And there was darkness and light, the first day...

Jossie teaches "Diabetic Foot Evaluation" to the Haitian
nurses, firefighters, and doctors.

Day one has come to a close, all is well after a hectic clinic/ OR day, big props to all of the amazing people here at HAH as well as our great team. On every trip, there is a learning curve, us learning the ways of our host hospital and the team learning each others ways. This can be a challenging process but one that brings respect, affection and admiration. We also started our teaching today. There were nurses, nursing students, OR nurses,EMTs and physicians from HAH as well as staff from other local PAP hospitals. This is a great way to

Job and a friend in clinic

" leave skills not scars" as Dr. H would say. These teaching opportunities not only help the staff at HAH but we hope it will affect long term patient care and broaden their knowledge bases which will allow growth at the institution. Looking forward to a busy day tomorrow. Much love goes out to our amazing PACU staff which took excellent care of our patients post operatively, Keeping us up to date on our paperwork and making sure everyone was taken care of. Cindy, way to take charge today. Jenel you did a great job! Thanks to Job and Dr. Delanois, it sure does make clinic easier when you have people on your team that speak the language. Thanks to Britt for running water to all of us and keeping the kids entertained!! Mesi, Mesi,
Ok time to go back to the mosquito nets and catch some ZZssss.

Jennifer

Welcome to Hati

Bonju,
Yo Jen here.
Good Morning from hopital Adventiste d'haiti. Yesterday began our journey to port au prince with an early morning trip to BWI and great help from American Airlines that allowed us our second bag at no charge. From BWI to Miami allowed us to meet up with Dr. De and head on down to Hati where although only 1.5 hours from Miami we gained an hour of time (Hati does not participate in Daylight savings time.) We were welcomed by our hosts, The Lindseys who are helping to run the hospital. We had many helping hands take our bags into our living space, an area upstairs from administration. There were many people to help take the equipment down to the Operating room, as Jenel and Cindy helped Jeannie set up our OR, our awesome anesthesia team got the ORs ready for our big surgery days. While some members of our team were setting up spaces, Dr. H, myself, Jossie and Job helped Dr. Dietrich screen some of the more complicated cases. All were pediatric patients ranging from baby to 17 years old most with severe deformity included untreated clubfoot, posterior medial bow of tibia, residual foot deformity after treated clubfoot and arthrogryposis. Today brings a busy day of 30-40 patients and 5-6 surgeries. We will also be lecturing on all aspects of hospital care from Anesthesia to Post anesthesia care to CPR and Infection Control as well as wound care and Diabetic foot exam. This week promises to be a challenging life changing adventure!
Jennifer

the Hatians adore their children

Propac for Haiti

Tara and I testing the ProPaq that we
are bringing for the new HAH PACU

We're continuing down, getting ready for our mid-June mission to Haiti. The hospital where we will be working, Hopital Adventiste d'Haiti, until recently did not have any Recovery Room facilities for patients undergoing surgery. They simply were woken up in the OR, and transported to the floor. Needless to say, this is not the safest scenario, but it is one that is repeated daily in small hospitals throughout the developing world. We read about another orthopedic group that was visiting HAH a few months ago, and had a disaster occur in a 10 year old girl a few hours after surgery. Apparently the child did fine initially, but was found without signs of life on the ward a few hours after surgery. There is no way of telling if a recovery room (PACU - post anesthesia care unit) would have saved her life, but in any case, the hospital administration decided that it was time to invest in a PACU. To help bolster this effort, we are bringing down four PACU/ICU nurses to help train the local Haitian nurses.

