Medical Trip - February 17-25, 2011
Overall Missions Goal: Serve God’s beloved poor.
(Double click here to see pictures of people of Gandou)
Mission Focuses:
1. Continue to build sister parish relationship and understand current status of ongoing
projects.
2. Provide health care for the people of our sister parish in the following ways:
a. Run medical clinic/pharmacy and provide the best possible medical care to the
greatest number possible.
b. Run dental clinic and provide cleanings, restoration, and extractions.
c. Home health care nurse to visit homes to gather community information, better
understand living conditions, train people on handwashing and build tippy taps to aid
in handwashing, train school on toothbrushing and use of provided fluoride.
d. Provide eye training to healthworkers.
e. Create ID cards for patients for best possible patient tracking.
f. Transport patients in need of surgery to Jacmel for surgery and to learn the surgery
process.
3. Provide opportunity for our team to experience Haiti and especially our sister parish.
(Double click here to see pictures of the Team)
Gandou Medical/Dental Team: 1 Priest, 2 doctors, 1 nurse practitioner, 2 nurses, 1 Pharmacist, 3 dentists, 1 hygienist, 5 translators, 5 support people
Jacmel Surgery Team: 1 surgeon, 1 nurse, 2 support people, 1 translator
Focus Area #1 - Sister Parish Relationship/Status of Ongoing Projects
• Earthquake Rebuilding/Construction projects
o PROCHE – Catholic Church’s Organization of the Rebuilding Efforts in Haiti
Father Nexcene knows about PROCHE, but PROCHE is not yet up and going and therefore nothing can be done through them. Father has talked to his bishop about the situation and the approach that is being taken to earthquake rebuilding at the moment is to have an archdiocese person check the rebuilding plans to make sure the plans show the building to meet anti-seismic requirements. If it does that they are allowed to go ahead and start rebuilding. Father has already done this with the plans for the school and for that reason he was allowed to move ahead. Father said to wait on PROCHE would take too long. They have a big need now. Needs to get the school kids out of the tents. Needs to get a Church for mass. When it rains everything has to stop and people get wet. During the next trip or so Father would like us to sit down with the Bishop and discuss the rebuilding plans. Father said he would give us the blue prints for the rebuilding of the Church and School. Father said that if we start without PROCHE and can’t finish because we run out of money we can at that point ask PROCHE to help us find the money to finish.
o School
Father figured out how to get a two axel very large dump truck up the mountain to Gandou. One of the translators said the driver must be a dare devil. Father thinks the school will be done in April. It will have a tin roof. He has the blue prints. He has spent $18,500 so far. So far $12,159.54 on materials. Also $4,919.34 on payroll #1 and $1,518.74 on payroll #2. He had to build two cisterns (I don’t think this was originally planned). Total for the school is $35,139 and we have paid $15,000 so far. Remaining is $20,139.50. Father said he would give us a copy of the invoice. Currently stopped on the construction because the foreman had to go to Port-au-Prince, but the foreman will be back next week.
o Church (double click to see pictures of church services)
Construction will begin as soon as the school is done. Same people doing the construction.
o Homes we sent money to rebuild.
They are working on the homes we sent money for. Expects one of them to be done soon. One of the homes is right next to the rectory. We took pictures of this one. Seems nice. The second one will be started when the first is done. He expects to be done with both of them by June. Father still wants us to kick off a home building project because many of the poorest people are not getting a UNOPS home. Father told us that Francois and Xavier both have cracked homes and need money to rebuild them. Sister Fran had a $471 donation that was supposed to go to building homes and we left that for them. Father said it would not do much and we agreed but we told him it is was what we had to give at the moment. Need to work on this in future.
o UNOPS Homes
UNOPS is rebuilding some homes in Gandou. Father said the decision who gets one is political. We had a patient come into clinic who needed surgery and we asked him if he could go to Jamel like the next day for surgery and he said he could not because the UNOPS people were bring stuff to build him a home. Father said UNOPS had used his truck for a day or two to transport materials and they saw that it worked so they purchased one just like it and are using it. Father said the UNOPS homes are ok but they only have one room. This is not very pratical for a family. Families need some rooms inside to change and sleep ect. Not sure what type of floor is in the UNOPS homes. Other organization that is building homes is called Jaconie (not sure of the spelling).
