Monday, February 15, 2010

Some people collect stamps...

Dear Family and Friends,

First, thank you all for the messages of support, care and concern for not only me but the team I was with. I would most especially like to thank you all for the thoughts and prayers for the people of Haiti. These will be needed for a long time to come. I am back safely on US soil…well US snow. I am ok.

Second, forgive any spelling or punctuation errors...blame it on fatigue.

I am only posting a few pictures.  I'm sure you all have seen enough on the news.  I am happy to share the pictures and videos I did take when I see you all in person. 

So how am I...the altered sense of reality is at times a little overwhelming but manageable. It is funny how things here at home, with no relation to Haiti, give me the feeling of being on the streets of Port-au-Prince. The most surprising of these things so far has been the snow. Baltimore, like most of the region was pounded while I was away (as you all know far better than I do) and there are very few places to put all of the excess from the roads and sidewalks. The mounds that are jutting into the small side streets that cause one car to pause and allow another car to pass first are much like the road conditions getting around PaP. Places to put the rubble from the fallen buildings are also in short supply down there and we often came to partially blocked roads full of vehicles trying to pass. It was jarring to feel transported back to Haiti by snow! That and the empty grocery store down the street from my house. Seriously, how could there not be one single onion left in the whole store?! What were people cooking this week?



As most of you also heard already, I did manage to contract Dengue Fever while I was down there. (Note to self: reapply bug spray several times a day) As the title of this post indicates…some people collect stamps…I seem to have a penchant for tropical diseases! We all need our hobbies I guess. But as with all things, it could have been much worse so I feel a bit lucky that it was just Dengue (the pic is me on the transport out trying to show Kristen G. how happy I was to be going home).



“So how was it?” is the question I have gotten from most people I have seen so far at work today. It is a fair and valid question, but there is no easy answer. Both better and worse than you could imagine is really the only thing I can say. People are living in makeshift tents, so our accommodations were the Plaza in comparison.


We stayed at what had been, and I’m sure will be again, an elementary school. The 82nd airborne as well as a group from the Navy (Go NAVY) had set up supply depots and were also camped on the grounds. The “girls” were upstairs in the 6th grade classroom and the “boys” were downstairs in first grade. When our team got larger, and the heat too much to bear, several camped outside. I already mentioned the showers in a previous post…so no need to revisit that! Especially since I once again have hot water and privacy :-).


Days started at 5 am (and 1 and 2 and 3 and 4 thanks to a very vocal rooster) …and lots to do all day long. My main role was to set up management, supply chain and fiscal structures to support our team. While challenging, they are now in place for the most part. The hardest thing for me I think was finding a way to make a use of myself at the hospital when the need was overwhelmingly clinical…so I passed out water to the patients and their families (it was a good 95 degrees) and emptied bed pans (hospital sanitation was a bit sketchy to say the least). The flies were untenable at times and the smell quite honestly, everywhere, was horrid. But I didn’t “hurl” once so I’m pretty happy about that. The teams from Maryland Shock Trauma and from here at IHV are amazing and I know that the work they did, and that the new team continues to do, is making a difference.  Below is a picture of me with Dr. Redfield, Dr. Scalea, Dr. Bucci and Cozanne at the hospital, one of the scrubs drying back at camp, a couple of the parts of the hospital that collapsed and one of the treatment tents set up outside the buildings where over 300 patients are seen each day.

 

  

  

  

 

The city looks as you might imagine, although the news did not capture the actual experience of being there. There is concrete dust everywhere, the leaves on the trees are white in most places and breathing can be a challenge when the cars and slight breeze stir it all up. In many places there are houses and buildings seemingly untouched while the one that had been between them is a pile of dust and concrete. The death toll is around 200,000 so far, and unfortunately there will be more…both from the catastrophic injuries sustained as well as the overwhelming potential for disease outbreak (cholera and typhoid being two of our primary concerns). I met a woman at the hospital that spoke no english but desribed to me her experience during the earthquake...the gist (which I got clearly) was that it was horrific, she is grateful to be alive, and I am grateful that I was not there.

I have even less affection for the media than I did before I left. The depictions of unrest and violence are a categorical misrepresentation of the reality on the ground, and a completely unfair picture of how the vast majority of the people of Haiti are soldiering on calmly and peacefully.

Of course, I saw things best left un-described…things a non-clinician would normally not encounter and that completely reaffirm the fact that it is probably best I did not pursue medicine as a career. Like my colleague Anthony described in his first dispatch after arriving stateside, the words “blunt crush injury” and “soft tissue damage” will stay with me forever.

Humor got us through for the most part. And the resiliency of the Haitian people. Street life has resumed and people are trying as best they can to go about their lives amid the rubble. Children laugh, people embrace, and the world continues to turn.  These kids had daily wheelchair races at the hospital. 



The feelings I have being home are a mix of gratitude and uselessness. Having been there and seen, I know what is going on day to day and how much work there is left to do. I am hoping to get healthy and rested and get back down to do whatever small part I can.  In the mean time, I am so thankful to be home and that I have a home to go to.

