News from Deschapelles and Rehabilitation at HAS

The following is an account sent by email to us from Denise English, the director of the Rehabilitation Technician Training Program. Denise is currently in Deschapelles, Haiti, at HAS.

I find my telling of this new beginning far differently than I imagined. It will remain an account of hope and reaffirmation.

We arrived, Chuck Gulas and I, on January 4, 2010. Chuck flew in from St. Louis. Ian Rawson and I flew in from Pittsburgh. Chuck was waving from the curb outside the airport, having arrived ahead of us.

The trip up from Port au Prince to Deschapelles went smoothly. The vistas spectacular. Haiti never disappoints.

Chuck Gulas, PT PhD, is the Dean of the School of Health Professions at Maryville University in St. Louis, Missouri. This is his third trip to Haiti as volunteer faculty for Health Volunteers Overseas www.hvousa.org.

Beginning the second Rehabilitation Technician Training Program at Hopital Albert Schweitzer (HAS), brought us back. We’re a team. Class started on January 6, 2010.

We find ourselves sharing knowledge and laughter with our six delightful students – each one different – each one engaging – each one expressing their desire to become part of the health care community here assisting the disabled.

They are pioneers. Rehabilitation in this country is in its infancy. Chuck has a way with students. Knowledge delivered with humor. Yesterday class finished with laughter.

The last several days have been quite somber. The students each know someone who has been affected by the earthquake in Port au Prince. Most have family there. Yesterday phone service began to return with news of family and friends. Some good. Some devastating.

Patients began arriving at HAS before dawn on Wednesday. We’d felt the quake here late in the afternoon Tuesday, and the after shocks continued into the next day. We’re not certain, but we think that we felt some slight ones yesterday.

Most medical facilities in Port au Prince were rendered inoperable. Hôpital Albert Schweitzer is one of the few operating without interruption, having been spared the damage of the earthquake. It is now a key rescue facility.

Wednesday continued to see the arrival of vehicle after vehicle of the injured from Port au Prince. Many have been identified as from this area, or having family here. We are 70 miles by road from the capitol.

Our classroom at the hospital has been turned over for patient care. The Physiotherapi room is cleared out and functions as a ward.

Yesterday, we had class here at the house. The day began with discussion of news the students had received. The day ended, as noted above, with laughter. A good decision to spend the day together yesterday. A sense of purpose in a situation that is full of uncertainty.

Chuck and I were privileged to witness the initial mobilization of the hospital staff and community members in response to the arrival of the injured. A sense of calm – in the midst of suffering – prevailed. Patients were carried in the doors – often in the arms of security staff and other hospital employees called into action. Community members came to assist. We began to fill up fast. A search began for additional beds and mattresses. The staff began evaluating and then designating people for radiology and surgery. The nurses moving quietly between patients. Soon it appeared that every possible place was filled.

Hallways were impassable at times.

The patients continued to arrive through the night Wednesday and were still coming last night, Thursday, when I returned to the house around 11:00.

There was not as much heart-wrenching wailing this evening. Hymns could be heard being sung in the wards

Earlier last evening, Tomasz Skowronski, our HVO onsite contact and my partner in coordinating the HAS end of the training program needs for our teachers, was helping to coordinate and effort to secure more beds and mattresses. Now we were spilling out into the courtyards. The halls had long ago been filled to capacity – and then some.

The decision was easily made to press into service a bed and two mattresses that we were not using. Why we didn’t think of it sooner I don’t know. Tomasz arrived shortly with his team and whisked them off. We slept better knowing that someone else did as well. It was touching to watch Tomasz work along side of the others here.

David Charles, PT - the Director of Rehabilitation Services here at HAS – has been a leader in the efforts here – moving amongst the patients and assisting the physicians and nurses. Today we hope to be able to begin to work with him as patients are identified as ready for rehabilitation services.

The injuries are sobering – fractures, spinal cord and head injuries, amputations.

