One Year Later

Friday night at 6pm at John Hancock Hall in Boston there will be an event commemorating the one year anniversary for those who lost their lives in the earthquake in Port-Au -Prince.

If you can not attend in person you may want to consider joining in the event through the the web cast.

For more information check out  the Partners In Health, Stand With Haiti website.

Dreams of Haiti

I bade a friend goodbye this morning before she boarded a plane to Turks & Caicos. 
She is flying from there to Milot, Haiti.


I am proud.  I am envious. 

Songs From Haiti

A quick piece of news: Hopital Sacre Coeur was featured on The Takeaway, because apparently producer Anna Sale was recently in Milot for eight days blogging about  the earthquake, the hospitals and its patients and what lies in store for the country in a series called Rehabilitation in Rural Haiti.

It's worth reading, especially the entry entitled Stumbling Through Creole and Hymns in the Earthquake Tent, because besides capturing life in Tent City perfectly, she also includes audio of one of the women who is currently a patient, singing a hymn.

It made me miss my guys in Tent 3 who sang every day.
I tried to embed the audio here and couldn't, so go check out the blog entry and listen to Marie Genese-Pompee sing.

 I think it will make your day better. It definitely helped mine.

Let's Dance for 100 Beds Tonight

Do you love 90's music? And dancing? And... beds?

Tonight at Middlesex in Central Square Cambridge, MA they'll be pumping up the 90's jams for a cause is not only worthwhile, but specific and measurable.

I found out about 100 Beds for Haiti through connections I made while working at Hospital Sacre Coeur in Milot.  Their goal is simple: to send 100 beds to HSC by June 2010, and guess what?
Thanks to great organizing, 100% of the money raised is earmarked for this specific cause.

These beds will improve patient care now, but will also allow the hospital, which not only services the earthquake victims, but also serves as a health care center for a larger, local community to develop long term plans for sustainability.

So come on out tonight at 9pm and meet me at Middlesex at 315 Mass Ave in Cambridge, MA.
It's a $5 donation at the door, we'll rock out to some Spice Girls and Michael Jackson, and before you know it we'll have made it possible for this amazing hospital to be even more amazing.

I'm not convinced yet. Why beds?
Before the earthquake HSC was just a 73 bed hospital, but in a matter of days it expanded to welcome more than 400 patients. There were at least 175 mattresses that I know of donated by a cruise ship, and probably more than that from near and far as well, but many of the patients we cared for rested day and night on bare cots.

While I was in Milot the hospital was home to about 273 patients; as of March 17th they have discharged some more to Port Au Prince, but the hospital plans to continue offering services to a newly expanded population.

It would be great to start expanding the number of beds to match the number of patients. Having proper beds improves patient outcome by limiting post op discomfort which in turn aids in speeding physical therapy tolerance. PT promotes rehabilitation (obviously) but also prevents complications such as pneumonia and DVTs. Plus.. I didn't assemble a sample group or crunch the numbers myself, but from sheer observation in the tents I can tell you that decubitis ulcers (bed sores) seem to form quicker in patients who are cot-ridden as opposed to bed - ridden.

Imagine surviving an earthquake, a painful and debilitating crush injury to your leg and an amputation  in a very limited surgical environment only to die while in recovery from a preventable condition like a DVT or an infected bed sore?

Adding more beds to Hopital Sacre Coeur serves a short term and a long term purpose. It  improves the outcome of patients who are currently being treated and it also offers sustainability for the hospital's future. Part of CRUDEM's mission is continuing to stabilize HSC so that even when the foreign volunteers begin to dwindle, local staff can continue to offer exceptional care to their patients. Adding 100 more beds allows HSC to plan for the long term development of their recovery center.

Check out the facebook event for YoYoYo 90's Jam: Heal the World Edition, and  invite your friends. Then grab a slap bracelet, a mood ring and a five dollar bill and meet me at 9pm. Simple.

i'm so glad that trouble don't last always

"There's a gospel choir from BC downstairs," I told the patient as I thumbed his dilaudid into a paper cup.

"You mean BU," he said, "Think about it. Gospel from Boston College?"

"Why not?" I asked, puzzled. He took the pills and swallowed them with a grimace.

"Catholic music isn't that happy," he pointed out. "I'd know - I'm Catholic."

I grinned as I headed downstairs, remembering how my mother would often roll her eyes and ask me why the adolescent choir at St. T's never sang anything she could clap her hands to.

Down in the Atrium a modest crowd had gathered to hear the (BU) Choir sing. Another RN waved me over to where she was standing, "They just did that James Taylor song I love."

