Final thoughts

Being back to work seems a little surreal. Our return journey on Saturday passed in a blur. Free wireless in Port au Prince but had to pay at Miami!! 5 security checkpoints, 3 immigration posts and 2 sets of customs later we were in Halifax! Smooth and punctual flights, except in and out of Pearson which was a tad bumpy . We even had a couple of team meals and beers along the way, so it felt a lot more pleasant than the drag it could have been.

Now that the dust has settled I think we can say for sure that it was a positive experience. I saw things I would not see here in Halifax, both good and bad. I saw a 14 year old bleed out from a gunshot wound for lack of blood and blood products, but I also saw good teamwork save the day and the patients under challenging circumstances. The surgeries we did undoubtedly changed the patients' lives for the better and will allow them to contribute positively to the future of this fascinating, troubled country.

There is plenty of work still to do at Bernard Mevs. There is a need for better organisation and inventory in the ORs. Better biomedical support would enable the anesthesia machines and monitors to work properly and would allow more challenging cases to be done there. The hospital badly needs a better ultrasound machine for the ER and OR. Plenty of things to target in future missions and fundraising.

Would I do it again? Absolutely! I think I speak for most of my colleagues when I say I look forward to going back.

I would like to thank Chad Coles and Dave Amirault and of course Marc Butler for making all this happen. Finally I would like to thank my wife and children for their love and support: nightly Face Time conversations kept me calm and grounded, I love you all!

Until the next time then.....

Haitian miscellany

Team broken earth headquarters

Luxury accommodation: I am at the back on the bottom

Traditional Haitian tombs

Sugar cane

Bustling market

Site of future Olympic stadium

Suicidal Tap-Tap overtaking us

Classroom at Martinette school

Shanty town: many who fled PAP after earthquake live here, mass grave of c240000 is over the hill.

We will not forget you Haiti!

Last night

It has been both quick week and a long one and either way it is at an end. Today was an interesting day. 8 of us went to Tytoo gardens orphanage while the ortho guys went to the medical school to teach.

The orphanage visit was very interesting and we concluded that in future visits a deployment to their community clinic would be productive. We returned to Bernard Mevs to find a contingent of Brazilian UN troops lined up outside in fullbody armour toting automatic weapons. Not sure 

what they were up to apart from posturing - a show of force I guess since it seems MINUSTAH doesn't do an awful lot to make life any safer round here.

While we were away Nick the super ER resident donated blood since the one patient in the hospital with A neg blood needed a transfusion! Another example of how members of the team have stepped up during our brief tour of duty!

That being said we headed to their logistic base since we all like the burritos and generous rum measures for our final Haitian team dinner. We had no sooner finished dinner and were kicking back when one of the EMTs from Bernard Mevs walked in and said an anesthesiologist was needed. Not sure how this happened since we were all supposed to be done at 7 and there are five Haitian anesthesiologists. Nevertheless Heather took one for the team and went back with him while the rest of us stayed. A good night was had by all who stayed, fact we managed to drink the UN dry of rum!!

Now we are all gathered on the roof,listening to a carefully curated playlist and enjoying some well deserved refreshment, a happy cohesive team content to have completed a mission under challenging conditions. At the very least I have managed to acquire a voodoo doll! It has been a positive experience for us all, a we we're chance to work with other disciplines we do. It work with in our regular life. We will certainly never forget this unique experience and I for one look forward to coming back. The rain is now falling and we are seeking shelter. Will update the blog as we return to Nova Scotia.

Visit to Tytoo gardens part two : the pictures

On the road to the orphanage

Someone is tired

Little ones at play

How could you say no to that face?

They are all huggers!

Food aid: part of the Elderly outreach programme

The school the charity built

Well equipped playground

See my twitter feed also. @axe1314 Also have some on Facebook : look for Andrew Jarvie

Orphans and starfish: a trip to Tytoo Gardens orphanage part one

Gandhi famously said ' I like your Christ but I do not like your Christians- why can your Christians not be more like your Christ?' I think we found some who are, on our trip to the Tytoo Gardens orphanage today.

The orphanage started out by accident when an entrepreneur from Ontario came to Haiti to avoid the attentions of Revenue Canada. He came to the coastal village of Martinette to set up a strip club/bordello and ended up feeding local hungry kids peanut butter sandwiches. He gradually realized how many children had been abandoned in the neighbourhood and began to take them in. His neighbour was a Christian involved in aid shipments and he began to help. Eventually he had a spiritual awakening and turned his den of ill repute into a place of hope for orphans, vulnerable children and young mothers.

It accommodates about 50 children, some orphans, some with their mothers. The organization runs a school and aims to provide food, shelter, education and a meaningful transition into adult life. They also run a community health clinic which was pristine, well equipped and efficiently run by a paramedic from Ontario, a nurse practitioner from Iowa and a Haitian Midwife. The organization also supports a couple of jewellery workshops which provide meaningful employment to women who might otherwise resorted to dire means to make ends meet.

The group had a very positive time interacting with kids who have had some trying times. There were many tragic stories: rescued child slaves, a girl rescued from ritual Vodoun abuse, a 15 year old and her 28 wk baby, a little girl with osteogenesis imperfecta who just wanted to go to school when no regular school would take her. All of them were very cute and friendly and we all found friends. We gave out toys and clothes, played games and cuddled babies. It was with heavy hearts that we had to leave to return to Bernard Mevs.