The families are remarkable – caring for and comforting, supporting one another.

Last night we were remarking that when we are in the midst of this we feel hopeful.

We are certain, more than ever, that the training of rehabilitation workers here will impact the lives of many that they touch. It already has. A reaffirmation.

Those who provide that service – our HVO Volunteers – and the sponsor organizations, Hôpital Albert Schweitzer and The Friends of HAS, are key.

In times like this, heroes are mentioned. They are indeed here in Deschapelles. We’ve seen them.

To make a donation to the Hôpital Albert Schweitzer earthquake relief fund, click HERE.

We need your support!

In order to continue to administer care to Haitians affected by this tragedy, we need your help! Please show your support through donations made online here:

www.hashaiti.org

Hôpital Albert Schweitzer Haiti (HAS), located 40 miles NW of Port Au Prince, was able to withstand the recent devastating earthquake and is currently operating with full staff helping victims. With mass casualty protocols in place, the medical staff is evaluating each patient, performing diagnostic tests and delivering life saving care.

Due to the expertise developed over its 54 year history, Hôpital Albert Schweitzer Haiti (HAS) is one of the few institutions positioned to provide timely hospital care for the injured. As the flow of people urgently seeking care increases over the next few days and weeks, our resources will be pushed to the breaking point. It is critical that we receive support to help us continue with our mission!

Pittsburgh Office
Hôpital Albert Schweitzer
P. O. Box 81046
Pittsburgh, PA 15217 USA
412.361.5200 phone
412.361.5400 fax

Afternoon Report Wednesday, 13 Jan 2009

As we have all heard many reports of the terrible disaster---a 7.0 earthquake in Haiti, the worst in 200 years. Up to 3 million people may have been affected. So far, tens of thousands of people have died.

Hôpital Albert Schweitzer Haiti, located 40 miles NW of Port-Au-Prince was able to withstand the recent devastating earthquake and is currently operating with full staff helping victims. With mass casualty protocols in place, the medical staff is evaluating each patient, performing diagnostic tests and delivering life saving care. Due to the expertise developed over its 54 year history, Hôpital Albert Schweitzer Haiti (HAS) is one of the few institutions positioned to provide timely hospital care for the injured. As the flow of people urgently seeking care increases over the next few days and weeks, our resources will be pushed to the breaking point. It is critical that we receive support to help us continue with our mission.

Ever since early this morning, a steady stream of vehicles, mainly the open-back pickups which serve as public taxis on Haiti's roads, has come to the front of the hospital. In the back are one or two people, their legs or arms covered in bandages or clothes. HAS security staff rush out to the truck with a backboard or gurney, and bring the patient inside to be triaged by the emergency team.

Now, in early afternoon, a crowd of over 200 people are outside the hospital, friends or neighbors of injured patients. They rush to the arriving trucks and try to help to carry the new patients inside. Occasionally, the combination of the person's injuries and the truck ride are more than can be sustained by the patient, and the family members, with great wailing, adapt to the shock of the loss of a loved one. A sound system has been set up outside, so that family members may be called into the hospital to meet with doctors.

Each patient is brought into the Observation Unit and quickly evaluated. Some are sent to for an X-Ray or lab test while others are taken immediately to the holding area outside surgery, where both operating rooms are being used full time.

All beds have been pressed into use, and still there are patients on benches. Gradually, some of the early arrivals and less injured are prepared for discharge.

Systems at HAS are working well; preparation and practice have paid off. The greatest resource, however, is the dignity and grace of people who have suffered a great shock and sometimes tragedy, and remain calm and show concern not just for the people with whom they have come here, but for others as well.

This is the most serious challenge ever faced by HAS in its 54-year history, and while we are currently coping with the onslaught of the injured, we urgently need support.

At this moment, we don't have the capability to accept material goods or personnel. Our greatest and most urgent need is for funds to pay overtime wages to our dedicated staff, and to buy replacement medicines and supplies.