The choir launched into a spirited number with the rhythmic hook "I love you more than I did the day before." I was suddenly reminded of a day I had spent not too long ago also listening to a gospel choir - a day I never wrote down, so I made a mental note to store as many details as I could when I got home.

We were in the tent. By 'we' I mean myself, the other RN, the two interpreters, the 36 patients, and 20+ family members I had grown accustomed to sharing space with. The air was buzzing, not just with talking but with the noise of music being played over amplifiers.

"You coming with me," said one of the patients I was closest to - a 21 year old with post quake bilateral above the knee amputations*, a wicked grin and a penchant for wheelies.

"Where?" I asked.

"To the program!" he answered and flashed that smile I had begun to count on to punctuate everything he said.

I declined, and away he rolled, all style and flair. I moved on the task of finding a thermometer.

"Hey, come on," said my translator noticing that I was standing still, "you have time and we'll go."

He took me by the arm and we exited the back of the tent. We walked along the barbed wire fence strewn with laundry, passing small children who stopped to openly stare at the blanc  as we went by.

We passed the row of tents and our feet beat on the rocks as the music got louder and louder and I began to make out voices. Up past the small building for less acute Tent City patients  and around a corner there was a small yard. A stage had been set up, and on stage were the same men in suits who had come into my tent to sing that morning. Off to the side there were several other groups of well dressed men warming up.
 It was a Gospel Festival.

Their audience sat in old fashioned wooden desks, the kind with the chair and the wrap-around arm. They had been taken out of the school rooms and set up here. The yard was stubbed with short fat grass, but was mostly rocks and dirt. Friends assisted their wounded loved ones to navigate crutches and wheelchairs over the ground to find preferable vantage points. I spotted Mr. Smiley and his sister, but they didn't notice me.
Like everyone else they were completely wrapped up in praising and singing.

"This is the Gospel Program," the interpreter said next to my ear. I moved out of the way as two men entered the yard flanking a woman with one leg using crutches. They guarded her as she found a place to stand in the shade. A cool breeze blew on our backs, and rustled the green leaves against the sky. The men sang of everlasting love into their microphones. Men and women clapped their hands or nodded along as children played tag, shrieking happily like children do when they are outside and no one is telling them to be quiet.

Not for the first or last time that week, I was amazed at how much joy a community can contain after enduring so much grief.

Back at work watching my patients dance in their seats, I thought it again.

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* "Look!" he exclaimed when we met, "we're the same height!"

Photos of Haiti

My photos from the trip to Haiti are up with captions here.  But I thought I'd share my favorite now...

Haiti is a paradox. She's a beautiful paradise of mountain tops and majesty, birthing streams running with undrinkable water. Her people are physically worn, but they are spiritually vibrant. 

Even at the constant mercy of a greedy government, neighbors gladly share everything they have with one another. Strangers adopt one another out of the streets into their humble homes. Then again, the same streets can be scattered with criminals who will gladly take what they aren't sure they'd receive otherwise. 

The buildings are crumbling. The people are singing. Love thrives in Haiti.

 Haiti greets you with open arms and a big heart, and when you see her tears you are moved beyond words, and when she sleeps at night you are relieved that she is dreaming. 

Unpacking Haiti, One Week Later

For the first week back, things were weird. And I wrote this and never published it. And now I'm feeling a bit more settled into my normal life, so I thought I'd share.

The shock I've been experiencing isn't traumatic, or upsetting. It doesn't make me freeze up, or have flashbacks or anything like that. I'm eating well and sleeping well, and I'm feeling really great.

In fact, a few coworkers who have not gone to Haiti said "you all come back with the same glow about you."

And we definitely do. I am nothing but happy that I went to Milot and met the people I met and did the work I did.

The shock part is subtle and cultural and environmental. I want to stress how it's not difficult to deal with, only that it's part of me now that layers a new dimension onto otherwise normal situations.

I was only gone for one week. And here only one week really passed. But for me, time in Haiti was all relative. An hour could feel like a day, or an afternoon like ten minutes. I felt like I was in Haiti for much longer than I was because so many things happened in such a short time frame. I went through so many emotions and discoveries in one week that it can't have possibly only been seven days.

Now I find myself thrown back into schedules of rehearsals and dates and plans, and people are referencing things we did together only two weeks ago, and I can't believe when I'm caught up in it all, that only last week all the details of my reality were vastly different.

