"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

Friday, November 18, 2011

Mike Suszter, Ortho Resident Trip Report

Mike Suszter is a senior Orthopaedic Surgery Resident in Riverside, California and recently returned from a volunteer trip to Haiti. 
One day in September I was contacted by my residency director, Dr. Wade Faerber, and asked if I would like to join him in Haiti with Dr. Scott Nelson. Being familiar with Dr. Nelson and having heard about previous trips to Haiti I jumped at the opportunity, brushed up on my French, and expedited a new passport. 
In the weeks prior to the trip I was filled with nervous excitement and was not sure what to expect. I had what seemed to be a million questions. What would the country be like? How had Haiti rebounded from the earthquake? What kind of food would there be? The days before the trip I found myself frantically packing and trying to anticipate every need (bug spray, surgical attire, snacks, and of course extra batteries for the camera).

Upon arriving in Haiti I was welcomed with 95 degree heat and 90% humidity. We were then picked up and escorted to the hospital. On the way from the airport I had my first exposure to Port-au-Prince, the Haitian people, and culture. The city was alive with people similar to worker bees around a honey hive. The sights, sounds, and smells were unbelievable. The city was alive with millions of people all working hard to help each other. Whether it was selling fruit at the market or filling tires at the side of the road everyone was busy and working hard…which was a small amount of foreshadowing for my week. 

Upon arrival to the hospital, we were greeted by numerous volunteers from all around the world. Each brought a special gift/talent to the hospital and the Haitian people. At a hospital one would expect nurses, doctors, and prosthetists to be among the volunteers, which there were many, but in addition there were physical therapists, architects, electricians, medical students, and theology students. It was amazing to learn about the many projects and experiences all these volunteers had to share. 

After we claimed our sleeping quarters, our group was eager to go out and experience Haiti. On a hike, led by Dr. Nelson, we trekked through the small villages and mountains of Haiti. Being out of shape I certainly struggled up and down the mountains, but once to the top we were all re-energized at the beautiful sites that overwhelmed our optic nerves. Who would have thought that a country so devastated by natural disaster 2 years ago would be so peaceful and beautiful? 

The following 6 days were mainly work days at the hospital. We started off with a clinic day where we saw an amazing array of patients. There were patients with untreated injuries from the earthquake, congenital disorders, acute injuries, and infections. As our Creole/French was not very impressive, we worked hand in hand with several local Haitians who acted as our translators/cast techs. I was very impressed with their work ethic, compassion, and casting capabilities. I was also surprised at the immense amount of technology that had been obtained by the hospital since the earthquake. Heck, the portable x-ray machine was far better that the ones we have at our institution. 
Throughout or clinic day we amassed an entire week’s worth of surgery. As to not bore you with all the surgical details, we worked tirelessly for 4 straight days in the OR to help as many people as possible. Our surgical case list was quite varied, from spine fractures to limb alignment surgeries. Working with Drs. Nelson and Faerber was fun, educational, and……..well one of the greatest surgical experiences ever!!!!! One of the most memorable moments came after we had done a surgery on a young girl with Blounts Disease (bow legs). After surgery we wheeled her out to the recovery room and found her mom, who immediately started crying (tears of joy) and gave Dr. Nelson a giant hug of appreciation. That moment reminded me how much of an impact we can have on people’s lives. 
That week we did many surgeries (big and small) and made just a small scratch in the need for orthopedic care in Haiti. Throughout my trip I was amazed at the state of the art care that was being provided in a small 18 bed hospital in the middle of a third world country. It re-energized me, encouraged me, and exposed me to medicine in the third world. 
After 7 days it was finally time for us to return home and upon getting back to my house I emptied my suitcase and did a survey of the things I had brought back with me: 
     1. 2 metal fish ornaments 
     2. 10 bug bites 
     3. 700 pictures 
     4. About 15 new friendships 
     5. A million stories 
     6. Most importantly a desire to volunteer my time in the future to this and other 
         volunteer programs around the world
L to R: Mike Suszter, Wade Faerber, Scott Nelson, Francel Alexis
In the coming months I may forget the French that I brushed up on but I will never forget the amazing pride and friendliness of the Haitian people and drive of the volunteers/employees at the hospital and can hardly wait for the next trip. 
I would like to thank LLUMC, Dr. Nelson, Dr. Faerber, and all my patients for allowing me the opportunity to grow both professionally and personally.

