I have about a dozen half-written journal entries that I need to post soon... Maybe my New Year's resolution should be to get more on top of that... Anyways, I've had a few requests for my suggested packing list, so am posting it as a note. It also contains a bit of commentary from Laura and myself...
Happy Holidays!
Suggested Packing List for Pharmacists
-enough clothes/scrubs for each day
(plus some extra if you get thrown up on or peed on in peds. Dress code is comfortable/casual, no white coat required)
-socks (and extra socks)
-comfortable shoes
-flip flops for the shower
-underwear
(it's coed sleeping, so don't bring your ratty undies)
-pajamas, and if you think you'll need it, an eye mask or ear plugs
(see previous coed sleeping note)
-Fannypack
(you will wear it at all times and keep your valuables, passport and money in it... socially unacceptable in the states, a MUST in Haiti)
-raincoat/poncho
-wide brimmed hat, sunblock, sunglasses
(helps with sun and rain)
-camera
(remember extra batteries or the charger)
-a journal
(optional)
-shampoo, soap, toothbrush, toothpaste, razor, deodarant, towel, etc.
-Sleeping bag/blankets/ pillow/ whatever you want for sleeping
(be sure to bring a fitted twin sheet – we have bunk beds with plastic covers on the mattresses and that sheet makes all the difference! Please consider bringing bedding that you're going to leave behind. Often times patients have no sheets or pillows unless we have them to give to them.)
-food/snacks
(2 meals a day are provided, but extra food/snacks is recommended. Good things are peanut butter crackers, tuna and cracker packs, granola bars, trail mix, candy, anything non perishable. There is access to a microwave and a hot pot)
-instant coffee/creamer/sugar
(if you're a coffee person or want to make friends with the coffee drinkers in your dorm room who didn't get this list and are jonesing for some caffeine)
-Reusable water bottle
(just the bottle, not bottled water)
-Cash
(American money works fine everywhere, don't get taken advantage of by the people offering to change money at the airport. They'll often try to tell you there are only 5 or 20 gourde to the US dollar, but it's actually more like 40. People often ask "how much money should I bring?", and it really depends... I suggest $60-$100. You may want to purchase burgers/beer from the UN or some artwork from the craft fair that our spinal cord patients put on. No bills larger than a $20, no one will be able to break them!)
-HEADLAMP
(notice this item is bolded... VERY essential...)
-Bug spray
(some volunteers also bring mosquito netting... I think it's about 50% of the people who like to have the netting.)
-any personal medications
-any items needed to do your job
(This is the list I send to incoming pharmacists, so if you're a nurse/provider/lab tech there may be some "tools of the trade" (like stethoscope, BP cuff, otoscope) that you ought to add to your personal packing list. This includes things like "I have a latex allergy, and gargantuan man-hands. I need XXL nitrile gloves." This doesn't really apply to pharmacists, as we rarely wear gloves, but to everyone else reading this, if this sounds like you, please bring a box of gloves!)
-Sharpies
-Pens
Also, I have some linens and towels at the hospital that have been laundered and can be borrowed by volunteers. This frees up some luggage space to bring needed items like diapers and chucks pads. Please contact me on my personal email address pitt5297@pacificu.edu and let me know if you're interested. I'll see if I have some I can "reserve" for you, and I'll let you know what items we're in need of!
~PJ
Tuesday, December 21, 2010
Wednesday, December 8, 2010
update on current conditions in PaP (post-election)
The Haitian government waited until midnight to announce the election results. Overnight there were drunken manifestations all around the palace and in parts of the city, but around here, things have been fairly quiet during the daytime today. We are safe, on lockdown, and things are fairly calm (all things considered.) As always, safety is our primary concern.
Report from Jason (Physical Therapist):
All main routes in Port au Prince/Petionville/Peguyville have barricades and burning tires in several locations. Some are manned by angry crowds with rocks. Several vehicles have been damaged. Many secondary streets also have tires burning. There are several tires burning in Petionville. PNH has been very slow to respond, and in some areas, there has been no PNH presence. Many officers have refused to report to duty due to the election results. Several stores have been broken in and looted (Comp Haiti in PV and Asterisks at Pl St Pierre). Kenscoff road is barricaded in Fermathe and also two locatons in Pelerin. A contact made it through to PV from Thomassin but reported that he had many difficulties and it took him a long time to pass down. There are large crowds throughout the city. Most are anti-Celestin/Preval. The situation is not safe and deteriorating. There are reports of buildings being looted in several cities. Reports that "the city is burning" are being sent out. Gun fire is light and sporadic. American Airlines has cancelled all flights.
~PJ
Report from Jason (Physical Therapist):
All main routes in Port au Prince/Petionville/Peguyville have barricades and burning tires in several locations. Some are manned by angry crowds with rocks. Several vehicles have been damaged. Many secondary streets also have tires burning. There are several tires burning in Petionville. PNH has been very slow to respond, and in some areas, there has been no PNH presence. Many officers have refused to report to duty due to the election results. Several stores have been broken in and looted (Comp Haiti in PV and Asterisks at Pl St Pierre). Kenscoff road is barricaded in Fermathe and also two locatons in Pelerin. A contact made it through to PV from Thomassin but reported that he had many difficulties and it took him a long time to pass down. There are large crowds throughout the city. Most are anti-Celestin/Preval. The situation is not safe and deteriorating. There are reports of buildings being looted in several cities. Reports that "the city is burning" are being sent out. Gun fire is light and sporadic. American Airlines has cancelled all flights.
~PJ
Sunday, November 28, 2010
Some highlights from todays elections, thanks to The Joint Operations and Tasking Centre of the UN...
For what it's worth, this note could also be titled "why I'm totally fine with the lock down, and spending the afternoon working on craft projects and laundry...)
Election matters:
On 27 November, in the early hours of Bahon (North Department), two unidentified suspects threw stones at the local electoral office.Later in the morning, suspects doused the building with gasoline but were unsuccessful in their attempts. No arrest was made.
On 27 November in the veining, gunshots were reportedly heard near Lycee Nationale and Serenett Voting Centers in Pignon (North Department). Military patrols were dispatched to the locations to control the situation. Upon their arrival the situation was calm. During the patrolling, a group of nineteen suspects were detained. Two pistols, two knives and two machetes were seized and the group was handed over to two HNP officers who, later, discharged the suspects.
On 28 November, at 05.50 hours, in Desdunes (Artibonite Department), 200 supporters from two political parties disputed over the elections.Automatic weapon fired occurred and four unidentified men were discovered dead from the gunfire.One victim was shot and killed at voting center #11 (Ecole Nationale Grandes Desdunes) and three were killed at voting center #10 (Ecole Nationale Grandes Desdunes). Both voting centers were closed momentarily but reopened mid-day. At voting center #8 (Ecole Nationale de Duclos) demonstrators threw stones against the voters and MINUSTAHvehicles. MINUSTAH military troops were dispatched from Gonaives to Desdunes and ensured the security in each voting center.
On 28 November, at about 07.30 hours, in Ecole Nation De Baille Tourible (Center Department), civil unrest at the voting center erupted and several citizens started throwing stone-like objects. HNP eventually controlled the situation. Similarly, at the Ecole Nat Henry Christophe De Thomonde (Center Department), unidentified people carrying AK-47-like rifles opened fire outside the voting centre while seven people tried to interrupt voting inside the voting center. Once peace was reinstituted, the situation returned calm in both places.
On 28 November, at about 08.40 hours, in Predot, Marigot commune (South-East Department) it was reported that at early morning at the voting center #118 (Ecole Nationale Saint Roc) members of rival political parties exchanged gunfire, after Inite supporters allegedly were caught stealing some 900 ballot papers. The voting center was closed at 07.45 hours and re-opened at 08.45 hours, after the situation returned calm. No information about the Ballot Papers. The HNP has identified the suspects. The investigation is ongoing.
On 28 November, at 09.30 in Verrettes (Artibonite) voting center #170 (Ecole National Moreau) was closed by the CEP authorities due the security measures were not well established.
On 28 November, at 09.50 hours, in Ouanaminthe (North-East Department) near voting centers #21 (Ecoles Communitaire Chienchiron), #22 (Ecole Communitaire Conception) and #23 (Ecole Communitaire St. Gabriel), an identified gunman fired gunshots against the deputy delegate of the City while onboard his vehicle and fled the scene. No injures nor arrests were reported.
On 28 November, at 10.30 hours, in Corail IDP Camp Voting Center #101 in Croix des Bouquets, PaP (West Department), unregistered voters became angry, attacked the voting center and attempted to break in. Rocks were thrown at MINUSTAH Military, UNPOL and electoral delegates. A soldier was struck by a rock and sustained a minor injury. At 12.50 hours the incident was still ongoing and the violence escalated. UNPOL & FPU were overwhelmed by the pressure from the attackers and evacuated Corail IDP camp. Subsequently, the UNPOL Sub Station was also evacuated and remains unsecured. The Sub Station contains MINUSTAH equipment such as computers and generators.
On 28 November, at 10.35 hours, in front of the Building 2004, on Airport Road PaP (West Department), about 300 people protested because they were not on the voting list and thus could not vote. HNP and FPU were dispatched to the scene. No further incidents reported.
On 28 November, at 11:00 hours, at Accra Nord voting center (154), in Delmas, PaP (West Department), an unidentified suspect attempted to burn the voting center by launching a “Molotov cocktail” and then fled the scene. No injuries were reported.
On 28 November, at 11:35 hours, at voting center #80 (Ecole Nati de Filles et Garcons) and #81 (Nouveau Ecole Professional) in Trou du Nord (North East Department) unidentified persons entered into the voting centers and began to shoot firearms in the air. The population and the HNP fled the scene. An exchange of gunfire between the MINUSTAH military and the suspects occurred. The suspects fled the scene. The situation returned calm, however only voting center # 80 was reopened.
