NHRegister.com Dispatches from Haiti

Filing from Haiti

2010-03-19T17:04:00.001-04:00

Nothing they taught me in journalism school could have prepared me for this trip.

I had an idea about what I was getting into when I volunteered to accompany a medical mission to Haiti organized by St. Mary Roman Catholic Church in Milford.

I had read all the reports coming out of Haiti in the aftermath of the Jan. 12 earthquake that devastated the country’s urban centers.

And I talked to the team members about what they hoped to accomplish through their health clinic and surgery center in the village of Marbial and the city of Jacmel.

And I did my homework before the trip so I could be prepared as possible to file stories and write blog posts with photos from a quake-ravaged country with a crippled infrastructure and rural areas with little electricity and no cell phone service.

Before I could even begin to think about technology, I had to think about biology — my own. I arranged to meet with a travel doctor about a month before the trip and was given a schedule of vaccines to get before departing for Haiti.

I got a total of four vaccinations — typhoid, tetanus, hepatitis A and hepatitis B. Typhoid was by far the most painful, but hepatitis B was fun because it comes in three parts. I got two of my “hep B” shots but I have to get another booster in six months.

Moving onto malaria: There is no vaccine, to the dismay of humanitarian organizations trying to combat the problem in poor countries plagued by the mosquito-spread disease.

Instead, I took Chloroquine pills once a week two weeks before the trip, once during the trip, and I will continue for four more weeks. If I come down with any symptoms of malaria in the next year, I am to head straight to my doctor and report myself as recently returned from a trip to Haiti.

The malaria pills work, but they are not 100 percent effective. As a safety precaution, I brought a mosquito net with me and a spray bottle of DEET that I used to douse myself with three times a day.

The Centers for Disease Control and Prevention also recommends a rabies shot, which I declined. In six months, I am supposed to get a tuberculosis test to make sure I did not contract that disease on my visit.

Arranging my vaccines was the easy part compared to figuring out how I would file stories and update my blog from Haiti. Luckily I got a lot of help from our technology gurus at the Register, some advice from colleagues at other papers I’ve worked at, and pointers from my journalism professors at the University of Colorado in Boulder.

This is how I did it:

I carried everything I needed in a hip pack that never left my side during the trip — notepads and pens, a Flip digital video recorder, digital camera and my global edition BlackBerry, complete with international phone plan. I also had a laptop computer with an international air card.

It was a great setup except I had no cell phone service in Marbial, so it was impossible to file reports from the village. So I would spend one day in Marbial reporting on the medical clinic and taking photos and video and then the next morning I would hitch a ride down the 10-mile-long rocky riverbed to the town of Jacmel, where I could get online and file stories and photos from my laptop.

When the laptop would run out of power (in about 20 minutes) I would continue to take pictures and write stories on my BlackBerry, and then send them directly to the Register. Then it was back to Marbial to start the process anew.

We actually had electricity for five hours a day in Marbial so I could juice up all of my gadgets at night before the lights went out at 11 p.m. sharp. But the real rush of relief came when I would press “send” on my laptop every other morning and know that my reports would get to my editors back in New Haven.

Sometimes that moment came from the back seat of a Land Cruiser as we “off-roaded” over the riverbed. Sometimes it came from the floor outside the hospital in Jacmel where I was observing the surgery team operate on patients.

It’s a different kind of deadline, filing stories from Haiti. I am hoping it makes deadlines back in New Haven a little easier to handle. Then again, here I am late on a Friday afternoon filing my weekend story. I guess some things never change.

Coming home

2010-03-15T16:21:00.000-04:00

It was a long, hard journey home for the St. Mary medical mission, thanks in no small part to the major storm that churned through the northeast on Saturday.

After seven physically and emotionally draining days in Marbial, the medical team drove down the rocky riverbed one more time for the year and spent the night in a house in Jacmel owned by an American couple. For their hard work, the doctors and nurses were rewarded with a spectacular Caribbean sunrise before setting off for the airport in earthquake-torn Port-au-Prince.

The American Airlines flight took off late from Port-au-Prince Saturday afternoon, and was diverted to Miami because JFK airport in New York shut down for dangerously high winds. After taking an hour or more to go through customs, the team managed to find a nearby hotel that could accommodate the large group.

