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Children’s in Haiti

Boston Children’s role in the Global Health Delivery Partnership

by Boston Children's Hospital staff on June 18, 2012

By Kim Wilson, MD, MPH, associate director of the Global Pediatrics Program.

For most children in the United States, seeing a pediatrician is an annual event. For other children, especially those with more complex problems, visits to pediatric subspecialists are common. But in many parts of the world seeing any type of doctor, pediatric specialist or not, is simply impossible.

Ever year eight million children die in developing nations where there are few or no doctors and nurses trained in pediatric care. What’s worse, many of these deaths are preventable. Public health initiatives that increase access to clean water and improve nutrition have done much to contain these numbers, but more needs to be done to provide quality health care to children all over the world.

As Paul Farmer, MD, founder of Partners in Health (PIH) and Chair of Global Health and Social Medicine at Harvard Medical School, recently stated, the clinical expertise we have at Boston Children’s Hospital can have a profound affect in achieving this goal. And I’m proud to say that our physicians and nurses have taken on this challenge, with global health activities happening in over 160 different sites, including ongoing programs in Haiti, Rwanda, Liberia, Ghana and Uganda. Full story »

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Reflecting on Haiti

by Boston Children's Hospital staff on January 22, 2012

By Dennis Rosen, MD

Photo: Dennis Rosen

This month marks the second anniversary of the January 2010 earthquake that devastated Port au Prince, killing more than a quarter million, injuring over 350,000, and leaving an estimated one million without shelter. Having gone there three times since then with groups from Children’s Hospital Boston to participate in the relief efforts, hardly a day goes by that I am not reminded of what I saw and lived during those weeks. Ranging from the truly horrible to inspiring and uplifting, many of the experiences were unlike any others I had had prior to setting foot in Haiti.

The first time I went was in May 2010 with a group that worked at the General Hospital along with Partners in Health. Conditions on the ground were utterly chaotic, and the disorganization made it difficult for foreign volunteers to work as we were accustomed to doing back home. This only added to our frustration at the discrepancy between the enormity of the challenges we faced and what we could (or could not do) to help. Many of those we cared for were suffering from the after-effects of injuries sustained in the earthquake, including chronic bone infections following amputations. A significant number of the children we saw were malnourished, their golden, frizzy hair and big bellies (often full of worms) helping us to make the diagnosis as soon as we saw them.

Others presented with routine medical and surgical problems which would have been straightforward in Boston but which were, in fact, very difficult to treat in Haiti because of the limited resources available and the lack of continuity of medical care. Perhaps the hardest of all was to repeatedly see children die from conditions and diseases which could have been prevented or treated back home, at little cost, and to be powerless to stop that from happening. On both the first and the second trips our teams cared for children who died from diphtheria. Previously widespread in the United States, it has not been reported here since 2003 thanks to widespread vaccination. However, diphtheria remains endemic in Haiti, and because most children do not have access to vaccinations, hundreds die from it there each year. Full story »

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Children’s Global Health: A return to Haiti

by Boston Children's Hospital staff on July 28, 2011

Michael Felber, RN, is a nurse at Children’s Hospital Boston. He spent two weeks as a medical volunteer in Haiti in March of 2010, in the aftermath of the earthquake that devastated the country. The following February he returned with a group of clinicians from the Global Surgery Program at Children’s, to work at a hospital founded by Partners In Health. While there he met a child who changed his understanding of the relationship between caregiver and patient. This is the second half of his story, for the first blog entry, click here.

Louveda's first day in Boston

It took two months to get Louveda to Boston. I communicated by phone and email with Sybill and David weekly. I was sure that it would eventually be possible to get her here, but I feared for her well being in the meantime. I work part-time at Shriners Burn Hospital, so I know of too many children who died waiting for their immigration paperwork to be processed.

