Haiti mission 2011

One year after the devastating earthquake rocked the world of Haitian people, I traveled to Port-au-Prince with Project Medishare out of Miami University. My one week deployment was marked by sensory overload.  There was the hot sun, the humidity, the mosquitoes.  Proud Haitian citizens lined the streets in their colorful garb. The roads were bumpy and strewn with cement chunks.  Tent City extended as far as the eye can see.  One can only imagine life under those tarps.  I learned that they are ruled by self-proclaimed "chiefs".  Children are sold for money; they must work for their new families.

Bernard Mevs / Project Medishare Hospital is within a gated compound of structured buildings now, re-located from the tent hospital at the airport approximately 6 months ago. It is the only critical care / trauma hospital in Haiti.  The hospital accommodates approximately 30 patients.

The facilities within the compound for the volunteers are adequate at best.  Bottled water is provided, however running water to bathe shuts down frequently.  Haitian food is provided at 10am & 2pm.  It is an acquired taste that is difficult to acquire within one week.  Lodging is a small room packed with bunk beds, plywood walls & a dirt floor.  Generated electricity will go out periodically throughout the day for brief intervals.  Homeless persons are everywhere, even within our gated hospital.

I worked in the Emergency area from 6pm - 6am for seven consecutive nights.  Countless people benefited as a direct result of the volunteers.  Not speaking Creole was easily solved.  Interpreters were readily available and invaluable for patient teaching.  But by far, the best communication with the Haitians was a warm smile, gentle touch, and eye contact. 

Patients came in a continuous flow through the Emergency area.  Some were routine visits: 32 year-old man with a kidney stone, 18 year-old girl in sickle cell crisis needing IV fluids, Congestive Heart Failure patient treated with medications and released.  She surely would have been admitted to the hospital if in the United States.  A woman with an intracerebral hemorrhage and very poor prognosis was loaded into the back of a truck by her family to go home to die.  Malaria and typhoid were among the complaints.

Lots of pediatric patients came to ED for a variety of problems.  A sixteen year-old cholera patient was to be transferred to "cholera camp”; transportation was in an open pick-up truck in the rain.  A 24 hour old newborn had umbilical oozing; fortunately it was not infected, the "string" was not tied tight enough.  The physician clamped it with a traditional clamp.  A lifeless four-year old girl was brought in by her father.  She was electrocuted from faulty power.  The father brandished a gun threatening to kill the mother.  He was detained by the police.  A 13-year old girl in the pediatrics unit needed mitral valve surgery; she arrested and died on Tuesday.  Her transportation to the United States for surgery was scheduled for Thursday.  The premies in NICU cling to life.  There are no NICU ventilators, yet even a 0.7 Kg baby survived for days.  These patients and families need to be held and comforted.  As nurses, we can provide solace and compassion.  These patients and families are not demanding at all.  A smile, a word, a touch are appreciated; their eyes tell it all.

There were many trauma patients brought to the facility.  We treated many lacerations, contusions, and wounds. Some were a result of rocks being thrown.  There is rioting in the area due to political dissent.  Rioting, for the most part, consists of the people throwing the cement rocks.   Some trauma patients were due to basic lack of safety, especially driving.  Cars are precious commodities; they are packed with people hanging out of the vehicle (some without any doors).  The bumpy roads would eject passengers while the driver drove fast and furious!  Small buses called "Tap-taps" raced through the roads.  The passengers “tapped” the top of the bus to signal for a stop.

The most disturbing trauma patients were from street violence.  Civil unrest undermines basic humanitarism.  A twenty year-old male was brought in with a screwdriver rammed completely through his head.  He had resisted when two men tried to take his cell phone.  Domestic abuse is common.  Women came in severely beaten by their spouses. An adult male patient came in with a head bleed, pneumothorax, and fractures.  He had been caught stealing and the police had beaten him.  They had him handcuffed to the gurney despite the injuries.

Supplies are meager.  It is not uncommon to wash specimen containers or medication cups to re-use.  Ability to improvise is essential.  The experience has given stewardship a whole new priority for me.  There is one C-t scanner available, however it is a two hour journey to get there.  C-t scans do not get ordered unless absolutely critical to the outcome of the patient.

