Safety Nurse in Haiti: A Medical Mission Trip - Origin Story Pt. 2

[SafetyNurse1968, ADN, BSN, MSN, PhD]

A magnitude 7.0M earthquake¹ rocked Haiti in January of 2010, when our daughter Riley was only a few months old. A 7.0 is big. By January 24, 52 aftershocks measuring 4.5 or greater were recorded. Haiti is a country with high national debt, poor housing conditions and a high level of poverty, so the death toll was high; somewhere between 100,000 and 316,000 people died. Conditions and politics in Haiti made it difficult to settle on a final number of fatalities.

When the earthquake hit Haiti, I had been a nurse almost 4 years. During that time I had worked in oncology, cancer research, and integrative health, and I was getting my MSN, but I never lost sight of my original reason for entering the field of nursing. I wanted to get my hands dirty, helping people. As my husband and I watched the news and saw the horrifying effects of the earthquake, I thought to myself, I have to go there - this is why I became a nurse. I asked around about medical mission work in Haiti and discovered a local group called Mission Manna (which later became Consider Haiti²).

One of the reasons I wanted to go with a local group was because I had heard so many bad things about large national groups. News reports³ suggested that many of our donation dollars were not getting into the hands of those who needed it the most. Mismanagement of funds and politics often get in the way of good intentions, and I wanted to do the most good with the small resources I had to offer. Consider Haiti (CH) utilizes 95% of all donations in Haiti. The group directly funds local, Haitian workers to lead relief efforts. CH has worked for 15 years to empower a small group of communities to be self-sustaining, running programs in Montrouis, Fon Baptist and Ivoire, including community health; sustainable nutrition, clean water and medical care programs.

Consider Haiti runs two, weeklong medical clinics for Haitian children each year. One trip goes in the fall and one in the Spring. More than a thousand children are seen during each trip, and the pediatric clinics are often the only healthcare the children receive each year. Services include food, nutritional supplements, growth checks (height & weight as well as head and arm circumference measurements), deworming, vitamins and education.

All volunteers pay their own way, so I started a website/fundraiser to pay for my plane ticket, and requested the time off of work. Preparation for the trip involved visiting the local community health department for immunizations⁴. I got a Typhoid immunization, and updated my Tdap. The risk for contracting Malaria in Haiti is moderate. Malaria prevention consists of a combination of mosquito avoidance and chemoprophylaxis. I purchased some insect repellent with lots of DEET, and decided to do the Atovaquonone-proguanil⁵ chemoprophylaxis. You start taking this drug 1-2 days before travel, take it daily at the same time each day and daily for 7 days after leaving the area. It is well tolerated, and side effects are rare. I also got a prescription for Cipro to take with me in case I accidentally drank contaminated water and got traveler's diarrhea.

We met a few times before our departure date. Many individuals and healthcare companies donated medicines and medical supplies, and we had to go through all the supplies and do an inventory. We took expired medications (I can write a whole article on that since studies have shown meds don't actually expire⁶). The main medications we took were skin related - every topical ointment you can possibly imagine from triple antibiotic ointment, to Vaseline to hydrocortisone, to Tinactin. We also took huge bottles of Ivermectin for deworming. Hypertensives and antibiotics were also in high demand. We had dandruff shampoo and moisturizer as well. We also had to bring scales for weighing, wound care supplies, basic pediatric rehydration supplies (IV kits, tubing, bags of fluid), oral rehydration, and empty pill bottles and ziplock bags for handing out prescriptions. Gloves, wipes, alcohol prep pads, a few injectables all had to go.

I got a book of Haitian medical phrases and started practicing. I heard over and over again to not bring candy or toys for the children - "it's fun, but you will run out", and to instead bring deflated soccer balls and an air pump, and lots of American dollars. Infusing the economy of Haiti with our money by purchasing goods and services is the best gift we can give. I packed a lot of small bills in preparation for the arts and craft sales I was told would go on daily outside our compound.

We'd be staying at a resort - kind of embarrassing, but the only place at the time that was safe for white people to stay in the area. I packed modest t-shirts and shorts, as well as a few skorts, being warned to not wear revealing or tight clothing. I also brought my computer so I could write – we were told there was internet at the resort. My plan was to post on facebook daily for my family and financial supporters. Essential items included a sleeping bag and pad, a headlamp, a box of gloves, a hat, sunscreen, water bottle and good walking shoes. Not much else was needed. I also brought my running shoes. The founder of Consider Haiti was going with us and she assured me that we could go for a run, if I didn't mind being stared at like I was insane. I have never minded, and it happens all the time here, so why would it be any different in another country?

