Cultural Sensitivity For Volunteers

Team Sinai will be departing soon for their mission week in Haiti. In preparation, husband and wife team leaders, Merrill Chaus and John Herzenberg, put together some words of advice and hopefully wisdom and maybe even inspiration for all team members to consider....

As we approach this mission, our collective thoughts and consciousness subtly but inexorably will shift away from our natural day to day activities stateside, and towards the mission ahead of us. Today we want to talk about the issue of cultural sensitivity. This is going to be a daily challenge during our entire stay in Haiti. Here's some thoughts to consider:

1. We are guests in a Haitian hospital, and so we must always behave as the gracious guest. There may be times when you are feeling exasperated by some of our host doctors/nurses/staff/patients. Take a moment to compose yourself, and act graciously. Always defer to the sensitivities of our hosts. Scott Nelson, our orthopedic host, has pointed that it is more important to build relationships than to simply provide medical expertise.
2. While we are "Team Sinai", we are not competing with any other team, other than ourselves.
3. Make a serious effort to use Creole or French phrases whenever possible. Say "Bonjour" (good morning), or "Bonswa" (good afternoon) to every Haitian staff or patient you come across. By using their language, you are sending them a message that you value and respect their culture, their language, and them. It is also a great ice breaker when you mangle a phrase. While we are in Haiti, make an effort to learn MORE phrases. Arm yourself with a phrase card you can study from.   Your homework (BEFORE WE ARRIVE) is to learn how to say in Creole "How are you?".....there will be a quiz when we meet in the airport....Hint: there are two correct answers to this question...Extra credit for anyone who gets both...

4. Make an effort to work with the local Haitians, not around them. Ask them what they think is the best way to treat something or deal with a problem. The entire nation of Haiti is in the lowest, most desperate point in their history. The last thing they need is to feel their pride or integrity or intelligence challenged. We are going to be in Haiti for a mere seven days. They live there forever.
5. Be kind and sensitive to the patients. Explain (with the help of a translator) what you are doing, if it will hurt, and why you are doing it. You may want to take a photograph of a patient. Ask permission first. Back home you would never think of whipping out your camera and photographing a patient without first asking permission. The same standards must be observed in Haiti. If you photograph someone without their permission, particularly if they are in a compromised situation, in pain, or incompletely dressed, then you are relating to them as if they were less than human. Kindness and consideration should always be at the forefront of your actions.
6. If you witness another team member acting inappropriately, take them aside and gently point out to them that their actions may be interpreted as insulting or dismissive.

7. Don't do anything in the hospital that you would not be allowed to do back home. This is particularly important for the young people in our group. The Haitian nurses and doctors and patients will be constantly observing our every action. The Haitians are sensitive to the concept of having to suffer with a lower quality of medical care than most of the rest of the world. Nonetheless, as a matter of pride, they will reject any medication that is beyond its expiration date. Please do NOT bring any expired items! Many of you may be willing to take a Tylenol in your own homes that is slightly beyond expiration date, but this is not acceptable during our mission.
8. Dress modestly. In the USA, it is common for men and women  to wear shorts. Many young women in the USA bare their midriffs. In Haiti, this is not acceptable. Remember, we are guests. Be friendly and engaging. Make an effort to talk and interact with the Haitians. Do not spend all your time with the other Team Sinai members. Make local friends.
9. We are working in an Adventist Hospital, affiliated with the Seventh Day Adventist faith. The Adventists pray frequently, openly, and often use biblical references. Team Sinai is comprised of a multicultural and multiethnic mix. We must always be respectful of our SDA hosts. When our hosts pause to pray, your appropriate response is to also pause, lower your head, and be respectful.
10. We are going as volunteers, and must be willing to do whatever the local authorities deem important for us to do. Be gracious, be flexible, and always cheerful. We are not heroes. We simply have the privilege to serve.

Primer For Volunteers At Hopital Adventiste

Michael Fielder volunteered at Hopital Adventiste d'Haiti with Explorers San Frontieres and developed the Primer for HAH Volunteers.  Within the site are some good orientation photos and a handy Medical Creole Cheatsheet worth downloading.  Thanks to IC Andrew Haglund for bringing this information to our attention.

The Real Meal Deal

Toward the latter part of April and early May, some volunteers were reporting a scarcity and even complete absence of the previously "guaranteed" prepared meal at Hopital Adventiste d'Haiti   At least 3 seasoned volunteers, Drs Scott, Hasan and Ryan have confirmed that at least over the past two weeks there has been one Haitian meal of generous proportion available for all the volunteers each day.

