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HAM's first mission to Haiti in 2011 began January 4th and extended throughout the month. Three teams of volunteers flew down during the month led by Dr. Tracee Laing and Paul Hammond. The amazing volunteers who participated in these missions were Keith Hare, Sarah Hare, Dr. Leslie Mihalov, Nurse Nina Stroup, Dr. Janine Flood, Nurse Terrie Hostetter, and
Judy Bradley. Major accomplishments were made during the month, including introducing first eye clinic
in Dumay since the earthquake and the first ever in our new facility, securing formal authorization for the Dumay clinic from the Mayor of Croix des Bouquet, and completion of the process giving HAM formal Haitian governmental status as an official Haitian NGO.
Below, follow the adventures of the teams through their daily posts and pictures sent directly from Haiti.
Thursday, January 27th: Please forgive the lack of communication, Tracee and Paul didn't reach a computer until this evening. Their hike across the mountains earlier this week was beautiful, but filled with a bit more excitement than hoped for. Unfortunately, Paul had some unexpected health issues during the journey, and they decided to take a few extra days of rest and skip the visit to All Hands Volunteers in Leogone. They are heading back to Ohio tomorrow morning, a few days ahead of schedule. Nothing major, just a precautionary measure so no worries.
Below are some pictures from Tracee and Paul's journey this week. We hope you have enjoyed the posts from the missions this month, and we look forward to sharing future adventures with you all.
Top left and right, and above left: scenes along the trail from Kenscoff to La Visite National Forest
Above right: Paul and Tracee in front of La Auberge, a beautiful mountain retreat
Below left and right: some of the beauty of La Auberge
Above left: Paul sitting next to the rescue vehicle, a Yamaha Rhino
Above right: southern vista at dusk
Below left and right: views of La Visite National Forest
Above left and right: scenes from the drive down the mountain to Jacmel, southern coast of Haiti
Below left: L'amite hotel on the beach in Jacmel
Below right: the beach in front of L'amite
 
Above: the back of the bus, from Jacmel to Port-au-Prince Sunday, January 23rd: A day of rest. (Charles demonstrates at right)
Tomorrow, our third team of Dr. Janine, Nurse Terrie and Judy depart for Ohio in the morning, and Dr. Tracee and Paul will be hiking over the mountains to the city of Jacmel on the southern coast of Haiti. It is a two day hike void of communications networks, so they shall be out of touch. On Thursday, they will take the bus from Jacmel to Leogone to work for a few days with the group All Hands Volunteers (previously known as Hands On Disaster
Response). During the next week, they will post reports on here whenever possible, so please stay tuned.
Saturday, January 22nd: Thought we'd share some scenes from the streets of Port-au-Prince. Enjoy!
Friday, January 21st: Our final day at the Dumay clinic was a busy one. Dr. Janine, C  harles, Judy and Terrie attended to 43 peoples eyes. HAM would especially like to thank Marco Ophthalmics for loaning a portable autorefractor for this trip. Dr. Tracee saw the other patients while Dr. Jacques did some surgeries. The cholera clinic has continued to see a decrease in the number of patients, good news indeed, but one patient today was quite ill and needed to be transported to St. Damiens Hospital for more intensive treatment.
Top right: Dumay clinic staff charting eye patients and taking visual acuity
Top left: Nurse Terrie taking blood pressure and pulse readings for eye clinic
Above left: Charles takes autorefractor readings on eye patient
Above center: eye patient shows off artificial tears, and vitamins donated by the Brick Warriors Lego robotics team, Newark, OH
Above right: Red Cross "ambulance" preparing to take cholera patient to St. Damiens Hospital
Below left: completed sign at Dumay crossroads leading people to Centre de Santé Communautaire de Dumay
Below right: unfinished sign at entrance to the Centre de Santé Communautaire de Dumay
Bottom right: Dr. Jacques leading staff meeting
Bottom left: clinic staff...Haitian culture eschews smiling in photos
 Construction crews were working on the final phases of construction as Paul juggled discussions with the mason, the plumber, the carpenter, the plumber, the well guy, and the sign painter. Hard as we tried, the jobs were not all completed, but far enough into the last stages that we feel comfortable leaving final direction to the staff. For the next planned HAM mission this coming May, the teams will be able to live at the clinic, a great achievement indeed. 
The workday ended with a Dumay clinic staff meeting, run by Dr. Jacques, but included Dr. Tracee and Paul. We wanted to recognize Dr. Jacques and the staff for working so hard with us to successfully set up the Centre de Santé Communautaire de Dumay in the past year. Looking at the clinic and what has been achieved in providing a stable, functional and accessible health care delivery system to a community of 20,000 at a time great crisis. To anyone who thinks that humanitarian efforts in Haiti since the January 12, 2010 earthquake have failed, I suggest the look closely at Dumay and open their eyes.
Thursday, January 20th: The third medical team visited Dr. Joey for the first time, working at his Hospital Haiti Medicare in the morning. They spent the afternoon with Joey at a small but well supplied health clinic called Kay la Sante in Tabarre that was directly supporting a tent camp. Dr. Janine and her crew attended to matters of the eyes at both locations, an uncommon and extremely well received event in communities of extreme poverty. Meanwhile, Paul was off to get the rear suspension of the truck fixed, hoping this would truly be the final installment of Haitian auto repair, for this mission at least.
Below are some pictures from the day.
