Haiti Village Health

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2010-11-10T10:44:00.000-04:00

Our blog has been relocated to our website.

Please go to
www.haitivillagehealth.ca
for updates.

Bod Me Limbe/Farewell Haiti

2010-08-21T17:23:00.000-03:00

My last week in Haiti has been spent in Bod Me Limbe, where Haiti Village Health’s permanent clinic is located. Bod Me Limbe is about a one and a half hour drive from Cap Haitian in Northern Haiti. It is a very beautiful area with a picturesque mountainous landscape that is green for miles. Bod Me Limbe more specifically is located along the edge of the ocean, providing a nice cool breeze with the sound of crashing waves with spectacular views of the distant mountains beyond the coast.

Bod Me Limbe is very remote, so much in fact that many Haitians I spoke with in Jacmel had never heard of it before. The guesthouse has no running water and a generator that only provides electricity in the evenings. Taking a shower out of a bucket was something I had to get used to but eventually I got the hang of it. Otherwise, the guesthouse is quite the comfortable spot. My room in particular opened up to a patio with a view of the facing ocean and swaying palm trees, a lovely sight to wake up to every morning.

The clinic, as well as a school, is located just behind the guesthouse. My days in Bod Me Limbe were spent doing triage at the clinic. I enjoyed learning about how the permanent clinic operated and was happy to see its sustainable format in practice, supported by an all Haitian staff. Patients come to the clinic not just from Bod Me Limbe, but from villages all around, including Titoit, Fage and Noman. Santos, the HVH coordinator for the clinic, informed me that people come far distances from all around in the mountains to have access to the clinic. On their first visit, patients provide information including their name, age and address so that a file can be created for them to reference for future visits. They then receive a card with their name and file number on it so that their file can be quickly located upon their return. Also, a large directory of patient names and file numbers has been created in the event that the patient misplaces or forgets to bring their card. From my experiences with the other clinics, I think the patient records at the Bod Me Limbe clinic are an awesome method because it was often hard to get medical history from patients in Jacmel. The clinic is open Monday to Friday, with a nurse and two health agents in everyday and a doctor three days per week. The health agents are two women from the local area who have been trained in triage and first aid in the event that something arises when the doctor and nurse are not there. They also regularly visit the nearby villages to teach people about the importance of things like hand washing and water sanitization. Overall, I would have to say that the clinic seems to be doing great things for the area and is very well organized in its approach.

Tonight will be my last night in Haiti. I am spending it in Port-au-Prince so that I can get to the airport easily for my morning flight tomorrow. I am staying with Grassroots United, an organization that has worked with HVH in acquiring and moving medications in Haiti. On the one hand, I feel ready to go home because I’ve really come to miss my family and friends, but on the other, I know I will miss Haiti once I’m gone and feel so grateful to have had this experience. I have met so many wonderful people who have unfortunately found themselves in poor circumstances but are still able to keep a smile on their faces. The children most of all have touched my heart, particularly our little helpers in Chabin who were so jovial and thoughtful. I have also had some great experience shadowing nurses and doctors as well as learning triage. All an all it was an excellent trip and I look forward to hopefully coming again in the future!

Madelin Rocheleau

A Few Pictures from my Time in Haiti

2010-08-15T13:18:00.000-03:00

The Chabin Clinic

2010-08-13T00:36:00.000-03:00

Yesterday, Haiti Village Health Clinic in Chabin had its final day open for the month of August. In total, our clinic saw 87 timoun (children), 35 granmoun (elderly), 17 fanm ansent (pregnant women) and 151 patients from the general public, totalling 191 visitors.

I really enjoyed my time at the Chabin clinic over the past week and a half. I got some great experience taking vitals, working in the lab and pharmacy, shadowing doctors and medical students, and even had the chance to dress a wound for a lovely Haitian gentleman who had spent some time learning English in Palm Springs, Florida, while training to become a chef. We also saw a lot of adorable babies, timid little children, hardworking parents and grandparents over the course of our clinic. One of our most memorable patients for me, however, was the last patient we saw on the last day of the clinic. It was a mother who had come in with two of her daughters to see our medical staff. Her two daughter were adorable, both wearing frilly pink and white dresses with bows and braids in their hair. As for the mother, she seemed tired and overworked, like she had put in a lot of hard, long days throughout her life. Through a series of questioning and examinations, Catherine and Jude, one of the nurses from Cavalry Chapel, concluded that the mother was suffering from a number of chronic conditions for which we thankfully had most of the necessary medications. She ended up going home with 15 different medications for herself and several for each of her children as well. Although of clinic is only equipped for primary care, this particular case, for me, showed the necessity for something as basic as primary care in an area like Chabin. I’m very glad that we were able to provide this woman and her children with medications that will make their lives at least a little bit easier.

We had some help during our time in Chabin from an awesome team of volunteers who are here in Haiti with Calvary Chapel. Without them, our clinic would not have experienced the success that it did. Their group offered us some nurses, students, a physiotherapist and a pharmacist who were all wonderful to work with. Calvary Chapel also provided us with the tent we used for the clinic, a generator to give us power, and they built all the tables and benches we used to sit and see patients. A big thanks to all those at Calvary Chapel from HVH!

The last day at the clinic ended up being one of the most emotional days for me in Haiti so far. After we were done seeing patients, the other students and I stayed behind to help some of the Cavalry Chapel volunteers disassemble the tent. While we waited for them to arrive, we got to spend some quality time with the children who hang around our clinic every day and help us to pack up. Together, we sang songs, laughed and played throughout the afternoon. I’d managed to pick up enough basic Creole to ask children their names and ages and, along with the help of some older, French-speaking kids as translators, was able to get to know some of them a little bit better. When the other volunteers arrived, we deflated the tent, transforming it into a jumping playground for the kids, which was heart-warming to watch. We then packed the tent into the truck and began loading up the furniture, during which time it began to rain slightly. One of my favourite little boys, Nixon, started tugging on our shirts, saying something in Creole we didn’t understand. We were eventually explained that he was trying to get us to go in the truck so we wouldn’t get wet, which was just about the cutest thing I had ever heard. One of the other volunteers then mentioned that a common voodoo belief was that getting wet from the rain is what causes illness and, seeing the kids trying to cover their heads, we decided to shield their heads with our hands, eventually creating a little house for our limbs which all the children huddled under. It was adorable! Eventually however, after a lot of hugs, included a nice big squeeze from Nixon, we unfortunately had to leave Chabin. As the truck drove off with the children waving us goodbye, I couldn’t help but shed some tears because I immediately began to miss their smiling faces.

Fortunately, the clinic will be opening again next month, and eventually, HVH is hoping to build a permanent clinic in its location so that the people of Chabin can have regular access to it. I’m sure future clinic teams can look forward to having the chance to meet our awesome little helpers who have I feel so fortunate to have met and will never forget.

Next week, I’m planning to pay a visit to HVH’s permanent clinic which has been established up north in Bod Me Limbe. I’m excited to see how the more permanent clinic is run and what kind of medical issues they encounter on a regular basis, so more updates to come.

Madelin Rocheleau

New HVH Clinic in Chabin

2010-08-04T16:35:00.000-03:00

This week has been off to a great start for our new Haiti Village Health Clinic in Chabin. The clinic opened Monday and has seen 139 patients over the last three days.

The location of the clinic in Chabin is very picturesque. It is nestled part way up a mountain off the beaten path from the main road towards Port-au-Prince. This spot provides spectacular views of the surrounding valleys, rivers and luscious greenery and well as a nice cool breeze that keeps the mosquitoes away, always an added bonus!

The clinic is divided into several sections: general information, vitals, triage, consultations, laboratory and pharmacy. We have some native Haitians working in the first section, taking patients names, ages, hometowns, and contact information. The second station is where I have been positioned along with two other students from Toronto area, Jessica and Elizabeth. The three of us rotate between the lab and vitals. At the vitals station, we take patients’ blood pressures, pulse, weight, and temperature. At the lab, we do urine tests and occasionally help out in the pharmacy. Catherine, along with Wesley, another new volunteer from Vancouver, Ruth, our guesthouse manager and nursing student, and Cassidy, an EMT who has been working in Port-au-Prince, are located in the triage section. There they take the patients’ histories and do some basic diagnostics. More complicated cases are then sent to one of our two doctors, Dave and Mona, for consultations. Patients then proceed to the pharmacy to get their prescriptions filled. Overall, I’ve found the clinic to be very well organized and efficient thanks to these stations, with all of the volunteers put in positions where their expertise can be most useful.

We have also had the opportunity to meet a ton of amazing children during our time in Chabin. All of them have the most beautiful smiles and get super excited at the chance to mingle with the clinic staff after we’ve finished seeing our patients. They love to help us pack and lock up our supplies at the end of the days which is just the cutest thing to witness. Initially, we were locking everything up in a nearby school, so the kids got a kick out of riding our rented taptap truck up the bumpy mountain. Now, we’ve began to put everything in a nearby house at the end of the day for more convenience, and without fail, every afternoon the children are there and eager to assist us in carrying our boxes. They are all too adorable!

Over the next week or so, we hopefully have more successful clinic days to look forward to, so more updates to come.

Madelin Rocheleau

More news from Jacmel

2010-07-29T23:20:00.000-03:00

This week, my fellow volunteers and I spent our time helping out with the Haiti Family Initiative while we wait for our clinic in Chabin to open. The Haiti Family Initiative is a 7 week summer camp program which also occasionally holds free clinics depending on whether or not the weekly team has any medically trained volunteers. Sarah, Catherine and I were able to assist with the clinic this week.

All three of us helped with patient intake, which consisted of taking down patient’s names and ages, history, chief complaint and vitals (pulse and blood pressure readings). Initially, I was paired with either Sarah or Catherine, recording the information they received from the patients as I am not yet in medical school. Eventually however, I was trained on how to take vitals myself and was able to do patient intake on my own, which was very exciting for me as an aspiring med student. Sarah and Catherine also were able to move on to assisting the doctors in patient diagnosis and treatment, which for them was awesome because they were able to use more of their medical expertise. Eventually they were even given their own patients, which was great experience for them.

We also had the opportunity to go on a tour of the local hospital, Saint-Michel. There definitely was a lot of destruction caused by the earthquake but we had the impression that it had once been a very nice hospital campus. There were also some new buildings that had been constructed by Doctors without Borders, which provide beds for the pediatric and internal medicine wards. There were also a lot of engineers and construction workers on hand continuing to repair the hospital. According to those who had seen Saint-Michel right after the earthquake, the hospital has made a lot of progress.

Today, Dr. Mona brought over a ton of medications for the new clinic, so tonight we’re working on taking inventory and categorizing these items so that they will be ready for use in Chabin next week.

That's all for now, more updates to come!

Madelin Rocheleau
volunteer

An Update from Jacmel

2010-07-24T23:18:00.000-03:00

Bonjou from Haiti!

My name is Madelin and I am a first time volunteer with Haiti Village Health. Two other volunteers, Sarah and Catherine, and I have just moved into the guesthouse in Jacmel with Namita to help her and Mona's efforts in the town. We are all very excited to be here and help in any way that we can.

Being only a couple of days into my stay, I would have to say that my first impression of Haiti is that it is a beautiful island with beautiful people who have unfortunately been condemned to such a dire situation. Despite the fact that the earthquake took place over six months ago, there is still a lot of work to be done. Regardless of their struggles however, all of the Haitians that I have met thus far have been so warm and friendly. Truly an inspiration.

Here at the guesthouse, we are currently in preparation for the opening of our new clinic in Chabin, just outside of Jacmel. Today, we just finished putting together some cards which will be used to give patients access to the clinic. They will be distributed tomorrow morning. 168 cards each were created for pregnant women, children under five and elders, totalling 504 cards. These individuals will receive free access to the clinic. An additional 324 were made that can be purchased for 50gds (approximately USD$1.25) for the rest of the general public. These cards will be reused once they have been brought in by the patients. The clinic opening is currently scheduled for August 2nd.

Tomorrow, we are planning to pay a visit to one of the local tent camps in Jacmel called Pinchinat. These camps have been set up to provide temporary housing to those whose homes have been damaged or destroyed by the earthquake. This is sure to be an experience as I’ve heard that the conditions there are extremely grim.

I will be staying in Jacmel over the next month and will be sure to follow up in the coming weeks with more updates regarding our efforts and experiences.

Until next time,
Madelin Rocheleau

Update Volunteers in Jacmel

2010-07-23T18:35:00.000-03:00

MEDICAL CLINIC
Well our medical students and volunteers from Canada have arrived to help in preparation with the upcoming medical clinic in Chabin. We have secured a large tent with the help of Calvary Chapel to use until construction of the clinic is completed. These young students will work alongside our Haitian staff to prepare for the opening. A health committee has been formed in the region to educate the residents about the new clinic, and also to ask for their help in planning this health project.

RESOURCE FINDER
If you're looking for health facilities in Haiti, check out Resource Finder at the link in the left column. This will be updated by Health Facilities throughout Haiti to aid in finding specialists and directing patient care.

AIR TRANSPORT
Plans for our air ambulance service are underway. We hope to have two full time planes on the ground by mid November offering free service to those in need. The logistics of medical dispatch and education of local health staff is currently being planned.

MEDICAL DEPOT
The depot is quite empty at the moment but we are hoping for a supply from Direct Relief International in the upcoming week. These medicines will be distributed to local NGOs free of charge for use in their clinics.

BOD ME CLINIC
The clinic is running well under the direction of Mr Santo Pierre. Our chlorine project is underway. Santo identified that some villagers are still unsure as to the benefit of chlorine so our physician will work with the Agence Sante (community Health workers) to increase our public relations campaign as to the benefit of clean water.

I hope to have an update from the medical students on the ground to post next week, along with some photos.

Tiffany

Update....long overdue

2010-07-09T05:46:00.000-03:00

Well Haiti Village Health has been busy in country, despite my lack of updates on the blog.

I returned to Haiti in May to follow our programs in Jacmel under the care of Dr. Mona Alexis. She continued her work with the Department of Health and with the refugee camp in the city. We continue to host medical teams doing mobile clinics in the region, and staying our our guest house in Jacmel.

I had the opportunity to work at JPHRO, Sean Penn's refugee camp in Petionville. This camp has over 50,000 people living one huge tent cities. There are several small clinics on the grounds but JPHRO provides 24 hour emergency care to this population. It was a busy day at the clinic, including one woman who had a ruptured ectopic pregnancy. JPHRO is well prepared with a referral network and she was rushed off shortly to a nenearby hospital.

On Mother's Day, I enjoyed Partners in Health in a new mobile medical clinic van. Our day clinic was held downtown near the National Palace which had been demolished. I'm not sure of the number of patients seen but it was a long day. It was great to work alongside Haitian doctors and nurses and my Creole is definately improving.

In June, Namita Kumar joined Haiti Village Health as our new in-country manager. She will be supervising the programs in the Southern Region.

So, what are we up to now? As you know, initially our role had been in medical coordination. We still continue in this capacity in terms of facilitating information but we have narrowed our focus.

MEDICAL CLINIC CHABIN WITH LIFELIFE HAITI
In 2009 I was approached by Pastor Bob Davisson regarding starting a medical clinic at one of his 52 schools in Southern Haiti. I did a few site assessments but unfortunately funding was not available at that time. We are still in need of funding, but we have volunteers and supplies, and will be opening a new medical clinic at his site. Our first medical team will be on the ground in late July and we hope to continue to host volunteers until the clinic can run independantly. This is similar to the prprogram we started in the north, but will be an accelerated version.

GOOGLE RESOURCE FINDER
Earlier this year I was asked to sit on a working Committee with the US State Department regarding the mapping of Health Facilities in Haiti. This led to improved mapping through the organization Shoreland. Google's site, Resource Finder, will be the public window to Health Facilities in Haiti. Haiti Village Health will be sending field workers out to teach local health care workers how to enter data directly to the database. Namita and our in-country tech guru Patrice Tellyrand will spearhead this project. MSPP (the Department of Health) gave the official go ahead last week and the site will launch shortly.

COMMUNITY CENTER FOR PINCHINAT
We have been working closely with the refugee camp in Jacmel, providing medication and supplies since the earthquake. We have assisted the camp leaders in attending meetings at the United Nations Cluster meetings so that their voice was heard in the decision making process. Together with Calvary Chapel, a Community Center will be built at the local camp. We will facilitate programs operating at the center.

EMERGENCY MEDICAL AIR TRANSPORT
We are currently working with three partner organizations to establish a country wide, emergency air transport service for Haiti. Jacmel is on the list as one of the fixed in country locations. Several volunteer pilots have been to the region and had meetings with the local airport authorities both in Jacmel and in the North. This service is desperately needed in Haiti as road conditions are so poor.

MEDICAL DEPOT
Since the earthquake, we have been involved with the storage and distribution of medical supplies in Jacmel. Currently, the supplies at the depot are limited but we expect a new shipment soon from Direct Relief International. The Aid Matrix Foundation will provide training to workers in inventory supply and management. Calvary Chapel will be constructing a new depot in August with climate control. We are looking for a partner for funding for this essential project to continue.

BOD ME LIMBE CLINIC
Our clinic is still operating in the North as it was pre-earthquake. Open five days per week. We also have community programs in worm distribution, prenatal and children's vitamins, clean water and sanitation.

NGO (NON GOVERNMENTAL ORGANIZATION) COORDINATION
We had been busy in the early days post quake with coordination at the airport. Currently OCHA (the United Nations) and the Clinton Foundation are teaming up to encourage the registration of NGOs nationwide. We have been able to provide information to them, and to facilitate projects linking individuals to organizations.

So, how can you help now?
Haiti Village Health needs funding to continue our projects and to help with the construction of the new clinic in Chabin, and to continue with our support in the north.

We are also in need of volunteers, both medical and non medical to support our clinics in the north and south. For further information on volunteering, please email haitivillagehealth@yahoo.com.

I will begin to provide regular updates on our projects, with photos as available.

Thank you all for your continued support.

Tiffany Keenan, MD
Founder & Director

Update from Tiffany's Trip

2010-04-03T11:33:00.001-03:00

Our Bermuda Dental Team and Communications Director are finally back home once again. It is a difficult transition for anyone going from third to first world nation, but the experience and life lessons learned are invaluable.

I've been busy over the last week continuing my work with NGO coordination. While in Haiti, I spent time in Jacmel meeting with the World Health Organization, Ministry of Health and my own workers on the ground to come up with a plan for Haiti Village Health in Jacmel. In the end our motto was "Go big or Go Home". Because of Haiti's centralized system of Healthcare we were running into several hurdles in working with the Ministry of Health. Dr. Delouches greatly appreciated all the work that HVH was able to contribute but as the WHO was stepping up to the table I began to work for other ways to be most effective in networking individuals and getting the job done.

So, after my Jacmel trip, I left Dr. Mona in charge of Health logistics and managament, Fredo in charge of the Guest Hostel and Ruth working as a nurse volunteer and assisting at the guest house.

