Haiti nursing experience
I thought that I knew all about transcultural nursing when I wrote about Yoshi- the young Hassidic Jewish patient we cared for and got through his bone marrow transplant.
I didn't think that caring for Haitians and the nurses would qualify for this writing post. I'll give it my best shot.
Last January I traveled to Haitii with 2 other nursing faculty to give the nurses an inservice- or what we call in the US "Continuing nursing education" (CEU's.) The nurses in Haitii do not have CEU's. They get through their education and have no other benefits to further their education. At my school of nursing, we thought- why can't we offer them continuing ed?
Barbara- put together a Power Point presentation on cardiac assessment. Mimi did one on maternal complications. I did mine on HIV/AIDS. A brief history- Haitii is the poorest country in the western hemishphere. If you are looking at data- worst in infancy mortality. Worst in HIV, Worst in poverty. Worst in life expectancy. Worst in income (average 300/year for one who is working.) Life expectancy is about 48 for men and 45 for women. Worst in incidence in TB. This is a country that is 90 minutes from our shores in FL and a universe away as far as means go.
We stayed on the grounds of Hopital Sacre Coure (Sacred Heart) and worked in this 68 bed hospital. This hospital is in Milou, about 12 miles from Cap Haitian. The 12 mile journey is over an hour by Land Rover due to the horrific roads. I quickly learned that there was no running water. No plumping for the clinics- though the hospital thanks to the sisters- had toilets.
Nurses out there- we had 1 sink for 68 patients. We had 1 sharps box for 68 patients. We had no running water to drink- so if you didn't bring your own water- you were thirsty. My colleagues and I went back to our "dorm" rooms for lunch and hydration. Up again after 2, back to the hospital. Our hosts made us lunch and provided us with drinking water. We spent the remaining evening giving care, providing inservices and just trying to "be there" for our Haitian nurses. They work much longer shifts then I ever do in the US. What was very different is that for the patients who made it to our hospital- their care givers had to provide food and water. Hopital Sacre Coure has no cafeteria. No water. That is the way it is in most 3rd world countries. The family/friends have to provide food and often bed clothes- though here we did have a laundry.
Food for the patients you wonder? Just outside of the "emergency room" is an out door market. Probably the only income for many- they make rice soup, fried plaintains, fried veggies of what ever they can find. To have a job is a luxury- and to provide food for the patients of our hospital is guaranteed job. Family members have to buy food AND water for their patients. We had no water to offer them. I could change dressings.... but could not offer the burn patient a sip of water. I was nearly passing out due to the severity of her burns. Gagging. She was moaning. All I could do was hold her good hand and help her to fall asleep without medication. Haunts me as she probably died from her horrific injuries.
I came back to our dorms each night tired but thankful. I ate a lot of rice. Took 1 skimpy shower in a week. Didn't wash my hair- had no water. Took care of a lot of suffering Haitians who were so grateful for all that we did.
Flew back to Ft. Lauderdale and was shell shocked at the waste.
Wish every nurse. Or American Teen could see the horrific conditions that exist just miles from our shores.
My practice today has changed and I try hard to educate my students about watching what we waste and are careless about.
Soap box? Off of for now...:bowingpur
oncnursemsn has '30' year(s) of experience and specializes in 'Education and oncology'. From 'Boston, MA'; Joined Dec '07; Posts: 231; Likes: 354.
Must Read Topics1Feb 12, '09 by Butterfly51At least they were thankful for the care you gave. Not like some here who do not appreciate the care we give. To be perfectly honest there are hospitals in places like FL and NY that are very third world, the nurses have to take out the garbage, pack boxes in supply room (personal experience) treated like nothing by management and patients alike. Management only highlight the negative, and never commend nurses for a job well done. Good job.0Feb 12, '09 by Chayo1989I hope to one day go to Haiti and have that experience. One of my aspirations growing up was to go to Haiti, Africa and Guatemala on a medical mission. I admire those that do that on a regular basis.