I was not there long enough to forget how to drive a car, or what pizza tasted like. But I also wasn't there long enough to process all the things I saw and did and felt. So coming back is a strange mix of feeling sometimes like I will never be the same, and then thinking maybe nothing's changed after all. I feel like I was plopped in and out of an alternate reality. Since nothing here is different, it's hard to imagine that I went at all sometimes. And the lines are blurred even more when I'm sleeping.

Every night since returning (and even when I nap)  I dream that when I wake up I will put on my scrubs and spray DEET on my neck and fill my water bottle from the filter and walk to the hospital. Without fail, in my dreams I am writing out to do lists, and I remember which ones need a new IV line today, and which ones have a wound dressing due. In my dreams I am eating a grapefruit with Colleen W. and we are talking about the orphans.

Then I wake up and I'm in my cozy room under my white and purple quilt, and the contrast is startling. But even more startling is the realization that although the dream wasn't real the people and places in the dream are very real. As I sing at karaoke night or read the news on my itouch on the bus they are out there somewhere else in a land of palm trees and poverty. But "somewhere else," might as well be a dreamland because even if I do get to go back to Haiti, most of those particular  people will have moved on by then. I may never see them again anyway.

Leaving Haiti

I titled this entry "Leaving Haiti," to offer parallels to Leaving Costa Rica and Leaving Japan, but I don't know yet if it's the same at all.

Before I even got to Haiti a coworker advised me, "as soon as you get there remember you'll be leaving. Otherwise it just becomes impossible to walk away at the end." She pointed out, "just like you leave your shift at the end of the day to another nurse, I had to remember to trust the next ones coming after me."

She was right, but no matter how I thought about it I couldn't wrap my mind around it. To knowingly walk away from such suffering is already very difficult, and it only became more difficult as I got to know the patients personally.

Starting on Monday I attended a brief Eucharist service every morning in the chapel. It was my way of starting the day with a clear head, a fresh perspective and a connection to God. I've never done to a daily service before in my life, not even when I was living with the Sisters of the Good Shepherd in New Jersey. To be honest, I don't always even say a formal prayer in the morning. But I figured I needed all the help I could get.

On March 4th the Gospel reading was the story of the rich man and Lazarus from Luke 16. I felt terrible as Sister Ann read it out loud. It seemed as though the message couldn't be more clear. I am the rich man, and these people are Lazarus. How could I return home now that I've seen this level of poverty with my own eyes?

I began to pray and slowly my despair turned into gratitude. 

I realized how easily I could be living some other life. But every single event in my life fell into place to lead me to this moment, there in a chapel in Milot, Haiti. It wasn't my fault or my doing that I was born in the United States. But that was the beginning of my story. And then every next step led little by little to what I would become and where I would go.  It was mind blowing. With any slight alteration of course, I wouldn't have been sitting there surrounded by surgeons and nurses at seven in the morning. With a start, I realized that was true of every single person I met on the trip. God built our lives, and He has a plan. 

My behavior doesn't always demonstrate faith in a higher plan. In fact, most of the time I act like I don't believe in a "Plan," at all.  I like to be in control of my own life and of my environment. I like to take credit for the things I do. I like to plan the future.  And it's easy to grab onto my life tightly and try to steer it the way I want. And for the most part, it's probably not too harmful. It certainly keeps me moving.  But ultimately, I have to submit to the idea that I am not in control simply because that's what faith is. I need to let go, because letting go is believing. It's a trust fall with God.

My brain argues with me every time I try to relax and trust God. "Stop it!" it yells, "the path of least resistance is not for people of your educational background and social grooming!" But trusting God isn't the same as giving up, or taking the path of least resistance. In fact, some times what you find is the hardest path. But it's a path you'll never find unless you shut down all the things you think you want and listen to what you're meant to have. 

From my journal on March 4th: 

... so I am going to trust the plan. The plan is for me to be here this week. The plan is for me to leave on Saturday. To see my Mom, and my brother. To pay my bills. To fill the shifts at work that are mine to fill. And if the plan is for me to return here again - God will surely let me know. I will continue to pray for Him to tell me. I will pray for ears to hear it. 

And that's how I was able to leave. 

The day I left we all had to work a morning shift. I pushed my goodbyes off as long as possible. I built a wall of protection around myself by passing out medications, hanging IV fluids, and cleaning external fixators. When I started contemplating alphabetizing the med desk I knew I couldn't put it off any longer.

I started at the back of the tent and worked my way to the front, but word traveled fast that I was saying my final goodbyes and soon I had a small procession of family members and patients who could walk following me from bed to bed. Eyes were wiped, blessings were said and I told each person to be strong and to get well. Then the interpreter yelled that I was going to miss my ride.