On 28 November, at 11.40 hours, in the vicinity of the voting center #175 (Eglise Grande Commission Chapelle Evang du Christ) (Artibonite), gunshots were exchanged after armed locals fired upon MINUSTAH troops providing security at the polling center. The report stated that alleged inaccurate voting lists did not have most people listed. No injuries were reported. The voting center was closed.
Today, as of 14.00 hrs, a restriction of movement was put in place for all MINUSTAH staff as a precaution against the possibility of encountering political related violence in the area of Port au Prince. Small peaceful groups of demonstrators have been spotted in Petion Ville, John Brown area and Rue Methelus. However, at the end of this reporting period 3,000 people were reported gathered in Petion Ville.
Election matters:
On 27 November, in the early hours of Bahon (North Department), two unidentified suspects threw stones at the local electoral office.Later in the morning, suspects doused the building with gasoline but were unsuccessful in their attempts. No arrest was made.
On 27 November in the veining, gunshots were reportedly heard near Lycee Nationale and Serenett Voting Centers in Pignon (North Department). Military patrols were dispatched to the locations to control the situation. Upon their arrival the situation was calm. During the patrolling, a group of nineteen suspects were detained. Two pistols, two knives and two machetes were seized and the group was handed over to two HNP officers who, later, discharged the suspects.
On 28 November, at 05.50 hours, in Desdunes (Artibonite Department), 200 supporters from two political parties disputed over the elections.Automatic weapon fired occurred and four unidentified men were discovered dead from the gunfire.One victim was shot and killed at voting center #11 (Ecole Nationale Grandes Desdunes) and three were killed at voting center #10 (Ecole Nationale Grandes Desdunes). Both voting centers were closed momentarily but reopened mid-day. At voting center #8 (Ecole Nationale de Duclos) demonstrators threw stones against the voters and MINUSTAHvehicles. MINUSTAH military troops were dispatched from Gonaives to Desdunes and ensured the security in each voting center.
On 28 November, at about 07.30 hours, in Ecole Nation De Baille Tourible (Center Department), civil unrest at the voting center erupted and several citizens started throwing stone-like objects. HNP eventually controlled the situation. Similarly, at the Ecole Nat Henry Christophe De Thomonde (Center Department), unidentified people carrying AK-47-like rifles opened fire outside the voting centre while seven people tried to interrupt voting inside the voting center. Once peace was reinstituted, the situation returned calm in both places.
On 28 November, at about 08.40 hours, in Predot, Marigot commune (South-East Department) it was reported that at early morning at the voting center #118 (Ecole Nationale Saint Roc) members of rival political parties exchanged gunfire, after Inite supporters allegedly were caught stealing some 900 ballot papers. The voting center was closed at 07.45 hours and re-opened at 08.45 hours, after the situation returned calm. No information about the Ballot Papers. The HNP has identified the suspects. The investigation is ongoing.
On 28 November, at 09.30 in Verrettes (Artibonite) voting center #170 (Ecole National Moreau) was closed by the CEP authorities due the security measures were not well established.
On 28 November, at 09.50 hours, in Ouanaminthe (North-East Department) near voting centers #21 (Ecoles Communitaire Chienchiron), #22 (Ecole Communitaire Conception) and #23 (Ecole Communitaire St. Gabriel), an identified gunman fired gunshots against the deputy delegate of the City while onboard his vehicle and fled the scene. No injures nor arrests were reported.
On 28 November, at 10.30 hours, in Corail IDP Camp Voting Center #101 in Croix des Bouquets, PaP (West Department), unregistered voters became angry, attacked the voting center and attempted to break in. Rocks were thrown at MINUSTAH Military, UNPOL and electoral delegates. A soldier was struck by a rock and sustained a minor injury. At 12.50 hours the incident was still ongoing and the violence escalated. UNPOL & FPU were overwhelmed by the pressure from the attackers and evacuated Corail IDP camp. Subsequently, the UNPOL Sub Station was also evacuated and remains unsecured. The Sub Station contains MINUSTAH equipment such as computers and generators.
On 28 November, at 10.35 hours, in front of the Building 2004, on Airport Road PaP (West Department), about 300 people protested because they were not on the voting list and thus could not vote. HNP and FPU were dispatched to the scene. No further incidents reported.
On 28 November, at 11:00 hours, at Accra Nord voting center (154), in Delmas, PaP (West Department), an unidentified suspect attempted to burn the voting center by launching a “Molotov cocktail” and then fled the scene. No injuries were reported.
On 28 November, at 11:35 hours, at voting center #80 (Ecole Nati de Filles et Garcons) and #81 (Nouveau Ecole Professional) in Trou du Nord (North East Department) unidentified persons entered into the voting centers and began to shoot firearms in the air. The population and the HNP fled the scene. An exchange of gunfire between the MINUSTAH military and the suspects occurred. The suspects fled the scene. The situation returned calm, however only voting center # 80 was reopened.
On 28 November, at 11.40 hours, in the vicinity of the voting center #175 (Eglise Grande Commission Chapelle Evang du Christ) (Artibonite), gunshots were exchanged after armed locals fired upon MINUSTAH troops providing security at the polling center. The report stated that alleged inaccurate voting lists did not have most people listed. No injuries were reported. The voting center was closed.
Today, as of 14.00 hrs, a restriction of movement was put in place for all MINUSTAH staff as a precaution against the possibility of encountering political related violence in the area of Port au Prince. Small peaceful groups of demonstrators have been spotted in Petion Ville, John Brown area and Rue Methelus. However, at the end of this reporting period 3,000 people were reported gathered in Petion Ville.
TOTAL LOCKDOWN
It's official, we are in total lockdown. Reports we're hearing are that polling stations were closed at 4pm, and 12 of the presidential candidates are calling for the elections to be canceled. Preval's party is being accused of massive fraud, and over 400,000 fake ballots have been intercepted coming over from the Dominican Republic.
The head of security at HRG just informed us of widespread manifestations; 35,000 people are marching through the streets protesting the election process. I suspect things will continue to be tense through the night.
Below are a few of the Flash reports from the JOTC
JOTC FLASH REPORT #6.1 – 28 November 2010 (1310 Hours)
Update 1250 hours: The rock throwing continues and the violence has escalated. UNPOL & FPU were overwhelmed by the pressure from the attackers and have evacuated Corail IDP camp.
Subsequently, the UNPOL Sub Station has been evacuated and is unsecured. The Sub Station contains MINUSTAH equipment and is also unsecured.
JOTC FLASH REPORT #9 – 28 November 2010 (1435 Hours)
WHAT: Voting Center attacked
WHEN: On 28 November at 1330 hours
WHERE: Voting Center #376 Ecole Communitaire de Merceron in Thomazeau (West Department)
WHO: Local people
WHY / HOW: Unknown reasons
ACTION TAKEN: UNPOL was dispatched to the scene and managed to control the situation.
ADDITIONAL INFORMATION
Local people pelted with stones the mentioned voting center.
· One person was injured and transported to the hospital.
· The Polling is ongoing
Subject: ***JOTC Flash Report No 6-28 Nov --UPDATE Shooting in Grande Desdunes--***
Flash Report # 6 UPDATE Shooting in Grande Desdunes (Artibonite Department)
· It was confirmed that an other individual was killed during the early actions at the Voting Center # 10 (Ecole Nationale Grandes Desdunes)
· At about 0830 hours the Voting Center # 10 (Ecole Nationale Grandes Desdunes) was reopened.
· The MINUSTAH QRT has arrived and ensured Voting Centers 10, 11 and 8. currently moving to VC # 9 some barricades has been found and locals are throwing stones against MINUSTAH Troops.
· The situation is unstable. Information to come.
~PJ
The head of security at HRG just informed us of widespread manifestations; 35,000 people are marching through the streets protesting the election process. I suspect things will continue to be tense through the night.
Below are a few of the Flash reports from the JOTC
JOTC FLASH REPORT #6.1 – 28 November 2010 (1310 Hours)
Update 1250 hours: The rock throwing continues and the violence has escalated. UNPOL & FPU were overwhelmed by the pressure from the attackers and have evacuated Corail IDP camp.
Subsequently, the UNPOL Sub Station has been evacuated and is unsecured. The Sub Station contains MINUSTAH equipment and is also unsecured.
JOTC FLASH REPORT #9 – 28 November 2010 (1435 Hours)
WHAT: Voting Center attacked
WHEN: On 28 November at 1330 hours
WHERE: Voting Center #376 Ecole Communitaire de Merceron in Thomazeau (West Department)
WHO: Local people
WHY / HOW: Unknown reasons
ACTION TAKEN: UNPOL was dispatched to the scene and managed to control the situation.
ADDITIONAL INFORMATION
Local people pelted with stones the mentioned voting center.
· One person was injured and transported to the hospital.
· The Polling is ongoing
Subject: ***JOTC Flash Report No 6-28 Nov --UPDATE Shooting in Grande Desdunes--***
Flash Report # 6 UPDATE Shooting in Grande Desdunes (Artibonite Department)
· It was confirmed that an other individual was killed during the early actions at the Voting Center # 10 (Ecole Nationale Grandes Desdunes)
· At about 0830 hours the Voting Center # 10 (Ecole Nationale Grandes Desdunes) was reopened.
· The MINUSTAH QRT has arrived and ensured Voting Centers 10, 11 and 8. currently moving to VC # 9 some barricades has been found and locals are throwing stones against MINUSTAH Troops.
· The situation is unstable. Information to come.
