I decided to go to Haiti for I was hearing about all the crushing injuries and just knew that PT skills would be needed.  Many were saying that there was no need at this time for PT but I knew from all the reports of amputations and fractures that initial care from a PT can make all the difference in the patients totally recovery.  I was going to go alone because I really had no plans for where I would end up working and to take a group with no plans for their safety or well being was not a great idea.  As I began planning my trip, Victor Banta, Engineer and Photographer, Hell, MI, Tiffani Bacon, Pediatric PT, Charlotte, NC, Kirsten Benya, PT, Saint Louis, MO, and Ashley Brewer, former Peace Corps Volunteer and currently Alcohol Saleswoman, Saint Louis, MO all expressed a great need to join me.  They were all aware that this was a logistics trip and plans were nonexistent.  I knew a little about Victor Banta while the rest of the volunteers were total strangers, but when you have a group passionate for an adventure, everything tends to fall into place.

We had to get all our immunizations up to date, Typhoid shot, Tetanus shot, Malarone tablets for Malaria, and I was given Ciprofloxacin in case someone came down with major diarrhea.  The CDC mentions that we might consider a series of Rabies vaccine because of the high prevalent of Rabies in animals but we declined.  Because of no plans nor destination, we packed so we would be self-sufficient.  I will draw up a list but we had tents to over the counter drugs to first aid kits.  I received my Typhoid shot at Providence Travel Shot Clinic and the information and lists for items to bring was invaluable.  I strongly recommend a Travel Shot Clinic because they answer all your travel questions and are very knowledgeable.  We were able to bring 2 suitcases 50 pounds apiece and carry on.  We packed our clothes and sleeping bag in one and carried down medical supplies in another.  Don’t forget your VISA!!  Also, go to your phone company and have them shut off roaming and set you up for international.  Also, ask them what the text message and phone rate is when in Haiti so you know.  At this time, AT&T has a deal for volunteers going to Haiti.  If roaming is off and you pay for Internet service on your phone, you can connect to the wireless locations at no charge.  Roaming is very expensive.  Lastly, call the credit card companies that you will be using and let them know the dates you are going to be down there so they don’t lock your card up.  REI gave me a 20 percent discount on all purchases.  If you talk to a manager at a sports department, you should be able to get some discount.

The day before I left, I suddenly had to get a root canal and an oral surgeon fit me right in.  They gave me a carton each of toothbrushes, toothpaste and dental floss plus they had these ribbon pins that they were giving out.  They bagged all the pins for the kids in Haiti.  A girl scout troupe ran by Shannon Graham, OT made several fleece blankets for they wanted to help the children of Haiti.  They originally wanted to give all their cookie money to HOLIA but I suggested that the children of Haiti would love a homemade item instead.  In the meantime, Victor, Kirsten, Ashley and Tiffani were all frantically packing, and planning.  I don’t think many of us actually received much sleep the few days before we left.  Kirsten, Tiffani and Victor had never been to a disaster before so I was hoping everything would be ok.  A Haitian friend of mine, Adler, said “Don’t go!! Unsafe!” but in my stubbornness I said, “ I am going so tell me how.”  His words stayed with me though.  Many others said that they were just waiting to see when I would go and not surprised—including my mother.  So….

Off we all flew from different states and no idea what the other person looked like or who they were as a person.  We all were going to meet in Santo Domingo on Feb 2.  Here I had never been to a third world country and I felt responsible for 4 others.  As we were approaching Santo Domingo by air, I saw the dilapidated houses, roofs missing, cars junked and overall poverty wherever I looked.  I must admit that I had a HUGE moment of panic, I thought ADLER is RIGHT, get ME off this flight and back to the USA but instead I looked at Victor and said, “Don’t worry Big Guy—I’ll take care of you.”  LOL if Victor had only knew how I was really feeling at that time.