The next day, the flight home was delayed for four hours while American Airlines attempted not-so-successfully or smoothly to straighten out the mess caused by the storm cancellation. When the team finally arrived at JFK, more mayhem awaited. The tired doctors, nurses and volunteers stared at the baggage claim conveyor belt for two hours and collected 20 of 21 checked bags. One suitcase never made it back. Time to get in another line and wait.

By this time, the St. Mary medical mission team was getting good at waiting around for things.

But the team eventually and most importantly – safely – made it back to St. Mary’s Church in Milford Sunday night. It was just in time for everyone to go home, have a quick meal and a hot shower before going to bed and waking up to a fresh work week.

Even though they left Haiti behind, the place and its people will remain in their hearts and minds. And for some members of the team there is always the promise of next year, another chance to save some lives and spread some hope.

Teaching women's health

2010-03-12T20:55:00.000-05:00

There is a word in Creole that does not exist in the English language: pedisyon.

It translates to something like this: being pregnant for a long time – years even – while still having a monthly menstrual cycle. It is an example of the void of education about women’s health issues among peasant populations in Haiti.

Multiple times during the trip, women of child-bearing age and some far too old to have children complained to doctors that they have been pregnant for years but the baby will not come out of the belly. The women usually describe getting pregnant and then having a hemorrhage, followed by a return of their monthly period. They think the baby is still in their belly. Some of the women say they can feel kicking. The women do not understand that they have miscarried and there is no baby.

Bridgeport Hospital medical resident Sangeetha Thiviyarajah examines one of these women and has to break the news to her.

“Tell her there is no chance she is pregnant. You cannot be pregnant for two years,” she tells the interpreter.

The woman looks confused, and disbelieving. She is rail thin and does not have the extended belly of a pregnant woman. But she uses the word “pedisyon,” a word she probably learned from her mother.

“I think they need education on pregnancy and menstrual cycles,” Thiviyarajah later explains. The misinformation gets passed down through generations of women.

The team also treats multiple women for sexually transmitted disease. They prescribe antibiotics for the women and try to explain to them that they need to have their sexual partners get treated for the disease as well. There is also wide-spread anemia among women of child-bearing age because they are malnourished and have multiple children at a young age. One 40-year-old woman tells doctors she has had 16 children, although six of them died.

There is a lot of ground to cover with the education of women about health issues, but the team has made a start, one woman at a time. Dispelling the idea of pedisyon is just the beginning.

Adjusting to life in Marbial

2010-03-11T12:40:00.001-05:00

Daily life is getting easier and, at the same time, harder for the members of the St. Mary medical mission in Marbial. On the first couple of nights, simple things like showering, brushing teeth, getting ready for bed and going to the bathroom were difficult. Using the toilet involves filling up a bucket of well water for flushing. Showering involves filling up the same bucket, lugging it into a small room with a drain, and pouring cold well water over yourself. Those things are getting easier.

Sleeping through the night is getting a little easier as well. Now that the mosquito nets are up and in place, getting into bed simply means crawling under your net, tucking it under the mattress and closing your eyes. And people generally are so tired from working long, hard days in the sun caring for patients that they fall asleep more easily. You still don’t need an alarm clock – the roosters crow like clockwork.

But things are getting tougher as well. The team of four doctors, three nurses and two volunteers is worn out after three long days treating an average of 200 patients a day. The difficult cases, terrible poverty and sad stories of the Haitians is taking a toll on the volunteers. And the question of whether the mission can obtain more medicine is weighing heavily on everyone’s mind.

And then there are the dogs. When the sun goes down and after everyone goes to bed, the dogs that lay around in the hot sun all day perk up and get rowdy. When one doctor goes outside to brush her teeth, she comes running back into the room followed by a pack of barking dogs. She dives across her bed, tearing down the mosquito net and rolling backward onto the floor. The dogs stop at the door and do not come inside, but everyone is so terrified they refuse to go to the bathroom in the middle of the night. There is talk of setting a time in the middle of the night to wake up and take a team trip to the bathroom.

Going to market

2010-03-10T12:06:00.000-05:00

Every Tuesday in Marbial, more than 1,000 people travel from near and far – some walk half a day to get here – for the big social event of the week, the market.

