Monday, February 25, 2013


Recap – PoE Mission #3, February 2013 – by Linda Brown MD MPH

Thank you for your accompaniment and prayers on our journey to Haiti.

Our team of 15 volunteers on this medical mission included Linda Brown, Nick Candee, Suzanne Bloore, Reid Boswell, Laura Carman, Michael Chesson, Jill DiOrio, Barbara Foot, Donna Gross, Steve Gross, Virginia Harrington, Gloria Korta, Carol Hollingshead, Bill Saunders, Kate Saunders. We also had 14 Haitians working with us in patient care: Dr. Alex Le Brun, Dr. Emmanuel Bastian, Nurse Roseline Telfort, and 11 translators.

With their help, we provided mobile medical clinics in the following locations near Leogane:

Day, Village, Number of Patients
2/4  Monday,  Mathieu – 142 patients
2/5  Tuesday,  Bonyotte – 170 patients
2/6  Wednesday, Fayette – 175 patients
2/7  Thursday, Sarbousse – 215 patients
2/8  Friday, K-Moncil – 170 patients

Total: 872 patients

We deeply appreciate all our donors, in cash and in kind, for going on this medical mission with us.

A special thanks for our dentist friends who donated novocaine, dental instruments, toothbrushes, toothpaste. We gave toothbrushes and toothpaste to almost every patient. As you may recall in our 2011 report, extraction is the only curative treatment available in remote locations. So we tried to offer prophylaxis and prevention. .

Ramzi Dinno, a pharmacist in Weston again donated pharmaceuticals (dermatological creams, eye drops and ear drops) to treat tropical problems.

Bob Bristol’s employer, Nova Biomedical, Waltham, donated 15 glucometers and supplies, which are a treasured resource in Haiti. These glucometers help patients to better control their blood sugar. When we gave a patient a glucometer, we asked that patient to also check the blood sugar for other people living in their village. On Friday, Michael Chesson did a screening clinic for diabetes, and we offered to check the blood sugar for any adult.


The Epiphany hand-crafted carry-bags were beautiful, a lovely gift from the women in our church to the Haitian women.

 
Logistics of our 32 checked and 15+ carry-on bags: about 2,000 pounds of medical and dental supplies hand-carried to the Guest House at HSC in Leogane.


To recap: for 872 patients, we filled over 4,000 Rx, and gave patients deworming meds, vitamins, toothbrush, toothpaste, anti-fungal creams. Most women carried these away in a hand-crafted Epiphany bag. On behalf of the 872 people we treated, merci beaucoups!

 
We thank our Lord for our journey to Haiti. We are all missing the warmth and work in Haiti. For many members of the team, our work was transformative. We received far more from the Haitians than we gave. God willing, we return to Haiti on 8 March 2014.
 

A Prayer for Tomorrow


Take me as high as you want me to go, Lord,

Make me whatever you want me to be,

Lift me above my own narrow vision

That I might fulfill your true vision for me.

BJ Hoff

Wednesday, February 13, 2013


Last Day of Mobile Clinics - K-Moncil

by Kate Saunders

On the last day, we had our final prayer circle reciting the Lord's Prayer in both English and Creole. We then piled into the three vans/trucks and headed out past the farms and into the country near the water. The last day was by far the most scenic with amazing views of aqua blue water stretching all around us with a few fishing boats crawling across the water. There were stacks and stacks of incredible conch shells and women walking by with baskets of flip flops to sell. It was a great place to take a lunch break, have some quiet, and look at the indescribable beauty that is Haiti. It was also in my opinion one of the poorest places we have visited, a few children without any clothes or just a long shirt.

 We quickly set up within the local bar/cock fighting ring, since we were all pros now and we ended up seeing about 170 people during the day. We found that most of the backup was with the dentist who had a line circling all around the storage unit next to the beach chair he used as a dental chair. We figured this was due to all the sugar cane stalks the people chew on, which inevitably destroys their teeth. Once we saw our last patient, we went around and asked all the translators to fill out a pharmacy card with anything they needed. We had ran out of some of their requests, but we were able to decrease our inventory a lot and also help provide vitamins, tropical creams, toothbrushes and medicines for our amazing translators and their families back home. It was a great feeling being able to help them since none of this would have happened without their talented ability to translate between the Haitians and us.  We also presented our remaining children’s vitamins to the local agent santé.
 