I drove from Jacmel to Leogane to meet with Jim Luce of Orphans international Worldwide and his team from New York City. I had actually met them for the first time on a layover in NYC on my way to Haiti. We had a great meeting in Leogane which turned out to last the day as several members of the team joined me in PAP. We met with Americares who will be investing 50 million dollars in Haiti over the next 5 years. We also met with JPHRO, Jenkins Penn (yes, Sean) Haiti Relief Organization who are servicing a refugee camp of 50,000 people in Petionville. I also met Adam Marlatt of Global DIRT who is simply doing incredible work on the ground in Haiti getting supplies, people and patients to where they need to go.

From there I came up with a plan for NGO networking within not only Jacmel but throughout the country. I've been working on that plan this past week, and through NGO partners have presented it to NOAH, the National organization for the ADvancement of Haitians and also to a member of the Haitian American chamber of commerce.

As the plan develops further, I still continue to focus on the job at hand. Getting supplies, volunteers and patients to the most appropriate places to receive care.

My last 2 days in Haiti were busy ones. Our first problem came with finding a hotel in PAP. You wouldn't think this would be a problem but it was. And not in-expensive either, $400 for 3 rooms. Oh, how nice the air conditioning felt. My final day we had a meeting with Direct Relief International and the American Logsitics support network. Then I was off to catch my plane to Cap Haitian in the north while the team returned to Leogane. I had planned to spend more time in Cap to visit the clinic but my meetings in PAP took precedence. My HVH clinic manager, Santo Pierre met me at the airport and then we were quickly off on a Haitian mini-bus to the Dominican border.

It was the first time I had travelled to the Dominican. It's funny, typically the north always seemed much more crowded and chaotic than the south but after having seen the devastation of the earthquake the North truly looked green and beautiful. Santo and I talked busy the entire time to the border, where we decided to purchase a truck for our doctor and nurse...which would double as a part time tap tap (cab service) and also a standby ambulance. It seems like an excellent example of a cost recovery program.

The dominican border is interesting if you are travelling by local transport. I got off the Haitian minibus in Ounaminthe, got on a motorcycle with my suitcase sitting on the handlebars and Santo on a second one. At the border, I paid the Haitian departure tax of $10 USD. Then we continued by motorcycle about 500 feet and that was it. I got off, my suitcase was put into a wheelbarrow and Santo and I crossed to the DR border office. They took my passport, entered it into a computer that had an attached internet card, I paid another $10 USD and I was in. I took a motorocyle with Santo to the Dominican bus station and then boarded a proper air-conditioned bus for Santiago. (3 hours for $5). I must admit, it is a fast and efficient way to travel.

In Santiago, my medical student Roosevelt Pierre (Santo's brother) greeted me at the bus station. Well, I had to use some of my basic spanish, find a pay phone and then eventually through the manager of an internet cafe, I found Roosevelt.

He had a friend pick me up in a cab and we went for dinner before heading back to Roosevelt's dorm room. Myself and 4 others sponsor Roosevelt's medical education. In return he has made a commmittment to us to return to Haiti to work for the Haitian people. He has 18 months until he completes his studies and I am hoping to obtain a residency position in the USA or Canada for him. Doctors like him will be the leaders of tomorrow for Haiti.

So, next morning I was up at 0400 for the Jetblue flight from Santiago to Bermuda via NYC.

It was a whirlwind trip, only 7 days on the ground but it provided me personally with direction as well as my staff on the ground. Haiti Village Health has expanded from our initial clinic in the north but we still uphold the principles of bringing sustainable health care and support to Haitians, by Haitian.

I will be returning to Haiti on Thursday for 10 days for further meetings, and will be spending time at my village in the North.

I will keep you posted.
Tiffany Keenan

Re: jacmel update

2010-03-30T23:56:00.001-03:00

Update....Haiti Village Health

Just to let you know, Dr. Mona Alexis will continue to work for Haiti Village Health on the ground in Jacmel. She still continues to work closely with the Health Cluster system, and also the refugee camp at Pinchinat. Feel free to email any questions you have about Health care in the Southeast.

Fredo Fiefie will remain as on oursite Guest House manager, and will also be managing our Jacmel Air account. Again, feel free to direct any questions regarding to the Jacmel Air account and he will provide appropriate referrals to the leaders of the cluster system.

Ruth Pierre, who is a nursing student and also speaks excellent will be available for medical teams as a volunteer. We are hoping to provide her with on the job training until she resumes school in the fall.

I will continue to work closely with my team on the ground in NGO liason and support.

Most recently I am working on a proposal to present to NOAH, National Organization for the Advancement of Haitians, and Americares(investing 50 million to Haiti), and the ClintonBushFund for a National NGO coordination project.

I feel the importance of NGO coordination cannot be overstated. It was estimated by PEPFAR prior to the earthquake that 75% of Health care in Haiti was provided by NGOs. We have to channel our resources as much as possible toward a better future for Haiti.

Tiffany Keenan

On Mon, Mar 29, 2010 at 9:42 PM, Haiti Village Health <jacmelair@gmail.com> wrote:

hi everybody,

The logistic coordonator and the dental medical team are leaving today. want everyone to be a part of everything that is happening.

--
Haiti Village Health
Operation: Jacmel Airport
NGO Coordination

--
Dr. Tiffany Keenan
Haiti Village Health, Founder & Director
NGO Coordinator, Jacmel Airport
www.travax.com/m (Haiti Health Database)
www.haitivillagehealth.ca
www.haitivillagehealth.blogspot.com
Bermuda 441-599-7709
Haiti 509-3727-5832, 3486-6020
skype tiffany.keenan.1971

2010-03-30T19:40:00.000-03:00

Yesterday the medical team and I (the communications director) flew back into Port-au-Prince, so my time in Jacmel has come to an end. We had the opportunity to take the MAF private jet (as we drove into Jacmel a week ago) and to see the island of Haiti from a birds eye view was as unfortunate to witness as if you were on land. While we flew over I was able to view the many camps, tents, destroyed buildings, rubble and the amount of sanitation that had piled up in the 2 months after the quake.

Once we reached land, my heart began to ache once again having to face the thousands of people who sat along the sides of the city desperately trying to continue their reality of work and survive in the burning heat. As we crossed the place in which a market use to stand, people were now forced to sell their merchandise (meats, vegetables, fruits, clothes) in any place available. It made my reality of going back to Bermuda in a matter of days fearful; there was still a great need. Although I had the opportunity to help with distribution of food, medical services, visits to the orphanages and refugee camps I had the feeling of wanting to give more. We all did. The medical team had expressed to me, during the week in which they had worked at St. Michel's Hospital, there was still supplies needed and how the hospital was still in chaos.

During the day I had volunteered to work with them and I too saw the process and conditions amongst not only the people but as well as the doctors throughout the hospital. As people came in the clinic for medical treatment I watched how it took hours sometimes to even be triaged. With no medical experience myself I was given the role to assist anybody who was in need of information. From 9am to 4pm I grew remorseful by the amount of people who overflowed the waiting room, as I heard children who screamed in pain, and while others constantly asked how much longer would they have to wait. For a person who does not engage in any type of medical services I tried to assist in any way possible regardless the difficulty.

By the end of the day I was both emotionally and physically exhausted but wanted to encourage people to make a step and try to handle the responsibilities of being a true volunteer and helping those in need in Haiti.

2010-03-28T11:42:00.000-03:00

After a week in Jacmel, Haiti and as one of the new Communication Directors to the Haiti Village Health NGO it has been a non-stop adventure from the beginning. At the age of 21 and my first time assisting with relief work I find the mind-blowing experience, fulfilling yet overwhelming beyond measure. I try to recall the days just after the earthquake, while I sat home in Bermuda, watching CNN news obsessively trying to paint a picture which would help me grasp a better perspective of what Haiti must look like. Not imagining 2 months later I would fly into Port-au-Prince along with 2 others and gain the opportunity to view the disaster myself.

For the first few days my eyes were distraught to the many things that they were being exposed to. With thousands of people along the streets as we drove through Port-au-Prince and moving swiftly along to the Southeast, Jacmel which was our destination, I grew speechless. Wondering if the terror of it all would ever end I became sadden to what was being presented in front of me for 4 hours straight. By my first night I knew my main objective would be to do any and everything within power to help the people of Haiti; but where do I start.

Traveling to St. Teresa’s orphanage instantly became an interest of mine. Seeing all the children that ran throughout the rubble from the collapsed buildings bare footed astounded me but they played around it as if it did not exist. As myself and 3 others exited the truck I was startled as one child grabbed my hand, looked up at me and smiled. I immediately noticed that most if not all the children carried a warm, softening look along their faces and became tremendously excited to see each of us. The little one that adopted me into his world quickly took me around the area showing me the place which he now called home. Unable to communicate through words his facial expressions had told me everything that I needed to know about what he was trying to tell me. At this moment I had realized that kids will be kids, they did not choose this world, they was given it. After our tour we decided to complete a small distribution of juice boxes, blankets and snacks amongst the children we saw and give the rest to the nuns for later. As we left they thanked us by waving as the truck pulled away, shouting “Merci”. For the rest of the trip back to the guest house I sat and realized that it was the first time coming face to face with the suffering that had overcome this town and my heart began to ache for them but also encouraged me to continue my mission. Just seeing the looks on all their faces meant they were grateful for the work we were trying to accomplish.

The Emergency Stage for HVH

2010-03-23T20:07:00.000-03:00

During the first weeks following the quake, as you know Haiti Village Health was assigned to the operating of the airstrip in Jacmel. While the airport became flooded of planes and volunteers it was our responsibility to record the responsive teams that flew in. Here is a brief overview of the numbers which we verified:

PLANES:

week 3: 39
week 4: 80
week 5: 59
week 6: 59
week 7: 50
week 8: 19
TOTAL: 306

VOLUNTEERS:

week 3: 18
week 4: 76
week 5: 54
week 6: 58
week 7: 45
week 8: 39
week 9: 4
TOTAL: 294

As you can see Haiti Village Health relief staff were exceptionally busy to assure that teams arrived safely throughout the emergency stages post earthquake.

Update, Saturday, back in Haiti

2010-03-21T03:10:00.001-03:00

I just wanted to give you an update from Jacmel and also share the article wrtten about my work, and the work of Joseph Barnell, and list other great contacts for telecomms in PAP.

http://www.huffingtonpost.com/georgianne-nienaber/haiti-time-for-an-ngo-pol_b_506913.html

I spent just 24 hours in PAP but made great connections with JPHRO, a relief organization started by Sean Penn and Alison Thompson which provides direct relief to the second largest IDP camp in PAP.

http://jphrodonate.org/beattherain.html They're doing great work servicing a refugee camp (IDP camp) of over 50,000 people.

They have teamed up with Bill Coltart's CMAT,

www.canadianmedicalteams.org who will help provide a staff of medical volunteers and

IMAT, Chris Thompkins www.imateam.org

(I sent Chris and other volunteers to Leogane in days after the quake where they ended up working with CMAT)

I met Dr. Jim Thompson,

http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/02/haiti-use-of-sms-text-messaging-in-operational-biosurveillance.html

The work he is doing in biosurveillance in PAP is amazing, and for only 500K he could get the country connected. The article on SMS technology for tracking this epidimilogy information could easily be applied to distribution and supply of medication and even medical personnel.

Today we spent time working on our Networking meeting for the Southeast on Monday. We have invited all NGOs in the area, along with OCHA, the Mayor's office and the Senator's office.

We sat down tonight with 4 of the large health NGOs in jacmel to plan on how we can improve our own coordination and.

I feel that this is finally starting to come together and will keep you posted on the south, Hopefully we'll get our protype started in the north soon (we've already had a meeting with MSPP there) and with funding, only 750K, we can get all of Haiti coordinated in terms of NGOs.

In a country that has more NGOs per capita in any of the world, why does Haiti remain in such chaos? Some may complain about the lack of coordination in the Haiti government, or corruption. I say one of our faults as first world society's is our own lack of coordination among NGOs.

The time is now for change. I only hope that there is someone out their with funding to help me, and the many small NGOs I've worked with , to make that change happen.

Tiffany

--
Dr. Tiffany Keenan
Haiti Village Health, Founder & Director
NGO Coordinator, Jacmel Airport
www.travax.com/m (Haiti Health Database)
www.haitivillagehealth.ca
www.haitivillagehealth.blogspot.com
Bermuda 441-599-7709
Haiti 509-3727-5832, 3486-6020
skype tiffany.keenan.1971

Another write-up - Tiffany calls it like it is!

2010-03-21T02:54:00.000-03:00

Haiti: Time for an NGO Police?
by Georgianne Nienaber

"Any military commander will tell you that the first step to taking control of an area is to take over the airport."

And so Dr. Tiffany Keenan, an emergency room doctor from Bermuda, did so at the Jacmel airport in the days and weeks immediately following the January 12 earthquake in Haiti. Keenan looks like she weighs about 100 pounds soaking wet, but don't let that fool you. Not only did she coordinate air traffic and relief deliveries with the Canadian military, she also managed to update a database of health clinics in the region--all within five weeks time. As a direct result of her tenacity and take charge attitude, many emergency supply flights were able to land, and she immediately placed doctors and nurses on choppers to assist in areas most in need. Meanwhile, everything and everyone else was bottled up in the Dominican Republic or at the heavily damaged Port-au-Prince airport.

We met her after conversing with Namita Kumar, her logistics coordinator at Haiti Village Health. Kumar was sharing an internet connection with us at a hotel in Petionville while we were uploading some stories and photos. When she heard about an IDP camp we visited that was in desperate need of medical care, she forwarded our videos and photos to Dr. Keenan who got back to us within hours, wanting to meet and share information. Timing was dicey, since we were all moving quickly, but a missed flight left the doctor in Port-au-Prince for an unplanned night. So, we secured a room for her and headed out to dinner to get acquainted.

Canadian-born Keenan is all rapid-fire talk and earnest blue eyes. Taking notes resulted in my pen tearing the paper several times as it skidded across the surface in a desperate attempt to keep up with her enthusiasm, ideas, and heart-felt passion for the Haitian people. She founded Haiti Village Health, in 2006 with the hope of creating a sustainable medical infrastructure staffed by Haitians and not foreign NGOs.

The water glasses had yet to appear on the table before the doctor showed us the most important piece of paper in her possession. It looks like she talks--a maze of ideas and logistics combined with a veritable warren of associations that form her plan for health coordination in rural Haiti. Keenan decries the "band-aid" approach of foreign aid, which may dress the wound, but does nothing to solve the very real problems faced by Haitian society.

A nationally recognized NGO coordinator is one of her dreams for Haiti. This requirement is especially evident in the aftermath of the earthquake. Keenan says that it was only she and the Salvation Army who spoke with the local Senator about relief coordination. After working in Haiti for over four years she says, " It has taken me a long time to realize that for real change to happen in the long run, you must work with the Haitian government."

During the confusion, chaos and ongoing lack of emergency healthcare coordination, Dr. Keenan encountered some NGO missionary groups that she found to be standoffish and has concerns that one group in particular was doing field amputations with no anesthesia. We have heard similar reports, so her account rang true. "There were six hospitals in operation where they could have taken these patients," she said.

The end result is that Keenan now sees a need for "an NGO police."

"We need more coordination. Why set up a new clinic within two minutes walking distance from an existing one?"

The answer is obvious, but this kind of duplication of services and stockpiling of supplies without matching resources with needs is common these days in post-catastrophe Haiti.

She is hoping Haiti Village Health will get government recognition as an NGO liaison--her polite term for the "NGO police."

Keenan is especially critical of NGOs that "overstate what they have done since the quake. They want their names stamped all over this (disaster)." What she says is true. The logos of international "charitable" organizations are more numerous than the number of tents in the IDP camps. Make no mistake about it charity is "corporate business" in Haiti.

Doctors Without Borders has crossed her steadfast path more than once, and it appears that the fiery Keenan is beginning to make an impression.

"I'm a bit of a cowboy, " she laughs.

No kidding.

A Doctors Without Borders (Medecins Sans Frontiers) representative initially told her that the French NGO was not going to cooperate with the local Haitian hospital. "Then two or three days later, they showed up and said they were going to TAKE OVER THE HOSPITAL," she says.

It did not take much more for Keenan to "get into a heated discussion with them," and within six days MSF was talking with the Community Coalition for Haiti about what Haitians wanted for Haitians. Keenan did not mention whether she rode a white horse and lassoed and hog-tied the French doctors in the process.

This is not the first time the medical aid group has been under criticism while working in a disaster area and ignoring local wishes. After the Indonesian tsunami it was widely reported that MSF urged donors to stop sending it money for Asian tsunami victims, saying it had collected enough funds to manage its own relief effort there and that donors should focus on donating to other MSF relief efforts. Meanwhile other aid organizations were scrambling for donations and rebuilding had barely begun.

When we discussed the video of the forsaken IDP camp on Highway 1, Keenan was incensed. "This should not be happening now!" The camp has no medical care, not enough tents, no food deliveries and little water. The only aid we saw there was a group of latrine builders from the Irish NGO, HAVEN.

It was good to hear Keenan agree with our assessment that aid is not being distributed equitably here. HAVEN was the first aid group we encountered at the Highway 1 camp, even though we had been mentioning their plight wherever we stopped and had stopped back on a regular basis to see how they were faring. HAVEN asked us if we had seen other camps without sanitation and took notes on their locations. It seems that the smaller groups and individuals like Keenan have a much better ability to grasp the enormity of what is needed. Perhaps it is because they are not afraid to move among the Haitian people and go to the locations where desperation is reaching epic proportions.

Keenan minced no words about planeload after planeload of missionaries flying into Port-au-Prince on American Airlines.

"This is nothing more than disaster tourism. Why don't they send money instead of people? Why are missionaries bringing builders? Haitians can do their own building."

Keenan funds all of her emergency relief work in Haiti out-of-pocket. More than once she has been told that her job in Bermuda is on the line because of her relief work. She was $15,000 in the hole until friends and supporters did a benefit for her that she says, "Brought me to about par."

This is a problem faced by doctors who work in disaster situations, let alone those who volunteer time for consistent charitable work in countries like Haiti. Jobs and family harmony at home are put at risk and personal income and savings take huge hits.

"You know that movie with Kevin Costner? Well I keep thinking if I continue building my dream here, it will all happen. I never know if there will be enough money, but I was finally able to buy an old truck for the clinic with the last of the money."

What is her biggest dream now?

If we could get 60 Blackberries, I could link all of the doctors and nurses here. Mobile devices are the key to communication, where travel is so difficult. There is a prototype--it is da-bomb--a digital stethoscope that you can attach to a Blackberry and transmit the information to a doctor here or in the States or wherever. Nurses could use it in rural communities where we cannot send doctors on a regular basis.