The scene is a whirlwind of exotic sights and sounds and smells. You feel like you’ve landed in the middle of a National Geographic spread on some far-away third-world country. Then again, that’s where you are.

Brightly garbed women carry plantains, baskets, buckets and jugs on their heads. Men lead donkeys loaded down with baskets of vegetables, cornmeal, rice, coffee and tobacco. Children ride motorcycles through the market and run around hawking candy and trinkets.

The scene is crowded and chaotic. A guide recommends that anyone who goes down to the Tuesday market bring a partner because it is so big you can get lost.

I ignored the advice and managed to avoid getting lost, but I attracted a following of small, curious children wanting money or food from the single red-headed white person at the market.

A group from the medical mission decided to head down to the market to buy some baskets as souvenirs from their trip. Luckily they had Agathe Mezik with them. Mezik is a nurse in Connecticut who is Haitian by birth. She speaks Creole and is able to haggle with the basket weaver to buy six baskets for the tourist-doctors standing out like sore thumbs in the bustling market.

On the walk back to the medical clinic, a man spoke in Creole to Mezik and told him that his daughter needs to see a doctor, can she help? She told him to go to the clinic and wait in line with his daughter.

“She will get help there,” she says in Creole.

Helping hands

2010-03-09T12:54:00.000-05:00

Bridgeport Hospital surgeon Richard Garvey assists Mark Bianchi in a surgery Monday. Frantz Paul looks on.

People in Marbial line up bright and early Monday to receive care from the St. Mary medical mission team.

The value of electricity

2010-03-08T16:38:00.001-05:00

The St. Mary medical mission got a surprise when they came to Marbial – electricity. After three hours of driving through the ruins of Port-au-Prince and the mountains of central Haiti and then one mile down a rocky riverbed in the dark, it almost seemed surreal to be pulling alongside a building that glowed from the inside with electricity.

But sure enough, the people of St. Therese Church were eager to show off the generator donated to them last year by St. Mary Church in Milford. Waiting inside for the team was a nicely set table and a spread of food that included rice, pasta, meat, and dumpling soup.
The church even had a room set aside with beds for the group, another welcome surprise.

The place still maintained a rustic feel… To flush the toilet, you fill up a bucket of water and take it with you to do the flushing. And the beds required a MacGyver-like configuration of mosquito nets. Think duct tape, tent poles, rubber bands, well hooks and more duct tape.
And obviously there is no cell phone service. This reporter had to hitch a ride 10 miles down the not-so-dry rocky riverbed to be able to get cell phone service and file stories. The team has a satellite phone in Marbial for emergencies.

Waking up in Haiti

2010-03-08T11:36:00.002-05:00

There is no need for an alarm clock in

Haiti

. The roosters here start crowing at 3 a.m., about the time that the dogs stop yelping. And the roosters are persistent. They will make sure you are awake for 7 a.m. Mass.

Much of the medical team started the week by attending Roman Catholic Mass at St. Therese Church, a beautiful whitewashed church with concrete walls and a tin roof – making it one of the few buildings around that people are not afraid of collapsing on top of them in an earthquake.

The people of Marbial walk for great distances, even miles, to get to Sunday church, an incredible social event for the people of the parish. They come wearing their Sunday finest – women in beautiful old-fashioned dresses, neatly ironed and finished off with a straw hat or brightly colored scarf and men in suits. But when they kneel down to pray, you can see the soles of their shoes are worn through.

Still, the people give thanks at Mass for that they have. St. Therese’ pastor, Bertrand Dieuveille, welcomed the Connecticut medical team about to descend upon his flock. He compared them to Jesus, coming to heal the poor.

“We have the life of God within us, but we do not have health. We suffer here,” he told the congregation. When he told the parish that St. Mary Church plans to send a medical mission once a year and eventually set up a permanent clinic, they applauded.

Later, during the sign of peace, a ritual in the Catholic mass, church members made their way to the doctors and nurses to shake their hands, hug them, say “peace” and “thank you.”

After a bumpy and stressful journey to Marbial, it was an emotional showing of kindness.

“I thought, ‘this is why I came here,’” said Michele Covino, a nurse at Bridgeport Hospital.