~PJ
Tuesday, November 23, 2010
Cholera update, by the numbers, written on 23 November on the UN helicopter ride back to PaP from up north
Approximate numbers for the past 48 hours:
3 successful I/Os with 16 gauge IV/admix needles
1 unsuccessful code on a man who'd ingested an unknown poison
20 kids de-wormed (after seeing a few 5 inch or longer worms come out of kids butts, they all got a weight-based dose of pierazine)
about 100 patients seen/treated
and for almost 7 hours Terry and myself were the only providers and our 3 teenage translators and 1 lab tech were our junior nurses.
NO CHOLERA DEATHS ON OUR WATCH (though there are at least 3 children who would have died had we not been there)
~PJ
3 successful I/Os with 16 gauge IV/admix needles
1 unsuccessful code on a man who'd ingested an unknown poison
20 kids de-wormed (after seeing a few 5 inch or longer worms come out of kids butts, they all got a weight-based dose of pierazine)
about 100 patients seen/treated
and for almost 7 hours Terry and myself were the only providers and our 3 teenage translators and 1 lab tech were our junior nurses.
NO CHOLERA DEATHS ON OUR WATCH (though there are at least 3 children who would have died had we not been there)
~PJ
Monday, November 22, 2010
Cholera Update written 22 November from St. Louis du Nord (I couldn't figure out how to post this from my crackberry as a note!)
It's a little past 5am, and I'm up watching the sunrise on the roof of a special needs orphanage in St. Louis du Nord while getting ready for a full day of "cholera-palooza".
The ride here from Port de Paix last night was rather interesting. We drove through two parts of a political rally (elections are the 28th), and the second part was a mob of people who flooded the streets. We sat in the truck as literally a thousand or more locals marched, danced, and chanted around us that the opposition has cholera.
Don't worry, we were safe. We are a whole world away from the riots in CAP. Political demonstrations here are like street parties with a purpose - lots of music, people dancing/marching, t-shirts and posters of the candidate... Far more entertaining that watching a debate on TV...
Here at the hospital, the census is actually down from a week ago, but it has been rainy and stormy up here for days. And anyone who knows Haiti knows that this sort of weather keeps people at home. They are scared of the rain. Which means by the time we see them they are critically ill, or they die at home.
(For the record, Haitians would not do well in the Pacific Northwest.)
I got the link below from Jen, the doctor I work with over at Heartline Ministries.
http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/11/notes-from-the-epicenter-we-are-out-of-everything-cholera-haiti.html
We are hearing stories like this from all over the country. Yesterday we came in on a very small plane that Big Dave and I crammed full of Lactated Ringers and other lifesaving supplies. We had to shuffle cases of LR over to a hospital in Port de Paix last night because they literally didn't have enough to make it through the night.
The UN report (OCHA Haiti) on the November 16th stated:
"The Ministry of Health reports 1,039 dead and 16,799 hospitalised cases of cholera."
From what I've seen, I am sure that those numbers are way too low - many of the smaller facilities are so understaffed and overwhelmed, there is no time to report cases.
~PJ
The ride here from Port de Paix last night was rather interesting. We drove through two parts of a political rally (elections are the 28th), and the second part was a mob of people who flooded the streets. We sat in the truck as literally a thousand or more locals marched, danced, and chanted around us that the opposition has cholera.
Don't worry, we were safe. We are a whole world away from the riots in CAP. Political demonstrations here are like street parties with a purpose - lots of music, people dancing/marching, t-shirts and posters of the candidate... Far more entertaining that watching a debate on TV...
Here at the hospital, the census is actually down from a week ago, but it has been rainy and stormy up here for days. And anyone who knows Haiti knows that this sort of weather keeps people at home. They are scared of the rain. Which means by the time we see them they are critically ill, or they die at home.
(For the record, Haitians would not do well in the Pacific Northwest.)
I got the link below from Jen, the doctor I work with over at Heartline Ministries.
http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/11/notes-from-the-epicenter-we-are-out-of-everything-cholera-haiti.html
We are hearing stories like this from all over the country. Yesterday we came in on a very small plane that Big Dave and I crammed full of Lactated Ringers and other lifesaving supplies. We had to shuffle cases of LR over to a hospital in Port de Paix last night because they literally didn't have enough to make it through the night.
The UN report (OCHA Haiti) on the November 16th stated:
"The Ministry of Health reports 1,039 dead and 16,799 hospitalised cases of cholera."
From what I've seen, I am sure that those numbers are way too low - many of the smaller facilities are so understaffed and overwhelmed, there is no time to report cases.
~PJ
Cholera Update written 22 November from St. Louis du Nord (I couldn't figure out how to post this from my crackberry as a note!)
It's a little past 5am, and I'm up watching the sunrise on the roof of a special needs orphanage in St. Louis du Nord while getting ready for a full day of "cholera-palooza".
The ride here from Port de Paix last night was rather interesting. We drove through two parts of a political rally (elections are the 28th), and the second part was a mob of people who flooded the streets. We sat in the truck as literally a thousand or more locals marched, danced, and chanted around us that the opposition has cholera.
Don't worry, we were safe. We are a whole world away from the riots in CAP. Political demonstrations here are like street parties with a purpose - lots of music, people dancing/marching, t-shirts and posters of the candidate... Far more entertaining that watching a debate on TV...
Here at the hospital, the census is actually down from a week ago, but it has been rainy and stormy up here for days. And anyone who knows Haiti knows that this sort of weather keeps people at home. They are scared of the rain. Which means by the time we see them they are critically ill, or they die at home.
(For the record, Haitians would not do well in the Pacific Northwest.)
I got the link below from Jen, the doctor I work with over at Heartline Ministries.
http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/11/notes-from-the-epicenter-we-are-out-of-everything-cholera-haiti.html
We are hearing stories like this from all over the country. Yesterday we came in on a very small plane that Big Dave and I crammed full of Lactated Ringers and other lifesaving supplies. We had to shuffle cases of LR over to a hospital in Port de Paix last night because they literally didn't have enough to make it through the night.
The UN report (OCHA Haiti) on the November 16th stated:
"The Ministry of Health reports 1,039 dead and 16,799 hospitalised cases of cholera."
From what I've seen, I am sure that those numbers are way too low - many of the smaller facilities are so understaffed and overwhelmed, there is no time to report cases.
a cholera clinic in a bible college
the other half of the cholera clinic
treating pediatric cholera patients on the floor of the library
where we stayed in St. Louis
hanging out with some of the street kids in St. Louis du Nord
~PJ
The ride here from Port de Paix last night was rather interesting. We drove through two parts of a political rally (elections are the 28th), and the second part was a mob of people who flooded the streets. We sat in the truck as literally a thousand or more locals marched, danced, and chanted around us that the opposition has cholera.
Don't worry, we were safe. We are a whole world away from the riots in CAP. Political demonstrations here are like street parties with a purpose - lots of music, people dancing/marching, t-shirts and posters of the candidate... Far more entertaining that watching a debate on TV...
Here at the hospital, the census is actually down from a week ago, but it has been rainy and stormy up here for days. And anyone who knows Haiti knows that this sort of weather keeps people at home. They are scared of the rain. Which means by the time we see them they are critically ill, or they die at home.
(For the record, Haitians would not do well in the Pacific Northwest.)
I got the link below from Jen, the doctor I work with over at Heartline Ministries.
http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/11/notes-from-the-epicenter-we-are-out-of-everything-cholera-haiti.html
We are hearing stories like this from all over the country. Yesterday we came in on a very small plane that Big Dave and I crammed full of Lactated Ringers and other lifesaving supplies. We had to shuffle cases of LR over to a hospital in Port de Paix last night because they literally didn't have enough to make it through the night.
The UN report (OCHA Haiti) on the November 16th stated:
"The Ministry of Health reports 1,039 dead and 16,799 hospitalised cases of cholera."
From what I've seen, I am sure that those numbers are way too low - many of the smaller facilities are so understaffed and overwhelmed, there is no time to report cases.
a cholera clinic in a bible college
the other half of the cholera clinic
treating pediatric cholera patients on the floor of the library
where we stayed in St. Louis
hanging out with some of the street kids in St. Louis du Nord
~PJ
Sunday, November 21, 2010
Heading up to St. Louis du Nord, written on 21 November
I'm typing this on my way to St. Louis... Du Nord, not Missouri. As many of you have heard on the news, the cholera situation is getting worse. Fabienne (MTI), Terry and I are on a small UN plane headed up North with cases of life-saving LR and supplies.
I don't know what the cell coverage will be like, but wanted to send this quick update. I'm safe, and promise to STAY THAT WAY while up in the hot zone.
And FYI - while it looks much closer on a map, we will actually be 4-6 hours drive away from CAP, where all the rioting is happening, so I don't expect to be caught in the middle of any civil unrest... I want to "Save the World", but I don't want to die in the process!
I'll write more when/if I can, and expect to return to PaP with plenty to be thankful for in time for Thanksgiving.
~PJ
I don't know what the cell coverage will be like, but wanted to send this quick update. I'm safe, and promise to STAY THAT WAY while up in the hot zone.
And FYI - while it looks much closer on a map, we will actually be 4-6 hours drive away from CAP, where all the rioting is happening, so I don't expect to be caught in the middle of any civil unrest... I want to "Save the World", but I don't want to die in the process!
I'll write more when/if I can, and expect to return to PaP with plenty to be thankful for in time for Thanksgiving.
~PJ
Heading up to St. Louis du Nord, written on 21 November
I'm typing this on my way to St. Louis... Du Nord, not Missouri. As many of you have heard on the news, the cholera situation is getting worse. Fabienne (MTI), Terry and I are on a small UN plane headed up North with cases of life-saving LR and supplies.
I don't know what the cell coverage will be like, but wanted to send this quick update. I'm safe, and promise to STAY THAT WAY while up in the hot zone.
And FYI - while it looks much closer on a map, we will actually be 4-6 hours drive away from CAP, where all the rioting is happening, so I don't expect to be caught in the middle of any civil unrest... I want to "Save the World", but I don't want to die in the process!
