Bon Fwa Day 6 Update Becca

Port au Prince, Wednesday, Jan 27, 2010, 09:00pm — The team decided they were "too loopy to talk one on one" so I was on speakerphone for this call and folks headed off bed one by one as we talked. They called from the new place they're staying in Pelerin #5, in a dusty soccer filed near the house of one of the staff members of BIC. It is a "hillside paradise with flowers right out of Avatar and a view for 10 miles to another mountaintop." The area has "incredibly steep winding roads." Anne said they are "roads that strike fear in the hearts of stick shift drivers." The team sounds happy in their new digs: "it's just us, nothing cramping our style."

Infectious disease

Today they worked in two teams. Anne and Roger went back to the clinic they were at for part of yesterday. They called Team 1 who came and the two teams worked together for about two hours. They went out to dinner tonight with Team 1 and two Haitian doctors, at a restaurant across the street from BIC's compound. They said "Yesterday it was wound care, today it was pediatrics." The providers didn't show up for a few hours, so after assessing the situation and their own skill set, they jumped in and provided care to the best of their ability.

They spoke about needing to check themselves because much of what they were presented with were things they had heard about but had never actually seen or treated before. They were able to consult with an MD in these situations. They had to "change our scientific, public health mentality." They gave the example of measles, which in Haiti kills children and that "the idea of dying from infectious disease is a reality here. If someone has a rash and a fever they need, well they need global poverty to be fixed." They saw a lot of kids with fevers and diarrhea and saw how herd immunity is totally different in Haiti, but said they did not see enough people to get a handle on any patterns of disease emerging in this area.

Recovery

Anne said that the Ministry of Health in Haiti is functionally intact and is busy mostly with coordinating international help. Anne said the Ministry of Health is where she would look for epidemic information. They said that the "ad-hoc and semi-permanent organizations are getting better at distributing meds."

They made the point that Port au Prince has 10 times the population of New Orleans and the earthquake killed 100 times the number of people as Hurricane Katrina, but the team seems to be seeing the situation on the ground progressing faster than in New Orleans even though "it's a bigger city, there are more dead, no port or airport, and the US was fucking up distribution." They see a lot of "desperate waiting and lack of resources" which was described as actually relieving to see because it means the situation is no longer "all crisis all the time."

At BIC

In regards to BIC, Ekip Bon Fwa is "forming a lot of friendships and relationships… it's turning out to be a good place to network with Haitian volunteers." BIC was described as "a 2 story building with an adjoining alleyway." It used to be an auction house, there are 6 indoor display rooms, a balcony, a covered space in the front. BIC is a "hard place to be if you only speak English." There are folks that they run into who are willing to hang out for a while and translate. Anne learned French back in high school and said "Do your homework, you never know!"

BIC was described as "a clearing house, where people go who want to help on a grass roots level." BIC folks have "a lot figured out, are good at finding stuff for people to do." One example, a staff member of BIC wanted members of Team 2 to go to the tent city in her neighborhood to help treat folks. There are "not a lot of international folks, not a lot of white faces."

Standard of care

There were a few Haitian-American nurses at BIC, who Anne and Grace worked alongside; observing, learning and helping. They saw one person with a dressed wound that had not been cleaned in 9 days. The nurse scrubbed it with hydrogen peroxide, poured iodine over it, applied antibiotic ointment, covered it with gauze, taped it down, and wrote the date on the bandage.

Another person had chest pain. Anne had an ECG and together with the nurse they decided the pain was due to a panic attack so the nurse gave her Xanax and a friend took her to a quieter space to "chill out." BIC was described as "very noisy" and "crazy busy." Folks that are working there can go up to the roof to have a "place to go to not have the chaos all around me."

"Moral support is hard to do without Creole." There was an infant they saw with badly sunken eyes from dehydration, the nurses gave her a bottle. "She gulped it down, that baby was hungry!" Her mother had died in the earthquake and the infant had a minor head wound. The baby's aunt had brought her and the nurse got the woman laughing by just chatting and joking around while they cared for the baby. This was stressed as an important part of care.

The politics of amputation

A Haitian-American nurse from New York City told them that many Haitians now fear US doctors because of all the amputations. Her take on is was that "many went overboard on amputations." Many are unnecessary, many are done very badly and get gangrenous.

Ekip Bon Fwa members heard the same from doctors working out of an "ad-hoc hospital across from the MSF hospital destroyed in the earthquake" with some MSF staff, some not. These doctors were also critical of US doctors, with the opinion that the US amputates because it's fast.

They met a man who they were told "will walk in 6 more days and would have been an amputee." They were shown pictures of people amputated with no anesthesia, given no antibiotics and no aftercare. A picture of an amputated leg with only 5 stitches and a picture of tissue being cut with regular scissors. Anne said "Desperate medicine is bad medicine."

They talked about the self-feeding cycle of people providing treatment without the right tools or knowledge because they are unprepared, so they badly mess things up for people needing care and the next team that come in is not prepared for the mess left after the first round, so they treat without the right tools or knowledge, and they mess things up further and the cycle repeats this way.

New normal

Grace described driving around with some of the folks from BIC who would "make off hand comments about normal and really fucked up shit at the same time. The fucked up stuff is what's normal now." She gave an example of one man pointing to a collapsed market and mentioning that there were 3 alive and 7 dead people in there, some friends of his. When asked if search and rescue was working on it. He said that they had given up.

Overall Ekip Bon Fwa sounded incredibly motivated today.

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