandre next time she was there, but connecting them would prove difficult, given that we did not know his last name or anyone in the village who might help us reach him.

After many e-mails, my big break came in October, when I was connected with another Episcopal group that works in Trouin. Among the contacts suggested was the priest at St. Marc’s. Then, bingo, in one e-mail everything changed. “I know him,” was the first thing I heard from Pere Jois Goursse.  More e-mails ensued, and Pere Goursse was reaching out to Alexandre’s mother.  Suddenly there was hope of having him seen in November.

I called our favorite driver in Haiti, Mr. Zo Chery, and conversations began about where to take Alexandre – Fond des Blancs, or Mirebelais? There was a major complication, though. Alexandre’s mother was expecting a baby any day and could not travel with him.

More e-mails and talk of taking Alexandre to Port Au Prince where Dr. Chandra would be working for a few days. In the end, it was too much. We decided to wait for the new baby and his mother’s recovery.

By January, we had another chance of having him seen by Dr. Chandra, but again we could not connect all the dots. Alexandre’s mother was not fully recovered from the birth of her third child, and Dr. Chandra’s schedule proved tricky as well. Then her trip was postponed. We would wait for another visit in February, which was again delayed until March. By the time I arrived in Haiti on March 7, 2015, her trip was on hold.

Meanwhile, I had plans to visit with Pere Goursse. He came to Hopital St. Croix on Wednesday, on his way to Port Au Prince. Those of us who had worked at the school that day -- Nick Candee, Carol Hokana, Barbara and Elizabeth Foot -- had a chance to sit with him and learn more about Alexandre’s village.

On Thursday we headed back to Trouin. I was at peace. Coming this far already seemed like a miracle. Maybe we would see Alexandre, but anything could happen. In my heart, I knew we were close, and regardless of what transpired we would connect him with medical care eventually.

Thursday, March 12, 2015:

Our medical mission sets up shop in an area just beyond where we were in 2014.  I have an eye out for Alexandre and his mother, but by noon there’s no sign of them.

Around that time, Carol Hokana comes to me and says “Linda says we should take a walk into town for lunch. Let’s go and try to find Alexandre.” I’m on board. Victor, our wonderful translator is with us. We arrive in the center of Trouin, and start asking for Alexandre. At first people say they don’t know him. Are they protecting him and his family from prying “blancs,” or foreigners?  I wonder.

Then one person says the family moved to Jacmel. I know enough to be suspicious of that. We are told to inquire at the school office. We start asking questions, describing who we are looking for. One question leads to another. Several people are sent out to look for Alexandre. Before we know it, he comes bounding into the office.  I can’t believe my eyes. We descend on him. “Zanmi mwen,” “My friend,” I say. There is laughter and celebration. He is taller and his front teeth are missing, but it is Alexandre. He is still wearing oversized crocs, perhaps the same ones he had on last year.

We ask him to take us to his mother. He darts off but we are following close behind; she appears and I start explaining through Victor, who I am -- the lady who has been talking with Pere Goursse. A woman close by calls out to Alexandre’s mother that we should take that beautiful baby of hers to our medical clinic. We head out, baby Georgina, toddler Claudia, and Alexandre in tow. His mother walks quickly, outpacing us all.

My heart sings. But then Alexandre nearly steps in front of a speeding motorcycle. I grab his hand, and he walks with me -- as if we have known each other for a long time.

From the beginning I have cared deeply for this child, but in the process of looking for him and trying to arrange care, I have sometimes wondered if we would ever connect him to a doctor who can help. Are we doing the right thing? Will we ultimately disappoint his family?

Then I tell myself there was never any guarantee that we would identify, much less find him in person; progress is slow but steady. “Pitit pitit n’arrive,” Little by little we get there. I am living this Haitian proverb. On this day, I know that I cannot give up; I will continue to fight for him.

On our way back to the clinic, Carol carries the baby. I have Alexandre by the hand, and his mother is ahead of us with the toddler, Claudia. My heart is bursting at the seams. We walk into the church where we are seeing patients, and my eyes meet Dr. Linda’s.

I am in a joyful state of awe. Is this really happening? If I close my eyes will Alexandre and his family disappear? I stay close by, never letting them out of my sight.

All members of the family are seen at the clinic. Alexandre’s mother seems comfortable one minute and perplexed the next. I don’t blame her; this must be a shock. I marvel at her trust.

While we wait for medications, I sit with Alexandre.  He is a typical six-year-old, antsy and interested in all that surrounds us. Occasionally while we wait, he disappears. I go in search of him, mildly panicked at the thought of losing him; he is easily found -- once outside the front door, another time down in the school.

At one point I give him my cell phone to keep him busy and sitting still. He is thrilled. After I get him off the emergency phone number app, he goes to iTunes and is giggling as Cat Stevens croons “Moon shadow, moon shadow... “ Next Alexandre flips through my photo stream and lets out a gleeful shriek when he comes upon a picture of Bill Saunders holding up a big orange drink at the Arowak Hotel.

