On the way to Haiti

I have now crossed the great Pacific Ocean stretching over 10.000 kms between Auckland and LA. It is amazing how these modern aircrafts can whizz you across without getting your feet wet and in comfort , the extent of which depends on where in the plane you sit!


I now have to cross the width of North America which is a huge land mass stretching over 4.000 kms between LA and New York. Then it’s off to the south following the east coast of the States and into the Caribbean.



Island of Hispaniola






View of Santiago

Monument of the Restoration



















I will be landing in Santiago de los Caballeros which is in the north of the Dominican Republic. Both Haiti and the Dominican Republic are situated on the island of Hispaniola (“Little Spain”) discovered by Christopher Columbus in 1492 and named by him. Santiago (Saint James of the Knights) is the second largest city in the Dominican Republic and was founded very early (1495) in the Spanish colonisation of the ‘Americas’. The city was destroyed on a number of occasions by earthquakes and in 1805 Haitian General  Henri Christophe invaded Santo Domingo, as the country was known then, and killed hundreds of Santiago inhabitants.
 

One of the many churches in Santiago

The Dominican Republic is far more developed than Haiti and is one of the biggest producers of tobacco and cigars worldwide. It is also known for its merengue music and dance (very close to salsa).

So as soon as I arrive in Santiago I will ride my horse into town, light a cigar, order a rhum and hit the merengue dance floor! ( photos will be withheld of course).

First case

Dr Etienne, who is one of the orthopaedic trainees at Justinien Hospital, has sent me a photo of a young child with chronic osteomyelitis of the tibia. Apparently the infection has been going on for the last 5 months and it is clear from the photo that most of the leg bone has died .

Large sequestrum of the tibia

 This will require surgery to remove the dead bone and immobilisation of the leg (plaster or external fixator) until the new bone formed by the periosteum (tissue surrounding normal bone) is strong enough to allow this child to walk again. Normally an Xray would show the extend of the bone regeneration. Once the dead bone has been removed the skin will normally close over and if necessary a skin graft can be carried out. Secondary bone grafting is sometimes required once the skin is healed and the infection treated.

I guess I will see this young boy on the ward next week.

Third time round!

I am just in the process of packing my bags for my 3rd orthopaedic teaching mission to Cap Haitien since the 2010 earthquake in Port au Prince.Since my last visit in 2012 Hearts and Hands for Haiti have been fund raising for the School of Physical Therapy Project which first started 4 years ago and which finally came to fruition last year with the first intake of students.They are currently housed temporarily awaiting the completion of a permanent building.Thanks to the help of the United Nations and Indonesian troops from the local MINUSTA contingent the old building, donated by the Evangelical Church of Haiti, has been renovated and looks magically transformed.(photos before and after attached)

Riviere Salee 2012

Riviere Salee 2014

 
 Two years ago HHH hosted Dr Ogedad Pierre and he spent 3 months working with me at Dunedin Hospital. His orthopaedic training is coming to an end and going by the photos of cases he has treated at Justinien Hospital since his time in NZ I can assure you that his time in NZ has been very beneficial and it is great to see Haitien patients benefiting from his outstanding skills as a doctor and orthopaedic surgeon. The aim of my visit this time is to concentrate on the teaching of pediatric orthopaedic and spinal surgery.Dr Ogedad has assembled a number of children who require surgery for different deformities including brittle bone disease,clubfeet,congenital malformations etc.These will form the basis for my teaching of surgical skills pertaining to orthopaedic surgery in children. I will also continue teaching on advanced techniques in the management of spinal injuries and serious skeletal trauma including pelvic and hip fractures. Finally I have assembled a pile of used and expired implants and surgical instruments which is filling up most of my 2 suitcases.

One of my suitcases

 
 I am very thankful to Dunedin Hospital, and in particular the orthopaedic operating theatre nurses who have collected the equipment over the last couple of years! Some of this will be very valuable in Haiti and would you believe that all these implants are not been able to be reused in NZ because they are labelled as single use despite the fact that they are made of metal and can be safely resterilized! What a waste! I will be away for 4 weeks and am thankful to HHH for their generous sponsorship of my trip.I am looking forward to spending time with Robyn and catching up with all my Haitian friends.I hope you will enjoy my blog.

 M'swete'w tout bon bagay (Best wishes in Creole)