A Healthier Village – Creating Access to Quality Care and Health Education

Our 4th trip back to Haiti began with the boarding of our 4am flight carrying 6 large hockey bags full of medications and medical supplies to be used at the 3-day clinic we would host with our partners at the Be Like Brit (BLB) Orphanage in Grand Goave, Haiti. For this trip we were thankful to have Susan Sawyer, a pediatric nurse practitioner, as well as Kim Campbell, a Regis graduate nursing student, join us to help see patients and gather community data.

By afternoon, we had made it to Grand Goave where we enjoyed a warm welcome by our friends and colleagues, Mirlaine and Madona, who serve as the orphanage’s in- house nurse and nursing assistant. We were also greeted by our friend and partner, Cherylann Gengel, who co- founded Be Like Brit after her and her husband lost their daughter, Britney, in Haiti’s devastating 2010 earthquake while she was in the country volunteering.

 

Over the course of the 3 days, we were able to care for and gather data on over 120 patients; mostly women and children ages 6 months to 12 years- none of whom would have had access to healthcare services had we not opened the BLB clinic to them for care. In addition to being able to provide care to the underserved and often very sick people of the community, we have also had the privilege of working with and mentoring the in-house nurse who cares for the 66 orphaned children living at the BLB orphanage. Each day as time permitted we also were able to work with BLB to deliver an age specific healthcare curriculum for the children. We are excited to continue to work with our friends at BLB to roll out more community education initiatives not only for the orphanage but also for the Grand Goave community.

Here are a few highlights (of many) from our 3 clinical days:

Day 1 brought us a mom with an 8-month- old with fever and bronchiolitis. The mother was determined to provide care for her child and brought the baby in for the three days she knew we were hosting the clinic so that the baby could receive nebulizer treatments and medications. By day 3, the baby’s lungs had started to clear, and her fever had been treated.

 

Mid-morning on Day 2, a mom and her 5 children walked several miles from the mountains and arrived at our clinic with a variety of concerns. Mostly related to dehydration, abdominal pain, fungal infections and malnourishment. The children were ages 20 months, 4,8,11, and 12. The oldest daughter, a beautiful young girl, had a few concerns. She complained of abdominal cramping and changes related to puberty. As we reassured her of these normal developmental reproductive changes, she casually mentioned that she could not see out of her right eye.

Through questioning, we found out that an ember from a small fire built for cooking entered that eye causing blindness. Basic survival is full of so many risks in Haiti! We informed her that a team of eye specialists would be coming to BLB in January 2019 and that she should be sure to see them. Mirlaine, the BLB nurse, reassured her mother that she would help get the young girl to the clinic that day. During our visit with this family, the mother told us that none of them had eaten. We encouraged her to use the water source from BLB and Cherylann arranged for us to visit them later that day to see how else we could help. During our visit, we saw their shelter cobbled together from spare wood, tin and burlap bags.

The children were able to go to school until last year, but we found out that they barely had enough money for food, let alone school. We spent time with the kids and later drove the mother back to BLB where she was given a month’s supply of beans and rice.

Before we finished our clinic on day 2, a young woman who was pregnant with twins came to see us at the clinic. She was unsure how far along she was in her pregnancy but measured close to full-term. Her blood pressure was elevated, and with test strips we had purchased thanks to Health eVillages, we were able to detect that she was spilling large amounts of protein in her urine. Pre-eclampsia is the diagnosis associated with these findings and is a major concern in pregnancy as it can lead to adverse events to both mom and baby. We could tell the mother was frightened as she knew that while there might be a medical option to keep her and her babies safe, it was beyond her means and therefore most likely out of reach in a place like Haiti where care for complicated procedures is not available to those who cannot pay. But Cherylann Gengel of BLB wasn’t going to let that happen on this day. After hearing about the women’s situation, she took the expectant mothers hand and reassured her that all of her medical bills would be taken care of and that she just needed to focus on taking care of herself, and loving her babies when they were finally in her arms. To see this young woman go from despair to hope was a true blessing that we will never forget. After a long day of arranging transportation and finding a medical facility that would be willing to take her in the condition she was in, we finally got a call the following morning and were told that she received an emergency C-section. Soon after, we received a beautiful picture of two healthy babies and confirmation that their mother was doing great. Had we not been there, we don’t know that anyone would have caught the elevated blood pressure, headaches, peripheral edema, or proteinuria. The patient did not recognize the warning signs of her condition. Even if she had been aware that there was a problem, she did not have the means to address it. Maternal mortality rates are extremely high in Haiti, and this woman and her two babies could easily have been one among far too many.

On day 3 of our clinic, a particular patient comes to mind. It was late morning and we all were feeling a bit tired. A 17-year-old boy came into the clinic by himself and sat down. He reported, through a translator, congestion and back pain. After a few more follow-up questions, we quickly realized that the congestion and the back pain were separate issues. Sheryl asked our interpreter, Walter, to ask a few questions about the back pain including, “Have you had a previous injury or sustain any trauma?” I don’t think any of us were prepared for the boy’s translated response. He proceeded to tell us that the back pain was from his parents beating him, but that he now lives with his sister. Sheryl then asked Walter to translate whether the boy felt safe now. Walter looked puzzled, but proceeded to translate. Our patient looked up at Sheryl and Walter and then down at the floor while his eyes filled up with tears. As he wiped a tear from his eye, he told us that he did feel much safer now that he was living with his sister and that he does not see his parents anymore.

As we reflect back on this, we feel that the boy was so appreciative that someone asked about his feelings that he was overcome with emotion. It seems that most Haitians are just trying to survive and people rarely ask them about how they are feeling. On this day and to this young man, someone really showed that they cared- because that’s what nurses do- they care!

We also wanted to highlight one person who we are so very thankful to have the opportunity to work with. Mirlaine, the resident BLB nurse, has been an incredible partner and collaborator and we are so very grateful to her. We have had the pleasure of working with Mirlaine for almost 2 years having met her during our first trip to BLB in early 2017. The comfort and trust that we now share with her has helped us develop a real trust in the community- something not always easy to earn in Haiti. With the use of the HEV tablets, we have been able to stay in touch with Mirlaine when we are not in Haiti and the technology has provided her a database to use as a medical reference and an educational resource.

Mirlaine has been able to send us patient follow-up questions and photos of multiple patients we have seen together during our clinic sessions. The tablets have provided a way to continue developing our partnership and our role as nurse mentors. Mirlaine is a gifted nurse who cares deeply for her community and our project would not be possible without her leadership.

So, although it has been our role as nurse mentors to provide guidance to Mirlaine as she expands her clinical care knowledge, she, in many ways, has taught us so much about how to care for the people in her community and been an inspiration to us.

A thousand thank yous to Health eVillages, Regis College, and Be Like Brit for making it all possible. We cannot wait to return!

In closing, we would like to leave you with a quote pulled from a reflection Kim Campbell, the Regis graduate nursing student, wrote after returning with the Regis team from Haiti.

 

“Haiti breaks my heart – breaks apart my pride, my concepts of the human condition, my own selfishness, and sense of entitlement. But, out of that brokenness, I am lifted up by the strength of community I witnessed, by the triumph of faith when reason tells you there is nothing left to believe in. These lift me up, drive me to be a better practitioner, to be a kinder and more compassionate person, renewed in spirit and purpose. I am beyond thankful for this experience.”

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