Image: Dr. Keenan discussing the possibilities of social networking with bio-surviellance expert Jim Wilson

Keenan recognizes that without a communications network to allocate supplies from central locations, relief workers cannot do their jobs. She sees social networking and mobile technology as key elements in monitoring of disease outbreaks as well.

Dr. Keenan, who has worked in Canada, Bermuda, Congo and Haiti, was first introduced to the village of Bod Me Limbe during a visit to the North of Haiti while working in the Capital, Port au Prince in early 2006. Haiti is a permanent part of her life now.

"I don't have children, so I guess you could say that Haiti is my baby."

After a week of witnessing despair like we have never seen, Dr. Keenan is a breath of fresh air, inspiration, and hope that individuals can make a difference.

You can keep up with Keenan at her blog and on Facebook.

That is, if keeping up with her is even a remote possibility.

Tuesday, March 16

2010-03-16T22:10:00.000-03:00

As Haiti Village Health's new logistics rep, I spent the first couple of days acclimatizing to my new surroundings, never having done disaster relief work before. I quickly saw the mammoth undertaking that Tiffany and her team have taken upon themselves and I admire them for it. There are a lot of NGOs here in Jacmel and a lot of people who need them. Now it's a question of getting exactly what is needed to the people who need it most. Like I said, a mammoth undertaking.

After a couple of days, I felt like I was getting the hang of what it is I was supposed to be doing. A lot of my work as logistics rep is done on the computer and I was finding myself eager to also get out there and see the people and do what I could for them. So I was eagerly anticipating participating in the flashlight distribution to Camp Pinchinat. Pinchinat is the biggest Displaced Persons Camp in Jacmel, housing over 1000 families. They all live in tents crowded together in a soccer stadium and with no electricity, there were daily fire alarms as people used candles to see at night. So it was imperative we get them these flashlights (donated by the Canadian military) as soon as possible. Jo and I were in charge of doing the distribution, but I quickly learned that it would not be the simple matter of marching into the camp with the flashlights and handing them out. As with any space crowded with people who lack everything, there are some small security issues with Pinchinat. So to make sure we would be able to distribute the flashlights fairly and without causing any problems, we invited 2 of the camp's managers to sit down with us as well as a rep from the Canadian military to discuss the best way to do this. Within half an hour we had a plan and were just waiting on a list of the camp's most needy (women with kids, pregnant women, old people) to distribute to priority tents.

We arrived at the camp at 9am on Friday: Jo, myself, and two of our staff from the airport to help carry the boxes, Gaby and Placide. This was the first time I had gone in depth into the camp and seen just how people were suffering from the quake. The tents were indeed close together, and had nothing inside them except a couple of mattresses. While we were there, camp residents were busy with their daily routine (washing clothes making food, kids running around and playing) in the most unnatural of circumstances. Despite their desperate need for lighting, the residents were respectful of us. Though one or two hanger-ons kept asking us to give them "a flash", and others followed us around as we endlessly made our way up and down the rows, they let us do our job and tried to help us where they could. It was hard work, harder than I expected. With the heat and the extent of the camp, it took a long time to do the distribution. It was also hard because it was the first time I came face to face with how people are suffering and my heart broke for them. It was nice that we could play a small part in making their lives just a little easier and I only wish we had another 1000 of anything to give them.

Airport Changes

2010-03-14T10:13:00.001-03:00

Well, I'm still trying to micromanage issues from home. Yesterday our Canadian friends, the military left the airport. Our staff arranged a small goodbye for them on Friday by having a Haitian Troubadour band perform. Their departure brings changes to our airport.

The Canadian had been providing security, and were giving the Airport Authority instruction on airport operations. We will see how this week unfolds without their presence on the ground.

Namita Kumar, my logistics rep from Canada has been doing a wonderful job keeping the flow going on the ground. My staff still remain Ruth, Fredo and Gaby however on Thursday when the electricity was removed (as the Canadians were closing up) we moved our main operations to the Haiti Village House Guest House located about 5 minutes from the airport. One staff member still remains at the airport daily, with internet connection being available at the house.

Haiti Village Health had received a donation of crank-handheld flashlights from the Canadian military. These were distributed this week by team members. Namita will send an update of her time spent at the refugee camp giving out these lights.

On the home front, Bermudians Leanna Lambert (upcoming journalist), Dr. Kianna Simmons (dentist) and Dr. Kimberly Rego (physician) are planning their journey to Haiti on March 19th. Dr. Simmons is hoping to start a regional dental facility in Jacmel as her mother is originally from the area.

Fundraising, the Bermuda Government hosted a "FOR HAITI WITH LOVE" telethon last sunday and the total is up to $100,000. Haiti Village Health was represented and will receive 1/4 of the proceeds which is wonderful.

Fundraising efforts were happening in Canada as well with a concert night hosted by Susan Butler and a hockey game hosted by Jonathan Cormier with proceeds towards HVH and ORA (a partner in Canada).

Please continue to think of Haiti village Health as our budget has grown from $25,000 annually to $40,000 with extra staff and supplies we've needed post earthquake.

Thank you for your support.
Tiffany
--
Dr. Tiffany Keenan
Haiti Village Health, Founder & Director
NGO Coordinator, Jacmel Airport
www.travax.com/m (Haiti Health Database)
www.haitivillagehealth.ca
www.haitivillagehealth.blogspot.com
Bermuda 441-599-7709
Haiti 509-3727-5832, 3486-6020
skype tiffany.keenan.1971

Update March 10th

2010-03-10T08:27:00.001-04:00

Well, it's just over 2 weeks since I returned from Haiti and things are changing every day. The airport authority has decided to stop international flights when the Canadian Military leaves on Sunday. This will severely limit the medical teams and supplies that come in to the region. In one regard we should be thankful we've been able to continue on for two months, but in another, it's unfortunate that "free aid" will have difficulty getting into the country.

My staff on the ground are doing their best to work with the Airport Authority on this issue and we are making appeals to the Mayor's office and Senator to see if we can extend jacmel's time as "International Airport"

Dr. Mona is still continuing her work at the Health Meetings and Namita Kumar, our new logistics rep, has been doing a great job keeping things organized.

More updates on fundraising efforts soon.

Haiti Village Health Gains More Publicity

2010-03-09T12:04:00.000-04:00

Doctor's Haiti mission gets a helping hand

By Nadia Arandjelovic

Helping out: Sandys Rotary Club recently donated a cheque for $5,120 to Haiti Health Village (HVH), following a presentation by its founder Dr. Tiffany Keenan, currently an Emergency Room Physician at King Edward VII Memorial Hospital. HVH provides health and medical services to rural villages in Haiti. Pictured are Sandys Rotary Club's president James Watlington and Dr. Keenan.

A doctor who built a clinic in a small Haitian village has received a donation from the Sandys Rotary Club to continue her work.
The club gave $5,120 to Haiti Village Health (HVH), a charity founded by Bermuda resident Tiffany Keenan.
Funds were raised through a donation from members, which was matched by Sandys Rotary.
The money will be used to buy a number of portable solar-powered chlorine generators to provide safe drinking water for up to 5,000 villagers in Bord de Mer Limbe in North Haiti.
Dr. Keenan, who works as an Emergency Room physician at King Edward VII Memorial Hospital, thanked the club and said: "This donation will provide a long-term solution to drinking water needs for many thousands of Haitians. HVH is grateful to Sandys Rotary Club for their support and generosity."
Haiti is recognised as the poorest country in the Western hemisphere. Much of its 8.3 million population lives on less than $1 a day.
Dr. Keenan, a Canadian, first visited the developing country in 2006 on a volunteer project. It was then she realised how much need there was for proper medical facilities and even basic sanitation services there.

She began taking medical teams to the village each time with more doctors, nurses and medical supplies. In the fall of 2007 she raised enough money through private donations to set up a permanent clinic.
In June of 2008 she opened the clinic doors to the community and staffed the facility with Haitians, including a nurse, doctor and two community health workers all of whom are volunteers. In May of this year, she opened a similar project in the southern region of the Caribbean island.
Dr. Keenan said: "Before this people had to travel for an hour-and-a-half on foot for full-time services, or two hours by motorcycle or truck to get to the closest hospital."
Forced to drink untreated water from a dirty well, people suffered from stomach bugs, diarrhea and even typhoid, she explained.
Sandys Rotary's donation "is really going to change things" said Dr. Keenan.
"People, especially children, will be a lot healthier when the water project is started," she added.
So far every dollar that is raised for HVH goes directly towards their projects.
Dr. Keenan takes volunteers with her to Haiti three or four times each year a team of 12 can treat up to 200 patients a day. In the past year she has seen progress in the community: "I think you see the big change in the children. They are happier, their energy level is higher."
Though she didn't initially intend to become so involved in the project, Dr. Keenan did so because the work needed to be done.
She told The Royal Gazette: "My life will never be the same and I know Haiti will always be a part of my life. Haiti is where my heart is at the moment."
l For more information or to donate visit www.haitivillagehealth.ca/.

Another Write-Up in "The Royal Gazette"

2010-03-09T12:00:00.000-04:00

Bermuda doctor meets movie star Angelina Jolie in Haiti

By Mikaela Ian Pearman

Bermuda-based doctor Tiffany Keenan (left) meets movie star Angelina Jolie in Haiti.

Bermuda-based Emergency Room Doctor Tiffany Keenan got a touch of glamour while treating earthquake victims in Haiti when movie star Angelina Jolie showed up.
Ms Jolie visited Jacmel — a village in Haiti— on Wednesday and was met by members of the Canadian Force and Dr. Keenan.
The actress travelled to Haiti in support of humanitarian efforts being made by the international community since the earthquake devastated the country January 12.
She came on a United Nations aircraft and said: "I think that all the efforts being made to deliver aid to Haiti are amazing. It's beautiful to see the enthusiasm of the people who are here in support of the Haitian people. The co-operation among all the nations who've come here is wonderful and heart-warming."
On Dr. Keenan's blog, www.haitivillagehealth.blogspot.com, she said: "A great start to the day. Ms Jolie just passed through Jacmel airport. She was greeted by the UN and Canadian military. The Major was kind enough to make introductions for me.
"We discussed my coordination at the airport, and she asked about the need for certain countries to help in certain zones. I told her we had just discussed this in our health meeting.
"She was very pleasant and not at all rushed to talk, but she had an agenda and the UN whisked her away to Pinchinat, the refugee camp. Great to have her bringing more publicity to Haiti. And yes she is beautiful."

Dr. Keenan left for Haiti a week after the hurricane and has not said when she will return.
The 38-year-old, who lives in Paget, set up the Haiti Village Health charity several years ago and has a clinic in the northern part of the island, run by locals.
While she is in Jacmel treating patients, she updates her blog daily.
On Tuesday she said: "Busy day as always. Sorry about the spam e-mail. Meeting tonight with hospital, community coalition for Haiti and MSF. Trying to improve flow there.
"Today flew plane of 6 patients to US coordinated by team Ange. Two young kids with amputations. Very hard to see but they will be fitted with prosthetic limbs. One young boy with fractured tib fib and external fixators. Docs advised amputation but hoping to save his leg at shriners hospital.
"Moved new medical team to Pinchinat refugee camp. Venezuelans starting work as well. Globe and Mail reporters in town. May stay at my new guesthouse. Busy busy. Goodnight."
She also spoke about a possibly of staying in Haiti.
"Our team has grown to eight at present and we still need a few more. One of our concerns is the need for a coordinated effort for future health care in the region. I see myself as having a long term role to play in this situation. I did have a potential job offer from the Director of the Dominican Red Cross. I would love to continue in this role, but it is difficult without full funding and I have my work responsibilities as a full-time emergency doctor in Bermuda."
Earlier this week, Dr. Keenan fell victim to an Internet scam and her e-mail account was hacked with the sender asking for money.
The message said she was in the UK from a week in Haiti helping earthquake victims and her hotel was destroyed by fire. It also said she had no means of paying for the hotel and needed $2,070 in order to return home.

Article Written in Bermuda's "The Royal Gazette"

2010-03-09T11:47:00.002-04:00

Bermuda-based doctor ended up running Haiti's airport::

By Sam Strangeways

Emergency room doctor Tiffany Keenan went to Haiti to tend to earthquake victims — and found herself running an airport.
The King Edward VII Memorial Hospital medic has just returned from five weeks in the Caribbean country, where she took charge of Jacmel Airport in the south.
Dr. Keenan told The Royal Gazette: "I thought I would do medicine. The Canadian disaster relief team was volunteering in Jacmel and I thought I would join them. But as soon as I saw what was going on in the airport, I knew I couldn't leave."
The 38-year-old Canadian had been to Haiti many times before the catastrophic magnitude 7.0 earthquake hit on January 12. She set up a charity called Haiti Village Health several years ago and has a clinic in the north, run by locals.
She arranged to stay with friends from the organisation Joy in Hope Ministries and flew into Jacmel Airport on a private flight a week after the earthquake.
As the aircraft neared land, she saw one of her friends directing planes on the ground. "He had taken over Jacmel Airport," said Dr. Keenan, who lives in Paget.
She explained that the mayor and airport authority ceded control as they were unable to cope with the sudden influx of flights bringing in supplies, aid workers and military personnel.
"It's a tiny airport," she said. "It had previously had two flights a week. We were getting at least 35 to 40 flights a day.
"It seemed completely unreal and we would look at one another at night and say: 'How can we be doing this?' Pure adrenalin keeps you going all day long."
Dr. Keenan, who speaks French and the local Creole, helped her friends at the airport for several days before they announced they were leaving and wanted her to take over.
Along with a midwife friend from Canada, she did just that, spending the next month greeting planes, organising medical evacuations, registering air arrivals, getting vital supplies onto the right trucks and helping aid workers get where they needed to go.
The women had to hire their own security — men with baseball bats — and act as immigration officers, noting down passengers' passport details in a notebook.
Their efforts did not go unnoticed — CNN's chief international correspondent Christiane Amanpour visited the airport, as did film star and UN ambassador Angelina Jolie.
"I became good friends with air traffic control," said Dr. Keenan. "Those were the guys responsible for getting people on helicopters and up into the mountains. I knew I could go and do the [medical] work but if I didn't stay, who was going to stay and coordinate on the ground?"
As the weeks progressed, the Canadian military gradually began to take over airport operations, working with Dr. Keenan and volunteers she had managed to recruit.
As well as running the airport, she and her team collected data for a long-term health coordination project aimed at assessing the medical facilities of the whole island.
Although she got to treat just one patient while in Haiti this time — a road crash victim from Canada — Dr. Keenan has no regrets about the trip and plans to return there on March 18.
She now has 15 staff working for her in Haiti, as well as people helping in North America and volunteer Lianna Lambert in Bermuda.
"I'm very happy with what happened — this project exploded and it exploded in five weeks," said Dr. Keenan, who is originally from New Brunswick. "I ended up getting involved in so many things.
"For me, this was my dream job, even though it's not true emergency medicine. Taking over a whole airport was never what I planned to do. Even though I didn't touch patients, I know I was putting doctors in the right places to give the best medical care."
• Read more about Dr. Keenan's time in Haiti and her health coordination project at www.haitivillagehealth.blogspot.com. Donations to her charity can be made to Bank of Bermuda account number 010-871135-001.

Updates

2010-03-08T12:14:00.000-04:00

Well it's March 8th. I'm here in Bermuda and it's been a busy two weeks since I returned home. The work has not stopped in any way, I've just had to add on some emergency room shifts on top of keeping our operations running in Jacmel. Luckily I've got great staff on the ground that are keeping this process going. You'll see we've added some photos and will start to add regular links of up to date information from the southeast region. Information on flights, medical teams, and weekly reports on our situation on the ground. New changes will be coming to the blog in the upcoming weeks as well.

Here in Bermuda, tonight the government is hosting a Haiti Telethon and Haiti Village Health is being recognized as one of the recipients. I will keep you all posted.

I will be returning to Haiti March 18th with a team from Bermuda.
Tiffany

Photos from Haiti

2010-03-08T11:43:00.002-04:00

Haiti 7.0 Earthquake

Photos from Haiti

2010-03-08T11:23:00.002-04:00

Haiti 7.0 Earthquake

Temperature

2010-02-25T12:55:00.000-04:00

Funny thing about working in a third world country that you do not have a radio station or television to find out what the weather is going to be. Having no ac or heat in our houses or tents we just have to adapt to the climate.
Sent from my BlackBerry® device from Digicel

Sunday, February 21st.

2010-02-22T21:43:00.001-04:00

I'm sitting here on a corner bench table in Nassau, having left Haiti yesterday at noon. I think I left off yesterday morning, getting to the airport early to get a sick missionary friend out of the country.

The next few hours were just a blur. I knew my plane was coming at 1:00 and I had to have my exit strategy in place. Managing 10 staff is not an easy thing, but it definately works better when everyone has a job description and knows how to answer up the chain. We'd met on Friday to discuss the strategy and yesterday I had to put the final plan into action.

Our Project Jacmel Airport staff is as follows:

Director and Founder - Me, Dr. Tiffany Keenan volunteer

Airport Logistics Coordinator - Cesar Espinoza (Calvary Chapel) volunteer

Health Coordinator - Karen Cimer volunteer, and just hired yesterday my doctor from the north, Mona Alexis

Health Volunteer Coordinator - Marilyn Wilson volunteer (based in US)

Airport Registration - Ruth, Fredo and Gaby, Deanna Canadian Military Clerk

Flight and Supply Coordinator - Gina volunteer (Joy in Hope Ministries)

Airport baggage handlers - 4 haitian bulky men

HVH Guest House/Airport go to guy - Evans (whose house burned down yesterday and his uncle was severely burned, I still did hear how he was doing)

HVH Guest House Cook - Genesis (it was her granddaughter that survived after 15 days in the rubble post earthquake)

HVH Guest House Cleaner - Irinese

Tap tap driver - Jacques (this is the one we're renting for $60/day and starts with a screwdriver in the ignition)

I didn't mention my friend Jo Barbosa in all of this. He presently works for Hearts Together for Haiti in the Dominican Republic but he did come over for 2 weeks to assist at the airport, but will be returning to his project in the Dominican.

That actually makes 19 in total. Wow, I didn't know the operation had grown so large.

So I worked on the job descriptions, had everyone sign off on them and tried to wrap things up by 1:00. It was a tight deadline. I wanted to explore depots for medical supplies in town so I arranged for Maggie from Community Coalition for Haiti to meet with Maxo Noel, pharmacist to explore 3 buildings in town. They also met with the supply coordinator from the Canadian military to discuss inventory computerized options.

It was a quick departure once my plane arrived. I said my quick goodbyes to all including Major Kevin Skirrow of the Canadian Forces and Bassin, Airport Director and of course all my Haitian staff. I registered my passport as we all do before departure and headed out to my plane. It was so busy in those last few moments that Jo actually walked to the bathroom with me and we talked outside the stall about a few pressing issues.

