OMS Tour, Prenatal Checkup, Vaginal Exam, Epilepsy, & Optometry

Wednesday, June 18, 2008

This morning I went on a tour of the OMS International mission compounds around Vaudreuil with the new team plus Jen. First we went to see the clinic, which is right next to where I'm staying, then we drove a few minutes down the road to the new Radio 4VEH station (VEH stands for Voix Evangélique d'Haiti or Evangelical Voice of Haiti, and 4V is the radio station code for Haiti). The old station is located in the compound where we're staying, and Radio 4VEH has been running for the past 58 years or so.

Next we drove to the new seminary site. They are still building the place, and the new team is here to help out with that. Jen and I returned to the clinic while the team stayed at the construction site to work there.

Just to introduce the new people that came yesterday: Julie is an RN who was a missionary here 6 years ago. She brought a team with her, 4 of them are teenagers from her church, Tyler, Ali (Alison), Matt, and Jacob. Then there's Kelly (high school social studies teacher), Cindy (middle school technology advisor from Tennessee), and a couple from Alabama, Heather and Mike, who is a pastor. Christine (lab technician) and Jen (college student) came with this group as an addition to Tim's group. So they're helping out at the clinic lab.

Wednesdays are prenatal checkup days, so I shadowed Gavin while he consulted pregnant women. I learned how to measure fundus height and find fetal heartbeat with a handheld ultrasound machine. One lady who is 3-months pregnant was having vaginal bleeds, so Gavin checked to see if the cervix was open and assess risk of miscarriage. This was the first time I've ever seen a vaginal exam done. It seemed painful for the patient, and definitely wasn't a pleasant sight, but it's something that I'll need to be familiar with some day.

One of the pregnant women was HIV positive, so Gavin told me that HIV+ pregnant women can get ARV treatment at a hospital for free. Like I said in my last post, people who are HIV positive are referred to a hospital for ARV treatment when their conditions become too bad, and I found out that they also get ARV for free, but only when their condition is bad enough.

One of the non-pregnant patient we saw was a woman who's been epileptic since she was little. One time she had a seizure and broke her left humerus (bone of upper arm) at two places. A while ago she had a surgery to put a big nail along the center of her humerus, but the tip of the nail sticks out under the skin at her left shoulder. She's been on carbamazepine (my classmates should know what class of anticonvulsant this is) and hasn't had a seizure since. She can't speak but can make sounds with her voice, and she's very outgoing and expressive with her arms and face. (Now, where's the lesion?) She was brought here by her mother from far away as many people travel several hours to get here.

Gavin was done seeing patients a bit early today (we've been having less patients since Christmas time because less people have been able to afford to come here due to rising food prices), so I joined Carly and Anna at the optometry. They brought a bunch of frames and lenses from the States and have been making glasses for patients here. Usually they just ask questions like, "Do you have problem seeing far or near?" but sometimes the answers aren't just yes/no or far/near. Some people give complicated answers like, "When the sun is high or if I cover one eye, I can't see well." Even I have to ask them to repeat several times to understand what they are saying, so I'd imagine it'd be a lot harder for Carly and Anna who hasn't spent as much time in Haiti. Nonetheless they seem to be doing a great job... and I'm not saying that just because they're probably reading this.

After dinner, one of the missionary couple's daughter Kaeli, who is 8 years old, brought a deck of UNO, so a few of us played UNO with her. I hadn't played UNO in such a long time. I think I should play more card games with my friends in med school. After we sent Keyleigh to bed, we played what my friends call Hillari-picto-pass, which is basically a chinese telephone with pictionary but you alternate between drawing and writing caption. As usual, it was a fun game.

Shadowing, HIV, & Breast Exam

Tuesday, June 17, 8:40PM, 2008

I started "working" at the clinic yesterday, and I say "working" because it's what we say, but I'm really just shadowing doctors for now. Yesterday morning I shadowed Dr. Rodney, a Haitian doctor who studied medicine in Dominican Republic. I could understand most of what was going on while he talked with the patients, but Rodney kindly explained things to me in English. He seems like a really nice guy.

In the afternoon, Gavin (Irish doctor) asked Laura (Irish med student) and me to do some computer work. We compiled all the drug records from mobile clinics to see how much of each drug was dispensed in the past year. We didn't think it would take very long because we thought we just had to punch in numbers, but it turned out to be quite time consuming because sometimes we had hard time figuring out the handwritings. No wonder why pharmacists take so long to fill prescriptions... just kidding. But yeah, we felt how hard it must be for pharmacists who have to decode prescriptions everyday. That took us the entire afternoon. The data we complied should prove useful since we'll be doing another mobile clinic this month.

After dinner, Amy (Canadian RN) and Julie (Irish physical therapist) invited us (the short term team and me) to their place to watch a movie. I didn't think I'd get to watch many movies here, so it was a treat. We watched the new Pink Panther with Steve Martin. Not a great movie, but I liked the silly humor that made no sense. "I would like to buy a hamb&@#$er." That was pretty funny.