We will update the www.hashaiti.org website with news of relief efforts. To make a donation that will have immediate impact, please go to www.hashaiti.org.

Thank you again for the many expressions of help and caring that are coming from around the globe.

HAS Haiti 1/13/09

These are images taken today outside of Hôpital Albert Schweitzer Haiti. Please, if you are able to dig deeply into your hearts and help us, please do so immediately through making direct contributions to our hospital.


Click HERE for a statement from the Friends' president, Lucy Rawson.

Earthquake in Haiti - Morning Report for Wednesday, 13 January 2010

Please donate to the HAS Haiti Earthquake Relief Fund by clicking HERE.

The following is the report we received this morning from Haiti:

The halls are filled with people who have come in overnight; all nurses and residents were called in to handle a large number of new patients - traumatic injuries, mostly. Hard to get a social history, but several reports of collapses of multi-story buildings in Petite Riviere.

The influx has been handled professionally by the all-Haitian medical staff and nurses - although all available gurneys and benches are occupied, patients are triaged and staged along the corridor to the operating suite and lab/radiology. Families and friends wait anxiously outside, while the necessary care is provided calmly and quietly.

Among the most serious impacts has been the loss of communications as the cell phone towers collapsed; everyone in this area has family in Port-au-Prince, with no contact. Several people left last night for PauP, taking public transport as far as possible, and then prepared to walk several miles into town to check on family members and to report back to anxious relatives.

Out here in the valley, we experienced only minor tremors, but people poured out of their houses onto the roads. As I write this, I am feeling a very small aftershock. Major cell towers are out and only Haitel has a signal. Only a few calls are getting through to PauP, where the radio says that many large buildings have been affected. Our twelve new residents and all physicians all have families in PauP, but can't find out how they are.

You may be getting better news from CNN or Fox than we are; we will continue to monitor as best we can, but we are afraid that the daylight will bring sad information from Port au Prince. Earthquakes are rare here - only the older people realized what was going on. Since the hospital has lights and electric current, the front is crowded with people listening to radios and sharing rumors.

Unfortunately, Haiti has a long experience with natural disasters, including floods, hurricanes and mudslides; each one reinforces our awareness of the fragility of the formal social service system, and the strength of the informal systems, where communities and families come together to care for victims and to ensure that the most seriously injured come to HAS and other facilities.

We are grateful for the many messages of support; time and demands don't allow for personal answers, but be assured of our appreciation. As is usual in disasters, we have sufficient doctors and nurses, a full stock of medications for the most part, and we are fortunate to have not lost power or water. We appreciate your concern, and will continue to offer updates as time allows.

Ian Rawson and the HAS staff

Please donate to the HAS Haiti Earthquake Relief Fund by clicking HERE.

Meet HTRIP

Since 1956, Hôpital Albert Schweitzer Haiti (HAS) has provided vital health and economic recovery resources to the inhabitants of Haiti’s Artibonite Valley. HAS has always been more than a hospital—it works with Haitians to revitalize and improve the health and well-being of the over 300,000 inhabitants of that region. As a hospital program, the HAS Haiti Timber Re-Introduction Project (HTRIP) is unique amongst reforestation efforts. The project intends to have a range of positive impacts on people’s lives in this region: improved economic stability, and the basis for combating the environmental problems that lead to malnutrition and other serious health conditions. We haven't talked much about HTRIP on this blog, but that's just because we're so busy with this exciting project. Since its inception in 2005, HTRIP has become increasingly effective, despite its relatively small budget. This past summer, HTRIP added 5 new communities to the program, including over 1,050 graduates of its education programs. Now, there is a total of 35 participating communities involved in HTRIP, who have grown over 80,000 seedlings!

To boot, a pair of young filmmakers recently travelled to Haiti, and made a short film about the project, which we hope will be ready to show you in early 2010!

We recently received some seasonal updates from our collaborators in Deschapelles. Here's what they have to say!