Sunday, November 13, 2011

Operations Update From Hopital Adventiste

Dr Scott Nelson is returning home from another week at Hopital Adventiste.  In addition to the excerpt noted below, you can read the rest of his report on the CURE Caribe Blog.
Chaos, hard work, excitement and challenges usually eclipse my ability to write reports until the controlled rage of the GE turbines on the 757 pull me into my seat and I start assimilating my thoughts. We fluently lift off into the sky leaving behind a different world, looking down at shacks and rubble with a few new roofs decorating the landscape.
It was a week of mixed emotions. Terry and Jeannie Dietrich moved out on Wednesday to go back to Wisconsin. I felt a sense of defeatism and disappointment that we have not been able to inspire any surgeons to make a long term commitment towards the international orthopaedic program that has blossomed since the earthquake. It has enabled many talented surgeons to come down and effectively use their expertise to give a level of care to the Haitian people, that in some ways is beyond even that in the US. They both did an outstanding job of hosting this flourishing program. Amongst many of their contributions was the training of a couple of orthopaedic technicians – Jeanty and Jean Joel have been well trained to prepare the cases, assist in surgery, and maintain organization of the equipment.
Francel Alexis (far left in image above) is a recent graduate of the Haitian orthopaedic residency and is finishing a year long fellowship sponsored through Cure International. He is now at HAH and will hopefully stay there to help anchor down the orthopaedic program and provide follow up for our patients. His affable personality and motivation are real assets to the program.

Thursday, November 10, 2011


The following post was written by Amy Lindsay and can be read in its entirety on the Beauty In The Mess blog.
Today was a sad day. A day of change and uncertainty as we said good-bye to Terry and Jeannie Dietrich. They served whole-heartedly for the year that they were here and it was great having them here. Now we will have to find a way to move on and continue the orthopedic program even without them. They will still be back for a few weeks here and there, but currently we don’t have a long-term replacement for Dr. Dietrich, which is disconcerting. There may be an orthopedic surgeon that might be able to come down, but as of right now there is a lot of unknowns about how it will all work.

Thursday, August 4, 2011

The Future Is Now

Dr Francel Alexis graduated in 2004 from the Medical School of Haiti State University.  He subsequently completed a year of general internship then rendered his one year of mandatory year of social service to his country.  He subsequently completed 4 years of an Orthopaedic Surgery residency at the same university where he went to medical school.
Francel is currently engaged in a 14-month Pediatric Orthopaedic Surgery Fellowship comprised of spending 8 months at the CURE Hospital in the Dominican Republic and 6 months here at Hopital Adventiste under the tutelage of Dr Terry Dietrich.
Here at Hopital Adventiste, Dr Alexis divides his time between very busy clinics and the operating room where he has proven to be an eager student.  Francel would like to eventually private practice as the only Haitian fellowship-trained pediatric orthopaedic surgeon in his country.
Pictured below is Dr Zeno Charles Marcel who recently graduated from the Universitad de Montemorelos in Mexico.  ZJ is currently fulfilling his year of social service by working with Dr Dietrich here at Hopital Adventiste.  ZJ's goal is to complete an orthopaedic  surgical residency in the United States and eventually return to serve in an underserved nation such as Haiti.
Jonathan Mills, pictured on the left in the image below, is a 2nd year medical student at Loma Linda University. During his summer break between first and second years, Jonathan has spent several weeks volunteering on the orthopaedic service here at Hopital Adventiste.
All three of the aforementioned gentlemen have been performing in an exemplary fashion and have increased our productivity immensely.  Their enthusiasm, energy, and willingness to serve have been greatly appreciated. It appears that the spirit of volunterism in our speciality is alive and well and the future is indeed bright.  

Wednesday, August 3, 2011

Advanced Clubfoot Reconstruction

A club foot, or congenital talipes equinovarus, is a congenital deformity involving one foot or both. The affected foot appears rotated internally at the ankle and inverted at the foot with the toes pointing downward. Without treatment, persons afflicted often appear to walk on their ankles or on the sides of their feet. It is a common birth defect and Hopital Adventiste sees an inordinate amount of these patients in the orthopaedic clinic.  
Most patients can be treated nonoperatively with serial casting but resistent and neglected cases require surgical management.  Typically most of the worst cases, like the patient featured below, are referred to this facility for treatment.
Dr Nelson has become skilled at using the Taylor Spatial Frame for correcting many of these advanced deformities.  The technique involves the use of an elaborate system of wires, pins, rings, nuts and bolts to employ gradual distraction to correct the pathology.
The correction algorithm is based on data inputed into a computer program which tells the patient or family member how much distraction to perform, typically only a small fraction of the overall correction each day.  The patient often wears the machine for several months before the desired result is achieved and the device is removed.