Today, I got to shadow Dr. Gary (Haitian doctor who studied medicine in P-au-P). He was also very nice and tried to explain almost everything to me. He didn't speak much English, so he spoke to me in Creole most of the time, which was a great practice for me. He specializes in HIV patients, so I got to see a number of them. Before we saw patients, the patients had a HIV support group, so I listened in with the group for a while. I could only understand about half of what they said, but it was interesting nonetheless.

In the morning we see most of the patients, then we get lab results in the afternoon, so we see the patients again then. So many patients stay here pretty much the whole day because they have to do labs. What surprised me was that many of them had multiple infections. Most of them, even non-HIV patients, had two or more of bacterial or fungal infections, e.g. combination of malaria, H. pylori, and/or syphilis.

The first HIV patient we saw was a 26-year-old woman. Dr. Gary had stepped out for a minute, so I decided to talk with her. First thing she told me was that she had just lost her 5-month-old baby, probably from complications due to HIV. She said it so plainly that I didn't know how to react. I wonder if things like this happen so often that they don't make a big deal of them, or if she's just coping well. She almost seemed apathetic about the whole situation. It was difficult for me to understand what was going on in her mind.

One of the non-HIV patient was complaining that she had pain in her breasts, so Dr. Gary taught me how to do a breast exam. I guess I wasn't too surprised that my first breast exam would be here in Haiti. We didn't find anything. Physical exams are much more direct here. We don't use the gowns here that we use in the US. The patients just take off their shirt and bra without hesitation. It makes things a lot easier. I think the gowns make things even more awkward.

While Dr. Gary was taking a break for a bit, I sat in with Laura in Gavin's office. It was a lot easier to understand what was going on because Gavin spoke a lot slower than the Haitian doctors. Although, I'm not sure if the Irish accent is helping or not (jk). One old lady had a stoke a while back, and she had right hemiparesis (Hey class, where is the lesion?). We didn't do a neurological exam, so I didn't get to find out where exactly the lesion was, but it was fun thinking about it in my head... probably somewhere between medulla and primary motor cortex. I can't believe I'm missing Basic Neurology from spring quarter already. It was a fun class.

The last patient we saw today had just been tested positive for HIV today, so Dr. Gary talked through things with her. He assured to her that this wasn't the end of her life, and that we're here to support her. She seemed to be taking things pretty well, but I can't even imagine what it would be like finding out that I have HIV... Perhaps it wouldn't be so devastating if I had access to antiretrovirals and could keep things under control, but in Haiti... At our clinic we don't have ARV, so we give them palliative care until their condition gets too bad or AIDS become fully manifest. At that time we would send them to a hospital where they could get treated with ARV, although I don't know what that would cost them.

Another group of short term mission team arrived here this afternoon along with couple of former long term missionaries and girl named Jen who is joining the current medical team for their last two weeks. The new group will be doing some construction work for 10 days or so, but I haven't heard much about them yet, and I can only remember a few of their names (Jacob, Tyler, Ali, Matt...) so I'll talk about them more later as I find out. Tomorrow morning I'll be going on a tour with them to see some of OMS International's mission sites (Radio 4VEH, seminary, etc.), so I'm sure I'll get to know them soon.

Arrival

Sunday, June 15, 10:00PM, Haiti Time

Layover at Miami couldn't be easier. The gate I got off and the gate I got on where only about 30 yards apart, and I arrived a few minutes before boarding time, so everything happened as planned.

When I arrived at Port-au-Prince, a cab driver called Nadar was supposed to meet me and take me to the domestic flight terminal. I was to hold up a sign that says "OMS" and he would know that it's me. Everything went as planned... except that Nadar didn't show up.

So I had to talk to a random chauffeur who told me he knows Nadar, but he usually doesn't work on Sundays because he goes to church. I borrowed his phone to call Gavin (the Irish doctor with whom I'll be working), and Gavin told me that Nadar had called to let him know that he won't be able to make it. Great. So I just went with the random chauffeur to the domestic flight terminal. The ride took about 15 minutes, and I arrived at the terminal around 8:45AM.

Nadar was also supposed to have reserved a ticket to Cap-Haitien for me, but since he never showed up, I didn't have a reservation. Incidentally, I ran into two missionaries from OMS Cap-Haitien who were visiting P-au-P and flying back today. They were hoping to get a ride on the 9:00AM flight. Since I didn't have a reservation, the ticket lady said the earliest available flight is 1:30PM... Well, what else could I do? So I just said I'll take the earliest flight. Then just as she was making the ticket for me they opened up a spot on the 9:00AM flight, so I got on 5 minutes before it took off.