I'll write more when/if I can, and expect to return to PaP with plenty to be thankful for in time for Thanksgiving.
(the photo is of the small plane we flew up on)
~PJ
I don't know what the cell coverage will be like, but wanted to send this quick update. I'm safe, and promise to STAY THAT WAY while up in the hot zone.
And FYI - while it looks much closer on a map, we will actually be 4-6 hours drive away from CAP, where all the rioting is happening, so I don't expect to be caught in the middle of any civil unrest... I want to "Save the World", but I don't want to die in the process!
I'll write more when/if I can, and expect to return to PaP with plenty to be thankful for in time for Thanksgiving.
(the photo is of the small plane we flew up on)
~PJ
Wednesday, October 27, 2010
cholera update
Good news: the cholera situation appears to be getting better. As Ted (Medical Teams International) put it last night, “no one is claiming victory yet”, but we were able to shut down two of the mobile/satellite clinics and our team of providers in St. Marc is seeing a drop in new admissions, and a drop in the severity of cases.
Bad news: Cholera is now in Haiti, and won’t be gone any time soon. Additionally, often times with such a highly infectious disease, there is a surge of cases, a lull (or calm before the storm), then a BIG outbreak. Especially with something like Cholera, that can take a week to show symptoms.
So we’re praying for the best, and celebrating the victories, while planning for the worst-case scenario – an outbreak in a tent city.
It must seem so foreign to the outside world - us being almost giddy with excitement about a cholera outbreak – but we all were. After the earthquake, there were so many injured. So many people that we could do nothing to help, other than to ease their pain (and in the beginning, we didn’t even have the supplies to do that.) But cholera – now that’s a whole different story. THIS is something we can fix. Cholera, if caught in time and properly treated, is totally curable. I like to jokingly say “there’s a drug for that”, and in this case, there IS a drug for that, but 80% of the time you don’t even have to give a drug. Rehydration with ORS and/or IV Hartmann’s solution (LR) will cure most cases of cholera, and proper education will prevent it from spreading. And education is really the key - and talking to people on a level that they understand, and will listen to.
For example, I live in a shipping container with a bunch of construction workers from Alabama. One of them asked me the other day “What is Cholera, and how would I get it?” And my response, after 10 hours of talking to medical people was “Cholera is a bacterial infection that is spread through the oral-fecal route.” Before it could set in that I was talking in “medical-ease” to a non-medical person, he asked “what does that mean?” to which I responded “it means don’t lick assholes.” We laughed, and then I went on with a more appropriate answer…
Cholera, the Cliffs Notes version…
Cholera is a deadly, but treatable, infection caused by eating or drinking something that contains v. cholerae bacteria. It could be from contaminated food, unsafe water, dirty hands, or coming into contact with the vomit or poop of infected people. If you have cholera, you will throw up a lot, have stomach cramps, and have very bad watery diarrhea, that looks like watery “rice-water”. There’s no fever, and they say there’s no rectal pain, but I suspect having up to 10 liters of watery diarrhea come out your butt might cause a little discomfort. It can take up to a week for symptoms to show up, and even after the symptoms go away, there are bacteria in your poop for up to 2 weeks.
As I said, cholera is very deadly – the dehydration can kill you in a matter of hours – but also very treatable. The keys to surviving are community education / prevention, and early treatment. If caught early, most cases can be cured with oral rehydration. More serious cases need IV hydration with electrolytes, and very severe cases need IV hydration and antibiotics.
Many groups have been getting the word out to the communities – through radio broadcast, skits, songs, and pastors. In the Arbonite area, we have utilized local pastors, who called their congregation together to dispel the myths and teach about prevention and early detection. And we have worked at coming up with “sustainable solutions”. For example, it is not always possible for people in tent cities to drink bottled or purified water. But they have a pot, and they have fire. They can boil water, and if there is dirt in it, let the sediment settle and only drink the clear water from the top. We are teaching people to do the best they can with what they have, and it is paying off.
At least, for the moment it is… The reality is, that cholera will be around for quite some time, and if and when it ever hits a tent city, the impact will be devastating. The CCRT is still in full operational mode, and has begun planning and preparing for what may come in the next 7 days.
Bad news: Cholera is now in Haiti, and won’t be gone any time soon. Additionally, often times with such a highly infectious disease, there is a surge of cases, a lull (or calm before the storm), then a BIG outbreak. Especially with something like Cholera, that can take a week to show symptoms.
So we’re praying for the best, and celebrating the victories, while planning for the worst-case scenario – an outbreak in a tent city.
It must seem so foreign to the outside world - us being almost giddy with excitement about a cholera outbreak – but we all were. After the earthquake, there were so many injured. So many people that we could do nothing to help, other than to ease their pain (and in the beginning, we didn’t even have the supplies to do that.) But cholera – now that’s a whole different story. THIS is something we can fix. Cholera, if caught in time and properly treated, is totally curable. I like to jokingly say “there’s a drug for that”, and in this case, there IS a drug for that, but 80% of the time you don’t even have to give a drug. Rehydration with ORS and/or IV Hartmann’s solution (LR) will cure most cases of cholera, and proper education will prevent it from spreading. And education is really the key - and talking to people on a level that they understand, and will listen to.
For example, I live in a shipping container with a bunch of construction workers from Alabama. One of them asked me the other day “What is Cholera, and how would I get it?” And my response, after 10 hours of talking to medical people was “Cholera is a bacterial infection that is spread through the oral-fecal route.” Before it could set in that I was talking in “medical-ease” to a non-medical person, he asked “what does that mean?” to which I responded “it means don’t lick assholes.” We laughed, and then I went on with a more appropriate answer…
Cholera, the Cliffs Notes version…
Cholera is a deadly, but treatable, infection caused by eating or drinking something that contains v. cholerae bacteria. It could be from contaminated food, unsafe water, dirty hands, or coming into contact with the vomit or poop of infected people. If you have cholera, you will throw up a lot, have stomach cramps, and have very bad watery diarrhea, that looks like watery “rice-water”. There’s no fever, and they say there’s no rectal pain, but I suspect having up to 10 liters of watery diarrhea come out your butt might cause a little discomfort. It can take up to a week for symptoms to show up, and even after the symptoms go away, there are bacteria in your poop for up to 2 weeks.
As I said, cholera is very deadly – the dehydration can kill you in a matter of hours – but also very treatable. The keys to surviving are community education / prevention, and early treatment. If caught early, most cases can be cured with oral rehydration. More serious cases need IV hydration with electrolytes, and very severe cases need IV hydration and antibiotics.
Many groups have been getting the word out to the communities – through radio broadcast, skits, songs, and pastors. In the Arbonite area, we have utilized local pastors, who called their congregation together to dispel the myths and teach about prevention and early detection. And we have worked at coming up with “sustainable solutions”. For example, it is not always possible for people in tent cities to drink bottled or purified water. But they have a pot, and they have fire. They can boil water, and if there is dirt in it, let the sediment settle and only drink the clear water from the top. We are teaching people to do the best they can with what they have, and it is paying off.
At least, for the moment it is… The reality is, that cholera will be around for quite some time, and if and when it ever hits a tent city, the impact will be devastating. The CCRT is still in full operational mode, and has begun planning and preparing for what may come in the next 7 days.
Saturday, October 16, 2010
Mwen kontan retounen lakay mwen
I haven’t written in quite some time. I almost feel like a Catholic going in for confession for the first time in years… But when my days are filled with critical drug shortages, funding concerns, and feeling helpless and frustrated, it’s hard to write about “saving the world”. Some days I feel like I’m barely treading water. But I’ve gotten so used to “Haiti life”, that sometimes I forget that “treading water” to me is moving at lightning speed for the rest of the world. And that sometimes I ought to take my own advice, and remember “the starfish story”.
For those of you not familiar with it, here’s “the starfish story”…
There is a big storm, and thousands of starfish are washed ashore; the sand is literally covered in a blanket of them. Along the beach wanders a little boy, picking up starfish and throwing them as hard as he can, sending them sailing back into the safety of the water. An older gentleman is watching the young boy, and after a while, he says, “What’s the use? It’s a futile effort – there are so many of them, you’ll never make a difference.” The little boy bends over and picks up another starfish, and throws it sailing into the ocean, watching as it twirls in the air, then plops beneath the waves. He turns and looks at the old man and says to him “It made a difference to that one.”
Nine months ago, the country of Haiti experienced an earthquake of such magnitude, it will take years – maybe even generations – to recover. After the quake, people from all over the globe opened their hearts and helped the people affected by the devastation. The people of Haiti are so grateful, and have shown such gratitude, but they are also frustrated and there is (understandably) unrest – so much aid has been promised that hasn’t been delivered. Nine months after the quake, well into hurricane season, 1.7 million people are still living in tent cities. Children go hungry, and illnesses go untreated, sometimes until it’s too late. Many of the NGOs who came down after the quake have pulled out (primarily due to a lack of funding), leaving a heavier patient burden for those of us who are left.
This is my day to day life – using my “food money” to buy vancomycin off the streets, and making the tough decisions when no more is to be found, begging for diapers for our preemies and ensure for our tube feed patients, and assisting other NGOs on my days off… As the only American pharmacist who “calls Haiti home”, there is no lack of work to be found…
But my day to day life is also being serenaded at 1am in the logistics room, having a terminally ill girl hug me and tell me she loves me for taking care of her, waking up grateful for a roof over my head – in a way that most Americans will never understand – and finding crazy MacGyver solutions to save the day. And while most people get a postcard from coworkers on vacation that say “on the beach, wish you were here”, I often get messages like this one from the other day: “This is to let you know that I am not the only one that you lack, but rather Project Medishare can not live without you. Miss you much Princess, Marc-Junior”…
I am touched, moved, and inspired by everything – the patients, my employees, the work I do. And I wouldn’t trade it for anything in the world.
