JOURNAL OF INTERNATIONAL NURSING
JOIN
Journal of International
Nursing
JOIN Journal of International Nursing; Vol 2; June, 2011
** You can download Today, Leogane by clicking on the tab at the top of the page |
This month’s spotlight is on our new e-book - Today, Leogane. It has taken me a year - and being back in Haiti for the one year memorial of the January 12, 2010 earthquake that - in just 7 seconds - took over 350,000 lives - left over 1 million homeless - and undermined the already fragile healthcare infrastructure and its workforce; many of those who perished were nurses and student nurses who had been inside caring for patients - or in classrooms - learning to be a nurse. No one knows how many nursing faculty perished on that terrible day in a county where there is just one nurse to 10,000 - 12,000 persons - and an even greater shortage of nursing faculty.
Standing there at the mass graves in Leogane on January 12, 2011, I knew that it was time to tell the stories of the many beautiful people who I had the privilege to care for over those dark days - and to give voice to the remarkable heores of care - the student nurses and nurses of Leogane, Haiti.
I hope that you will find the book inspiring and see the need to uplift the vocation and profession of nursing in Haiti. By helping one nurse we help hundreds as the circle of their influence is an ever widening sphere of care - making care stronger than all of her antagonists - care that is stronger than poverty, stronger than hate, stronger than disparity, stronger than social injustice.
Helping Student Nurses in Haiti:
One aid organization - Friends of the Children of Haiti is philanthropic organization that works with nurses to improve the lives of people in Haiti: Friends of the Children of Haiti or FOTCH (www.fotcoh.org/home.html ).
Dianne Peterson, an ED and now radiology nurse from Missoula, MT. Dianne has been a nurse for over 30 years. In 2008 she made her first trip to Haiti—right after Hurricane Ike.
Dianne went to work with the aid organization founded by Dick & Barb Hammond - a couple from Illinois - who have dedicated their lives to improving the lives of their friends in Haiti. Every two months a team travels to Cyvadier to care for hundreds of patients. Please see this website to read their magnificent stories: http://haiti.pnn.com/10724-the-front-page
Dianne first learned about FOTCH from a colleague and friend—Kay Nygaard (an ICU nurse—retired after a few decades of care!) who has traveled with FOTCH to Haiti five times in the past several years.
While in Haiti in November, Dianne met Dr. Nelson—a Haitian physician. She asked about helping Haitian nurses and asked if he knew of any. He quickly smiled and said, ’yes, I know someone’. Dianne got to meet Nadine Moise. Nadine cannot afford to finish school—she lost both of her parents in the 1/12/10 quake. Because of FOTCH we get to meet this beautiful person who wants to be a nurse.
We at NFNI would like to help Nadine finish nursing school. To date, Kaye and friends, Dianne and friends and NFNI have been able to give her $1500 USD toward her schooling – she started back to school on Jan. 17, 2011. I was able to meet Nadine and Dr. Nelson on Sunday January 9 while I was in Port au Prince – she is a lovely person – and is dedicated to her studies! As the CEO of NFNI, I am personally dedicated to helping Nadine, but we need to raise moiney to help her: If you’d like to help her finish school please email me at:
Michele @nursesfornursesinternational.com – or, if you better yet, you can read Today, Léogâne – every book that is downloaded helps us to build our business and our foundation – helping to raise funds to help Nadine and others – like Cici – who want to finish nursing school.
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Officials in Haiti say that more than 300,000 people have been diagnosed with cholera and they estimated 5,000 have died (MSF, June 3, 2011). Nurses are always needed: J/P HRO @ http://jphro.org/ is one aid organization ready to take volunteer nurses.