Wednesday, January 19th: Back to the Dumay clinic for a busy and productive day. Dr. Jacques was  attending a Health Cluster meeting, so it was only Dr. Tracee seeing general medicine patients. She attended to over 60 patients with a variety of ills. There were several children with very high fevers, 104 and over, two of which had hand, foot and mouth disease, a viral illness that causes a very sore mouth and high fevers. One girl with a high fever had tonsilitis and possib  le pneumonia. She was sent to Nurse Terrie for a shot, as pictured on the right. Terrie did an outstanding job of preparing the girl, and her mother, for the shot as well as consoling them afterwords. The girl was a real trouper, with not a tear shed from the stick of the needle. Tracee also had an "urgent case" brought to her by the staff when a woman who was thirsty decided to drink from the marked container of a strong bleach solution located by the cholera area, used for disinfecting hands. Fortunately, the simple cure was for the woman to drink lots of clean water, which we provided.
 Dr. Janine, Charles and Judy ran another successful day of eye clinics, seeing over 30 patients. Charles, HAM's Man Friday in Haiti, originally worked for HAM as an eye technician, trained by Dr. Janine at the Bethel eye clinic. Ever since w  e were ousted and all our eye equipment was locked up by Bethel, Charles has been working for us in many other capacities, but always longing to return to his first passion as an eye technician. The return of the Dumay eye clinic this week, with new equipment brought by Dr. Janine, provided a long awaited return to this passion for Charles. Pictured right is a patient being examined by Charles under the light of the Bluminator, a cobalt filter used to detect any damage to the cornea.
About mid-day,the clinic got a visit from two folks from a Portuguese humanitarian organization called AMI. Dr. Jacques had met one of them, Jessica, at a recent Health Cluster meeting where he had announced that HAM was looking for for a tent to use for the cholera patients. AMI has had a program in Haiti since after the earthquake, supporting people in a tent camp on Delmas 33. Their  project is ending this month. The two representatives showed up today to check us out, and after a tour of the facilities and space, they committed to donating their tent to us for an expanded cholera support space. The tent was donated to them by the American Red Cross and is a large one that will fill the 240 square foot space we have dedicated for this purpose. As mentioned in prior posts, UNOPS has laid a base of gravel in preparation for pouring a cement platform fora tent. If all goes according to plan, we will have the final base poured and the tent set up before the end of the month.
Construction projects at the clinic are also moving along nicely, as we got the electric pump for the water well working today, so we now have running water in the clinic. Additionally, the final touches on the security wall are under way with the installation of the razor wire along the top of the wall. We are on track for accomplishing our many goals for the month.
Tuesday, January 18th: Another day in the Dumay clinic,
but today was quite different and very  exciting; it marked the first eye clinic
in Dumay since the earthquake and the first ever in our new facility. Dr.
Janine borrowed, purchased and received donated equipment to once again treat
patients with vision complaints.
She saw several patients with glaucoma that could be treated with vision
saving drops. She saw very appreciative patients who had their vision
significantly improved with glasses. One patient had previously suffered from a 
foreign body in her eye. Friends
had told her a little granulated sugar in her eye would solve her problem, so
she tried it. The “cure” resulted
in permanent corneal scarring. A hard lesson learned. But Dr. Janine was able
to treat her with antibiotic eye drops to help the healing process and prevent
further scarring.
The number of cholera patients arriving at the clinic has
decreased over the past 2 weeks, but one lethargic woman was brought to the
clinic today in the back of a pick-up truck . She failed to respond to re-hydration therapy, so she was
taken from the clinic to a nearby hospital by Red Cross ambulance.
Each year Joyce Miller of Lancaster, Ohio, makes over a
dozen quilts to bring to babies in Haiti. Additionally, the women at Worthington
First Presbyterian Church, Worthington, Ohio, donated hand knit blankets to be
distributed this year. Pictured below are two ill children seen by Dr. Tracee
who received these new, hand-made blankets.
 
While the medical team spent the day curing ills at the
Dumay clinic, Paul was forced to return to the Office of Assurance near
downtown. Alas, yesterday’s all-day process failed to net the desired results,
and Paul and Joel were forced to head back to seek out final authorization.
Despite Charles’ assurances that his “connection” would have everything ready
for us, it took over three hours to accomplish the goal. One delay had nothing
to do with the process, however. Driving to the Assurance Office, we found
ourselves in the midst of a terrible traffic jam that ultimately required us to
turn around and take a lengthy detour, parking a few blocks away from the
office and walking there. We
quickly discovered this was because a manifestation, protest turned riot, was
in process on our original route. In fact, there turned out to be several
manifestations around the downtown area today due to clashed between supporters
of Jean Claude “Baby Doc” Duvalier and those who wanted him jailed. As it turned out, President Preval had
Duvalier arrested this afternoon and taken downtown to jail. Paul and Joel were
actually passed by the arrest motorcade racing down the streets, sirens blaring
and being chased by camera crews. Too much action for our crew, who were more
than happy to be heading the other direction. Once clear of the excitement, they
shopped for a few necessities and headed back to the clinic to pick up the team
after a long day.
Fortunately, the road between Carolyn’s and the Dumay clinic
is way outside the normal path of most any manifestation. We have several good sources of
information and keep close tabs on the situations in town, and the team’s
safety is always our primary concern.
Haitian post-earthquake wind chime
Monday, January 17th: Monday at the Dumay clinic is usually one of the busiest
days of the week.  Just like in the
USA, all the complaints from the weekend are saved up. It’s also surgery day
for Dr. Jacques, so we have 2 Dr’s in the clinic each Monday, a general
practitioner and surgeon. This week,
we also have Dr. Tracee, who saw most of the children since Dr. Leslie returned
to the USA. We are seeing lots of
respiratory infections, complicated by the constant dust and diesel fumes. Bronchiolitis is a common diagnosis
this month in patients less than 1 year old. Dr. Tracee was very happy to see a mom she had asked to return
with her one month old daughter on Friday. When last seen, the baby  was
slightly dehydrated and very hungry.
