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Winter Medical Mission (Part 2)

Day Four 

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Good evening family and friends,

Today was our third clinic day in Haiti! Again, a group of 3 doctors, 6 medical students, a nurse, a pharmacist, and a pharmacy student packed themselves into 2 white trucks and travelled to a nearby community for our "Traveling Clinic". We drove down Rue Nationale, the road that leads to Port-au-Prince, then took a turn for an hour's trip to Cercadie. The trip was a beautiful drive through the countryside, although it was rocky and a bit dusty for the students riding in the bed of the pick-up truck. 

 

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We saw about 105 patients while we were there. One of the interesting patients presented with a large nodule, midline under the chin and was diagnosed with a Hypoglossal Duct Cyst. We saw lots of young children at the clinic, several of whom were malnourished and were suspected to have Kwashiorkor's and were sent to the hospital for further evaluation and treatment. Other diagnoses included pyelonephritis, bronchitis, and tinea capitis.  After lunch, Mattie and Syed gave a short educational talk about proper hygiene, habits that can help to improve acid reflux, and how to properly take medications. Mona was helping to entertain the children all day and they loved the foam visors they made.

At our primary clinic in Fontaine, the team had another great day with several interesting patients. One of the patients was a follow-up Angina patient of Vinny's who was seen on Tuesday and asked to return on Friday. Although his chest pain and angina symptoms resolved with the beta blocker, the man came to us today because he had stopped urinating since last night. Upon exam, we discovered he had a severe phimosis-an adhesion of the foreskin around the penis-which had caused an obstruction with a tiny pinpoint hole leaking urine. He was in a lot of pain, and we could even see the bulge of his bladder on his lower abdomen, which was confirmed on ultrasound. Thankfully, we called the hospital in Pignon and arranged him a consultation immediately to open the phimosis and drain his bladder. He will follow-up with us tomorrow and we will arrange a circumcision to prevent this problem in the future.  

Some of the other interesting diagnoses from today at Fontaine were genital herpes, Trichomonas infection, and an inguinal hernia.  We also continued our treatment of the young man with paralysis.  He and his caregiver were able to remember one of the exercises that Rich had taught him, which was an encouraging sign!  We are still hopeful that by tomorrow we can help him to learn to be more proactive in his own care, in order to prevent further issues, such as more pressure ulcers.  In total, it was a very productive day and we were able to see 166 patients.

  When both clinics were over, everyone joined together for a delicious dinner followed by reflection and discussion on the roof. We shared  our experiences from the day and discussed interesting clinical cases. Rich, our physical therapist, gave a small presentation to share his insight on how PT can be used in patient care and management, specifically in the case of paralysis such as the patient  he had been caring for over the past few days in Fontaine. Michael, one of our pharmacists, spoke briefly about different pain medications, their indications, side effects, and proper use. These presentations are very educational for us all to learn more about  how the medical professions can and do work together in complete and well-rounded patient care. We are lucky to have such a diverse and knowledgeable team this year to provide this quality of care for Fontaine and the neighboring communities. We have all learned  a lot!

Lastly, Pierre-Louis the director of St. Gabriel's school where we are staying shared his story. From a young boy that wanted to be a priest.  As he grew to a young man he dreamt of going to business school. He worked hard and saved money and with the support of his family, was able to attend college in Port-au-Prince. Unfortunately, after the earthquake of 2010 his apartment and the university were badly damaged. An American parish with some mission work based out of Haiti, helped to arrange for a scholarship to Siena College in Loudonville, NY, of which Pierre was one of the lucky three men selected to attend. However, Pierre was always determined to return to Fontaine and start a secondary school in the local community. Previously, the closest secondary school was over a 2-hour walk, one way. With the sponsorship of Christ Our Light Church in Loudonville and the Friends of Fontaine, the school was built in 2012 and currently has 254 students. While at Siena, Pierre had the goal to arrange for the students to visit Haiti, and with the help of a UB medical student Vinny Polsinelli, he was able to make this a reality. Then, Vinny came to attend UB Medical School and helped to establish the partnership between Friends of Fontaine and the medical brigade in which we now find ourselves. The rest is history.