The visit however was far from the depressing and sad event I expected and I left with a renewed faith in the basic goodness of humanity. They were extremely hospitable and provided the most delicious lunch we have had here. It was Katrina's birthday and they even sang Happy Birthday and provided a cake which was very touching. A birthday she will not soon forget.

To explain the starfish reference : a man was walking along a beach and found lots of starfish stranded by the tide, dying in the sun. He began to throw them back in the sea. A little girl came up to him and said ' You  are a fool, you can't save all of them!' He replied ' Maybe so but I saved this one!'

That is the philosophy of this organization: they can't save all the abandoned and vulnerable children of Haiti but they can make a difference to some. They can provide some hope in a country which badly needs some.

For further information see their website: tytoogardens.ca

They are on Facebook also: https://www.facebook.com/pages/Tytoo-Gardens-Orphanage/228173623933912?hc_location=timeline

Pictures to follow when my devices are charged!

A stormy night in Port au Prince....

.......after a busy day in the hospital for everyone.

Day began in ICU with an interesting diagnosis: unconscious patient was obtunded due to neurosyphilis which was nowhere on our differential diagnosis! We got plenty of cases done in the OR. An excision of a skin cancer with grafting, an Achilles' tendon lengthening and then the case the ortho pods had been waiting all week to do: an intramedullary nailing of a femur. We were all set to start it at 8 when we discovered the patient was anaemic. No cross match and when we did no blood in the hospital! Nearly got the patient's brother to donate a unit but we  diverted another patients blood and got the case underway after lunch.

After several days of hearty lunches we were given short rations today, not sure why, maybe they saw us on the roof last night!,

The IM nail took a while and we were going to start a plastics case when another 14 year old GSW to chest was transferred from another hospital! At least a litre in his chest drains. Became I tubed and had to be tubed. There followed much conversations with surgeons regarding possible surgery until a thoracic surgeon agreed to come in. Was told he would take an hour and we are still waiting! Bullet also managed to exit giving him a T12 paraplegia so his long term outlook is bleak.

Meanwhile we have reviewed Shauna's rash and have established a differential of secondary syphilis or leprosy. Could just be a reaction to DEET but that would be too obvious.

Meanwhile  Dave Amirault and Marti LeBlanc headed to the medical school for some teaching. When Marti got back we did another unusual case: a 59 year old woman with a tumour of her hard palate the size of a lemon! Was surprisingly easy to intubation so the case was pleasingly uneventful. We left the OR to find a thunderstorm underway. Welcome relief from the muggy conditions today and quite spectacular.

We headed off to MINUSTAH for dinner and a few cold ones. Our fun was curtailed by 'problemes d'electricitie' but we left refreshed to convene on the roof. The poor kid with the GSW remains in ICU holding his own, no sign of the surgeon! 

Tomorrow am we have a field trip to an orphanage which promises to be emotionally disturbing, but will be an insight into the problems Haiti still faces.

IM nail gets underway

Dave consults Marti in the OR

Controlled drug box

State of the art anaesthesia setup

On the beach part two

Shanty town

Wahoo Bay

Gets great ratings on Trip Advisor!

Steve masters paddle boarding......

.....or not!

Cindi in her Bond Girl bikini!

Delicious spiny lobster Haitian style

Busy market 

Always room for one more passenger!

Ready for the beach!

Haitian roadside gas/petrol stalls

On the beach part one

Time for a well deserved day of rest for the hardworking Halifax Broken Earth team. We worked in the OR until midnight and ER was jumping as ever. Bit of activity outside last night:  two UN APCs were circling , shining their lights and we could hear search dogs barking. Not sure what that was all about! 

Anyway the day started with a revision of a cleft palate in a seriously cute 6 month old ( see twitter, you are following me aren't you? I am @axe1314) Then it was off to Wahoo Bay after a fascinating journey skirting Cite Soleil, the most dangerous slum in the world, through some beautiful rural areas. We passed through at least 3 bustling marketplaces selling everything from mangos to shoes. All along the roads were not only free range chickens, but free range horses, cows and goats!

We arrived at a gorgeous resort for some well earned R and R. Sea was warm and welcoming. The cleanest I have felt all week, even though I managed to cut my feet on the rocks. Managed to witness action man Steve attempt paddle boarding and Cindi in her Bond Girl bikini! Lunch was BBQ burgers and dogs but thanks to all star Ortho resident Keith the second course was spicy grilled Haitian spiny lobsters- yum!

Return journey was more interesting than anticipated when someone tried to snatch a camera from one of the ER gals through the window while we were stopped in mad Port au Prince traffic. He was unsuccessful but it made us a little edgy when our driver took us in the back door of Bernard Mevs!

Then after a nap it was off to MINUSTAH for burritos and rum. Met an expatriate Brit with a bit of a death wish who had worked at Bernard Mevs previously. He is a paramedic who now does 'security' for a charity in Cite Soleil, the notorious slum. When he left on his motorbike he wasn't wearing a helmet and his light was out, so he wouldn't stand out , or so he told us. Interesting people you meet in places like this!

Since we are not allowed to drink here we are definitely not on the roof drinking Prestige before we get back to work tomorrow!

Welcome to the neighbourhood

Crowd gathers to watch World Cup qualifier

Local traders hawk their wares

Local Shoppers Drug Mart...

Front of house was removed to widen street!

Retake contemplating 

Tropicana lounge....

Another day of leisure at the Port au Prince Spa!

Hospital entrance at night: to left pharmacy and open area where relatives sleep, in shadows at gate guard with shotgun in hand!