For those of you not familiar with it, here’s “the starfish story”…
There is a big storm, and thousands of starfish are washed ashore; the sand is literally covered in a blanket of them. Along the beach wanders a little boy, picking up starfish and throwing them as hard as he can, sending them sailing back into the safety of the water. An older gentleman is watching the young boy, and after a while, he says, “What’s the use? It’s a futile effort – there are so many of them, you’ll never make a difference.” The little boy bends over and picks up another starfish, and throws it sailing into the ocean, watching as it twirls in the air, then plops beneath the waves. He turns and looks at the old man and says to him “It made a difference to that one.”
Nine months ago, the country of Haiti experienced an earthquake of such magnitude, it will take years – maybe even generations – to recover. After the quake, people from all over the globe opened their hearts and helped the people affected by the devastation. The people of Haiti are so grateful, and have shown such gratitude, but they are also frustrated and there is (understandably) unrest – so much aid has been promised that hasn’t been delivered. Nine months after the quake, well into hurricane season, 1.7 million people are still living in tent cities. Children go hungry, and illnesses go untreated, sometimes until it’s too late. Many of the NGOs who came down after the quake have pulled out (primarily due to a lack of funding), leaving a heavier patient burden for those of us who are left.
This is my day to day life – using my “food money” to buy vancomycin off the streets, and making the tough decisions when no more is to be found, begging for diapers for our preemies and ensure for our tube feed patients, and assisting other NGOs on my days off… As the only American pharmacist who “calls Haiti home”, there is no lack of work to be found…
But my day to day life is also being serenaded at 1am in the logistics room, having a terminally ill girl hug me and tell me she loves me for taking care of her, waking up grateful for a roof over my head – in a way that most Americans will never understand – and finding crazy MacGyver solutions to save the day. And while most people get a postcard from coworkers on vacation that say “on the beach, wish you were here”, I often get messages like this one from the other day: “This is to let you know that I am not the only one that you lack, but rather Project Medishare can not live without you. Miss you much Princess, Marc-Junior”…
I am touched, moved, and inspired by everything – the patients, my employees, the work I do. And I wouldn’t trade it for anything in the world.
Saturday, September 25, 2010
ve been really bad about writing lately. I keep meaning to write about Stefanie's amazing eye surgery, my birthday in Haiti, and about being shot by two film crews. (MOM - not shot with bullets, shot with cameras.) But there are never enough hours in the day, and those of you who know me well know that I am always spreading myself too thin.
So here's the important stuff for tonight:
I'm safe, my staff and volunteers are safe.
Tropical storm Matthew hit us unexpectedly... We were in the car when it hit - dodging falling trees and pieces of metal roofing - and for the first time since June, I am grateful to NOT be in the field hospital. I can't even begin to imagine what would have happened if the tents of the field hospital would have come down on 150+ patients. Our hospital is okay, but many of our partner NGOs sustained damage, most notably J/P HRO... Whose medical facilities and volunteer living area was destroyed. Beth (their CMO) called me on her way down to transfer a child with an acute abdominal injury. The big tree fell on the x-ray tent, no idea if the machine is functional. Their hospital literally blew away. The tent their volunteers sleep in is destroyed, and she has no idea where her stuff is. Sitting on the back of the truck bed, she told me "I grabbed my passport, but I don't know where anything is. Not even my bible."
I made them an emergency kit for tonight (emergency meds, bandages, IV fluids and start kits, basically an ambulance in a box), and sent up all of the clean, dry scrubs that I've had donated over the past few months (as well as my birthday cake... Beth looked like she could use a little something sweet.)
At 6am, Ryan and I will be taking up a crew to assess their supply needs and assist with triaging and the rebuilding of their hospital. I'll keep ya'all up to date on what's going on.
(photos attached were taken during our wild car ride back to the hospital - thanks for keeping us safe Jenkins!)
So here's the important stuff for tonight:
I'm safe, my staff and volunteers are safe.
Tropical storm Matthew hit us unexpectedly... We were in the car when it hit - dodging falling trees and pieces of metal roofing - and for the first time since June, I am grateful to NOT be in the field hospital. I can't even begin to imagine what would have happened if the tents of the field hospital would have come down on 150+ patients. Our hospital is okay, but many of our partner NGOs sustained damage, most notably J/P HRO... Whose medical facilities and volunteer living area was destroyed. Beth (their CMO) called me on her way down to transfer a child with an acute abdominal injury. The big tree fell on the x-ray tent, no idea if the machine is functional. Their hospital literally blew away. The tent their volunteers sleep in is destroyed, and she has no idea where her stuff is. Sitting on the back of the truck bed, she told me "I grabbed my passport, but I don't know where anything is. Not even my bible."
I made them an emergency kit for tonight (emergency meds, bandages, IV fluids and start kits, basically an ambulance in a box), and sent up all of the clean, dry scrubs that I've had donated over the past few months (as well as my birthday cake... Beth looked like she could use a little something sweet.)
At 6am, Ryan and I will be taking up a crew to assess their supply needs and assist with triaging and the rebuilding of their hospital. I'll keep ya'all up to date on what's going on.
(photos attached were taken during our wild car ride back to the hospital - thanks for keeping us safe Jenkins!)
Tuesday, August 3, 2010
Teaching doctors to write prescriptions
I walked up to the white board, and wrote:
P-scribble-f-scribble
7 scribble-d-scribble-scribble
Bigger-messier-scribble.
Then I turned to the gathered Haitian doctors and said "do you know what this is?" To which they responded "a prescription".
My response: "Exactly. Now, can you tell me what it's for?"
"No, we can't read that."
My response: "Neither can I"
The room erupted in giggles. Oh, good. That could have just as easily gone the other way and been totally offensive.
The other day I met with Jerry, one of the surgeon-brothers who owns the building, and while discussing some of the concerns about outpatient prescriptions and clinic, he made an odd request. He asked me to meet with the doctors and teach them how to write a prescription.
Anyone who works in pharmacy knows how giddy I got at this request - how many times we have seen illegible scripts that might be decipherable if held sideways, while squinting, and taking great liberty with spelling. But I had to take it seriously, and have it be well received, as this was my first "CE (continuing education) lesson" for the Haitian doctors.
At one point, one of the doctors said (I swear I am not making this up) "but it takes so long to write things legibly".
My response: "then just write the diagnosis, and I'll prescribe. When I can't read your writing, that's essentially what I'm doing if I fill the prescription."
It was brief, only 15-20 minutes, but we covered the formulary (and more importantly, the difference between formulary and inventory), how to write a prescription, and the importance of legible handwriting.
P-scribble-f-scribble
7 scribble-d-scribble-scribble
Bigger-messier-scribble.
Then I turned to the gathered Haitian doctors and said "do you know what this is?" To which they responded "a prescription".
My response: "Exactly. Now, can you tell me what it's for?"
"No, we can't read that."
My response: "Neither can I"
The room erupted in giggles. Oh, good. That could have just as easily gone the other way and been totally offensive.
The other day I met with Jerry, one of the surgeon-brothers who owns the building, and while discussing some of the concerns about outpatient prescriptions and clinic, he made an odd request. He asked me to meet with the doctors and teach them how to write a prescription.
Anyone who works in pharmacy knows how giddy I got at this request - how many times we have seen illegible scripts that might be decipherable if held sideways, while squinting, and taking great liberty with spelling. But I had to take it seriously, and have it be well received, as this was my first "CE (continuing education) lesson" for the Haitian doctors.
At one point, one of the doctors said (I swear I am not making this up) "but it takes so long to write things legibly".
My response: "then just write the diagnosis, and I'll prescribe. When I can't read your writing, that's essentially what I'm doing if I fill the prescription."
It was brief, only 15-20 minutes, but we covered the formulary (and more importantly, the difference between formulary and inventory), how to write a prescription, and the importance of legible handwriting.
Wednesday, July 21, 2010
chemo day in haiti
I just realized I didn't send this a few days ago...SOP (Standard Operating Procedure) for mixing chemo in Haiti:
wear gloves, closed-toed-shoes, and face mask (if available). Do procedure in the parking lot, not in an enclosed, non-vented space. DO NOT get pregnant anytime soon...
I'm typing this as I'm waiting for the pre-chemo IVFs (a liter of normal saline with 20 MEQ of KCl and 2gms of MgSO4) to run into my patients veins. She looks like a pin cushion; came in super dehydrated and we had to start the IV at the wrist, but we can't infuse the chemo that way. I'm praying the fluids will "plump her up" so we can find a good vein on her arm. Otherwise, it's an IJ (intra-jugular) on the right side so it dumps into the vena cava (thanks, Anu, for that clinical pearl!)
For the record, we don't do chemo at our facility in Haiti. But the Haitian oncologist who agreed to carry out the palliative chemo plan for this lady designed by the providers in the states totally bailed, and, well, I'm a softie for cancer patients. Always have been.
I was sitting there talking to her parents through a translator, holding back the tears. This isn't my first rodeo, and while it gets easier to hold on, it's still a bumpy ride. Palliative chemo is not curative, which is a hard concept to get in the states, much less through a translator in a third world country. We're doing some sublingual morphine intensol to help with the pain, and have nausea meds on hand just in case.
Chemo isn't something I normally "play with", and I got nervous about the base IVFs suggested by the doctor - after some research and a "phone a friend" call to Toni at Samaritan, we changed it to the correct ones. I am so grateful to all of the teachers and mentors I have had along the way. It really does "take a village," and mine is a global one. So with the right recipe in hand, time to wait to see what sort of access we were going to get.
... a few hours later...
A liter and a half of fluid, and still no luck getting good IV access in her arm. An IJ it is then. Well, actually, to be precise, an EJ.