Tuesday, August 2, 2011

Blue Monday

Most orthopods prefer operating as opposed to seeing patients and this group is probably no exception.  After worship/hospital staff meeting we walked the gauntlet (see image below) through at least a hundred patients plus family member anxiously waiting to be seen.  

In reality, there were a number of really interesting cases to review ranging all the way from tumors, infections, fractures and congenital abnormalities.  

There were also a couple of surprises including the young man below on whom Scott and I had fixed bilateral radial clubhands on a trip to Cap Haitien in February of 2009.

The patients lined both hallways and overall were incredibly longsuffering and understanding including the little fellow below awaiting scheduling for corrective clubfoot surgery.

In between  seeing patients in the clinic, we fit in a few surgical cases.  In the background of the image below, Adeel and Jim are performing a proximal row carpectomy for a 5 month old trans-scaphoid perilunate dislocation of the wrist.  We were very fortunate to be able to use formal surgical tourniquet pictured below in the foreground.  This machine was procurred by Redlands, California orthopaedic surgeon Gray Frykman.

ICU nurse Wes Easter (on the left in the image above) was 2 for 2 on his first intubations performed under the tutelage of anesthesiologist Maria Adrianne (on the right in the image above).  We will soon be entering the inaugural nurse anesthesia training program at Loma Linda University. 
One of the innovations were experienced this clinic visit, was the use of the ipad for image review, a technique perfected by ortho resident Adeel Husain.  The concept really streamlined the review of xray images and was effective in presenting cases, including mini movies of patients ambulating, to Dr Nelson.

The image above depicts 16-case surgical load for today, probably won't get it all completed but we'll give it a good shot.

Monday, August 1, 2011

First Real Day On The Job

Before going any further, it might be worthwhile to introduce all of the members of our team:  Adam Lorenzetti (PGY3 LLU Ortho Resident), Adeel Husain (PGY4 LLU Ortho Resident), Wes Easter (LLU ICU Nurse), Ken Kuck (LLU Surgical Tech), Jim Matiko (Redlands Ortho Surgeon),  and team leader Scott Nelson (LLU Ortho Surgeon).  We are all pictured below gathered around Terry Dietrich's newly completed, custom designed with orthopaedic theme, Tap Tap complete with Scott's picture on the side.
Kneeling from L to R are Adeel Husain, Ken Kuck, and Wes Easter.  Standing from L to R are Adam Lorenzetti and Jim Matiko.  Peering out over his photo from the rear of the tap tap is Scott Nelson.
We spent most of the day sorting, cleaning and organizing equipment.  The lady on the right, affectionately known as "Vieja" is Scott's former nurse from the Dominican Republic who frequently makes the long journey across Hispaniola to join him when he comes.  Her organizational skills are legendary and she kept us focused throughout the day.
It was great to have Adeel join the team.  We not only appreciated an extra pair of hands and his enthusiasm, he also brought our six remaining suitcases that Spirit Airlines had failed to deliver on time.
The hospital continues to provide us with one meal per day which usually consists of some variation of rice and beans and something extra like mixed vegetables or fried plantain.  We all agree that the meals have been pretty tasty.
Since Wes will soon be entering Loma Linda's inaugural nurse anesthesia program, we bequeathed to him the unenviable task of organizing the equipment and meds in the anesthesia cubicle.
In addition to the housekeeping activities in the OR, we managed to squeeze in a couple of surgical cases.  In the image above, Ken, Adam, and Adeel are removing hardware on a patient with a postoperative spine infection. Peering over the drapes is Maria Adrianne, an extraordinary anesthesiologist from the Dominican Republic. Not only is she clinically competent, she gives excellent neck massages to exhausted surgeons.
It's great to be here and we all feel privileged to serve and be part of this program.

Sunday, July 31, 2011

Good To Be Back

We flew out of LAX late Friday night on the "red eye" to Fort Lauderdale then on to PAP.  Flew on Spirit Airlines as they had the cheapest flight.  Turns out that they have their ways of capturing the differential in the end such as charging for a carry on and in flight beverages.  They also informed us at check-in that the weight limit for checked bags had been decreased from 50 to 40 lbs.  Fortunately we were able to talk ourselves out of a weight penalty.  Please be aware that airlines are becoming increasingly adept at employing cost cutting measures so check with them prior to packing your bags to make sure you don't exceed the allotted weight restriction.
Immigration and customs were a breeze however we were one of the last to depart as 6/10 of our checked bags didn't arrive with us so we had to complete the paperwork for retrieval.  We're hoping that they will arrive later today.
The hospital looks very much the same only quieter, no patients sleeping in the halls.  We took a long hike up into the hills, returned for a nap then made rounds to become familiar with the caseload on the wards.  Pics below were taken at a small SDA church we stopped at along the way. 