The American volunteers gather on the roof in the evenings.  The wind is gentle, the moon is full, and we are all going through the same incredible experience.  The comradery is almost palpable. We bonded in a special way and continue to exchange e-mails and photos.  Our departure was of many mixed emotions. This experience will take time to process.

 I hope that my work serving others is a testament to the mission of Providence.

A sense of pride, fulfillment, awe, and selflessness are my gifts as a direct result of my mission to Haiti.   by Jo Birdsong

Jo Birdsong is planning a medical mission to Haiti in July 2011 with Project Helping Hands.  This will be a two-week deployment working outdoor clinics, as well as outreach to the Tent Cities and orphanages.  One Nurse At A Time awarded her a $1000 scholarship to help defray her expenses for this mission.

Helping One Patient at a Time

For the past two months, I worked at a sexual violence project in Guatemala City for Doctors Without Borders/Medicos Sin Fronteras or MSF.  I'd travelled several times to this beautiful, culturally diverse country, but was not aware of the rising violence.  Guatemala and other Central American countries are on the transportation path of cocaine shipments to the US.  With increased drug activity, narco-traffic has exploded as have gangs.  Murder rates are phenomenal - 16 to 18 a day in the capital city!

Guatemala also has a legacy of atrocities committed against the civilian population during the two decade civil war.  Remnants of that war include a culture of fear and silence.  Atrocities such as rape continue in the public eye, but that eye is blindly turned away. The judicial system is ineffective, rarely prosecuting offenders (5% of cases get to court).

Fortunately, I was not on the front line hearing the horrific stories, but our doctors and psychologists and social workers gave emergency attention to these vulnerable patients.  The majority are women and attacks come from unknown assailants.  But the victims are also children violated in their own homes by relatives.  And "secondary victims" such as family members also require psychological assistance.

My role was Medical Coordinator, overall in charge of the medical aspects of the program.  One task was to write the protocols for our program in Guatemala.  The government has their protocol, but it's based on cheap and available drugs, and not based on sound medical science.  For example, gonnorhea is treated with Cipro and Hepatitis B vaccine is not available.  MSF is more nimble and well funded and can provide quality care free of charge to all.

One of my biggest challenges was to begin the conversation about elective termination of pregnancy in a country where it is illegal.  Obviously, in the case of pregnancy from rape, many women will request abortion.  And MSF's position is to assist women in their reproductive health decisions regardless of legalities.  Credible organizations exist who will properly perform terminations, but with coded phone calls and confidential exchange of information.  The team, in the Guatemalan spirit of fear and silence, had never spoken openly about this issue although women had made requests for these services.  Once we opened the conversation and discussed the way forward, the doctors and psychologists and social workers breathed a collective sigh of relief to have ideas shared in the open.

MSF is opening another violence program in Honduras where the violence, amazingly enough, is even worse.  The murder rate is higher.  Statistics are hard to obtain for sexual violence, but the needs are great. And contraception is illegal. 

I tell myself, we are here to help because the system is failing.  Changes and improvements come slowly.  But we can help one patient at a time.

Sue Averill, RN, BSN, MBA
co-founder One Nurse At A Time

Encountering Medical Missions

The Encountering Medical Missions conference was a huge success!  I talked with tons of nurses who were interested in going on their first medical mission and they were excited to find out about One Nurse At A Time and the Directory you have on your website and the scholarships you offer for nurses to help others.   One nurse said:  “It is great to find out about an organization like this one that is right in the northwest out of Seattle.”   It was amazing to talk to others who feel the same way!

Thanks,

 Becky Elder, FNP

Medical Mission with Hearts in Motion

 Guatemala January 2011 

ONE NURSE AT A TIME is a 501 (c)(3) nonprofit organization created by nurses who are passionate about giving back to our local and global community through volunteer and humanitarian medical pursuits. We are dedicated to assisting other nurses enhance our profession as they too, look for opportunities to serve locally, nationally and internationally. Are you interested in volunteering your nursing skills to those in need, but unsure of how to get started? We are here to help make the process easier.  Visit our website www.onenurseatatime.org  and follow our blog  and follow us on Facebook.