 

I was working a night shift at Children’s Hospital Boston when Louveda finally arrived, accompanied by David. Jay, one of the nurses from the Children’s team, met her at the gate, brought her to the ambulance that would take her to Shriners Hospital. When I made my way to Shriners Hospital’s Acute Care Unit the next morning after my shift, I felt a wave of relief and gratitude when I saw her name on the board behind the nurse’s station.

She was frail but remarkably upbeat. It had been months since we had last seen each other, but she greeted me as if I had just stepped out for the afternoon, and told me she wanted to visit my house. She was clearly enjoying her new surroundings, but you could also sense her nervousness. She asked every new person she met if they were going to “take [her] skin.” She was still hugely protective of her wounds, and unsure of her new caregivers. Full story »

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Children’s Global Health: A return to Haiti

by Boston Children's Hospital staff on July 22, 2011

Michael Felber, RN, is a nurse at Children’s Hospital Boston. He spent two weeks as a medical volunteer in Haiti in March of 2010, in the aftermath of the earthquake that devastated the country. The following February he returned with a group of clinicians from the Global Surgery Program at Children’s, to work at a hospital founded by Partners In Health. While there he met a child who changed his understanding of the relationship between caregiver and patient.

Michael Felber and Louveda

In February of 2011 I spent a week working with a Children’s team in the village of Cange, in Haiti’s Central Plateau. The region has been served by Partners In Health and its Haitian sister organization Zanmi Lasante for over 25 years. Together they have built a hospital and a multitude of programs to improve health, education, agriculture and social services. Our goal was to collaborate with PIH and Zamni Lasante, in their development of surgical programs and medical education for Haiti.

Our first patient was Louveda, a sweet and articulate 12-year-old girl with severe burns on her thighs and abdomen from a kerosene lantern accident two months earlier. Both her parents had died in the past year so her 14-year-old sister, Anita, was her primary caretaker. (Since Louveda’s accident, the two girls lived at the hospital, sharing a single bed.) She was wrapped in wet, stained bandages. She tried to remain as still as possible because it hurt her to move. She said it was hard to rest because her bandages were hot and itchy.

With the help of the Haitian clinical staff we arranged for sedation in an operating room so we could change her dressings and assess and debride her wounds. We brought a stretcher to her bedside, and in a calm and mater of fact way she asked, “Am I dead?” It occurred to me that in the two months she had been in the main surgical ward of the hospital, an open room with about twenty other patients, she had seen others die and be removed on stretchers. And it was realistic to assume that she too would not survive her injuries. Despite it all she seemed calm. In the operating room she smiled and held my hand as she went to sleep.

While she slept we cut her bandages off with scissors. The smell and wounds were overwhelming. Her upper legs and stomach were covered with deep, angry red wounds. There was a pressure ulcer on her left ankle, nearly exposing bone. We washed her wounds and put her in a clean gown and fresh bandages. As the initial shock of her injuries wore off, we began thinking of a long-term plan for her.

The good news was she was medically stable, but that wouldn’t last. She was anemic and malnourished. (A common complication for burn patients because they tend to have greatly elevated nutritional needs.) Her body was compensating physically, but would not be able to do so indefinitely. Her breathing and pulse were too fast and her muscles and skin were wasting and breaking down. She needed nutritional support, blood, physical therapy and help for emotional trauma. And mostly she needed skin grafts to close her wounds. Her injuries were extensive but treatable, but not with the resources available in Cange at this time. Full story »

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Children’s doctors and nurses continue relief efforts in Haiti

by Boston Children's Hospital staff on December 15, 2010

It’s been almost a year since an earthquake ravaged the island of Haiti, leaving 300,000 dead and over a million people homeless. Since the disaster, clinicians from Children’s Hospital Boston have been traveling to the country to provide care. Recently, a team of nurses and physicians returned from Port au Prince, where they spent a week helping with relief efforts. Conditions were extremely difficult: on top of a rapidly spreading outbreak of cholera, hurricane Tomas hit the island a few hours before they arrived, increasing the workload of the Haitian medical staff, already working around the clock to provide care for the Haitian people. Patrica Lincoln, BSN, one of the Children’s staff members on the trip, shares her experiences.