Alex Herzenberg packing gear for Haiti

We also are bringing a donation from Operation Rainbow, in the form of an advanced (well actually, used and refurbished) ProPaq monitor for their newly minted PACU. This allows monitoring of a patient's blood pressure, temperature, and heart rate, and pulse oximetry simultaneously during the first few critical hours after surgery. We tested it out on a young man who had come over the house to tutor Brittany in her schoolwork. Poor fellow found himself hooked up to leads and cuffs, and electrodes, and then John started interrogating him. It looked like a scene taken from "Meet the Parents"...
We approach our mission with both excitement and trepidation, hoping that the Lord will watch over us and over our patients. Our goal is to go, do good work, and get all our team members back home safely, and leave all the patients healthy and healing.

The Real Dr. D. Stands Up...

Ronald E. Delanois, M.D., is a senior orthopedic surgeon at Sinai Hospital in Baltimore at the Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, where is he also the Fellowship Director. Prior to coming to Sinai, he served 18 years in the United States Air Force, the last eight as the division head of the Adult Reconstructive Service at the Naval Medical Center Portsmouth. He is a widely regarded expert in joint replacement.

Ron obtained his M.D. from the Uniformed Services University of the Health Sciences (USUHS). He did his orthopedic training in the Air Force at Wilford Hall Medical Center in San Antonio, Texas, followed by a Fellowship in Joint Replacement at Johns Hopkins. Dr. Delanois currently holds an academic appointment at USUHS, Bethesda, as a clinical assistant professor of surgery. He is an active member in the Society of Military Orthopedic Surgeons as well as the American Academy of Orthopaedic Surgeons.

Dr. Delanois lives in Lutherville, Maryland, with his wife and their three children. He enjoys competitive cycling and collects fine writing instruments. Ron speaks both French and Creyole.

Dr. O

Dr. Ed O’Laughlin is a pediatric anesthesiologist practicing for many years in the Baltimore area and currently working at Sinai Hospital of Baltimore.  He is looking forward to our upcoming June trip to Adventiste. "Dr. O" has already served on two previous orthopedic missions to Haiti, the previous two being with Dr. Scott Nelson, working out of Cap Hatien. Ed is a Francophone, and is working on his Creole.

Ed is a devoted father of five, grandfather of three, married 35 years. Ed is an avid croquet player and enjoys the travel and competition. He even has his own professional grade court, one of the best on the east coast.  While he supports himself and his family through his work as an anesthesiologist, he dreams of the day that croquet will become an Olympic sport, opening up an opportunity for Ed to be the oldest U.S.A. Olympian.

Croquet now...

Croquet then.....(Edouard Manet)

Jeff the Younger

Welcome to Dr. Jeff Young, who will be joining us on Team Sinai at Adventiste. Originally a native of Maryland, Jeff studied at  the University of Pennsylvania Medical School, and then went off to Northwestern University (Chicago) for his orthopedic residency. He completed a pediatric orthopaedic fellowship at the Royal Children’s Hospital in Melbourne, Australia. Subsequent to that, he did a six month fellowship with here in Baltimore at the International Center for Limb Lengthening at Sinai Hospital.  Jeff has already been bitten by the mission bug.  His prior mission trip experiences include trips to Guatemala, Colombia and Nicaragua. On his return to the USA from Haiti, he will be joining Drs. Larry Rinsky, Jim Gamble, and Meghan Imrie on the orthopedic faculty at Stanford University in Palo Alto, California. The Bay area is the home of Operation Rainbow, co-sponsor of our upcoming mid-June mission to Haiti, so Jeff plans to continue as an active participant in overseas missions with Operation Rainbow.

Jeff and friends in Nicaragua

Hawaii Nurse, Waka Waka Lua!

