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Thanks for all of the comments and support I’ve received from you. The Haiti Dental team indeed survived our trip to Ile a Vache, through the project, back home, and are mostly back in the saddle again.
Like expected, the first week back from a project is accompanied with piles of notes, paperwork, mail, and questions to be dealt with. I am stressed with feeling like I’m behind schedule, and yet there is an unmistakable sense of reward and calm with another project completed.
Dr. Ken Marti from Granite Bay was our lead dentist for the trip. Drs. Barry Turner (Grass Valley), Ed Weiss (Auburn), and Terry Prechter (Yuba City) rounded our dental team. I am an oral surgeon and practice in Auburn and Roseville, and as you might expect, a majority of my practice involves tooth extractions. The other dentists not only extracted teeth while in Haiti, but provided restorative services (fillings). Dental hygienists Vicki Bayne and Anna Skacel cleaned teeth, applied sealants, and provided education for our patients.
Our three RNs (Robin Prechter, Karen Leighty, and Sharyn Turner) acted as dental assistants, provided instrument maintenance and sterilization, education, and supported the medical interests of the volunteers and the patients. Ruth Terao served as dental assistant and Spanish translator. Bernice Owczarzak also served as dental assistant and had a birthday during our mission.
Jill Marti (Physical Therapy) investigated Sister Flora’s orphanage and school facilities, patients, and staff with regard to physical therapy issues. Brian Kuhl was a general volunteer. Monte Short (Flying Doctors) served as trip coordinator not only for our dental clinic, but for the medical clinic the week following our dental clinic. Mandy Thody, manager of Good Samaritan of Haiti, served as host coordinator and worked with Monte on the hundreds of details needed to sponsor a dental clinic, such as providing patients for the doctors, and keeping the volunteers fed and sheltered.
After arriving in Port-au-Prince, a 4.5 hour bus trip and one-hour boat trip were required to reach Ile a Vache (island of cattle) and the village of Castra. A resort at Pt. Morgan (45 min) and the orphanage operated by Sister Flora were the closest things to a business that I saw on the island. A few motorcycles and some fishing boats were seen, but walking was the way to travel. I did see a few people riding donkeys. Other livestock commonly seen included chickens, pigs, goats, sheep, horses, and some cattle.
Two generators, two shop vacs, an air compressor, and lots of electrical cords all needed assembling for the energy to operate our clinic. We treated about 250 patients with approximately $150,000 worth of dentistry. I took one biopsy for a benign lesion which was processed by UCSF Dermatology Pathology Department. At least one patient was referred to a dentist on the “mainland” of Haiti for extensive dental work.
New friendships were developed and others strengthened during our week in Haiti. Living conditions were simple as expected, especially with regard to our hygiene, food, and bathroom expectations. Electric fans seem like one of the best inventions ever. Although the conditions required adjustments on our part, we all agreed they probably had a positive effect on the inhabitants. Obesity is virtually unknown here, as a testament to the diet and walking. A few exceptions to this were the ease of obtaining Coca-Cola, Sprite, and Prestige Beer, and the candy bars available at roadway (walkway) stands.
Essential hypertension and Malaria (and other mosquito-borne diseases) were the illnesses we saw evidence or history of. Most of us on the team were taking doxycycline or malarone for prophylaxis. We were provided mosquito nets for sleeping. Five or six of us shared some sort of URI or bronchitis about halfway through our clinic week, depleting the medical clinic’s supply of Zithromycin in the process. Glad that’s over with.
A few of our patients admitted to having been treated by a dentist. Interestingly, most of our patients had a few carious teeth, but many had multiple hopeless teeth. Most of the patients with the more serious dental problems was a combination of caries (cavities) or periodontal (gum) disease.
Jill Marti commented that some of the equipment at the orphanage was comparable to some PT clinics in the US. The biggest problem she saw was the lack of trained staff to work with their patients, which is mirrored in the spectrum of health care needs in Haiti in general.
Upon our return, we were bussed into the compound for the hotel with 12′ tall gates and armed guards. There was a restaurant on site and most importantly, a swimming pool, which was where half of us made a beeline for. I’m not going to repeat the boring details of getting through customs/immigration in Port-au-Prince nor JFK. The most interesting thing for sure about the flight home was the 4 hour long sunset. We’ll have a debriefing someday with most of the team, but for now we are still getting settled into our routines again.
Thanks again for spending the time to read our blog. I hope this helps explain our project and encourages some of you to participate in some charity work if you haven’t already.
