This is day 5 of Team Sinai's adventure in Haiti. We can't believe that we are this far into it. Even those of us who have been on mission trips before have never quite had an experience like this.  We are living on the second floor of the hospital which is open to the outside and open to a patient ward.  We hear everything especially at 3 in the morning when a patient with PTSD wakes up and starts screaming. When we try to get back to sleep the roosters start crowing.  We start our day at 6:30 with a meeting out on the front steps (Aaron can't find the lid to the percolator so we can't even have real coffee!)  Last night we finished at 1130 tonight was earlier for some of us but others are still in the  OR....
The need is so great here.  We have many patients scheduled for the OR each day. The ortho team round on between  40 and 50 patients a day. As well as taking care of the patients there we have a pediatric ward which has between 5-7 patients a day.  The urgent care center is closed when we are busy but people still come.  People are waiting outside by the time we go out to our morning meeting. W e have been seeing at least 15 pediatric patients a day (another pediatrician also is seeing kids at the same time). The ER is hopping with interesting cases.  We have seen the beginnings of life as well as the end. Many happy moments and many sad.
The people are wonderful and so appreciative of everything we do.We are working with other volunteers from the US who are also great and very helpful.
The nurses who work in the hospital are paid very little and have many patients to care for.  Most others who work in the hospital are volunteers.  All of the translators (our best friends) volunteer.  They are great!  Sometimes you are not quite sure that they have told the patient what you want them to say of if they are saying what they think they should be told. Sometimes they say much more than you have told them to. :)
It has been an extremely tiring week but one none of us would ever take back.
Goodnight.

Welcome to Haiti... this is what you wanted!

Posted by David Herzenberg, GN, our beloved nephew...

Let me preface this blog with a couple truths.

1.     I only slept 3.5 hours last night

2.     I woke up at 4:30am

3.     Been traveling all day

4.     I refuse to check or edit this blog for content save for spelling errors

     The Herzenbergs plan a disaster relief mission to Haiti in wake of the most recent earthquake… hilarity ensues.  Keeping in tradition with past travels, our late night of packing is not to be out done by our early morning emergency.  Our transportation to BWI airport seemed to have overlooked a minor detail of our reservation.  It’s in situations like these that I see the true value in using military time.  We somehow rise to the occasion and hit the road by our own volition at 5:30 am, or 0530hr to clear up any confusion.  Miraculously we arrive at the airport with time to spare, greet the rest of the team, and manage to board the plane with thoughts of anticipation, excitement and nervousness. 

            

     And we’re up and off… and for the most part the first flight was uneventful, which happens to be a quality I quite enjoy while flying.  Sleep, sweet, sweet much needed sleep. We land in San Juan around 1200hr local time.  The reality of our mission is becoming more of… well… a reality.  Although we are still in the terminal I can feel the sweet sensation of tropical heat though moistened breaths.  I am slightly disheartened to see a Cinnabon in the terminal… Don’t get me started!!  Anyhow, we board the tiny double propeller plane on the tarmac and I instantly feel like I’m sitting in a giant croc pot, stewing in my teammates juices.  We have an issue with one of our bags that delays our departure.  Apparently a few moderately large containers of hand sanitizer have managed to spill contents and the smell has alerted the crew.  Unsure as to the source of the smell, the crew spends an additional 45 min “solving” the issue before we depart. 

            

     Finally we are up and off again…  Just a quick oceanic voyage from San Juan to Port Au Prince.  It is instantly clear we are traveling in the midst of the rainy season.  I play a long game of charades with the low hanging cumulonimbus clouds.  It was not difficult to appreciate the Dominican landscape… rolling green pastures enclosed by even greener mountain ranges.  My eyes pick out several unexpected yet familiar shapes.  The landscape is dotted with a myriad of baseball diamonds, so many in fact; Sammy Sosa himself would be impressed.  However, this wondrous backdrop does not continue forever.  Like a slide in a power point presentation, our lush greenery is abruptly replaced by a landscape that is stripped and brown.  My mind is jarred by the contrast and is searching for answers as to how such a dichotomy can exist.  Static from the overhead speakers is followed by the captain’s voice, “Attention passengers, we have just crosses into Haiti’s airspace.”  Closing in on the capital, tell tale signs of disaster make themselves known.  Those bright blue dots, some spread out, some so close together, what are they, they seem so familiar.  No, those drops of bright blue are not swimming pools, they are the lengths of blue tarp that are covering damaged homes and providing extra shelter from monsoon rains.  Welcome to Haiti.