With a young friend in Esteli, Nicaragua

My name is Alex. I am a 27 year old ICU nurse, and recently moved back to Baltimore with John and Merrill (the ‘rents). I was born in North Carolina, but grew up here in “Bawlmer”, including graduating from Villa Julie College of Nursing (AKA Stevenson University). For the past 4 years working as a travel nurse. My work has taken me to NYC (Bellvue Hospital) , Hawaii, San Francisco, and most recently, San Diego. I went on my first of several missions with Operation Rainbow to Nicaragua, 11 years ago. I started as a young “helper”, then in subsequent years, as a nursing student, and finally as a full-fledged RN.  My earliest memory of mission work was greeting my dad coming home after his first mission to Nicaragua in 1998. His team was caught in Hurricane MItch, and stranded for a week. By the time they arrived home, the news media was staked out at the airport covering the return. That was pretty exciting for me to see. My mom also went on several missions to places that made the Top Ten Travel Warning List of the State Department, including Pakistan after an earthquake, Sri Lanka after a Tsunami, and Haiti, two weeks after the earthquake. Some how, my parents decided that these missions were safe enough for my little sisters and me. Throughout the years, all of us have joined my parents on these mission trips, usually to Nicaragua, though my little sister Brittany was with our parents at Adventiste in Haiti last year.  Our friends didn’t quite understand it when I showed them pictures from our trips. 

Administering an IV in Nicaragua

They thought that when we went to the tropics, we must have been going to fancy resorts!  In any case, these were the most special experiences in my life, and they helped to cement my decision to become a nurse.  In fact, it was on a Rainbow mission in 2006 when I began my passage into professionalism, learning I had learned enough to pass two things:  my first Foley catheter and the NCLEX (waiting desperately for my test score results to download in the painfully slow dial-up internet cafe in Esteli).

 

Waiting for a fake wave in Singapore.

During the past few years I’ve enjoyed practicing in a different kind of tropics: the Aloha state of Hawaii, as a traveling nurse.  I feel extremely lucky and excited to join the team this year on the mission to Haiti.

Real waves, Kailua Beach, Oahu

Climbing in Hawaii

Francel, we're so glad you are here!

It's a pleasure to introduce the most recent addition to Team Sinai, Dr. Francel Alexis. We are so grateful that he will be joining us, and also staying on after we depart to help look after the patients we treat when we go to Haiti later in June.....

I am a 31 years old (young) Haitian orthopedic surgeon. I was born and grew up in Les Cayes, in the South of Haiti. I attended high school in Port au Prince at the Institution of Saint Louis de Gonzague. I graduated from the Medical School of the Haitian State University in 2004, and then worked for one year of national service in Les Cayes. Soon after, I started my 4 year orthopedic residency at the Haitian State University Hospital.

I have had the opportunity to spend some time rotating through various hospitals in the USA and France. Since 2007, I have attended the yearly SIGN Conference for Treatment of Difficult Fractures in Richland, Washington. In North America, I have had the privilege to visit famous hospitals in Kansas, Texas, Indiana, North Carolina, and Ottawa. I also visited a hospital in Guadeloupe, France. Back home in Haiti, I recently enjoyed working at Hopital Adventiste with the long term volunteer docs: Terry Dietrich and Scott Nelson, so I am already familiar with the workings of Adventiste.

Immediately after the earthquake of January 12, 2010, I volunteered at the General Hospital (HICC) in Les Cayes along side Médecins sans Frontiérs (MSF).

I am doing now a Fellowship in Pediatric Orthopedic Surgery at the CURE International Hospital in Dominican Republic since November 2010 with Dr. Dan Ruggles. I am married to my lovely Wideline and we have three beautiful children. I look forward to working with the other members of Team Sinai!

Francel ALEXIS, MD

The Prodigal Daughter

I am a Haitian American Nurse Practitioner who specializes in Cardiology.   Helping Haiti has been a goal of mine for some time and the earthquake disaster only intensified my desire to go to my homeland and help out.  I hope this trip will only be the first of many back to Haiti in a professional, volunteer capacity.  It is important to me to go back to my country and help rebuild and support my people.