After coffee (palatable, not great), fresh fruit, and an omelette, our bags were loaded onto the bus and we had a short trip to the airport. We attempted to stay together as a group, but we were split up several times and redirected to another corner of the staging area for reasons unknown. In the line to check bags, an employee with scales weighed each bag. We all shuffled items back and forth and back and forth in order to get under 50#. We checked, paid for a second bag, and headed towards security. After security was customs, and then security again. Seriously, Haiti International Airport? It was less than 100′ from security to customs and another 50′ to the second security point. There was no place to go, no purchases, bathrooms, or exits/entrances. What possible reason is there to be screened twice within the same area? Wow, if I didn’t know better, I’d think I was ranting.
Well, just one more not-understandable thing. The check-in agents were careful to give us very detailed directions for how to get to our gate. The stupid thing is: there is no other way to go. We went through security, continued down the cattle chute through customs, and again through security #2 which leads directly into the hot, packed waiting lounge with wall to wall humanity. Now they are giving endless boarding instructions, none of which we could understand. We got up when a bunch of our crowd stood up, and headed up the ramp. Incredibly, we were met with more security people who wanted to look at the passport a third time in the last 30 minutes.
Monte gave us the obligatory “You’re the best group I’ve ever worked with, I love you all more than my grandma, etc., etc.” Thanks Monte, we saw you work very hard for us all the time we’ve been here. I can honestly say that this is the best Haiti mission trip I’ve ever worked at!
We are on the plane now, seated and buckled, and feeling more relaxed. I’m still in travel mode, so I’m not ready to be more philosophical or reflective at the moment. About half of our group is coughing or sniffling, so we are not quite as healthy as when we left. I finished reading John Wooden’s new biography and also finished the last few chapters of the Malcom Gladwell book, What the Dog Saw.
As I anticipated, applause broke out as Jet Blue Flight 1834 main gear touched down just past the numbers. Don’t know why this happens, but like the 7th inning stretch or the two minute warning, I know I’m back home. Then the Beatles song Back in the USSR runs through my head a few times. I don’t think the applause is for the landing itself. Passengers never think a greased landing is anything special; they just complain about the hard ones. The general public pretty much grades the entire flight of the pilot by the last 3 seconds of the landing. I have nearly 500 landings as pilot-in-command in my logbook, and there is only one of those landings that Karen remembers. You’ll have to ask her for the rest of the story.
We were assured by Jet Blue personnel in PAP that our bags were checked through to SFO and we would not be reclaiming them at JFK. As we deplaned, guess what? We were told to go to Passport Control, then reclaim our bags and go through Baggage check again. Great news. We did that, then re-checked the bags at the proper area, then boarded a tram to another terminal for the next flight.
Food court, Dunkin DoNuts, CheeseburgerCheeseburger, Starbucks; we are back home for sure. Everyone in our group has their cell phones and is turning data roaming back on and making calls.
The last flight has a 5:21 departure and estimated 6:38 minutes in flight. I picked up the New York Times and as we prepared to push back, read the now week old story about the 777 that went missing near Indonesia. We’re over north central Colorado right now at FL36 (36,000′) with a ground speed of 514 (the best I’ve seen so far; most of the trip it’s been 450 or so). I can see the lights of Denver about half-way to the horizon. Ahead of us is a solid cloud bank as we approach the Rocky Mountains. The light continues to slowly fade, but it has afforded us the longest slowest sunset I’ve ever seen.
We were supposed to touch down at SFO about 8:45 pm. Our pilot got us here a little early. Baggage collection was easy; no customs or passport control, as we did all that at JFK. We met our van driver who had parked his van in the garage instead of at the curb to pick us up. There was a little Keystone Cops wheeling our luggage carts onto the elevator, off of the elevator, back on the elevator, until we located the van. Once we got to the van, our driver loaded the bags in back, us in front, and I don’t remember much else until we stopped at Ed’s house in Auburn. Karen and I got home about 11:00pm. Going to sleep was not a problem.
I’ll write one more blog to summarize and closeout.
Steve Leighty, DDS
This blog is being written on Saturday. Yesterday was so tiring that I basically passed out after dinner and crashed into bed. Karen had her earplugs in and facemask on and allowed me to keep the light on to make my blog, but it wasn’t meant to be. How could traveling all day be so tiring? Glad you asked.