Dr. Mona Alexis had arrived and I briefly said to her as I greeted her that we wanted to offer her a new job as Health Coordinator in Jacmel (we had already discussed her taking a break from my clinic in the north and she arranged a locum replacement. I had arranged for her husband Wilson to get a job with Save the Children earlier in the week). So with a kiss on the cheek, i told her to discuss the new job with Karen.

Karen Cimer, a Newfoundlander is a real trooper. We've been working together for over 4 years now at my clinic in the North and I convinced her to come down to replace me when I knew I had to return to work in Bermuda. With only 5 days on the ground, I was handing the reigns over to her and now she's got to train Mona. It looks like we'll be getting satellite internet at the guest house and a generator, so I'll be able to maintain contact with her through skype and blackberry communications.

So, a dramatic ending...but then a delay. Two US Navy helicopters arrived with some top brass so our small plane's departure was delayed until they shut down their engines. I had time to run back inside, grab my memory stick, phone charger and drop off the house keys.

The two pilots picked me up in a columbia aircraft....great plane. Joan, a medical resident who had been working in Les Cayes was also on board. It was just a small 4 seater but a luxury aircraft. I never knew that small planes could fly so high. At one point we were above 16,000 feet and were wearing oxygen. I knew we were climbing high and when I checked my initial oxygen saturation it was only 84%. I guess that's why I was yawning.

We had to drop down because we had ice forming on the wings and then were able to remove the oxygen. We landed first in Provinciales in Turks and Caicos to refuel. It was a brief stop and then off to Nassau. I actually feel asleep for about 30 minutes on the plane. For once, I didn't get out my notebook to plan. I was able to get a good aerial view of the damage in the Leogane region as we flew over. Leogane, Grand Goave, Petit Goave was the epicenter of the quake. Buildings everywhere were crumbled and tent cities could be seen all over.

We landed in Nassau around 5:30 at the Odyssey airport. I had already met Matt, Abraham and Cameron of the Bahamas Habitat crew but it was great to see their staging area and depot at the airport. I headed over to the Sheraton Hotel (who does offer a rate of $135 per night for Humanitarian work) with the two pilots and Joan. We got together and discussed their experience in Haiti. One of the pilots was an incident commander and he gave me a one pointer, that I needed a communications director....

called away...more tomorrow

--
Dr. Tiffany Keenan
Haiti Village Health, Founder & Director
NGO Coordinator, Jacmel Airport
www.haitivillagehealth.ca
www.haitivillagehealth.blogspot.com

Final morning

2010-02-20T07:42:00.001-04:00

I was up at 5 o'clock today to the sound of roosters and the darkness. I started my day thinking about the past 5 weeks I've been on the ground and now today I must go home. I have a full time job as an emergency room doctor and must return to my duties.

I currently have a staff now of 10. Its unbelievable how things have changed in such a short period of time.

Last night the team finally had a chance to go for a swim, the first time in 5 weeks. We went to Cyvadier beach just 10 minutes from Jacmel and swam in the dark and munched on chicken from Madame Barbeque. In the dark you may ask?? Yes. We can't leave the airport in the day. Its open 7 am to dusk and we are there.

We did have a special guest at the beach, one of the regional senators is a friend of my Haitian friend so he came to chat with me on the beach as he knew I was leaving soon. He's actually a dentist and has insight to the healthcare system so he will be a valued resource.

Yesterday I sat with the team to work out an organization structure to plan for my departure. Everyone has a role and through the power of the internet and (soon a new satellite system) I will still be connected to my team through skype.

I also met with the Jacmel airport authority. They have requested my help in making Jacmel an international airport. We are compiling details of flights and volunteers to date, and will research interested airlines to put forward to the National Airport Authority to seek approval for International status. I'm not sure how far it will go but to date my team is currently acting in the capacity of immigration as we take passport details of all that enter. Yes, it does sound like I've got my hands into a lot, and it is true, I do. I'm just thankful for my volunteer staff.

I met with the delegate mayor yesterday as well. We discussed the health clinics in Jacmel as he haf not been receiving all the commnications from the Dept of Health. They've been very overwhelmed as you can imagine.

Well must go now, just got a call that one of our missionary friends is unwell and we've got to get her back home to the states. There's an early plane that will get her to santiago and from there to the US.

Tiffany
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Volunteers needed

2010-02-20T07:20:00.001-04:00

As you may be aware, I have been working in Jacmel as NGO coordinator at the airport since January 18th. I am working with MSPP (Dept of Health) and the Health Cluster of the United Nations to help place medical teams in underserviced regions of the southeast. If you have friends that would be interested in volunteering in a hospital or at a mobile clinic, please have them email Marilyn at Jacmelair.volunteer@gmail.com. She will send them a brief introduction of our work and a registration form.

The immediate need for disaster relief is waning and we are now in the Early Recovery phase. Our goal is to augment the Haitian Health Care system and to create mobile teams for difficult to reach areas.

To date we have received over 350 NGO flights and 400+ volunteers through the Jacmel airport.

Tiffany
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Thursday Feb 18

2010-02-19T07:49:00.001-04:00

The day starting when I met my new cook's granddaughter. My creole is getting better and after a few minutes I was able to grasp the real story. Genesis's (my cook) daughter was killed along with her husband in Port au Prince when the earthquake happened. Her grandaughter was also trapped in the house , for 15 days, but she survived. Someone was going through the rubble and found the baby who is only 1 year old. The baby was taken to the university hospital in PAP and remained for 3 days. She suffered cuts and bruises and just has a small scar on her left cheek and back. Physically she seems fine but one cannot even imagine the emotional impact of that situation on a 12 month old.

Genesis is so happy to have her granddaughter with her now but tears started to stream down her face when I asked about her daughter. She said she was only 20 years old and a beautiful, sweet girl.

As I sat with Karen after we said how that was only one story of the over 200,000 that lost their lives. In health care we're beginning to move into the recovery phase but how will the country deal with the long term emotional impact of this earthquake? Psychologists are starting to flow into the region, for both adults and children to help them deal with the impact. It is only the beginning.

Tiffany
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Tuesday and Wednesday February 16 to 18, 2010

2010-02-19T00:09:00.001-04:00

Last night I attended my first Health Cluster meeting - about 25
Participants ranging from smaller ngo's to the WHO', Save the Children, and the Canadian DART team, sat in a large circle under canopy of a UN tent to exchange information about needs and strategize about addressing them. The meeting was chaired by the head of the Red Cross and the minister of health. Tiffany's matrix compilation of the needs and conditions of the health facilities and mobile clinics has become a major planning tool, referenced by all in the region.

Tuesday morning saw the arrival of our prime minister, Stephen Harper. The formality at the airport was only surpassed by the security - all the extra guns were out. He had a quick tour of the city before returning to the airport where he met five of the directors of local ngo's. Tiffany was among them, and of particular interest to the PM because of her coordination effort. Explanations of their work in this region were shared and some needs communicated. There were many official photos taken - to follow.

The afternoon was taken up largely with the usual airport confusion. I, Karen, was tasked with ordering medications and supplies from a Direct Relief International storage facility in Port au Prince - for the entire Jacmel region. There is no orientation for this or stats to guide me. This is a far cry away from ordering for a small clinic in Bod me Limbe. Multiply a Bod me Limbe order by thirty, I was told. My order was so large that it prompted an email of shock from PaP and Tiffany explained the need here which further prompted a visit from the organization to see how they can help us more. Going big worked for us.
Wednesday brought a new member to the HVH coordination project. Marlene, from ,New Orleans, arrived for an orientation on becoming the new coordinator of medical volunteers, in the USA, for our region. Interested volunteers will soon find an easy website to facilitate placement and travel to Jacmel. She is a delight and welcome addition and this service will help Haitians and Americans wonderfully.
We took time to celebrate the birthday of one of our key team members, Cesar, at a late night dinner in a local hotel. Our Haitian team members and friends were most of the party and it was a well deserved treat for all- after weeks without a day off; a gift to Cesar ourselves, and the suffering Haitian economy.
And by day's end, all the medications and supplies ordered from PaP had arrived via huge truck and were snuggly stored in our supply depot. And the email was sent to all the local ngo's to come and shop for free.
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Thursday Feb 18

2010-02-18T08:23:00.001-04:00

I'm sorry I haven't blogged as much in recent days though a few of the other team members are now beginning to send updates. I will be leaving shortly and am trying to ensure continuity of the work I am doing here.

The past several days were busy. First Prime Minister Harpers visit. We had a wonderful discussion with him and a few of the NGOs on the ground.

We had several medical teams dispatched. A large one to Support thre hospital in Bainet just about 3 hours from here. The red cross dominican assisted with a salvation army relief clinic in Decosse just north of the city. The following day they helped at a clinic near the airport. They were also able to arrange transfer of a you baby with hydrocephalus t the dominican republic for treatment.

We have a medical team in seguin at present and another on their way there.

Karen Cimer, a HVH long term team member has arrived to continue my health coordination efforts. Marilyn Wilson arrived yesterday from New Orleans yesterday and will assume the role of volunteer coordinator. I met her husband on his way out of Haiti 2 weeks ago and we had a brief conversation about the importance of a coordinarted response to health care. He said Marilyn may be intereste and I'm so happy everything worked out and we were able to get her on the ground.

She will help coordinate volunteers from the USA and Canada to match our needs here in the south.

Cesar Espinoza from Florida started working with logistics over 1 week ago and I am very happy that he will be continuing for the next several months in that role.

The work at the airport is coming together but I've come a long way in just over a month.

Yesterday I was able to meet members of the organization Direct Relief International. They heard that I was coordinating ngos in Jacmel and contacted me regarding medication shipments. They were surprised with thr quantities I ordered from them. Once we chatted on the phone and after we met in person yesterday in the city they fully understand the need in trying to service all of southeastern Haiti.

I was happy that the Hearts Together Team from Windsor, Ontario had arrived as they were able to assist with the unloading of a full cube van full of medications.

So, that's a little insight to the last few days. We did pause last night after the truck got unloaded to celebrate Cesar's 32nd birthday. We took our truck, a tap tap that we rent for 60 bucks a day and has to be started with a screwdriver to a nice restaurant in Cayes Jacmel, about 20 minutes away. We don't get much of a break here so it was nice to be together outside of the airport environment. Cesar had an enjoyable time and happy birthday was sung in all languages.

On the tap tap ride home someone commented how different life is here in Haiti. I hope from reading my blog that you are able to get some idea of the challenges faced in the disaster relief efforts.

Tiffany
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Tuesday, February 16, 20l0

2010-02-17T00:50:00.000-04:00

A new perspective: working with Tiffany:

We awakened in great comfort relative to our Haitian neighbors. It was the second night in the new HVH guesthouse - rented and furnished by Tiffany and Jo. It will be used to house visiting volunteers and generate income for HVH. We had scrambled eggs for breakfast before taking a tap-tap to the airport

I am new here -HVH team member, Karen from Newfoundland - and tasked with learning Tiffany's job. I may show competence in a small part ultimately. The HVH office and control centre is at the airport. We meet all incoming non-military aircraft, document their mission purpose and & location, assist with provision of transportation, accommodations, translators, food rations and water. As well, we provide a gateway for medical supplies and medications,and give orientation packages documenting the locations and mandates of regional ngo's and the documents required by each group to record health statistics and epidemiological concerns. The HVH airport project is also responsible for all unaccompanied supplies carried in by aircraft, which is then transferred to a central depot. The staff also facilitates flights of volunteers out of Jacmel - on empty planes returning to their origin. So this is the most basic description of the work organization, but there is so much more - the relentless needs and resulting coordination- that constitute most of the day. And night.

The vastness of this work should come as no surprise, when the creator of this coordination effort is considered, but it makes the shock of being cast into it no less jarring. Fortunately, a very competent team is already in place, and teaching me patiently. .
Blackberry is dying - not enough juice tonight - to be continued in daylight.
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Airport

2010-02-15T20:44:00.000-04:00

So after another day starting at 6am and still going we are in and out of meeting using three phones at one time coordinating shipments of people medicine medical tools supplies staffing medical facilities delivering people servicing food needs connecting planes and trying to communicate with all the non government organizations we are making progress in servicing the people of haiti
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update Friday, February 12th

2010-02-12T23:01:00.001-04:00

I was able to steal a few early morning hours away from the airport to catch up on emails. It's not an easy thing to do. I actually bought a blackberry just last week for that purpose. I still can't keep up to all my message but now with the help of a volunteer secretary I'm trying my best.

So, this morning's meeting started with the organization Bumi Sehat. I first met this organization at the hotel Hosanna where I picked up a pilot that had stayed overnight. They are great people and come with a full team of logistics, water & sanitation along with health. They are a global midwifery association that has started operations in jacmel. They will be receiving a large 44 foot dome tent on Sunday and will set up a birthing center there. They have Canadian representatives, along with their American counterparts. Their goal is to establish a long term presence in the area. I visited their new office in downtown Jacmel and the birthing center is located just behind.

Together we went to the refugee camp Pinchinat (the one that Angelina visited on Wednesday) to meet with one of the local "leaders" Charlotte, the French and Venezuelan medical teams. Unfortunately the Venezuelans were not in the camp, but we established a closer relationship with the French and the Bumi Sehat team. They have already done health assessments in the camp, and have given their number to be used for "on call" deliveries. Actually while we were visiting the French tent, there was a woman in labour. They were able to take her to their home birth the baby there.

There is growing concern about prenatal care, pregnancies, and abortions in the area. I may have mentioned earlier about young girls basically taking over the counter abortion pills purchased from the local pharmacies. We've had two with massive hemorrhage because of this. Haiti definately has a long way to come in terms of education.

So, after the refugee camp it was back to the airport. It was a busy day despite it being a day of mourning, just one month since the earthquake. The country had closed up all shops in a day of remembrance. There were several church services including one in Pinchinat while I was there. i also saw a peaceful march of people in the city.

The airport however, did not stop. Planes arriving on a regular basis as always. I guess the issue with my staff here is that they never get a day off. And we're not at the point that we can give people shifts. I'd hope that at least Ruth and Fredo would have a few hours off to attend the services but I had to call them in early to deal with the planes.

I was able to meet the Disaster Response Coordinator for the American Red Cross. He asked for my input of needs in the area. Both the Canadian and American Cross will have a long term presence here.

In the early afternoon I met with a German organization that will be starting Child Friendly Centers in the city. they will start with two projects composed of teachers, psychologists and social workers to work with the kids. I will relay this information to the Health Cluster.

I was happy this afternoon to finally complete our listing of health clinics and needs in the region. We have about 75 sites registered. We have each site linked to another spreadsheet which gives an outline of the area, needs for specific doctors and schedule for teams.

I was able to get this printed just in time for our 4:30 health meeting. We had many organiztions in attendance to prioritize health needs in the South East region. I had the input of another great Canadian contact, Mr. Allen McNicoll who works out of the Eastern region of Fond Jonwell. There was a new team present from the US and we helped them decide where their team could be most useful.

So now here I am at the hotel as the internet is still down at the guest house. Jo and I were chatting about our new guest house that should be ready for us to move in on Sunday. He's been busy all day buying supplies to get the house outfitted.

I feel that things are beginning to get organized, but Haiti is still a long way from the recovery phase.

Update Thursday continued

2010-02-12T11:26:00.001-04:00

So, we landed on the beach in Bainet. Of course everyone was excited to see us and gathered around. Bainet had not had any assessments so my first priority was to speak with the mayor. We met with him to discuss the health needs in the area. I had the listing of clinics and asked him which he would prefer we visited first.

The team then broke up. I appointed the ACDIVOCA rep to go with the American and nurse to the general hospital. Fredo and I hired a motorcycle and headed out to the countryside. We travelled first 30 minutes to the east to the Dispensaire Brasilienne. It is staffed by 2 HaRNs. We discussed the OCHA evaluation questions and then further discussed other health care needs. Primary concerns was lack of medication, support staff and shelter for the people.

We had a short snack of local oranges with our bike driver and learned a e more about the politics of the area. Many people from the PAP region are moving across the mountains looking for new homes.

We then headed 30 minutes north to the Dispensaire Bahot. The nurse and auxiliary nurse expressed similar concerns.

Another issue that was addressed was transport. To go to Brasilienne we had to cross the river 3 times and this is not the rainy season. There would be no way for a woman in active labour to be able to gain access to a hospital when the river is high.

This only reinforces the fact that further midwives and prenatal education are needed to recognize high risk cases. also a means of transport such as an ambulance be invaluable to these remote regions.

We met up with the Hospital based team at the Landing zone for the helicopter by the beach at 1530h. They found the hospital building to be a solid structure but they too were lacking medication, supplies, electricity and water. The teamagreed to return there on Saturday to work alongside the Haitian staff. Of course, this is with the approval of Public Health and the Hospital administration.

Got to run now to the refugee camp for meetings but will have further updates later.

Update Thursday, Feb 11

2010-02-11T21:22:00.000-04:00

Well I didn't get the chance to finish my writing from yesterday. After my meet and greet with angelina Joli I was right back to work.

A helicopter arrived that was scheduled to send groups on a site assessment. They didn't show so I spoke with air traffic about myself and a few others going. I had been planning to get a team to the region anyway and this was an excellent opportunity. Luckily a rep from ACDIVOCA was around who spoke creole, and I encouraged a family doc and his nurse to join us as we had been discussing site assessments.

So in a few short minutes, I left the airport to my new wingman Cesar Espinoza from Miami, Ruth and Gina. I took Fredo along as my translator.

The flight out along the south coast was beautiful. It took only 10 minutes by air to make what would have been a 3 hour rough ride.

Ill tell you more about the day tomorrow as my fingers are tired from texting. But overall what a start to the day with Angelina and a helicopter trip. The smile on my friend Fredo's face was overwhelming. What an opportunity for this 23 year old wanna be doctor.
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Angelina Jolie

2010-02-10T08:35:00.000-04:00

A great start to the day. Ms Jolie just passed through Jacmel airport. She was greeted by the UN and canadian military. The Major was kind enough to make introductions for me. We discussed my coordination at the airport, and she asked about the need for certain countries to help in certain zones. I told her we had just discussed this in our health meeting. She was very pleasant and not at all rushed to talk, but she had an agenda and the UN whisked her away to Pinchinat the refugee camp.

Great to have her bringing more publicity to Haiti.

And yes she is beautiful.
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Update

2010-02-09T22:33:00.000-04:00

Busy day as always. Sorry about the spam email.

Meeting tonight with hospital, community coalition for Haiti and MSF. Trying to improve flow there.

Today flew plane of 6 patients to US coordinated by team Ange. 2 young kids with amputations. Very hard to see but they will be fitted with prosthetic limbs. One young boy with fractured tib fib and external fixators. Docs advised amputation but hoping to save his leg at shriners hospital.

Moved new medical team to Pinchinat refugee camp. Venezuelans starting work as well.

Globe and mail reporters in town. May stay at my new guest house.