The two missionaries I met at P-au-P who were on the plane with me were Amy and Julie. Amy is an RN from Canada, and Julie is a physiotherapist (physical therapist in US English) from Ireland. So I'll be working with them as well. It was really nice to meet them at the airport since I was getting nervous about the fact that Nadar didn't show up.

Gavin met all of us at the airport. He had come to pick me up, but he didn't know Amy and Julie were coming as well. Anyhow we all got a ride to the OMS compound together, everything turned out to work really well.

After lunch I took a nap and had dinner with some of short-term missionary team members. They are medical volunteers from all over the US, mostly college aged. Among them were Tim (lab professor and leader of the group), Christina (sp? Tim's daughter), Mary (lab technician) Anna and her sister Carly, Beth, Emily, We were also joined by Junius (a Haitian-American doctor who is staying in the same building as Tim and I) and Laura (med student from Ireland). It was a lot of fun talking with them, and it was a very relaxing evening. I'll talk more about them later since it's getting late.

I don't have access to internet right now, so I'll probably post this tomorrow, hopefully. I'm pretty impressed that they have electricity for most of the day. It went out just as I started writing this entry, but it seems like I won't have to worry much about keeping my laptop charged.

Thank God for a day of safe travel!

In the Air

Sunday, June 15, 2:30AM (EDT, Miami)

I'm writing this on my way to Miami, hoping that I could post it just before I have to board the plane... but we're scheduled to land only 5 minutes before the boarding time of my next flight, and the plane leaves an hour after that, so I'm not sure if I'll be able to.

Anyhow, once I'm in Haiti, I may not have much chance to blog or send out newsletters as much as I hope to since apparently the internet access is very limited there. I guess I'll have to go and find out.

It's a strange feeling to be going back to Haiti. Going the first time was really exciting because I didn't know what to expect, but this time I keep thinking about my previous trip, what it was like, and what I learned. Random Creole phrases keep popping into my mind. I hope I'll get to use a lot of Creole again. Hmm, the dialect is probably different since it's northern Haiti this time. I'll have to adjust to that.

I should get some rest. I arrive at Port-au-Prince at 7:55AM Haiti time, then I take another flight to Cap-Haïtien. I have long day ahead of me. I'm stoked.

I want to sleep, but my seat is broken such that it doesn't recline back... ahh, my back.

Thank You!

Thank you everyone who sent in donations to support my trip to Haiti this summer! Thanks to you, I've now raised all the funds needed for the trip! It really means a lot to me that so many people have contributed. It's not just about my going to Haiti and volunteering, but now it's about all of you partnering together to help people in Haiti. Not only that, you are also investing in my life and career, as I aspire to serve in developing countries as a physician. The fact that you are supporting me will keep me humble hearted and motivated to do my best in whatever tasks I may be given, however menial or challenging they may seem. So once again, THANK YOU!

Any extra donations I receive beyond the goal of $2550 will be used to help people in Haiti in some form or another and not for personal benefit. I bet you would have guessed that, but just in case you were wondering. =)

Reintroduction

Hi there!

For those of you who may not know me, my name is SunMin, and I am a medical student at University of California, San Diego (UCSD).

This summer I am traveling to Haiti, from June 14^th to August 9^th, to volunteer at a clinic called Bethesda Medical Clinic (BMC). BMC is located in a small village called Vaudreuil, just outside Cap-Haïtien, which is on the northern coast of Haiti (Google Map). The organization that I am going through is called OMS International, which also runs Raido 4VEH in the same area. I learned Creole while spending 4 months in Haiti last year, so I am very excited about the opportunity to go back to Haiti this summer.

I don't know exactly what I'll be doing at the clinic yet, but BMC is one of the top-rated clinics in northern Haiti, sees about 150-200 patients per day, five days a week, and has in-patient care. So I imagine I'll be pretty busy at BMC this summer, and there's no doubt that it will be a challenging and rewarding experience!

I am confident that my time in Haiti this summer will be an invaluable learning experience since my career goal as a physician is to serve rural communities in impoverished countries. My previous travels to Sierra Leone, Kenya, and Haiti have stirred in my heart a passion for the medically underserved in poverty-stricken parts of the world. My experience in Haiti this summer will allow me to further improve skills that are necessary to serve effectively as a doctor.

To finance this 8-week project, I must raise $2550 which covers the costs of airfare to, from, and within Haiti, room and board, and travel insurance. Will you consider partnering with me by supporting me financially or by prayer? Any amount of contribution will be greatly appreciated.

Please feel free to subscribe to this blog as I will be posting updates during my trip.

Sincerely,
SunMin Kim

To donate, please click the button below.

Fundraiser Progress

As of Sunday, June 15, 10:00PM
Contributions:
$580 (Surplus from previous Haiti trip)
$200 x 3
$100 x 8
$50 x 10
$30 x 2
$25 x 1
$20 x 8

Total: $2725 (100+%)
Goal: $2550
Unmet Need: $0

To donate, please click the button below.