            We land, we deplane, we make our way across the tarmac into the terminal.  Unapologetically Haiti greets us in the only way she can.  We are blasted by heat, assaulted by humidity, overcome by noise, and intimidated by a culture that remains a mystery to most of us.  We rally, we steady our nerves, we collect our baggage.  We feel good with the knowledge that all of our bags and our entire team has made it, at least, to the airport.  Only one problem remains… does anyone know how we are going to get to the hospital?  I’ll spare the details, but if you have ever traveled in a third world country, much less after a disaster, you understand how difficult it can be to get to your destination from the airport.  Our arranged transport arrived, somewhat delayed by unpredictable PAP traffic, and underequiped to transport of team of 18 laden down with 2,000 lbs of geat. After another hour in the sun, we wade our way through the airport loiterers and solicitors and fill three vans with our crew and bags.  We are moving again. 

           

     I’ve had the honor of volunteering in the wake of several disasters; the atmosphere here in Haiti is no different.  Filthy streets, undulating crowds of people, outstretched hands reaching into your vehicle looking for a donation, animals rooting out a meal, piles of trash clogging the streets, rivers of plastic damming up the gutters, the sweet stench of rotting organic matter, that dry feeling you get in your nose from swirling dust and diesel fumes, crippled buildings, roads, and infrastructure, numerous tent cities, and traffic, my god the traffic!  Ladies and Gentlemen of Team Sinai, you have arrived; this is what you asked for. 

     There is more… but I’m just too tired to write.  Part of the team got drafted to the OR within an hours of our arrival. The rest of us unpack, set up our mosquito nets on the open air veranda. We have a 6:30 am preconference tomorrow before we hit the floor. Just know that I’m safe, (perhaps not from the Mosquito’s) I’m at the hospital we are staying at, and it’s hot! Hotter then… well… Haiti… 

Again, sorry for the bad grammar and poor usage of imagery. More to follow...

Stay tuned.Publish Post

Carlene "Central Sterile" Williams

Team Sinai is getting ready to depart for our long planned mission, and final preparations are at a fever pitch. Pictured here is Carlene Williams, Central Sterile Technician at Sinai Hospital. She will be responsible for organizing, cleaning, and sterilizing all of our surgical equipment. Pictured here with Amy Montillano, O.R. nurse, Carlene has contributed significantly to our preparations and organization. Carlene was in the U.S. Army for more than 10 years, so she is no stranger to working under difficult field conditions.

Dumpster Diving

We'll be in Haiti next week, so we're down to the wire on our preparations.  Aaron and his crew are busy readying the anesthesia and pediatric gear, John is preparing surgical sets, and the rest of us are getting our gear together for wound care, nursing care, nutrition, and any number of miscellaneous items. Just when we thought we had all bases covered, we heard that the hospital is "very very low on IV fluids...." so now wer're scrambling to locate IV bags of Lactated Ringers Solution. Luckily, our hospital has a corner of the Recieving Dock set aside for discards from the hospital. We are allowed to "dumpster dive" for all kinds of goodies that would otherwise be periodically picked up by a distribution group called Project Hope. (Sorry Hopers.....we diverted some of the discards that were coming your way...)

 It's been weekend of packing. We were about 90% done when American Airlines threw us a curveball: there is an embargo on any extra bags to Haiti. We were hoping to have several of the team members take three checked bags so that we could bring in more gear. AA says ixnay on that. Now we're scrambling to jettison that which is not "mission critical" and make our selves leaner and meaner. AA also decided that they will only accept duffle bags (no crates). Great news for Aaron who just finished packing his delicate anesthesia monitors and other breakables into 6 shipping crates and now has to move everything into duffles. It could have been worse, we could have found this out at the airport during "check in"....