Busy busy. Goodnight.
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Spam email

2010-02-09T10:22:00.000-04:00

My account was compromised, please do not send money.
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Friday, Update

2010-02-06T08:28:00.001-04:00

Jo flew back to Santiago to take care of family issues and should be returning again next week.

Always a crisis to manage here, I received a text message from one of the DART team members from our hospital in the east end of Jacmel that a woman was "bleeding out" after trying to perform a spntaneous abortion and they were requesting blood. Unfortunately phone services were not working well and I was unable to connect with them. In the end, they found an O negative donor, which is a universal blood type and were able to do a direct transfusion. The woman improved within a short period of time. We had discussed the issue of having blood available to us in the past at our health meetings but we did not have an adequate "cold chain". There are so many contingencies that it is hard to prepare for them all. I think now we need a standby list of possible blood donors so that this process can be faciliated in the future.

As we hear of self induced abortions, I'm concerned of what will happen to the birth rate in the next 9 months. Many women in Haiti use the injectable 3 month birth control but with the collapse of the health system it means there will be many moer unwanted pregnancies. As disaster relief is turning more to long term planning, these are issues that will need to be dealt with.

In terms of coordination, I met with members of Cayes Jacmel and St Michel hospital to discuss strategy for coordination. We discussed having someone fill my position and I have received a few emails of interested people which is promising. Our team has grown to 8 at present and we still need a few more. One of our concerns is the need for a coordinated effort for future health care in the region. I see myself as having a long term role to play in this situation. I did have a potential job offer from the Director of the Dominican Red Cross. I would love to continue in this role, but it is difficult without full funding and I have my work responsibilities as a full time Emerg doc in Bermuda.

In terms of coordination, internet, satellite and mobile technology are going to have a large role to play. I met an organization yesterday called "Make it Right". They are going to assist us with mappiing coordinates of clinics in the region. I had actually been working on a mobile phone technology project with my friend Paul Stevers from Bermuda. Paul, more than ever Haiti needs this. If we can map clinics, give each doc or nurse a blakberry for communication, have a central server abroad to compile data and have telemedicine we can improve long term care in Haiti. This is needed, and we are on the brink. I am hoping that the South East may set an example for the rest of the country.

Tiffany

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Update Fri Feb 5

2010-02-06T07:16:00.000-04:00

Finally I feel connected. My blackberry is up and running. Still have 500 messages to get through and little time to do it. Jo left today so I'm managing all airport operations again. More to follow.
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Updates x3

2010-02-04T08:53:00.001-04:00

February 1, 2010

Today was focussed on airport operations. Two new organizations presented to the region, Angel Wings International will be working in Jacmel for the next 6 months and an organization from the Lutheran Church. As well I should tell you about the group Bemi Sehat, a midwifery based program that will be starting a birthing center in the region. They come with a 44 foot dome tent and will begin work later this week. Through my contacts, we were able to secure them a temporary permit for the department of health.

All organizations in the region are encouraged to attend the Health Cluster meetings led by the Department of Health. I brief all of the groups travelling through the airport, however some still arrive by boat and by car. All medical teams are advised to complete health surveillance forms. Honestly, many groups have been operating "under the radar" in Haiti for many years. In my work here in the spring, I was trying to encourage NGOs to work with the government. Many become frustruated as policies often take so long for approval. I think this earthquake in many ways is uniting medical aid, forcing everyone to work together which in the end will (hopefully) lead to improved health infrastructure and ultimately better patient care in the region. As we know, government bureaucracy is frustrating everywhere but even more so in Haiti.

We continued to receive small shipments of medical supplies from individual pilots flying out of Port au Prince. I was hand delivered potent pain medications which will help many of those having orthopedic and other surgeries. One of these planes was sponsored by Help for Orphans International. Sarah flew in with Jonathan on the plane and discussed her work in PAP while dropping off meds. Apparently John Travolta flew his 737 into PAP about a week ago, and the supplies have been slowly getting distributed around the region.

Our health cluster meeting was well attended and over 2 hours, which was typical. We did learn that the measles vaccine program would be put into full force on Wednesday. The fridges however did not arrive yet so the current vaccines are still in my house. The gel packs needed to be frozen so the representative from the Canadian DART team took them to their base to have them frozen for Wednesday.

I've finally had a few moments to start my nightly "telephone rounds" at the hospital. Basically I'm checking in with our larger centers to assess needs in terms of staffing, support personnel, meds and placement of physicians.

Hopefully I'll have a medical placement volunteer today, that can further help with long term planning for medical teams/physicians.

I've also realized that I too will need a replacement, at least for the short term. I leave Haiti February 20^th but will return again in March. I'm accepting applications. If any of you have a medical or public health background, with strong management skills and can work non stop 12+hour days, please email me your CV.

Tuesday, February 2^nd

A long day as usual, but we were joined by several new teams. The International Medical Assistance Team sent another crew of 6 via Santiago. Then later CCH sent another 6 for St. Michel. I did have to do a little reorganizing for the crew. I was hoping to send the IMAT to Maribal, a more remote mountain area but when I heard that Cayes Jacmel saw 400 people yesterday I knew they were in trouble. So, we've re-deployed them along with 2 staff from CCH to help out with Cayes Jacmel. I'm not sure what caused the sudden increase in patient numbers but this is Haiti, and when the word gets out that they are performing operations then people just flock in.

We had several great donations of medical supplies today as well, small amounts but much needed items. One of the planes was from PAP. They informed me of the process for receiving meds from the WHO depot. I will send a team up on Thursday to the depot for a pickup. I tried to go through the proper channels of ordering the meds via WHO but it seems that going directly to the depot is our best bet.

We did have an obstetric emergency today at the Lutheran Medical clinic. We arranged for referral to St. Michel for assessment. There are three others at Cayes Jacmel awaiting referrral out of the country, another young man with a spinal cord injury, an 18 month old baby that had a cardiac arrest and a third. The process is extremely difficult and the American team is working on the paperwork.

Tonight we greeted our first guests at the House on Rue Pieton in the city. The CCH team will stay until Sunday. They got delayed by a few days because of a snowstorm. They'll overlap with the incoming team to provide some continuity of care.

I'm wiped today so this blog is a little short. And yes, it may be a day late because the wireless internet was down today.

But just before I go, I want to say how proud I am of the Canadian military. I've been expressing my need for more staff and I had a clerk given to me today to help in a support role. Deana will be helping medical volunteers in the region. She was able to draw up a great spreadsheet to track volunteers and is teaching Ruth how to use the program. We also recruiting Peter from the fireman division, during his off duty hours. He will be assisting Barton with non-medical volunteers and project planning. And end of day I was treated to a large topographical map of the area. It will allow teams to have a greater knowledge of where they are going and help us to quickly identify needs.

Go Canada!!

Wednesday February 3, 2010

Another busy day, but at least I'm getting to bed before midnight. I met a lot of interesting people at the airport. One organizations has connections with the Maritime department out of Florida and will soon starting sending shipments via Miami to the port of Jacmel. We were able to assist her with connections at the local hospitals and are depot for biomedical storage. We also had 3 small groups from outside the city that came to ask for our assistance. One canadian woman has been living in a small sea side village 10 minutes by motorboat from Jacmel. She said that 150 homes in her village were destroyed and she needs help. We also got three other requests from small villages for assistance. We're beginnning to see that these are the smaller forgotten places. My team is helping to provide service for all. We are uniting both the large NGOs and small ones with the community to provide the best care to the Haiti people. I see so many groups coming through the airport that say they are interested in disaster relief. They are in for 24 hours to do assessments and then go back home to regroup. We are on the ground now and have been since 7 days after the quake. If there are groups in Jacmel, we know about them. We are the NGO connection. Actually I'd debated whether or not we should form a new group for this project. In the end, I'm continuing to call myself Haiti Village Health, Project Jacmel Airport, with my affiliate partners.

I am so happy to have one of the military secretary's doing some work for us. Today she was finally able to get the spreadsheet printed of all the medical organizations in the area. She merged our contact list with our volunteer list which will make it easier for my airport staff. And, we've got our map on the wall with locations of medical projects in the area. The project is starting to run more smoothly.

Tonight I met with the group from Community Coalition for Haiti that are staying downstairs. I've been working closely with them from the beginning and we are trying to strategize to get medical care to the more remote areas in association with the Department of Health clinics. We're looking for small medical teams, 2 doctors, 4 nurses/EMT/pharmacist, 2 support staff. These groups would go to small remote villages to work with Haitian doctors or simply run mobile clinics.

I'm very happy to inform you that Haiti Village Health will be opening a small guest house in Jacmel. It can house 12 people...visiting medical teams or volunteers. I signed the lease today for 6 months and our move in date is February 14^th. What a Valentine's present that will be!! We've got significant start up costs in terms of buying a generator, inverter, batteries and furniture. Once we are established I hope that guest fees will cover the expenses. I welcome anyone interested to come for a visit. $30 per person per day which includes 3 meals per day. If anyone is interested in coming to act as guest house manager for 1 month or greater please send me your details.

We also had another Health Cluster meeting tonight. They seem to get more "painful" as time goes on. They are still disorganized and last approximately 2 hours. Tonight's main topics: measles vaccine to restart in the city on Friday, lack of chlorinated water at the refugee camp, disapproval of infant formula being donated by the government of the Dominican Republic (we encourage all moms to breastfeed and free formula doesn't set a good predent), a new psychological support group has been formed but they need funding (anyone interested in helping this great project or writing them a grant proposal please contact me. These two gentlemen are well educated and are currently offering services for free but can expand their operation with funding....post traumatic stress is abundant in the region). We also discussed the OR capacity both at Cayes Jacmel and Hospital St. Michel.

I've got some stats of patients seen to date and will post soon.

More tomorrow...and guess what (I'm finally breaking down and buying a Haitian blackberry). The internet has been very poor lately and for those in the mobile technology industry. I don't know how these types of relief efforts were ever coordinated without cell phone technology. It's not uncommon for me to have palm pilot in one hand texting and talking on the phone at the same time. Today I actually got 3 calls while on my cell. The world is connected....

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

Ask a question on any topic and get answers from real people. Go to Yahoo! Answers.

Update

2010-02-01T00:12:00.001-04:00

Sunday, January 31st

I think I've missed a couple of days but hope I can catch you up tonight.

Our operations are still continuing and expanding. Yesterday I met with Plan International that have operations in Haiti. They were interested in hearing more about our work in the region and how we can partner on specific activities. At the meeting was Mme Germaine of the Red Cross and Larry Walker of Community Coalition for Haiti, one of my partners representing Hospital St Michel. Haiti Village Health and CCH are presently working to support the biomedical depot in the city. It is stocked with donated meds which are distributed to partners within our network. Plan may be able to assist with some funding to keep the facility going.

We also had a Health Cluster meeting. Many issues were discussed, including updates from the more remote clinics in the region. A health assessment was done in Cotes de Feres by ACDI VOCA a USAID funded organization. Among the greatest needs were a refugee camp with 3500 people and only one latrine, lack of medications and the need for a special care home. Twenty people with physical and mental handicaps are now living in a small school as their home was destroyed. One of the greatest barriers to helping this village is that it takes 5 1/2 hours to drive the 130 km due to poor roads. In discussions with the Canadian DART team, I am hoping that they may be able to go in to assist in the quick construction of latrines in the area. Working closely with Base Jacmel Airport gives me several good connections regarding the possibility of flying teams in by helicopter to the region.

Back to the health cluster, we also encountered another snag. There was a suspected case of measles in one of our refugee camps (Pechinat, over 7000 people). UNICEF sent vaccines and the process began Friday. Unfortunately the government building where vaccines were stored in Jacmel was damaged. The group seemed a little confused as to how to proceed so I offered up the fridge at our guest house. It still seemed a little shocking to me that the vaccines were loaded up into the back of our truck and then delivered to the fridge in my kitchen. I know...you public health advocates out there are saying "cold chain" which to lay people means ensuring that the vaccines are kept under specific temperature control. Well, in times of disaster you do what you have to do. In speaking with Mme Germaine of the Health Office yesterday, she did inform me that UNICEF was donating a fridge and that it should arrive by Monday. I brought this subject up at the logistics meeting yesterday morning, and WFP said there would not be a problem placing the fridge in their storage facility.

Haiti...improvisation.

So, today I went to Cayes Jacmel which is about 20 minutes east of the city. I had vsited the hospital once before in the spring while I was doing my health assessment. How it has grown in the past several weeks. As I knew of the potential capacity of the center, i directed several physicians to augment the services there. We moved doctors from lavallee de Jacmel in the mountains to assist in Cayes Jacmel. It is currently our best hospital in the city. It has two functionnal operating rooms and a brand new, mobile OR donated by a Swiss Humanitarian agency.

(I'm sorry I just have to stop for a moment now. The rain is pounding down overhead. It has been dry here for so long, which is what we need. I can only think of the thousands now who are sleeping outside with little shelter or cover......I think too of Cayes jacmel that I visited today. They have 40 inpatients well outpatients as they have very little space. when I was there today I saw the simple tarps that were placed over the patients. I looked up and discussed with one of the surgeons as to what would happen if the rains came. A young boy sleeping outside with an external fixator on his leg from a broken bone.....rain falling around him....little pain medications and fear in his eyes. I think of him now as I recall his mother comforting him today. Trying to keep him calm when he was in pain.......rain......and we simply need a few large tents to provide shelter for these patients.....please don't forget Haiti....this crisis is anywhere from over)

So, back to the Mobile OR unit. They performed their first surgery today. Skin grafting of wounds on a woman's hand and foot. The tendons in her left hand were exposed from a crush injury during the earthquake. A skin graft was taken from her left thigh and placed on her hand and foot. The surgery went well medically, slight problems with the electricity in that they had a power outage half way through. Luckily the secondary generator kicked in. As I mentioned with this third functional OR, Cayes Jacmel has the best facility in the south at present.

After the OR evaluation I had a look at the current OR and staff accommodations. There is room for over 20 doctors and nurses. That facility will get a lot of use in the next 3 months. It was typically run by a local doctor Philippe who performed surgery once weekly there. Now they are performed several ORs daily and have 40 inpatients (within only one nurse....don't worry I may have two volunteer Haitian RNs to assist them tomorrow)

So after Cayes it was back to the airport. It was actually strange to be out of the city even such a short distance as the airport has become almost my first home. I am lucky to have my secretary Ruth, Fredo and now my good friend Jo Barbosa to act as manager of Airport Operations for NGOs while I coordinate logistics and attend meetings.

This afternoon Sarah Wallace and I were invited to the family home of a friend of mine from Bermuda, Mrs. Frigga Simmons. Frigga was born in Jacmel and moved to the US as a teen and then Bermuda. We were able to spend time with her Aunt and Uncle and discussed the earthquake, its effects in Jacmel and potential future of the region.

Sarah and I returned to the airport and I packed up for transfer to my new accommodations at Haitian Children's Home, under the care of Danny Pye. We are renting the top level of the home for the next 3 months. En route, we saw a large amount of traffic on the road. It looked like there had been an accident, so being the Emerg doc that I am I ran over to see if I could help. There was a young man lying on the road with none other that the Canadian RCMP by his side. (Yes, they are in Haiti and have been here for several years.). We were unsure if he was hit by a car or simply just fell off his motorbike, but he had decreased level of consciousness and was bleeding from the mouth and head. So we did what one would do....call the UN for the ambulance. The RCMP, bless their souls, did have a first aid kit with them. Unfortunately I didn't find the gloves until my hands were already streaked with blood. And sorry to all my EMT friends, I was unable to do c-spine precautions as I knew there would be no c-collar, and if he did have a neck fracture, we would have little ability to deal with that injury. So I bandaged him up (again my EMT friends I have the ultimate respect for what you do in the field) and awaited the ambulance. I called my partners on the ground as I was planning to take him to the General Hospital. I was instructed to go to Cayes Jacmel. My friends took my bags to the guest house and I went with the patient (accompanied by his friend) with lights and sirens to cayes Jacmel. I tried to call the facility to give report. No laughing EMTs, I really did want to give them a heads up. Unfortuantely cell coverage isn't the best at that hospital so I texted one of the docs that works there. The text didn't go through, but they were quickly able to deal with the patient when he arrived. We moved him by stretcher to the bed. The orthopedic surgery was attending to him, had one look and said ?maybe we should start mannitol. I suggested that we get him cleaned up, stitched up, treated for pain and then observe him for the night.

In any North American institution this young 24 year old would have immediate xrays of his neck and a cat scan of his head. But this is Haiti and we must learn to work with what we have.

So, from the hospital to the airport. It was funny but as I finally had time to speak with the ambulance driver and told him I was Tiffany, he said oh "Dokte Tiffany". My name seems to be catching on. At least now I have his direct number, though all ambulance transfers must be approved by the hospital administrator.

Tonight was a special feature at the airport. We were entertained by the boys and young men of Trinity House. It is affiliated with St.Joseph's home for boys in PAP which some of you may have seen before. AS St Jo's was demolished in the earthquake, many boys have come to live here and the capacity of Trinity House has grown from 20-40. It was a very entertaining show with drums, dance and even fire. A welcome break from our gruelling schedule.

So, here I am now, 11pm, probably time for bed but I really want to be able to share my stories with you. One of my team members writes articles for health magazines and follows the news closely. He says that Haiti is dying out in the media. Please, remember that there are thousands of people still in great need. Almost 200,000 have died but there are another 200,000 displaced without shelter.

My other concern as well, is the predictions that we are hearing regarding another large quake. 3% chance of >7 on the Richter scale, 25% of >6 and 90% change of >5.0 (which could still cause severe damage). Tremors are expected as well.

Please keep my team and Haiti in your thoughts and prayers.

Goodnight.

Tiffany

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Update, Wednesday January 27

2010-01-28T07:30:00.002-04:00

Update, Wednesay January 28th

Our day started out with the medical evacuation of an 8 week old boy. He had surgery at the Hospital St. Michel for an abdominal problem and went into Congestive Heart Failure (fluid on the lungs) after the operation. I had tried yesterday to get him evacuated to Port au Prince or the US ship but everything was full. Overnight, one of the members of the team at the hospital made personal contacts through the military and he was accepted on the US ship.

When brought to the airport, the baby was on a ventilator and arrived in a small basket. I spoke with the parents to explain the situation and had to ask them to chose which parent would go with the child. The father decided to go, and the mother was very upset when I told her (in my broken Creole) to say goodbye to the baby. The baby, father, anesthesist and RN were transported via a US helicopter to the USS Comfort. They returned shortly after and said the baby did well in transport.

Later today we met to discuss the referral process for medical evacuations. Unfortunately the roads are still very poor in Port au Prince and true emergency must be flown by helicopter. I met with the Canadian DART representative and a contact from Cayes Jacmel Hospital (which is now our main operable facility in the area). The main goal is to keep patients in the country as much as possible. Milot Hospital in Northern Haiti has some of the best facilities at present. There is also the Partners in health Unit in Port au Prince along with the Miami base. We are attempting to get information from the Health Cluster in PAP as they should have this referral network established.