We all met up—no problem.  It was great placing names with faces.  I had rented a SUV but when we arrived, I found out that they would take me off site to get the rental.  I wasn’t going anywhere with anyone all by myself so I began making car rental deals at the airport.  After haggling for over an hour and then making them bring out an SUV and a minivan to see which one would fit all 5 of us, 5 carry ons, and 10 big suitcases, we were able to all fit in the minivan with 2 duffel bags duct taped and bungee cord to the roof.  With your car rental, you can check with your master card or visa but I was told to decline all car insurance, make yourself the main driver and master card will cover any damage up to $30,000. We found out later that you can rent a bus and driver but its 400 dollars each way.  By the time we had rented the vehicle, it was getting to be evening so we drove to Santo Domingo and stayed at a hotel for the night.  We were all exhausted but so excited.  It is discouraged to drive after dark in the DR and in Haiti so you need to stay the night in Santo Domingo when you arrive.  Just FYI–Money Exchange—we found that exchanging money at the airport in the DR is more cost efficient then exchanging your money in Miami.  DR gave us 34 to 1 and Miami gave 30 to 1.  The exchange rate on the streets of DR varied from 36-30 rubles.  When paying cash, I used the calculator on iPhone for figuring out the exchange rate.  Remember that you can bargain with the street prices, car rental and hotel rates.    As far as language, we didn’t have any major problems for several speak at least limited English, could get someone that could speak English, or you just figured it out nonverbally between the Haitian or DR.  The Dominican Republic and Haitian drivers are speed demons, use their horns as a way of communication as Victor observed, and swerve in and out barely sideswiping your car.  Trucks are usually way overloaded to where you think they will topple over with their goods and people are hitching a ride on top of the goods.

After a great breakfast at the hotel, we set out the next morning to the local grocery store and further loaded our already packed van with canned goods, packaged goods and lots of water.  We figured 86 ounces a day for 6 days times 5 people plus water for washing.  We were able to buy the 5-gallon jugs plus a few cases of water.

While the others shopped, one would stay and watch the van.  Tiffani went to the ice cream store for 1 more ice cream before Haiti.  On the way to Jimani, we got to know each other.  Tiffani has the biggest purest heart, sees the good in everybody and she really loves children, and Kirsten is Ms. Organizer, has everything that you could ever need, and is no nonsense woman.  The military should look into recruiting Kerstin.   After opening up and offering the alcohol wipes in the van several times choking you with the smell, I was ready to hide those suckersJ Ashley is Kirsten’s niece.  She served with the Peace Corps in Haiti several years ago and was looking forward to organizing and helping with the day-to-day operations of a camp.  Ashley is young, tall and beautiful with a quiet, funny but determined personality.  Victor has an engineer/photographer brain and is in to details, details.  Somehow, we all fit and complimented each other.  Together, we were a whole invincible strong unit.

All I knew is that IMA (International Medical Alliance) is in Jimani at some hospital so we head to Jimani.  HOLIA and PT students worked with IMA at the Free Clinic in the 9th ward during Katrina.  The roads are potholed and scant road signs.  Cows, roosters, goats, starving skinny dogs that look like if you touch them that they will fall over and die, and naked or half clad children all run in the streets.  Big trucks and dilapidated cars speeding down the roads.  Kids would wash our windows or whole van if we stopped at a stop sign in hopes of getting paid. There are armed young guards sitting at posts throughout the country. If they indicate it, you stop at the post but otherwise just look like you know what you are doing and keep going.   All along the way, we hardly had to stop for directions for there were street vendors everywhere and we would look at them and shrug, and they would point the way.  We soon started to relax our fears for we had to be smart and cautious but none of us ever felt any danger.  The scenery becomes beautiful with this huge lake that goes on for miles and miles, tree canopies across the roadway, blooming flowers and cacti.  We all thought what a great place this would be for resorts to employ people but building around that lake is nonexistent.  People along the way were happy to see us and thankful that we had come to help Haiti.