"Ok," his voice boomed out, as he gently pushed his way to the center of the small crowd, "she is really going now!"   I ran out of the tent to a chorus of blessings and goodbyes and demands for promises of a return trip. 

Back at the compound my friends, old and new were packing up. I grabbed my belongings from inside and then joined everyone on the porch. Some of our coworkers from BHCHP had just arrived from the airport, ready to start their orientation.

 "Any words of wisdom?" they asked us. We told them everything we knew. 
Then, just like leaving work after an eight hour shift, we were done.  We might have another shift in the future, but for now the plan led home. And as we piled into the truck for the bumpy ride to Cap Haitian I felt alright. 

World Religions 101

It was night time and the air in the tent had cooled off considerably. Everyone had quieted down and were talking softly among themselves, reading Bibles, or sleeping. One man in the corner was singing a hymn very quietly that had gone on for quite some time.

"Michelle," my patient called out, "can you help me please?"

I stopped what I was doing and approached his bed, thinking he needed his pain medication.

"Please, can you help me understand this?" He was speaking in English and pointing to a passage in a Bible that was also in English. This particular young man had been enrolled in school for many years and proudly spoke both "higher" and "lower" English fairly well. I know this because he once explained to me that "maybe" was lower English but "perhaps," was higher. I was impressed.

"I am reading this and I need to understand," he said. "Ok, shoot," I responded.

“Speak to the people of Israel, saying, ‘If a woman conceives and bears a male child, then she shall be unclean seven days. As at the time of her menstruation, she shall be unclean," he read.

Oh boy I thought.

"What is conceives?" he asked, "does it mean have a baby?"

"Yes, it means have a baby."

"And... menstruation? How is that?"

Words failed me. "It means..." I stalled for a minute, "well it means..."

"Is it like when a lady has her bleeding?"

"Yes. Exactly." I began to get suspicious of his need for my tutorial, but his question wasn't about feminine body functions.

"Ok... then it says a woman will be unclean for seven days if she has a baby and it is a boy. And she is unclean for seven days if she has her bleeding."

"Mmmhmmm."

"Ok. 'If she bears a female child she shall be be unclean for two weeks.'"  He looked at me. This isn't my favorite part of Leviticus* so I just nodded, waiting.

"If a lady has her bleeding or a boy baby she is unclean for one week and a girl baby she is unclean for two weeks, so what is unclean?"

"Oh wow. Ok... well the Jewish people had a lot of rules for things," I stopped, wondering how far in over my head I was about to get. "And there were rules about when you could and couldn't enter a temple. Having a baby is one, touching a dead body is another."

He stared at me, not blankly, but waiting for more explanation.

Guessing his question I said, "Temple for the Jewish people is like going to church for Christians."

"So if a lady has a baby she can't go to church? If she is unmarried?"

I had no idea where the last part came from. "No, I said, "whether or not she is married. She has to stay away for a certain amount of time. Then there are things you have to do to get clean again. Rituals."

"But we don't do that here," he said, his brow furrowing. "We don't say that."

Realizing I was about to deliver the most diverse theology lesson he may have ever heard, I tried to chose my words sensitively, "It's a different religion.  Jesus was Jewish. When Jesus came, some people started a new religion. That's where Christians came from. They don't follow all the same rules of the Jewish people."

 For good measure I added,"We have the New Testament."

He looked relieved. "Ok. Because I was surprised to read that. We don't do that here."

He was just worried that they weren't following the Bible as closely as they could be. I shook my head in wonderment. Across the tent, the hymn continued.

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* I do not have a favorite part of Leviticus.

Lost In translation

On Wednesday we had to tell him that he couldn't keep his leg.

He's been through a lot. But the injury was too great, the infection is too strong. His leg will take him if we don't take his leg. The doctor wiped his own eyes as he explained it to the man.

The interpreter stood at the bedside and relayed everything.

The man looked at the doctor and nodded. Then he smiled. 

The other RN started to tear up. "God bless his heart,"she said. "He's so brave."

The next morning the man came back, with two legs, from the OR sobbing.

He said he had no idea he was going to lose his leg. And he said the doctor had betrayed him. He doesn't trust us anymore.

Did the interpreter tell him what the doctor said and he just misunderstood? I really doubt it.

I have a feeling the interpreter himself didn't understand. Or else was just uncomfortable bearing the news. 

I have never felt the way I did yesterday. I don't know if I've ever been so angry.

Finally the doctor calmed the man down and convinced him to go through with the procedure. 