The next stage of the further development of the Friends of Fontaine and St. Gabriel's School is the training of community health workers. Two of which have begun training in Pignon and who we have met working with us this week during the clinic. They will act as a point of care in the community for follow-up, clinical advice, and to help provide transportation to the bigger hospitals nearby. 

We are proud to continually support these noble efforts. This June St. Gabriel's School will have its first graduation and hopes to have 1-2 students accepted to medical school in Port-au-Prince. Providing scholarships for these students would offer an amazing opportunity to invest in the future of health care in Fontaine, and we hope to contribute to that goal in the future.

Bonne nuit,  Mattie R., Vinny P., Christine R.

DAY 5

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Bonswa,

Yesterday we had our last day of clinic. The traveling clinic went out to Gaspard, about forty-five minutes from Fontaine. While there we were able to see 100 patients. At our home clinic in Fontaine, we saw around 110 patients. Some patient highlights include a several cardiology cases of mitral regurgitation and a systolic flow murmur which the students were very excited to hear and identify. Paige saw a case of thyroiditis which we all found very interesting.  The patient was tachycardic and we speculated that she was likely in a hyperthyroid state.  The thyroid had started to go down on its own, so we counseled the patient appropriately and sent her on her way.

 Several more serious conditions included a man whose finger was bitten off by a horse and a young man who presented with infection after a knife fight. Christine was excited to aspirate a knee effusion with Dr. Holmes. We gave several educational presentations to patients while they were waiting. Rich presented about proper lifting and position for musculoskeletal health. Mercedi presented about how to take medications. Mattie handed out toothbrushes and toothpaste and gave an interactive talk with a group of children about dental hygiene and general hygiene.

We packed up all the remaining clinic supplies to prepare for our journey home. Some students also took a walk to the sugar cane fields with some of the Haitian student translators, and got to enjoy a special treat. We all reunited again at St. Gabriel's to enjoy a feast and a party to celebrate a successful trip. We all shared a champagne toast with everyone, including our new Haitian friends. We were all very well fed with a menu of chicken, goat, lasagna, baked ziti, fried plantains, rice, salad, and cake. Then, Johncy, one of our translators, started up the music - an eclectic collection of 90's N*SYNC, Haitian kopta music, and Reggae. We also learned and danced some of the traditional dances.

After a very eventful night, we all packed and went to bed.   Everyone woke up very early to leave Fontaine to head to the airport and Cap Haitian.  We have arrived safely at our hotel and are enjoying the nice 80-degree weather before we have to come back to frigid Buffalo.  Thank you all so much for your support, thoughts, and prayers as we have been down here in Haiti.  We truly appreciate it! Until next time!

 -The UB Haiti Medical Team   

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FOLLOW UP REFLECTION

Dear friends and family,

We've now been home for a week and had some time to reflect on our experiences in Fontaine. Our impetus was to use our medical skills and resources to leave a positive impression on this poor but spirited community. From a medical perspective we've seen some fascinating cases, and been granted the opportunity to learn from our patients, physicians, and classmates, and finally make modest interventions to ease burdens on our patients' lives. Perhaps more importantly we've been offered the chance to understand the socioeconomic context that our patients' come from, and see first-hand how extreme poverty can force a very simple, curable malady to transform into an unforgiving and disfiguring illness. 

Over the course of 3 years and 6 medical trips, we've seen the school and community change; power wires now pass above the streets, a store has opened its doors in town, families have grown, our young translator "trainees" from St. Gabriel's are now independent and set their sights on medical school or college, the community health worker program has finally launched and we had the honor to teach these young health professionals who will serve as health care leaders for this community, ensuring some level of care during our absence.   

We hope that you continue to support us as our program grows and seeks to fulfill the needs of this community. This year we expanded our role and held a satellite clinic in distant communities every day for the first time, which went remarkably well. Our Haitian colleagues have asked our support to send a soon-to-be graduate of St. Gabriel's secondary school to medical school next year, a request we hope to fulfill. 

Thank you for all of your support toward this trip, and the 5 others. We believe your support and contributions have, and will continue to positively impact the lives of this community.

Sincerely,

Vinny and the Haiti team

Sarah Goh