A little about myself, I studied undergraduate nursing in Chicago at University of Illinois. I worked as a Cardiac nurse at Miami Heart Institute and in the Cath Lab at Baptist Medical Center in Miami, Florida.  I came to Baltimore 10 years ago for graduate studies at Johns Hopkins School of Nursing.  For the last five years I have worked for the Johns Hopkins Division of Cardiology as a Nurse Practioner.  I look forward to being a part of this Team Sinai and going back to my homeland! Oh, and one more thing, I speak Kreyole and French much better than my cousin Ron!

Hooray for Bollywood!!

As we continue to introduce you to the new members of Team Sinai, please welcome Dr. Jossie Abraham. In her own words...

I am extremely excited to be on this trip to Haiti and can’t wait to make a difference!  A little about myself, I was born and raised in New York City.  I went to Lehman College (Bronx, NY) for my bachelors degree and then to the New York College of Podiatric Medicine for graduate school. After graduation from Podiatry School, I completed a three year residency in foot and ankle surgery.  Currently I’m at the Rubin Institute for Advanced Orthopaedics at Sinai Hospital of Baltimore, for a post-residency fellowship in foot and ankle reconstruction.  

From our wedding album

Jossie and Jen at work in clinic

Before I started my path in medicine, I experienced witnessing my grandfather passing away in a small rural hospital in India. It was then that I made a decision to try to make a difference in this world and to do whatever I can with my hands to benefit those that are less fortunate. I can’t wait for this trip to Haiti, my first mission trip, and I hope this will not be the last.

Yo, Jen!

Meet Dr. Jennifer D'Amico, one of three podiatric fellows who will be joining Team Sinai in Haiti next month.....

Dr. Jennifer D'Amico graduated from her podiatric residency in beautiful San Diego, CA where she gained valuable experience in foot and ankle reconstruction as well as orthopedic trauma. While living in San Diego, Jen also reconnected with her passion for the arts which included ceramics.She's now with us in Baltimore at Sinai as a limb reconsruction fellow doing a great job. Dr. D'Amico loves to volunteer (homeless outreach, Girls Think Tank). After graduating, Jen had a whirlwind mission trip to Nepal with Healing the Children where they did mostly reconstructive surgery on children and adults with neglected clubfoot. That experience in Kathmandu solidified her passion for helping the disadvantaged. Jen herself came from a modest background, surviving with her mother and brothers on food stamps and help from mom's family. Through hard work and dedication, Jen is realizing the American dream, graduating from college, podiatry school, residency, and finishing up her fellowship. She'll be returning to San Diego as an attending surgeon this summer. Jennifer is looking forward to continuing her mission work as a way of helping people around the world who are disadvantaged. She is very excited to be joining Team Sinai for our June 2011 Haiti mission. She is not concerned about potential security issues in Haiti. She knows that if anything were to happen to her, she has three Italian brothers who will come protect their little sister!

Jen and her big brothers in the "hood"

Papa Doc and Baby Doc

Team Sinai is proud to welcome two “new” members who are actually both experienced volunteers at Hopital Adventiste d’Haiti. John (Papa Doc) Sauter has worked with CURE teams twice in HAH and son Chris (Baby Doc) helped his dad on the last mission. 

John (Papa Doc), Chris (Baby Doc) at HAH
with interpreters Tony and Roosevelt.

Dr. John Sauter has been in anesthesia practice for the past 23 years.  Following residency he served four years of active duty in the US Navy practicing anesthesia, including stints on Aircraft Carriers Saratoga and Forrestal, and aboard the Baltimore based hospital ship USNS Comfort. Since separation from the service, John has been practicing in the Philadelphia suburbs. His special interests are obstetrical and cardiothoracic anesthesia, but has a broad experience in orthopedic, general surgery, GYN, and urology anesthesia.

