Arrived in Haiti

Left Santiago yesterday on the Caribe Tours bus which is a great way to go across to Haiti as the conductor or ‘bus hostess’ takes care of all the formalities of the border crossing. They even provide you with lunch and a drink: better than most airlines these days! All went well until bus had a punctured tyre which delayed us for about a good hour. The mechanic from Santiago had to be called to come and change the tyre which was not like what you see on the formula one circuits!!! For a reason unknown to me my cellphone didn’t work in the Dominican but I remember from last time that it works in Haiti. So as soon as we got to the border I had a message which said: Welcome to Viet Nam! I wondered whether the bus had been hijacked but my fellow passengers reassured me that we were entering Haiti. The also told me that the Haitian Telecom had been bought by Vietnamese! You can image the message you will get entering Viet Nam!

Changing a bus tyre is hard work!

 

 There is a new border crossing and compared to my last visit everything was very ordered and efficient. I even had to fill out an entry form! On arrival to Cap Haitien I was picked up by Steve Benford, an anaesthetist from York, UK, who was part of the first mission. I am staying with Robyn and the rest of the team in an apartment on top of the Evangelical Church which has a lovely view of Cap Haitien. An alarm clock is not required as early church services will wake you without any doubt: their singing is very loud like everything else in Haiti.

I had just time to drop my suitcases when I was whisked away to a nice dinner at the Roi Christophe hotel to meet Dr Ogedad and Cherubin whom I had worked with on my last 2 visits. Dr Ogedad is now married and his wife is expecting their first baby! It was wonderful to catch up with everybody.

Today I went to the hospital with Steve and we found out about a couple of new rules they have introduced since my last visit to prevent surgeons from operating: no operating on a Monday as that theatre cleaning day, patients have to pay now for access to theatre for acute operations, etc. I did a quick ward round and saw the little boy with osteomyelitis, a patient with severe bilateral ankle and knee contractures who was almost unable to walk, a fracture neck of femur, the usual tibia and femur fractures as well as a traumatic hip dislocation.

Neglected shoulder dislocation

Outpatient clinic was very busy and we saw many interesting cases .I met the new intake of registrars and we went over basic principles of orthopaedic examination. There were many patients with neglected fractures, unreduced dislocations, malunions and post traumatic joint stiffness. I made a wonderful clinical diagnosis of Duchenne muscular dystrophy in an 8 year old boy and this was a great feeling as he had all the classic signs. Unfortunately n there is no treatment for this condition and the prognosis is very poor. These patients often become crippled progressively and die in early adulthood mainly of respiratory failure once the muscles which move the chest become paralysed.

Calf hypetrophy typical of Duchenne's

The Renovator in action

 

I caught up with the plaster technician who is still using the Renovator saw from Mega Mitre 10 to take off plasters which I bought for them 2 years ago. He looked so happy!

Tomorrow is operating day. I wonder how many cases we will be able to do?