We started out with the usual coffee/bread/spicy peanut butter/banana breakfast as the sun rose. We each took one of our dental bags down to the beach to wait for the boat. The now familiar green and yellow fiberglass boat arrived. A hollowed out canoe was maneuvered near the bow so we were able to step on the canoe and into the boat without stepping in the water. As opposed to our night time trip to the island, our trip back to the mainland (which is actually an island itself of course) was on very calm seas. No water spray, no drenching of Steve. We were able to converse and take photos.
After pulling up to the dock in Les Cayes, we were helped up and out of the boat by these bystanders who pointed out a friend of theirs who was spreading out some trinkets or wooden objects or wrist bands, or cheap jewelry. I was happy to see the Nissan bus waiting for us. Again the workers Monte hired put all of the luggage up on top and covered it with a tarp before we began our next leg of the journey.
The eastward bus ride was basically just like the westbound one. Incessant swerving, passing, braking, acceleration, all with never-ending honking. Repeat nonstop for 5 hours; that’s the deal. There was some very soothing Caribbean steel band music playing when we boarded the bus, but when we started nearing Port-au-Prince the radio stations were what the driver wanted to hear. I often listen to talk radio so I can identify, but we had to ask twice for him to turn it down because we couldn’t understand anything, and it was really annoying when we were trying to talk with the person in the next seat.
The odd thing that happened when we were about halfway on our trip. We had just passed through a police check-point, which means we were just crawling along at 2mph and the police were eyeing all the vehicles; not stopping us, not boarding the bus. About a block past the checkpoint, our driver pulled over and this one guy who was the ‘bus boss’ hopped out and walked over to a pair of armed policemen and motioned towards the bus. Aside from our dental team, there were about 5 or 6 locals whom all sat at the front of the bus on the left side. One of the cops opened the door and looked inside, saw the local passengers and a girl about 25 got up and went outside, followed shortly by the guy sitting next to her.
There was lots of gesturing, talking, everybody was using a cell phone, and a larger crowed was gathering. After about 20 minutes, the girl came back on the bus to collect her belongings. She explained in perfect English that she was a Haitian and a missionary. She said that somebody reported her as being kidnapped and that the police were taking her to be questioned. She then said anytime that God does something good, the Devil interferes. We had one of our interpreters on board and we asked him what just happened, but he was at the back of the bus and couldn’t tell us anything. Ruth, Ed’s assistant, speaks Spanish and went up to the bus boss to ask him about what we had just witnessed (she thought she had heard him speak Spanish earlier in the day). He glared at her for a long time, but never did communicate with her. At this point we all decided to just keep out of what was not our business.
We of course know nothing about this other that what the young girl said. Most of us thought it was very odd that the ‘bus boss’ took it upon himself to turn this couple over to the authorities in this manner, meaning that he ordered the driver to pull over even after we had passed the checkpoint. It was just another reminder that we are in a foreign country and we are not in charge, nor are we in a need to know level.
After getting into PAP, we spent 45 minutes winding through narrow downtown streets dropping off all of the local passengers. Then the bus boss asked is we wanted to go to the airport, and Monte got our interpreter Pouchon to go sit in front with the driver to help him get us to the Royal Palm Inn, not the airport. In another 30 minutes, we stopped outside a 12′ tall white metal gate and honked. A security man with a sawed off shotgun opened the door and let us in the courtyard. We climbed out of our seats for the first time in over 5 hours and looked around the hotel courtyard. Palm trees everywhere, a pool, two stories of hotel rooms (perhaps 50 rooms in total), a water cooler, and a covered restaurant. An oasis of safety and comfort (literally) in the middle of poverty and chaos.
As soon as we signed the register and got our bags in the room, Karen and I were in the pool for a refreshing end to the day. Ken then brought around a menu. The cooks wanted us to order now (5:30 pm) although we would be eating at 7:00 pm. After a nice shower and clean up (I used up two razors to shave my beard off) we sat down to dinner. Karen had shrimp Creole and I had a garlic fish, which was served whole — wasn’t expecting that! Karen and I also ordered a lobster to share, wanting to experience the authentic local cooking style. We learned that the local cooking style is to cook the living daylights out of the lobster to make sure all the moisture is gone and then cook it quite a bit more to toughen it up. After that, blacken for awhile to cover any resemblance of lobster taste. We give the lobster dinner negative 5 stars. At least the portion size was small, so we didn’t have to eat much.
Back at the room, we made the final luggage shuffling and did our preparations for bed. Breakfast at 6:30 am; on our way back home…..
Remember, all the earlier blogs are available on my website. If you could indulge me, take time to Like us on Facebook. Kristin Singhasmenon (Satin Web Solutions) designed my website and keeps reminding me to ask all my friends to like us.
