HAITI: A Medical Team’s Mission to Perform Cardiothoracic Surgery

The hospital is run by the Daughters of Charity, a catholic sisterhood. Three nuns manage the hospital which hosts international medical teams nine months out of the year. The teams range from general surgery, cardiothoracic surgery, orthopedic surgery, plastic surgery, pediatric care, OB/GYN care, urology and other specialties that all see patients here using donated medical equipment that they bring and ship to Haiti. This hospital is nationally recognized in Haiti and patients come from all over the country, traveling on bumpy, unpaved roads for several hours to have the chance to receive necessary medical care.

The team performed mitral valve replacement on three patients. There was a cardiothoracic surgeon, perfusionist, physician assistant, anesthesiologist, nurse anesthetist, scrub technician, biomedical engineer, respiratory therapists and intensive care nurses on the team.

During an operation, the team prepared the heart for perfusion during a mitral valve replacement of Jackson.

The Haitian nurses worked with the ICU nurses to care for the patients. The Haitian nurses were responsible for the patient care and our nurses taught them how to interpret the monitors, and patients’ vitals and lab results.

The respiratory therapists and the ICU nurses gave in-services to the Haitian hospital staff to learn the equipment, such as ventilators and heart monitors.

Jackson, a 19 year old, could not attend school due to his rheumatic heart condition and endocarditis. He received a St Jude mitral valve. He weighed only 99 pounds prior to his operation. He was very excited to be able to play soccer again and go to school. He plans on being a cardiologist.

Louis, a 41 year old Evangelical minister, received a mitral valve replacement. He is a widower with four children. He was hoping that this operation would end his heart problems and that he would require no more operations.

Yonel, a 24 year old business man, had a thoracotomy to repair a patent ductus arteriosus (PDA). He weighed a 120 pounds prior to the operation. He planned to return to Cap Haitian to work on his business and spend time with his friend (pictured).

Rosema, a 42 year old mother of five, received a mitral valve replacement. Unfortunately, she suffered a stroke during the operation and lost motor control in the left side of her body. She has since regained control. Her husband helped with the physical therapy and planned to work with her to improve her motor function when they returned home to Port-au-Prince.

There is only one X ray machine in Northern Haiti. The patients had to walk outside the hospital to the next building for chest X-rays. The patients were walking 1 to 2 days after their operations, as well as eating on their own.

The families of the patients became very close during the week of operations. They would pray at the bed of each patient together. 80% of the population is Catholic and the rest are Protestant. The majority of Haitians practice voodoo.

A little girl at the hospital with her mother. I think she had the chicken pox because she was covered in red dots. Children in Haiti have a very difficult life- one in five children dies before the age of five! Many children suffer from malnourishment and disease.

A young mother delivered her first child two months premature. The infant weighed 2 kilograms at birth and was on a ventilator for several days. Mothers do not bond with babies that they do not think will survive. The infant mortality rate is very high with 94 deaths per 1000 births compared to 8 in 1000 in developed countries. On our first day a baby died following birth because the placenta had dropped and the umbilical cord was not cut. The blood drained from the baby into the placenta causing the baby to become hypovolemic.

There are no landfills or biohazard disposal. The hospital incinerates the

biohazard behind the building in an open enclosure. There are sharps and contaminated objects exposed.

In Haiti, children must pay tuition to attend school. They must also purchase an uniform which costs about $20 per child. This is very expensive, as the average annual income is only $900.

• Milot is one of the few towns in Haiti that has clean water. They have a town well which many children bath in, as well as gather water to carry home.

• Milot has a population of 30,000 living in an area less than two square miles.

• Children also play and bath in the creek that runs through the town. In the creek people do laundry and the livestock swim in the water.

• Less than 40% of the population has access to clean drinking water.

Most of the houses are made of cement and corrugated tin. Fortunately, the climate is very warm and humid year round. However, the rainy season can cause a lot of damage to the houses and the roads.

Children are supposed to begin school at the age of six, but many families cannot afford it. Many of the schools are run by church missions, but some towns do not even have schools.

Children play in the streets and in the open sewer that runs along the edge of the rode.

Many women marry and have children at a young age. The average family size is 5 children. The high infant and child mortality rate increases the number of children a family may have due to the increased probability of death.

Approximately 70% of the population is unemployed. Most people live on subsistence agriculture and an informal economy of bartering. 80% of the population lives below the poverty line.

The average life span for a Haitian is 54 years old. And only 60 % of the population has access to any health care services.

Cap Haitian is a city on the coast of Haiti. It has a population of 1million people. President Aristide was scheduled to visit and had issued a decree of no manifestations (protests) during his visit to Cap Haitian. He is an unpopular president and riots often occur in the part of Haiti against his government. There were soldiers standing in the streets with machine guns in preparation for his visit.

Despite the poverty and harsh living conditions, the people of Haiti were very friendly and cheerful. I was amazed out how beautiful the country was and how happy the people seemed. The patients we saw were incredibly grateful (even when the outcome was looking bleak). It was great to work with the staff at the hospital whom were terrific.