Airport operations have slowed down in terms of food and medical supplies. Food at present in the city is being distributed through the world food program and our storage facility is almost empty. Medical supplies have slowed too though I heard we may be getting more tomorrow.

I have a contact at Health Partners International that I have requested med packs from. Hopefully we'll get those flown down in the next several days. We have many teams coming to the area and these packs are ideal for mobile clinics.

At 4:00 it was time for the Health Cluster meeting. Dr. Delouche and several other local groups were there. I gave the update from the Logistics end of things and also the mobile clinics. Two I my new volunteers are working in that group. The current docs are preparing to leave and we are now trying to coordinate replacements for them. We are also going to provide coverage to areas in the more remote parts of the city, and ensure we have doctors at the refugee camps, which are now at 6000 and 1800, and a growing one of 500 people.

I met with a contact from the Dominican Red Cross after. We are working together to get supplies to Haiti. We are forming a needs list, and I will be facilitating pickup and distribution of all supplies.

On the medical front, we are still seeing plenty of patients with fractures and open wounds. One doctor said that she didn't realize just how important rehab medicine would be needed at this time. She is seeing already a lot of amputations that are having difficulty with healing and will need secondary repair. The orthopedic and general surgeons are going to be busy in this area for a long time.

update Tuesday, Jan 26th

2010-01-27T00:40:00.001-04:00

I thought I should start to include the date on my updates, as I find it very hard to keep track of the days of the week.

Today I brought two other team members on board to help with our coordination project, Patrick Adams a freeland journalist and Barton Brooks who has extensive experience in International Grassroots aid projects. They will augment our Haitian staff. Patrick will serve as liason with the Dominican Red Cross. Barton will coordinate placement of personnel in the clinics around the city. My nursing student Ruth came on board a few days ago as our secretary and my personal assistance. Her cousin Fredo is coordinating our staff and transport at the airport.

We will be joined in the next few days by my former manager Jo Barbosa. We also have an administrative coordinator working with the Canadian Disaster Assistance Response Team who will be providing guidance and support.

Today was busy with meetings. I attending the UN logistics meeting in the morning and the health care meeting in the afternoon.

I was also busy trying to coordinate the evacuation of an eight week old baby that had post-operative problems and coul not be weaned from the ventilator. Unfortuantely the Miami field hospital in Port au Prince was full as was the USS Comfort. We had search and rescue prepared to take the infant but without an accepting facility we were forced to keep her here overnight with limited resources. I hope that they are able to wean her off the vent overnight.

I'm very excited by the work we're able to accomplish here. Facilitating medical personnel working both in the city and countryside is an important task as the Haitian Healthcare infrastructure has taken a hit, and was not strong to start with.

I look forward in the upcoming weeks to further coordinate with Save the Children, Medair, Plan International and Caritas.

Tiffany

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Update

2010-01-25T01:14:00.001-04:00

Another long day, it's midnight and I thought I'd be in bed much earlier but I got excited when I heard news that our first Red Cross shipment was at the port. We're coordinating logistics for pick up now.

Today was very busy at the airport, several flights from the US with volunteers and supplies. There were no US flights today. The Canadian military has been busy though. They are continuing to unload gear for their new base camp in Jacmel. And tonight I was surprised to see lights on the runway and a C-130 dropping off more supplies.

This morning I attended the logistics meeting at UN headquarters. We discussed issues of storage of goods, transportation and security. The Canadian government, CIDA, and WFP along with other partners were in attendance. There is still much to do but shipments are moving. Presently our storage depot is the central facility in Jacmel. Supplies are being distributed to hospitals and clinics in the area.

As I stated, we had sevveral volunteers arrive today. I was happy to be in communication with the hospital facilites in Leogane, an area just north of Jacmel. We were able to airlift a general and orthopedic surgeon. An anesthetist was transported just about 30 minutes after he landed and an emergency room doctor later in the day.

The general hospital was very busy with patients, with the Community coalition for Haiti doing primary triage. Several patients were referred to the hospital in Cayes Jacmel, just 20 minutes east of the city. They have 3 operating rooms and the doctors have been busy, but not overwhelmed. The main concern is supplies. For those in the medical profession, we know that orthopedic surgeons are like carpenters, they need their drills, screws and plates.

I was happy that Dr. Charles Rene of Lavallee de Jacmel arrived today. He came with a large surgical team to start operation in Lavallee, about 45 minutes west of the city.

More tremors today as well. I heard that we are actually still getting 3-5 tremors per day, and will until the tectonic plates actually settle in place.

I did receive an update today on figures for this disaster. 111,000 confirmed deaths and 185,000 IDP (Internally displaced people). Startling, the numbers speak for themselves.

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

The new Internet Explorer® 8 - Faster, safer, easier. Optimized for Yahoo! Get it Now for Free!

Update

2010-01-24T00:28:00.001-04:00

Sorry I didn't blog last night but I was just so exhausted. Today was also a very busy day.

Yesteray, some highlights. Myself and Sarah continued our work coordinating medical logistics at the airport. We received news from the FOTCOH medical team had delivered 30 week twins the previous day and they weren't doing well. With the Canadian Military I was able to arrange transport of the babies, in their home made incubators to Port au Prince via helicopter. They were accompanied by medical staff from the FOTCOH clinic. They said everything went smoothly in PAP. The babies were quickly assessed and referred out to a treatment hospital, and the American Helicopter returned them to Jacmel.

We started working more closely with the World Food Program yesterday, as we are responsible for the materials coming off the many US helicopters landing. As of yesterday afternoon, they finally provided us with a worker at the airport to aid in logistics (though she did ask me to cover for her today while she took her lunch break).

Today was very busy with humanitarian small NGO missions. We did have an unfortunate crash of one of the Agape planes. The pilots are great, and had been on the airstrip several times before. They felt it was likely a landing gear malfunction. I knew something was wrong as soon as they touched down. The right wing touched down on the runway and then the plane did a 180 turn, landing in the grass on the side. The pilots walked out a few minutes later. We were so happy that no one was hurt!! The Canadian military, myself and a medic went up to the plane to make sure everyone was okay. We were still able to use the gear and supplies on the plane as well.

I was very happy, that eleven days after the earthquake that the large partners, UN, WFP, USAID were able to sit down for an organization meeting. They divided up into clusters (smaller subgroups) for management of the disaster. I was able to attend the Water cluster at 4:00, providing information on water trucks that were available. And then at 5:00 the Health Cluster. We subdivided into three cells - Ambulatory care (medical clinis, outpatient services), Inpatient care (hospitals, surgical capacity), supply and distribution (that's me) The meeting was a little chaotic but at least we finally had a better idea of what was happening in the city. We have a logistics meeting tomorrow at 1000h at the UN to discuss further planning.

Prior to this meeting I spent time with the Dominican Director of the Red Cross. He arrived in Jacmel unaccompanied and he wanted to assess the situation at the port where they were shipping supplies. I liased him with the Canadian DART representative, and secured them transportation to the port. They were actually unloading a shipment of supplies from the Dominican and we met the Southeastern director of the Red Cross.

But, the biggest highlight of my day was speaking with Christianne Amanpour of CNN. I don't always follow the news closely but I know her. After speaking with the Base Commander, he referred her to me for the Humanitarium side of things. We spoke for a few minutes and then she went to one of our distribution locations and off to the refugee camp.

It's late now and I've got a busy day ahead.

Goodnight.

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

Yahoo! Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!

Facebook/Blog update

2010-01-22T00:22:00.001-04:00

Today was another long one, and I'm exhausted now so this will be short.

We spent our day at the airport once again. Supply planes from the Dominican were few as it was a public holiday and there are increasing problems with air traffic through there.

We had only 2 planes from Florida, but they did carry valuable orthopedic supplies and surgeons which started work in Cayes Jacmel.

More earthquakes again today. Two just around noon. I was in the airport for the first one and the whole place just shook. About 5 minutes later while standing outside the land moved beneath my feet. I heard they registered 4.1 I can't quite describe the feeling, like a subway train passing by and the ground rolling beneath you.

We were able to coordinate much needed medical volunteers to the Leogane area that was hit so hard. We had information from our first team on the ground that there was a baby that needed an amputation of her foot. She was taken to the field operating room which had just been set up. The teams travelled onboard Canadian Huey Helicopters. Go Canada!!! Actually we've been working very closely with them and they've been as accommodating as possible.

So that brings me to the airport. My friends Danny, Gwen and Nick have been there for over a week and have decided it's time to return again to their families and child care duties. I decided that I would take over management of missionaries/supplies arriving at the airport. The Canadians will be securing the airport tomorrow. Tonight I met with the Military Police and UN commander. They feel this role is essential but beyond their mandate at present. I know I am an Emergency Room doctor, but at this point in time I do feel my role is best served helping coordinate the other small NGOs on the ground. It is true that the UN, World Food Program, USaid deliver huge amounts of aid, but if it had not been for Danny Pye and his team working from day 1 to get supplies into Jacmel, many more lives would have been lost.

So, tomorrow at 6 am, we will meet at the airport to begin our day. I will be joined by Sarah Wallace of Olive Tree Projects and Jeff Brown in coordinating this effort.

Please keep us all in your thoughts and prayers.

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

Yahoo! Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!

update Facebook/Blog...6.1 earthquake this morning jacmel

2010-01-20T21:52:00.001-04:00

I was just barely awake this morning when the building began to shake. Being my first night in country I wasn't prepared psychologically. I felt like a train was coming, but then the shaking continued. I ran outside initially, just on the balcony but quickly went downstairs. I'm not sure how long it lasted but likely at least 30 seconds. My friends Gwen and Nick said that it flelt similar to the earthquake last week. they had been receiving many tremors and they knew this one was more intense and of longer duration. we weren't surprised when we heard it registered as a 6.1.

We quickly went down to the airport to assess the damage. Everything was fine there but they were rocking.

Last night we were trying to plan and strategize. I was appointed as airport control for medical planes arriving. The past few days Danny, Nick and Gwen had been managing all of these duties on their own. Air traffic control, plane direction, security. This is no easy task as I learned today.

We had over 25 planes land in the Jacmel airport. Many small 4-6 seaters from Fort Lauderdale shuttling people and supplies. Small aircraft from the Dominican Republic with the same. Agape, MFI and pilots that had just vollunteered their time and planes to drop people off.

We also had a large Canadian contingent arrive today, with over 6 hercules aircraft and 110 soldiers. They will augment the DART team that is already on the ground.

Many helicopters, US military, Candian S&R from their supply ship in the harbour. The US Blackhawk is just about the biggest chopper I've ever seen. And when those things touch down, you can't imagine the wind and sound.

Actually the Herc was the loudest, as earlier in the day they were testing the runway for stability so they really had to push their engines. I'm pretty filthy at the moment and we're all very sunburnt but that's all just a good day's work.

So, it was a crazy day to say the least and when I sit back now and 8 pm it's hard to believe what we're in the middle of right now. As the Canadian and American choppers would arrive, they would bring tons of supplies. These were carried offf by hand...both Military and Haitian personnel joined in. The US didn't have any people at the landing site so the Canadians were shuttling their supplies and delivering them to the awaiting World Food Program trucks which then took them to the UN Secured WFP.

Just thought I would share with you the work of my friend Sarah Wallace from Edmonton, Alberta Canada. She was featured today as "The Third most intriguing person in the US" on CNN. She's sitting with me now. She came to Haiti over one year ago. Althought she is trained as a midwife, she came to teach and start an orphanage. At the young age of 24, she's a pretty incredible gal.

At 4 pm today we tried to provide some coordination to volunteers and teams arriving on the ground. All NGOs in the area had a meeting at Hospital St Michel with the hospital administration and regional Ministry of Health. To date there has been no coordination of work on the ground. that's right, a job that I thought the UN or red Cross should be taking over is just not happening. Jacmel has several docs, surgeons and nurses. Too many for the present needs of the city. They are in dire lack of supplies. In our final discussions we designated the group CCH, based in the US, to work as the hospital liason. As a group of NGOs we will organize ourselves with the local Ministry of Health to go where the needs are greatest.

The epicenter of the earthquake hit Grand Goave and Petit goave not much more than 20 miles from here. We had a medical team of EMTs out there today and they witnessed devastation. 4 people in need of amputations, one amputation in the field with a saw and no anesthetic, a field of 1500 people awaiting health care. we are trying to arrange flights into there tomorrow. We have told the Canadians about the situation, but their present mandate is to set up the field hospital in jacmel. We are hoping to reach the area tomorrow by private aircraft My new best fried Jonathan is willing to fly just about anywhere with his small cesna. He did a recon mission today but was unable to land. They advised the people to clear the airstrip with machetes to cut down some trees. We are hoping it will be ready in the morning.

Our other options for flights is via Leo gane, where we di have several planes deployed today. Currently MSF have a great field hospital there, but just to the East in Christianville they are in dire need of supplies. Their hospital was severely damaged. Grand Goave and Petit Goave are about 30 minutes by truck so that may be our alternative for supplies/personnel tomomorw. A helicopter would be ideal, the current US and Cdn choppers are being used mainly for PAP. So if you know of someone in the south with a chopper, send them to Jacmel. We have a full team ready with supplies to send their tomorrow. Let's hope they can get out.

So, what do we have for healthcare in Jacmel right now? The hospital is open with people still outside on stretchers. THe OR is functioning but supplies are minimal They were running out of Halothane anesthetic. Did I mention that I personally gave $160 tonight to the hospital administrator to buy gas for the generator. We had to call the gas station owner personally to get it. And this was at about 7 pm, when we were already using flashlights to get out of our meeting.

The clinic in Cayes Jaccmel is open and functional but they have no supplies for their OR Dr.. Philippe arrived today and hopefully he will get that functional.

The FOTCOH clinic was open today providing medical care.

The Canadian military is camped out at the airport, the UN base and their newly claimed land in Raymond, in the care of Danny Pye with haitian children's home.

Supplies, we received some via cargo ship from the DR and hoping for more tomorrow. Of course we're getting many by plane but the needs are still great for medical eqment.

I am hoping my good friend Dr. Charles Rene l arrive tomorrow to begin work in Lavallee de Jacmel.

So, here we 9 pm, just debating whether we'll sleep inside or out. I think I'll stay in and just hope my spidey senses will tingle if another quake comes. Truly, our house is very secureand I feel comfortable here.

For photos of our days adventure check out the fook site of Gwen Mangine....that's where I'm staying.

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Facebook/Blog Jacmel update

2010-01-20T00:38:00.001-04:00

Hello All

I arrived in Jacmel this afternoon on a small private plane from Florida. There is a lot more plane movement and shipment of supplies into jacmel in the past 48 hours.

The Canadian military has landed 3- C 130s and the americans are dropping off supplies by helicopters. The airport was pretty confusing today when we arrived as Air Traffic control is quite limited.

I met with Dr. Annie Bouchard of the Canadian DART team. As I am familiar with the area, I was able to give her intelligence of local clinics in the area and possible locations for setup of the field hospital.

The field hospital will be deployed in the next 48 hours. Presently the DART team are staying with the UN at their base near the airport.

You know it's a small world when you run into old friends in Haiti. I met Dr. Rob Ennis, a med school colleague of mine from St. John's Newfoundland, memorial medical school. He's a member of the DART team. i hope to work with them more closely over the coming days.

The city is devastated in areas, though along the east end (near Cyvadier) there was not as much damage. I met with good friends Sarah Wallace from olive Tree Projects, Danny Pye of Haitian children's home, Lia Van de Donk of Love you can feel orphanage and Pastor Placide who works with Bob Davisson of Lifeline Haiti. At the hospital I also spoke with Dr. Sem Gaspard and Dr. Frantzo Nelson who works with FOTCOH.

On the ground Haitian Children's Home under the care of Danny Pye, Gwen and her husband Nick have done increble work in organizing shipments of supplies and people.

I flew down with members of the Friends of the children of Haiti, based in Cyvadier, and they will be opening their clinic tomorrow.

The city is dark, there is no electricity except for those that have generator like Gwen and Nick which is where I am presently staying.

Most people are not sleeping in their homes for fear of another earthquake and not knowing the structural integrity of their homes.

Oh, for those who remember Trinity House, it is still standing and the boys are all doing well.

The streets are still closed in many parts of the city. A mass grave was started near the cemetary for remains.

On a final note, I must share a happy story on the strengh of a newborn. A 22 day old baby was pulled today out of the rubble by some search and rescue workers. At this point, they had been finding mostly dead bodies. Just after they found the baby, the Canadian DART team drove by they were doing a site assessment. I was there when they rushed the baby to the hospital. She is alive, cried when they inserted her intravenous line and then peed shortly after. The power and life of a newborn.

So, what does tomorrow hold...I'm still figurng that out but I will try to keep you posted as best I can.

Tiffany

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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update

2010-01-19T08:44:00.001-04:00

I'm still in the US awaiting a flight to Cap Haitian, hopefully today. Initial plans were for me to go to Jacmel to help my friend Danny Pye and the Haitian Children's Home, but last night I received an email from a friend in the north. He has a 25 bed hospital which needs staffing and supervision. The north, Cap Haitian, has started seeing a flux of patients from Port au Prince. Our network is working closely with Dr. Jasmin, Minister of Health and the UN to coordinate the efforts of medical personnel in the area. The Hospital Sacre Coeur, in Milot, has started receiving patients by helicopter from Port au Prince. I will be working closely with Konbite Sante, a Maine based charity at the Justinian Hospital to coordinate these efforts. Jacmel has not been forgotton. The group Friends of the Children of Haiti will be arriving there tomorrow to set up at their clinic. They are bringing disaster response professionals. Soon Dr. Charles Rene and his team from lavallee de Jacmel will be getting their hospital prepared for casualties as well. i will try my best to update facebook as much as possible. For Bermudians interested in helping, we are starting to compile a volunteer list as stated under the care of Dianne Flood. Please email her details of your name, occupation, possible travel dates. For Canadians email to Brenda Burns at djburns@nb.sympatico.ca.

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Haiti Village Health Bermuda and Feed My Lambs Ministry

2010-01-14T11:18:00.001-04:00

I have just been speaking with Philip Rego of Feed My Lambs Ministry here in Bermuda. We will be teaming up in a united effort to direct Bermudian support for the disaster in Haiti.

Many people have asked how they can volunteer their time/resources. We will be meeting tomorrow to discuss these opportunities and will keep information posted on the blog and my facebook site.

Tiffany

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Update

2010-01-14T01:41:00.001-04:00

Just a brief update from Haiti. As many of you are aware, our primary facility is based in Northern Haiti. I have not been able to reach any of my staff there but there is little report of damage in the north.

Many of you know the orphanage that we follow in Port au Prince run by Etienne Bruny. i am still awaiting word of the status of the orphanage.

