Day 3: EMC in Haiti
We woke up early and packed our bags as planned then gathered for coffee before getting back on the bus.
We woke up early and packed our bags as planned then gathered for coffee before getting back on the bus. There was a National Holiday and some concern about demonstrations in Port au Prince where we planned to travel to later that night.
We started our day at Hôpital Universitaire de Mirebalais. This new teaching hospital, that opened earlier this year, is a beautiful piece of architecture. White walls decked with large, intricate ironwork medallions surround bright, airy, clean and organized hospital wards. Waiting areas are spacious and open with rows of church pews providing ample seating for patients and visitors. Large mosaic murals created by local artists flank lobbies and separate treatment areas for women’s and maternal health, pediatrics, emergency and medical patients. Adjacent gardens were landscaped to promote rest and healing. This hospital was designed, as every Partners in Health — Zanmi Lasante health center is, to respect patients’ time, privacy and ability to heal, with an eye towards efficiency and beauty, powered by solar energy.
One of our guests, Tomekia Strickland, MD an Ob-GYN, gave Grand Rounds at the hospital along with Dr. Christophe Milien, Director of Women’s Health. She presented on a study about post partum hemorrhage, the leading cause of maternal mortality in the world, followed by a demonstration on the use of uterine balloon tamponade for postpartum hemorrhage in resource-poor settings. They demonstrated that common catheter devices can be inserted into the uterus of a hemorrhaging mother and inflated to apply pressure to blood vessels and stimulate the natural release of prostaglandins to stop bleeding quickly. They’re cheap and easy to use in areas where other resources are unavailable or ineffective.
Dr. Strickland & Partner’s in Health Meredith and Dr. Millien demonstrate how to use a uterine tampenade
The tamponade can be constructed out of a regular condom or glove, medical tubing or a catheter, a string and some saline solution. Dr. Strickland pulled out all the supplies and put together a condom catheter, teaching the nurses and midwives in attendance how to “MacGyver” a proven lifesaver. It’s a testament to the staff’s dedication to learn new skills that even when Dr. Strickland unrolled the condoms and filled them with fluid to maximum capacity, nobody in the room cracked a joke. This was an audience who understood how deadly postpartum hemorrhage can be.
After Rounds, we toured the hospital noting the customized ultraviolet light-boxes (that kill bacteria) and circulating fans that reduce the spread of infectious diseases like tuberculosis. We checked out the radiation and oncology departments with the only CT scanner in the country. We visited the clean, bright labor and delivery unit, draped with curtains to provide privacy and equipped with oxygen and suction, equipment that’s unavailable in many other maternal health settings. The NICU had some of the only ventilators in Haiti, making Mirebalaisthe only hospital equipped to care for babies born prematurely or too sick to breathe. Outside the maternity wing, mothers napped in the patio or nursed their babies. It was a serene, clean hospital where any of us would be happy to receive care.
When our tour was over, we grabbed boxed lunches (chicken and rice, fried potatoes, macaroni and an onion sauce — delicious) and hopped back on the bus and back to Hinche, where we split into two groups. Group one toured St. Therese Hospital, which is operated by the Haitian Ministry of Health in partnership with Partner’s in Health. Midwives for Haitistudents and graduates have a strong presence at St. Therese, which we’re told has raised the standard of care for the entire hospital. Built in the 1920s, the wards are small, dark and overcrowded and electricity and light are intermittent. Some buildings are crumbling and have been condemned. Large shipping containers, which delivered much-needed post-earthquake supplies have been abandoned and take up much of the hospital grounds. A recent coat of green paint has spruced the hospital up a bit, but with few amenities or basic supplies and not enough staff to meet patient needs, there was no covering up the contrast between this neglected hospital and the hospital at Mirebalais.
Midwives for Haiti Founder, Nadene Brunk & Christy Turlington Burns with recently graduated midwife, Juslene
Several women were in active labor in the overflowing maternity ward. We were told that earlier, there weren’t enough beds for all the mothers who needed them. When a 15-year-old with eclampsia and seizures was admitted in labor, the only space available was the floor. Several hours later a visiting lactation nurse found the patient and her newborn baby lying on the ground several feet apart. The young mother was too ill to breastfeed him so the nurse held the baby to her breast for her. Without this support, it’s unclear what would have happened to that baby. St. Therese has no NICU or intensive care unit and very limited surgical capabilities. While this hospital provides much greater services than many others in Haiti, it’s a far cry from the quality needed to meet the community’s needs.
Group two visited a nearby orphanage for 57 girls ages 5 to 19. With no toys, games or sporting equipment to play with, we interacted through the universal language of iPhones. We played music, took pictures, shot videos and showed the girls photos of our families, homes, pets and friends. The girls were delighted with Rihanna, Beyonce and Jay Z, but disappointed that none of us could satisfy their Bieber fever. Most of the girls were eager to snuggle, chat, and be the center of attention, if only for the time it took to snap their picture.
Groups one and two swapped locations, giving everyone a chance to tour St. Therese and play with the girls, then back on the road headed for PAP.
On Tuesday AM, our group split in two again, with some returning to the United States. Several others visited the Caribbean Craft factory that manufactures papier-mache artwork for our board member, Christiane Lemieux’s company, DwellStudios. Magalie Dresse, the owner, took us through the factory production explaining the Haitian craft of paper mâché and how she’s made it a job-creating world-wide business for Haitian locals exporting to companies such as DwellStudios and West Elm.
Christy and Christiane Lemieux at Caribbean Craft
The rest of the group then went onto to Jacmel to visit the coastal artisan community and theCiné institute who we have been working with to create the Making of a Midwife film series, of which Part 1 and Part 2 are available to watch. The school recently opened their Audio Institute where they will now educate students in sound in addition to film production through the Film institute.
Ciné institute, Jacmel