On the plane trip to the States from the DR, a woman that had been there as well asked one of my colleagues how you go back to your day to day life after being in Haiti and seeing the things we saw. While it brought a tear to my eye, the answer is…the people of Haiti have, so it is the least I can do.

Do what you can, with what you have, where you are – Theodore Roosevelt.

Here is a picture I took on the way to Haiti from the DR by bus...there is still a great deal of beauty there.



Thank you all again for being such an amazing source of support, strength and comfort in my life. I couldn’t do this work without you all to come home to!

Love, K.

Sunday, February 7, 2010

Still in Haiti but heading for R&R

So the good news is they are trying to get me out Wednesday to the DR and then stateside Thursday. The bad news is they are trying to get me out Wednesday and then stateside Thursday.

The work that has been done so far is amazing. The news reports of violence and unrest are completely unrepresentative of what is going on in the camps and the streets. These people just want help and they are waiting patiently for our logistic systems to catch up with their needs.

The hospital we are working with is up and running despite the fact that 1/3 of it fell during the earthquake. The parts of the compound that fell are still there, and the 100 people that perished (staff and patients) are still inside the rubble. Their colleagues have to walk past it each day. Yet the persevere.

It is not without challenges...so many are traumatized. Our staff still have no shelter and most are sleeping on the streets with their families. Yet again, they come to work everyday and are working 12 to 14 hour days by our sides.

The destruction is everywhere. Some buildings became complete dust while the ones on either side seem undamaged. It is hot, the days are long and hard, but what we endure is nothing compared to the people of this country that lost everything. Most that lost homes and family are trying to dig their homesteads out themselves' We often pass huge piles of rubble that used to be a home or a store and there are people with shovels and crowbars trying to clear their land, or retrieve the remains of their loved ones for a proper burial.

I passed a house yesterday that probably used to be a three story house...an old man (late 70's most likely) and his wife were sitting on top in lawn chairs, she was bringing him his coffee. This is Haiti.

Again, sorry for no pictures...but even when I am able to post, I have not been able to bring myself to photograph the misery of the worst scenes. The things I will post are the moderate. It just felt too invasive.

Bright point of today was the kids at the hospital having wheelchair races. A young boy that had his foot amputated and another with a broken ankle. They each have a sibling taking care of them at the hospital. I don't know where their parents are. The one boy's brother, without fail, wheels him over on time several times a day to get the dressings on his other wounds changed. These kids are no more than 9. They had me take their picture today. I will post that one when I get home.

Despite all of this, a great deal of daily life has returned to normal. The street vendors are out selling food and goods. People are everywhere and they soldier on. So the least we can do is the same.

Courage ma chere, as my friend Dianne told me today when I finally got to see her. We have to be strong right now.

See you all soon!

Thursday, February 4, 2010

Haiti...Safe and Sound

So I realized as I logged in that it has been almost exactly a year since my last post. First, I am safe and sound and doing fine.

I do not have my cord with me to download my photos. If I find a card reader I will try and add photos while I am still here but if not I will edit these posts once I'm stateside again.

The getting here was a bit of an adventure. I flew into the DR and stayed overnight. I then made my way into town and caught the Tera Bus across the border. (Sorry Mom, CRS doesn't drive into Haiti on Monday, but I was with several other folks from other organizations and CRS met me once I got to PaP) It was a lot like taking the Chinatown bus to New York. They even played a very strange movie, lots of American rap music and then local music from the DR. The border crossing was smooth going as far as the paper work goes, but there were tons of folks looking for something...anything really. I do have to say it seems to be the same at any border, but the desperation here was a bit more palpable than normal.

We are set up (24 of us, the surgical teams from Shock Trauma, Redfield, Amoroso, Talwani, Matt W. and I - Riedel comes tomorrow) at a school that has been "appropriated" for housing relief and aid workers. The US Army is also here, so we feel pretty safe.

We've got tents and lots of bed nets set up in the 6th grade classroom on the second floor. You would be surprised how comfortable a tile floor is after the days here.

Adapting quickly is easier than I thought. While I managed all my life to avoid communal showers...here there is no choice. Crisis Response International set up showers, 3 minute limit, cold...but feels so good at the end of the day and not too bad in the morning (if the water is working).

The work at the Hospital is amazing. Triage sees a good 250 patients a day, 20+ surgeries per day, outreach to the tent communities that have popped up. The local team and the Shock Trauma teams are rock starts.

14 of our team down here lost their homes. We are working to get them tents and cooking/hygiene kits. They still come to work everyday.

I cannot try and describe the day to day right now and for that I am sorry. The destruction is what you might imagine, actually a bit worse. But the world response is visible and people are getting help. This will be a very long process and effort...years not months.

I will try and write more as time allows. But know that I'm safe and working to get home as soon as I can.

Love,

k.

Wednesday, February 11, 2009

On my way to work today...