Women in the mom’s neighborhood told her that her milk was watery and
therefore bad and that she should stop breastfeeding, so the mom was trying to
feed the one month old “regular food.”
When Dr. Tracee told her to start breastfeeding again, the mother said
she couldn’t because she hadn’t breastfed her daughter in two days and her milk
would be “spoiled”. After a long talk on Friday about the realities of
breastfeeding, and mom agreed to breast feed on demand. Today, the little girl was much
happier, healthier and .5 kg heavier on return, but mom still complained of her
“colic.” We agreed she should try
eating less
onion and cabbage. Some things are universal.
When the doctors finished seeing patients, they took the
mile hike through fields and a riverbed to catch the nearest Tap Tap home.
Meanwhile, Paul and Charles had to take the truck for it’s
annual vehicle license and assurance renewal.  This was a true cultural
experience, and unfortunately not a very pleasant one. For the city of
Port-au-Prince and surrounding areas with a population of well over 3 million,
there is one office for vehicle licenses, one office for driver’s licenses, and
one office of vehicle assurance. Of course, they are in different locations
around the city. First we visited the place to get the vehicle license renewed.
It consisted of a large lot packed with what appeared to be impounded vehicles,
in the center of which was a large Quonset hut we had to drive the truck
through. Inside were inspectors who had you pop the hood so the could inspect
the engine. It was hard to understand exactly what they were looking for as
they poked around under there for a few minutes. The inspector then closed the
hood and sent us off to do the paperwork. This consisted of shuffling back and
forth between several offices where we stood in long lines for what felt like
an eternity. It felt as if the process was meant for us to chase our tail
without any semblance of logic. After returning to one office three times and
waiting for well over an hour, it was finally determined that we could not
complete that specific process as their internet connection was too slow to
complete that specific process. I also noticed that there seemed to be several
hushed side discussions between the inspectors and other officials and those
trying to obtain their licenses, like Charles, involving money. I asked Charles
about this, to which he responded, “They do business here…monkey business”.
Next it was off to the Office of Vehicle Assurances. Insurance
is required on all vehicles in Haiti and is  obtained through the government run
office of “assurance”. The place
was packed with men standing around in an outdoor courtyard waiting for
something. It was crazy and confusing and occasionally an official would walk
half way down the stairs from the second story and call out a series of numbers
through a megaphone. Most of the men standing around had a small ticket with a
hand written number on it, 5 digits long. What immediately came to mind was the
DMV in California, or the BMV in Ohio, the state office of motor vehicles where
you come in and take a number and wait for a very long time. While those state
systems always seemed to take forever and were overly bureaucratic and complex,
they pale in comparison to the Haitian system. Given the number of people waiting, it was easy to assume
that if they were currently on 5 digit numbers, they must have started with the
number one only last week. Fortunately, Charles had a connection at the office,
and he called the cell phone of an employee friend of his who helped us
fast-track the system. In reality, that meant we only had to spend 4 hours
there waiting for another vehicle inspection and our paperwork. It’s painful to
imagine what the process would take without a connection. Finally, our number
was called and an inspector came out to inspect about 5 vehicles, all parked on
the street as there was no parking lot. He went from one v ehicle to the next,
having the owner pop open the hood and then looked under it. In true Haitian
fashion, not only did the inspector and the vehicle owner look and discuss the
engine, so did every other male in the vicinity. Once again, it was unclear
exactly what the inspector was looking for under there, but an official process
is still an official process. Time was of the essence, as we had to pick up the
third HAM team at the airport at 4:15, so we ended up leaving Charles’ cousin
Joel at the Assurance Office to finalize the paperwork. Fortunately, we made it
to the airport on time to pick up Dr. Janine Flood, Nurse Terrie Hostetter, and
Judy Bradley. The third team has arrived!
Saturday, January 15: The medical team headed back to Dr.
Joey’s hospital off of Delmas 33
to see  patients from the neighborhood. Fortunately, there have been no more
reports of violence in the area, or anywhere in Port-au-Prince for that matter,
since Wednesday’s anniversary of the earthquake. On the way there, we noticed
an intermittent screeching sound coming from the right side of the truck,
causing concern that we might have another vehicle breakdown. Fortunately, the
screeching stopped and we made it to Joey’s without incident.
 In a medium sized room upstairs at the hospital, Dr. Leslie
and Dr. Tracee set up to see patients while Nurse Nina arranged the medicines
around a desk she used as the pharmacy. There was only one interpreter for the
three of them, Johnny, as Charles and Paul needed to run some errands and do
some important shopping. This trip is the first time Johnny has worked with
HAM, and he has done an outstanding job. He is a friend of Charles from Port-au-Paix, though he lived in the U.S. for about 10 years on political asylum
from Haiti until the Presidency of Bertrand Aristides ended as the result of
coup de taut in 2004. The team saw
many patients with Johnny translating for all 3 blancs, but one memorable visit
stood out. She was a 18 month old
girl who the team could hear babbling cheerfully outside the door as she
awaited her turn, only to discover she had multiple infection which could have
been life-threatening if not treated appropriately. She remained happy and
talkative throughout the exam, yet another example of the resilience of the
Haitian people.