Per our "SOP," I mixed the chemo outside. We have no hood, no real ventilation in the pharmacy, so it's actually safer for me to mix outdoors. It was quite the show, quite the drama for a few needle punctures, but there needed to be some safety measures beyond what is normal in Haiti. On went the closed-toed-shoes, the face mask, and gloves. Rony, Shane, Hannah and Sam stood watch - both to watch me, and to keep others from coming to "hang out" while I was mixing poison (or as I explained it to Shane, mixing radioactive waste).
The bag was hand carried over, and I hung it myself. Spent the rest of the day checking in on her - monitoring pain and nausea. We kept the pain at bay, and the nausea too, so I'd chock it up as a success.
After the chemo, we did more supportive fluids, and I chatted with the parents about making sure she is well hydrated before next month, so we don't have to do another EJ.
I emailed Matt, the doctor whose overseeing care from the states. His email back was short, and the lyrics brought a smile to my face:
"Some will fall in love with life and drink it like a fountain that is pouring like an avalanche coming down a mountain. I've only met you once, but I think it fits you. Thanks."
~PJ
Sunday, July 18, 2010
my 15 minutes with anderson cooper
He had been in Port au Prince earlier in the week to cover the six month anniversary of the quake, flew back to New Orleans to cover the capping of the oil spill for a few days, then came back for a personal visit. I mentioned that I hadn't heard the news about the oil spill ceasing - when I'm working long days in the hospital sometimes I forget the rest of the world exists. So he filled me in on what's happened since I left the states. Yes, my friends, Anderson Cooper gave me my own personal newscast.
He mentioned how sad it is that so many of the NGOs are pulling out of Haiti, and I was quick to mention that Medishare is still here. "Oh yeah, I love you guys! You do great work!" When we parted ways, he thanked us for our continued work down here, and reminded us that we are making a huge difference for the people of Haiti.
Anderson Cooper 360
~PJ
Friday, July 16, 2010
say "aahhh"
It's funny how we sometimes end up exactly where we're supposed to be, even if we don't know we're supposed to be there. The other day while sitting in the logistics office, waiting for my caffeine to set in, I started talking to a couple of University of Miami students about their project. They were here field testing a very interesting "tele-medicine" software developed by MIT. Their plan was to head out to New Life Children's Home (www.newlife4kids.org) to shoot some video footage and talk with Miriam, the Missions Director, about how the software might be useful in Haiti. Janet (a teacher from Oregon whose "alter ego" is a warehouse pixie in Haiti) had brought a bunch of school supplies to donate, so was heading out with them. One of the UM students, Sean, seemed a little disappointed that they weren't able to do more for the orphanage they'd been working with, so I suggested we "de-worm" all of the kids.Miriam estimates that approximately 90% of the children in the tent cities have some sort of intestinal worm. The living conditions are filthy, with many people sleeping on the dirt, and there is really no way to have anything be "sanitary." When a worm infestation isn't treated, the worms migrate out of the intestines and into other areas. Seeing a kid cough up worms that are 6 inches long is one of those things you never forget. And in a country where so many of the children are already malnourished, parasitic worms are even more deadly. Many organizations and school will periodically de-worm all of the children as a precaution. Anti-helmintics (de-worming medicine) are worth their weight in gold in Haiti, and I'd just been gifted a few thousand mebendazole chewable tablets, and playing with orphans is always a fun way to spend half a day.
Sean and Janet assisting with de-worming orphans
It was so sweet - the kids all filed into the classroom, and sang a song in Creole welcoming us and thanking us for coming. Then they were seated and a translator helped me explain what we were going to do. One of the hardest things for me to explain, even through a translator, is the concept of "chewing a tablet". Remember, most people in Haiti have never even seen a doctor. So I demonstrated for them. (hey, it's been a while since I've been de-wormed) Crunch, crunch, crunch, then I opened my mouth and stuck out my tongue and said "aaaahhhhh" to show the white paste that was covering my tongue. All of the kids laughed. As Janet, Sean and I gave each of them their dose, they chewed it up and stuck out their tongues and said "aaahhhh". Much much giggling, and I'm sure the teachers were less than thrilled at the new game I'd taught their students, but it got the kids to laugh and not spit the tablets out. I can tell you from experience, they taste HORRIBLE. Well, horrible with a mint aftertaste.
After "dosing" all of the orphans in the classroom, I walked around and "dosed" some of the handicapped kids - it was much easier to come to them than get their wheelchairs inside. The children from the classroom followed, clapping and laughing, continuing the game. After the "de-worming party", Janet gifted the teachers at the school some much appreciated school supplies for the children. From one teacher to another, even with the language barrier it was clear the gratitude for the gifts. I spoke with Miriam and her daughter about medication needs for the Home, which has clinics for quadriplegics and paraplegics under their mango tree every Wednesday. We're all in this together, and if we can provide help, we will.
~PJ
Monday, July 12, 2010
blood drive
Practitioners who are new to Haiti often ask about the blood supply; more specifically, if there is a supply. The answer is kind of, sort of, it's complicated. Today was a perfect example.
We had a news crew show up at the hospital, and in the middle of "show and tell with Sanjay Gupta," the CNO came into logistics asking about our blood types. A patient was just admitted who would die tonight if she didn't get blood. When someone needs blood down here, the first thing we do is ask family to donate (if there is family). If they're willing to donate, we type their blood to see if they match. If they're not a match, or if the patient has no family, we look to our staff/volunteers to see if anyone is a possible donor. No one who knew their type was a match, so those of us who haven't been typed yet (or couldn't remember our type) headed off to the lab to find out if we were a match.
It's a fairly simple procedure to be typed; lance the finger, a few drops of blood in each reservoir, add the chemicals, and spin around. Jen, our PR person from Miami, ended up being a perfect match. She hates needles, and it was clear that even being typed was a little out of her comfort zone. But as she put it, a persons life literally depends on her donating - how can you say no? I handed her a package of pop-tarts from my uuber-secret-stash on her way to donate... It's not like the Red Cross back home where you get cookies and punch...
Of course, the work is not done once you find a match. Turns out today we had bags for blood donation without the chemical-anti-coagulants to add to the blood to make it useable... So a new game begins... Calling Big Paul from MMRC to see if he can locate some, or maybe we can sweet talk the Haitian Red Cross out of some. Then there's the excitement of a trip to Hospital General to do the actual donation, and praying that #1, they don't loose the blood you've just donated, and #2, that you make it back in time to get the blood to the patient while it can still do some good (have I mentioned that traffic SUCKS in Port au Prince?). In this case, the Gods were smiling on us.
Later on I caught up with our heroic donor, and she told me about meeting the girl whose life she saved, and how her eyes had lit up when the translator explained what was happening. In her own words:
"After all the anxiety I went through---The cool thing-- I got to meet the patient. 'Mesi anpil,' she said. She grabbed my hand and pulled it to her chest. She was weak, but her smile and her eyes said more thanks than her words. It is something I will never forget. I know that my one donation may just buy her some more time. I hope that someone else is able to donate so she has enough blood until her medical problem is corrected. Just seeing that little bit of hope in her eyes meant so much to me."
In the states, we donate blood all the time, but it's more of a karmic donation... We all give, so those who need it have access to it, and the idea is that should we ever need blood, it's there for us... I can only imagine what it must have felt like to have that connection with a patient... Although, I suspect, at some point I will know exactly what it feels like; at some point I'll be the match, and hoping there are still some pop-tarts left in the stash...
~PJ
We had a news crew show up at the hospital, and in the middle of "show and tell with Sanjay Gupta," the CNO came into logistics asking about our blood types. A patient was just admitted who would die tonight if she didn't get blood. When someone needs blood down here, the first thing we do is ask family to donate (if there is family). If they're willing to donate, we type their blood to see if they match. If they're not a match, or if the patient has no family, we look to our staff/volunteers to see if anyone is a possible donor. No one who knew their type was a match, so those of us who haven't been typed yet (or couldn't remember our type) headed off to the lab to find out if we were a match.
Of course, the work is not done once you find a match. Turns out today we had bags for blood donation without the chemical-anti-coagulants to add to the blood to make it useable... So a new game begins... Calling Big Paul from MMRC to see if he can locate some, or maybe we can sweet talk the Haitian Red Cross out of some. Then there's the excitement of a trip to Hospital General to do the actual donation, and praying that #1, they don't loose the blood you've just donated, and #2, that you make it back in time to get the blood to the patient while it can still do some good (have I mentioned that traffic SUCKS in Port au Prince?). In this case, the Gods were smiling on us.
Later on I caught up with our heroic donor, and she told me about meeting the girl whose life she saved, and how her eyes had lit up when the translator explained what was happening. In her own words:
"After all the anxiety I went through---The cool thing-- I got to meet the patient. 'Mesi anpil,' she said. She grabbed my hand and pulled it to her chest. She was weak, but her smile and her eyes said more thanks than her words. It is something I will never forget. I know that my one donation may just buy her some more time. I hope that someone else is able to donate so she has enough blood until her medical problem is corrected. Just seeing that little bit of hope in her eyes meant so much to me."
In the states, we donate blood all the time, but it's more of a karmic donation... We all give, so those who need it have access to it, and the idea is that should we ever need blood, it's there for us... I can only imagine what it must have felt like to have that connection with a patient... Although, I suspect, at some point I will know exactly what it feels like; at some point I'll be the match, and hoping there are still some pop-tarts left in the stash...
~PJ
Saturday, July 10, 2010
back from my hiatus
I’m writing this on the plane, heading back to Port au Prince, after a whirlwind week of family, friends, geocaching, gathering supplies, oh, and a minor operation. As you may already know, I ended up having surgery when I returned from my first deployment to Haiti (which was in no way a result of anything having to do with Haiti). Turns out we weren’t aggressive enough, and 2 months later, I had to have surgery again. I wish it were something glamorous, with a cool story and a neat scar. But it’s not – it’s been a pain in the butt. Literally.