Packing is an event, and in this picture, you can see Amy Montillano (the O.R. nurse on Team Sinai) and Ella Joy Napoles. Ella is a Sinai O.R. nurse who has been on missions past with us, but unfortunately can't make it to Haiti. However, she is planning to go with us to Ecuador in October. Ella is a great sport, and spent Sunday afternoon at Chez Herzenberg helping us with the packing.

Who shot JR?

John Russell ("JR") has been a PACU nurse at Sinai for ten years. His hobbies include fixing broken things, gardening, cars, and cooking. (John: should be plenty of broken things to fix, not much gardening, no fancy cars, and not much cooking at HAH...bring your own food!)  John tells us that "I am looking forward to Haiti for the opportunity to work with a group of people who are there only to do what is right, not for money, fame or prestige."

John is an avid camper and hiker, and has already staked out his corner of the hospital roof to pitch his four-man tent, to be left behind as a gift for a homeless Haitian family.

The Three Musketeers (Les Zuckerbergs)

"You are not required to complete the task;

nevertheless, you are not exempt from beginning the work".

            "If I am only for myself, who am I?"

"The more charity you do, the more peace you will create"

                                                --Ethics of the Fathers

Gabe, Jeremy and Aaron Zuckerberg are honored to join Team Sinai's mission to Haiti.

Gabe, a Beth Tfiloh High School junior and Jeremy a University of Maryland sophmore have spent long hours working with children both in and out of the hospital setting, and are anxious to bring smiles and friendship to the patients in Port au Prince.

Papa Aaron is double boarded in Peds and Anesthesia. His day job is Pediatric Intensivist, but he dreams of being a professional cyclist. This photo of Aaron in Sponge Bob Land (his unit is a shrine to the Bikini Bottom group..) is taken from the article in 2009 Baltimore Magazine's "Best of...". Aaron was voted the Best Pediatric Anesthesiologist in Baltimore.

Plumpy'nut and Medika Mamba

In the simple yet eloquent words of Haitibones blogger traumaqueen, “Haiti is hungry. Very hungry”.  http://traumaqueen1.blogspot.com/2010/05/everyone-here-has-chest-pain.html

Most people in Haiti eat only one meal per day. Even the patients hospitalized in Hopital Adventiste d’Haiti (HAH) are given only one meal per day. Even if that meal is 500 calories, it is still inadequate nutrition to heal wounds, clear infections, and knit bones. Many returning volunteer docs and nurses we have contacted after their return from HAH confirm that malnutrition is a huge problem.

 A little research on the Internet, and we found “Plumpy Nut”, a Ready to Use Therapeutic Food (RUTF). That's NGO-speak for a food product especially designed and manufactured to treat hungry children in Africa suffering from moderate to severe malnutrition. Where to find Plumpy Nut? There's a great story by Anderson Cooper that explains the origins of Plumpy Nut and how its use in Niger and other African nations has made a huge dent in the need to hospitalize children with malnutrition.          http://www.cbsnews.com/stories/2007/10/19/60minutes/main3386661.shtml

Plumpy Nut is manufactured in Niger, Ethiopia, Malawi, Mozambique, and the DR of Congo. How are we supposed to get PN to bring with us to Haiti? A little more research and deeper drilling on the internet reveals that a new factory (Edesia.... http://www.edesiallc.org/index.html) recently opened in Providence, Rhode Island (and Plymouth Plantations) for manufacturing Plumpy Nut. Our daughter Danielle happens to be a grad student in Providence at the Rhode Island School of Design (RISD), and just finished her first year in the Interior Architecture Department. What an opportunity to kill three birds with one stone, so I flew up to Providence this week, had a back stage tour of Edesia (see photos of our Edesia tour), purchased 500 lbs of Plumpy Nut, threw the 15 cartons (34 lbs each) in the back of Danielle's Ford Escape, and drove back to Baltimore with Danielle, Matisse the cat, and 15 cartons of Plumpy Nut (each containing 150 sachets, 500 calories per sachet, 75,000 calories per carton). Now all we have to do is figure out how to distribute the 15 cartons into the checked bags of Team Sinai along with all the other gear and supplies we're bringing! More about Plumpy Nut and the Haitian factory in Cap Haitien producing Medika Mamba later...