• School in Gandou
Father had asked for money to build tables for the school kids and we sent it. I found some of the tables and took pictures of them. They seem very nice. Father said they have 7 and they are going to make 21 more. We gave father the list of sponsor students very early in the week and asked him to fill out the list of student names for the new sponsorships and to correct the information for the old ones. Father was so busy with everything (transporting our patients, getting ready for Sunday, dealing with patient tickets, ect that he could not get to this until the last day. When he was about ¾ done we had an emergency case with a little baby and had to pull him off again to take the baby to Jacmel. At the last minute, Father has asked us to bring some toys for the little children in the school. We did not do this but asked him what types of toys he was thinking of. He said, trucks, crayons, color paper, dolls. Father said he was looking for stuff the teachers could use to keep the little kids busy. Father said we can bring these toys over the course of a couple trips, don’t need to bring them all at once. Measured the new school. It is 16 foot by 60 foot. It has two 6 foot wide and 6 foot deep by about 15 foot long (each) cisterns on the north west porch corners. In the old school where the earthquake had damaged it, on the least damaged end they added a subwall and a wooden pillar inside the room (I guess to catch the cement roof if it falls) and started using it again for the real small kids.
• High School/LaVallee House
This is working very well. On the way to Gandou we saw some of the students walking on the road in LaVallee going back to the house. On the way back to Jacmel we stopped and walked to the house and took some pictures. Father was very proud of the house. We saw some of the kids inside. They were so happy and thankful. The house is very nice. Father said there is 14 students in the house plus an older person. He said it could be 15 or 16 max. Father gave us the names of the students.
• Clinic
Sister Fran asked again how much people were paying for the glasses that we left last time. The health care workers said 100 goudes. Sister explained again that we pay less than $1 US for them. Father Nexcene told the health care workers to start charging $0 for them. We spent a large amount of time talking through the referral program. It is very clear that the referral program is working well now. The health works have reduced the number of people in our referral program by about 40 since the last trip. Of this 40 not all received care….many received care, but some refused care, move away, or died. In August I updated our referral database with all the patients from the July trip and sent Father Nexcene 3 hard copies of all the referral patients in the database. One copy for Father and one copy for the 2 health workers. Before we got there Father had sat down with the health workers and reviewed the status of every patient in the referral database. They had marked the status on every page (all 180 some patients). At the end of the week I pulled out the 40 done patients and added about 40 more for the week. Before this trip we had gone for 2 years with little progress with the referral program and therefore we decided we had to do something about it and kicked off the surgery trip. If we had known that the referral program had started working much better in the last six months I am not sure we would have made the same decision. The cost summaries the health workers were reporting for the total costs for general surgeries was cheaper than what it cost us for the surgery trip and likely would still be a little less than what it would cost us if we had our own surgeon going, but takes much much longer. The health workers are working so hard on the referral program now it seems prudent that we send them a little (like $100) bonus when we can. Sister Fran and I were both very impressed. We want to keep this going. It will save us in the end.
• Internet
The internet had been broken for a long period of time and that is why father has not been able to communicate with us very much before the trip. Father reported that the hurricane and the humidity did the damage. He showed us a new router that he said had to be replaced to fix the issue. Everything is fine now and working well. Father understood our desire to communicate often. We asked Father if he had switched to Vonage yet. He said he had not and was still using Magic Jack. Father said Vonage works very much the same as Magic Jack and should be purchased in the USA and brought to him. There is only USA numbers for Vonage as well. He asked us to do this. He believes Vonage will be better for him. When we used the Magic Jack to call Haiti it worked but not well. You have to wait after you say something. Bonnie and I could hardly communicate with it.
• Next Trip
June 8-16 is ok. Father needs to spend the night at Matthew 25 the night before the trip so he is there and ready for us to pick him up. Bring tubs with lids next time to put our tents and air matrices in to protect them from rodents.