However, it is important to note that volunteers are still responsible for their own breakfasts and suppers.  In addition, there remains an abundant selection of "leftovers" discarded by departing volunteers that you are welcome to scavenge.

Trip Reports Welcome

This blog was conceived with a decidedly orthopaedic focus but we soon realized that the restoration of Hopital Adventiste d'Haiti is truly a team approach encompassing many facets of the volunteer spectrum.  To that end, we welcome input from physicians of all specialties, nurses, medical students, physician assistants, therapists, contractors, pastors, social workers, administrators, organizers, and cleaners...anyone with a story to tell.  

 

You are encouraged to:

• send in a report even if you volunteered weeks ago
• tell us a little bit about yourself and the makeup of your team if applicable, where you're from and your dates of service
• tell us what the trip meant to you
• provide up to date information (if recent volunteer) regarding current conditions at HAH
• read the Things to Bring and Volunteer Info sections and suggest additions or corrections
• present memorable moments, acquaintances, and experiences
• share a few photos from your trip
• send us links from other volunteer blogs or other relevant sites of interest 
• forward the haitbones link to anyone who might be interested in writing a trip report

In other words, we are soliciting your aid to keep ongoing enthusiasm for the project alive in spite of waning coverage for the plight of Haiti in the mainstream media.

Please email your blog contributions to rongeur@gmail.com 

Thank-you for your service and continued support.

Surviving The Port Au Prince Airport Experience

There are few things as unnerving in Haiti as the arrival in the airport and passage to Hopital Adventiste.  What follows is our brief survival guide.  

The Immigration portion is relatively painless except for the long lines.  We noted with amusement then frustration as the leaders/organizers of a couple of the larger volunteer groups bullied their way to the front of the lines.  Apparently, they were demanding special dispensation for members of their team ostensibly because they were there to save Haiti.  The only problem was the majority of the arrivees were volunteers as well so there was no indication for preferential treatment.  This selfish behavior drew the ire of a few  of the locals and escalated into an embarrassing shouting match.  As mentioned in a previous post, there are few heroes in Haiti so please be patient and wait your turn.

Once you make it through the Immigration ordeal, Customs is relatively painless.  We carried letters requesting exemption from tariffs but the Customs personnel appeared to be unimpressed and largely ignored them.  Agents may want to take a look inside your bags but we were not aware of anyone pressured to pay duty for medical supplies.    Never the less, I would recommend obtaining the introductory papers that can be procured from Loma Linda University Global Health Institute.

When you leave Customs, if at all possible, stay underneath the covered walkway before exiting through the Red Gate.  Not only will you be protected from the brutal rays of the sun until your transportation arrives (which could be hours), you don't want to head out into the sea of humanity prematurely for reasons outlined below.

Before exiting the Red Gate, make sure that you confirm that your driver is outside the enclosure.  He will usually be holding up a piece of paper with identifying information that you will be able to recognize.

As soon as you pass through the Red Gate, hordes of entrepreneurs will descend upon your luggage expecting to be compensated even if they lay hands upon your gear momentarily.  Our recommendation is to make sure that you have a few $1 bills ready for the airport.  Do not open up your wallet with multiple bills exposed.  Find a couple of the ringleaders and hand out no more than two dollars/bag in gratitude for them transporting your gear to the vehicle. 

Multiple others will cry foul and demand reimbursement but stand firm as you will never come close to appeasing everyone.  Climb into your vehicle as soon as possible to escape the mob.  Another option is to solicit your driver to help navigate the impasse however that tactic will be dependent upon how fluent you are in French/Creole or how well your driver understands English.

The drive from the airport can be harrowing but you will observe things that will remain in you memory for years to come.  It was comforting to know that we were in good hands as we were driven to the hospital.

Recommended Vaccines Before You Depart For Haiti

A number of vaccines, noted below, are recommended for travelers to Haiti by the Centers for Disease Control and Prevention. See your doctor before you travel to make sure you have had all necessary vaccines.

• Routine: Be sure that you are up to date on vaccines such as measles/mumps/rubella (MMR), diphtheria/pertussis/tetanus (DPT), polio, seasonal and 2009 H1N1 flu, and varicella as appropriate for your age. This will protect you and also the people you are going to help.
  