Wednesday, July 20, 2011

Now Available: Haiti Together We Move!

Before the earthquake last year, poor Haitians had never had access to comprehensive, high quality orthopedic surgery. That has changed. Haiti Adventist Hospital in Port au Prince is now providing world class orthopedic care to all patients at no charge. The project is in need of long term funding. A high quality coffee table book has been published to raise funds to support this work.
HAITI TOGETHER WE MOVE tells the story of the efforts of hundreds of volunteers to treat thousands of patients at Hopital Adventiste d' Haiti. Prior to the earthquake, this small mission hospital did not have the capability to perform significant orthopedic surgery. That was changed by the arrival of millions of dollars worth of equipment, implants and orthopedic specialists in the days and weeks after January 12, 2010. As the earthquake victims were treated, other patients with preexisting orthopedic problems started coming to the hospital as well. Acquired, congenital and developmental deformities of the upper and lower extremities are regularly being successfully treated. The substantial costs of this project are currently being born by the hospital and generous donors, including Loma Linda University. This model does not have long term sustainability for several reasons. An endowment has been created to fund this project in perpetuity. The Haitian Indigent Patient Endowment will subsidize orthopedic care at Haiti Adventist Hospital.
Image by Ron Haviv
The coffee table book is a collection of images from very well known professional photographers (Ron Haviv above and Antonio Bolfo below). Supplementary photos provided by volunteers involved in the project help tell the stories. The beauty of Haiti and the Haitian people and their culture is portrayed. First hand accounts of experiences in the chaotic days immediately following the disaster tie the pictures together. The months that have followed have been filled with remarkable interactions of volunteers caring for Haitians who have in many cases suffered for years with their deformities.
Every dollar donated to this project will be an integral part of the endowment. The interest generated by the fund will be used to subsidize the cost of providing care for these patients with little or no resources. As the donated implants are used, they need to be replaced. Maintenance of expensive equipment is an ongoing challenge in every hospital and Haiti Adventist Hospital is no exception. Important and complementary medical services are lacking and require funding to be developed. Hospital staffing is inadequate to care for the volumes of poor patients needing care. Haiti and Haiti Adventist Hospital have needs beyond needs. 
Image by Antonio Bolfo
The ongoing generosity of highly trained orthopedic and anesthesia specialists is one of the core elements that is making it possible for this project to continue. Teams continue to arrive weekly to provide free care. Members of the teams bring needed medications and operating room supplies including sterile drapes, gowns, gloves. Replacement orthopedic implants including rods, plates and screws are also generously donated. In addition, these volunteers pay their travel costs and all of the costs associated with their time at the hospital. The accommodations continue to be spartan. As funding becomes available, these needs can be addressed and the project can grow and improve and expand the care being provided.

Click here to donate and to purchase the book.

Monday, July 18, 2011

Father/Daughter Team Serves In Haiti

Brock Cummings and his daughter Chloe recently returned from a volunteer stint at Hopital Adventiste in Port au Prince.  Dr Cummings is an orthopaedic surgeon in private practice in Paradise, California.  Chloe Cummings is going to be entering her senior year in high school and is entertaining several options in the health care field upon graduation.
Chole wrote on her blog Tape and Tarp, "Our 2011 trip to Haiti was unlike anything we've ever experienced. We saw God working through the volunteers as well as the Haitian people themselves. We learned lessons about service, humility, medicine, and the local culture. Throughout the ups and downs, we know it's a trip we'll never forget."
If there are any health care professionals reading who are looking for a potentially life-changing summer "vacation" for you and your offspring, spend a week volunteering at Hopital Adventiste.  Contact Amy at arussell@llu.edu for more details.
Father and daughter team in action
View more images from the Cummings' trip here.

Wednesday, July 13, 2011

CURE Clubfoot Program

A year and a half ago, a deadly earthquake shattered lives in Haiti. The CURE Clubfoot program in that country was shattered as well, but it was quickly re-established and is once again bringing healing to children throughout Haiti. Recently, Dr. Robert Cady, Co-Medical Director of CURE Clubfoot in Haiti, and Mr. John Mitchell, of MD Orthopaedics (a designer of braces used in the treatment of clubfoot), visited that country, joining Kendy Bellegarde, country coordinator of CURE Clubfoot in Haiti, to see the program in action and lend a hand as they went. 

