I just returned yesterday from Haiti with the Physical Therapy volunteers, Linda Lange, Cheryl Costello, and Kelly Miletich, who also happens to be my daughter. Trying to explain your first trip toHaiti is like trying to explain the colors of the rainbow to someone who can’t see…but here goes!
We started our trip flying into the PortAu PrinceAirport. The experience of acquiring our luggage, fighting for carts to carry our luggage, negotiating though immigration despite their efforts to check our bags, and fending off the hands of men trying to grab our luggage was an exercise in bravery. We found our way to our drivers and took off on a winding journey through the crowded streets to Matthew 25, the guest house where we spent our first night.
Port Au Prince gave us our first understanding of the complex set of issues facing Haiti. Pigs, goats, chickens, and dogs wandered rooting among piles of garbage which lined the streets. Tent cities were scattered here and there, anywhere you could find a bit of land not occupied by buildings or the rubble from buildings which had collapsed during the earthquake. No cleanup from the earthquake was evident. Rebar and chunks of concrete were everywhere, along with gaping holes in the few paved sidewalks and the occasional paved street. Most of the streets were rock chunks, definitely not what we would call gravel.
Children and adults carried containers, jugs, and 5 gallon buckets filled with water from one of the wells which are the main supply for drinking and bathing. The water isn’t clean and must be filtered and chlorinated prior to drinking. Street vendors sit on the sidewalks selling used clothing, produce, bread, medications, and a thousand other items. It looked like an endless garage sale. Yet, despite the desperate living conditions, you would see women fixing each others hair, or men congregating to talk, and you would be amazed to see laughter and smiles on the faces of these resilient people. I will never again take for granted the many blessings we enjoy inAmerica.
The city never seems to sleep. Trucks honk horns at each other throughout the night, since there seems to be enough room for one vehicle on the narrower streets. Dogs bark, people sing, roosters crow. The electricity goes on and off. There is no air conditioning, and it is hot and muggy. Yet we all seemed to sleep.
Day 2 included a trip up the mountain to Grand Bois. The ride is like being on a five hour trip on the dinosaur ride at Walt Disney World. I think our driver liked hearing our hysterical laughter when the rocky trail was especially rough, because he would glance back and smile at the four of us crammed into the back of the extended cab. I can’t tell you how many times we hit the roof of the cab. How Cindy fell asleep during the ride, I will never know. Along the road you see cows, goats, donkeys, chickens and pigs, some tied, others wandering loose with a rope dangling from their neck. Children were getting out of school, so you would round a curve and they would scatter, laughing and yelling “blanc” (unsure of spelling) which means “white”. They would wave, and some would practice their English, yelling “good morning.” We would practice our Creole, but I guess I’m not good at it, and got made fun of frequently!
We stopped at an orphanage along the way, where Cheryl fell in love with Wilby, a little boy with CP, and Kelly caused a riot handing out tootsie rolls. The children latched on to us like Velcro, and loved posing for pictures and then laughing when Linda or I would show them their photo. I expected the mountains to have villages dotted here and there, with wilderness in between villages. Instead, huts dot the entire mountain side, and people are everywhere. It is a noisy mountain with the sounds of livestock and people.
The clinic is an oasis on the mountain. Dr. Leo and his staff of physicians and nurses, as well as the cooks, cleaning women, grounds keepers, and various others who I remember their names but am not foolish enough to try to spell, are an amazing group of dedicated individuals. They work non-stop. We would hear women giving birth in the middle of the night, or EKG monitors beeping, or Natalie calling for Dr. Leo. Yet they were up before us and seeing patients already when we started our day.
We treated patients for four days. The first day we saw only four patients. The physicians spent time with us, watching our evaluations and treatments and helping translate. We weren’t sure if we only saw four that day because PT was unknown to the staff, or to the patients, or if they were easing us into the experience. We must have gained trust because the next day we saw about twenty patients in five hours, in a room the size of a physician’s exam room!
One of the biggest barriers to treatment was the language barrier. We would motion for a patient to stand up, but they would mirror our hand gestures instead. We would try to use tactile cues, but that didn’t work either. Cheryl learned the PT terms in Creole and became our translator when Dr. Leo, Liz, or Alfred weren’t available.
We roughly saw 60 patients in four days. We treated back pain, scoliosis, arthritis, stroke, paraparesis, and shoulder pain primarily. Linda performed her first patient transfer to a donkey. The most rewarding experience for me was seeing a paraparetic patient walk in with tone which allowed only a squatting posture. After teaching the family range of motion and inhibition of tone, Kelly and I taught them standing activities and gait training. The man walked out of our room with assistance, but fully erect. The saddest situation was a man with arthritis who was severely contracted in both legs. His wife despondently stated, “You came too late.”
In the evenings, we did formal training with the medical staff. They were good natured, and listened to us ramble on about our field. We taught basic assessment, range of motion, stretching, electrical stimulation, massage, taping for injured joints, and the basics of therapeutic ex, with emphasis on the types of patients we had seen. It was a lot of fun, and hopefully was useful for the staff.
We had the opportunity to go to market on Saturday. Oh my goodness, what an experience! I have never seen so many people crammed into one area. There was a donkey parking lot. People were selling chickens, pasta and rice, water, bowls, used clothing, candy and gum, and on and on. Liz bought shoes to take back to someone in the village, but we observed an elderly woman leaving the market area hobbling along with no shoes. Kelly gave her the cheerleading shoes she was wearing, and put on the bigger shoes from the market, that would have been to large for the woman’s little feet. After hugs and photos the woman took off at a clip, and was soon far ahead of us!!
Sunday, down the mountain…Disney ride in reverse. Along the way we stopped while Dr. Leo monitored government workers sterilizing after a woman passed during the night from cholera. Liz, Cindy, and Dr. Leo traveled in the other vehicle, along with a boy and his mom who were going to the hospital in Port Au Prince for a strangulated hernia. Apparently there was some emesis in that vehicle due to the bumpy ride. We got the easier journey, I think. The final night we stayed at Bob’s house, and elegant estate overlooking the city of Port Au Prince. It was a nice punctuation point for our amazing journey.
Although we have returned home, I know we are forever changed. Before I went, I wondered what I could offer. I thought that the people had more urgent needs, such as clean water, food, shelter and clothing. But in the process of seeing patients I realized something…when our patients here hurt or lose function, they take medication, get therapy, have surgery, or have assistance to get meals, bathe, and get around. On the mountain, the people spend their day in physical activity just trying to survive. They travel miles to get water and food. They have limited shelter and clothes. Dysfunction means you can’t meet your basic needs, things we take for granted. Yet they were grateful for our presence, they maintain an optimistic attitude, they smile and laugh and play soccer. They attend church, and are highly spiritual.
Thanks to Dr. Leo and the entire ServeHaiti staff, for the experience of a lifetime. I will be back!