Who helped make those arrangements? One day i would still like to do that.3Feb 14, '09 by RubyRN,CHPNI was stranded in Haiti on 9/11 while on a medical mission. Too scared to fly home, never felt as safe anywhere in Western Hemisphere I have traveled as I did there. No TV's, no radios, no mass media. The people where grateful for our help and I met many wonderful people whom I still call friends. I returned home only to be on information overload to the point of physical illness because of media frenzy following not to mention the stress of a full time job. I know what you are talking about .1Feb 15, '09 by choosier2003I used to be in the military and I was one of the first guys off the boat when we finally went in and liberated haiti. It was the most horrible living conditions I had ever seen and that was back in 1995. that has been 14 years ago now and I really hope that conditions have improved, but by reading your article it sounds like there hasnt been a whole lot of progress towards restoring the country to the way it was before WE did that to them through our embargo. Anyway, I am an R.N. now and have always dreamed of going back there again to do some missionary work, please let me know if and when you go back , I would be very interested in going.4Feb 17, '09 by oncnursemsnQuestions about safety are certainly warranted, but we were in Northern Haiti, just 8 miles from Cap Haitian, a little "town" of Milou, pop 200,000. The only hospital for that number.... We were safe- not like in PAP (Port au Prince) the nation's capital and area of much unrest. Everyone probably remembers the food riots this past year that occurred there over the steep price of rice and wheat. The biggest problem with safety is having very wealthy sharing space and resources with the poorest of the poor. In Milou- everyone was poor. You'll find 4 star hotels in PAP, with armed guards and iron fences to keep the poor out. You'll find opulent meats and fruits, hidden from the beggars and children on the streets.
I never feared for my safety, and by the end of our time there, I wasn't even locking my room in the dorms we were using. My money, camera, etc was safe. The employees were so darned glad to have steady work they would never ever jeopardize their employment by bad behaviour.
Those who are interested- check out Crudem.org website. That's the organisation I traveled with- though it is a Catholic non-profit. At the end of every year, CRUDEM takes all the donations it receives from visitors and volunteers and divides it up evenly amongst all employees. If you are in the laundry or a doctor, you get an even portion. This is what allows these families to send their kids to school- costs of uniforms and books is borne by every family. It's why when you see them dressed for school, they look like they came out of a catalog- very proud. You'll never see a wrinkled or soiled uniform, and the girls' hair is usually decorated with many coordinated bows. We could learn from their standards in this country- some of the things my students wear make me blush. No, I'm not THAT old....1Feb 17, '09 by Elvish, BSN, RN GuideI share many of your sentiments, Jess. We stayed in Pignon, which is in North Central Haiti, about 30mi south of Cap. I remember people being worried about my safety as an American down there, but this was such a poor area, its inhabitants cared far more about where their next meal was coming from vs the nationality of their visitors. I felt absolutely no danger walking down the street alone at night. Can't say that for many places here!!1Feb 18, '09 by MemphisTigerThanks for sharing this. I taught high school in 2004 at a school in Port au Prince. It was an amazing experience, however due to the political unrest I had to leave before the end of the school year. Once I obtain my RN, I want to go back to Haiti and help in a medical clinic. Haiti is one of the major reasons I've decided to pursue my RN.3Feb 18, '09 by UtahTNCCRNi am glad to see this article. last march i went to haiti on a medical humanitarian mission with a group called healing hands for haiti. we were in port a prince for 15 days. this has become the most humbling experience in my 20+ years of nursing /er experience. extremely hot temperatures, minimal water and power and an abundance of files and bed bugs. i ran the clinic most of the days i was there and saw amazing patients. everything from simple jumper’s knee to severe hypertension, dislocated left elbow, hydrocephalus and adolescent seizure disorder. many of the patients would sit in the waiting room extremely quiet, in their sunday best clothes for 10-12 hours with their children waiting to see me. we visited most of the orphanages evaluated, treated and played with the children while there. voodoo is a predominate practice in this country for most things like problems between friends to medical treatment. any deformities or handicaps are seen as a curse. for this reason orphanages are abundant. i watched as the children were given a small bowl of rice with puréed beans poured in the center of the rice approx 20cc's. this would be one of their two meals per day of the same food. we visited the local hospitals one in particular hopital de canape-vert had two ambulance in front; all four tires were flat on each. as we were rounding we went into the newborn infant unit to look at the children. beds mad our of round steel had the white paint wore off form them from over use, a 3/4 inch pipe ran the distance of the room with an iv bag hanging from it. the bag was .9% ns with 20 meq of potassium in it. it ran down to the drip chamber where one through another 15 iv tubing sets were plugged into, all ran to different children. wide open no pumps, no cardiac monitors no nothing. this was the first time in my career i wanted to know where the **** is jcaho when you need them. i have pictures. as far as our safety, it was extremely unsettled; as the days passed while we were there i noticed the build up of haitian police and un forces with check points and automatic weapons abundant. we were grateful to have un advisors staying at our compound in the apartments that allowed the un security forces to be in the compound 24/7 as well as un helicopters over head etc. we left on march 31 (monday) and thursday the major offensive and riots started. they live in cinderblock houses approx 10x10 sheet metal roofs, material for a door. drink from the river that runs through port a prince that is grey, due to garbage being dumped in it , washing their clothes in it, cleaning food, bodily waste disposal and animals laying in it and doing. there is no health department here. the people of haiti are absolutely amazing. it is not how they survive it is that they survive and they are happy and loving. treating for worms, lice etc. would i do it again? in a heart beat!