Saturday, May 14, 2011

Haiti: Together We Move

In Haiti: Together We Move, readers will be guided through the events that transpired at Haiti Adventist Hospital in the 12 months following the devastating earthquake.
The story begins just two days after the earthquake with amazing pictures and accounts of the immediate responders to Port au Prince.
Heroic stories and accounts of life saving operations are woven with vivid, moving photographs taken by numerous professional photographers including Paul Sebring and Cosmin Cosma.
With each turn of the page you will travel and experience the events that transformed Haiti Adventist Hospital from a rescue orthopedic center to what is now one of the main referral centers in all of Haiti and a leader in providing orthopedic care for the indigent.
Chronic, life altering orthopedic conditions are now treated on a daily basis and these stories are shared through the first person accounts of over 30 volunteer doctors, nurses and volunteers who traveled to Port au Prince to serve those in need. Haiti: Together We Move is 108 pages of incredible stories and photographs that will open your eyes and hearts to those in need in Haiti. We invite you to purchase a copy for yourself and help support the thousands in need all across Haiti.
Pre-order the book here.

Tuesday, May 10, 2011

Headed Back To Haiti

Team Sinai is readying themselves for a return engagement at Hopital Adventiste.  Official Team Sinai blogger, Merrill Chaus writes:

"From the moment we left after our weeklong mission last June, we couldn’t wait to go back. We had an amazing, life altering experience, and were able to help over 50 indigent patients who needed orthopedic surgery. Many were originally injured in the earthquake of January 12, 2010, and some were more recent trauma victims, and many were children with birth defects. We had arranged to return to Adventiste Hopital over the Christmas break, 2010, but our plans were thwarted by political and civil instability surrounding the December elections. Things in Port-au-Prince got pretty hairy, prompting American Airlines to temporarily suspend flights. Moreover, the organization hosting us, Adventist Health International, decided to temporarily evacuate their expatriate staff at Adventiste to the Dominican Republic. By the time the smoke settled, we had lost our travel window. Over the next few months, we planned, calculated, and regrouped, and finally were able to reschedule our mission to this June 2011. Most of the original 18-team members from last year were not able to make the new date, but we have successfully recruited replacements."
Led by internationally renowned pediatric orthopaedic surgeon, John Herzenberg, MD, Team Sinai is enthusiastic, motivated, and highly competent.  Both Drs Scott Nelson and Terry Dietrich hold this group in high regard and have greatly appreciated their contribution to date.  Follow their progress on the Team Sinai blog.

Monday, March 28, 2011

Scott Nelson Update From Hopital Adventiste

A 7 year old boy with a scarred and contracted leg hops up and down the street in front of Hôpital Adventiste. He has been doing this for the last 5 years since his leg was burned. He lives with his 9 year old brother, their parents are dead. Never before has there been hope. An excision of some scar tissue with full thickness skin grafting and specialized external fixation  was performed.
Read the rest of Dr Nelson's recent trip report here.

Saturday, March 19, 2011

Long Time No Hear

We have not posted any new updates from Hopital Adventiste for several weeks and will continue to assume a peripheral role as long as more viable news options exist.  haitibones.org readers are encouraged to follow the development of HAH's orthopaedic program on Terry and Jeanie Dietrich's Caribbean Orthopedics blog.  Terry and Jeanie have been posting progress reports on a regular basis and we've found them to be most informative.
You can also follow the Dietrich team on Facebook and on their official webpage, Orthopedic Ministries of the Caribbean.
There exists a continuing need for volunteers including orthopaedic surgeons, anesthesiologists, nurses and physical therapists.  Contact LLU Global Health or email Terry directly at tj.dietrich99@gmail.com for more information.

Wednesday, February 2, 2011

Voices Of Haiti

Jeremy Cowart is a professional photographer from Nashville, Tennessee and wrote the following intro to his Haiti photo gallery:

"After the 7.0 earthquake rocked Haiti on January 12th of this year, I was deeply moved as most of you were. For days I watched as the television flashed images of gloom and doom... dead bodies, crumbled buildings... It just felt like a heartless display of numbers and statistics. "How were the people feeling?" I wondered. I was tired of hearing endless reports from strangers that just arrived to this devastated nation. So I decided to go to Port-Au-Prince myself and ask them directly. My question was simply "What do you have to say about all this?" 
Jeremy's photo essay reveals the many answers to that question.

