There were quite a lot of admissions overnight mainly femoral and tibial fractures. I also saw a patient who had a varus deformity of the distal femur, a very stiff knee, and a short leg following a fracture 4 months ago. The Xray revealed the problem where a distal tibial plate was used for the distal femur. This unfortunate young man obviously will require an osteotomy with an extensive arthrolysis or maybe a knee fusion. The ward round was quick today as we had a visit from an orthopaedic professor from Marseilles in France. He gave an uninterrupted lecture of 3 hours on different orthopaedic topics some of them not really relevant to the Haitien context.
The out patient clinic was reasonable busy and we saw an 18 month old girl with a genu valgum with an unclear history. Xrays did not show any abnormality and I wonder whether she had an undisplaced metaphyseal fracture which sometimes can develop a valgus deformity. Hopefully it will remodel spontaneously. Then a 5 day old baby presented with a varus deformity of the distal tibia on one side and a recurvatum deformity of the femur on the other. Otherwise the baby was normal and Xrays showed some bony sclerosis but no fracture. This looked like congenital bowing and again I told the residents to follow up the child regularly to see whether the deformity corrects spontaneously.
At around midday the tetraplegic patient arrived and was dropped off outside the clinic on a spinal board. She was a tiny thin lady in her sixties who 2 weeks earlier had fallen from a bridge and dislocated her neck. After assessment by the anaesthetists she was taken to theatre for surgery. The dislocation was reduced and the C6C7 level wired and fused. It is unlikely that she will recover the use of her legs and arms.
In the evening we had a very pleasant fare well dinner at the Roi Christophe hotel with Dr Pierre Louis, the residents and the visitors from France.
Thursday 1 December 2011
Well my suitcase is packed and I have eaten my last delicious Haitien breakfast prepared as usual by Robyn. I am taking the bus to Santiago in an hour where I have to stay overnight to catch an early morning flight to Miami. Then it’s a non stop trip to Dunedin via Los Angeles, Auckland and Christchurch. My family will be pleased to see me again after 6 weeks of absence and I am very grateful to them for allowing me to come to Haiti for such a long time. Their sacrifice has contributed to everything that I have been able to achieve here and everybody I have spoken to has asked me to specially thank them for this.
A very special thanks also goes to Hearts and Hands for Haiti who have made this trip possible and your support and prayers have helped the success of my work here.
Finally a very big thank you to Robyn who, as usual, has been outstanding in making my stay here in Cap Haitien so exciting and rewarding. She has looked after me so well by preparing yummy lunches everyday, even bought me Belgian chocolate biscuits, and basically has been in the background organizing things in the most masterful way. We had a wonderful time and I will never forget the games of domino we played on a number of evenings: that was great fun! Thank you Robyn.
Thank you also to Bernadette for the exquisite Haitien food and for your beautiful smile.
So in the end I would like to say: Haiti I love you from the bottom of my heart and au revoir!