Chris Sauter is 23 years old and currently with 'rents in Philly.  He graduated from Colgate University last spring where he concentrated in Molecular Biology and minored in Economics.  He spent one semester working at the National Cancer Institute and another semester at the University of Cardiff, Wales.  He currently works at a research laboratory at Thomas Jefferson University in the division of Medical Oncology, spending most of his time in the company of mice and rats.  In his spare time, he enjoys outdoor activities, reading, and volunteering. He is a certified Wilderness First Responder.  Chris’ previous experience as a volunteer in Haiti was a unique, eye opening experience, and cemented his desire to follow in Dad’s footsteps in a medical career.  

Chris outside the wire at HAH

John’s wife Eve is proud of the two men in her life
As a family, they enjoy hiking and cycling.

Gentle Jenel

I'm working here....

Jenel Slonaker is a Surgical Technician at the Rubin Institute for Advanced Orthopedics at Sinai Hospital. She was born just north of us in Lancaster, PA, and studied Surgical Technology in New Jersey. After graduation, she worked at the Hospital for Joint Diseases in New York, and at Shock Trauma Hospital in Baltimore. For the past several years, she has been with us at Sinai. Jenel is a Surgical Tech by day, and a student at CCBC (Community College of Baltimore County) by night, working on her Bachelor's Degree.

"Dr. D, did you forget to put
this back in...?"

Jenel is mission experienced, having traveled with Operation Walk Maryland to Ecuador in 2010. Our own Dr. Harpal Khanuja led that mission, and reports that Jenel worked hard, and was inspired by the opportunity to help people in need. Her long term goal now is to become a Physician Assistant.
Jenel is pictured above helping us to remove an external fixator, and we're not sure WHAT she's doing with that proximal femur on the right, though she looks like she is ready to blast off into outer space....
We anticipate running two operating rooms in Haiti next month, and this should keep Jenel on her toes!

Will the REAL Dr. Dre, please stand up!

Doctor Dre

Team Sinai welcomes Dr. Arup De (pronounced "aw-roop dee"), anesthesiologist extraordinaire. He doesn't know it yet, but his official Team Sinai nom de guerre will be Dr. Dre (AKA Andre Romelle Young, the West Coast G-funk Rapper). Why not just plain "Dr. De"? Because that nick name is already taken by our very own Dr. Ron Delanois, universally known at Sinai Hospital as "Dr. D". Here in his own words, the real Dr. Dre stands up...

Doctor De and Friend

          I as born in India, grew up outside of Boston, and completed my undergraduate and medical education at the University of Massachusetts.  Next came residency in anesthesiology at the Brigham and Women’s Hospital in Boston.  After completion of my training, I worked in several different private practice hospitals in Massachusetts and Texas.  I decided to return to my academic roots, and so I currently work at the Albany Medical Center in Albany, New York. My major goal is to establish a program in international anesthesia outreach for our senior anesthesia residents. Adventiste may turn out to be an ideal location for my residents to rotate through on an ongoing basis.

         My international experience to date includes three Operation Smile missions in India – one in Kolkata, and two in Guwahati.  My Bengali fluency came in handy in all three missions. Not sure how much Bengali will help me in Haiti, but I have been reviewing some  Kreyole phrases to get ready!

I'm also part of IMSuRT, the International Medical Surgical Response Team, which operates through NDMS (National Disaster Management System),  under the executive branch of the United States Government.  Through IMSuRT, I spent a frigid January week in Washington DC, during the Obama inauguration. Luckily, there were no disasters, other than a few frozen finger tips.

Professionally, I am keen on ultrasound-guided regional anesthesia. This has great promise as a practical tool in the developing world. Regional anesthesia is almost always safer than general inhalational anesthesia, though it can be trickier to perform regionals. Ultrasound guidance has the potential to make regional anesthesia the method of choice in the developing world, thus imparting a greater margin of safety for patients. I hope to share these skills with our Haitian anesthesiology colleagues next month at Adventiste Hospital. 