Meanwhile, Paul, Charles and a substitute driver, Ronald,
headed off to downtown Port-au-Prince to withdraw money from the HAM account at
Fonkoze Bank, a non-profit bank and the largest micro-finance institution in
Haiti. There is always a long line
of people waiting to withdraw money and as with all institutions here, the
process of doing business seems to take an inordinate amount of time. Afterwards, we headed to the hardware
store to purchase the plumbing supplies. We have discovered  that the best
prices and the fastest service is at Eke Depot, Eko in Creole translates to “home”, interestingly enough. In
fact, Eko Dept has chosen to duplicate the logo right down to the same color as
its namesake in the U.S. without direct affiliation. Shopping there is faster because they have their inventory
right out on the floor as opposed to all other hardware stores in Haiti, where
there are up to 5 paperwork steps involved before one can even see or touch the
actual product. We shopped, paid and were out in record time, carefully
transporting 20 foot lengths of 1.25 inch galvanized pipe draped over the truck
up to Carolyn’s. Heading back to pick up the medical team, the intermittent
screeching noise from the truck returned. After picking up the medical team,
the screeching was joined by a grinding sound and we were forced to stop and
search for the source. Taking off
both of the rear wheels, Ronald discovered that a piece of metal on the right rear
braking system had broken off. He jerry-rigged a temporary solution with a
found coat hanger that ended the screeching and grinding, and we were able to
return safe and sound back to Carolyn’s. Looks like the truck’s going back into
the “shop” tomorrow.
Top right: Dr. Tracee with patients at Hospital Haiti Medicare
Top left: Nurse Nina and her pharmacy set-up
Bottom right: Johnny, a busy interpreter having to translate for three blancs simultaniously
Bottom left: Entrance to Eko Depot...the monk at the front sold separately
Friday, January 14th: It was back to Dumay today where a large contingent of patients were waiting.  Dr. Tracee, Dr. Leslie and Dr. Jacques saw over 90 patients. In between seeing patients, Dr. Leslie and Dr. Jacques performed two more hernia procedures, so it was a busy day of medicine. Once again, Dr.Leslie served as Jacques' anesthesiologist, which is a real challenge without the benefit of modern technology. One of the patients experienced a common reaction to the anesthesia, easily delt with in the USA, but it caused quite a stir in the Dumay clinic, due  to the loud moaning and reciting of the Creole alphabet being heard throughout the complex. The surgical patients, one with a ventral hernia and the other with an inguinal hernia, did very well, but Dr. Leslie grew a few more gray hairs. Just like in the USA, there were many babies with bronchiolitis. There was a sad, but typical case of a young man who's foot was run over by a car 11 days ago, with a fractured and lacerated/infected toe. We were able to treat the infection and brace the fracture. We treated many patients with HTN, chronic pain, gastritis, rashes and respiratory infections.
Paul had a slightly more mundane day, working with various contractors in a push to get all the construction on the facility completed before HAM leaves at the end of the month. Most projects are close to completion, but as usual, and typical in the US as well, it's getting the final work finished that's  a challenge. There is still a fair amount of resourcing to do, scouting for affordable prices on parts and equipment that is priced 2 to 5 times higher here than in the U.S. We use local contractors and labor to support the community and to get the most reasonable prices, but these folks don't have vehicles and can't really "shop" for the best prices, so often it's up to Paul and Charles to scour Port-au-Prince for the most reasonable prices. The challenge is multiplied by the fact that it takes about 45 minutes to get to the clinic in the mornings, and it's another hour and a half to get to downtown Port-au-Prince from there, where the major hardware outlets are, even after the morning traffic rush. We finally figured out why traffic was so light last week, and sorry Keith, it wasn't your magic touch after all. School started Monday of this week, and it's back to the usual bumper to bumper we remember from previous trips. So, while the doctors and nurses are seeing patients the next several days, Paul and Charles will be on the hunt for pipe and plumbing parts, deadbolts, mattresses and a stove for the volunteer quarters. For HAM's next mission to Haiti, the teams shall stay at the clinic, a long awaited goal. Top right: A busy nurse intake room today
Left: Sad boy who's foot was run over by a Tap Tap...11 days ago
Bottom right: Finishing layer of cement going on outside of the volunteer sleeping porch
Above:Tailgate of the HAM truck now sporting the official logo of the Haitian Ministry of Health, our newest official partner
Below left: Dr. Leslie and a wide eyed patient
Below Right: Nurse Nina and Nurse Carmel, partners in health
Thursday, January 13th: Yesterday was the one-year anniversary of the earthquake that decimated  Port-au-Prince and surrounding communities, killing over 300,000 according to updated numbers from the Prime Minister of Haiti. It was a day of mourning and remembrance for most, unfortunately, some in the city used the occasion as an opportunity to voice their frustration about the slow recovery and the abysmal living conditions for many. There were manifestations, protests that usually involve violence, in several areas of the city with cars burned, police officers injured, and several people killed. A  major manifestation took place at Delmas 33 regarding a tent camp where thousands of people have been living since the earthquake. The owner of the property agreed to allow the tent camp for one year, and the year is now up so he has demanded serviced be cut off in about 15 days and everyone is to be off the property within 30 days. These people have no jobs, no money, and nowhere to go, so it is a major dilemma.This also happens to be very close to Dr. Joey's hospital, where the team were suppose to work today. It was unanimously decided we would not head in that direction today, just to be safe, and we went off to Dumay instead. Good thing, as Dr. Dezard, the Haitian doctor who was suppose to be there today was indisposed and couldn't make it, and there were several very sick people who showed up. Dr. Leslie, Dr. Tracee and Nurse Nina attended to over 50 patients for a busy morning.