HAITI: The scene on the ground

2010-03-07T09:19:00.001-05:00

PORT-AU-PRINCE, Haiti — Despair and hopelessness are written across the faces of Haitians crowded into the streets of this earthquake-ravaged city.
A team of medical professionals and volunteers organized by St. Mary Church in Milford arrived in Port-au-Prince Saturday afternoon and quickly became immersed in the exhaust-choked city, where children missing limbs hawk trinkets as armed military trucks roll through the center of town.
It is the children that get to West Haven school nurse Susan Marchitto.
“None of them have smiles,” she said. “Look across the street. They play in the dirt with no toys, no food.”

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Persistent children and desperate-looking men beg for money, some more forceful than others. A steady line of old cars and brightly painted vehicles called tap-taps files past the airport, making the air thick with smog and noisy with honking and squeaky brakes.
It is hard to tell how much the city has recovered from the Jan. 12 earthquake that killed more than 200,000 and left 1 million homeless. The city appears collapsed and desperate and lost, but the team’s guide says it always looks like this.
“A lot of poverty, but I can’t tell if it has changed since the earthquake,” said Sangeetha Thiviyarajah, a third-year resident at Bridgeport Hospital.
But there are glimmers of hope hidden among the chaos.
One nurse with the team, Agathe Mezile from Milford Hospital, was reunited with her sister at the airport. Mezile, who is from Haiti, brought her sister a fully cooked turkey and a ham on the plane. She said her sister lost her house in the quake and has been living in a tent.
Mezile said goodbye to her sister and is heading to Marbial to help heal her people.

THE JOURNEY BEGINS

The first leg of the mission seems simple: Get the team, its belongings and 20 suitcases full of medical supplies and medicine safely from Port-au-Prince to Marbial, a poor, rural village nestled in the mountains of central Haiti. The trip involves traveling along a winding, mountain road from the earthquake-devastated capital city to Jacmel, a southern port city known for its beautiful French-inspired architecture and vibrant arts scene. Jacmel suffered widespread damage in the earthquake and is struggling to recapture its bustling pre-disaster culture and tourist economy.
From there, the road to Marbial, if you can call it a road, follows a rock-strewn riverbed that floods in the rainy season. The 10-mile, slow-going trip isolates Marbial from the bigger cities in Haiti, giving the village a quainter, more peaceful feel, but also cutting the people off from what little medical and social resources the country has to offer. Even in the cities, access to hospitals and medical care costs money, and many of the people most desperate for care can’t afford to pay for it. Without the most basic level of health care, many of the poorest Haitians don’t live long. Treatable chronic disease such as high blood pressure and diabetes are widespread killers.
The team was hoping to secure vaccines for diseases like diphtheria, tetanus and typhoid, but was unable to get them. Instead, they will likely be treating children for terrible, deadly diseases that could have been prevented with a basic vaccination program.
Part of the church’s and the medical team’s vision is to become a long-term presence in Marbial. The group’s ultimate goal is to set up a permanent health care clinic in the village and help get the people more reliable access to doctors and medicine.
In the future, they hope to administer vaccines to children rather than treat their preventable infections.
For now, the team has one week to make the biggest impact possible and give the people of Marbial a little bit of hope for the future.

A CONNECTION

The idea for the medical mission was born three years ago when St. Mary Church became a member of the Parish Twinning Program of the Americas, an organization that matches Roman Catholic parishes in the United States with sister parishes in less-developed countries.
St. Mary was connected to St. Therese Church in Marbial, which sits alongside a river. The people of Marbial are poor, but there is not the feeling of desperation and despair that is palpable in post-disaster Port-au-Prince.
Village life centers on the river. The river is silty, brown in color, and is used for everything from washing clothes and bathing, even for drinking water. Children in the village walk for miles to get to school. The only electricity in the village is supplied by a generator in the church that was donated by St. Mary Church.
St. Mary takes good care of its sister parish.
Since the spring of 2007, St. Mary has raised tens of thousands of dollars — more than $16,000 for educating the parish’s 500 students and $20,000 for the medical mission. It has already started fund-raising efforts to support another medical mission to Marbial next spring.
In addition to the church, the individual members of the medical team raised funds to buy medicine and supplies that will be used in the makeshift medical clinic in Marbial and the surgery set-up in Jacmel. Just days before the trip, Bridgeport Hospital pediatrician Mary Lou Gaeta accepted a $1,100 donation from the Mercy Learning Center in Bridgeport. It was one of many generous donations to the mission that will enable the team to have a bigger impact and help people stay healthy longer.
The last leg of the trip to Marbial involves turning onto an extremely bumpy dirt road through the mountains and then connecting with the even more treacherous riverbed.
It is getting dark, and the team has its work cut out for it. The next morning, they will set up the clinic where they will try to bring some miracles to Marbial.