Did you all know there is a rumor in Haiti that there wasn't an earthquake at all but that America bombed the country and is now trying to kill everyone with amputations? 

The man came back from surgery late last night, at the end of my shift, heavily sedated. He smiled at me weakly as I changed out his IV bag. He trusts me still. 

Just keep the chickens outside the tent

 This will post tomorrow since I won't get the internet.


The other day there was a snake behind my tent. It was curling itself through the barbed wire fence, which is covered on top by laundry the family members have laid out to dry in the unforgiving sunlight. Some of the local boys started poking me as I left my tent and tried to walk along the small path to the pharmacy/ER tent. "Look! Look! Snake!" I looked and smiled. "Nice!"

They laughed, thinking I didn't understand them or else I would have jumped. "No! SNAKE!"

I stopped and smiled again. "I know," I told them in Creole, "it's ok. I like it."

"You LIKE snake?" This stopped them.

In broken Creole I tried to explain that when I was a teacher we had a pet snake in the classroom. 

They were astonished.

A few minutes later, I had returned to my tent with the supplies I had needed and was organizing my tiny nursing station. The tent was loud, but all the patients were stable. I had time to regroup. Then a group of young people approached me with a translator. They wanted to know more about the snake. 

Except they didn't know the word "snake." They tried to ask about "serpants," but kept saying "supper," prompting me to mime eating which made them crazy. "In America you eat supper?" I kept hearing them ask and I kept saying saying "yes, yes!" They were howling and clutching their stomachs. 

 Finally one drew me a picture. 

"Oh! A snake!" I said, and did my best snake impression. 

Forget it. After that I couldn't talk to them for two seconds without them asking me for another snake impression. We spent the rest of the afternoon dancing and doing snake impressions.

The boy from outside had said  to me, "All Haitians are afraid of snakes. Why aren't you?"

I answered that little snakes are fine but I am worried by big snakes.

"Like anacondas?" 

"Yeah. Anacondas." 

And I couldn't find the words in french or creole to explain that for an anaconda I'd be a great appetizer. I should work on that before I leave.

Day Two: Hitting the Ground Running

Actually we hit the ground last evening, and have been running since.

Right now, to paint a picture, I'm on a porch. It's pouring but the computers are sheltered by a roof. The rest of the volunteers are milling about drinking beer and relaxing, or sleeping beneath mosquito nets behind the thin wall to my left. I'm in my scrubs and interrupting my own writing to chat with two 4th year med students who are sitting with me. They are discussing creating an art therapy group for the children, who are all having nightmares. These are my new friends, comrades. I'm so proud.

I'm not sure how I want to frame all of the information I have for you. A narrative would be overwhelming at this point, and we're only two days in. So much has happened, I feel as though I've been here for a week already, and yet I'm sure as the actual week goes on I will start to think  I only got here.

I have fallen in love with Haiti and with the people here. It's a beautiful country and the people have a spirit which is incredible. It blows me away and puts any faith or hope I may have to shame.
I want to talk more in depth about it. Because sometimes it's easy to take for granted. In fact - I have to. If we spent all our time marveling at everyone nothing would get done. But once in a while a look from a patient, or seeing an exchange between two people will hit me- HARD. And it makes me stop everything.

BHCHP can be proud of us so far. Although last night we worked together we got split up today and we're each handling a tent of 36 patients. The teamwork here is amazing. Sometimes there aren't enough people to go around and that's hard, but everyone is here to help. There were two other RNs with me for the first part of the day. One had been in charge of our tent all week and she left this afternoon; she gave me a quick orientation last night. The other RN, April is an ER nurse from Oklahoma and and she's awesome. We gave out all the meds, did vitals, flagged patients for surgical wound rounds and once that was done ,  set to work immediately rewriting every chart (which are in complete disarray), creating our own plan for medication distribution, and updating the care plan papers that hang taped above the beds because they were mostly outdated.

I want to go be social, and I still need to wash the DEET off my skin. But first, another picture:

Today in my tent I was creating a system for how to communicate with our MD, who was in and out because he was also rounding with ortho across the road in the OR.  To paint the picture for you even more, the tents are hot, hot hot. It's hot outside, but worse in the tents. It's over 100 degrees easily, and muggy. Inside there are a lot of flies looking for wounds we forgot to cover. It smells like people in the tent. There are not only 36 patients, there are family members sleeping on the ground, or sharing cots.