Tuesday, February 1, 2011

Looking For Volunteers

The following note was sent by Amy Lindsey, Haiti Volunteer Coordinator and wife of HAH Administrator, Nathan Lindsay.
First of all I would like to thank each one of you for the time, interest, and energy that you have spent in helping the people at Hopital Adventiste d’Haiti. Through your care and concern many people have received treatment that otherwise would not have been provided. It is through help like yours that we are able to keep the hospital functioning.
Now that it has been over a year since the earthquake, the overall operations of the hospital have changed. That being said, there is still plenty to do at the hospital, especially in orthopedics. For those of you who may not already know him, Terry Dietrich is an orthopedic surgeon from Wisconsin who is anchoring the orthopedic service here at HAH for the next year. Although he will be here most of that time, there are a few dates throughout the year that he will be gone and we are looking for some willing orthopedic surgeons to fill in for a week or 2 in his absence.
Currently I am desperately trying to find orthopedic coverage for Feb 27-March 5, and March 6-12. Unfortunately the person who was scheduled to come is no longer able to and so we are looking for at least 1-2 orthopedic surgeons for each of those weeks (preferably 2 if Terry is gone). I know that it is short notice, but if you could possibly make it work please let me know ASAP. 
If you are interested in coming, we also suggest trying to bring some support staff with you (anesthesia, scrub tech, etc.). I’ll be happy to discuss any specifics with you if you are interested.
Thank you again for everything that you have done. I look forward to hearing from you soon.
Amy Lindsey 
Diquini 63, Carrefour, Port-au-Prince, Haiti 
Haiti phone number 011-509-3430-8150 
Fax (909) 558-0263