So, on my way to and from work this week there were many interesting things to look at. I thought I'd share the view! (bandwidth willing).



Ok, looks that that is it for the bandwidth tonight! The Zebra and 13 year old "temporary" bridge will have to wait!

Missing you all!

k.

Saturday, February 7, 2009

Back in Africa...

Dear Luci and M,

Howdy from Tanzania. So the trip back over was much better than the last trip home! It's a good 100+ degrees here for most of the day but it's a nice break from the cold back in B'more!

Even with a pretty packed work schedule it's been fun. The training I gave went really well. The games to teach health care quality improvement techniques went over a lot better than I had even hoped. Lots of smiles and laughs. I had folks work in teams to make the best paper airplane and improve it after each test flight. Most of them had never made a paper airplane before so needless to say there was a large variety of design! But they really got into it. When we had to change the flight path as design improved they were even doing things like having people hold the doors at the very far end of the room open! It was great.

Photos will have to come later. You won't want to miss the very serious airplane flying battle!!

Hope all is well in NYC and B'more!!

Love,

Kik

Wednesday, October 8, 2008

delayed but prudent...since I was dreaming of it!

ok, so Ethiopian Airlines is not in fact my favorite airline any longer. I wasn't going to mention it...but just woke up after vividly remembering the flight home...

so without graphic detail...how exactly do bugs, lots of bugs, ok...cockroaches (lots of them) get on a plane? (I know, luggage, but seriously?!) And how do I always (and yes I'm comfortable using the very overgeneralized always) end up next to the guy with raging TB? (just kidding Mom. It wasn't TB, and no I'm not coughing and my screen was negative...and the bugs weren't that bad. Actually Mom, forget everything you just read and remember I love what I do.) but really, bad cough...seemed really hot...thin...hello?!

So did I mention I was glad to be home, well at a minimum not on a plane on my way home?

Wednesday, September 17, 2008

Late breaker...

So Dr. Bola just sent me these pics of when he and Dr. Dotun (aka Dusty) came to visit me at my posters in Mexico. As soon as I get my new laptop I can return the favor and send them the pics of the two of them in front of their poster, yeah! So here are Bola and Dotun....and me in Mexico.

This is me and Bola



And this is Dotun and me (yes, he's tall).



So this is me with my suave Nigerian doctor buds. And no I didn't wear the same shirt all week Mom, this is all the same day when everyone had a chance to come by and visit.

Ok, back to Rwanda time and jet lag :).

Welcome to the US...

Dear Luci and M,

So I actually made it all the way inside the Embassy today. Last time I was here we made it to the security gate and ended up going into town for our meeting. I was supposed to give a presentation so I brought my lap top and the necessary USB to be told we couldn't bring any of it in. This time, I knew enough to send things in advance, but apparently the USB rule has been laxed a bit so I didn't have to send everything in advance after all. They have consolidated the US Government agencies into the new Embassy building here, USAID, CDC, State...

All that to say, we made it fully inside the walls today. There is a first set of walls, then you enter another building and go through security again. As we cleared the second level and walked through the courtyard one of the guys we were meeting said "welcome to the US". It was shockingly accurate. It feels entirely separate from the place we are actually in. A piece of US soil in the middle of Kigali. It was all constructed by US contractors. I wouldn't be surprised if the materials were sourced from the US too. It's an impressive structure, and there is a nice atrium area and coffee shop and official looking Marines around. I would not have been the least surprised has I encountered a McDonald's or a Starbucks.

For obvious reasons, there are no pictures. But just wanted you to know I was stateside for about an hour and half today and I didn't even have to change planes!

Cheers,

Kik

A hot shower beats a bucket any day!

Dear Luci and M,

While I have remained in a perpetual state of jet lag for the past several years a few fundamental truths are beginning to emerge:

1) No matter what your watch says it is in fact morning when the sun comes up, get used to it.

2) Sleeping on the plane doesn't really help.

3) Coffee is good.

4) A hot shower beats a bucket any day!!!!!

xo,

kik

Tuesday, September 16, 2008

For once my bag got here before I did!

Dear Luci and M,

Hello from Rwanda...again. Made it safe and sound. Ethiopian Airlines may be my new favorite carrier. The plane was old and I skipped the meals because they looked pretty, ummmmm, not pretty (but it's airplane food which is a lot like hospital food without the added bonus of a hospital stay). The upside? The plane was only about half full so I got an entire row to myself which means I got some sleep! And even though I had to transfer in Addis Ababa and in Entebbe (which made little sense since there is a direct flight from Addis to Kigali but I'm not complaining as all flights took off and most importantly landed!) my bag arrived. Ahead of me in fact. Apparently my bag was smarter than my itinerary and hopped the direct flight instead of the detour through Uganda. I might want to think about that next time.

Off to a running start, the work is going well and so far no goat on a stick! No pictures yet but will try and get some shots of the blooming jacaranda trees since it is coming into springtime here.

Hope all is well in B'more and NYC! Miss you both.

Kik