• Mass Stipends
No problem
• Father Nexene’s Priorities
Father talked about how is always running people to the hospital and always the one dealing with medical emergencies. Father would like to have a full time Nurse for the clinic and to deal with some of these emergencies. He talked about times when he runs someone to the hospital and by the time he gets back someone else is waiting on him. Father talked about a full time nurse would be better than a part time doctor. The reason for this is because if someone is part time then when they leave they may try to come back and find the river is too high. When the river is too high then they may try to come back but not be able to for a long period of time. It is better to have someone full time. Father don’t yet know the costs of a full time nurse. Father wants to kick off a construction project for the clinic. Father would like to kick off a construction project for the old side of the rectory. Father said his priories are still the school then the Church then the rectory. Father wants to see if we can help kids go to the University. The translator San Louis reported that he organizes the same type thing in Baudin right now. University kids are required to submit grade reports and survey. If they don’t do what they are required then they don’t get the money. San Louis reported that it is about $2,000 US per year for tuition ($1,000 twice a year). San Louis charges $60 US per semester to organize this. Father asked for a regular amount for the truck repair. Father reported that prices are always going up. Tires were $175 each and now they are $195. Father reported that the shocks on the truck are in need of repair before the next trip. Father reported that the shocks are $1900 Haitian per side for the front. He only needs the fronts. Father asked for a regular amount for the rectory repair. Father asked with continue to help the rebuilding of homes, not just the two we started but all the other ones in the area that need fixed.
• Money
Sent
• Visit to the USA
Father Pascal told Father Nexcene that he should come to the USA this year. They decided that it would be after Easter.
• Other
o Culligan water jugs
$60 Haitian ($8 US) per Culligan jug. Father said the group uses like 18-25 jugs of water per trip. Father currently has 9
jugs. Father can get more if we give the money for it. Father could then have all the jugs full and at Gandou before our trips start.
o Motorcycle
Honda makes a 125cc ($4,000), 200cc ($5000), and a 250cc ($6000). Father said based on information he has from Caritas the 200cc is
better than the 250cc, but I don’t know how this could be. Francois and Xavier currently don’t know how to drive a motorcycle, but they
likely could learn. Father said Francois and Xavier would need a helmet and guards/other protection.
o New project for Latrine building.
Father said he would like to start a Latrine project. He is worried about people’s health without it. Father said he would email us
estimates.
o Population of Gandou
Father reported that there are about 11,000 people in the Gandou area.
Mission Focus Area #2 – Health Care for our Sister Parish
• Medical clinic/pharmacy
Clinic Results/Numbers - Totals estimated at about 1,000 Patients including school kids. Patient flow was steady with no issues finding
patients. We used lights most every night some to finish. Last day we stopped creating new dossiers at noon and it worked out prefect.
• Dental clinic/cleanings/restoration, and extractions.
Dental Results/Numbers - Estimated at about 600 extractions and 150 repairs. Cleansing unknown. Dental chairs are needed. Need to
let Father know what we want and he can try to have them made. Hired extra translator to help in dental. Used Dr. Lintz as more of a
dentist and less of a translator. First day (Saturday) setup in the school tents. The problem was the ground was not flat in this
location. Very strong team that worked very hard.
• Home health care visits/gather community information/train people on handwashing, build tippy taps,
toothbrushing in school, and use of provided fluoride.
First day of clinic was so crazy did not get Sandy out to do this. Sandy went out late the second day with sister Fran, one of the health
workers, and one of the translators. Found it very diffuclt to communicate to the people. People struggled to answer even what seemed
like the most straight forward questions…for example how many people live in this house – likely because the number constantly
changes. Found the translator makes a big difference on how much data you gather. Found people just don’t each much meat. Found
most of the people use bleach in their water. Third day of clinic Sandy went out with Father Nexcene and Father Pascal to a chapel.
Chapel experience was great…could really understand much more about the difficulty of life in such an isolated environment. Very
physically challenging. Fourth day did the tippy taps with the teachers in the school. This was a great exercise. Everyone seemed to
enjoy the exercise. Passed out soap and hand washing instructions to people in the clinic. With the help of doctor Lentz did the tooth
brush training at the school. Father organized the whole school to listen to the training all at one time. This was the best training
session we have ever had for the school.
• Eye training to healthworkers.
Sister Fran continued her training on the eye course. Trained for two half days. Sister was very happy with the ability of the health
workers to pick up the subject. Overall very happy with the way training went.
