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Over their Easter/Passover/Spring Break a team of physicians and medical students from the State University of New York at Buffalo made a medical mission trip to Fontaine, Haiti. Each day a member of the team was assigned to make an entry into the group's daily journal. Below are those daily entries. You will find their entries informative, inspiring and give you a glimpse of daily life in one small community in Haiti. Fr. David E. Noone

From the University of Buffalo Haiti Team: Easter Medical Mission to Fontaine Haiti

Saturday, April 4
Dear Family and Friends,
This is just a quick note to say that we arrived ok in Fontaine, Haiti. The flight was uneventful except for a 1 hour delay out of JFK. Pierre-Louis and others met us outside the airport, piled our luggage in the back of a pick-up truck and we piled in two vans. The ride from Port-au-Prince to Fontaine took about 5 hours and went over a beautiful mountain range. The last couple hours of driving was on a very bumpy dirt road which wore us out. Along the way we saw lots of people. Some had little stands of produce and other items they were selling in the many outdoor markets along the road. Others were carrying large heavy objects on their heads like a 5 gallon container filled with bottled water. Others were just hanging out, playing basketball and other games with friends. There is a real sense of community here. We arrived in Fontaine and enjoyed touring the school and eating supper. They cooked lots of delicious food for us - namely goat meat, plantain, carrots, brown rice with spicy sauce, and more. We had a group debriefing session afterwards and talked about the day tomorrow. Pierre-Louis invited us to Easter church celebration - at 7:30 am so we're heading to bed soon. Just wanted to let you know that we're all ok and have had a good first day in Haiti. David Holmes, MD Clinical Associate Professor, Director of Global Health Education University at Buffalo, Department t of Family Medicine

"Compassion is more than feeling sorry for someone. It's being moved toward action." - unknown

Sunday, April 5

Dear Family, Friends and Faculty -
We woke up to the rooster crowing this morning and a beautiful sunrise. Then we walked through town briefly and went church. The music was amazing and we felt very welcome. As soon as we got back, we set up clinic - with an intake room for vitals, a provider room and a pharmacy. By 12:15 we were seeing patients. At 6:15ish, when we wrapped things up, we had seen a total of 109 patients! Not bad for a half day! Most of the patients we saw today were children, many who go to St. Gabriel's School. Our youngest patient was five months old. We helped people who were having vision problems, a young girl who had a heart murmur, a young man who had a bad eye infection. And the donkey bite the team saw last year was well healed! We are very grateful that things went very smoothly today. As the kids waited, some of us got the chance to break away and play. The kids loved bubbles, volleyball and soccer. We are making some new friends. We are just headed to bed after some of us held our own Easter celebration on the roof! Beautiful weather here, sorry. On behalf of the team, Torie

Monday, April 6

Hi Family and Friends,
Today's update is written by several of us who each wrote a couple sentences.
We are having a great experience in Haiti and seeing a lot of our world away from home. Today we had our second day of clinic and, much to our disbelief, were even busier than the first, adding another 157 patients to the 109 from yesterday! The people of Fontaine are very happy to have us - we thoroughly appreciate their gratitude. We continued to expand upon the interesting medical findings from yesterday: cysts, heat exhaustion, cortisone shots, hernias and reflux were among our favorites. We were able to make a big difference by giving out A LOT of glasses to many of the patients. Also, for some of the more serious cases, we were able to use some of the extra funds we raised to send patients to specialists at hospitals. For a young girl, we caught a heart murmur and are referring her to a cardiologist. For a young adult man who is progressively going blind, we are sending him to an ophthalmologist. We have been able to treat many patients for headaches, hypertension, diabetes, reflux and other diseases we see regularly back home. It has also been very eye opening to see how many patients we have that can be treated with a meal or water, which we take for, granted. Seeing the gratitude in people's eyes after they were treated has truly been rewarding and keeps us going throughout the long days. We learn as much from our patients as they learn from us. We are very grateful to be welcomed in the community and learn so much from them. Even though we had a packed day it was easy to find strength and encouragement in each other. Luckily, it was easy to be inspired by the people we saw and the community members who assisted us during the day. We started with a prayer as a group, including the staff, translators and student volunteers and asked God to work through us and bless each person that we spoke to, saw and touched today. On behalf of our team, Mike, Travis, Brian, Megan, Nick, Gaurang, and Doug