We were all told to bring an extra, empty suitcase to take meds and supplies. We were also told not to declare anything, and to not make a big deal out of being a medical mission. There was always the possibility that everything we were bringing would be confiscated at the airport, though with bribes to the right people, we should sale through customs. The group consisted of 12 people: 3 doctors, 2 Nurse practitioners, 2 people who were not in healthcare, the founder of consider Haiti (who is married to a Haitian and speaks perfect Creole), and 4 nurses. I was rooming with another nurse who had never been, but almost everyone else had been on multiple trips.

I was interested to see what the country looked like from the air and was sad to see the deforestation I had read about confirmed from above. As we landed I could see the airport itself had suffered in the earthquake - I saw pile after pile of rubble, where buildings had once stood, and so many people missing limbs from the crushing injuries so common in a quake. I didn't see a single building over 3 stories tall, with most being one story. There was row after row of homes thrown together from aluminum siding, concrete, boards and tarps. The water source ran in a ditch by the road. The air was thick and full of smoke, graffiti was everywhere, the roads and streets were choked with motos, buses, tap taps, bicycles, horses, donkeys, dogs, people, pigs, goats, chickens and trash. People were everywhere, carrying baskets on their heads, dancing, talking, trading, fixing things. Food vendors sold unidentifiable meats, fruits, grains, candy, soda pop. It was overwhelming.

Even though we were at a resort, we were instructed to NOT DRINK THE WATER, including ICE. Many people do well with this until they get in the shower. We are so used to opening our mouths in the shower, but a good trick I used was to wet my toothbrush with bottle water, and brush before getting in the shower - holding the toothpaste in my mouth while showering ensured I didn't take too long of a shower and didn't open my mouth in there either! Guards with machine guns stood at the entrance (a necessary precaution I was told). We were told it was fine to leave, but best to go in groups. The guards were to keep people out, not vice versa.

The first day hundreds of families were already waiting for us. We set up a few tables, and had our Doctors and NPs sit at tables with translators. The first day I worked at the deworming station. We crushed mixed the Ivermectin with a pudding called la bouie, which was made by the host community. The dose was scooped into a small plastic cup and each child was brought to us. We exhorted each child to mange, mange la bouie (eat, eat the pudding!). They would look up at us with wide eyes and open their little mouths for a bite of pudding. Other stations included weights and measures (each child had a card to show growth from the previous visit), followed by a visit to the doctor's table, prescriptions and treatment if needed and nutritional supplements if the family was in that particular program. We saw several "Kwash" babies - children with protein malnourishment called Kwashiorker⁷. In these children, the visible manifestations included orange hair and skin, and swollen bellies. I overheard the nurses commenting that there were fewer "Kwash" babies this year than last year.

Subsequent days found me doing weights and measures, working the prescription table, and handing out supplements. I was interested to learn the most common maladies included high blood pressures, high blood sugar, malnourishment, and "female" problems. So many women came to us with venereal disease or UTIs due to the lack of education about prevention, and no access to condoms or running water.

Here is a quote from one of my journal entries to sum up the experience:

Quote

An older woman came in today with a 19-month-old child (Riley's age) the little girl was very quiet and thin. For some reason M__ asked this woman what her story was - after the earthquake, her house burned down and she lost her family - she was wandering around when she heard a baby crying. This little girl was lying in the grass with a huge, infected abscess on her leg. Her parents had abandoned her because they thought she would not live. This woman took her in and nursed her back to health. They have nothing; nowhere to live, and nothing to eat. The woman said she took the little girl in because that is what Jesus would do. At this point we were all sobbing. I am crying now. We all snuck money into the woman's purse and told her she was a good mama. She said she and the little girl love each other, and that is all that matters.

I want to encourage anyone reading this to go on a medical mission trip. At a minimum, please consider getting involved. At the end of the day it's purely selfish you end up feeling good about yourself, and about the work you are doing- it changes you. You become a better person. The help one American dollar can give in a country like Haiti is astounding. I am sending a lovely young Hatian woman to nursing school, and you can read all about that in part 3.