Medications are readied at last; it’s time for Alexandre and family to go home. Carol, Victor, and I walk them back down the road. I insert some money into the family’s medicine bag. Carol tells his mom, she is a good mother. She smiles from ear-to-ear and is, finally, completely at ease. I tell her that Father Goursse will soon be in touch about next steps. She seems to understand and heads off down the road toward home.

Victor, Carol, and I turn around and go back to the clinic. I am stupefied. Can this really have happened? My love for this child is intense, unlike anything I have ever experienced for someone who is not a member of my family. But in that moment, and indeed for a long time, I have no words to describe what I feel.

In the following days, talks continue about next steps for Alexandre. Before we leave Leogane on Saturday morning, I meet the wife of a local pediatrician and we learn that there is now an ophthalmologist at Hopital St. Croix.

Now it seems there is a good chance that Alexandre will be seen very soon by the pediatrician and the eye doctor, probably in the next few weeks.*

But this is Haiti, and I know that things can change. What looks easy and straightforward one day can slip away the next. By now, though, we have lots of contacts and relationships, and I have other ideas if this falls through. I know I won’t stop until we can get something done for this child.

END

*I learned a week ago that the ophthalmologist who visits Hopital St. Croix is embroiled in a contract dispute and is not expected to see patients there for the indefinite future. Other leads are in play. Stay tuned.

A CLEARER VISION FOR HAITI

by Dan Seligman

It's 2015 and my 3rd medical mission to Haiti with Marissa. For this year, I have been preparing for my role as “the eye doc". Nice role for a podiatrist of 35 years! Why was I taking on this role? Simple... not too many people have serious foot problems and I had, by osmosis, learned the eye craft from my wife's father. Armed with the basics of "is it clearer this way or that way" I took on this task in 2013. That year showed us that there was a tremendous need for glasses amongst the people of Haiti.  We examined and dispensed all of our 300 pairs of reading glasses that year.

I managed through our collected donations, to get for 2015 a portable field vision eye testing setup and a Lensometer to measure the prescriptions of acquired glasses. To prepare myself, I asked an Optometric friend to give me a crash course in examining and evaluating basic vision issues. We also acquired a very large collection of reading glasses from Blessings International, prescription glasses, sun glasses and eye medications.  Armed with all this, we were ready to fill a critical void: giving clearer vision for our patients. We had a bonus in having Henry Marks, a college student and member of POE assist me in this mission.  Regrettably, our portable testing equipment was too difficult to transport to Haiti this year, but we hope to donate them to the Optometry Dept of Hopital St Croix in a future trip.

So,,,how did we do?  With the help of Henry, we were able to exam and dispense over 600 pairs of reading, 70 plus sunglasses and some prescription glasses to Haitians from about 10 years old to a farmer over 85 years old. The medical group saw over 1,200 people and about half the patients saw us too.  Why were we so much in demand?  Many people, especially the women, perform household tasks that requires close-up work.  In their environment, dusty, dim indoor lighting and very bright sunlight, eyes begin to wear and strain early with simple tasks such as threading sewing needles, viewing labels, and very importantly, Bible reading.

Each day we set up our "Eye Corner" amongst the doctors and triage staff. The medical staff made a referral to Henry and me to assess their vision needs. We saw many older people with developing cataracts, young kids with eye injuries, and teens and mothers who were eager to read clearer. To the best of our abilities we addressed the needs of those people, including recommendations for follow up in a clinical setting within the local hospital. Credit should be given to my translator, Jean-Marie, a young Haitian who was very skilled in explaining, defining and instructing the patients.

FSIL: I was also given an opportunity to lecture at the Nursing School affiliated with Hopital St. Croix, in my profession of Podiatry and Orthopedics. I was very grateful that by our final field clinic day, Henry had learned (with Jean-Marie) how to exam and assess patients, and dispense glasses. Also, through arrangements of Dr. Linda and Nick, I was asked to examine a dozen teachers affiliated with the Diocese School. They are dedicated young teachers who were very much in touch with the work of the medical and church mission group.

So... what was my take on all this work?  Several interesting observations came out.

1. People are much more eager to participate in their health care compared to several years ago after the earthquake.

2. People know better what they need...probably because they have a greater awareness of their surroundings since the shock of the earthquake is behind them.

3. People, especially teenage girls, who needed glasses for reading, school or homework, actually asked for glasses in specific styles, color and shape....vanity despite their poverty!  As the adage goes, If you look good, you feel good. Happy to help them!!

4. People want to improve their circumstances and if seeing clearer improves that, then there will be a brighter future for them.

Finally, I thank the members of the parish for having invited my wife Marissa (the pharmacist) and me (the foot/eye doctor) to participate in the workings of the POE in its endeavors to help the less fortunate. There is the old tenet in the Torah that states that we all should strive to leave this earth several notches better than we found it.  Thanks to all.

Dan and Marissa are members of Temple Shir Tikveh of Winchester; this was their third mission.