A few of us then went back to the beach to see all of the fishing boats come in after a long day on the water. They pulled the boats up on the beach side by side and then cleaned their catch of the day. The fishes they caught and cleaned were amazing neon blues, pinks and purples. The children were also running around, playing with their new plastic bottles from the pharmacy, and wanting us to take their pictures.

 It was hard to believe that this was our last day and we were able to help so many people, physically and mentally, over such a short period of time. The time spent in this country has given me so much. It is without question, a third world country and very poor, yet I have not seen one Haitian feeling sorry for themselves or wondering why they have so little. Instead, everyone I encountered, from the very young children to the old farmers, are such joyful and happy people. They are quick to show a smile and wave when we drive by. It was also great to see how all the Haitians, especially our translators, interacted. Driving to our mobile clinics, you would see the translators in the back of the pickup joking with each other and laughing so hard that they sometimes had to hold on to each other to keep from falling over. It is very inspiring and makes me in awe that people in such terrible conditions can still find joy and laughter and continue each day, one foot at a time, even after terrible struggles and conditions. As Steve Gross mentioned a few days earlier in one of our nightly meetings “They have been beaten up but not broken down”.

Tuesday, February 12, 2013


Sequel to first Haiti post
by Mike Chesson

On our fourth day we were in a medium sized, nice house on a side street off a secondary road, across from a soccer field, with a Habitat project behind us. We drew probably the biggest crowd of the trip. I worked in the pharmacy all day, but filling orders rather than counting pills up front, our operations expertly supervised by Reid, Carol, and Barbara, with Kate, Jill, and Nick working the back of the shop. It was hot and humid, but with some breeze and out of the sun. Haitians filled the courtyard in front of the building and seeped down the alley beside the pharmacy. They kept encroaching on the entrance and by afternoon were blocking the steps, but Super Mario and his assistant kept them from entering. The entire scene was a mixture of misery and hope, desperation and energy.

Friday was our last day, spent on the ocean in a small fishing village. With a new translator, Sammy, I tested glucose levels on more than 40 Haitians. The work was not as demanding as the pharmacy or triage, and not as heartbreaking as doing interviews. I had time to observe the Haitians waiting for treatment, and they were certainly watching me. Toward the end of the day there was a little precious of perhaps five with pigtails and a white pinafore. Her frame was fragile, her features delicate, but her eyes would melt a stone.

 
As we began the slow process of shutting down the clinic and packing to leave our last clinic of the trip there were several fishing vessels on the horizon, their hulls rough silhouettes.  Their sails were rigged like nothing one would see off the U.S. coast, and were almost Biblical in appearance, reminding me of dhows, more like the profiles one would see in the Persian Gulf. 
We rode back to the guest house on the usual bad roads past huge compounds, big homes surrounded by walls topped with razor wire on the edge of cane fields.  One middle-aged man was hacking away at standing cane with a machete.  Contented cattle were tethered nearby, grazing quietly.  Goats, pigs, and chickens completed the scene as we entered the outskirts of Leogane.  A new Hummer driven by a white man [or mulatto – Ed.] passed us, perhaps headed out to his country estate. 
 
We climbed out of our vehicles near sunset in the hospital courtyard, and trailed up the steps to the guest house, following now mostly empty duffle bags, our medical supplies nearly depleted.  The scene turned chaotic as we said goodbye to our drivers and translators with small gifts of Celtics hats, toothpaste, and scarves for their wives and girlfriends.