  I had done all my patient care and was trying to sort out all the orders I needed clarified. (There were a lot of them). Then twenty men in suits walked into our cramped, thick aired tent. They were smiling and shaking hands. I ignored them after a minute because they didn't seem harmful, and there are people in and out the tents all day volunteering to help their neighbors and family.

Just then one of the patient's family members sidled up to me and said "you know, I'm not his family."
He pointed at the patient, "he lost everyone in the earthquake. But I stay here. I wash him, I bring him food. I take care of him. I met him here. I also have no family.

"I do it because the Lord loves me, so I love him."

The men in suits lined up in the center of the tent, and began singing. They were an acapella Gospel group. And they were amazing. They sang for a long, long time. My patient's "family member," translated for me:

"If you have problems... don't worry. For the Lord is with you.
"Don't cry... don't cry. He understands you."

All around us patients smiled, bowed their heads or sang along. They have so much faith. They have no doubt. They adopt one another. They live for each other because that's how to stay alive.

I have literally never seen anything like it. I'm floored.

Nurses Gone Wild: Ft. Lauderdale

 Day One (actually).

I should have called the previous entry "Day Zero," since today will be my first day in Haiti.
This will likely be my last blog update, although they said there are computers on the compound.

Had a lovely day yesterday, mostly all to myself, in Ft. Lauderdale since Colleen and Yolanda were delayed at Logan. I even got a slight tan sitting by the pool! (I know:  it's unhealthy. I'm over it.)

After dinner we embarked on a mission to Target because another co worker, Ashley, called to tell us that the hospital ( Hopital Sacre Coeur) needs staplers badly - all the patient charts are falling apart and documents are being lost. Funny how we don't think of it, but office supplies are all part of keeping patient care flowing smoothly.

Our cab driver for the evening, a Jamaican man named Seymour, quickly became our new favorite person as he explained his retirement plan. Then we had a sing-a-long with him.

When Stacey arrived I was already asleep, but it wasn't very late. My anti malaria pill knocked me out. Thank goodness that little monster is just once a week.

We're heading to the airport soon but our flight isn't until 10am. My phone works on the frequencies in Haiti, but it's expensive to do much besides text message. I can text  to Twitter, so that's your best bet for anything particularly interesting or important especially if you're following from BHCHP. Just keep in mind because my phone is not very fancy, I can't see any responses. If there's an emergency at home - please text straight to my phone. I'll get it, and receiving messages over there is included in my bundle.

Day One. A new world holds me to a promise, standing by, standing by...

Day One.
This morning I am flying solo to Ft. Lauderdale. About an hour after I arrive the rest of the team will get there.
We have a hotel room booked for the night, and during the day we plan to hydrate, rest and bond. (I also plan to get some Vitamin D!) Also, yesterday I caved and bought an ipod touch, so I will also be practicing my Creole using this Byki App all day.

Tomorrow we board the cargo plane to Haiti. When we arrive we'll be given our assignments.
I have no idea what to expect.
Sinead worked in the ER. Rachel worked in the pysch unit (she speaks fluent Creole so that makes sense). Barry, our director of nursing, worked as their director of nursing while he was there. Not knowing the language, most of his staff, or the protocols, he jumped in and helped keep the place running for his seven days.  This week our co worker, Amy M. has a facebook status that says she is working night shifts... in the ICU.

There is so much that I know ("bring flip flops for when you get to shower," "use DEET it's the only thing that works..") but the unknowns of where I'll be working and how it will be set up, and what kind of skills I'll be calling on (and learning!) are just  huge right now.

The Things I'm Carrying

I am leaving Friday morning for my trip and I find myself in full speed ahead mode, which explains the lack of sitting still and blogging, I hope. Almost everything is done, leaving me with some time in the next few days to relax, dine with family and friends, and second guess everything I put in my duffel bag.

I have been busy tying up loose ends (paying bills that will be due while I'm gone, finishing the script proposal I was working on all month, etc), so that I have nothing to worry about once I'm on my way.*

I've also been involved in more direct preparations like buying supplies, and transferring money to a Caribbean plane company since they don't take credit cards.

Since BHCHP first started sending people over to help staff at Hospital Sacre Coeur enough time has passed that nurses have now returned. They pass on stories that are emotional, unbelievable, inspiring, and energizing. 

They've also been passing on really useful advice about things we'll need, and things to expect.

Packing has been a big deal. I like to travel lightly, plus one leg of the trip is in a cargo plane where weight counts! Still, I don't want to find myself unprepared for working the 16-20 hour shifts every day while staying healthy.