Sunday, January 16, 2011

Year In Review From Terry Dietrich

Haiti Adventist Hospital has served the people of Carrefour, Port as Prince and beyond for about 30 years. It miraculously was not significantly damaged on January 12. Within 2 weeks, it was cleared by engineers to function as a hospital. It's normal operation as primarily a small center for OB/GYN and occasional cases of urology and general surgery was totally disrupted. Dr Nelson started caring for the patients injured in the earthquake and did orthopedic stabilizations on hundreds of victims with the help of many orthopedic and specialty teams. Millions of dollars of orthopedic implants for fracture fixation were generously donated by orthopedic companies. Most of that donated material eventually found its way to HAH. He went well beyond caring for the earthquake victims and began treating many orthopedic cases that had been neglected for years and even decades. An example is Staille. Look up the Youtube video that was made of her. She returned to the clinic a couple of weeks ago and the external fixators were removed. She is walking much better all the time. A final video will be made to add to Youtube in a few months. Because of Dr Nelson's unselfish efforts, HAH has become known as the primary orthopedic referral center for most of the country. Patients are transferred here from all regions of the country with spinal and extremity trauma. Arthroscopy equipment has been obtained and now adds another important orthopedic capability.
The hospital is still in recovery mode from the disaster and the overwhelming number of patients, mainly indigents, that have been cared for in the last 12 months. It struggles to meet its overhead. There are high hopes that in 2-3 months the picture will brighten. A new patient wing project which has been dormant for several years is the top priority. Its completion will allow us to attract more paying patients to increase the hospital's revenue stream. Teams of volunteers with expertise in construction could help to finish that project, A strong effort has been put forth to remodel the ORs so that we can begin doing total joint replacement. Boldt construction in Wisconsin has made a generous proposal to see that project through. That would also have potential to improve the hospital's financial picture. If the hospital is strong financially, then it should be possible to fund a program so that excellent perpetual care can be provided to the indigents.
Meanwhile, the challenges continue. The volume of orthopedic cases that present daily in the clinic could be managed by one orthopedic surgeon. However, it would leave virtually no time for anything else. Managing the many challenging surgical cases requires at least another full time orthopedist. The cases cover the entire spectrum of orthopedic subspecialties. Children's deformities, trauma, infections, tumors, spine, sportsmedicine, upper extremity trauma and deformities, and adult reconstruction are evenly represented. Is there a living orthopedic surgeon besides Scott Nelson who has the ability let alone boldness and confidence to even attempt to undertake such a challenge? Fortunately, there are excellent, well trained subspecialists who are generous with their time and resources and have participated already and continue to commit to support the work here. Orthopedists such as John Herzenberg, Bob Cady, Karl Rathjen, Todd Smith, Fred Liss, Allen and Cassie Gabriel, Gerald King, Duncan Miles and many others too numerous to mention, have all made valuable contributions. One of the biggest challenges facing the orthopedic program is the lack of regular anesthesia services. Cases of necessity are at times delayed as much as several days when volunteers are unavailable to give anesthesia. Another urgent need is assistance in managing patients with comorbidities. Patients needing general surgical consultation require transfer to another facility. No equipment or expertise is available for post anesthesia monitoring or ICU management. Blood is difficult if not nearly impossible to obtain for pre and postsurgical patients.
The Haitian presidential election fueled civil unrest in Port au Prince in December, created major uncertainties for specialty teams with plans to work at HAH. Several teams postponed or cancelled their travel plans and leadership made the decision to evacuate all expatriates from the country until fears of more violence subsided. It is too early to tell what lasting effects will result from more than 2 weeks of orthopedic care being unavailable.
Optimism abounds at HAH as volunteers continue to daily throw themselves into the tasks at hand. Training orthopedic technicians is a challenge and delight. It is very gratifying to watch the first trainee, Jean Joel, enthusiastically apply his quick mind to learning new concepts and skills. Working with the Haitian translators gives all of the volunteers daily cultural interaction that is priceless.
The very important prosthetics program is about to get into high gear. In November, Project Hope installed the buildings for housing patients in need of prosthetics and the lab for patient examination and prosthetic construction. The man in charge of the development of the prosthetics program arrived a few days ago. Now the key elements are in place for the hundreds and perhaps thousands of the unfortunate earthquake victims who lost ams and legs and still need artificial limbs.
The need for infectious disease expertise is pressing. Many of the earthquake victims had open wounds, commonly associated with fractures. A significant percentage of those wounds and fractures developed chronic infections due to the delay in proper initial wound care. Many other patients present to the orthopedic clinic daily with chronic bone and joint infections that have been part of their lives since long before January 12. These patients again highlight the years of orthopedic neglect that the indigent Haitians have lived with for decades. It is nearly impossible to obtain timely and accurate cultures to identify organisms. If drug sensitivities could be obtained in a timely fashion, the appropriate antibiotics may or may not be available. Broad spectrum antibiotics are relatively available but who knows for how long. The pharmacy is badly in need of strong leadership and organization and we could always use the assistance of a biomedical engineer.
None of the needs that are presented here added to those not even mentioned are so great that several million dollars couldn't easily solve. Global Health has done a remarkable work at organizing the relief efforts. The funds raised have been applied in effective ways. Perhaps with renewed interest on the anniversary of the disaster, there will be a 10 fold or even 100 fold increase in the financial support of HAH through Global Health that will transform the effort into a world class program.
Much more can be said of this incredible God blessed opportunity. Every person reading these words can be privileged to participate in this work either by a personal commitment to volunteer or a gift of financial support.

Friday, January 14, 2011

Adopting Haiti

It was 5:52 p.m. on January 12, 2010, just one hour after a massive earthquake had hit Haiti, and Timothy Wolfer wrote an impulsive but sincere post on his Facebook page. 
“Any one want to help a poor documentary film maker buy a ticket to Haiti?” 
For most other people, the comment would have been nothing more than an offhand shot in the dark. But Wolfer, a Pacific Union College film and television major with experience filming in humanitarian crisis zones, was so serious that immediately after posting, he began packing his bags.
Six hours later, an anonymous donor supplied Wolfer with two airplane tickets. Recruiting a friend to assist, Wolfer headed to the airport that weekend. All flights to Haiti were cancelled, so he did the next best thing: landing in the Dominican Republic, Wolfer hitchhiked with his camera equipment across the border into Haiti—a wasteland of devastation and uncertainty.
Now exactly one year later, the resulting film, Adopting Haiti, will be released to a worldwide audience online on Wednesday, January 12. Mattoid Entertainment will screen the film exclusively on www.hulu.com.