Paul spent much of the morning with the plumber and a cadre of "consultants" reworking the system from the well to the water tanks on the roof of the clinic and outbuilding. A few words about working on local Haitian construction projects. When having a discussion with any contractor, mason, electrician, plumber or the like, any male with 100 feet will magnetically be drawn into the conversation adding their two cents, or more like two bucks worth. The conversation quickly digresses into a loud and animated debate in Creole. This proves somewhat challenging for the non-Creole speaking member of the conversation, especially when that individual needs to make the final decision and is paying for the work. Direct questions are often responded to with contradicting answers after great debate, the interpreter throwing in their opinion as well. The non-Creole speaker much show great patience and diplomacy in these situations...or be very loud and gesticulate wildly to get the point across.
Two doctors seeing people in the morning took care of the patient load by noon, so the team decided to drive to Croix des Bouquet to purchase some metal art for the upcoming Art from the Heart auction. Croix des Bouquet is the center of metal work in Haiti, and there are a few specific show that are always on the agenda to visit. One is the shop of Serge Jolimeau, a renowned metal artist who Dr. Tracee has been visiting for many years. It was great fun to see what fantastic work Serge has been doing of late, and the team was able to purchase some beautiful new pieces for the upcoming Granville Ohio Art from the Heart auction in May. Despite the change in plans, the day turned out to be most productive.
Above left: metal art canvases before the hammer
Above: A Serge Jolimeau masterpiece, unfortunately too large to transport with the HAM team
Wednesday, January 12th: Today is the one-year anniversary of the earthquake. All government offices and most business are closed today. HAM has closed the clinic, except for the cholera center, and given the staff a paid holiday. Out of respect, the HAM team will stay at Carolyn's and allow all those who suffered through the actual quake last year the space and time to remember and mourn in their own way. We have also heard reports that there have been manifestations, protests that often become violent, on Delmas 33, so it does not appear safe to be traveling the roads today.
In remembrance if the anniversary, we have posted some of our memorable photos from the last year.
Tuesday, January 11th: Keith and Sarah headed back to Ohio today, while Dr. Leslie and Nurse Nina went to work with our friend Dr. Joey at his hospital and at a tent camp. Dr. Tracee, Paul, Dr. Jacques and Charles had a day of meetings in downtown Port-au-Prince. It seemed simple enough to drop off Leslie and Nina at Dr. Joey's on the way to take Keith and Sarah to the airport, and afterwords Tracee, Paul and the rest could head downtown. But nothing ends up being simple in Haiti. Monday evening, after dropping the HAM team off at Carolyn's, the truck broke down again, this time the front wheel hub on the other side. It took no less than 7 vehicles to transport the teams to their various destinations today, between Tap Taps, Taxis, borrowed cars from friends, and eventually the HAM truck after repairs. Fortunately, Keith and Sarah made their flights and are now back in Ohio, safe and sound. We are keeping our fingers crossed that this will be the end of the truck breakdown, for this trip anyways.
Dr. Joey kept Leslie and Nina busy seeing patients at his hospital for the first half of the morning. His hospital is located in a poor neighborhood off of Delmas 33, and he charges patients on a sliding scale, never turning away those who can not pay. His facility is differentiated as a hospital in that he has it staffed with nurses 24/7, though there is not a doctor there all the time. The furnishings and equipment are minimal at best, but what Joey does for his community with the barest of resources. is astounding. It is always a pleasure for us to work and support him as much as possible. Later in the morning, Joey took Leslie and Nina to tent camp where he volunteers to see patients every Tuesday. It was a productive day for this team.
Dr. Tracee and crew missed their first meeting due to transportation delays, but were able to make it to the Health Cluster meeting early enough engage with some folks beforehand. The Health Cluster is composed of representatives from the international NGO's working in Haiti, primarily the major organizations such as the World Health Organization, UNICEF, MSF and the like. They meet weekly together with the Haitian Ministry of Health to coordinate efforts and share needs and concerns. Today's meeting itself was simply an update on the spread of cholera throughout the country departments and what the response had been. These meetings present their greatest value to HAM in that it's an opportunity to connect with other groups to find and share resources. We are currently searching for a cholera tent, cholera beds and supporting supplies and this was an opportunity for us to connect directly with larger NGO's, such as UNICEF, who may be able to help us. Interestingly enough, we were approached by a group called Homeopathes Sans Frontiere, who have been working in the country off and on since the earthquake. They approached us, saying we appeared to be "different" from all the other groups at the meeting, and we had a nice chat. They are departing the country at the end of the week and are looking for a group to leave their remaining supplies with, so we have arranged to meet with them at Dr. Joey's hospital on Thursday. However, our greatest accomplishment was that we turned over to the Minster of Health, our vast collection of paperwork, stamped, sealed and notarized by every conceivable official agency in the US and Haiti. This, along with $972.50 USD, is the final step in getting HAM official NGO status in Haiti, a major accomplishment that will help our organization greatly in working in Haiti.
It took us most of the afternoon to reunite the teams and return to Carolyn's, as traffic was horrible, worse than the usual horrible. We assume this because of the huge influx of foreign media descending upon Haiti for the anniversary of the earthquake. The circus is back in town.
Monday, January 10th: Yesterday afternoon, our second team arrived, Dr. Leslie Mihalov and Nurse  Nina Stroup. Today the crew of 6 headed out to the Dumay clinic for a long and productive day of work. While Keith and Sarah worked to finish up the electrical projects, Dr. Leslie served as the anesthesiologist for Dr. Jacques as he performed two hernia surgeries. Dr. Jacques, the clinic medical director, is also a  general surgeon. He performs minor surgeries at the clinic each week. With Dr. Leslie here, they were able to schedule more serious procedures on the two children in need of hernia repairs. All went well, with nurse BonCoeur assisting during surgery. Nurse Nina covered the post-op as well as attending to two motorcycle crash victims who appeared in the afternoon. Dr. Leslie spent the afternoon seeing children, and Dr. Tracee saw patients the entire day. We were also visited by one of our staff nurses, Nurse Nanontte, who just gave birth to a beautiful little girl 12 days ago. Obviously, both mother and daughter are doing well.
