HHH work 2011: Work

Where am I!

Justinien Hospital Centre for Rehabilitation. This is a multi roomed building right on the coast away from the hospital. It has a large (ish) gym area room with three plinths and some gym equipment. It is air-conditioned. I have never loved an air-conditioning unit more. I am hotter when I go to bed than when I am working, and it is cooler in the evenings thankfully. It is in many ways amazingly well resourced and in other ways totally useless! I will try and explain this. Following the earthquake a lot of aid resources were sent to Haiti. One such project that benefitted from these resources was the brainchild of Andre Vulcain’s who decided a rehabilitation centre was required for victims (especially amputee’s) of the disaster as well as any patients discharged from the hospital requiring physical therapy input. The building already existed it just needed staff and equipment. Equipment arrived by the container load however no current physical therapists existed in Haiti. As explained in the first blog 3 nurses were recruited to train to be physical therapists. This sounds fine but if it wasn’t for HHH fortuitously arriving on queue with trained Physio’s they wouldn’t have got any training. The poor girls are stressed out running a clinic by themselves following three months of basic training in Physio concepts and no support apart from when we turn up. The situation is crazy but I don’t want to bog you down with health planning in Haiti! Suffice to say they a grateful when we turn up. Equipment wise the centre has two concreted in heated whirlpools! I’ve only seen them in old text books, never used them. But not to worry they don’t work so are used as storage containers instead! They have more bandages and dressings than they know what to do with as well as knee and wrist braces, crutches, moon boots, and frames and finally giant wheelchairs and giant pressure cushions that would fit two people at least (can you guess where the equipment came from?). In total the centre has thousands and thousands of dollars of equipment that the nurses have no idea how to use. One of the giant commodes we noticed had ended up at the hospital and was used as a waiting area bench for three people! A lot of the equipment is obviously targeted at people with amputations however I’m afraid to report I haven’t seen one amputee patient yet, where are they?

What’s the work like?

How do I explain this? Each day I have worked so far I have encountered conditions I didn’t think really existed or were possible. I will try and explain why. 75% of the patients are referrals from orthopaedics the rest of the patients seem to have had some kind of stroke. The resources and equipment available to the surgeons is limited therefore affecting the outcome potential. This is compounded by the fact that patients at the hospital have to pay for and provide EVERYTHING. This means that they have to bring their own food and bedding and if they are prescribed a medication then relatives have to go and find and buy the drugs out of the hospital. Claire explained a case where a gentleman was on bed rest without traction with a fractured femur and tib/fib and finally had surgery one month later when he had saved up enough money for the surgery! This may also explain some of the reasons for some of the injuries we are encountering. On top of this there are no Physio’s working at the hospital so joints are not encouraged to move as much as they might and therefore are presenting sometimes so stiff and deformed you’re not sure what you can really achieve. Patients are never on pain killers and you’re putting them through their painful paces and they do it with a smile. Ok a wincing smile! But it is remarkable!