Contact Abbe Smith at 203-789-5615 or at asmith@nhregister.com.

Editor’s note: Nearly two months after the earthquake in Haiti, the devastation is no longer front-page news. But the desperate nation needs help more than ever. A team of doctors and volunteers organized by St. Mary Church in Milford arrived in Haiti Saturday. Register reporter Abbe Smith is with them and, for the next week, will document their efforts.

Packing light, sort of

2010-03-05T10:57:00.017-05:00

The suggested packing list for a humanitarian trip to Haiti reads like a survival guide:
Mosquito net, check. Permethrin spray for clothing, Deet spray for skin, malaria pills for the inside, check. Emergency Cipro prescription in case of traveler’s diarrhea, Imodium for same affliction, two roles of toilet paper, for, well, ditto – check, check and check. Oh but there’s more, way more. (A snapshot of this reporter's items are at left) Each member of the St. Mary’s medical mission was given a suggested packing list that reads as follows:

Clothing -Approx. 4/5 days worth - items can be washed. T-shirts, comfortable pants/jeans/shorts, shower sandals (flip-flops), comfy sneakers/shoes, nightgown, socks, shower robe (optional), scrubs (at least four pair), underwear, light blanket for sleeping.

Toiletries - Malaria meds, personal meds, soap, razor toothbrush & toothpaste, two bath towels(will be left there), hairbrush/comb, one hand towel - will be left there, sunscreen, one wash cloth (will be left there),bug repellent. toilet paper.

Comfort items - Two medium water bottles, sunglasses, wet towelettes, kleenex, mirror, bowl for personal care, two sheets(will be left there), small travel pillow, Imodium or Pepto-Bismol, Cipro 500mg. (Optional), favorite snacks, and a mosquito net with poles.

Other Important Items, - PASSPORT, notebook/journal & pen, license, copy of doc/nursing license if appropriate, small pocket flashlight with extra batteries, passport holder or fanny pack.

Everyone on the trip has his or her own personal super-item. Sue Marchitto needs her reading glasses. Richard Garvey came up with the tent poles-duct tape-mosquito net combo that seems to be popular with the group. This reporter is bringing a ridiculous amount of power bars, organic beef jerky, trail mix and canned salmon. Oh and a headlamp, key for late-night treks to whatever “rustic” bathroom set-up we have. (It is rumored to involve a bucket.)

For the physicians, Sue also recommends the following:

Haiti Diseases handbook and Haitian/English handouts
Stethoscope and BP cuff for medical personnel
opthalmoscopes (if you have one)

As it turns out, I don’t have a opthalmoscope, so I will be without...

First stop - Jacmel

2010-03-05T09:40:00.001-05:00

We are flying into Port-au-Prince and are scheduled to land Saturday afternoon. From there, we will take ground transportation over bumpy terrain to Jacmel, a southern port town that was heavily devastated in the Jan. 12 earthquake.
To give you a better idea of our first destination, check out the map below.

Changing lives

2010-03-04T22:35:00.000-05:00

There is a young Haitian girl in Marbial whose life is about the change dramatically. The girl, about 13 years old, has a large congenital tumor on her face, a deformity she has probably had since birth. She is slated to be one of the first patients in line for surgery when Bridgeport Hospital surgeons set up camp in a hospital in Jacmel. Richard Garvey met the girl last year on St. Mary’s reconnaissance trip to Marbial and indentified her as a candidate for surgery.

