It's Not Too Late...

to donate to the Hopital Adventiste Ortho Project and still claim a deduction on your 2010 Income Tax Return! We're all bombarded with pleas for financial assistance this time of year but I cannot think of a purer philanthropic endeavor as 100% of your tax-deductable donation will go directly to patient care...no administrative fees whatsoever.  In addition, I've never met anyone who can stretch a buck further than Scott or the Dietrichs.

Earlier this month I had the opportunity to serve 10 days with Scott Nelson and Terry and Jeannie Dietrich at Hopital Adventiste d'Haiti.  You can read about the trip on this blog as well as the Orthopedic Ministries of the Caribbean website.

Jeannie and Terry Dietrich

For those of you who are not familiar with the Dietrichs, Terry and Jeannie recently put a lucrative orthopaedic practice on ice (literally, they are from Wisconsin) for 12 months.  They have dedicated a year of their lives (without financial remuneration) to not only maintain the gains made by Scott Nelson and short-term volunteers since the Big Quake but are attempting to create a viable musculoskeletal program that can be self-supporting for years to come.

Jeannie cleans and organizes equipment, preps patients, and first assists...even more impressive considering she sustained a bad fracture/dislocation of her shoulder 3 wks prior to this photo being taken 

The following is an additional update written by Terry Dietrich shortly after leaving Haiti a few days ago:

The work that was started at HAH in the days and weeks after Jan 12 by Dr Nelson is of inestimable value to the Haitian people. They have never had a comprehensive orthopedic program available in the past.  Now they have at their disposal (especially the indigent patients) expert care that can address generations of neglected and untreated musculoskeletal conditions such as limb anomalies like clubfeet, spine deformities, acute trauma, tumors and infections. From what I have been able to see during the total of seven weeks that I have been involved at HAH, is that it has become one of the few bright spots in an otherwise largely dismal picture of what has happened (or more correctly, NOT happened) in Port-au-Prince since the Big Quake on January 12.  God has certainly worked strongly through Dr Nelson and the hundreds of volunteers at HAH to not only help the Haitians directly injured during the earthquake but hundreds of others such as Staille and the 37y/o lady who came to HAH one week ago yesterday with an unstable pelvic fracture. She had been initially evaluated at Medecins Sans Frontieres and told she would need to be at bed rest for at least 3 months. She was returning to Florida to be with her husband in West Palm Beach, one of the most affluent communities in Florida prior to her injury. Dr Nelson and I finished surgically stabilizing her pelvis at 4am and then cleaned the instruments and restocked the trays so they could be properly sterilized and ready for the next time needed. That work was finished at 5am. We left the hospital 30 minutes later for the airport to return to the United States and Dominican Republic respectively. This was just 36 hours after Dr Nelson had been hand delivered a letter absolving HAH and sponsoring entities of any responsibility for any anything that might happen to him during his continued stay in Haiti. He had decided to stay at HAH to provide ongoing urgent care for patients that still required his expertise for 2 more days after all the expatriates had been ordered to evacuate Haiti. Those extra two days that I was able to have with Dr Nelson were a gift from God. It helped me greatly to be able to finalize several aspects of patient care that I can now be better able to manage.

Dr Dietrich is hoping to establish elective Sports Medicine and Total Joint Arthoplasty programs at HAH to supplement income for indigent patients.  Donations of functioning Linvatec arthroscopic gear welcomed.

Some of the more pressing needs are as follows:

• Travel expenses for OEC tech to recalibrate C-arm damaged during power fluctuations - ($1,000)
• Funding for Vieja (Dominican OR nurse, worth her weight in gold) to return for 4 1-week reorganization stints - ($3,000)
• Set of reusable, heavy-duty cloth surgical gowns - ($5000)
• Doubling of inverter capacity to protect electronics against power fluctuations - ($6,000)
• Funding for Ortho Technician training program - ($10,000)
• Funding for Haitian anesthesiologist to commit to at least 2 full days a week - ($1,000/month)
• Second OEC 9600 C-arm as this would enable the team to perform simultaneous cases that require imaging as well as serve as a backup - ($50,000)
• Renovating the Operating Theatre (creating additional room, enlarging existing rooms - ($100,000)
• Indigent patient fund (presently care is free but in order for the hospital to survive, this policy will be forced to change sooner rather than later) - ($$$$$)

If you're inclined to contribute, simply click here and under the Comments section write "HAH Ortho" and/or any other specific instructions you desire. 