The return trip to the airport in Port Au Prince Saturday morning was less heart- pounding, and the ride was filled with laughter about kudzu, Nickers, and Reid’s rendition of “Take Me Home, Country Road” the evening before.  Despite heavy traffic as we neared the city, and stops for gas and to let off translators, our convoy of all three vehicles arrived together at the airport.  We had an easy time checking in, and got through customs and security quickly.
At the baggage terminal in Miami we had an interminable wait for our luggage, which arrived in dribs and drabs.  All 15 of the team were there, but the group seemed smaller, somehow diminished now that our work was done.  We were quiet, tired, and anxious to check on connecting flights back to Boston amidst news of a blizzard, fifth largest in the city’s history.  Something indescribably wonderful was ending.  Fifteen people, some of them strangers until Haiti, had worked, ate, and lived together for eight days in a strange land.  By the time we returned home none of us were strangers; all were friends.  Perhaps our country seemed less normal than when we had left it.  Haiti had become the new normal and now filled a big place in our hearts.

One of our number was meeting her sister to drive to Fort Lauderdale to see other family members.  Three were staying overnight in South Beach for a gala meal with friends on Lincoln Road.  Most had booked rooms at the airport hotel, their connecting flight cancelled because of the storm, having been told they would not get back until Tuesday. 
The bag counts began to be completed.  It was time to say goodbye.  There were firm handshakes as we looked into each other’s eyes, hugs, and tears.  And then it was over.  The fire had been scattered, its embers flying in all directions, perhaps to spark other flames for Haiti.  As Father Kerwin said to us about his country, Dare to Come!  And thank you Jesus!

Thursday, February 7, 2013


Day 2 Tuesday
by Reid Boswell, MD
There are times in life when we are faced with brinksmanship and end up backing down, only to discover that perhaps the outcome was probably for the best. We awoke with every expectation that we would be traveling to our dear friend Dr. Gladys’ clinic in Bayottte in the picturesque foothills of the mountains, surrounded by blooming bougainvillea, and more than enough space to spread out for our clinic day. We discovered that, despite everyone’s best efforts, communication can fail. We headed off, some of us happily riding in the back of the Daihatsu flatbed truck, taking in the sounds and smells of Haiti. We turned off the main road, past the familiar “One Love Bar” heading towards the foothills. Our convoy abruptly stopped in front of what appeared to be an abandoned earthquake damaged school or something and were told that this was where our clinic would be. There was a small courtyard and a 400 square foot structure, with a much larger rubble-strewn structure behind.
Our leader is passionate about our mission, but apparently the local agent setting up the clinic was equally insistent that he would not lose face if we did not set up our clinic where he said. So, brinksmanship. We looked around at the few scattered faces of the locals expecting to see the doctor that day, and the consensus was to stay. The clinicians and the pharmacy were squeezed together in the 400 square foot house, triage was just outside, and the dentist settled into a corner of the courtyard. Slowly, the flow of patients developed, many people came, and by the end of the day, we saw many more patients than we had seen on day one.  There were several patients with blood pressures so high that, as the old medical joke says, they were at “patent pending.” Several presumed malaria cases, many of which were children. I saw a young man with an enormous hydrocoele (look it up) who needed surgical intervention sooner rather than later.  There was of course a variety of GI complaints, some probably caused by H. pylori, which we were well-equipped to treat. Ibuprofen and acetaminophen flew out the door to treat the aches and pains which are inevitable for hard-working farmers and those sleeping on the ground. We ran out of vitamins, and ended up getting creative about medication adjustments as our supplies began to run low. Our main translator Mario was stationed at the back door to dispense the medication to our patients in the colorful, loving-made Epiphany cloth bags. Every time I glanced over, I saw smiling children and patients crowding the door to retrieve their medication, vitamins and toothbrushes.
At the end of the day, I was tired and my feet were throbbing from being on my feet all day checking pharmacy orders. But I couldn’t help feeling an enormous sense of pride in our incredible team, face with sudden change in plans and limited space and resources, and yet all who needed to be seen were seen. Driving back on the Daihatsu flatbed, dust blowing in my eyes and hanging onto my beloved Red Sox cap, I thought about our patients that day and what would have happened if we had pushed on. Did we make a difference? I don’t know, but we showed up and did the best we could.
After dinner, we met with Father Kerwin who encouraged us, thanking us for giving up maybe a ski vacation or a pleasure cruise to come to Haiti. When asked what more we can do, he replied with an old Creole saying, that roughly translates to “many hands make light work.” His last words were “Dare to come, for that is Christian.” I thought to myself, “Father, it is a two-way street.” I feel like I receive as much or more from the Haitian people we meet and work with than anything that I give back.

