Haiti is the poorest country in the Western Hemisphere and one of the poorest in the world. It is about the size of our state of Maryland and has a population of 11 million. Hospital Pierre Payen is located two hours northwest of the capital city of Port-au-Prince and 10 miles south of St. Marc. The main highway which passes through Haiti (two-lane asphalt) is between the regular medical clinic / guesthouse and the hospital. Throughout the year a team of excellent Haitian physicians handles the medical needs of patients including deliveries at the medical clinic and in a small inpatient unit adjacent to the clinic. They do not have surgeons on full time staff and therefore rely on several visiting surgical teams from the United States. There are approximately 5-6 such surgical visits every year.
After 13 hours of travel, the Operation Medical surgical team of 18 arrived at Hospital Pierre Pyen’s (HPP) guesthouse where our Haitian cooks had a wonderful meal ready to serve. This was the seventh trip that this group is made to HPP since the earthquake of 2010. It was our third trip on behalf of Operation Medical. The first four were sponsored by the Carlisle Presbytery.
Participants on this trip included the following:
Dr. Scott Barnes, Internal Medicine
Dr. Lou Boxer, Anesthesiology
Linda Brindle, RN
Dr. Morgan Callahan, General Surgery
Christi Catalano, CRNA
Dr. Joe Cincotta, Internal Medicine
Dr. Philip Eck, Anesthesiology
Mirjam Evers, Photographer
Charmaine Garner, RN
Chip Goodhart, CRNA
Carolyn Holencik, CRNA
Mary Jensik, CPA, Operation Medical Board Member
Dr. John Judson, Team leader
Dr. Emerson (Butch) Knight, Urologist
Daniel Lynch, Surgical Technician
Dr. Kyle Packer, General Surgeon
Dr. John Reidell, General Surgeon
Patty Reidell, RN
Nancy Schaeffer, RN
This was a wonderful team. Many were strangers when we boarded our flights but quickly bonded to become a very effective, compassionate, and mutually supporting medical team. This was the first time that we had doctors trained in internal medicine to manage our clinic. It represented a tremendous upgrade. Dr. Scott Barnes and Dr. Joe Cincotta did a fantastic job with the help of Nancy Schaeffer and Carolyn Holencik who managed patient flow and registered patients before being seen by the physicians. Carolyn also assisted in the Operating Room during the second week. I believe that internal medicine should be included on all such missions. A total of 250 patients were seen in the clinic and, of these, 48 underwent surgical procedures. A complete list of the surgical procedures is attached to this report. Another first for our group was the addition of a urologist, Dr. Butch Knight. He was there for the seven second week and it multiple surgical procedures for relief of urinary obstruction. Again, this was a valuable addition to the team.
This year, we also had excellent surgical and anesthesia staffing. During the first week, there were three general surgeons (Dr. Ridell, Dr. Packer, and Dr. Morgan) and, during the second week, we had one general surgeon (Dr. Ridell) and the urologist. For anesthesia, we had one anesthesiologist each week (Dr. Eck for the first week in Dr. Boxer for the second week). In addition, there were two certified nurse anesthetists (Christi Catalano and Chip Goodhart during the first week and Chip with assistance from Carolyn Holencik during the second week). They were busy all day every day in the operating room. We are still seeking ways to make the operating room run a little more efficiently to reduce turnover times. Having the new autoclave was a major help on this trip. Our head nurse, Charmaine Garner spent countless hours gathering supplies prior to this trip and, in Haiti, seem to be working all the time. She spent most of her time managing the operating room schedule, preparing supplies, and organizing instruments for various operations. Jen Stoner, who has been with the team every year since 2010 is a pharmacist but over the years has gotten this so well organized that she is now able to spend significant time assisting the OR staff. Dr. Riddell’s wife, Patti, and Dan Lynch were our main scrub nurses and did a beautiful job. Dan, in addition, knew a pathologist in his hometown and arranged to have our pathology specimens examined free of charge. The report was sent back to HPP within two weeks. Linda Brindle was an amazing multitalented nurse who spent most of her time in the operating room but was also willing to take on any task requested with a smile. We also had the pleasure of having Operation Medical representative, Mary Jensik, and photographer Mirjam Evers with our team to document our activities. Their insightful questions increased everyone’s awareness. We are hopeful that all of these people will be able to return with the team in October 2018.
Among the surgical procedures, there were three done as emergencies. These included two incarcerated inguinal hernias in adult males and one middle-age male with a huge painful mass in his abdomen. The mass turned out to be a tumor of the spleen which had grown attachments to many nearby organs. In dividing these attachments there was unexpected blood loss but the blood bank in St. Marc had no blood. Getting blood from Port-au-Prince would’ve taken four hours which was too long. Two team members actually donated their own blood but this was flawed because we did not have adequate anticoagulation for the blood that was drawn.
Everyone on the team came together and did what they could to assist the surgeons and the anesthesia people but, unfortunately, the patient expired in the operating room. I spoke with the patient’s brother to inform them of the patient’s death. He knew that his brother had a terrible problem and had been praying with Watson, one of the Haitian missionaries at HPP. The brother thanked our team for trying to help his brother and simply said things are not always under our control. I stayed with the brother until morgue transportation arrived and then rejoined the team in the guesthouse. This was a very depressing turn of events but in many ways, it helped bond the team.
Other new things noted at the hospital include a new 60 kW generator provided by donors from Central Pennsylvania and a new medical director, Dr. Jacques Patrick, a gastroenterologist from Port au Prince comes to HPP 3-4 times each week. On January 18, 2018, there is a new couple arriving to manage the Pierre Payen as well as help with hospital management Dawn and Mike Vantervort from Hanover Pennsylvania, are very well qualified since both are nurses and both have spent about 10 years together in Haiti. They returned to the states, about ten years ago, mainly for the children’s education. They are totally fluent in Creole and have a great understanding of Haiti as a country. This will make a huge difference with future teams coming to HPP.
On Wednesday evening, October 25, Mary Jensik hosted everyone for drinks and pizza at Moulin sur Mer, a beautiful beach resort just a few miles from HPP. This was a wonderful break for the team and very much appreciated. On Friday, October 27, the team went to Kalico Beach, another fine resort. Those staying for one week left on the following day October 28 while the rest of the team stayed Kalico Saturday night. A total of eight people returned at the end of the first week-all, as scheduled. Two (Dr. Knight and Dr. Boxer) arrived on Sunday. At the end of the mission the team had an early morning flight on Saturday, November 4, and thus spent the final night at the Servotel which has nice accommodations and a less than five minute transport to the airport in large vans.
Unfortunately, since I was team leader, I had to leave after the first week due to health issues. I will not be personally returning to Haiti for any future surgical missions but have hope and confidence that the other team members will continue this effort. I am also looking forward to seeing some of Mirjam Ever’s photos.