The documentary follows the story of Maison des Enfants de Dieu, an orphanage in Haiti. Through a friend’s connection Wolfer had been invited to stay at the orphanage. When he arrived, he unexpectedly found himself in the middle of a developing story. In the wake of the earthquake’s destruction, the U.S. State Department was trying to evacuate the orphanage’s children out of the disaster zone. The situation had stirred up media frenzy, as Fox News and CNN descended upon the orphanage.
Wolfer captured more than 20 hours of footage, chronicling the plight of the orphans, the efforts of the orphanage staff, and the eventual military evacuation of those children who had American families waiting for them. Some of his exclusive footage was used on news broadcasts from Haiti; the rest he carefully sorted upon returning to PUC and began editing into a documentary initially called Taking Haiti Home. 
His first screening of the work in progress, at the Cameo Theater in nearby St. Helena, was a big hit. The film was well received, and Wolfer invited Greg and Tawnya Constantino, adoptive parents who were featured in the movie, for a spirited and informative question and answer session. 
Not long after, Wolfer was afforded a serendipitous opportunity. By chance, a friend and colleague met one of the heads of Mattoid Entertainment, an independent film distribution company founded by entertainment industry veterans Andrew Robinson, Jenna Edwards and Jeremy McGovern. Mattoid was seeking to acquire and distribute new documentary films. The colleague couldn’t give enough praise for Wolfer’s film, and by the end of the conversation Robinson asked for an introduction.
The resulting conversation and film screening impressed Mattoid Entertainment. “We…felt that it had a lot of heart, was well put together and really took you inside the world of those going through the aftermath of the Haiti earthquake,” says Edwards. “It is a heart-felt documentary that takes you into the trenches and was made by a wonderful filmmaker, so we are all very excited …to get the film out.”
Wolfer and Mattoid reached an agreement, and the company took over marketing and distribution while Wolfer retained rights to the film and final cut approval. Having worked with online distribution before, Mattoid felt that an online release would be the best outlet for the film to remain timely and to receive the broadest possible audience. 
Wolfer’s next priority is to finish school and complete his bachelor’s degree in film and television at PUC. But in the long term, he plans to develop more documentaries—“something adventurous,” he says, that involves more travel and more opportunities to experience different cultures.

Thursday, January 13, 2011

Haiti: Through Our Own Eyes

In the year following the devastating Haitian Earthquake child rights organisation Plan International commissioned a photojournalist to train and work with 22 Haitian teenagers. Over the course of two weeks these young people documented the world through their own eyes.

Tuesday, January 11, 2011

Photographer Looks Back At Surviving Haiti Quake

Dan Woolley was in the Hotel Montana in Port-au-Prince last January when Haiti was struck by a massive earthquake. He was rescued days later, after living in the hotel's elevator. He looks back at his ordeal, with the AP's Rich Matthews.

Monday, January 10, 2011

Doctor In Haiti Used Rebar To Fix Broken Leg

Volunteer surgeon, Dr Bill Tendhaaf, ran out of "external fixators" early on so he went into the trash found some rebar and went work. No pain killers in this hospital. Instead, the patients were singing Christian hymns to get their minds off the agony.  No rebar being used at HAH, but there remains a continuing need for equipment and supplies to maintain the orthopaedic program.

Haiti Earthquake Aftermath Montage

A week after the devastating earthquake hit Haiti, Khalid Mohtaseb was hired to shoot ENG footage for two international networks. This is a montage of personal footage he shot of the aftermath during his spare time, in and around Port au Prince.  A couple of days before the anniversary of The Big One, these images serve as a reminder of how devastating the initial event was.

Saturday, January 8, 2011

Haiti: One Year Later

Médecins sans Frontières teams established a major orthopaedic center in Carrefour, very close to Hopital Adventiste, shortly after the Big Quake.  Now the MSF facilty is closed to musculoskeletal trauma and the Dietrichs, with help from volunteers, are picking up the slack at HAH.

Friday, January 7, 2011

On Eve Of Haiti Quake Anniversary Little Change

Little has changed except at Hopital Adventiste d'Haiti where the orthopaedic program that Dr Scott Nelson started shortly after the Big Quake is flourishing under the guidance of Terry and Jeannie Dietrich.

Thursday, January 6, 2011

A Photographer Reflects On The Difficult Year For Haiti

Photographer Damon Winter reflects on the difficult year for Haiti starting at the 30 second mark extending for the next 4 minutes.  Ignore the rest of the video on how the Tea Party helped set the political agenda in 2010 and Oprah Winfrey's new cable network.

Wednesday, January 5, 2011

Haiti: Where Aid Failed

Haiti should be an unlikely backdrop for the latest failure of the humanitarian relief system. The country is small and accessible and, following last January's earthquake, it hosts one of the largest and best-funded international aid deployments in the world. An estimated 12,000 non-governmental organisations are there. Why then, have at least 2,500 people died of cholera, a disease that's easily treated and controlled?
As you read more on the story and ponder the dysfunction that has plagued many NGO efforts to date, it makes one realize what a great opportunity exists for a prospective donor to maximize bang for the buck by contributing to the Ortho Program at Hopital Adventiste.
Image by Nicholas Kamm