 

Haiti Medical Mission Cast of Characters ...
We have 15 enthusiastic and hard working team mates here! What great people!

Co- leaders M. Linda Brown MD MPH and Nick Candee return for their 3rd Epiphany Haiti mission.  This is Linda’s 4th, as she worked in Haiti a month after the January 2010 earthquake.  The Epiphany mission began in early 2011 when Susie Almquist and Linda Brown decided to organize a medical mission to Haiti from Epiphany. Linda sought help from Dr. Emilie Hitron who has taken medical missions to Haiti for over 10 years. The first team of five included Susie as well as Mary Provo and John Cuozzo, who all returned as veterans on the second mission in 2012 (alas we are not blessed with their skills and good company this year).  The second mission team also included Cherie Arruda, Didier Collin, Reid Boswell, Sandy Bristol, Carol Hollingshead, Bill Saunders, Nancy Strong, Marissa Seligman, Dan Seligman and Phyllis Pengelly.
 
INTRODUCTIONS TO OUR MISSION 3 TEAM:

Linda is a primary care doctor at Brigham & Women’s in Chestnut Hill. Medical relief work is her passion, which started in Honduras after Hurricane Mitch, 1999. She returned to study public health, and earned a MPH at Harvard in June 2001. Since 2001, she has done international medical work in many parts of the world.

 Nick, her husband, serves as chief of mission control as well as a master pill counter in the pharmacy. He is former head of global operations for the NFPA and opened offices in Mexico City, Sao Paulo, Ottawa, Paris and Hong Kong. He also launched a magazine and trade show / conference in Spanish, completed many licensing accords for translations, and was a frequent speaker in fire safety events, often in Spanish or Portuguese.

VETERANS:  Reid Boswell, Carol Hollingshead, and Bill Saunders returned after serving on Mission 2

Reid is an occupational health physician at Mount Auburn Hospital and at least for one week out of the year, attempts to transform into a somewhat workable primary care physician.

Carol retired after working at Meditech (a medical software company) for 30 years and has gone on several Epiphany missions with Bill.
 
Bill retired after working as a marketing guru for a couple of high tech companies, which allows him to go on meaningful trips to places like Haiti and Rwanda.

 NEW MEMBERS:
 
Laura Carman MD is a primary care physician at Cambridge Health Alliance in Revere, and fluent in French (and by the way, with her husband Tom Goslin is one snappy tango dancer).

Mike Chesson, a history professor and guru on the US Civil War, is hanging out with old friends, making new ones, and very happy to have been invited to join the team.

 Jill Diorio had long wanted to join one of these missions. She was wonderful in making our 3rd Creole dinner the success that it was.  In March, she will be traveling to El Hogar in Honduras

Barbara Foot with MS Public Health has long-standing interest in international health.  She worked for UNICEF long ago with a focus on French West Africa, and is the new co- chair for Mission & Outreach at PoE, so she is walking the talk.
 
Virginia Harrington of Marshfield worked with Carol at Meditech, and was enticed to join our mission from Carol and Bill’s stories. She is serving as our LPN.
Gloria Korta MD is a GYN specialist at Winchester hospital. She worked in a hospital in Geneva, Switzerland, and so early on used French for hands- on care.

Kate Saunders is a daughter of Bill and Carol, grew up at PoE, and was also enticed to join our mission from her parent’s stories. She works on IT for Meditech.

SUPPORT FROM ALL SAINTS’ CHURCH: We are blessed with the talents of Suzanne Bloore, as well as Steve and Donna Gross.

 Suzanne Bloore led All Saints’ last mission to Honduras, and is fluent in Spanish [and Portuguese]. Creole will be an interesting challenge. She is a lawyer.
 
Donna Gross has been a Nurse Practitioner at the Holyoke clinic at Harvard for 40 years, so our alumni from that community college may have met her professionally!  She lived in Haiti for a month 35 years ago.