Steve Leighty, DDS
Brian went to Les Cayes with Nestor yesterday to find and purchase local anesthetic. We haven’t heard Nestor’s version yet, but Brian’s story was like a cross between Clockwork Orange and Kill Bill. They left the island mid-morning and when they arrived in Les Cayes, they rented a motor scooter and went to some dental clinics, offices and a number of pharmacies carrying an empty box of 2% lidocaine. After a couple of hours, he made the purchase (I didn’t hear what price they paid yet). Then they went to eat lunch and Nestor wanted Brian to hang out until he returned, so he left him there, with a couple of words to the waitress. Not long after Nestor left, the waitress decided she didn’t want him hanging around inside the place so she booted him out so he stood around for a couple of hours waiting on Nestor. When Nestor showed up, they went to the market and soon after arriving, Nestor said he needed to go do some business, so he told Brian he’d have to just sit tight until he returned. Once again, Brian found himself the only Caucasian within sight, and the only one who didn’t speak French. After a couple of hours, Nestor indeed arrived again and they walked past the restaurant again, which had a convenience store next to it. For the third time Nestor pulled his disappearing act and Brian was hanging around for another two hours. The only thing different about this waiting period was that Brian learned how people are allowed to drink in the convenience stores. As the townspeople started getting a buzz on, they started harassing this tall American Brian. They started talking French louder and slower, in hopes Brian would have instant language skills. Fast forward to Nestor coming back for good and they made their way to the dock. It was about 7:30 or 8:00 pm when Brian was spotted walking up the hill to the kitchen, and we all cheered his success and got him a beer.
The lidocaine Brian purchased allowed us to work today (Thursday) — we had run out of our supply Wednesday evening. We cannibalized (sorry, maybe that’s not the best choice of words) the two shop vacs in order to make the suction system hobble along until the end of the day.
Breakfast was a crackup again this morning. Our outside dining area has 4 tables which are more or less placed next to each other for ease of passing the serving plates. We fill all four tables completely. Just like on Southwest Airlines, they often say “This is a completely sold out flight; if you see an empty seat, that one is yours.” The wait staff is careful to put tablecloths on the wooden surface before serving. They never give us a coffee cup without a saucer. This morning the early ones all sat at table one. The server carefully placed cups, saucers, and a plate of silverware on tables two, three and four. When she served the coffee and the hot water, again she placed them on the tables where nobody was sitting. Bread and peanut butter, same thing. We walked over to the next table and passed all the cups, coffee and food to the table where we were sitting. Since none of us speak French, it will remain a mystery why the unusual serving arrangements.
My cold is no better today, my lungs have more noises in them, and I just don’t have the energy I should. Christine Meserve arrived and was able to unlock the medical supplies and I started taking Zithromycin along with my Doxycycline for malaria prophylaxis. Suffice it to say that as of today, I know the exact location of every toilet, trench, and outhouse in the village. Next subject, please.
Lunch was pasta shells today instead of ketchup and onion sandwiches. We’ve collectively drank more Coca-Cola and Sprite this week than we have in years, but it’s the only cold drink (except beer) that we are offered. Still no ice cubes seen.
The last day of a clinic like this is special for several reasons. Firstly, we all come to grips with the idea that we can’t treat everybody who has shown up hoping to be seen. Monte said we need to stop with patients and start tearing down our equipment at 3:00pm. It was really about 4:00 or 4:30 before all the docs had quit. We made two big piles on round tables of supplies we were donating to the medical team and any future medical/dental teams who come to this area. The all-important mandatory team photos were taken in front of the church.
The second special thing for the last day is the special “show” of singing or dancing, usually performed by the kids. We were told to be back at the church at 6:00pm for “our” show. About 20 kids entertained us with singing which was preceded by Pastor Don leading a rousing rendition of Amazing Grace in Creole. And when I say rousing I’m talking about 8 verses! Recognizing the tune but not the words, the children sang Jesus Loves the Little Children of the World, followed by How Great Thou Art. The pastor prayed for the team, asking God’s blessings on our travel and our charity work. Finally he talked about the importance of serving the weak and the needy. For me, the thing that made the Pastor’s message and prayer so authentic was that the patient treatment tables were desks that were far too narrow to be adequate. The pastor’s doors were taken off of his house and (quite literally) held up all of the patients that were treated this week, by nailing them to the top of the desks.
