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Haiti: Six Months After the Earthquake by Katherine Brieger, RD, CDE
Most of us working in health care wanted to offer help to Haiti following the devastating earthquake. Inspired by the media images, we wanted to reach out, but did not know how to do so.
Hudson River HealthCare (HRHCare) is a network of 16 federally quality health centers working with the poor and uninsured in the US. Many of our staff members have devoted their professional careers to providing care to those most in need, so it was not surprising when several staff members responded immediately to the Haitian crisis. Three of our medical providers and one translator flew to Haiti to offer their assistance. Dr. Childebar St. Louis and Dr. Louis Paul, both Haitian doctors, and a family nurse practitioner, Louise Lindenmeyer, were able to help provide medical care. Dan Desmond, a Creole interpreter on staff, was able to provide desperately needed translation services.
Following their return, a small team of HRHCare executives met to discuss how we might respond to the crisis in Haiti. Anne Nolon, President and CEO, Jim Sinkoff, CFO, Dr. St. Louis and I met to map out a strategy for a follow up trip to Haiti. Our intent was to go to two specific areas of Haiti to evaluate whether we could assist with direct services using volunteer staff and to see what the needs were for a long term commitment assisting with the development of community health centers.
These initial discussions led to a two week trip to two locations in Haiti. Our trip was planned for July, which is the rainy season, and happened to coincide with the six month anniversary of the earthquake. We were prepared for some of what we saw: Jim Sinkoff has been involved with Haiti through a group which uses soccer to strengthen a community located in Jacquet. He told us to expect a lack of infrastructure in almost every aspect of Haitian life. And Dr. St. Louis had been in Haiti just months earlier and described what we might see.
We first visited Milot, located in the Cap Haitien region in northern Haiti, then Port-au-Prince. Our first week’s destination was Crudem, a hospital system supported by volunteer foreign medical staff in Milot, to work in the ambulatory clinics. We stayed in volunteer quarters and assisted in several clinics. Dr. St. Louis worked in the adult ambulatory clinic and helped doing rounds for overflow hospital patients.
Tents were set up on the grounds of the hospital to accommodate the earthquake evacuees, who had come there with amputations and other serious issues. Some overflow hospital patients were also housed in the tents. I assisted in the pharmacy, giving out supplies to the nurses and patient family members living in the tents. I had the opportunity to also assist in the pediatric clinic where my role was simple — taking vitals and recording them in the paper medical record. I saw mothers who had walked for miles holding their babies, hoping to get help from the doctors. For many of them, malnutrition was a primary diagnosis. Secondary infections were common as were parasitic infections and fungal issues. One young girl brought in by her mother had had a fever for 10 days and was unable to stand without assistance.
As a dietitian, I had studied malnutrition and seen some limited cases, but in Haiti, malnutrition was a prevalent health problem owing to the poverty that existed prior to the earthquake. In the pediatric unit of the hospital there was further evidence of severe malnutrition. A young boy with kwashiorkor was being treated there. Some of the children and babies we saw in the hospital had secondary infections or conditions associated with malnutrition.
Efforts to correct this are limited as a result of funding and infrastructure in the public health system. I visited the nutrition clinic on the hospital grounds. Children received supplemental milk, bread and peanut butter.
Another afternoon, I worked with patients who had diabetes. Two of the women I spoke to had had amputations, not caused by the earthquake, but caused by lack of money to pay for diabetes medications. I spent some time, working with an interpreter, with a small group of patients who wanted to learn more about diabetes and how to improve their control. It is difficult to counsel patients when the one thing they need is medication.
Our team spent some time looking at how we might be able to offer some long term assistance. We met with the hospital administrators and found that they were seeking our assistance in getting a grant for a community outreach program. After further discussions, the Chief Medical Officer said that they would like to develop training for the health staff of the hospitals. This included medical, nursing, community health workers as well as dentists. Our plan is to work with the hospital by helping them to get their grant proposal funded and by coordinating some training programs they are interested in for their staff. By supporting their staff, we can help build a stronger Haiti.
The second part of the trip was focused on Port-au-Prince, the area that was devastated by the earthquake. We found a lack of infrastructure which made so much of life difficult for the Haitian people. Their public health system was not well developed before the earthquake and now, it is very limited. Our focus during this part of the trip was to conduct first aid training for four days, with a group of lay people. They were part of the soccer association (Konbit Football) seeking to improve the community through community action. They had asked our team to provide this training and then to offer medical clinics in the afternoon. We agreed and worked at the school used by the soccer group.
Donated first aid kits were made available to all 50 trained in first aid. The people were eager to learn. Dr. St. Louis would offer the class in the morning, and then conduct clinics in the afternoon in an empty classroom. Over 130 patients were seen in the afternoons. Nurses from the medical school, which was destroyed during the earthquake, took blood pressures. I assisted Dr. St. Louis with the medical clinics. After the blood pressures were taken, I worked with the nurses offering diabetes instruction. They had asked if I could help them to understand diabetes treatment and some of the underlying physiology. They were eager to learn and so I promised to send them more information in Creole.
It is difficult to describe how this experience has affected all of us on the team. I know for myself, I cannot stop thinking about the Haitian people. Their resilience in the face of such overwhelming devastation is hard to understand. Many of them are still living in tent cities with limited resources and not much hope for an improved future. The people we met and worked with were so grateful for the small things we did. We are going back to work with the groups again. I hope that in some small way, we can help to bring change to Haiti, most importantly, by helping to strengthen the Haitians’ ability to provide their own health care.
ACU Board Member Katherine Brieger, RD, CDE, and COO of Hudson River HealthCare, Inc., was part of a team that visited Haiti to provide medical assistance in July 2010. This is her first person account of the trip.
Also available is an audio program with interviews of the team members, including Anne Nolan, Kathy Brieger, Dr. Childebar St. Louis, and Jim Sinkoff. The audio program was produced by Paul Westpheling.Click here to listen.
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