Over 5 hours later, we are right on the border in Jimani, DR.  I had just begun to drive and I am thinking—“Man, we are never going to find that hospital for the towns are BIG and the roads are so winding.”  Suddenly a small sticker on the side of a bus we were passing caught my eye and I thought it said IMA.  I screech to a stop and run up to the bus.  It’s a new group just gathering their belongings, heading to IMA in Jimani!!  As we travel through the winding unmarked roads following this crazy bus driver to the hospital/orphanage way out of the way, we all realize that we would have never found IMA in Jimani by ourselves.  In Jimani, IMA has been servicing that area for 12 years as vision clinic, dental, and gynecological services.  They now are a hospital, orphanage and clinic for Haitians.  They plan on starting a rehab.  They have a kitchen that everyone can use, a house across the street that has mattresses, a shower, toilets but toilet paper goes into the trash NOT the toilet!!  They serve meals but due to the cost of providing meals for all volunteers and the fact that they are now feeding patients, they strongly encourage you to be self sufficient with meals and water.

We pull into IMA and tents are set up, flags from different countries volunteering are flying, hot, and dusty but the buildings are huge and open.  Patients are in large tents, lying on balconies, on floors on mats or cots in the orphanage, surgery is performed with an open door in a clinic room, armed guards, bustling medical and other staff all over the place.  It was AMAZING.  At the time we were there, they were caring for 160 people.  As I greeted Dale, MD and Dorothy, MA, founders of IMA, my volunteers had found a group of PTs from LSU.  Because of IMA serving the Free Clinic during Katrina, LSU PT grads decided to “give back” and help Haiti.  They told us that they were the first PTs to volunteer for IMA and the need was great.  We met Jason and David.  David informed us of the immense need for PTs in Ford Parisien at Love A Child orphanage 25 miles from Port A Prince.  We discussed the problems, the logistics, the lack of supplies and the great need for PTs.  We were given a tour of the hospital and tents and invited to spend the night at IMA.  We expected nothing and here we had a place to sleep, rice meal to eat, toilets, water, wireless service and showers.  I felt like I was in heaven or in a palace.

The next morning, David joined us in our already jam packed van for the ride to Fond Parisien.  Tiffani ended up with a pretty sore bottom riding for 2-3 hours on the hard center council in the van with all knees/bodies jammed together.  When we drew near the Haitian border, we learned it was market day.  The border was absolutely crazy that day with everyone trying to get into 1 spot, people, supplies, food, wares, motorcycles, cars, armed guards and trucks.  We were deadlocked there forever.  I became almost claustrophobic with the closeness and the dust of it all.  I left the van, others soon joined me and we took pictures, talked to other volunteers and observed the mayhem until finally our van could move.  We were in scrubs and were waved through at the border.  Tiffani was so glad to be able to move again.

David introduced us to Harvard International Group at Love A Child and they were thrilled we were there for the week.  They had 161 patients, all of them needing PT services and no PTs.  They had 70 tents set up with 3 patients a tent and 3 family members.  The orphaned injured children were all being transferred to the front rows because of child abductors seeking to claim orphaned children.  Victor and Ashley immediately became our PT techs for we could see that these services were badly needed and no way could 3 PTs handle all those patients.  Most were on mats on the floor of the tents.  The degrees in the tent must have reached 110 degrees most days but would cool down to the high 70s at night.  The temperature there was 95 degrees with little tree coverage.   The warm breezes that would occasionally blow were a godsend.  We took a brief tour of Love A child and off we went to work.  Victor and Ashley helped us get patients off the floor to stand.  Victor, always in his cowboy hat, cut down adult crutches, as you will see in some of the pictures so that the children could use them, and helped Tiffani with the children.  REMEMBER DUCT TAPE!!!  Comes in so handy for all sorts of uses including holding the sides of crutches together.  Ashley became adept at using her gait belt and with her blond hair, blue eyes and quick smile, had patients anxious and willing to see her.  At the end of the week, I noticed Ashley with that gait belt hung low on her hips, in scrubs, striding fast but confidently down the rows of tents (no time to waste because Kirsten, her aunt, kept cracking that whip to see all the patients that they could).  I thought that that girl should consider a new profession because she looked like the perfect PT.