Tuesday April 7
Hello from Haiti,
We just finished our round circle recap of the day on the roof of the school and the students headed down for jackets... yes, the nights are cool. Amidst the many stories told our favorite is that of an 88 year old gentleman who was delivered to our clinic at 7:30 a.m. today on a neighbor's donkey - as he was unsteady on his feet all were eager to help him. After receiving a thorough examination and very compassionate care here he finally spoke up to thank us and admitted to being the man who sold this land to Pierre Louise's family on which St Gabriel's school was built. He spoke of the blessing that the school has been to the village of Fontaine. Another highlight of the day was the arrival of Cherub, a University at Buffalo student who had to postpone her trip due to unforeseen circumstances. She rearranged her flights and worked with the staff at the school to get herself here to the clinic to rejoin the medical mission team. She was determined to get here to the work she promised God that she would do. The inspiring stories just go on and on. We started clinic at about 8:30 following a joining of hands by the interpreters and team to praise God for his Empowering Hand in this effort. We finished by 6 p.m. after seeing another 152 patients...all so hardy, gentle and oh so brave. We are humbled. All day long the front yard of the school was full of toddlers with balloons, children coloring pictures, and teenage boys laughing with the whoopee cushions we handed out. The village children played soccer and Frisbee with the medical students who couldn't wait to put down their stethoscopes and just play. The wandering chickens caused a few "delay of game" calls. We enjoyed a walk down a steep rocky road that leads to the river in Fontaine and met many kids carrying a jug of water home-the teenagers hung multiple jugs off their motorbikes parking in the center of the river. Everyone knows everyone- the sense of community here is truly remarkable. We all feel very fortunate to be part of this team doing a pretty graceful dance in a very busy, foreign but loving clinic setting. God is so good. Love to all of you. We are definitely feeling the distance and wishing we could pick up the phone and just hear your voices. Till, then, thanks for your support. Love you all. On behalf of our team, Allison Killeen.

Wednesday, April 8
Hi everyone!
We awoke this morning to a hot, humid day-the roosters wake you up first, then the goats, then the donkeys, dogs and then finally, when you can't ignore it any longer, the laughing, screaming children. Clinic started around 8:30 AM but when I snuck down to start setting up at 7:45 AM, we already had a line of stooped elderly men and women sitting on the front porch gossiping between exhausted young mothers hugging wailing toddlers to their chests. We had a long day ahead of us that we started with a prayer as a group including the staff, translators and student volunteers as we asked God to work through us and bless each person that we spoke to, saw and touched today. Sunday and Monday the lessons of the day were how to give pelvic (GYN) and testicular exams -the NPs and Dr. Holmes made sure to ask everyone if they had had a chance to practice on a real patient. To use a popular phrase: the villagers of Fontaine are the real MVP's-they really don't seem to mind our clumsy hands and nervous, inexperienced questions. Our work here is such an educational gold rush-you never know what you're going to find or do next! Yesterday and today the lessons were general surgery. Each one of us either performed our own surgery (lidocaine, scalpels: the whole nine yards!) on a patient or stitched up a patient. To be able to learn, practice and make mistakes under the calm, patient tutelage of Dr. Holmes is an experience that many medical students will never be able to have and definitely wouldn't be able to do so in a low-stress, non-OR environment. Now consider that we haven't finished up first year yet and we have been able to operate on real people--unbelievable. We are so lucky to have such enthusiastic practitioners with us to happily, calmly and patiently work with us one-on-one in such a low stress environment, and we have learned so much from them and from each other in such a short time. We ended early today-clinic lasted only from 8:30 AM to 4:30 PM-so that we could trek out to the soccer field to play against the village boys. Unfortunately, USA lost to Haiti 2-1, but we believe that Haiti might have had the home field advantage; none of us had ever played on a dirt field next to bulls and roosters, dribbling in between the piles of cow dung and garbage piles. We also saw the village's public school this afternoon: two ripped tarps draped over two wooden benches in front of a faded, lopsided chalkboard in the middle of a garbage dump. Apparently when it rains, there is no school because all of the children would get wet. Pictures to come, it's incredibly sobering to see what a primary school in a third world country is compared to a primary school classroom back home. Finally, before dinner we took a "quick" (by Haitian standards, so a very long and roundabout) walk to the sugarcane "factory". There we saw men hacking away at sugar cane feeding it into a press and then boiling the syrup to make sugar. Very raw, very dirty, very dangerous, very eye-opening. We saw 137 patients today which, was incredible, considering that a lot of us were tied up in the surgical corner (yes, our patients laid on a mattress in the corner of the practitioner room in the clinic-pictures to come, of course!) and we ended early. We see patients faster now because it's easy to anticipate the complaints that patients arrive with and we are used to treating a lot of the same issues: yeast infections, high blood pressure, STD's, acid reflux, parasitic worms, etc. etc. Tomorrow is our last day and we're almost out of meds so we're a little anxious to see how it goes, but we're happy that we're using everything we're bringing. Thank you for all of your support, encouragement and generosity along the way. Karina & the Haiti Team