  • Measles has been eliminated from Haiti, but there is a risk of a measles outbreak if someone who has measles travels to Haiti. Therefore, it is very important that you are protected against measles. If you are protected against measles, this ensures that you will not be able to spread the disease in Haiti. Make sure that you have evidence of measles immunity through one of the following ways:
    
    1. evidence of measles vaccination (2 doses), OR
    2. laboratory evidence of immunity or confirmation of disease, OR
    3. having been born before January 1, 1957, as evidence of acquired infection.
    If you are not protected against measles through one of these ways, CDC recommends that you get the MMR vaccine before traveling to Haiti.
  • A current tetanus shot is also very important.
• Hepatitis A or immune globulin (IG): Even if your departure is imminent, one dose of hepatitis A vaccine provides adequate short-term protection for healthy people. For long term protection, a second dose is required 6–18 months after the first dose, depending on the brand of vaccine used.
• Typhoid: There are two vaccines available for typhoid prevention. The injectable vaccine may be preferable to the oral vaccine in cases where travel is imminent. The oral vaccine requires refrigeration and 4 tablets taken every other day over one week.
• Hepatitis B: If your departure is imminent, the first in a three-dose series (day 0, 1 month and 6 months) may provide some protection. An accelerated dosing schedule may be used (doses at days 0, 7, and at 21–30 days with a booster at 12 months).
• Rabies: If your activities in Haiti will bring you into contact with animals such as dogs, cats, bats, mongooses or other carnivores, you should consider pre-exposure rabies vaccination, which is a three-shot series (days 0, 7, and 21 or 28) given before travel. Even if you receive pre-exposure vaccination, you will still need immediate medical treatment if you are bitten or scratched by an animal. (See the Animals section for more information.)
• The vaccine recommendations on this page are based on diseases previously observed in Haiti and the possibility for outbreaks in the aftermath of the earthquake. At this time, vaccines for diseases such cholera and meningitis are not recommended and polio booster vaccination for individuals already fully vaccinated against polio is not recommended.

CDC Warns Haiti Relief Workers To Watch For Signs Of Dengue Fever

The Centers for Disease Control and Prevention are warning people who helped with earthquake relief in Haiti to be on the lookout for Dengue fever. 

Dengue fever is characterized by high fever plus two or more of the following: headache, retro-orbital pain, joint pain, muscle or bone pain, rash, mild hemorrhagic manifestations (e.g., nose or gum bleed, petechiae, or easy bruising), and leukopenia.

The incubation for the virus ranges from three to 14 days but is typically about one week; therefore, illness may occur while the workers are stationed in Haiti or after they return to the US. Most dengue fever cases can be treated with bed rest, acetaminophen, and oral fluids.

A small proportion of patients develop dengue hemorrhagic fever (DHF). In those cases, patients have a resolving fever or a recent history of fever lasting two to seven days, any hemorrhagic manifestation, thrombocytopenia (platelet count <100,000/mm3), and abnormal vascular permeability evidenced by hemoconcentration, hypoalbuminemia, or abdominal or pleural effusions. DHF can result in circulatory instability or shock, and the risk for these complications may be increased among persons with prior dengue infection. Adequate management of DHF patients generally requires timely hospitalization and judicious administration of intravascular fluids and close monitoring of vital signs and hemodynamic status. 

The 7.0 magnitude earthquake that struck just outside Port au Prince on January 12, 2010, caused extensive damage to homes and utilities and left many residents without proper shelter or access to important services such as electricity and water. Exposure to the elements and increased opportunities for mosquito breeding site proliferation have likely increased the risk of disease spreading, such as dengue.

Since dengue is endemic in Haiti and relief workers responding to previous disasters in Haiti reported high rates of dengue infection, the CDC Dengue Branch is warning physicians to evaluate travelers returning with a febrile illness (or a recent history of febrile illness) from Haiti and report cases of suspected dengue to either their local health department or CDC.

If you have questions, call the CDC's at 800-CDC-INFO (800-232-4636).

More "Junk For Jesus"

A truckload of broken wheelchairs and rusty beds without mattresses arrived at Hopital Adventiste today and workers commenced unloading "the gift."  In the image below you can see the look of gratitude on Jerry’s face.

An attempt was made to tell the chauffeur that he had arrived at the wrong location but he assured the staff that there was no mistake.

This incident and post hopefully serves as a gentle reminder that we all need to be careful before donating unclaimed treasures to a third world mission project.  Although the needs are great,  please examine the practicality of your intent before money and energy for transport then probable disposal is expended.