After the surgery, Dr. Jacques, Paul, Charles, and representatives from each of the Dumay zones drove to Croix des Bouquet to see the mayor and request a formal letter of authorization for HAM to operate our clinic in Dumay. Dumay is under the jurisdiction of Croix des Bouquet, and the formality of such a letter from the mayor helps assure HAM will have no legal problem working on the property in the future. The mayor was a most interesting man, occupying a  large office furnished only with an ancient wooden desk stacked high with papers and folders, and two equally old wooden file cabinets. He used an old pair of reading glasses, seemingly only held together by sitting on his face. He spoke with Dr. Jacques in French for a while, reviewing HAM legal documents that Jacques placed in front of him. When he came across a copy of the HAM statutes in English, Jacques tried to replace it with a French version, to which he responded in clear English that he was just fine with the English version. Paul was quite startled, but immediately complimented him on his command of English. Interestingly enough, the Mayor had never left Haiti and learned English entirely within the country. He was quite pleasant and after reviewing all the documents, stated that he would prepare the formal letter of authorization, which we could pick up from him on Friday. Everyone was delighted.
One of the major projects Paul and Keith were hoping to complete in January, was to wire the pump at the water well to the clinic solar power system so the the water tank on the clinic roof could be filled and we would have running water at the clinic. While there is an existing submerged electrical pump in the well, it required 220-240 volts, therefore requiring a large transformer. Keith had installed the transformer last week, but when we turned on the pump, it only ran for a few minutes before overwhelming the solar system inverter. Further complicating matters, the pump actually routed water first to a huge holding tank about 200 yards in the opposite direction as the clinic. When the main tank was filled to a high enough level, water would then flow back about 300 yards to the clinic. We had no information on how deep the water well was, or what size and condition the pump was in. It was determined that we had no choice but to pull off the well head and hand pump mechanism, and pull up the pump. Today was the day it was done, and a true feat of brute strength and ingenuity by the Haitian crew. The only equipment used were four pipe wrenches and pure strength. They hauled up 240 feet of water filled 2" steel pipe that was the guts of the hand pump mechanism, then then 280' of 2" hose and electrical wire with a .75 horsepower submergable pump on the end. Finally, we know the well depth, and the pump size and condition. We are now investigating a slightly smaller pump and we will re-route the water directly to the tanks on the clinic roof, since the larger tank on the back of the property is not in use.
Short video of well crew pulling manual pump pipe
Sunday, January 9th: For today's post, we asked Sarah Hare to write her impressions of Haiti as this  is her first trip here. Sarah is a senior at Muskingum University.
Traveling to Haiti was exciting. I love airplanes and traveling and I
had wanted to visit Haiti for a long time. I was practically bouncing off the walls the entire way
down, so excited about seeing the clinic and doing some electrical work. I thought I was prepared having looked
through photos taken from others’ previous trips and hearing the various
stories.
When we disembarked from the plane in Port au Prince one of
the first people to ‘greet us’ was an armed guard. In walking down the hall to get to the shuttle that would
take us to immigration I got my first glimpses of the damage the earthquake had
caused in Haiti. Immigration was
crowded with the people who had just arrived (many were groups coming down to
work with an NGO). There was very
little order to the baggage claim area.
But gathering our luggage was a little feat compared to getting out of
the fenced in airport area to go find the people that were there to pick us
up.
On our drive to Carolyn’s (where we would be staying for the
week) and I sat in the front seat so I could get the best views of the
drive. I was terrified. For all I had been told about Haiti and
all I had experienced in the various countries I have been to, I had no idea
what to expect, and whatever I had expected was nowhere close to what I
saw. It was not that what I saw
was bad or scary, more it was that I was tired and overwhelmed with the
difference of the city conditions from what I am used to.
The drive to Carolyn’s was incredible. Driving was completely different than
it is in the U.S.A. There really
are not rules that are followed.
The roads are not some of the worst I have seen but they also are not at
all spectacular. Cars used are the
ones that run, and the Haitians can make just about anything run. Car Horns are used to say
everything. ‘Hey, how are you?’
‘Coming around the corner’ ‘Get out of my way’ ‘Move’ etc. Every time a car horn sounds now I try
to figure out what it is saying.
One of my favorite times was the time spent traveling back and
forth to the clinic, or anywhere for that matter. Riding in the back of the truck gave me the opportunity to
really see some of the scenery, the traffic, and the people. Even though the traffic was usually
pretty crowded, I honestly felt safer riding in the back of that truck than I
do sometimes riding in a car in Ohio (though Joel is a pretty aggressive
driver).
There are significantly less pancaked buildings compared to
the pictures I saw from last April, but the number of tents and people is
overwhelming. There is trash
absolutely everywhere and various corners and ditches where trash is
burned. People are everywhere,
whether they are walking or sitting, selling wares or waiting for a taptap,
they are everywhere. (I love
taptaps by the way. They are
usually colorful and quite full of people trying to get somewhere. I still don’t understand how you know
where your taptap is going and how you earn money as a taptap driver.)
After my first day of complete culture shock, a shower, and
a night’s sleep, I was better able to cope with the vast difference in culture
and state of living. We spent
Wednesday at the clinic in Dumay working on the various projects that we had
brought to accomplish.
I was very impressed with the speed of the Haitians who
worked with us. They are hard workers.
