Uplift Haiti Medical Report Petit-Trou-de-Nippes, Haiti March 10th-17th, 2012 written by: Vanessa Rigaud On March 10th, 2012 an Uplift Haiti medical team returned to the town of Petit-Trou-de-Nippes to provide medical support to the town's underserved residents. This effort proved to be an effective supplement to the medical trip that was conducted in April of last year, and again included a free 2-day clinic-the cornerstone and primary focus of the mission. We also lead an open question-and answer-forum to follow up with participants of last yearâ€™s First Aid and Emergency Response class and performed a de-worming session at a nursery. The team consisted of Lydie Alexandre, team leader and registered nurse, Claudine Emmett-secretary, and Vanessa Rigaud- occupational therapist and photojournalist, who flew into Haiti from the United States and joined Dr.Thony Guilluame-internist and hospital administrator from Les Cayes, Haiti and Maico Joseph, our translator from Port-au-Prince. The team was hosted by Father Renee, the town's priest, who also provided room and board. The clinic was held in Petit-Trou-de-Nippesâ€™ Cultural Center from March 12th through the 13th. The clinic was set up in 3 stations: Lydie took vitals at station one, Dr.Thony performed medical evaluations at station two while Vanessa and Claudine filled out medications as prescribed by Dr.Thony at station three. Maico then translated the doses to the patients in creole before they headed out. In total the medical team treated 105 people during the two-day period, 19 males and 86 females. At 30% the most common primary diagnosis treated was hypertension, which was consistent with last yearâ€™s findings. Hypertension is prevalent in this community due to the high sodium and animal fat consumption of the population, with several of the 50+ age group suffering from cerebrovascular disease. One of our most noted patients was a 67-year-old female who was assisted into the clinic having suffered a cerebrovascular accident, or CVA, several months ago with right sided hemiparesis. She never seeked medical assistance and walked with a significant limp. Her blood pressure upon assessment was 177/107 and she was prescribed intensive medication for hypertension. Such a case is not uncommon within this community. Unfortunately, a number of the residents of Petit-Trou-de-Nippes became nonambulatory as a result their CVAs, as we found during our home visits on March 14th. Two out of the seven of the home visits performed were of elderly residents who were suffering from the after-effects of unmanaged and dangerously high blood pressure. One patient was a 102-year-old woman that, upon arrival, we immediately noticed to have a facial droop and slurred speech. Upon taking her blood pressure, which was 220/11, it was necessary to perform caregiver education with her family members in necessary diet recommendations, compliance with her blood pressure medications, and the negative effects of taking her medications with alcohol, as was her routine. Another home visit patient was an aphasic 77-year-old male who was bound to a rocking chair due to right-sided hemiplegia. He presented with poor positioning of the his hemiplegic right upper extremity. The patient was given a shoulder sling to wear when out of bed to prevent further subluxation of the shoulder and decrease the edema of his right hand. Caregiver education with the family was again performed to prevent any further debilitation. The medications used to treat our hypertensive patients included azore and HCTZ and were extremely effective. Two success stories include a 69-year-old male whose blood pressure decreased from 247/144 on Monday to 198/114 on Tuesday, and a 65-year-old female whose blood pressure went down from 248/137 to 177/107 the next day. These significant changes in hypertension with the use of the afore- stated medications would have been impossible without the help of our donors and the assistance from CrossLink International. With their help we were able to ensure these medications were administered to those that were much in need, thus possibly preventing the fruition of a debilitating disease. The second most common disease diagnosed was malaria at 18% and gastritis at 14%. More than 50% of patients we treated had co-morbidities, with the most prevalent secondary diagnosis being gastritis at 34% and intestinal parasites at 10%. Medications used to treat gastritis included prilosec and zantac. Hydroxychloroquine sulfate tablets were effective for malaria. These medications were essential in relieving life threatening
symptoms for our patients and were again partially provided by CrossLink International, personal funds of the team members and our donors. Although we attempted to anticipate the needs of all the residents of Petit-Trou-de-Nippes, as expected there were several unforeseeable conditions that required treatment beyond our supplies. For these cases we relied on donated funds to purchase additional medications in Les Cayes, which amounted to $70 in total for 22 patients. This included an additional 19 prescriptions for malaria, five females requiring nystatin, a vaginal suppository, to treat their yeast infections; and 3 prescriptions for scabies. In addition to medications, Uplift Haiti paid for the sonograms and travel expenses in the amount of $60 for two women with suspected fibroids. They were sent to Port-au-Prince on Thursday for their sonograms, and were both positive for fibroids. One of them will require a hysterectomy in the future. One of the most beneficial aspects of returning to Petit-Trou-de-Nippes was the opportunity to follow up on special cases from the year prior. We are happy to relate that the 53year woman we treated last year for postmenopausal bleeding, which resulted in the removal of fibroids via a hysterectomy that was fully paid for by Uplift Haiti, has fully recovered and is feeling great, as she announced during our introduction at Sunday’s church service. Another success story is of an 80-year-old female we diagnosed last year with diabetes after we found her blood sugar to be dangerously high at 400 with complaints of vision disturbances. She was happy to announce that due to our assessments, prescriptions and recommended diet changes we saved her life, and her glucose levels significantly improved to a more stable 91. One of our most memorable patients from last year was Fanya, the now 15-year-old wheelchair bound girl with a congenital disorder who required handmade resting hand splints for her spastic upper extremities the year prior. Fanya and her mother were ecstatic to see us return with brand new, more durable, adjustable hand splints that will help prevent further contractures of her spastic arms. These splints have a breathable fabric and are much easier for her mother to apply. We were also happy to note a decrease in muscle tone in her upper and lower extremities, as her mother has been demonstrating good carryover with the passive range of motion program she was taught the year prior. On the morning of Wednesday, March 13th UpLift Haiti performed an open question-and-answer forum with 14 motivated students from last year's First Aid and Emergency Response medical course. These students were given the title of Health Care Ambassadors for the town, educating the community on the basic first aid and disease prevention techniques they were taught last year. They currently meet twice a month to review the information and discuss ongoing projects for their community. One of their most significant contributions was a cholera prevention project which included cleaning and restricting access to certain parts of the beach that was used by many as an outhouse. They are currently brainstorming ideas for ways they can have an even bigger role within their town. During the session Dr. Thony and Lydie instructed the group on basic hygiene principles to prevent conditions such as athlete’s foot and intestinal parasites, in which they will pass along to the community. After the question-and-answer forum team members Lydie, Maico and Vanessa went to visit two nurseries and performed a de-worming session for approximately 55 children from ages three to five. Many of these children are exposed to parasites due to unclean water and food. The drug used to treat the parasites was albendazole. Each child was given one chewable tablet which will help to prevent malnourishment or sickness that may lead to absences from school. Uplift Haiti has high hopes of returning to Petit-Trou-de-Nippes next year to follow up on our special cases, add or make modifications to medications as necessary, provide ongoing support and training to the community's young health care ambassadors, and of course to continue to medically screen the population and treat illnesses. We are relieved to share that although we were much fewer in staff, this trip was still a massive success. We helped to improve the quality of life for a number of Petit-Trou-de-Nippes’ residents and in many cases may have saved several lives. We owe an enormous thank you to our volunteers from the United States and Haiti, CrossLink International, and our financial supporters. With your help we were able to uplift the grateful and loving people of Petit-Trou-de-Nippes, Haiti and make a positive impact in so many of their lives.
From March 10th-17th, 2012 five Uplift Haiti volunteers provided medical services to the town of Petit-Trou-de-Nippes, Haiti