 Steve worked as a Jesuit priest in Honduras, and later worked for ACCION on micro-finance throughout South America, so he is fluent in Spanish. In his third transformation, he served as chaplain for hospice.

 LOCAL TEAM:  our Haitian colleagues joined our team in Leogane. Let us introduce them!

Dr. Alex LeBrun, MD returns for his 3rd year working with us. He is our line coach on dealing with tropical diseases as well as pediatrics. He is married; his wife and young daughter are at home in Port au Prince.
 
Dr. Emmanuel Bastien, DDS also returns for his 3rd year with us, and impressed on us the importance of dental extraction for pain relief in this setting. His practice in Leogane was destroyed in the earthquake, but he opened a dental clinic at HSC in 2012. His wife and daughter live in Leogane.

Nurse Roseline Telfort  was with us in 2011 and we are delighted she is back with us in 2013!

We look forward to a lively week here in the state of Ouest!
Tuesday and before ..
by Mike Chesson

On a side trip to a tourist shopping alley after our arrival in Port Au Prince, the team members in a van saw a head on collision between two young men on motos, neither wearing a helmet.  One’s head hit the ground hard, and he did not move.  We saw no more.  Dr. Bpb at the guest house said there was probably no hope for either of them if the injuries were serious, because there was no place to take them. 

The drive of more than 90 minutes was the most dangerous I have ever been on, based on my view of the road ahead directly behind the driver, who was fast but also careful and cautious, as the best drivers are.  He was wearing a handsome Lacoste green and yellow polo.  Motos passed us on the right and left, and depending upon the flow of traffic in each direction, sometimes the outbound tide occupied two or even briefly three lanes of the unmarked road, at other times one lane.  We were passed by at least one convoy of obvious big shots, the VIP of the group probably in the BMW SUV, along with a herd of lesser black SUVs, followed by ordinary Haitians, flashing their lights in identical fashion and trying to draft the convoy.  We also passed a UN detachment, and one soldier gave us the fish eye, and looked hard at the van after we had passed, the kind of hard stare that most of us have seen from police officers.

Service the next morning started at 7:00 and my group arrived at 7:10, during what I very much hope was the opening hymn.  (All Haitian hymns seem to have eight or ten verses, and all that I heard were beautifully sung.)  We entered from the rear, hoping to hide in the back, but a very forthright usher in a suit took us to the second pew right up front.  He clearly knew his business.  Standing next to Father Kerwin was a senior LEM, perhaps also the senior warden, with a clipboard taking notes.  Was he writing down the names of late comers, of whom there were a few, or of absentees?  The young women acolytes were wearing high heels beneath their robes.  To the right of the altar was a choir of twenty children and teens, two-thirds of them girls and young women, led by a pair of sisters, the choir director and a teacher.  Most of the little girls were in pink.  There were a few young men looking in through the epistle side door, perhaps hoping to catch the eye of a young woman.  Move in a little closer gentlemen, though women often prefer the rascal to the saint.  As a reform project the saint has little to offer.  Walking around the altar during much of the service were two toddlers, a robust little boy, a “buster,” and a little girl about the same age, wearing bright red frilly ruffs around both ankles.  Each child climbed off the altar stage differently, the girl by backing off, putting one foot down, then the next; the boy by holding on to a rail of the cage next to the left side of the platform, perhaps used for some kind of manger scene.

The congregation of perhaps two hundred was not the frozen chosen, but God’s chosen.  One of our number noted that the prayers were in French, but God’s responses were in Creole.  The “service” ultimately lasted two hours, forty-five minutes, and featured a capital campaign and a pitch for the building fund after worship.  Passing the peace was particularly moving.  Father Kerwin gave prominent mention to the medical mission team in his remarks, and a number of elderly congregants shook our hands after the service.  Most of the worshipers were fashionably, even elegantly dressed.  It could have been Easter in an American church.

Toward the end of the service I noticed the young woman in front of us in the first pew.  She had a Barbie doll of the old-fashioned kind, not the current PC version.  The top of this bodacious Barbie had somehow fallen down, and the young woman was examining her.  The older woman next to her, probably her mother, told her to cover Barbie up.