Money is also needed. The UN says that they have received less than half of the $175 million it needs to carry out its life-saving programs in the country: Your contributions will be well used at http://www.msf.org, J/P HRO, by UNICEF at: http://www.unicefusa.org/work/emergencies/Haiti/? and Direct Relief International;
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Our Nurse of the Month is Rigan Louis:
It is so hard, I will go with you”; those were the first words that I remember hearing, the first words that I understood on that moonless night that had so many shooting stars, beautiful Haitian Creole songs, hours of haunting prayers, wailing, soft whimpers from somewhere in the dark and a near constant onslaught of tremors—after-shocks that cruelly announced that the earth had not yet finished having her way with the beautiful people of Haiti. It was the early morning hours of January 13, 2010 when I first met Rigan Louis—a senior nursing student at FSIL SON in Léogâne, Haiti. He is an exceptional human being—brave, kind and generous. He worked the long hours to help care for the hundreds who were in desperate need of care. We had little water, food and few supplies. He would say—’what do you need, I will try to get it’ - and he would. He would walk to the collapsed St. Croix hospital or to a crumbled clinic and scavenger whatever medical supplies he could. Together, with a handful of other student nurses, we cared for hundreds each day. It wasn’t until a long terrible week passed that international aid arrived. Rigan went to work for the Japanese in their surgical suite. In March he served an internship in WI. He will graduate from nursing school on December 10, 2010. November 22 he accepted a job as a Director of Nursing at the Hope Hospital in Delmas—a suburb of Port au Prince: All in less than a year.
Imagine if we as nurses were to all live and work by the mantra ‘it is so hard, I will go with you’ - imagine what that voice could do for the power of care: Rigan Louis—amidst the greatest hardships—found his voice of care.
Spotlight on our partners:
http://www.directrelief.org/
Direct Relief International is one of my heroes! I give them our highest aid organization rating
of ‘5 stars’:
I first got acquainted with Dan Smith, Senior Program Officer for Latin America and the Caribbean, at DRI in late January of this year. I had just gotten back from Haiti—and I was desperate to help get basic immunizations to my nurse friends in Haiti. The idea had hit me with a vengeance when—as we were kneeling in the deluge of human body fluids with few gloves and no forms of PPE—caring for yet another beautiful person suffering from the violent physical assaults levied against them by the tonnage of falling concrete—I quietly asked Martha if she had her immunizations. I will never forget her reply—she stood-up, straightened her back and said with some degree of force “no Mecheel, we are Haitians, we are not worth vaccines.” The effect of her words has impacted me in such a way that words fail...
Dan said, yes, they would like to help, but vaccines are very difficult to get into Haiti. I spoke with the FSIL Board & got the go-ahead to pursue vaccines for the student nurses and nurses of Léogâne; “You go girl.” I phoned and emailed every drug co., the Red Cross & International Red Cross, PAHO, WHO, CDC, and finally Senator Baucus’s Office in DC & an aid—Scott Guenther– set about to help find a way to get a drug co. to work w/ FSIL. Hundreds of hours in TC, emails and letters across several months began to be fruitful. From Scott, to PROMESS, to Merck, to DRI, to the MOPHP, back to DRI a relationship loop was forming under the able guidance of Dan and the DRI team. Long dedicated hours of work, team & network building and finally a letter from the MOPHP and an agreement from Merck: The purpose of helping nurses so that they could be safe & help others was being actualized. The professionals at DRI are amazing—I can’t recommend an aid agency more highly...they are real pros—in it for the service….they stir up grace in all they do...Please consider supporting this effective, ethical and dedicated aid organization...they believe in nurses….I believe in them…*
* Many hurdles were cleared by DRI: We learned that ‘we can do this’ & many others believe in nurses: At NFNI we will never lose our resolve: How do we help other nurses to maintain their resolve? Martha deserves to be protected against vaccine preventable disease; every nurse does…
Dan Smith; DRI, Santa Barbara - May 2010
Dianne’s Story – November 2010 (with the launch of our new book -Today, Leogane - we wanted to remind our readers about the long term ramifications of the 1/12/2010 and how daily life continues to be affected and offer Dianne's story):
In November of 2010, I traveled to Cyvadier, Haiti as a nurse volunteer for the organization, Friends of The Children of Haiti (FOTCOH).
It was eleven months after the 7.0 magnitude earthquake demolished many parts of Haiti. Trash, rubble, and semi-destroyed buildings attested to the devastation of an already ailing country. Many buildings, despite huge cracks, remain standing but the windows are boarded and doorways are blocked off. Some shops still try to operate. Anyone inside these buildings may be gambling with their lives…as it’s only a matter of time before they finish collapsing.