Before we left Auburn, I have to admit I had more reservations than probably anyone else on our team about the advisability of this trip, mostly with regard to security and safety. Look at what the State Department says about Americans traveling to Haiti. I have to stop here and give a shout-out to Pastor Dan Appel, one of my Rotary buddies from Auburn and someone who I have gotten so much spiritual support from. Our trip has not been without hiccups and some logistical snags, but I never really felt the danger I was sure I would feel. It was in the few words (translated) from this Haitian pastor that I truly felt peace and what I believe was God’s sanction or validity for this trip. Thanks to Dan as always for the good advice and support.
And lastly, the final day of clinic usually brings out the best meal of the week, and the chance to buy some handicrafts from the villagers. The meal didn’t disappoint, either. We had lobster again, we had the fish we were expecting last night, plus two types of salads, the ubiquitous rice and fried yams. And shock of shocks, we had dessert — a sweet coffee cake or pound cake that was excellent.
There was a champagne toast for the project and for Bernice, who had a birthday today. We left the kitchen with our crafts and instructions for tomorrow. Coffee at 7:00 am, leave for the beach at 8:30, then the bus drive to Port-au-Prince to a hotel that Monte and Mandy say has a restaurant, pool, power, and showers in each room.
Good night from Ile a Vache, Haiti
Steve Leighty, DDS
Breakfast is getting smaller and less paleo: Today we had coffee, banana, and bread/peanut butter. We had a brief discussion about our shortage of local anesthetic and identified the people and steps for checking on availability in Les Cayes or even Port-au-Prince. Our equipment and power have been working almost flawlessly, and our local anesthetic problem is really the only real dental problem we’ve had.
Most of our whining involves creature comforts like toilet paper or water with which to take a ladle shower or to flush the toilets with. We are getting more touchy about lighting and food, also. Thankfully there is drinking water. There may be a revolt if we have another lunch of ketchup/onion sandwiches. We haven’t seen an ice cube in a week. One thing there is an abundance of is Sprite and Coca-Cola, which are offered to the dental team all during the day. Most of us don’t normally drink sodas — it just is a strange juxtaposition to have sodas when we are lacking so many other things.
The laundry service is an unexpected service that is working pretty well. Dirty clothes are brought to the kitchen in a bag in the morning and in the evening the clothes have been washed and dried. Sometimes the clothes are dried hanging on a barbed wire fence and other times they are laid on the ground. The part of the picture that you don’t see are the amount of donkey, hog, horse, dog, cow, and goat dung that is everywhere.
Did I tell you about the hen and 4 chicks that have taken up residence in our bathroom? We had a gully washer of a rain storm for about 10 minutes this morning which tapered off into a gentle rain for another 20 minutes. Our generators both ran out of fuel at the same time this morning but replenishments arrived in about 30 minutes. Speaking of technical problems, our vacuum #1 went down this afternoon and is non-repairable. The hygienists and surgery have three inlets from vacuum #2, and Ed has his own vacuum, but the problem remains about what the other three GPs will do for suction tomorrow.
I finished of my box of Septocaine at 5:00pm today. We have about 20 Mepivicaine and 20 Lidocaine carpules between the group. Monte thinks he found some local anesthetic in Les Cayes, which Brian and one of the translators will go get early in the morning.
I got a brief interview with Mandy at lunch today. She lives in St. Croix most of the year. Good Samaritan Foundation (GSF), the NGO that Mandy has operated since 2013, deals with microcredit projects clean water/sewage and links to other Haitian NGOs that operate several vocational education projects. Mandy is fluent in French and is our room mother; keeping the cooks on task and helping to corral the translators and patients.
Phelix Joseph is everywhere, helping to translate, and doing lots of supportive things for this project and with Mandy and Monte. Phelix is a native and an attorney. One of his lifelong goals was to establish a school on Ile a Vache. He and Michael Gardner, the president of GSF, got some of their first funding from Rotary Club of Tortola (British Virgin Islands) in 2008. The school building was designed to also serve as an earthquake/hurricane shelter. The school was built in 2012 and is about 2 hours’ walk from our little Castra village.
Tomorrow is our last day of patient treatment and then Friday is a travel day to Port-au-Prince. We depart from the airport Saturday, heading for SFO through JFK.
The rumor is that the cooks are preparing fish for dinner tonight. However, the sun is now set (7:15pm) and the kitchen is completely silent, although there was some activity an hour ago.
My cough/cold is worse today but I tried to tough it through. I know I’m irritating everybody in the group; I’m just hoping I don’t have tuberculosis. Whatever ails me, I’m signing off for tonight.
Steve Leighty, DDS