We worked with two Haitians that are considered electricians and a
couple of ‘interpreters’. The
people that we worked along-side were very friendly and willing to work with
us. Haitians really amaze me. They
can make something out of nothing.
The Jerry-rigging that goes on in this country is truly impressive.
Something that was a little difficult to adjust to was what
we like to call “Haitian Time”.
Haitians do not follow the clock very closely. They take their time to do things and really don’t worry
about the time. Tracee and I had a
conversation about how Haitian time drove her nuts. I suggested that maybe Haitian time wasn’t the real problem
it was the US time that was the problem.
This conversation reminds me of a friend who often says “I am not right,
and you are not wrong. We are just
different, and that’s ok.”
Friday night we went out to dinner with friends of Carolyn’s
who work at the U.S. Embassy. I
really enjoyed my conversations with one of the woman who came. One of the stories she told me was
about her daughter who came to Haiti to visit. In the trip from the airport back to the house the daughter looked
around at the various scenes and commented about the interesting things she
saw. When they finally got home
her mom thanked her for being so positive about the things she saw. Many people criticize the country and
how the people are living. The
daughter said to her mom, “this is their country, why would I criticize their country?” This story really hit me. At the end of this trip I am going
home. I hope that in my time in
Haiti I have been able to be positive and left a positive impression upon those
with whom I have met.
Saturday, January 8th: The team spent the day on the road visiting some old friends and shopping a bit. The first stop was at St. Joseph's guest house, where the HAM teams stayed prior to the earthquake. St. Joseph's is primarily a home for street boys founded and r  un by Michael Geilenfeld. It collapsed during the earthquake last year. All the children and staff survived the disaster, but the six story structure was totally demolished. Excavation for a new building has been underway for several months. Dr. Tracee and Paul visited Michael and the construction site last September, and today's visit was a chance to catch up see what progress was being made. This was also Keith's first visit back since he last stayed there in January of `09. The St. Josephs Family actually consists of three homes in Haiti, the home for street boys in Port-au-Prince, a home for street children in Jacmel, and a home for severely disabled children in Kenscoff. We encourage you to look into the wonderful programs Michael and the St. Josephs Family have developed by going to http://www.heartswithhaiti.org/index.html.
Our attentions then turned to shopping for clinic needs such as additional network cable, pricing furnishings for the volunteer sleeping porch, and purchasing folding chairs for the clinic exam rooms and support spaces. Shopping in Port-au-Prince can be a most time consuming and frustrating exercise, but somehow today we managed to work through our list with no hassle in record time. We believe this may be due to the most excellent karmac touch of Keith, who seems to have the magic touch in getting Dr. Tracee's computer to work by simply laying hands on it. Now we fear that upon Keith and Sarah's departure Tuesday, all our good luck shall dissipate...we have asked him to lay hands on the mission before he leaves.
 We next visited Comite Artisanal Haitien, a fair trade artist coop where we shop for several of the art pieces we offer in HAM's Art from the Heart Haitian art auctions each year. The stock of art there was much better than we had found last year after the earthquake, and we are delighted with our purchases and are excited to be able to offer so many wonderful pieces at the upcoming Granville Art from the Heart event in May. We then had a simple lunch at the famous old Oloffson Hotel, enjoying the beautiful historic gingerbread architecture and artistic ambiance.
Afterwords, seeing that we still had a chunk of our afternoon intact, we decided to drive to Kenscoff to visit Wings of Hope, the home for severely disabled children mentioned earlier as part of the St. Josephs Family. Wings of Hope is an amazing place doing amazing work, and one of the only  homes for children with severe disabilities in all of Haiti. It too was destroyed in the earthquake, though miraculously again, all the children and staff survived. Wings is now in a rental house about a mile from their original facility, awaiting for their home to be rebuilt. Dr. Tracee and Paul had not visited Wings since before the earthquake, and Keith and Sarah have never visited before, so we were all excited to see how the kids were doing. The children were delighted to see us and though there current "digs" are not as functional as their previous home, all are doing well and making do. It is a great pleasure to see such important and inspiring work continue in the midst of the immense challenges in Haiti, and besides, it's always fun to play with the kids!
Friday, January 7th: Some images from the day.
Above left: Loucard Josaphat running the vaccine clinic
Above right: Group discussion about the water well depth and plumbing
Above left: Patient and his father waiting at pharmacy for prescription to be filled
Above right: Well technicians repairing hand pump mechanism on well
Above left: Sarah wiring network connector for local computer network at clinic
Above right: Keith in action pose assisting Edrique in wiring the volunteer sleeping porch
 
Above left: Dr. Tracee and Dr. Joey in back of HAM truck showing off their chapeaus
Above right: HAM team dining with Carolyn and friends
Thursday, January 6th: Despite the clinic yard being one large construction site, clinic operations seem to be r unning extremely smoothly. Patient load seems to vary from day to day but remains manageable, even with the cholera patient flow. It is most gratifying to see first hand how well the staff is performing under the excellent direction of Dr. Jacques, and has allowed Paul, and Tracee when she's not seeing patients, to focus on the longer range issues. 
Keith, Sarah and their Haitian crew have been sailing along ahead of schedule, completing the transformer installation without a hitch and cruising through much of the internet wiring throughout the facility. One of their goals has been to test out the water well pump and identify if the power produced by the solar system is enough to run the existing 240 volt pump, via the transformer. They got the pump started today and running for a few minutes before the inverter shut down. We won't know the real problem and solution until we know exactly what size and condition the submerged pump is in and how deep the well is. Those questions won't be answered until the pump is pulled up from the well. This requires a well service company to bring out the necessary equipment to pull the pipe and pump from the well, which we have b een trying to schedule. Our fingers are crossed they'll be out before Keith leaves Haiti on Tuesday.