That day, I met Jeff Berry.  He is a 16 year old.  His mother is 51 years old with a fractured hip and arm.  She is very thin as most of the patients were with loss of general muscle strength and tone.  Jeff and his mother plus his sisters lived in Port Au Prince and for a few days after the earthquake, Jeff searched for his mother not knowing if she was alive or dead or where she was.  He found her and carried/dragged her for a week until he was able to get medical care for her.  He stays with her, cares for her including bathing and some feeding, but he also helped me all week as my interpreter and PT tech.  This kid can speak 4 languages, sing and dance.  He wants to be a doctor so he had been working on getting great grades in Science and Math when he was attending school.  Jeff never once complained about their situation or the role he has to play with his mother.  He always had a ready smile and was a very handsome guy.  He is very religious and thanks God for saving his mother.  To hear him tell his story with all the emotion that he felt that week was overwhelming for me.  He ended up being my helper but also my BEST bud.

At the chiefs meeting later that night, it was suggested that we can train select Haitian translators and all family members on the patients home exercise programs (HEP) and gait training so that they can take over when no PTs available.  They all heartily agreed with that idea for sustainability and independence so we began to teach also throughout the week.   Each night at the chiefs meetings, we would discuss security issues and safety, clean water, the cost of providing food, managing patients more efficiently and effectively, and any other concerns.  The whole process on the changes constantly moving forward was fascinating.  Things changed at a daily/hourly rate of speed.   After chiefs meeting, all staff would meet and discuss problems and solutions for the coming days and weeks.

The surgeons were still performing 8-15 surgeries daily.  The head count for patients rose to 189 while we were there with 90 tents.  We had only a handful of tents when our week ended.  Patients would be brought in by helicopter daily raising a huge dust storm as they landed.  We had an intensive care tent, an ER tent,  regular patient tents, and then our own tents set up in a separate region.  We also had a pharmacy, a recreation center for children—thanks to the Ecuadorians, a cooking and serving tent, a casting room, equipment supply tent and a huge warehouse.  The Dominican Republic workers came with air-conditioned trailers, which they opened up for all needing a place to sit if suffering heat stroke.

We were busy from sunrise to sunset for rounds were at 7 am and we worked until we finished.  There were 5 teams assigned to 10 rows of tents with 7-10 tents in each row.  The team consisted of a Doctor, Nurses and PT.  Everyone had their name written on medical tape and placed on the front of their shirts.  It was just awesome working there for the Doctors were available at all times and perfectly willing to address any questions or concerns with patients.  Everyone truly just worked together concerned with giving the highest quality of care possible.  Everyone treated the patients with respect and dignity.  We worked with the Ecuadorians, Dominican Republic, a few Germans, Canadians and USA.

I could not get a whole tent of 4 people up for they just refused.  The Ecuadorian Doctor went out of his way several times over the next few days to talk to the people that they must get up with PT.  We could encourage strongly but not cross the boundaries.  Finally after 2 days of talks and seeing everyone else immerge from their tents, those patients were willing to move.  The amputations had to be taught exercises to maintain range of motion, gait training, transfers and we taught family members stump wrapping for Kirsten had brought 4 and 6 inch ace wraps.  The external fixation, hip pinning and casted fracture patients had to be taught gait training, transfers, HEP and moving of the particular joints affected.  The patients that had external fixation devices were terrified to move their hip or knee.  Many had foot drop due to disuse.  We ran out of walkers and had just a few pairs of crutches left when our week ended.  Even though I had brought several HEPs with pictures, we had no copy machine so I left a copy of each on the board for the Doctors, Nurses and family members to share.  Victor modified the crutches for the children but he also modified many wheelchairs with boards and we used the cast sleeves for slings.  A few had upper extremity amputations or injuries.  We found we were cleaning wounds and changing dressings for the nurses were unable to stump wrap and we honestly just ran out of time to address the teaching of the RNs for stump wrapping.  We wrote it on the list for the next group of PTs to address.

After just a couple of days of treatment, you would see many patients leaving their tents with family members and walking to the shade of the trees or patients would call your name out as you passed to show you that they were doing their exercises.

I will continue to work on our adventure and will post this for now.  Sorry it is so long but I am trying to give a heads up to people that volunteer plus tell the story….

We have many people on video but my site wont support the length of the videos so we posted one of them on U tube.  Feel free to listen to him at http://www.youtube.com/watch?v=-kQLMDbBkT4.  He pretty much says it all.