In the Jacmel region, I received word that Ellen McArthur, sister of Sarah of ORA International is doing well. There was severe damage in Jacmel indluding the hospital. One report from Pastor Placide of Life Line International states the damage was more severe than 2 combined hurricanes.

Our friend Bob of Life Line says his schools are safe in Jacmel and surrounding regions.

I thank you all for your calls of support today. I will continue to post updates as more information becomes available.

For those interested in donating to our interests in the region, we have online donation through Paypal or locally in New Brunswick through the office of Dr. Hudson.

Our prayers and thoughts are with the people of Haiti tonight. This is only the beginning of a very long journey of recovery for this troubled country.

Tiffany

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

www.haitivillagehealth.blogspot.com

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-7709

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Friday....Elizabeth Turnbull

2009-05-24T17:37:00.002-03:00

For those of you who've made attempts at learning Creole you'll be familiar with Creole Made Easy by Wally Turnbull. Well, I met his daughter Elizabeth on the plane. It was great talking about Haiti, and how she grew up at the Baptist Mission. It turns out that she's now working on Marketing for small NGOs just like Haiti Village Health. I think she's now become my new best friend.

It's a small world out there!!

Friday, May 22nd...on my way home

2009-05-24T17:26:00.002-03:00

For many of the team, it was a day of sadness. Leaving their new-found friends and Haiti behind. For me, a day to reflect on all that had been accomplished and to further consolidate this process of networking with the other organizations.

We boarded a small plane in Jacmel which flew us the 15 minute trip into the Port au Prince airport. We were soon at the International terminal, on our way back to our homes.

I was able to contact my good friend, Etienne Bruni, who runs an orphanage in PAP and he paid me a visit at the airport. I've visited his orphanage several times before and he does an incredible job with the children. Unfortunately, the last 6 months have been a very difficult time for his orphanage and finances are very tight. It was sad to hear his stories of struggling to provide meals for the children. The orphanage has great potential, but once again sponsorship is the key to keeping it running. I was able to give a small contribution to help, but hopefully soon a larger partner will be able to provide long term support.

So....my trip was coming close to an end. Did I do all that I had set out to? Yes, and more. With the help of Verbo and the Haitian Timoun Foundation I was able to arrange more meetings with both government official and civilians to get a much better idea of the political situation regarding healthcare in the country. By visiting the smaller rural clinics and speaking with the young doctors in their internship year, I can now understand their needs and their struggles.

My next step is to work on a proposal for the Ministry of Health. This would include our program for education with foreign NGO groups, as well as the Dokte chak semann or rotating doctor program which would get young interns further into the remote areas, but also allow them to work alongside foreign visiting medical teams. A website will follow after that to link NGOs working in the Southeast area of Haiti. I've already partnered with two other organizations, Haiti Connection and Medical Mission Exchange to consolidate our information rather than duplicate.

It will be a busy summer, and though I will not return to Haiti until November, I feel the networking that I'm building is key to better long term health care for the Haitian population.

Stay tuned for updates.

Thursday, May 21st Final Clinic Day

2009-05-24T17:21:00.002-03:00

Well, our last day in Clinic. Mona and I joined the FOTCOH team for the final morning, and was it ever a busy one.

In the end, over 2100 patients were seen at the clinic. A large portion of these will be followed at future clinics for well baby checks, diabetes and hypertension.

After a long morning, Mona and I got together to wrap up some clinic issues.

My work still wasn't over, I met up with my good friend Michael Rigel and his wife Georgette. They have a ministry in Jacmel and will soon be attending a missions course in Florida.

The final meeting was later in the evening with the organization Fomavend'h. This group of Haitian professionals are working to establish a clinic in the small village of Casse, just outside of Jacmel on the route to Marbial. I had visited the village earlier in the week with the team from Healing Hands. It was a great opportunity to learn more about their organizations, and perhaps link them with another sponsor so that their dreams can become reality.

After that long day, it was time for bed and soon time to bid farewell to FOTCOH and Jacmel.

Wednesday, May 20th Lavallee de Jacmel

2009-05-24T17:11:00.003-03:00

Wednesday was another busy day. Mona and I got up early to head up to the mountains of lavallee de jacmel. It's about one hour from Jacmel through some beautiful countryside. The coolness of the mountain air was refreshing from the heat of the city.

We visited the hospital started by Dr. Charles Rene of New Orleans. He is from the region and still continues to visit 3 times a year with medical teams. As his teams do procedures in general surgery, obs/gyne and ophthalmology we wanted to visit to establish a referral process for patients in the area.

Later that day we returned to the city. While having lunch downtown we met the board of Pazapa. A day school for children with disabilities in the area.

Next meeting was with 2 new medical students sponsored by Pastor Placide and Lifeline Haiti. As they will start univeristy in the fall, I thought having some input from our doctor Mona, a haitian trained physician would be useful to them.

Next stop was the orphanage "We can build an orphange" home of many children infected with HIV. Lia Van de Donk supervises and from the smiles on the childrens faces we could see that she was doing a good job.

A quick stop at the office of Haitian Children's Home and we picked up our worm medications donated by an organization in Port au Prince, to do our deworming campaign in both Bod me limbe and Labadie later this month.

Back to FOTOCOH for a little break, but then a few hours with Mona just further planning the clinic. It's been a great two weeks working with her. On team missions we're some overwhelmed with patients that it's difficult to take time to plan. We've developed a list of health indicators that we'll follow in the clinic, will hire a new Agence Sante or Community Health Worker and Mona will increase her clinic time from two to three days per week. I just hope the donations come in to match this increase in services.

Tuesday, May 19th

2009-05-20T01:01:00.001-03:00

My, it's funny how the days start to blend together. I think I'm just so exhausted now it's difficult to think straight.

The day started with FOTCOH clinic. Mona and I were off though mid-morning to meet with Verbo and the local government representative. As you can probably see, this week has been full of meetings. I've got plans for where I'd like the network to go but without the co-operation from the local government our work won't have the impact we want. The delegate gave us an overview of the governmental system, and in the end pointed us in the direction of MSPP which is the ministry of Public Health.

This meeting was arranged for this evening.

In the meantime, we met with Danny Pye of the Haitain Children's Home. Danny is a wonderful man and does such an amazing job living in Haiti and having 20 of his "own" Haitian children to support. As he is rooted in Jacmel, he is a much needed source of contact on the ground. We are presently planning a dental trip to Jacmel in the fall, and a school trip from Bermuda in February.

So that left us with our meeting with Dr. Delouche this evening. It took us some time to come to some starting points as to how the Network can work with the MSPP. Education and the Dokte Chaq Semann program were starting points. Next step is to make everything official by submitting our plan to his office. It is so important to have MSPP aware of all the activities in Haiti. Through the network, we are trying to encourage this active participation in the governmental aspect of Health Care. Yes, it will likely slow things down for us while getting their approval but at least they will be fully aware of our desires and maybe this project can be a tipping point for all NGOs working in Haiti.

Far fetched, yes, but why not dream big! Ptit a Ptit. You've got to start somewhere!!

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Monday, May 18th

2009-05-20T00:53:00.001-03:00

I was able to connect with the Healing Hands team again today. They were visiting Bassin Bleu, which is one of the major tourist attractions in the Jacmel area.

It is also home to a new school under construction by Linda Heston for Hands Helping Haiti. I was able to visit with Linda's local assistant Elyssee for a tour of the grounds. The school is scheduled to open in the fall with 6 classrooms. Linda presently runs 1-2 medical outreach clinic on site during the year with plans for a medical clinic in the future.

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Sunday, May 16th

2009-05-18T23:39:00.002-03:00

Sunday is a day of rest. Well, most of the day was. This was the opportunity for the team to enjoy a day of R&R at the beach...just 15 minutes east of Jacmel at TiMoulage. It is a beautiful area, but I long for my beach at Isle Caramel near our village of Bod me Limbe in the north.

Doctor Mona and I left mid-afternoon for a meeting with a representative from the city. We discussed health issues in Jacmel and how the government and city contribute to health care. Understanding the issues, and connecting with the local population is key to helping Haiti in the long run. This meeting led to two others, arranged for later this week.

It's great having Mona with me, as I work further on setting up the Health Network in Jacmel. Her understanding of the local system helps faciliate the types of projects I will be able to work on in the future with the health network.

I won't comment further on what the government needs to do to improve it's services, only that if change does not come from within Haiti most of our foreign contributions will only be band-aid treatments to this impoverished nation.

Saturday, May 16th

2009-05-18T23:13:00.002-03:00

Village de Casse and Tetkole

I was fortunate to make contact with Gail Buck of the Healing Hands Team in Port au Prince. Jan Groves and her team were in Jacmel on a rehab mission. They were travelling to a small village just north of Casse, that I wanted to visit so myself and Mona tagged along for the day.

The road to Casse was a difficult one to say the least. It's actually not a road after all. It is the river bed. After 90 minutes and 10 river crosses we did reach the village. The villagers were waiting at the top of the ridgeline. Unfortunately it was after 1 pm when we arrived and the skies were looking dark. The problem with travelling along the river bed is that the water levels continue to rise throughout the day, and flash floods can happen quickly if there is a heavy downpour.

The group was a bit torn with it's decision about what to do. In the end, four members of the Healing Hands team decided to stay the afternoon and spend the night in the village, along with a Haitian physician.

We handed off our water bottles and any granola bars that we had, with one flashlight and left them to start their busy clinic.

The rest of the group continued back the riverbed. The water levels were already rising and our tap tap got stuck. Luckily, the other tap-tap driven by Tour Haiti operator Cyril Pressoir was behind us and was able to gentle give us a nudge. We did have the UN landrover accompanying us but unfortunately they didn't have a winch. After 2 somewhat forceful taps we were out.

The remainder of the Healing Hands team had stayed in Jacmel to work at Tetkole...a day program for street kids. We joined them once we returned to the city.

Little did the rehab team know what they were getting into. They seemed quite releaved when Doctor Mona and I joined them. In the end, we saw about 110 people with mainly primary health care problems.

At the end of a long day, we joined the Friends of the Children of Haiti team at the Cyvadier Hotel.

It was a long day and I learned several important points....#1 don't attempt to cross riverbeds in Haiti in the rainy season #2 be well prepared for any medical missions and ensure you plan for the patient population you will see

Friday, May 15th

2009-05-15T19:58:00.001-03:00

The rains had continued, so my trip to Marbial was off for the day. It was time for clinic with the FOTCOH team.

It was a very busy day with several very heart breaking cases. The first was the 2 year old, malnourished as his father had difficulty supporting his three children since his wife passed away. I had to give him just a little cash to support himself and maybe get his young boy on the road to good nutrition.

The second was a 35 year old with metastatic breast cancer that was oozing from her breast and lymph glands. We cleaned her wounds and made her comfortable with analgesia.

Appreciate where you live!! Appreciate Canada!!

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Thursday, May 14th

2009-05-15T19:54:00.001-03:00

Well, a very productive day. I started out in the morning with meeting regarding setting up a mobile dentist program, as well as a low cost dental service in the city. If you have any dental friends please let refer them to me. This has the potential to be a great program, both in the city and the countryside.

Next I was off to visit the government clinic in Cayes Jacmel. Dr. Mona's husband, Wilson, works at this clinic. He is completing his social service year there. It's not easy for them as they have a 2 year old son, but the social service year is mandatory in Haiti. Young doctors have to go wherever they're needed. The clinic is in a lovely setting in the countryside. They have 4 physicians on staff including Haitians and Cubans. Unfortunately, they are not equipped with obstetric care but hope to have this in the future.

My following meeting was with Pastor Bob Davisson from Alberta. Bob has 23 schools in the Jacmel area and is a wealth of information. Together, we hope to open a medical clinic in Chabin at the site of his school there.

Sarah Wallace of Olive Tree Projects was next in line, prior to our group meeting. Sarah is connected with midwives for Haiti who will soon be opening a branch in the Jacmel area, where she can provide prenatal services for free.

At 7:00, I hosted the first meeting of the Jacmel Health Network at the Cap Lamandou Hotel. It was a great success with over 38 attendees. We had representatives from Jacmel, Cayes Jacmel, Bassin Blue, Cas, PAP and Cyvadier. They included foreign and Haitian physicians, nurses, orphange workers and school supporters.

There was interactive discussions with the Haitian physicians. Our first plan was to set up an education arrangement for Haitian physicians with visiting ex-pat medical teams. Other opportunities discussed were the mobile dental program, Dokte Chaq Semann, and networking regarding shipping and transportation issues.

This week my plan is to link more of the groups together. Our goal...improving health care in the region.

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Photos

2009-05-13T22:39:00.002-03:00

Well, today I was off with Bonnie and our driver to Cap Rouge. Cap Rouge is located just north of Jacmel and it took us about 90 minutes to get to the clinic which was almost at the end of the road.

The first picture you'll see is of the Clinique or Dispensaire in Cap Rouge. It is staffed by a local MD who you see me standing with. It is similar to the clinic in Labadie, for those of you that know it, and has attached living quarters for the doctor and nurse. They seemed quite interested in hearing more about the health network. They felt their greatest concerns were supplies and building size as well as cost of medications for the people.

We visited the local Government school as well. The principal recently received recognition for 30 years of service in the Haitian School system. From what we saw he seemed to run a pretty tight ship. The school was silent while in session. He said the children pay 100 gourdes per year for their education which is about $3 Cdn. He showed us the water collection system outside. It is basically rainwater collection from the roof. Bonnie will work with a partner she has in healthy water to treat the rainwater, ensuring it's safety for the children. She will also work with another contact I have in Port au Prince to provide regular de-worming medicine to the children.

After the return trip from Cap Rouge, we stopped at the Profamil Clinic in Jacmel. This clinic provides councilling service and treatment for STDs, family planning and prenatal care.

I returned to the FOTCOH clinic for the final hour of patient care.

It's been a busy day and exhaustion is starting to set in.

I've got to get some rest now for the Health Network Meeting tomorrow evening.
Tiffany

Day 2 - Cap Rouge with Bonnie

2009-05-13T21:53:00.000-03:00

Tuesday, May 12, Day 1 of clinic

2009-05-12T22:51:00.001-03:00

Hello all, well day 1 has come and gone. Everything went quite smoothly. Well, I guess I can say that since I wasn't the organizer. I'm not sure of our head count but there were a lot of people through.

I was working today with our Dr. Mona Alexis from Bod me Limbe. It was great to work with her in a non-pressured setting having a little more time to discuss patients and their management. We realized that although poverty is greater in the north, the south is in need of a greater network for health care. It is for just that reason that I am hosting a meeting of Health groups in the Jacmel area on Thursday evening.

Our day finished up around 4:00, then a few of the team headed for a quick dip on the beach, while I sat and chatted with Dr. Mona. We've come up with lots of great ideas for Bod me Limbe, including expanding our Community Health Worker/Agence Sante program.

This evening I've been kept busy with planning for Thursday evening while the team gets to know one another a little better.

It is a little strange being here in the south, but setting up this health network is for the greater good of the region and I know the benefits of it will be great.

Tiffany

Tiffany Keenan, MD CCFP

Haiti Village Health

www.haitivillagehealth.ca

"Sustainable Health Care in Haiti"

7 Marley Beach Drive

Warwick WK08

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Arrival in Jacmel

2009-05-12T00:38:00.002-03:00

Well we arrived in Jacmel around 2:30 today. The flight from Port au Prince was brief only 15 minutes. I must admit, though, it's got to be the shortest runway in the world.

We made it safely to the Friends of the Children of Haiti clinic in Cyvadier. After a brief site orientation, we discussed how the medical clinic would proceed tomorrow.

Then came the fun job of unpacking. Amy and I got the children's clothes. Lots of sorting to do but they will all be put to good use.

Tonight I was on the phone to my local Jacmel contacts arranging meetings for the upcoming week.

It looks like we've got lots to keep us busy!

Tiffany

On our way to Haiti

2009-05-10T21:40:00.002-03:00

Amy Buckley and I are on route to Jacmel, via Miami and Port au Prince. We are travelling with the Friends of the Children of Haiti (FOTCOH) team from Illinois.

Amy has travelled to Bod me Limbe with our Haiti Village Health team in May 2008.

Our Doctor Mona Alexis will be joining us in Jacmel tomorrow for 2 weeks experience with this large medical team.

Our clinic in the meantime will continue in the North under the care of Nurse Iranese while Doctor Mona is away.

FOTCOH has been operating their clinic for over 10 years in the Jacmel region of Haiti. We will be working with them part-time, as well as doing site assessments of smaller clinics and potential locations for a new school in the region.

The FOTCOH clinic is well equipped and internet capable so stay tuned for daily updates!!

Tiffany and Amy

Photos

2009-02-19T10:57:00.001-04:00

Check out the link to my web album below.

Haiti Jan 09 Jacmel Needs Assessment Clinic Followup

Our way to Cap Haitian

2009-02-18T17:53:00.002-04:00

SUNDAY

We were off on the return journey to Port au Prince. It was a beautiful drive once again through the mountains. The difficult part of the journey was getting through PAP. There was a lot of traffic even for a Sunday.

Our tortugair flight was on time and then finally we were in Cap Haitian. We were greeted by Santo Pierre, our new medical director.

At the Roi Christophe I also met with members of the Konbite Sante Health Team. I've been working with Konbite over the past year on an Emergency Room Assessment of the Justinien Hospital.

MONDAY

Time spent in the morning at the Justinian with the Konbite Team. In the afternoon I met with Dr. Medard of International Child Care. ICC has a clinic nearby in the village of Bas Limbe. We met to discuss a possible collaboration of services.

TUESDAY
Off to Bod me Limbe with Dr. Mona, Nurse Aldine and Santo to re-open the doors of the clinic. It had been closed for a brief time over the Christmas season. Everything was in order at the clinic and the staff will be returning to work on Monday.

In the evening, I attended the meeting of the Cap Haitian Health Care Network with Santo. The network started last year and the goal is to encourage cooperation of medical groups working in the region. It was great to put faces to the names I had been writing to for so long by email.

WEDNESDAY
Today I visited the Shada Clinic...sponsored by SOIL and Sasha Kramer. Dr. Mona works there each Wednesday so I visited to help out with consultations in the morning. Shada is the poorest neighbourhood in Cap Haitian and in desperate need of medical care. I plan to continue our support of this clinic through medication distribution.

In the afternoon, I was off to the Justinian for a meeting with Konbite Sante and the ER staff to discuss plans for a potential new addition to the ER department.

THURSDAY
Off to the hospital again in the morning. Returned for a meeting with Dr. Mona, Dr. Eugene (who works with the Cap Health Network) and Carwyn Hill of Haiti Hospital Appeal. Carwyn recently moved to Cap with his wife. We discussed the clinic at Shada and ways that we could improve the services offered there.

FRIDAY/SATURDAY
This was a wrap up day with Konbite Sante as well as my medical staff before we headed back to Port au Prince on Sunday.

MONDAY
In Port au Prince I was able to meet with the new National Director of International Child Care, Dr. Rudolph Magloire to discuss collaboration of our clinics.