Culinary Review Of The Humanitarian Daily Ration

The followers of the Supreme Master of Ching Hai prepared over 3000 vegan meals/day for the campus since the latter part of January.  Unfortunately, this past weekend, they all left for home.  Fortunately, prior to their departure, they worked with the Haitian cooking staff and trained them in the art of preparing meals for the masses so there remains a largely vegetarian prepared food option at least once a day. 

In the corner of the Volunteer Breakroom there is almost a case of orange Humanitarian Daily Rations that always seemed to be replenished in a mysterious fashion.

Humanitarian Daily Rations (HDRs), are food packs intended for humanitarian crises.  Each is intended to serve as a single person's full daily food supply, and contain somewhat over 2,200 calories. They have shelf-lives of about 3 years (I would have guessed much longer), and their contents are intended to be acceptable to a variety of religious and ethnic groups, including metro volunteers.

The meals are designed to be able to survive being air-dropped, without a parachute. This is safer for the refugees than parachuting large pallets of rations, as well as preventing meal hoarding by individuals.

The meals cost approximately 20 % the cost of the Army's equivalent Meals Ready to Eat (MRE).

Since volunteers may now have to rely more heavily upon these alternate food sources, we asked our resident gourmand, Pete Elsissy to critique one of the Humanitarian Daily Rations.  Although he reviewed Menu #4, they all are very similar.

There are always vegetable crackers, a fig bar, peanut butter, a fruit pastry (pop tart), a shortbread cookie, and jam in addition to two entrees.  Entree options include 2 of lentil or barley stew, vegetable rice, red beans and rice, beans and rice with tomato sauce, peas in tomato sauce, and beans with potatoes.

The bottom line is that Pete gave a big thumbs up for the crackers, cookies, and pop tart as long as they were slathered with peanut butter and jam.

Pete found the two entrees, peas in tomato sauce and rice with vegetable (singular, not plural) to be unpalatable.  As a side note, Jim regards anything soaked in ketchup highly so gave a big thumbs up to the peas in tomato sauce which proves there is no accounting for taste.

In spite of the fact that he scorned the entrees, the peanut butter/jam combo on the baked goods won Pete over and he rendered his overall endorsement to the Humanitarian Daily Rations.

In all seriousness, the Haitian beans and rice are tasty but can get a little long on the tooth  on a daily basis so Pete recommends that you exercise your culinary options...be adventurous and give the HDRs a go.

Before You Go To Haiti: A Volunteer's Guide

Craig Culbreth and Dennis Wilbanks from Florida Baptist Media Services fill you in on a few things you need to know before taking a mission trip to Haiti to assist in earthquake relief and recovery. 

Although not specifically intended for medical personnel, there are a couple of worthwhile tips to be gleaned from this short narrative.  I particularly found the comments relative to taking pictures of people to be apropos and well worth taking to heart.

Junk For Jesus

Between cases we all have spent time in the  storage room trying to sort through boxes of donated gear, much of it outdated, incomplete, damaged...essentially worthless and euphamistically referred to as "Junk for Jesus."  

We even got Chad Nelson involved in the organizing of the mountains of gear. 

The take home message is that if you or your hospital are contemplating donating unwanted equipment or supplies to an overseas mission field, please make sure that it is reasonably current, practical, and in good working order before you ship it.

SIGN Disaster Relief Handbook

A SIGN Disaster Relief Handbook has been published online and is designed to document lessons learned from Haiti and use them to be better prepared for the next phase of treating earthquake victims as well as for future disaster relief missions.

The handbook can be found at orthopaedia. Dr Lewis Zirkle is encouraging orthopaedic surgeons and other medical professionals to read the handbook and offer their input. Comments can be sent directly to SIGN at signcom@sign-post.org.

American Airlines Haiti Bag Limitations

We are getting excited about our upcoming trip to HAH and have been hearing many rumors regarding baggage limitations so thought it might be worthwhile to clarify this issue.  Here are the following guidelines from American Airlines that are current as of this date.  It is my understanding that the airlines are no longer adopting a liberal interpretation of their size and weight restrictions and are strictly applying the overage fees.  We'll soon find out!
 