This wasn’t my first time to Haiti as a volunteer nurse. I was there previously in September of 2008, one week after Hurricane Gustav slammed Haiti with 75 MPH winds. Gustav washed out roads, and caused mud slides that swept away tin roofed shelters that many called “home“. That year countless patients arrived at the clinic to receive care. Their stories touched us deeply as they told of losing their homes and all they owned.
The 2010 trip, in contrast with 2008, had a much different story. Many who arrived at the clinic had lost more than just their homes and personal belongings. This time - many had lost family members and friends who were crushed by collapsing buildings or who succumbed to infections in the aftermath.
Both catastrophes damaged the clinic in some way. The volunteers were still able to work through the inconvenience of intermittent power outages from an old and now damaged generator. At times water was unavailable for showering or flushing toilets. Going to the beach and bathing in the ocean was off limits - as the beaches were heavily contaminated with mud and debris. Even so, some of us were grateful to shower under a rain spout during a rainstorm. The soothing mineral-laced water was restorative even though it turned my white hair an interesting shade of green.
Our main concern was keeping our refrigerated medications staying cold. We managed by forbidding anyone to open the door unless absolutely necessary. Our electric powered nebulizers were useless. We remembered that we could connect the tubing to our one and only tank of oxygen to nebulize medications. Asthma is a huge problem in Haiti and many were in desperate need of treatments. Oxygen up to that point was hoarded unless really needed.
Volunteering as a nurse in Haiti means to always remember that there are many surprises. It means Plan A and Plan B do not follow what we in the US consider the normal “Standard of Practice.” It means being flexible and "going with the flow." By doing so, we managed to care for 2,525 patients during my two week stay in 2010.
I got used to seeing the thin Haitian transporter running down the road with a patient bouncing about in the wheel barrow. He mimicked the siren of a 1950’s ambulance wailing a loud “wooo-woooooooo” sound. Sometimes he transported a very ill or severely injured patient, but for the most part, the patient’s condition wasn't critical.
For now, Haiti is what it is. The people living there are doing the best they can by using what is available.
Another example is the ‘Plan A treatment’ for a fractured jaw would be to send the patient to the hospital. In Haiti, that is not possible. We had to formulate Plan B which meant searching the closets at the clinic for a stiff wire coat hanger, cutting off a piece of the wire, sterilizing it, and using it as a brace to stabilize the teeth so the lower jaw could be immobilized and mouth wired shut. Our dentist fortuitously had orthodontic training and came to the clinic with a collection of thin stainless wires. The wires were then threaded through the gums and wrapped around the coat hanger wire. By doing this, the offset fracture was reduced and the bottom teeth realigned almost perfectly. This method, by the way, was used on two of our three patients who suffered jaw fractures from motorcycle accidents.
The problems of Haiti are far from trivial. Diseases such as cholera, hypertension and diabetes are rampant. Malnutrition, premature deaths, abject poverty and extreme hopelessness cannot be overlooked or ignored if we are to claim ourselves as part of humanity and operate within the boundaries of justice and charity. But sometimes, that task is done by providing care to one wheel barrowful and to one dental patient at time. Doing that means not only stepping away from the advantages our US health care facilities provide, but also creatively designing alternative methods and utilizing the means at hand.
The serious issues in Haiti are overwhelming when viewed as a whole. But as a nurse, it’s hard to throw up my hands and just walk away. What I've learned I can apply in any setting. Sometimes it works, sometimes it doesn't. But that doesn't matter. What does matter, at least for me, is that I worked and became part of team that did more than doing nothing at all. Our team showed respect and compassion to all our patients. We communicated through language barriers and cultural differences the message over and over, that is, that they are not alone - others care and want to help.
Any knowledge or skills we nurses have learned and can pass on to other nurses…or to nursing students … will result in tremendous improvements in Haiti’s health care system.
As nurses we can play a vital role in this chain. I am honored to have lent my hands to advance in this process. I truly hope that in Haiti, “Plan A” will someday become the norm.
Dianne Peterson, RN – Missoula, Montana
sare.michele@gmail.com