As he stated, "I need a Beautiful cane for a Beautiful Man!"

Since arriving in Haiti, translator Edner and I have walked tent-to-tent gathering a census of PT patients, ages and need. We would start at about 6:30 am and go tent to tent until 9:30 am. Meanwhile from 8:00 am until 3:00 pm, Katie, Julia, Krysten, Emily, Shana and Jon worked at the PT tent. The patient population increased towards the end of the week for as we were taking the census, we were also encouraging the ones that hadn’t been seen to get to the PT tent. Throughout the day, we had 10-20 patients waiting sometimes for 4 hours for PT treatment in a steady stream. We have found that the majority needs strong encouragement to get off the devices that they have been using, and to move forward towards 1 crutch or a cane or nothing. They also all need tons of stretching, joint mobilization, functional massage, distraction, traction and strengthening. Barriers to understanding include depression/anxiety, unrealistic expectations and “old” misinformation. All need education to make sure they understand that they had “crushing” injuries that are HEALED now and that will continue to hurt for 6 months to a year or longer, joints will swell, need to continue to move forward in their ambulation, need to do their HEPs and the importance of them, and take more responsibility for their recovery. Depending on the patient, you might need to repeat yourself several times during the week/weeks you are here. Don’t assume they know. They have very limited knowledge of what they can expect or that it is OK to walk on something that hurts. Once they understand and you take away one device and give them the next step forward, you will see them adapting, accepting and see them progress with their gait and ROM. Many joints still are severely limited but already GREAT progress was seen with many this week.

We are lacking in CANES but I talked to Patrick, President of ARC camp, and I had asked him to announce that we really needed our canes returned if someone was no longer using one. The problems with that were that they get to go to the handicapped line at the food/supply distribution days if they have an assistive device. Many are keeping all of their equipment, using wheelchairs to haul water and supplies, walkers to hang clothes on and their canes/crutches. Patrick said a better way was for PT to announce that we would be having a “cane” day where patients with canes only would come to PT for treatment. Once they were there, we would take away the canes no longer needed, offer them a treat out of John Weiss’ bag (the treats will consist of the many items left behind by all you volunteers so THANK YOU!), and give them all PT but show them that they can walk down the road, get into their tents, ect without their canes. We have already found it useful to ambulate them down the road, walk them to their tent and do functional things with them when we have changed to a lesser device. With the lesser device change, all patients initially strongly object but as you show them that they CAN do it even if they have some difficulty, each day they look better and are progressing with their new device. We are going to mark their cane with their name and tell them to come back in a couple of days to see how they are doing. We will reassure them that they can have their cane back in a couple of days if they are not doing better. The treat incentive was Scottie HHI Drs advice and that was perfect solution because then we are still giving the Haitian people control over their
decisions. In turn, with less assistance of a device, their ROM is improving.

PTs and OTs—you really need to balance their FEAR, lack of medical knowledge, their limitations and what you envision them to achieve. Example: 15-year-old girl—severely limited/tight ROM of ankle with shortened heel cord and foot drop. She was walking on crutches for months non weight bearing on her leg. No fracture
of the ankle. This girl is what we all felt was a major DRAMA queen. We had to be VERY FIRM with the mother and the patient that she could ambulate with 1 crutch—thereby forcing her to begin using that leg. Her gait looked terrible that day but she wasn’t falling but she had some tears of frustration. Her mother was pretty mad at us for she had lost 2 daughters in the earthquake and she wasn’t going to see another have pain…. The PTs told her mother and the patient that we would try the 1 crutch for 1 week and that we guaranteed that they would both see results. We MADE the girl walk down the road with the 1 crutch, up/down a slope and to her tent. We told the mother NOT to grab her other arm and support her daughter but to let her walk with just the 1 crutch. As we were walking away, we turned around and mother was holding daughters other arm. Didn’t say anything because we all realized that they both would tire of that rapidly. Saw this girl tonight walking so much better, laughing and talking with her friends. Her mother was a ways in front of the group and all was good. Mother sees the change. The smiles at us were all we needed.

Could give examples all night but this case hit all of us the most for major progress made this week.

Reporting of the work done this week might seem harsh and unfeeling. That is the farthest from the truth. The PTs have been tough but loving, firm and unyielding but with detailed explanations and time consuming
functional activities to show the patients that they CAN. HOLIAs goal was to reduce disabilities, to restore function, and work towards independence for Camp Hope (ARC). We are achieving that goal one patient at a time—thanks to ALL of you volunteers!

For each picture of patients we post as you see the progress in the months to come, if you touched that patient—YOU had a part in their recovery. Hands of Light in Action, Love A Child, Harvard Humanitarian Initiative and Camp Hope THANK YOU!!