That afternoon we had a bucolic tour of downtown Leogane in the afternoon heat, and made it as far as the nursing school, despite heavy traffic, most of it motorcycles.  There was plenty of street life, and countless observers of the crazy blans in the noonday sun, clambering over streets that had been torn up for a Japanese construction project, with open, and mostly unmarked square sewer holes at regular intervals along the newly installed curbs.  We passed the site of a ruined Catholic church.  All that remains is the main altar, badly damaged, and now without even a tarp as protection against the weather.  The congregation worships under tarps just behind the ruined church. 

It was on this tour that I saw the first, and only happy dog, that I have seen in Haiti.  He had a beautiful rough reddish coat, and his tail was up, and wagging.  He was clearly fed on a regular basis.  Some family belonged to him.  He patrols the grassy grounds around the nursing school.  Virtually all Haitian dogs are short-haired, light tan, and despite small size variations, share the same conformation.  Their tails seem to be locked between their legs as they slink around the streets looking for something to eat, while avoiding speeding vehicles, and the people who ignore them.  Most of the females are pregnant or nursing.  To be a dog in Haiti is hell on earth.  They are not yet feral perhaps, but well on their way, should they live so long, approaching the yellow curs in Kipling’s stories. 

Our tour guide and translator, Watson, began by taking us through a cemetery across the highway from the hospital, church, and guest house.  He said that some, or many of the victims of the earth quake were buried there.  Later we learned that this was not true.  The cemetery inside is filled to overflowing with a densely crowded array of above ground tombs and family edifices, some of them quite elaborate.  Watson showed us what he said was the oldest grave in the cemetery, but knew neither its age, nor that of the cemetery itself.

On our first medical field trip on Monday I spent the day in the pharmacy, counting pills, and trying to help the doctors and other great people on the team.  Tuesday was my trial by triage, taking the blood pressures, temperatures, and pulses of countless Haitians of all ages, women and children, men and boys.  Few had only one medical problem.  Most had multiple serious issues.  One woman was anxious for me to take her blood pressure again when I got an “EE” reading.  I did, found it ok, and she asked if she could drink coffee.  Not one of them knew their weight.

Tuesday afternoon I sat in a courtyard in front of our impromptu clinic with Steve and our translators Nelson and Jack.  Almost all who were interviewed by me said things were bad last year, and worse this year.  Few had jobs.  The handsome men and beautiful women (of all ages) had great dignity and presence.  They were serious.  They had serious problems.  But I could detect enormous pride, and while being questioned by Jack who conveyed their responses to me, there was a lot of humor.

On our third trip today, we had a clinic at a higher elevation, close to some mountains, but to reach it had to cross a mostly dry river bed, actually driving a good way in the bed before we reached what had been Mount Carmel Church.  Most of the wall behind the altar was gone, as was a good part of the front wall near the roof.  The roof itself was in good shape.  The altar cross was forlorn and dusty. 

With Jack at my side we did 105 surveys, into early afternoon.  We encountered only one fussy baby; in an American setting there would have been countless screaming infants and children.  A couple of men were taxi drivers; a number of men and women were farmers; of the women who reported having jobs, most were vendors.  There was one teacher, a rugged man about forty, with no wife, children, or support system: no church, no friends or neighbors apparently, no one to help him.  Most had no jobs at all.  A few worked part time.    

Sharing a room with Reid and one of his Haitian colleagues, Dr. Alex, we had an AC malfunction Tuesday night.  The windows were wide open, and fortunately screened.  About 2:30 after sleeping soundly for six hours I awoke to the running of the hounds.  One dog was just outside the wall of our compound, and had apparently treed something.  He sounded like a very happy, and hopeful dog.  Eventually he stopped, but returned after a short interval with his pals.  About 4:00 the early shift of roosters began a call and response routine that was remarkable for its volume. 

And so it goes in the only nation state to be born as the result of a successful slave rebellion.