Katie Wallace, FNP, with a patient in Haiti

On a dark morning in early November, four doctors and eight nurses from Children’s Hospital Boston left for Haiti to assist the healthcare workers at Hospital Bernard Mevs, in Port-au-Prince, as part of a continuing relief effort coordinated by Project Medishare.

All of us had traveled to Haiti before, some even had family on the island, but we all came back for the same reason: to work alongside and help the Haitian people who have displayed a remarkable inner strength and sense of faith since the devastating earthquake hit the country almost a year ago. Full story »

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Children’s staff return to Haiti

by Boston Children's Hospital staff on November 4, 2010

It’s been almost ten months since an earthquake ravaged the island of Haiti, leaving 300,000 dead and over a million people homeless. Since the disaster, clinicians from Children’s Hospital Boston have been traveling to the country to provide care.

May, 2010- A pediatric tent at the General Hospital in Port au Prince

This coming Saturday, another team of 8 nurses and 4 physicians will be traveling to Port au Prince to help with the relief efforts. Conditions there are extremely difficult: on top of the reports of a rapidly spreading outbreak of cholera, hurricane Tomas is forecast to tear through Haiti only a few hours before they arrive. This is likely to cause significant loss of life, render tens of thousands homeless once again, and lead to the further spread of infectious disease, including cholera.

Here, Dr. Rosen shares his thoughts on his impending trip to the embattled island nation and why aid to Haiti is more important now than ever.

This weekend, our team of 12 nurses and physicians will travel to Port au Prince, Haiti, one of the many medical relief teams which have gone to Haiti from Children’s Hospital Boston to help with the medical relief efforts since the earthquake of January 12, 2010.

We will be providing direct patient care in the pediatric inpatient and outpatient units of Bernard Mevs hospital, which is run in collaboration with Project Medishare and staffed by Haitian nurses and physicians and American volunteers. We will also be doing teaching, both formal and hands on, at Bernard Mevs and at the General Hospital (HUEH) to help improve the level of pediatric care given in Haiti. Full story »

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Jill Merna, Nancy Joseph, Carla Odiago worked the night shift in the adult ward taking care of over 80 adult patients.

Jill Merna, Nancy Joseph, Carla Odiago worked nights taking care of over 80 adult patients.

From April 10 to 18, Children’s Hospital Boston sent a group of 26 clinicians to a field hospital in Haiti. Here, those who staffed the adult ward reflect on their experience.

Nancy Joseph, RN, BSN, MSN, FNP-C; staff nurse in CHPCC

This was my internal cry after arriving our first day. I thought I was going to lose my composure when those two women came in on the back of a truck requiring emergency C-sections.

Ayiti Cherie….
Bel mon, Bel moun, Bel lang
! a je! Full story »

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The ER team: from left, Sarah Wingerter, MD, Stephen Monteiro, MS EMT-P, Sarita Chung, MD, Alexis Schmid, RN, Michelle Marini, RN.

The ER team: from left, Sarah Wingerter, MD, Stephen Monteiro, MS EMT-P, Sarita Chung, MD, Alexis Schmid, RN, Michelle Marini, RN.

From April 10 to 18, Children’s Hospital Boston sent a group of 26 clinicians to a field hospital in Haiti. Here, those who staffed the Emergency Department reflect on their experience.

Sarah Wingerter, MD, Division of Emergency Medicine

In retrospect it seems hard to believe we only spent 8 days in Haiti.  Each day was so intense and so replete with new experiences and powerful emotions.   I remain awestruck and humbled by the fortitude of the Haitians I met, both patients and Medishare staff members.  To know that they continue to work on putting their lives back together despite the unimaginable challenges they face has given me a new perspective on what used to seem like inconveniences in my own comfortable life.  I learned a great deal about patience, humility, and selflessness from patients and parents who waited hours in the sweltering heat—many after walking miles to reach the medical facility—for the opportunity to receive care for medical problems they had endured for months or even years. Full story »

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