People say that healthcare workers make horrible patients. I am, admittedly, one of the worst patients EVER. (Editors Note: Yes, she is but we still love her) Rosales, my surgeon, just rolls his eyes at me when I mention I’m scheduled to return to Haiti 36 hours after he’s scheduled me for surgery. He says he’s committed to fixing me, despite my commitment to “Save the World”… He also says I used up a lot of “karma points” getting back to the states for my first surgery, so I should probably continue my work in Haiti to pay back my karmic debt. Who knew karma points were like penny-carnival tickets? Maybe next time I’ll trade some in for a gigantic, fluffy teddy bear…
I ended up changing my flight – adding a few days on the end of my trip to recover in Oregon. Now I'm headed back to Port au Prince... to "take it easy"...
~PJ
People say that healthcare workers make horrible patients. I am, admittedly, one of the worst patients EVER. (Editors Note: Yes, she is but we still love her) Rosales, my surgeon, just rolls his eyes at me when I mention I’m scheduled to return to Haiti 36 hours after he’s scheduled me for surgery. He says he’s committed to fixing me, despite my commitment to “Save the World”… He also says I used up a lot of “karma points” getting back to the states for my first surgery, so I should probably continue my work in Haiti to pay back my karmic debt. Who knew karma points were like penny-carnival tickets? Maybe next time I’ll trade some in for a gigantic, fluffy teddy bear…
I ended up changing my flight – adding a few days on the end of my trip to recover in Oregon. Now I'm headed back to Port au Prince... to "take it easy"...
~PJ
Wednesday, June 30, 2010
first staff photo at new hospital
Here is our first "staff photo" for the Bernard Mevs Project Medishare Hospital Pharmacy:
Georgia and Michel are missing, but we got most of us in the photo!
~PJ
Georgia and Michel are missing, but we got most of us in the photo!
~PJ
Friday, June 25, 2010
sherwood gazette article
During one of PJ's stops at home in Sherwood, I contacted the editor of our local newspaper, The Sherwood Gazette, and recommended he do an article on her. Sherwood is all about "local" and since PJ graduated from Sherwood High School and still has her home base in Sherwood, I knew the residents would love to hear her story.
The article came out in the July edition:
Helping in Haiti
~Cathi
The article came out in the July edition:
Helping in Haiti
~Cathi
exerpt from an email this morning
I want to send a real "update" - about hiring a new Haitian pharmacist, exploring the J/P HRO tent city, and planning tropical storm evacuation strategies (with J/P HRO, not Medishare... they're still in tents...)... But that may be a few days, and I wanted to share part of an email/friend request I got via facebook this morning that reminded me why I gave up the high paying job in the states and came to Haiti.
The "friend request" said this:
"You dont know me in person but i added you becuase i want to say thank u. Its those of you that help with the project medishare that make inpacts. the team 2 weeks ago changed my life. I am a missionary who was over there and got malaria. One of the doctors saw me and got me out of Haiti in time to save my life. I also saw you where friends with sam (Sam, my medical student) too. he is great he took care of me when i was there for that one night. He is like a big brother."
I never met her in person, but I do remember helping with her care - suggesting treatment options for malaria with one of the doctors for someone that we were talking about shipping to Miami. And it doesn't surprise me that Sam took great care of her - it is my firm belief that he will become the best doctor Haiti has ever seen.
Many of you who read my updates have not been down here to Haiti, and may find it hard to believe, but we are the height of medical technology in Haiti. Even now, when we're technically "closed" to new admits, we accept all of the American relief workers who are sent to us. And even when it means dragging the desk out of the nursing station to make room for an additional bed (and turning our supply area into a makeshift ER), we do the best we can with what we have.
~PJ
The "friend request" said this:
"You dont know me in person but i added you becuase i want to say thank u. Its those of you that help with the project medishare that make inpacts. the team 2 weeks ago changed my life. I am a missionary who was over there and got malaria. One of the doctors saw me and got me out of Haiti in time to save my life. I also saw you where friends with sam (Sam, my medical student) too. he is great he took care of me when i was there for that one night. He is like a big brother."
I never met her in person, but I do remember helping with her care - suggesting treatment options for malaria with one of the doctors for someone that we were talking about shipping to Miami. And it doesn't surprise me that Sam took great care of her - it is my firm belief that he will become the best doctor Haiti has ever seen.
Many of you who read my updates have not been down here to Haiti, and may find it hard to believe, but we are the height of medical technology in Haiti. Even now, when we're technically "closed" to new admits, we accept all of the American relief workers who are sent to us. And even when it means dragging the desk out of the nursing station to make room for an additional bed (and turning our supply area into a makeshift ER), we do the best we can with what we have.
~PJ
Monday, June 21, 2010
article published for Phi Lambda Sigma
Between PJ's first and second tours in Haiti, she was asked to write an article for the Phi Lambda Sigma's newsletter The Laurel.
It has been published in their April 2010 edition. As of the date I am writing this, it is not yet posted to their website yet. But I have put it up on my file server and can be downloaded from the link below. PJ's article is on page 6.
April 2010 The Laurel
~Cathi
It has been published in their April 2010 edition. As of the date I am writing this, it is not yet posted to their website yet. But I have put it up on my file server and can be downloaded from the link below. PJ's article is on page 6.
April 2010 The Laurel
~Cathi
Sunday, June 20, 2010
a day of rest
It was glorious. About 45 minutes away from the hospital is Wahoo Bay Beach Club and Resort, which felt like a paradise in the middle of the Caribbean. I ate the largest lobster I've ever seen, napped by the pool, and let my brain rest for a while.
~PJ
Wednesday, June 16, 2010
chemistry lesson
Since the patient was in acute pain, we took care of the dose, then I sat Sam down for a chemistry lesson. "If I have a pound of feathers, and a pound of lead, which weighs more?" was my first question. Then I remembered, I'm in Haiti - metric system - so rephrased the question with kilogram in place of pound. And, just like all of us, he answered "the kilogram of lead. Metal weighs more than feathers."
A kilogram weighs a kilogram, no matter what the material, but the kilo of feathers takes up more space than the kilo of lead. That "space" is the volume. We discussed it theoretically, but the concept didn't seem to be sticking. So I grabbed a bottle of pills off the shelf, and used each one to represent a milligram of morphine, and a tray as the milliliter. Some of us are more visual learners. Once the idea had sunk in, and he did the math, I let him do the dilution for the 1mg/ml morphine stock solution (under supervision, of course).
Back when I was doing my undergrad, I student taught chemistry, and Jim (Professor Schnieder) would have been proud of me. And I'm so proud of Sam - not only did he master a new concept in chemistry at 3am, he did it in his second language. Because, as I like to remind him, his English is WAY better than my creole.
~PJ
Saturday, June 12, 2010
life has a funny way of making sure we're exactly where we need to be
(meant to post yesterday (but I fell asleep typing... gee, imagine that...))
Life has a funny way of making sure we're exactly where we need to be. Tonight, for example, I was supposed to be off, but Shane (one of my assistants) is really sick, so I came in to man the pharmacy overnight. Funny how the compounding pharmacist happens to be here when the nurse comes looking for some concoction to make albendazole taste better (good luck with that!) and alternate dosing forms for a
hospice patient.
The albendazole "taste-testing" can wait for later - when I have more than just myself to do the tasting - plus, hospice care has always been one of my soft spots.
It's about 4am, I'm listening to Tracy Chapman sing about "Fast Cars," and waiting for Lauren to come pick up the "hospice kit" I spent half the night making for Peter. We can't save them all, no matter how hard we try. With Peter (also known as Peterson), we have tried and tried - even flew him to the states for treatment. But sadly, the humongous cancer tumor on his neck (about the size of his head) didn't respond to chemotherapy, and neither did the metastatic tumors that cropped up in his lungs and other areas. When it became clear that he would not get better, the hospital staff at Broward General (the hospital in South Florida that was covering the treatment) asked him and his mother about their wishes. Peter wanted to come back to Haiti, to see his brothers and sisters, and to die at home.
So Lauren brought him back, and tomorrow they will spend about 6 hours driving the 25 miles to take Peter and his mother home. (Did I mention that roads here SUCK?)
I made the usual suspects for the "hospice kit"; morphine in several strengths (both injectable and oral) to help with pain control, injectable lorazepam as well as a liquid lorazepam "with a chaser of haldol" for fear and anxiety, zofran (for the nausea on the bad roads), atropine drops for under the tongue (helps stop secretions)... And a custom ketamine/baclofen/diclofenac/lidocaine gel...
There is a very good chance that today will be Peter's last day on this planet. Without going into all the gory details, the plan is to keep him alive long enough to return home to see his family one last time. I took Lynden to translate for me - he used to teach kindergarden through 6th grade, so he's good with kids. I had Peter explain where it hurt, and describe the type of pain, and explained what I was going to try to do. The pain Peter is experiencing is excruciating, but not diffuse; it's specific to his neck (under the mass and up the back of it) and the area surrounding his chest tube.
I'd read an article a while back about topical ketamine for hospice patients, and we often compound baclofen/ketoprofen/lidocaine at Broadway (my job back in the states), so I did some research (in 4-point font, on my blackberry), and made a gel to ease his pain.
This was one of the few times in Haiti I've worn gloves... A gel designed to absorb through HIS skin would also absorb through mine. I warned him that the application process might hurt a little - I had to rub the gel into the places that hurt. He was a trooper, not even a tear. When I came back to check on him, he said the pain in his neck was gone. He was a little light headed, but able to carry on a conversation and play with the paints and play dough I brought him. He said he felt more "clear headed" than when he was on all the morphine - goal accomplished.