         

Queen of the Tundra: Cindy Swanson

Cindy Swanson writes…
Merrill asked me to write about myself for the Team Sinai Haiti blog. I guess I always have trouble talking about myself but here goes... My international travel started in 2000 when I joined the Peace Corps. I was in Belize as a part of a group that was training elementary school teachers how to use computers. It was a neat experience being there and lived there for six months.
My next adventure was teaching in a public school in Alaska. It was a village accessible only by bush flight on the Yukon National Wildlife refuge. The interesting thing was, it was more remote, otherworldly with less amenities than being in Peace Corps. I taught elementary and high school art in a village that was all Native Alaskan. I learned to live on the tundra with no running water. In the two years I was there, I learned an important thing that sociologists talk about, that there are two levels to another culture. There are the material things and the non-material things. It is relatively easy to get used to not having water, living in a house on stilts, the food, traveling by boat or plane, etc. The things that are more difficult to grasp are the intangible things like values, communication, and cultural norms. These things are usually learned more slowly. What I value might not be the same, what is normal for them may not be the same for me. As a teacher, I had to be very careful not to assume my way was better.

Tundra Cindy and the Shock Trauma Crew in Haiti

After coming back to the lower 48, I went to nursing school at Johns Hopkins and from there began working in the OR at Shock Trauma and have been there ever since. Last year after the Haitian earthquake, our hospital organized a team and set up camp in a half collapsed hospital in the city. Each week new teams would be rotated in to do basic triage and surgery. I went last April, and staffed three OR's doing mostly orthopedic, and general surgery. That week we were lucky to have an OB/GYN doctor with us, so we did OB as well. We had to learn to do surgery with limited supplies, intermittent electricity,and only a mini c-arm. I have wanted to go back since then, so I was really excited to learn that Team Sinai needed an OR nurse. See you all in June! ----Cindy Swanson, RN

Heading Back to Haiti

Bonjou and welcome to the official Team Sinai Haiti blog for our upcoming mission to Port-au-Prince, Haiti.  Our team is returning to volunteer at the same hospital where we served last year (June 2010), Adventiste Hopital d’Haiti.  From the moment we left after our weeklong mission last June, we couldn’t wait to go back. We had an amazing, life altering experience, and were able to help over 50 indigent patients who needed orthopedic surgery. Many were originally injured in the earthquake of January 12, 2010, and some were more recent trauma victims, and many were children with birth defects.  We had arranged to return to Adventiste Hopital over the Christmas break, 2010, but our plans were thwarted by political and civil instability surrounding the December elections. Things in Port-au-Prince got pretty hairy, prompting American Airlines to temporarily suspend flights. Moreover, the organization hosting us, Adventist Health International, decided to temporarily evacuate their expatriate staff at Adventiste to the Dominican Republic. By the time the smoke settled, we had lost our travel window. Over the next few months, we planned, calculated, and regrouped, and finally were able to reschedule our mission to this June 2011. Most of the original 18-team members from last year were not able to make the new date, but we have successfully recruited replacements. The returning team includes six veterans: Merrill, John, and Brittany Herzenberg, Job Timeny, Ram Shetty, and John Russell. (See me, Job Timeny, and John Russell rounding last year...)The brave newcomers are John and Chris Sauter, Ed O’Laughlin, Arup De, Julia Ramberg, Tara Leroy, Ron Delanois, Alex Herzenberg, Jossie Abraham, Jennifer D’Amico, Janel Slonaker, and Cindy Swanson. Over the next few weeks we will be introducing our new team members. We haven't yet told them about the first class accommodations for volunteers at Adventiste (see below), or the fact that it is 95 degrees in the daytime and 85 degrees at night. Air conditioning? Guess again...

Last year, we worked with Dr. Scott Nelson, who spent 6 months at Adventiste after the January earthquake. Scott's replacement is Dr. Terry Dietrich, who is serving for one year, together with his lovely wife Jeannie. We really look forward to helping Terry and Jeannie, as they are so tireless and committed to providing orthopedic care to the indigent population of Port au Prince. Stay tuned, more to follow in the coming weeks.