Thursday, April 9
Hello Friends, Family, and Faculty,
It was our last day in Fontaine and boy was it memorable! Our first patient of the day was a three year old boy with a developmental disability who came with his grandmother. Our Pediatric Nurse Practitioner, Allison, was able to educate the women about her grandson's condition and imparted some wisdom from her personal experience raising her own son with special needs. Not to mention, Dr. Holmes was busy almost all day performing minor surgeries on several patients to relieve irritating growths on the patients' head and necks. All of us learned so much from our hands on experience and through Dr. Holmes's patience with these surgeries. He saw 136 patients today. Our total for the week was over 700. Throughout the day we were blessed to meet inspiring people. A young girl came with a hard mass on her leg. We used some of the money we raised to help her go to the hospital for an X-ray, only costing $18 US. She returned later in the day with her X-ray film. Unfortunately, she may have an osteosarcoma. We are planning to help fund her to be evaluated and treated in Hinche, a hospital two hours away. Pierre Louis, will be helping us make these arrangements. We then followed up with several patients who came in earlier in the week receiving hypertension medication and we were pleased to find that many of them were responding well to treatment. After clinic we walked to a man's house for a post-op home visit to make sure everything was going well. He lived in a small unfinished cement brick home with his family. His bedroom was sparsely furnished with nothing but a bed and small table with a kerosene lantern on it. He had a wonderful smile that made us all feel happy. It's amazing how some people have so little yet seem so content and joyful. At the end of the day, some members of the community and some of the students at St. Gabriel's gave us a fancy going away dinner and dance. It was an amazing night of celebration, food, and dancing. Plates were full of goat, lasagna, vegetables, and homemade cookies. Everyone learned the traditional Haitian "kompa" and danced the night away. We feel sad about leaving our friends and patients in Fontaine and feel grateful for a wonderful week. On behalf of our team, Megan L

Friday, April 10

Dear Family, Friends and Faculty,
This morning some of us woke up a bit earlier than usual and went for a fun run up and down some of the hills in Fontaine. We probably only ran a mile, but it seemed like 10 for out of shape types like me. Despite that, it was fun doing this together and a great way to see more of the Fontaine countryside. After breakfast a few of us did some home visits on a couple patients we were concerned about. Thankfully, they are doing well. They were full of smiles and gratitude. One of them was a pastor and who lives next to his church. The church had a wood frame, metal corrugated roof, dirt floor and USAID tarps for the walls. Just outside the entrance was a pig nursing her piglet. As we were enjoying our time with the pastor another man walked up to us and said that he had been coughing for 3 months, but the medicine we gave him a few days ago (azithromycin) has helped him a lot. We appreciated the follow-up and glimpse of continuity of care, even with being here such a short time.

We then cleaned up our mess from the clinic, packed up our stuff, said some sad good-byes to our new friends and survived the 5+ hour bumpy trip back to Port-au-Prince. Tonight we are staying in a hotel so that we will be able to get to the airport on time tomorrow. We enjoyed relaxing, eating dinner together and then meeting for our final debriefing session. During this session we shared some of our favorite things about this week. Below is a summary of what was said:

Home visits and seeing the joy of some patients despite living in desolate conditions
How appreciative the patients were
Students were eager to learn and were quick learners
Soccer game
Camaraderie, teamwork
Getting to know the fellow students better outside of medical school
Debriefing sessions
The patients, especially the spunky old men who made me smile
Being taught and mentored
Teaching and inspiring the students from Fontaine who worked with us and want to be doctors some day (the UB med students did this which the Fontaine students appreciated)
Playing with the kids
Being inspired by the translators, some of whom are in college and have a strong desire to do what they can to change Haiti for the better
Being manager in the clinic (each half-day students rotated among 3 rooms: intake room, provider room and pharmacy. They also took turns being the clinic manager who had the job of overseeing patient flow and trouble shooting problems as they arose)
The resiliency of the patients
Exploring Fontaine - seeing the river, sugar cane factory and those walking in the street (people, donkeys and cows).
Learning from each other and gelling as a group
Unplugging and being in the moment - It was great not being plugged into internet, phones, etc.!
Laughing together - this is the best medicine

A few nights ago during the debriefing session, the group shared specific, positive things they noticed about each other. It was a very uplifting time and many things were mentioned about each member of the team. I am so impressed with everyone. They worked hard, always had a positive attitude and demonstrated how much they cared for each other as well as their patients. To the parents on this e-mail list - you have remarkable kids! You have clearly done a great job raising your children! Thank you for supporting them on this trip. I am inspired by each of them and what they did this week. On behalf of the team, David Holmes, MD/Clinical Associate Professor, Director of Global Health Education/University at Buffalo Department of Family Medicine

Friends of Fontaine, P.O. Box 11376, Albany, NY 12211.

"Friends of Fontaine" is a 501(c)(3) non-profit organization whose mission is "to foster growth and development in Fontaine, Haiti through education, health and other community services."
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