On my way back to the pharm Sam asked me what I had done. Sam is a Haitian medical student who will be starting his third year this fall. He had never heard of the concept of "hospice" or end of life care - it doesn't really exist in Haiti. Sam doesn't know it yet, but as of this week he will be an employee, not a volunteer. He'll be my "intern," and will have projects and presentations just like an intern in the states... Sounds like I've already found his first project...
~PJ
Life has a funny way of making sure we're exactly where we need to be. Tonight, for example, I was supposed to be off, but Shane (one of my assistants) is really sick, so I came in to man the pharmacy overnight. Funny how the compounding pharmacist happens to be here when the nurse comes looking for some concoction to make albendazole taste better (good luck with that!) and alternate dosing forms for a
hospice patient.
The albendazole "taste-testing" can wait for later - when I have more than just myself to do the tasting - plus, hospice care has always been one of my soft spots.
It's about 4am, I'm listening to Tracy Chapman sing about "Fast Cars," and waiting for Lauren to come pick up the "hospice kit" I spent half the night making for Peter. We can't save them all, no matter how hard we try. With Peter (also known as Peterson), we have tried and tried - even flew him to the states for treatment. But sadly, the humongous cancer tumor on his neck (about the size of his head) didn't respond to chemotherapy, and neither did the metastatic tumors that cropped up in his lungs and other areas. When it became clear that he would not get better, the hospital staff at Broward General (the hospital in South Florida that was covering the treatment) asked him and his mother about their wishes. Peter wanted to come back to Haiti, to see his brothers and sisters, and to die at home.
So Lauren brought him back, and tomorrow they will spend about 6 hours driving the 25 miles to take Peter and his mother home. (Did I mention that roads here SUCK?)
I made the usual suspects for the "hospice kit"; morphine in several strengths (both injectable and oral) to help with pain control, injectable lorazepam as well as a liquid lorazepam "with a chaser of haldol" for fear and anxiety, zofran (for the nausea on the bad roads), atropine drops for under the tongue (helps stop secretions)... And a custom ketamine/baclofen/diclofenac/lidocaine gel...
There is a very good chance that today will be Peter's last day on this planet. Without going into all the gory details, the plan is to keep him alive long enough to return home to see his family one last time. I took Lynden to translate for me - he used to teach kindergarden through 6th grade, so he's good with kids. I had Peter explain where it hurt, and describe the type of pain, and explained what I was going to try to do. The pain Peter is experiencing is excruciating, but not diffuse; it's specific to his neck (under the mass and up the back of it) and the area surrounding his chest tube.
I'd read an article a while back about topical ketamine for hospice patients, and we often compound baclofen/ketoprofen/lidocaine at Broadway (my job back in the states), so I did some research (in 4-point font, on my blackberry), and made a gel to ease his pain.
This was one of the few times in Haiti I've worn gloves... A gel designed to absorb through HIS skin would also absorb through mine. I warned him that the application process might hurt a little - I had to rub the gel into the places that hurt. He was a trooper, not even a tear. When I came back to check on him, he said the pain in his neck was gone. He was a little light headed, but able to carry on a conversation and play with the paints and play dough I brought him. He said he felt more "clear headed" than when he was on all the morphine - goal accomplished.
On my way back to the pharm Sam asked me what I had done. Sam is a Haitian medical student who will be starting his third year this fall. He had never heard of the concept of "hospice" or end of life care - it doesn't really exist in Haiti. Sam doesn't know it yet, but as of this week he will be an employee, not a volunteer. He'll be my "intern," and will have projects and presentations just like an intern in the states... Sounds like I've already found his first project...
~PJ
Thursday, June 10, 2010
catching my breath
Day three in the new hospital, and I'm finally able to sit long enough to catch my breath. Moving a hospital in 24 hours was insane, and while most things went smoothly, we will still be "settling in" for quite some time.
Lots of stuff has yet to be uncovered - for the pharmacy, it's a full one-third of our medication supply and all of our references. Well, not all of our references... I'm a good pharmacist - I hoard things and play the "worst case scenario" game in my head. As all the books were being packed, I grabbed my copy of Lexi, and tucked my Sanford guide in my bra strap. I know, I know, not the most professional thing to do, but my pockets were overflowing with the controlled substances that somehow didn't make it in the safe. The impressive pharmacy library I've amassed since February is packed somewhere in the "new Costco"... I'm hoping we'll find it by the end of next week, but I won't hold my breath...
Less than a week ago I walked into my new pharmacy for the first time. Or, rather, I squeezed through the door that would only open half way to look at the floor-to-ceiling piles of boxes and crap and thought to myself "how on Earth am I going to make a working pharmacy out of this pile?" We had no lights, no space, and just utter chaos. Georgia and I spent 9 hours that first day moving boxes so we could get the door to open. Now we have lighting, floor space, and my friends from Operation Blessing have offered to custom build the furniture I need including bar-level tables so we have a space to work.
I couldn't do it without my Haitian friends who work the night shift. Due to the low census (about 45) many of the night workers spend a lot of time just hanging out, so I've been finding them projects. Plus, the pharmacy has good music and good chocolate - both key essentials to a happy work environment. My "boys" (Fed, Claude, Sam, Lynden) have been fixing lights, hauling boxes, killing cockroaches, and teaching me Creole. My "girls" (Michel, Marie, Barbara) have been cleaning, organizing, killing cockroaches, and dancing with me in the pharmacy.
It's looking great - I'll post photos later - I'm typing this from the logistics center (on a REAL keyboard - not the blackberry for once!).
This evening I caught an allergic reaction to a drug in one of our volunteers. One of the new nurses had come to the pharmacy to get some cream thinking she might be having a reaction to sun block or bug spray. When I looked at the rash, it wasn't just her arms as she had thought. It covered her whole trunk, and her throat was feeling scratchy.
What's the best diagnostic tool we have? A thorough patient history. Turns out, one of the doctors had started her on Keflex (an antibiotic) earlier in the day. Classic allergic reaction. Luckily, there are drugs for that, and I have them handy at all times. I compounded her some cream to help with the pain and itching, gave her a big dose of benadryl, and sent her to bed with strict instructions to NOT TAKE ANY MORE of the antibiotic.
This morning in the "carpool" Jen made some comment about how awesome our lives are and what a great experience this is, and I have to agree. Hands down, this is the most rewarding job I have ever had, and I am so grateful to be working with such incredible people. As much as I miss my friends and family, I couldn't imagine being anywhere else on Earth.
~PJ
Lots of stuff has yet to be uncovered - for the pharmacy, it's a full one-third of our medication supply and all of our references. Well, not all of our references... I'm a good pharmacist - I hoard things and play the "worst case scenario" game in my head. As all the books were being packed, I grabbed my copy of Lexi, and tucked my Sanford guide in my bra strap. I know, I know, not the most professional thing to do, but my pockets were overflowing with the controlled substances that somehow didn't make it in the safe. The impressive pharmacy library I've amassed since February is packed somewhere in the "new Costco"... I'm hoping we'll find it by the end of next week, but I won't hold my breath...
Less than a week ago I walked into my new pharmacy for the first time. Or, rather, I squeezed through the door that would only open half way to look at the floor-to-ceiling piles of boxes and crap and thought to myself "how on Earth am I going to make a working pharmacy out of this pile?" We had no lights, no space, and just utter chaos. Georgia and I spent 9 hours that first day moving boxes so we could get the door to open. Now we have lighting, floor space, and my friends from Operation Blessing have offered to custom build the furniture I need including bar-level tables so we have a space to work.
I couldn't do it without my Haitian friends who work the night shift. Due to the low census (about 45) many of the night workers spend a lot of time just hanging out, so I've been finding them projects. Plus, the pharmacy has good music and good chocolate - both key essentials to a happy work environment. My "boys" (Fed, Claude, Sam, Lynden) have been fixing lights, hauling boxes, killing cockroaches, and teaching me Creole. My "girls" (Michel, Marie, Barbara) have been cleaning, organizing, killing cockroaches, and dancing with me in the pharmacy.
It's looking great - I'll post photos later - I'm typing this from the logistics center (on a REAL keyboard - not the blackberry for once!).
This evening I caught an allergic reaction to a drug in one of our volunteers. One of the new nurses had come to the pharmacy to get some cream thinking she might be having a reaction to sun block or bug spray. When I looked at the rash, it wasn't just her arms as she had thought. It covered her whole trunk, and her throat was feeling scratchy.
What's the best diagnostic tool we have? A thorough patient history. Turns out, one of the doctors had started her on Keflex (an antibiotic) earlier in the day. Classic allergic reaction. Luckily, there are drugs for that, and I have them handy at all times. I compounded her some cream to help with the pain and itching, gave her a big dose of benadryl, and sent her to bed with strict instructions to NOT TAKE ANY MORE of the antibiotic.
This morning in the "carpool" Jen made some comment about how awesome our lives are and what a great experience this is, and I have to agree. Hands down, this is the most rewarding job I have ever had, and I am so grateful to be working with such incredible people. As much as I miss my friends and family, I couldn't imagine being anywhere else on Earth.
~PJ
Sunday, June 6, 2010
went on another drug raid...
My first day back "in country", and I'm already pirating!
Operation Blessings opened their warehouse to us, and we were able to
fill a flatbed with much needed supplies...
~PJ
Operation Blessings opened their warehouse to us, and we were able to
fill a flatbed with much needed supplies...
~PJ
Saturday, June 5, 2010
photos of the new building
Here are some photos of the new building we are moving into. It has two operating rooms with a pass through and a real recovery room!
the grounds around the new building...
and some pics of the inside...
a few of the people outside...
and my new Pharmacy!...
~PJ
the grounds around the new building...
and some pics of the inside...
a few of the people outside...
and my new Pharmacy!...
~PJ
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