Thanks for the continued support of your thoughts and prayers.  Not only are your fiscal contributions greatly appreciated, but there exists an ongoing critical need for short-term volunteers, especially surgeons, anesthesiologists, and nurses.  Feel free to contact Terry and Jeannie directly at tj.dietrich99@gmail.com for more information.

Team Sinai Haiti Plans To Return

Team Sinai Haiti's plans were to return for a week of service on December 26, at which time  they would have been the only expatriate medical team present, with the long term volunteers being scheduled out for the Christmas/New Year holidays. Unfortunately, fate intervened, forcing them to cancel their trip.  Read the rest of their story.

All packed up but no place to go!

US Worker Held In Haiti Jail - Says He's Being Extorted

Paul Waggoner, humanitarian relief worker in Haiti and co-founder of the international NGO, Materials Management Relief Corps (MMRC) has been apparently unjustly detained in a Haitian prison. Add your voice to call on Senator Kerry to exhaust all means available to him and the U.S. government to ensure Mr. Waggoner's immediate release. 

Over the past couple of days, I have been contacted independently by 3 credible individuals who have brought the plight of Paul Waggoner (aka Little Paul) to my attention.  Each one of these veteran Haiti volunteers have had first hand knowledge of Little Paul and have vouched for his passion for the Haitian people and the contributions he has made to Hopital Adventiste since the Big Quake.

Read more of the story in Jessica Scott's blog, AOL News and the Men's Journal.

Trip In Brief From Flight AA 816 – 17 December 2010 By Scott Nelson

We thought that it was over when we finished all of the urgent cases of the week about 6 o’clock last night. After returning to the hospital from a dinner with Dr. Hans Larsen president of Societe Haitien de Orthaedie et Traumatologie we were faced with another patient in our emergency room who had been in a car accident. She had a complex pelvic fracture that under normal circumstances could have waited another day or two prior to surgery, but since there are no other options in Haiti for injuries of this type we prepared our instruments and aroused the operative team. We had just enough time to complete the case prior to our 5:30am departure from the hospital. After finishing the case and washing our instruments we went upstairs to finish packing our bags just as the roosters began to crow. This operation represented a culmination of blessings and teamwork that occurred throughout our trip. 

Just a few of the trip highlights… 

• Brent Scully, Sebastian, and Randy Tall installed an inverter system to protect our sensitive OR equipment against power surges and the frequent power failures that have inevitably caused our C-arm fluoroscope and monitoring equipment to fail. 
• Terry and Jeannie Dietrich – are perhaps the biggest of all blessings during this week. They are now on site full time and will be able to maintain continuity of care for our patients and provide a system to increase the productivity of our highly skilled surgical volunteers. Terry is also starting an orthopaedic technician training program which will have a major impact on the services at HAH as well as other hospitals around the country. 
• We spent a significant amount of time organizing and cleaning the operating room as this is an essential element to performing high quality operations and making the most out of our donated materials. Most all of the instrument and implant trays which were donated in the early days after the earthquake by Synthes, Smith & Nephew, KCI, Stryker and others are still in excellent condition and in regular use. 
• We upgraded the air conditioning in the sterile supply room thanks to Sebastian who did the dirty work. 
• Our electrical team also replaced the dangerously rusted out electrical outlets and switches in the OR and clinics 
• The clinic and orthopaedic x-ray rooms were completely reorganized, painted and scrubbed from top to bottom, giving a whole new look which is more in line with the quality operations that we do. 
• Patients from far and near, new and return, old and young came for evaluation, treatment and follow up. 
• Many operations were done both simple and complex including thoracic pedicle screw instrumentation for a T3 burst fracture, Taylor Spatial Frames, hip fractures, femur fractures, and tibia fractures amongst others. 
• Remediation from my former professor James Matiko who was able to refresh my surgical skills and improve upon the instrument organization process. His support and attention to detail goes well beyond the confines of the operating room. 
• Adventist Hospital in partnership with Cure International is now recognized as the premier center in Haiti for the treatment of clubfoot. 
• We were blessed by the cancelled flights of American Airlines and political manifestations which prolonged the stay of Dr. Matiko, Greg Bonner (biomed tech), Jere Chrispens (IT) and others. This honeymoon of productivity was ended with the decision of our Adventist leaders to evacuate expatriate workers in a police escorted motorcade early one morning due to the political instability and airport closures. 
• Jere Chrispens worked tirelessly with the technicians at Fuji to help develop an x-ray archival system for our digital x-ray machine. 
• Greg Bonner worked longer hours than the surgery team to resolve the fatal error messages that were preventing the C-arm from functioning. Finally at about 3am on the third day of work he wheeled the machine into the OR with signs of victory. Unfortunately the day after he left it failed again due to an unrelated problem and was again repaired by some diligent orthopaedic surgeons. 
• Even the little things count - like new x-ray gowns (thanks to Jerry Daly) that we are now able to hang on some hooks in the OR made by Brent. 