Here's a breakdown of what I'm bringing:

-Clothes. The hospital, like many hospitals here, supplies scrubs and there are staff who do laundry for everyone. So most people going down to this particular hospital have to only bring pajamas, underwear and socks. However, because I am so small I'm concerned that they won't have scrubs to fit me. Half the nurses I asked said "it won't be a problem," and half said "you should bring your own scrubs." So to avoid any form of work-disruptive uniform failure, I unfortunately have had to take up some valuable bag space with scrub pants and tee shirts.

- Medical Equipment. I'm bringing my own scissors, tape, and stethoscope and a fanny pack for carrying patient meds in the tents, as recommended. Each team member is also helping to bring donated supplies from BHCHP** such as gauze, sanitizer, bandages and gloves by taking as much as I can fit in our checked luggage. 

- Nourishment. The food situation is apparently good. Staff gets three meals a day, but although the food was raved about by the nurses, they also said it wasn't enough (quantity wise) to sustain them for those long shifts. My eating habits are defined by "grazing," and  I'm a person who becomes disoriented, cranky and labile when I don't get to munch. So into the bag went a ton of energy bars from my local Eastern Mountain Sports.

 In the same theme, there is apparently plenty of good, clean, bottled water where I am heading. However, it's easy in temperatures that are consistently over 100 F, to overdo it on "free" water. One of the MDs there a few weeks ago actually became severely hyponatremic ( his Na+ was 113!). He had a seizure and experienced some rhabdomyolysis to boot. To prevent this, I invested in some nuun tablets.

- Physical Needs. Normal toiletries plus a super absorbent towel, a personal first aid kit, all the medications listed in my Travel Clinic post, SPF 40 sunblock, and DEET. 

-Emotional Needs. My prayer book. My journal. My ipod. And, of course, my awesome team.

On the subject of "my awesome team,"  I am so excited about the people I am traveling with. To be fair, I thought about it and realized there is no one from work who I would not be excited to go with. Still, Colleen W. is in my group and she and I are close friends besides being good at working together. 

This past week, at an old friend's birthday party I got to talk briefly with an acquaintance who spends a majority of his time in Haiti. In fact, he was already there serving as a member of the medical community with Partners In Health when the earthquake hit. I told him that I felt like what I'm doing is small beans in comparison. 

But his response was reassuring, as he reminded me that they need nurses, and that's why we're going.

Our work is only a small part of a much larger picture. But I am grateful for a chance to work on something so big. 

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* Go ahead, you can say it. I'm the model of functionality. I know. 

** The fact that a non profit is donating medical supplies to this cause takes my breath away

Preparing for Haiti: Travel Clinic

I've been waiting a couple of days to post anything about Haiti, because I wanted to tell my mother in person. A blog entry is no way to find out your daughter is going to spend a week in Haiti.  Mom knows now, so now I can write about it to my heart's content.


As you may have read in yesterday's entry I am going (in part) through work. This is great news because I know most of the people I am traveling with, and one of the nurses going is a close friend of mine.

Yesterday I went to the Boston Medical Center Travel Clinic to start my medical preparations for the trip.

I can not recommend this place enough if you are planning a trip to a country with any health warnings. The Travel Clinic was clean and pleasant. The waiting room was very spacious. And every single person I interacted with from the moment I stepped through the door was friendly and helpful.

The nurse who took my vital signs was actually from Haiti. She asked where I was traveling and she thanked me, shyly, for going. I didn't know quite how to respond to that. I (shyly) told her I was scared but looking forward to being there. Which is the truth. 

Then I met Dr. Thea. He greeted me with a smile, asked where I was going and then asked some other questions about my life. He then asked if I wanted to ask questions first, or hear his "spiel." I opted for the spiel. He was well prepared with a small lecture on the diseases to watch out for in Haiti, including symptoms, pathology and treatments. 

Basically he reassured me that there is almost nothing medically that can go wrong on my trip.*

Meeting with Dr. Thea was great. He took a lot time to explain all his recommendations to me, and let me ask as many questions as I wanted. 

Next I headed to the lab, where I met a student doing a research project, a phlebotomist, and the nurse who gave me my vaccinations. We all chatted about our connections, strangely enough to BHCHP. 

For those of you who are curious, I'm going to write a bit about the precautions I've taken, and by proxy some of the dangers. So Mom... consider this one fair warning!

Here is what the Travel Clinic helped me with:

-  Hepatitis A vaccine. 

   Got this one yesterday. Pretty sure I already got this, in order to go to nursing school. It's 90% effective with the

   first dose.  So I'm considering this one a booster.