In an effort to ensure all customers' bags and relief effort items are accommodated on their scheduled flight, it is necessary to impose a bag limitation, on all excess, oversize, and overweight baggage to Port au Prince, Haiti (PAP). Customers traveling to Haiti are allowed:

• Two checked bags - 62 in/157 cm each (length + width + height) weighing no more than 50 lbs/23 kgs each
• One carry-on bag - 45 in/114 cm (length + width + height) weighing no more than 40 lbs/18 kgs
• Each passenger may check one additional piece of baggage. Excess baggage charges of $100 per bag will apply
• Oversized (63 - 115 in/160 - 292 cm) and overweight bags (51 lbs - 100 lbs / 23 - 45 kgs) will be permitted. Oversize and/or overweight charges will apply

Itinerary	Overweight Baggage Charges	Oversize Baggage Charges
For travel to/from Port au Prince, Haiti (PAP)	Checked baggage weighing over 50 lbs/23 kgs but not more than 70 lbs/32 kgs will be charged at the rate of $50 per piece. Checked baggage weighing over 70lbs/32 kgs but not more than 100 lbs/45 kgs will be charged at the rate of $100 per piece. Baggage weighing more than 100 lbs/45 kgs will not be accepted as checked baggage.	Checked baggage which is larger than 62 in/157 cm will be charged at the rate of $100 per piece. Baggage measuring more than 115 in/292 cm will not be accepted as checked baggage.

James Price, MD Volunteer Advice

The following advice was written by James Price, Orthopaedic surgeon from Dublin, Georgia and is reposted with permission.  Not only is the information applicable to many hospitals in Haiti, it is excellent counsel for any orthopaedic surgeon volunteering in a third-world country.

As one who has operated in third world hospitals and makeshift clinics, before and including Haiti- some further advice for first timers- so you will not have to learn the hard way. 

1- Do not assume anything. Just because you are going to a "hospital", they may not have anything that you expect them to have. If they have "it" there is an even chance it no longer works as it was old when it was donated several years ago and there was no one there who knew how to fix it when it malfunctioned and no spare parts anyway. If you really need it - bring it with you. 

2- You need help from people who live there. They need to arrange the patients to make efficient use of your time there. Contacts with American Missionaries, especially those with medical training, are a great resource. 

3- Build relationships with the local docs whenever possible. They can help find the kinds of cases you do and help out with follow up when you leave. The way they treat things may be old fashioned, but may be based on what they have to work with and their training. 

4- Leave the hospital or clinic better off than when you came. Remember, their supplies may be very limited. If you use up all the IV fluids showing off your arthroscopy skills, there may not be an IV for the next C-section. Cover the cost of what you use and leave a little extra. 

5- Keep it reasonable as far as complicated cases and potential complications. Remember, you are leaving- do not leave a potential disaster. I try to think in terms of something a general practioner would be comfortable following up for me when I leave a post op patient. 6- If you do elective surgery and do have a major complication after you leave, go back and take care of it or at least make arrangements with appropriate local docs. 

7- Keep our reputation in mind. American Orthopaedists are held in high regard in many third world countries. We do not want to do anything to change that opinion. 

8- Take at least one gallon of Cidex OPA along with a plastic container with a lid. A 20 minute soak of the instruments seems pretty safe. The lid keeps the flys that may be in the OR out of the sterile instrument soak. That helps morale. 

9- Learn how to make solutions, re-sterilize gloves and paper gowns. Look over old ways of treating things as it may be the only option you have. Remember pins in plaster, wedging casts, etc? 

10- Think about the next guy or gal that will be treating the patient, often without any records. Do not put on a cast if there is no way for the next doc to get it off- use a splint if you can. Take a marker and write on the cast or splint explaining what was done and what is underneath. 

11- Take care of yourself- be sure you do not become part of the problem by getting sick or injured. Be sure you should go in the first place. 

12- Do not get overwhelmed. You come for the right reasons. You do what you can do and then you go home. You always feel you did not do enough, because of the magnitude of the problem. Go easy on yourself, you have done what very few can or will do. 

13- Find out about and follow the rules for that country. Some countries welcome us, some do everything they can to make it difficult. We try to get tempory licenses whenever possible. 

14- Do not show up in a disaster area without planning, equipment, local contacts, etc. You will be in the way and part of the problem. 

15- Talk to and learn from the people you work with and who set up your OR at home. There is a lot more to it than you think. Even better, take them with you. 

16- Take someone with you that is very talented at fixing things if you are not yourself. 