• ID Cards
Once we got the system figured out again the process worked very well. Need to figure out what to do when there are 30 people sitting
in front of you. Stephanie did great with this difficult job.
• Provide Surgeries and Learn the Surgery Process in Haiti.
15 days was not enough time for the health workers to organize patients. What can we do in the future to get a little back from the
people. For example can they clean the Church or something to show that we don’t just give away everything….take some ownership in
it. On the first day of clinic in Gandou found two emergency cases. One was an appendix that was about to rupture. The second was
thought to be Osteomyelitis or severe Sickle cell. Sent both patients down to Jacmel team even though they were not expecting patients
until the next day. Surgery team performed an emergency surgery on the little box with the bad appendix. They very likely saved his
life. Performed 15 surgeries. Learned the process and a huge amount about Jacmel. Patients stayed in Jacmel overnight at a $10 per
night Archdiocese guest house. This is real potential place for us to stay in the future. It is a nice place. Great experience and well
worth the effort. Bonnie Krecker did a great job leading the team and may provide a more detailed report.
Mission Focus Area #3 – Team Members Experience Haiti and Especially Our Sister Parish.
• Travel to Gandou
• We taken many actions to ensure we had rental trucks ready for us at the air port and they were good enough to make it up the
mountain.
• Trucks were there but still had to work out payments etc and it took a while.
• Everyone got up early to leave Port-au-Prince in the morning.
• Father Nexcene showed up late to pick up the team….did not have a place to keep his truck the night before in Port-au-Prince spent the
night at another parish for a meeting/celebration and got stuck in traffic on the way down.
• Typical Haiti travel with many stops. Translator wanted to make sure the surgery team had a place to stay so we had to take extra time to
go to Jacmel. While there we looked at the surgery clinic.
• Travel from Gandou
• Had to leave very early because we had to take a 1hr detour.
• Had to take patients from Gandou to Port-au-Prince
• Had to stop in Jacmel to pick up patients to go to Port-au-Prince
• Very long day.
• Exposure to Haiti
• Sunday activities
• Market
• Walk to Spring
• Other
• Other
• General Haiti Earthquake Situation
• Very little progress in Port-au-Prince.
• Fields of tents and makeshift homes.
• Some people have setup their home in the median between the streets
• Unclear how this is going to work when it is raining.
• Unclear where these people are going to the bathroom.
• Unclear how they are cooking.
• Tents are all very close together.
• Some homes going up along the road to Jacmel.
• Matthew 25 Earthquake Situation - 500 people still in soccer field.
• Day by Day Events Summary:
• Wednesday February 16 – Surgery team travels from Cincinnati to Miami Florida and spends the night there.
• Thursday February17 – Remainder of Indiana Team travels very early in morning from Cincinnati to Miami Florida, then to Port-au-
Prince Haiti. Spend night at Matthew 25 Guest house in Port-au-Prince.
• Friday February 18 – Gandou team travels from Port-au-Prince to sister parish in Gandou. Surgery team spends morning at
Missionaries of Charity Orphanage in Port-au-Prince then travels to Jacmel.
• Saturday February 19 – Gandou team setup and run clinic and sends first patients down to Jacmel for unplanned surgery. Surgery team
performs emergency surgery.
• Sunday February 20 – Gandou team goes to Mass and tries to find more patients for surgery team. Surgery team checks on patient from
previous night and travels to Gandou to take patients down to Jacmel..
• Monday February 21 – Clinic/Surgeries
• Tuesday February 22 – Clinic/Surgeries
• Wednesday February 23- Clinic/Sugeries
• Thursday February 24 – Gandou team very early travel from Gandou to Jacmel to Port-au-Prince. Travel from Port-au-Prince to Miami
Florida and finally to Cincinnati. Surgery team takes final patients back to Gandou.
• Friday February 25 – Gandou team arrives home very early in the morning. Surgery team travels back to Port-au-Prince and spends the
night there.
• Saturday February 26 – Surgery team travels from Port-au-Prince to Miami.
• Sunday February 27 – Surgery team attends mass in Miami.
• Monday February 28 – Surgery team travels from Miami to Cincinnati and finally to home.