- Typhoid Vaccine

   Started this one yesterday. It's actually a series of four pills. The capsules contain live attenuated bacteria, so I

   have to keep them in the refrigerator. I am fascinated by the little pills and the orange brochure with a smiling capsule on the front which explains how to administer the doses effectively.

- Anti Malaria Pills

 I am taking a four week course of chloroquine. I feel confident in this choice of antimalarial agent because according to my own research into the subject this is the best tested and safest of them all. And the least expensive!

- Antibiotics

  I got a prescription filled today for some antibiotics to take with me in the event of traveler's diarrhea. Dr. Thea   explained the different types of diarrhea and what I can expect to do if it's not a bacterial case.

Additionally, I have already completed not one but two Hep B vaccination series in my lifetime and all my routine vaccinations are up to date, including tetanus.  The only other recommendation Dr. Thea had was to purchase an insecticide treated mosquito net for my sleeping quarters. I'm agreeable to the idea, but for now  I'm waiting to hear back from the first group about where they're sleeping before I decide on which net to order online.

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* This sentence has been censored and edited to protect my mother from going crazy when she reads this entry.

BHCHP in Haiti

Boston Healthcare for the Homeless was approached recently  for help with relief efforts at Hospital Sacre Coeur in Milot, Haiti. In response, BHCHP has committed to sending four staff members every week for six weeks, for a minimum of one week of service for each group.  

The first group is already there, including two McInnis House nurses. We've been in touch with them, they are working in the Emergency Room and the Psych Unit respectively. 

 The next group leaves this Friday. 

From staff members who are unable to make the trip at this time, the response is just as overwhelming. People have been donating hours to the "vacation bank" so that those who are going don't use up vacation time, as well as donating items for the staff like hand sanitizer and insect repellent. And, at McInnis House at least, since I can't speak to other parts of the program, nurses have been stepping up to cover shifts while the others are away.

There is amazing team work happening here at home as well as in Milot. 

I am always proud of the work that we do, but seeing everyone around me jump at the chance to contribute to Haiti's relief efforts gives me yet another reason to love this program.

the role of nurses in disaster response

An interesting post, the other day, from my friend Erin about the importance of nursing in disaster response.
Erin, who is training to be a Nurse Midwife, points out

"you can have the best surgeons and trauma docs in the whole wide world performing incredible surgeries on people, but if you don't have the nursing care afterwards to change dressings, pack wounds and dole out timely antibiotics, among other things, all that surgical effort was wasted if people die from infections."

Erin's full blog entry links to two very interesting articles, one from boston.com and the other from the executive director of Partner's In Health, both of which mention the need for good nursing care in Haiti.

That's all. I wanted to share Erin's point of view and by doing so join her in advocating for the important role surgical post op and med surg nurses can play in  responding to a disaster situation.

The more I hear about the efforts in Haiti and how many different disciplines are coming together to create a holistic response to this emergency situation the more amazed I am.

Just remember, we can ALL help to provide the supplies that are needed with simple online donations.

Stand With Haiti

Haiti Needs You

Please don't stop praying and donating. I know I sound like a broken record but I can not imagine how frustrating it must be save so many people from the wreckage only to lose them to infection because the antibiotic supply is so low right now. Please send money if you can.

Yesterday the aftershock took even more lives and created complications for rescue efforts.

Let's continue to stand in solidarity with Haiti and to offer them support as far reaching as we can afford.

Medical volunteering in Haiti

Partners in Health (PIH), and Doctors without Borders (MFS) both have medical personnel ready to deploy at a moment's notice for disaster response.

I am not part of any agency that would have sent members to Haiti during this time. But it's not surprising to have heard several people from various local public service roles wonder if there is something they can do that's more active than sending money.

The more I settle into my identity as "nurse," the harder it is to not imagine myself responding in person to emergencies of this magnitude.

I have since been convinced that the most useful thing any of us can do is send money right now.

However, as Deval Patrick mentioned at the meeting on Wednesday night, a time may come when more volunteers are recruited for various relief efforts in Haiti.

For any of you who may be interested in that you can contact Richard Chacon, Director of the Office for Refugees and Immigrants, through Deval Patrick's office at 617. 725. 4000.

You can also call the Massachusetts Emergency Management Agency at any time by dialing 211.

As always, it's a number you can call to get critical information about human and health services (like "where can I bring this confused old lady I just found?") or to obtain information during a disaster or public emergency.

You can use this service to inquire about smaller groups being organized for relief work (if and when that phase of response comes about).

Until then please send all the money and prayers you have.