Read The Complete Story

https://allnurses.com/the-origin-story-safety-nurse-t666381/

https://allnurses.com/safety-nurse-haiti-a-medical-t668116/

https://allnurses.com/healing-machete-wounds-safety-nurse-t670331/

References

¹21 Haiti earthquake - Wikipedia
2 Consider Haiti
3 Investigation Of American Red Cross Finances Finds 'Fundamental Concerns' : NPR
4 Health Information for Travelers to Haiti - Traveler view | Travelers' Health | CDC
5 Malaria - Chapter 3 - 218 Yellow Book | Travelers' Health | CDC
6 Drug Expiration Dates - Do They Mean Anything? - Harvard Health
7 Kwashiorkor - Wikipedi

[lolotambu]

I'm very happy and grateful that you posted this article. I already reached out to the organization. One of the reasons why I decided to change careers and pursue nursing is because I wish to deliver more impact than in my current profession. One such way is through medical missions. Thanks again and I'm sending many blessings your way!

[chipper_RN]

I've been reading posts on AN for a while, but this post made me finally create an account! I am a first year nurse who is got into nursing specifically to become a missionary nurse. My goal is to work long-term as a nurse abroad in orphan care, but I'm not sure what the process to get there will look like. SafetyNurse (or anyone else, really), if you have any resources or thoughts, I'd love to hear them! I'll hopefully be going to Haiti this summer to meet with some missionaries and see if having a nurse at the mission would be helpful for them. Right now I'm in med-surg/oncology/hospice and I'm going to start volunteering at a clinic to get some ambulatory care experience and hopefully experience with pedi patients. Any other areas I should get experience in before I go?

[silverbat]

While I think medical trips to other countries is a good service, there are places in the US that are in as desperate a need. Come with me to the Navajo Reservation. ( other Native American reservations also). No heat other than wood, no water except what can be trucked in, minimal food, inadequate medical care and housing.

[Nurse Tasha]

Hi! Can you inform me of the medical mission groups? I would love to attend!

[lolotambu]

There's so many organizations. You just need to do a quick google search and find the one that fits you the best.

[SafetyNurse1968, ADN, BSN, MSN, PhD]

I've been reading posts on AN for a while, but this post made me finally create an account! I am a first year nurse who is got into nursing specifically to become a missionary nurse. My goal is to work long-term as a nurse abroad in orphan care, but I'm not sure what the process to get there will look like. SafetyNurse (or anyone else, really), if you have any resources or thoughts, I'd love to hear them! I'll hopefully be going to Haiti this summer to meet with some missionaries and see if having a nurse at the mission would be helpful for them. Right now I'm in med-surg/oncology/hospice and I'm going to start volunteering at a clinic to get some ambulatory care experience and hopefully experience with pedi patients. Any other areas I should get experience in before I go?

Wound care would be extremely helpful. Just showing up and advocating for the people of Haiti is the most important step. You will make connections when you go this summer that will serve your goals. There is no end of opportunities for what you want to do. keep in touch after your visit this summer and let me know what you find out. If you do need contacts, I recommend simply reaching out to the folks at Consider Haiti - they will put you in touch with who needs you most.

[SafetyNurse1968, ADN, BSN, MSN, PhD]

While I think medical trips to other countries is a good service, there are places in the US that are in as desperate a need. Come with me to the Navajo Reservation. ( other Native American reservations also). No heat other than wood, no water except what can be trucked in, minimal food, inadequate medical care and housing.

You are so right, silverbat. I lived on the Rosebud Sioux reservation my junior and senior year of HS in 85-86. The poverty I saw there is on par with what I saw in Haiti. What makes it even more unbelievable is that it is happening RIGHT HERE in our country. I think it is important to go where you are called. I am called to Haiti. THANK YOU for being called to help the Navajo. Do what feeds your soul, and do the most good you can with the time you have. That's all I've got in the way of advice.

[SafetyNurse1968, ADN, BSN, MSN, PhD]

Hi! Can you inform me of the medical mission groups? I would love to attend!

Nurse Tasha: If you type "how to get involved with a medical mission trip" into the search bar of your google search engine, you will get many great ideas. Doctors without borders (you don't have to be a doctor!) or Samaritans Purse are great places to start.

[chipper_RN]

While I think medical trips to other countries is a good service, there are places in the US that are in as desperate a need. Come with me to the Navajo Reservation. ( other Native American reservations also). No heat other than wood, no water except what can be trucked in, minimal food, inadequate medical care and housing.

Silverbat, that's true, and one of the things I love most about nursing (and life) is that it doesn't need to be an either/or situation. I have a nurse friend who is very passionate about serving the Native American population and I applaud her for that. I feel called to serve in a different area at this time, but I'm so grateful that we as nursing professionals can come together to help ALL populations in need.