Update about the camp and plans

ARC—American Refugee Coalition plans to assist for 2 years.

LAC—Love A Child plans to take over medical needs at their clinic when HHI is done.

HHI—Harvard Humanitarian Initiative plans to continue to operate the ARC clinic at least until August 1, 2010 possibly longer. 1 doctor staffs this clinic. We have some RNs and Drs joining us so they will be welcome to work at the medical clinic or the PT clinic.

HOLIA—Hands of Light in Action plans to continue to provide PT services at least through Sept. 2010. We will reassess before that date to see if services are still needed or if potentials and goals have been met.
We are still actively recruiting VOLUNTEERS!

We all are meeting weekly and work together closely. LAC has been gracious enough to allow us to live in their “hotel” quarters. We were able to use a Pathfinder vehicle but the radiator leaked and its dead right now. We are calling for rides from ARC, walking to road and hitching rides on mopeds or walking a path through the fields to ARC (Camp Hope)-about 20 min walk but you see cows and goats along the way roaming among you freelyJ.

It is very important that you respect LAC rules, ARC and the patients. We have a GREAT working relationship with all of them at this time.

Malnutrition baby program

LAC has a program where they feed malnourished babies around the clock. At this time, there are 6 babies but that varies. We have talked to Carole and the Dr and have their support with a PT program for these
babies. They all have deficits with delayed development. We have been working with the babies but have been asked that since we are beginning treatment of babies that we extend that education to the mothers and the nurses. They want us to develop a plan that the nurses add into their schedule for the babies. This program has been a touching one for me for these babies respond with just 1 treatment and knowledge given to the nurses and the mothers will help these babies to thrive to their potential.

Warehouse

LAC has a HUGE warehouse that not only services LAC but it services many places in Haiti. They have the daunting task of organizing all of their donations received. Many donations come from the USA from individuals. They will send rice, cans of food, clothes, shoes, ect but if all items are not the same in the box—they have to be separated and placed with like items. They get donations of food, bedding, clothes,
medical supplies, toys, books, the list goes on and on. Volunteers of HOLIA on their off time are encouraged to help if only just for an hour or so. Just just letting Carole know when you are available can set up times. You will be welcomed. Its also a GREAT idea if you need something in that warehouse for I guarantee that if you work hard for a few hours that Carole wont have a problem with you needing some food items or water. We all helped today and received several cans of soup, ravioli, canned milk, 2 cases of water and ANIMAL CRACKERS!

LAC and the orphans

LAC doesn’t encourage us to play with the orphans because this is their home and when they let all volunteers play with them and give them gifts—the children start acting like American children at home. Spoiled and then they have behavior issues at LAC. I could go on but after Carole explained it to me, I understood. 2 of them did get permission to walk with us tonight to the ARC camp and stay a few hours but LAC doesn’t want them hanging around our home and us. They want to keep them on a schedule and in
their environment. Its ok to say Hi but don’t walk over to their area without permission and definitely don’t start having a bunch of photo moments and handing out gifts.

Dukens

He runs errands for LAC. If you need items for the kitchen or personal items, let Dugan know and
when he does a grocery run for LAC, he will also do one for you. You give him the money and he brings back the items and the change. If you don’t give him enough money, he will only buy what he can for you.

Jimmy

Runs the LAC radio station. Great guy. Often shows up to have tea in the morning or to chat at night.
Always offer him something to drink. Have a question about how much to pay—ask Jimmy.

Our Home

Our home has 4 bedrooms with sliding doors in back, air-conditioned, 4-bunk beds/room, bathroom and shower in each. Mattress, bedding and pillow supplied. Volunteers supply their own toilet paper and personal items.

Kitchen has microwave, hot plate, a few pots, refrigerator, stove is not working yet, big freezer, tons of canned food, coffee, and MREs presently. Unless you are REALLY picky, you don’t need to bring down TONS of food but more what you really love to eat for we have cans of fruit, soups, tomato sauce, some vegetables, powdered milk, coffee, tea, sugar packets—volunteers have been leaving all their food and some
of their supplies. We have lots of sunscreen and some mosquito repellent. Can buy coke and beer down the street from LAC. 15 min walk away. Jimmy knows what to pay on everything and is great resource.

Respect our home, take care of our home, keep it clean and picked up. Take the trash to the trash hole beside our house daily. DON’T put toilet paper in the toilet but in the trash instead even poop ones for it clogs up the sewer system then none of us has a toilet. I am NOT kidding on this one.