17- Take lots of Duct tape, superglue, epoxy putty, plastic sheeting, some tools, hoses, fly swatters, rolls of exam table paper (for the OR table), rubber bands, rubber tubing, more scrub brushes than you think you need, and paper gowns for the patients, earplugs for sleeping. 

18- Take cash for things you forgot. 

19- Take lots of local anesthetics. 

20- Be sure you have arranged good translators. 

21- Be willing to teach. 

22- Many third world Mission Hospitals are exactly that-Mission as in "Church Missions". Be sensitive to that fact and understand that they may consider themselves first and formost missionaries. We are their guests. 

23- Go back and do it again. You will be much better the second time. 

24- Thank you for the great efforts put forth by the AAOS membership. Keep it up.

Haiti Relief Volunteer Application Process

LLU/GHI coordinates and processes volunteers for Adventist Health International Services (AHIS), which manages and operates the Hopital Adventiste D'Haiti, in Port-au-Prince.  AHIS requires the forms to be filled out on their secure website in order to complete the volunteer application.  Click here to begin the process.

Haiti Volunteer Information From Dr Nelson

Thanks to the many volunteers interested in helping with the efforts in Haiti, it has become impossible to answer all the individual email inquiries. Planning weeks into the future is also difficult as the situation and needs are dynamic and changing by the day. If you are interested in volunteering or donating please go to www.lluglobal.com or www.cureinternational.org to find out the latest information and sign up. The volunteer teams are scheduled through the Loma Linda Global Health Institute in collaboration with CURE International at the above sites. Our efforts are currently focused at the Hopital Adventiste d'Haiti and include plans to provide ongoing care to earthquake victims while establishing a functional hospital and creating an orthopaedic and rehab focused long term teaching program.

Currently we have had ample surgeons, however nursing and ancillary staff has been in short supply. Many of the employees have lost immediate family members in the quake and have yet to come back to work. As time evolves local workers will fill in some of the workforce needs. However due to the high patient load and current lack of staff, RN, MD, and other ancillary volunteers are needed in the emergency department, pediatrics, OB, and rehab as well as surgery.

Surgical disposables (gowns, gloves, drapes, and dressings) are needed items and will continue to be in short supply. We are currently depending on donations for these items as a functional supply chain has yet to be established. Other needed items can be coordinated through Jerry Daly of LLU Global Health Institute or Heather Hunter of CURE International.

Project Ortho At The Hopital Adventiste d'Haiti

Over a week ago I received an email from Scott Nelson who had made his way to Port au Prince a couple of days after the tragedy had struck and had already started treating patients. He informed me of the incredible need for orthopaedic surgeons in the weeks to come and of his plans to devote several months to working at the Hopital Adventiste d'Haiti in an attempt to make a dent in all of the pathology. He also expressed a need for basic equipment such as a C-arm, fracture table, SIGN nails, autoclave, lab equipment, etc.

For those of you who are not familiar with Scott, he is a graduate of the Loma Linda University Orthopaedic Surgery Residency program. After completing a pediatric orthopaedic fellowship in San Diego he moved his family to the Dominican Republic where he has worked at the CURE Hospital in Santa Domingo for the past 5 years. During that time he has also made 19 1-week trips to Haiti and has become quite proficient working in that challenging environment.

I'm of the mindset that I like to know where my donations are going and I would prefer to contribute to an orthopaedic-related charity in this situation. I know from firsthand experience that Scott is incredibly frugal and resourceful and will see to it that the funds/equipment that are entrusted to him will be well spent.

If you feel so moved to help you may do so in one of the ways outlined below.

Click here to make a credit card donation to Loma Linda University Global Health. In the comments section please write "Haiti Ortho."

If you prefer to write a check, make it out to Loma Linda University and in the memo section include the words "Haiti Ortho." The address is Global Health Institute, 11226 Campus St., Loma Linda, CA 92354. Their phone number is 909.558.8541 if you have questions. Your donation will be sent to Gift Records in Loma Linda University where a receipt will be generated for tax purposes. 

Scott has already received 2 sets of SIGN Nails which will keep him going for a few weeks and he would appreciate help to offset that cost. If you would like to contribute to the purchase of the fracture fixation nails for Haiti, click here and include the words "Scott Nelson" in the comments section.

I have been in contact with Scott over the past couple of days and he is truly grateful for your impending generosity. I have been also been working closely with Jerry Daly of the Global Health Institute to ensure that your contribution is spent wisely. Please don't hesitate to contact me through this website if you have questions and thanks again for your interest in this project.