HAITI: A Medical Teams Mission to Perform Cardiothoracic Surgery

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• HAITI A Medical Teams Mission to Perform
  Cardiothoracic Surgery

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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.
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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.

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

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• 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.

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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.
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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.
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Children play in the streets and in the open
sewer that runs along the edge of the rode.
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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.
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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.
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The average life span for a Haitian is 54 years
old. And only 60 of the population has access
to any health care services.
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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.
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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.