When Bob and Carole or others come to visit us, welcome them and offer them something to eat or drink.
Bob stopped over with Carole’s sister yesterday evening and ate popcorn and had a beer. We are all one big
family and lets keep it that way. We work together. By the way, more popcorn is a great idea! If we have few volunteers and LAC has some volunteers coming to help in the warehouse, they might also stay here. Let them know that they can use our food and stuff if they want. Let them know that the kitchen table they can also sit at and use. Most important of all is that at night, many are pooped early and go to bed. You need to respect that and quiet down. Its OK to stay up late, talk, play cards but keep it down. Its so quiet that sound carries. Basically it comes down to respect of all different sleep requirements. Plan
respect of other people.

HHI DR SCOTTIE—

She is here through first week in July—-she is hilarious, serious, non stop energy, spastic and SHE TOTALLY ROCKS!!!!

ARC camp

I struggle with the gifts area because if you give gifts, you have more and more coming up to you. If anyone brings items to give away, you better have enough for all. Water and food—DO NOT GIVE WATER
AND FOOD. I know I know that you want to. You start giving water and food then we ALL get a ton of kids everyday hanging on us asking for things. You might really love 1 child and so you give that 1 child something or 1 adult. Im telling you—its NOT fair! When you give something to someone, it gets around camp in 15 minutes. Its just NOT fair to everyone else. Want to bring an item, then bring enough for ALL!

Some suggestions for gifts would be small cheap can openers, spices, marbles for the older children, Mancala games, playing cards…. Just if you bring an item, bring LOTS of the same sort of item so that all get some and not just your favorite few.

Hugs, pat on the back, a listening ear, a gentle touch, laughter and caring—that is all free and welcome!

Security

You shouldn’t be wondering alone at night outside of LAC. Someone should know where you are during the day and you should be in pairs outside LAC. At ARC, we wander all over the camp. Just NO issues. Same at LAC. Lock up your rooms and the kitchen when you leave. Bring your laundry in from the clothes line
only because things will disappear IF they are totally left alone. We have also walked in pairs to main road and stuck out our hand to get a moped/taxi ride to ARC. You pay those drivers. We have had no problem there but just know that in Haiti—number 1 is moped injuries… I really tend to stretch my disaster experiences as far as I feel safe so my son and I plus some other volunteers have used the taxi/mopeds for
transport. It’s a BLAST!! Hilarious! BUT Betsy has reminded me that I am breaking my own rules…….

LAC has a basketball court and we have a basketball. ARC has a soccer field and they have a soccer ball for use. Join in on the games. We occasionally start our own games but be firm and let ALL play including kids on cruches, ect if they so desire. Haitians are Very competitive when it comes to soccer so before a PT
soccer game—have the translators explain that ALL get to play.

Food or Supply Distribution

THIS IS AN ABSOLUTE NO-MISS EVENT. When LAC is going on a food/supply distribution, man you just have to go. Don’t say no because you are tired. We went on a food/supply distribution on Wed that had us all wanting to cry but so glad we went. We have pics and will tell more later but please please take advantage of these events. I promise you will not regret them. TAKE YOUR CAMERAS!!!

Come down with no expectations but just with that willingness to help, work hard and to care. You have to be versatile and go with the flow. In Haiti, things CHANGE hour by hour. Instead of disappointment, get over it and go on to what is next. Remember what you came down for. Think out of the box, grow with this experience and expand your abilities.

We all are HOT, feet hurt, tired and worn out at the end of PT treatment days. Just remember you are
here for a limited time. Try to make the very most of it for if you do, your time here will be so much more
memorable. Take advantage of getting to know the people at LAC, Patrick at ARC, the manager at ARC, the HHI Dr. Help out as needed even if tired. Everyday there is the unexpected, the expected and the options that pop up. Lifetime friends that are made. Tender moments. Competition in soccer/football and basketball. Hanging out for a bit at ARC towards evening just to talk and get to know people better.
All I am trying to say is take advantage of the opportunities that you are able to do for it all touches you and those memories will stay with you for the rest of your lives! I absolutely LOVE it here! Its changing, its
challenging, its so darn tiring, unexpected daily pops up, its hot, its occ frustrating, but its beautiful, the people care so much, are so thankful, there are smiles everywhere and welcomes. Sights to see and times to treasure….ENJOY!

Nancy Malone
President/Founder
Hands of Light in Action

PS As my 15-year-old Jon says—There is no where else at this moment I would rather be, Mom! The country is beautiful and the people I love!

He also is totally enjoying the BUGS! Stick bugs, praying mantis, digging out tarantulas, besides the children think he is the pied piper or something. They hang all over him.