A local crew of laborers provided to work for UNOPS to lay the base structure for the cholera tent arrived bright and early. While they waited for the UNOPS to show up, the crew cut down two trees needed to be removed while they waited, and just before noon the UNOPS staff arrived with the first dump truck full of sand and gravel. A week ago, Dr. Jacques had another local crew dig a deep new latrine hole adjacent to the tent plot specifically for the cholera patient waste. It's nice to see all these projects progressing so nicely.
 With regular patients all seen and the cholera patients well under the control of the staff, and Keith and Sarah's projects ahead of schedule, our team joined Paul for an afternoon shopping expedition to Petionville. Amazingly enough, we were able to accomplish all our shopping tasks in record time. This included a visit to Access Haiti to resolve a billing issue for our internet service at the clinic, Maxime's hardware store to price some major items and purchase deadbolt locks and door hinge screws, and Radio Shack for a multi-port network switch. Fortunately, there is a Radio Shack in Haiti, but just one...fortunately we know where it is!
Wednesday, January 5th: It was a long first day in
Dumay, mixed with great productivity, some nice surprises, and a bit of
frustration. We entered the clinic yard with excitement, directly from
the road through our new entry gate in our almost completed new security
wall. The major construction projects we had begun last summer are very
near completion and with some luck, we shall depart Haiti at the end of
the month with them all complete. These projects have included: a new 8
foot cement wall around the entire facility with a large sliding gate
for vehicle entry and two smaller gates for pedestrian access on two
sides; a 10 foot by 36 foot sleeping porch to house volunteer teams; and
a covered platform area in which patients can have their prescriptions
filled from outside the clinic.
Above: Entry gate to clinic from main road
Top right: Volunteer sleeping porch
Right: Patient access to pharmacy from outside the building
Bottom: Cholera patient being hydrated by IV
Keith and Sarah got to
work immediately installing a 240 volt transformer to the electrical
system so we will be able to run a water pump at the water well about
200 feet from the clinic. The pump will be used to fill a 300 gallon
tank on the roof of the clinic that will allow us the have running
water.
Tracee's
excitement came when a motorcycle accident victim was carted into the
clinic with facial lacerations and a moderate concussion. He had to
be carted off the the hospital.
There
were 8 patients who had come to the clinic treated for cholera within
the past 24 hours, though only one had to be transported to a hospital.
Patients fortunate enough to arrive at the clinic soon enough after the
symptoms of cholera appear, they can be effectively treated with
antibiotics, oral hydration, or IV hydration if necessary.  More
serious cases require transportation to a hospital, a 45 minute drive
over some very bumpy dirt roads. Currently, we are treating the cholera
patients in the storage room of an external facility adjacent to the
clinic, for isolation purposes. Our plan has been to acquire a tent to
place on a corner of the property, so Dr. Jacques has been soliciting
groups to assist us with this project. Our sweet surprise today was the
unexpected arrival of an UNOPS truck and staff to drop off two
wheelbarrows and inform us that a crew will arrive tomorrow to build a
240 square foot cement platform for a tent, supposedly to be provided by
UNICEF. Most exciting indeed!
The
frustrating portion of the day was that our driver, Joel, spent all
morning chasing down a replacement wheel hub for the truck, only to have
the new part not work properly after the mechanic installed it. When he
returned the part to the supplier, they had closed at 1pm and decided
not to open again. So, no truck again tomorrow. Some quick notes about
auto repair in Haiti: There is no Ford Dealer. Used parts are the norm,
new parts are hard to come by and usually twice the cost as in the U.S.
One has to provide the repair parts to the mechanic, who's "shop" is
usually a sidewalk somewhere. The word warranty does not translate into
Creole.
Tuesday, January 4th: We made it to Haiti, Dr Tracee, Paul, Keith and Sarah, though it was not the smoothest arrival. The flight and landing were just fine, but as we were collecting our baggage we discovered the TSA inspectors in Columbus decided to completely tear apart the duffel bag with the well wrapped autoclave surrounded by t-shirts as packing material. The real problem was they couldn't seem to get it all back in the duffel bag. What came around in the baggage carousal in Port au Prince was  somewhat disconcerting. Then, as we exited the airport with all our bags, Charles and Joel were no where to be found. This was the first time since Dr. Tracee has been going to Haiti that our Haitian care-takers have not been there waiting with open arms. This was understandably unsettling.We were further disadvantaged in that we didn't have our Haitian phone...Charles had been holding onto it since we were last here in September. After about 15 nervous minutes, Charles and Joel finally showed up, not in the HAM truck but in a Jeep Cheroke. It seems the bearing on the right from wheel of the truck had gone out on the way to the airport and they had to scramble to find alternative transportation. Joel had borrowed the Jeep from a friend and he took Dr. Tracee, Keith and Sarah to Carolyn's house while Paul and  Charles waited for Wilberne, the Dumay clinic administrator, to arrive in a Tap Tap to bring us and the volume of luggage back to  Carolyn's. Not exactly the most confident way to start the trip. Fortunately, when we finally got to Carolyn's and unpacked the autoclave duffel, all seemed to be accounted for and the equipment didn't appear damaged.
Tonight we're settling into Carolyn's and tomorrow morning it's off the Dumay to see how the clinic is being impacted by cholera first hand.
Top right: Columbus TSA repackaging job
Left: Team's baggage in back of Tap Tap
Bottom right: Dr. Tracee checking out Haitian paintings that Carolyn had collected, possibly to be used as future auction items
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