"I don't know what your destiny will be, but one thing I know: the only ones among you
who will be really happy are those who will have sought and found how to serve" Albert Schweitzer

Thursday, March 11, 2010

Michael Ziebelman, MD Trip Report

Michael Ziebelman is an Orthopaedic Surgeon practicing in Cocoa Beach, Florida and just returned after spending a week at the Hopital Adventiste d'Haiti earlier this month. He was kind enough to send the following trip report.
The C-arm was the guns, as was the digital xray machine. One of the translators in the clinic, Jean, was using it after a day or so. The trip was great professionally and personally rewarding. I stayed across the street at ACTS and they were very hospitable. As we all know, fracture management is the goal now. The exfix's need to be dynamized and the patients taught how to walk out of them so they do not become non-union machines; or converted to casts. Also rods will need interlocking screws out, etc.
I borrowed a 6" adjustable wrench and loosened all the exfix's a little. Patients are showing up with casts that were applied for the initial injury and these need removal, etc. Probably saw 2/day BBFA fx that needed ORIF, 1-2/day that will need rodding. I stayed in clinic so Scott and the other surgeons could operate. I would have brought my own wrench and vicegrips to remove the pins, and plan on leaving them for the next guy, so they do not need to be snap on. Most docs and nurses planned on leaving most of what they brought for the next crew or for the Haitians who were grateful for anything, clothes, linens, food, slim jims, gatorade, etc.
A cast saw may not be an absolute necessity but is close. So are the things that make it tick-extra blades, and even an extra power cord to rewire it. We were close with the one there dying but it lasted the week. A spare saw would be wonderful, but make sure it stay secure. The OB clinic was wiped out of there supplies one night.
I packed like I was going camping for a week, including food and liquids of choice. Our flight let us check baggage without paying, so I checked 140# and returned with 30#. Speaking of dollars, ones are the key since you cannot get change and the ATM would be in Haitian $$.
The head translator at the hospital is Frantz and he runs a tight ship, his guys vary from B+ to A+. Some others will volunteer and are just the opposite so I strongly suggest using the hospital translators, a bad one is horrible. The supply hall is at the opposite end of the ortho clinic hallway, the crew there tried to be as helpful as possible. I got a jar of Keflex from them and Motrin 200 and 400 and just dispensed it myself in the bags from the pharmacy, seemed to easier than writing the Rx and more convenient for the patients.
I am a street food person but would not take a chance in Haiti. That being said, the restaurant at the hotel-Auberge de Qebec is very good. It is a mile walk from the hospital and there are signs. I think rooms there start at $80, it is one of the few decent hotels standing and is good enough for Anderson Cooper. The hospital is willing to provide transportation to and from there.
I took the lead from the ER docs who were at ACTS and took Bactrim or Cipro after eating out in town. The cantina 200yds down the street from the main gate made us a nice dinner Thursday nite and used plastic utensils and paper plates and the food was superb. The market down the street from the hospital across from the Texaco station has a lot, you can pay in American dollars, everywhere.
Be prepared for rain, heat, and humidity, obviously, it is the tropics. Seeing patients in the tents in front of the hospital is exhausting from the heat. Light weight scrubs work great, or current technology wicking clothing.
The primary care clinic at ACTS saw 1400 patients Monday alone, 700 there and 700 in a mobile clinic. I was truly humbled by their effort. Also humbling are the nurses who would take weeks off w/o pay, and pay $1000 in plane fare to get there, not to mention buying there own stuff. Puts my effort in perspective.
I hope this is helpful, feel free to post my contact info.
Michael Ziebelman, MD, FAAOS
863.660.2514
msz1060@aol.com

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