Since October, our reforestation project has spent a good deal of time collecting data on the project's progress to date, throughout all the 35 participating communities. At present, we're really analyzing where we ought to focus our efforts for the coming year and beyond. Though this is a tedious effort, it still is not as exhausting as carving out terraces in the hills or building rock retaining walls as we do at the beginning of each year.

Most days, our team of about a dozen technicians splits into smaller groups, and we ride up to the more remote communities on motorcycles or ATV's, or occasionally (as distance and road quality dictate) our Landcruiser. Having arrived, we meet with the local community leader and walk with them to the plots. IT's normal to find only two or three plots on the side of one steep mountain, and often these plots have a great deal of distance between them.

After reaching each plot, we verify the owner of that plot, as well as the number, quality and length of the walls or canals within it, and the number of trees. Later in the spring, we'll start to measure the growth of each tree in relation to their distance from taller surrounding trees, neighboring canals and retaining walls, and tree mortality.

At this time of year (the dry season) our reforestation plots don't always look as one might normally imagine. The trees are planted earlier in the year, with the other crops the landowner has decided to grow. Young cedars, flamboyants, mahogonies and frenns are planted at one-yard distances from each other, and are interlaced with crops such as squash, peas, corn and millet. Now, in December, the millet is just about ready to harvest, towering with ten-foot stalks, and our seedlings seem lost in the mix. Fortunately, our trees are shaded from the brutal sun by other crops, and many of them will survive this hard season as a result.

In addition to data collection, HTRIP has been continuing regular instruction courses in new and old communities on some of the best strategies for soil conservation and sustainable farming strategies in the face of such harsh climate changes, and such tumultuous landscapes.

Stay tuned for more HTRIP updates in the new year!

See an HTRIP Slideshow here.

More info about HTRIP and other Friends projects here.

Stanley

Stanley is ten years old and lives in scenic Petite Riviere with his mothers and sisters in a small, but attractive painted house. Late this summer he was rushed to the hospital after an oil lamp toppled over by his bedside, and burning oil poured onto his legs. His legs and thighs were very badly burnt. 

After extensive skin grafts and surgery, Stanley was able to be moved and begin his rehabilitation. Not only did his muscles have to be excercised back into use, but special attention had to be paid to control scarring, which might have detrimental impacts on his everyday mobility and physical functionality. 

He left HAS and rehab being able to walk, and his mother was taught what daily excercises he needed to practice in order to continue proper healing. 

A few weeks ago, a team of RTTP and HAS staff members went to Petite Riviere to check up on Stanley. He hadn't checked in at HAS or any other clinics in the area for a long time, and some people were growing increasingly anxious to know how he was. 

Stanley wasn't very easy to find, since he hadn't checked in or scheduled any appointments. Although the hospital had records of him living in Petite Riviere, and some physical therapists recalled the neighborhood he lived in, there was still no clear notion of where to find him. 

After dozens of phone calls, a small team from HAS hopped from clinic to clinic, to local community leaders, trying to follow every lead as to where he might be. Eventually they found Stanley and his family. Much to the team's excitement, Stanley's mother had been very diligent with is daily exercises, and Stanley showed visible improvement. Although he is still mostly confined to his house and can't wear pants due to the irritation they cause for his wounds, Stanley was doing remarkably well.  After David Charles, one of the leading physical therapists at HAS sat down to test his range of motion and examine his overall flexibility, it was clear that he was indeed healing quite well. Stanley could even run, and demonstrated an impressive range of comfort in different movements. Some of his wounds were infected and needed cleaning, but Stanley denied that he was in any pain at all--what a trooper! 

We are all very confident that Stanley's family is taking his healing very seriously, and is being careful to make sure that he continues his daily exercises every day, and actively recovers through the rehabilitation techniques they learned at HAS, in the Physio-therapi department. 

Above: Stanley and his mother at home in Petite Riviere, after months of at-home rehabilitation and recovery.

To learn more about RTTP and other Friends of HAS projects, click here.