Haiti

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royalvic

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Just spent a week in Haiti and wanted to share a little bit of the experience.

Despite the earthquake being about 2 months ago, still seemed like it could have been a week or two ago but the appearance of Port-au-Prince. Streets are passable, but debris still line them, building still unsafely standing semi-erect. Occasional smell of what likely is decaying bodies when you drive past some rubble. People (barely) living, in tents if they are lucky, or shanties made from debris. Some people bath their children in the streets, people lining up to fill their buckets with unfiltered water, likely for drinking, as the lines for trucked in water is long. People spend the days on the streets, too hot to stay in tents, some try to sell stuff, but people are only buying food. The presidential palace is collapsed, yet the front lawn remains manicured, and secured by 3 officers.

HUEH - general hospital is a series of tents, American physicians and nurses do much of the 'active' staffing, Haitian medical staff, probably overwhelmed after 2 months of this aftermath, seem fatigued, and psychologically beaten. Trying to muster their efforts is challenging.

I worked near the airport at a field hospital with Medishare. A little out of the way for the general populace. High quality care by Haiti standards by American/Canadian physicians, but limited to xrays, cbcs/BMPs; however when I was there, had a some great consultants available - ortho, neurosurgery, plastics, wound specialists.

Anyhow, just needed to share a little. Incredibly overwhelming and defeating; what we provide is just a drop in the bucket, but hopefully helped a few people's lives.

If anybody is interested...definitely an eye opening experience; IMC and Medishare are the bigger groups I've come across, pretty different experiences.

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great job and thanks for sharing...
 
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Port-au-Prince is just an unsafe place. Just driving through the streets for less than 5 minutes you see several buildings that are semi-erect, angled over walking areas. Even some reasonably appearing structures are still collapsing. The streets are narrow, and people are just outside all the time (who could blame them, its 100F, and their tents or shanties obviously lack any ventilation), drivers are reckless. Tons of motorbikes - no helmets obviously. Their public transport is generally a pick-up truck with a canopied bed, called tap-taps; people ram in there, and obviously last one on is in a precarious spot if you hit a bump...and on top of that, you have gun violence. So needless to say, there is a constant flow trauma.

On top of that, you have tons of exacerbated chronic medical illness, and a ton of urgent care...a single night a the general hospital; 2 cerebral malaria, meningitis, septic abortion due to cytotec obtained on the street, pediatric complicated febrile seizure, another ped code, 2 pre-eclamptics, one of which seizure...

Amazing opportunity to help these people who are suffering, and at the same time, learn and practice medicine outside your comfort zone (for most people).
 
For those who are part of the CIR Union, CIR are partnered with Project Medishare and will pay for flights from Miami to Port-au-Prince for a week of volunteering. All you have to pay for are flights to Miami and preparation items.

Great for those who are looking for a short elective, or those who don't have a full month allotted for elective.
 
members of federal Dmat teams are still there now dealing with the cholera epidemic. I have been a total of 3 times and am going back again early next yr.
I was there a week after the earthquake when we were treating lots of acute issues. our team was seeing 400+ pts/day initially. subsequent trips have dealt more with primary care issues for the most part.
 
members of federal Dmat teams are still there now dealing with the cholera epidemic. I have been a total of 3 times and am going back again early next yr.
I was there a week after the earthquake when we were treating lots of acute issues. our team was seeing 400+ pts/day initially. subsequent trips have dealt more with primary care issues for the most part.

I'm going for the first time in March. Any tips? One of my attendings has been twice. Unfortunately, one of the doctors she befriended is now in jail in Haiti, ...terrible story and one which will require government intervention to get him out. But I'm excited to go regardless!
 
I'm going for the first time in March. Any tips? One of my attendings has been twice. Unfortunately, one of the doctors she befriended is now in jail in Haiti, ...terrible story and one which will require government intervention to get him out. But I'm excited to go regardless!

Buy the permetherin clothing spray sold by REI instead of paying big bucks for pretreated clothing. bring light weight clothing. nylon hiking pants with zip off legs(into shorts) are ideal. bring a pair of sandals.
doxy is good prophylaxis against malaria and cholera, is cheap, and for most folks has a better side effect profile than chloroquine(but you do need to take it daily).
get your immunizations as early as possible. some like typhoid are a pain in the butt to get.
look into the non-deet insect repellants. they are a lot less toxic than deet and work very well. I wore 100% deet on my first trip which was overkill. it left spots on all of my clothing...hate to think what it did to my skin.it's not the malaria you need to worry about, it's the dengue. a guy got it on my first trip and was totally miserable for around 10 days.
bring some baby powder for your shoes Q AM and some baby wipes to use if you need a shower and don't have access to one. bring lots of granola bars and fill your waterbottle once you clear security in the u.s. because it may be a while before you get access to clean water on your arrival to port au prince...and it will likely be 90+ degrees there.
also bring:
sunscreen!
good hat with brim and a bandana for your neck.
a small headlamp with replacement batteries.
you don't really need to exchange us dollars for Haitian goudes as everyone prefers dollars anyway. if possible don't check luggage as it doesn't always show up on the other side.....
consider being a vegetarian while there. you will see why after you see the local goats and chickens. on my first trip I had a bad goat incident(let's let it go at that) and have not eaten meat in Haiti since then. don't eat from roadside stands( you probably know that). leave your nice watch at home and buy a cheapie that you wouldn't mind losing or having stolen. don't bring anything with you that you can't replace. carry your passport and a copy of your medical license with you at all times.
have a great trip. the Haitian people are wonderful and will be very thankful for anything you can do there.
 
I just came back - what a fantastic experience! I can see why people go there multiple times. There were definitely some equipment things I would have brought and will buy should I go again, but I would highly recommend people do some medical relief work at least once in their lives. Although they're in rebuilding mode and I personally was in an actual hospital and outside some of the remaining tent hospitals, there are still tons of acute issues and sequelae of medical issues sustained in the earthquake
 
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