Although many other people and events deserve mention, I will end by thanking Marni and the boys who constantly encourage service, risk, and hard work. They encouraged me in my efforts to prioritize patient care over evacuation orders and when she found out that I was operating until the last hour of my stay, Marni even suggested that maybe I should stay longer. 

For the first time since January 12 the hospital is void of surgeons, but the patients just keep coming…

Update From Scott Nelson

Received the following note from Scott 7 hours ago, hopefully the case went well and they are safely on the plane by now.  My understanding is that the liaison with the local orthopaedist was to arrange coverage for their patients during Terry's absence.  

Just got back from dinner with Hans Larsen, president of the Haitian Ortho Society.  it was good. On arrival at HAH we found a 27 y F sp MVA with saacroiliac fracture/dislocation. I woke up Vieja and Adrian and they are cooking up the pelvis set to get her operated just in time to catch our ride to the airport at 5:30am. Also I got the C arm working today and we successfully operated on the 69 yo blind guy with the proximal femur fracture (see image below) that was 6wks out. Suffice it to say all is well - map buele. 

Update From Terry Dietrich

Had 7 cases today including the 69y/o blind gentleman with the subtrochanteric femur fracture, everything went well.  Followed by another BIG clinic which finished about 5:30.  Called Hans Larsen (prominent Haitian orthopod) and went to Petionville for dinner with him at a good restaurant. Made it back before 10 to find a 27 y/o in xray with an unstable pelvic fracture. Going to the OR in a bit...won't get much sleep before heading to the airport at 5:30 to catch my 8:30 flight. 

I saw a great case in clinic today. 53y/o farmer from 3 hours away. Raises just enough rice and beans on his small farm to keep his wife and five children from going hungry. Just hand to mouth, nothing left over to sell and get ahead. Has no animals or machinery to assist with the hard work, mainly a hoe to till and plant and scythe to harvest. Has TERRIBLE knees, bad valgus with instability bilaterally. In addition, the left hyperextends 40 degrees, walks way crouched over. 

Jeannie made it to Cabarete fine after a 9+ hour convoy trip and bus ride. I'll join her tomorrow hopefully by 3pm.

Update From Scott Nelson

I received the following update from Dr Nelson this evening.  I also had the opportunity to speak with him by phone earlier today.  Both he and Terry are safe and in good spirits.  

The day was kicked off by the evacuation of nearly all the expatriate employees and volunteers who fled the country in a police escorted convoy just before dawn. A core team of essential medical volunteers consisting of Terry Dietrich, Scott Nelson and our Dominican anesthesiologist and nurse stayed behind to take care of the patients that had been waiting for urgent surgeries and provide post operative care for the recently operated cases. As day broke the patients began to line the hallways. There were more patients than usual since many had not been able to come last week due to lack of public transportation during the riots that broke out across Port au Prince. We operated on seven patients today consisting of several severe fractures of the upper extremity which would have almost certainly gone without proper treatment had we not been there. In spite of the fact that we have closed ourselves down to new trauma referrals, seven more urgent cases are already scheduled for tomorrow. Fortunately there has been no civil unrest at the hospital or immediate area surrounding the property and we hope and pray for peace and God’s guidance as we continue our work.