The girl’s procedure is being led by Mark Bianchi, chief of otolaryngology at Bridgeport Hospital, with support from Garvey and certified nurse anesthetist Franz Paul. As an otolaryngologist, Bianchi specializes in ear, nose and throat disorders and surgeries of the head and neck. He says her case is a tricky one because during surgery he has to be careful not to harm the facial nerve or risk facial paralysis for the girl (pictured at left/photo by Garvey).

“The surgery is very meticulous and somewhat longer than it normally would be,” Bianchi said. “It could be very dramatic.”

The goal of the surgery is two-fold: to improve the girl’s quality of life by removing the disfiguring growth and preventing possible complications down the road for her. Bianchi said such tumors have a higher rate of turning into cancerous tumors.

The surgical team in Jacmel will face a wide range of problems and will have to make difficult decisions about who they can treat and who they cannot treat. Certain complex surgeries that require follow-up more than a week later might not be able to happen because the medical team will not be around long enough to ensure the proper follow-up. It is not yet known if the team will see many people with wounds left over from the earthquake. What is almost certain is there will be no shortage of people in need of help from the surgical team.

Doctor of the year

2010-03-04T22:31:00.000-05:00

It is two days before the St. Mary’s medical mission embarks for Haiti and the team just got great news: Trip leader Richard Garvey was named doctor of the year by the Greater Bridgeport Medical Association.
Pretty cool timing, if you ask trip organizer Michael Mercurio.
“I think it’s absolutely outstanding,” he said.

Garvey is a veteran surgeon at Bridgeport Hospital with more than three decades of experience under his belt and a stellar reputation in his field. But the award is just as much for his community outreach as it is for his work in the operating room. He was selected from about 200 physicians for the honor and will receive the award in May.

The news comes just two months after another team member, Susan Marchitto, was named Connecticut School Nurse of the Year. Marchitto is a school nurse at Washington Elementary School in West Haven.

The children and adults of Marbial (pictured at left/photos by Garvey) stand to benefit when the superstar-studded team of medical professionals and church volunteers pays them a visit next week. And though not everyone on the team has a “best physician of the year” designation at the end of their name, everyone on the trip has impressive medical credentials, inspiring stories of past volunteer work and medical missions, and big hearts. Mark Bianchi is an ear, nose and throat specialist who has spent the last 13 years engaging in countless hours to pro-bono health care for underprivileged children in Bridgeport. Mary Lou Gaeta, director of the pediatric inpatient unit at Bridgeport Hospital, accompanied a medical team to Thailand to help children with cleft lips, facial deformities or severe burns. Frederick Ramos, a second-year medical resident at Bridgeport Hospital, went on an average of four medical missions a year as a med student in the Philippines.

And that’s just to name a few…

The journey begins

2010-03-04T22:13:00.000-05:00

A team of doctors, nurses and volunteers is getting up bright and early Saturday morning to embark on a trip that will change their lives forever, but more importantly, change the lives of sick and injured Haitian people living in the rural mountain village of Marbial.

The team is kicking off their journey at 5 a.m. in the parking lot of Milford’s St. Mary Church, where the idea for the medical mission was born almost three years ago. It was long before a powerful earthquake struck in Haiti, bringing widespread death and devastation to a national already ravaged by extreme poverty and dismal living conditions. After the earthquake hit, the team members decided that it was more important than ever to stay on track with the mission. Often when major disasters happen, aid pours in at first but slowly trails off in the weeks and months to come. That’s when the Milford team is set to arrive and get to work.

The group will travel from Port-au-Prince to the southern port town of Jacmel and then down a bumpy dry riverbed to Marbial, where St. Mary's "twin" parish, St. Therese, patiently awaits their arrival. (At left is a picture of St. Therese and another of the "road" to Marbial. The photos were taken last year by Bridgeport Hospital surgeon Richard Garvey, one of the trip's organizers.)

This blog will follow the efforts of the St. Mary medical mission to bring medicine, health care and hope to some of the neediest people on the planet. The volunteers are taking time from their busy lives to travel to a country plagued by malnutrition, disease, unclean drinking water and crumbled infrastructure. Each volunteer has his or her own expertise to lend to the mission. Doctors, surgeons, nurses, a medical student and church volunteers, all with a common goal: leaving the Haitian people a little bit healthier and happier than they found them.