Wednesday, February 6, 2013


Haiti  - Epiphany Med Mission 3
FIRST MEDICAL CLINIC DAY – MONDAY
by Barbara Foot

Sunday evening brought lots of pill counting and efforts to get organized for Monday.  A few enthusiastic Super Bowl fans (Reid, Nick, Jill and Barbara), tried valiantly to tap into a live stream to catch the end of what sounded like a great game.  Unfortunately, our best effort met with a message stating that our location precluded us from receiving the stream (imagine Leogane not making it onto the NFL screen!).  Ever optimistic, we proceeded to “watch” (?) the end of the game by staring at the computer screen watching the play-by-play in written form – no pictures, no sound, just the posting every few seconds of the last play and where the ball was on the field.  We realized we looked pretty ridiculous staring at the screen sitting on a wicker bench in the Hopital Ste. Croix guest house in Leogane - but, as they say on the Bud Light commercial, “It’s only weird if it doesn’t work.”  And it did - not quite the same as watching it live but we got the outcome as it played out. 
After counting pills and packing everything into 5 extra large duffel bags Sunday night, the team was up bright and early Monday morning, anxious to begin our first clinic.  We loaded up the trucks with supplies, interpreters and team members and set out for Mathieu, a location approximately 30 minutes from the Hopital Ste. Croix.   The site was the open space between a beautiful Episcopal church that had been severely damaged in the earthquake (and is slowly being repaired) and the accompanying school.  Fortunately, there were tarps spread across the space that provided much appreciated shade.  School was in session, so we met with patients to the backdrop of children’s voices and elementary school lessons (no windows in this warm climate), and enjoyed distributing crayons, toothbrushes, and stickers to the enthusiastic children in their neatly pressed uniforms once classes finished for the day.

Despite the high number of novice team members, all went pretty smoothly.  Patients were first registered by the head translator and given a number.  They then went through triage for blood pressure, temperature and a health history, including reasons for today’s visit.  Triage was led by Donna, NP, with Virginia, LPN, and alternately Kate, Bill, Jill and Suzanne.  After triage, they answered a very short survey set up to capture a snap shot of how life is now compared to the past year.  They then met with one of the 4 physicians and/or the dentist for diagnosis and prescriptions.  Once they received their medications from the pharmacy, they were counseled by Mario, our Haitian “chief organizer/coordinator” on how to take them and set off, carrying everything in one of the beautiful hand-made bags from women at Epiphany. 
The pharmacy was a well-organized machine under Carol’s methodical direction, with medicines spread out across 3 long pew benches.  Each team member working directly with patients had a translator and they were indispensible in terms of bridging the language gaps.  Triage went without a hitch, with different team members shifting in and out throughout the course of the day.  The doctors and dentist set up stations in an open space behind a makeshift screen and efficiently saw over 140 patients with a host of health complaints. 

After we returned to the guest house last night, and everyone had a chance to shower, relax and swallow a dose of Nick’s favorite Haitian medication (ice cold Prestige beer!), we met to debrief over the first day.  All in all, everyone seemed very pleased with how it went – the few kinks were worked out pretty quickly and we figured out how to do things even better on Tuesday.  The most interesting part of the conversation focused on people’s impressions of the day.  Having worked alongside Steve on administering the survey to all adult patients, I was amazed at how open people were in meeting with us and discussing the challenges that they continue to face in general, and more specifically following the devastation of the earthquake and more recently this fall’s hurricane Sandy.  Most had no work to report, most were living in damaged homes or temporary make-shift homes built with materials provided by international organizations after the hurricane (now 3 years ago), and many had multiple health complaints.  The lack of work often means no tuition for children to attend school and difficulty securing adequate food.  Almost everyone reported their lives were getting worse this year compared to last.  And yet, in the face of numerous challenges and no obvious means to improvement, the individuals and families that we saw seemed incredibly resilient.  Many attributed this to their faith, and all seemed determined to persevere.  It was quite humbling to listen to their stories and to have them be willing to share them with us – perfect strangers.  Hopefully our presence, a warm smile, some very broken Creole, and a gentle touch repaid some of this trust and helped to bolster their sense of hope and faith, even if in a very small way.