Medical Visit to
Petit-Trou-de-Nippes
March 10-17, 2012
On March 10, an UPLIFT Haiti medical team returned to the town of Petit-Trou-de-Nippes. As with our first visit, in spring 2011, a 2-day medical clinic was the cornerstone of our trip.
In addition, we led a question-and-answer forum for young adults who participated in last year's first aid and emergency response class. We also conducted a de-worming project at a nursery school.
The team consisted of R.N. Lydie Alexandre, occupational therapist Vanessa Rigaud, and pharmacy assistant Claudine Emmett from the United States, and two Haitian volunteers, Dr. Thony Guilluame and translator Maico Joseph. We were again hosted by Father René Maxime, pastor of Notre Dame de la Nativité parish.
Petit-Trou-de-Nippes is 90 miles west of Port-au-Prince and just east of the Bay of Baradères.
The clinic was held at the town’s cultural center on March 12 and 13. Lydie took vitals and other intake information from arriving patients. Dr. Thony performed medical evaluations, and Vanessa and Claudine filled out prescriptions. Maico explained to patients how and when to take their medicine and how to carry out other instructions from the doctor.
The team treated 105 people—19 males and 86 females. As in 2011, the most common primary diagnosis was hypertension, which is very common throughout Haiti. Forty-four of the 106 patients were hypertensive. Several of the hypertensives over 50 years old suffered from constriction of blood vessels that supply the brain. Typical of them was a 67-year-old woman who had had a stroke several months earlier. She had never sought medical assistance and walked with a limp. Her blood pressure was 177/107, and so Dr. Thony prescribed intensive medication for hypertension.
We made home visits to seven patients on March 14. Two were an elderly woman and man suffering from un-managed and dangerously high blood pressure.
The woman, 102 years old, had a facial droop and slurred speech—and blood pressure of 220/110. We provided caregiver education to her family regarding diet, blood pressure medications, and negative effect of taking her medications with alcohol.
The man, 77 years old, was aphasic and confined to a rocking chair because of right-side paralysis. We gave him a sling to prevent further dislocation of his right shoulder and decrease edema of his right hand. We also provided the man’s family with caregiver education to minimize symptoms and discomfort.
Medications we used to treat hypertensive patients included Azor and HCTZ. These were extremely effective. Because of treatment with Azor, for example, a 69-year-old man’s blood pressure of 247/144 on Monday dropped to 198/114 on Tuesday, and the BP of a 65-year-old woman dropped from 248/137 to 177/107 during the same period.
These medications would have been impossible to provide without the help of donors and CrossLink International.
After hypertension, the most common diseases we diagnosed were malaria (18 percent of patients) and gastritis (14%). More than half the patients we saw had multiple diagnoses, and the two most common secondary diagnoses were gastritis (34%) and intestinal parasites (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 team members and our donors.
We encountered several patients who required treatments that our own medical toolkit could not provide. For these cases we relied on donated funds to purchase additional medicines in Les Cayes for 22 patients. These included prescription medicines to treat 19 people for malaria, five women for yeast infections, and three patients with scabies.
In addition to medicines, UPLIFT Haiti paid for sonograms and travel expenses for two women with suspected fibroids. They traveled to Port-au-Prince on Thursday, March 15, for sonograms. One woman tested positive for fibroids and the other for a mass on her ovaries. We are investigating the potential for surgical followup with these women.
We also followed up on special cases from our 2011 trip.
A woman whose fibroid surgery we funded in 2011 has recovered completely and is feeling great. An elderly diabetic woman who last year had dangerously high blood sugar levels of 400 and was having hallucinations is doing much better now. Her glucose levels have greatly improved and are now within the normal range. She said that our assessments, prescriptions and recommended diet changes saved her life.
One of our most memorable patients from last year is Fanya, a 15-year-old girl confined to a wheelchair due to a congenital disorder. Last year, we hand-made resting hand splints for her spastic upper extremities. This year, Fanya and her mother were ecstatic to see us return with new, more durable, adjustable hand splints that will help prevent further spastic muscle contractions in her arms. These splints have a breathable fabric and are much easier for her mother to apply. We were also happy to see that the muscles in Fanya’s upper and lower limbs are more relaxed, because she and her mother have continued with the passive range of motion activities we showed them last year.
On the morning of March 13, the UPLIFT Haiti team led a question-and-answer forum with 14 young adults from last year's First Aid and Emergency Response course. These students have become informal Health Care Ambassadors for their town, educating the community on basic first aid and disease prevention techniques they learned last year.
The students currently meet twice a month to review information and discuss ongoing projects. One of their significant contributions is a cholera prevention project that includes cleaning and restricting access to certain parts of the local beach that many people were using as an outhouse. The students currently are brainstorming ideas for how to take a bigger role in the community.
During the forum, Dr. Thony and Lydie instructed the group on hygiene principles the youth can pass along to their community to help prevent ailments such as athlete's foot and intestinal parasites.
After the forum, team members Lydie, Maico and Vanessa went to visit two nurseries and begin a de-worming project for about 55 three- to five-year-old children. Young children are frequently exposed to parasites because of unclean water and food. To wipe out the parasites, Lydie gave each child one chewable tablet of the drug albendazole. This will be repeated at four-month intervals to help prevent parasites from contributing to malnutrition or other illnesses. The cost of albendazole treatment is a mere 60 cents per child per year, yet most Haitian children receive no treatment at all.
On future visits to Petit-Trou-de-Nippes, we will continue to follow up on special cases, add or modify medications as necessary, provide ongoing support and training to the community's young health care ambassadors, and of course continue to medically screen the population and treat illness.
UPLIFT Haiti is making plans to return to Petit-Trou-de-Nippes again next year. We hope to be able to fund visits by two medical teams instead of one, but this will depend on donations. Our U.S. volunteers pay all travel and lodging expenses (about $700 per person) out of their own pockets. UPLIFT Haiti’s direct costs for a medical trip range from $1,500 to $2,000. Thus, even your small donations can have a big impact on the lives of people.
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 people of Petit-Trou-de-Nippes and make a positive impact on many lives.
Registered nurse Lydie Alexandre takes a patient's vital signs before he sees Dr. Thony for his medical evaluation.
Dr. Thony assesses a patient with degenerative joint disease.
UPLIFT Haiti volunteer Maico Joseph explains medication dosages to a patient.
Dr. Thony instructs 14 young health care ambassadors on basic hygiene techniques to prevent disease, so they can spread the knowledge to the community of Petit-Trou-de-Nippes.
Nurse Lydie hands each child at a nursery school a chewable tablet of albendazole, a de-worming medication.
© UPLIFT Haiti