I was also fortunate to meet with Bella Lam, Director of Canadian Feed the Children and her National Director, Mr. Madsen Gauchette. Bella had recently visited BML but was in Haiti at this time to assess her other programs in the region.

Now, it's almost 2 weeks later since I've visited Haiti. Overall it was a very good trip. The experience I gained in Jacmel will allow us to plan for future mission work in that region. I am pleased to see that our clinic in Bod me Limbe runs well under our local staff. That has been our goal all along...and now it has been achieved. Thank you to all for their support.

The rest of the journey

2009-02-18T17:46:00.002-04:00

Well, the internet wasn't working well at the hotel in Cap so this message is post-dated but here it is.

SATURDAY

Back to the FOTCOH clinic for a half day of consultations. In the afternoon we had the opportunity to visit the orphanage of Marlaine Alix, www.faithandloveinaction.com She has two separate homes, one for boys and one for girls. The orphanages suffered damage from the hurricanes of the fall and repairs were underway.

I had an interesting tour of the Medical Clinic of Dr. Neilson as well as a tour of the Hospital St. Michel in the afternoon. The medical staff that I met were all very welcoming. I plan to work on helping them get much needed medical supplies for the hospital through a few large US donors.

Haiti trip - Jacmel

2009-01-23T15:40:00.001-04:00

My husband Steve and I arrived safely in Haiti on Tuesday. We were greeted by our good friend, Jo Barbosa and Mikey, our new friend and driver from Jacmel.

We started on our three hour drive to Jacmel. The view from the mountains was beautiful though the switchbacks through the countryside were a little bit terrifying.

We are staying at the guest home of Bonnie MacAusland, who has an outreach mission in Haiti under the auspices of ORA International. Ellen Stewart, from Miramichi greeted us along with the Haiti housestaff. It's a beautiful yellow home on the Western Edge of Jacmel.

Our first day we visited the Haiti Children's Home, run by Danny Pye. Danny and his wife Leanne are amazing. They have a home that supports 22 Haitian children plus one of their own. He's been living in Haiti for the past 5 years with his "family". We stayed for dinner with the entire "family". It was a lot of fun. We also met Rosemary and Miles Blair from Fredericton who support a school in the Jacmel area.

WEDNESDAY

This morning we worked at the "Friends of the Children of Haiti" clinic in Cyvadier. Just 15 minutes east of Jacmel. FOTCOH was started by Dick Hammand and has been operating in Haiti for the past 20 years. They have a wonderful medical clinic setup and visiting teams of medical professionals from the US every 2 months. Jo worked with me doing translation and we worked alongside the US staff. Steve worked with the support staff of the clinic, learning how the logistics worked. I have the feeling we'll be working with FOTCOH again very soon.

After a day of 46 patients we had dinner at Bonnie's home with Ellen and friends. Then we were off to meet Bob Davisson of Life Line Haiti. Bob is from Alberta and we had been communicating for the past several months about a joint project in Jacmel. We learned more about his projects and 14 schools that he has built in the last 3 years. An amazing accomplishment in so little time.

THURSDAY

We were off at 5:30 am to tour the small mountain village of Savenette with Bob. 5:30...yes, we wanted to start the hike before the afternoon sun set in. It was about an hour's drive to the village of De Perido and then 15 minutes off the highway, through the devastation of the hurricanes of the summer. Then, it was a 60 minute hike up the mountain. For those that have travelled to Prunnette, it's almost twice the distance and a much steeper climb.

We were greeted with the singing of the school kids. It was great. The school in Savenette is an open-concept school with only tarps on the sides but they have a feeding program and honestly, I don't think the children could be happier. Bob has an excellent program there. All his school teachers are of high quality with Teacher's College Certification.

After the visit it was time for a shower and clean up before we toured Jacmel. It is a much smaller city than Cap Haitian and much cleaner. The mayor has received several grants and used the funding to keep the city clean. Though, apparently the joke in Jacmel is that the city stays cleans because the Hurricaines wash the garbage away at least once a year.

That evening we stopped for a take - away dinner of Fried Plantains, Fried Goat, Accre and Marinade. This was just before our surprise birthday party for Jo Barbosa. Jo's has been our good friend since I started working in Haiti and we were delighted to be able to spend his 29th birthday with him.

FRIDAY

We were off to another of Bob's schools today in Chabin. This is just 15 minutes west of Jacmel, and the original school that Miles and Rosemary had started. He's got a lovely school for kids from K-7 and the upper level has almost been completed for the high school. Bob hopes to develop the area in the future with a technical college and medical clinic.

We were joined by Sara Wallace of Olive Tree Projects. Sara is a midwife from Alberta and moved to Haiti in 2008 to start education projects for midwives and an orphanage. We've linked her with the FOTCOH group and she will be assisting them in the future as well.

On our return we visiting the medical clinic of Dr. Philippe who is affilitated with the Baptiste Mission in Cayes-Jacmel. He runs a small clinic in the center of Jacmel and performs surgeries at the Mission hospital.

We also met with the nurse at the Government Medical Clinic in Cyvadier. She operates this clinic solo but services a large area with vaccinations, family planning and prenatal care. They are presently doing expansion and hope to have a Haitian physician again during their social service year.

I guess that's it for the moment. I'd like to send photos and should be able to when we get to Cap Haitian. It has been a great learning experience to date. Keep posted on our blog for updates.

Tiffany

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Friday, November 21st THE WAY HOME

2008-11-29T18:47:00.004-04:00

Our Mission Completed. We saw over 800 people, distributed 120 packs of prenatal vitamins and treated over 1300 people with anit-worm medications.

We left Cormier Plage after a well deserved rest for our final trip in Haitian transportation. By far, this was the bumpiest ride I'd ever had in Haiti. I must remind volunteers that anyone with a bad back would not be able to tolerate the Haitian roads - especially after the rains.

We got to Lynx early as always, but the plane was delayed so we had an extra 90 minutes to waste away at the airport. Lucky for me I was able to meet a contact I'd been communicating with for a while. Dr. Pat Wolff from St. Louis and Medika Mamba Queen(the nutritionally peanut butter meal replacement) was at the airport seeing off one of her workers. We had used this nutrition substitute for severely malnourished children in July and August in Bod me Limbe with great success. Dr. Wolff recently was awarded a grant and now supplies this supplement to malnourished children through a day program at the Justinian. It was a great time for us to network.

Eventually our flight got off the ground, including our nurse Katrina. There was a brief moment of anxiety regarding her entry requirements into the US, as the Lynx ticketing agents had removed an important card from her passport in Fort Lauderdale. The pilot took care of things, though it did take a special phone call to customs in Florida. I'll remember that one for next time.

So, just 2 1/2 hours later and we arrived in Fort Lauderdale. Impossible it seems, that another world could exist just at Haiti's doorstep. If only we could communicate to them, our families and friends and all those around us the dire needs of the Haitian.

For the team, it truly was a learning experience and eye-opener. I know that some will return but that none will forget the experience they've had in their 2 week exposure to another corner of our huge big planet.

Thursday, November 20th

2008-11-29T18:36:00.003-04:00

The rain continued intermittently through the night, but we slept very well, and in luxury, in comparison with all but a few of Haiti's people. And with full stomachs we set off at 7:30 am in a dilapidated tap-tap truck, and then a tap-tap boat, for Labadie to work our final pediatric blitz. Katrina laughed uncontrollably the entire road journey, while hanging on for dear life in the bed of this pick-up, as if it were a roller coaster ride. She indirectly admitted later to laughing because of shear terror.

We set up within the walls of the Hearts Together for Haiti compound; a walled area enclosing a tropical garden, a small and beautiful stone house, and a large "gazebo", a roof-covered patio. The triage process, physician assessments, and laboratory works took place in the gazebo. As in previous clinics, all children were given Albendazole, to combat parasitic infections, and vitamins, to combat the realities that accompany hunger. The pharmacy was set up on the porch of the house and a stone walkway naturally led patients from one metal gate, where Jo admitted them, to the gazebo, and finally to the pharmacy, for prescribed medications, before exiting through the only other gate in the wall. It was somewhat of an idyllic work environment, even with the threatening skies and occasional downpour. The children had similar illnesses to those in the Bod me Limbe area - pneumonia, ear infections, diarrhea (with many reports of seeing worms) and skin infections. But overall, the general level of health was much higher in Labadie than seen in our previous clinics, most likely due to a much higher standard of living in this community.

Hearts Together for Haiti has been fostering these people for more than 10 years, and part of their effort includes a full time medical clinic staffed by Cuban doctors, one of whom worked with us today, along with a rather stern Cuban nurse.

A relatively short work day, we said our sad good-byes to the translators around 4 pm, on the dock of the Labadie shore, promising to e-mail and return as soon as possible.

We boarded our boat back toward Cormier Plage with many of us feeling the heaviness of our regrets and the cruel injustice of not being able to do more for our worthy working companions, almost all of whom had not experienced the dignity of a single day's work since our last mission in May. Six months.

Our final evening in Haiti was spent reminiscing about the week's events, listening to Jo's legitimate laments about the realities of the difficult life he has chosen in serving Haiti's people, and discussing future plans to return. How privileged we are to be on the giving end.

Karen.

Wednesday, November 19th

2008-11-29T18:16:00.007-04:00

Well through the night we all heard the rain....and some of us felt it too. For me it was a fine misting through my mosquito. For Jill in the large room it was a puddle of water on her bed that had been blown in through the eaves of the house. Either way, as I sat there listening to the rain, I knew we wouldn't be leaving Bod me Limbe by boat.

This is actually the first time we have been unable to cross the bay to Labadie by boat. Our back up plan, contact our new found friend with the 1 ton truck and hope that he can make it through the high waters of the mangrove swamp to the village.

For Nurse Karen it meant more time in the pharmacy, and it allowed me time to work on a new contract with our Haitian MD Mona. Luckily, the truck driver was able to make it through and the skies opened up to allow us a dry drive to Labadie.

The route was long though. Part way to Cap Haitien the rains began and we had to pull a blue tarp over the truck to keep us dry. It did just that, keep us dry, but I think the crew sitting at the front began to suffer some effects of the carbon monoxide that was venting up through the tarp.

After almost a 2 hour drive to Cap Haitien, we were ready to head to Cormier Plage where we would spend the night. Another 30 minutes and we had arrived. Cormier Plage is a beautiful Haitian "resort" with warm water and full electricity. It was a little luxury the team deserved after their 10 days of hard work in Bod me Limbe.

The weather was still wet and overcast so it was not a beach day, but at least time to reflect on the week, and prepare for our last day of children's visits in Labadie.

Tuesday, November 18th

2008-11-29T18:13:00.002-04:00

A little back dated post but here it is. Tuesday was another of our Pediatric Blitz today. We saw all children from the village of Guioton in the morning with add ons. There was a lumps and bumps clinic by Dr. Jan in the afternoon as well as rechecks from earlier in the week.

Jill had been scheduled to have a toothbrushing education session for the school kids but this was cancelled as the kids were off on a holiday. I guess that will have to wait until February.

Our afternoon ran a little late after all the patients were gone. All supplies needed to be put away and accounted for. Then there was the pharmacy where our faithful Miss Karen spends endless hours keeping track of all the meds to ensure that we have an adequate stock.

I spent the afternoon with Dr. Mona and Nurse Aldine reviewing medications, stocking their mini-pharmacy and discussing patient issues. It's so much easier leaving the clinic, knowing that the patients will have access to full time medical services.

Friday update

2008-11-20T22:47:00.001-04:00

Just wanted to let you know that we finished up our last clinic in Labadie this afternoon and all is well. We are off to Fort Lauderdale in the morning and will post more updates then.

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

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Monday with Josh Tracey

2008-11-17T21:24:00.001-04:00

If is Monday then it must be me and this must be Haiti.

Well woke up this morning to a General Clinic Day and I can safely say that we had a line around the block long before I had the opportunity to pop out to the local Starbucks for a triple espresso. In fact there was a line around the block before I even got out of bed.

166 patients by days end. A trip record. High on the icky factor we drained a number of abcesses and ganglion cysts. Good thing I did not sleep through that lecture day. Say a number of sickle cell anemia cases which is not uncommon among the population and treated a man who we believe to have been misdiagnosed with philoriasis. We worked him over and assessed a hernia. Unfortunately he does not have the money to travel to the hospital for surgical consult and hernias are not one of the condition that we provide funds for. We did provide h im with medication and some support and wished him well and recommended regular rechecks with our Haitian staff. We also saw a couple who were trying to concieve for the last 4 years and our assessment was that it probably was for mostly treatable causes. We treated what we could and offered counselling and sent them off with best wishes. Only time will tell.

I am told that I was tasked with the new guy job, the Sex Ed class. I have done these in Canada and was very suprised with the level of maturity, interest and practical knowledge. The teens asked very directed and seriosu questions about HIV and AIDS and were extremely interested in hearing what we had to say and thankful for us having offered the class. Still a few jokes were levied here and there, or at least that is what the translator told me. In fact I think I may have learned a thing or two but nothing suitable for record here.

Tonight we are doing a Haitian version of the Dragon's Den. HVH is trying to prototype a microcredit opportunity here in the village. Offering small loans to people who have ideas for businesses that can help improve their lot. We are using a model based on research from other groups in Haiti and from the great Nobel winner Muhammad Yunus of the Grameen Bank in Bangladesh.

I can say that I am having a great time and this is the opportunity of a lifetime for a med student. I would highly recommend it to anyone. I feel that we are living in a luxury which sometimes give me pause. Then I listen to the old timers tell me that the first trips involved sleeping on a mat on the floors of the school, showering from a bucket and treating water every morning to drink. Oh yeah and the treating patients by headlamp and candlelight. they never tire of re-telling that one.

Wishing everyone the best at home. See you soon.

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Yahoo! Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!

Sunday with Jill Alison

2008-11-17T08:38:00.001-04:00

Finally after the hectic and rewarding week the day of rest for both us and the Haitians who certainly could use it more than us. The group broke up as some took time to enjoy the down morning, Katrina and Jan braved the often day long services at the Baptist Church just to hear the singing (they did not last the day). Carolyn, Karen and myself went off to visit the seniors who they or their families sponsor in their homes which is always a great visit for all.

In the afternoon everyone reassembled for row to Ile Caramel and Sante Pou Yo tradition. From the beach, a lot like Lost, everyone went snorkeling, swimming, hiking or lazing under a palm tree. Those of us that went hiking got the full on Indiana Jones experience as we got turned around coming back from a scramble to the top of the island. Arriving at a small cliff area and seeing the beach we decided that discretion was not the better part of valour and that returning at all costs with the Crystal Skull was so we scrambled down to the beach. Safely I am pleased to say with no major spider, evil villian or 20 minute chase scenes. All true except for the Crystal Skull part unless you count a water bottle.

Jo surprised us on our return with an evening of Kompa (the local Haitian version of Soca, Raggae and Calypso all rolled into one. He had hired a DJ from the next big town and everyone got lessons in how to really dance. But of course by 10:30 we were all exhausted and knew that with a General Clinic day approaching the crowds would start to form before 6:30.

See you all soon.

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Ask a question on any topic and get answers from real people. Go to Yahoo! Answers.

Satuday with Chuck

2008-11-17T08:26:00.001-04:00

Ah Saturday. A day of going to the beach, playing sports or a lazy morning reading the paper with your relaxing Tim Hortons 2x2. Not so much for us this Saturday. Today is Seniors Day which does not mean that they get 15% off all purchases but rather they get to see the doctor.

We treated 106 patients today. Most are surprisingly healthy for their age and circumstance which is something that the returning members of the team say is common. It sort of says if you can make it through to this age you are tough enough to keep going. We had one lady who arrived suffering from pneumonia, dehydration and weakness. She was admitted for the day and given IV fluids and a bed in which to rest and started on a course of antibiotics. By closing she was able to walk out under her own power and we wish her the best encouraging her to come back to see our Haitian Doctor in a week.

Saturday was also our Head Translator Alex's birthday. Wishes went out I am sure from all of his absent friends. Jo made one of his unique cake creations with whatever was available. I am told that in the past it has been everything from Raisin Bran to Cassava clearly indicating that with enough cocoa and sugar you can make the world a happy place.

Two other members of our team Josh and Kyle worked themselves into a soccer game with the locals and were promptly showed up but had a great time and I think the boys took it easy on them.

We were visited by a fellow from Montreal, Pierre Minh, who most of the team knows from past visits. He is a PHd student who has spent some time in Haiti learning about medical aid groups, how they work and how effective they are. Nice guy and certainly knows the language and the people well.

The evening was reserved for a meal of goat (one less morning alarm clock) rice and potato salad (while the local ladies we have hired make most of the meal Jo does the more North American comfort food dishes). After dinner we all went out to the traditional Voudou night with a bright fire, drumming, singing, dancing and celebration of the spirits.

See you all when I get back

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Yahoo! Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!

Friday with Katrina Hicks

2008-11-14T21:37:00.001-04:00

G'day! Wow what can I say yes I did get peed on on my first day in Haiti with the kids. You quickly forget or do noot realize that they do not wear diapers down here. Certainly catches you with your pants down but hopefully not your mouth open!

Today we did a morning clinic and say opwards of 40 kids and adults by lunch. Ahhh lunch some of the simplest things, a bagette from the only French bakery in the north of the country, the Croissant D'or. Jo only keeps a 2 day supply so it is savoured. Melt in your mouth.

After lunch we broke into two groups with teams going to Bouchi, Mongoio and those drawing the short straw all the way to Giotan and hour and a half walk up the beach and a river crossing. We distributed in total 482 albendazole tablets and prenatal vitamins. Those that came from that far are a little dragging this evening. Everyone, especially those on their first trip were very much affected by the village visits and were so moved by how welcoming the villagers were. Inviting us into their homes and sharing what they had. Smiles and hellos all around. Compared to the villages being at Jo's is like staying on Main Street in a major town especially tonight wince we have set up village video night. On the special Sante Pou Yo movie sheet outside of Jo's we are showing Spiderman I and the kids and adults alike are spellbound. You can hear a pin drop. Especially now that the chickens and roosters have gone to bed and given that we had rooster for dinner we may get to sleep in. When is goat night?

Must go back to teaching the Canadians how to play cribbage.

Katrina

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Yahoo! Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!

Thursday with Carolyn Lemay

2008-11-14T09:33:00.001-04:00

Ah yes that soft hum of village activity that eases you into every morning in the village. That is of course until the goats start bleating at the top of their little goaty lungs and the roosters that will inevitably soon see the inside of a pot start crowing at what, the moon since the sun can't possibly be up yet. Who would have thought that the sweeping of dirt would be so loud. All of is a welcoming cacophony that says you are certainly not home anymore.

Today we headed out to the clinic in Bas Limbe to meet with the doctors there and to work with them to expand our presence in the region and to reach out to the others. We saw over 120 children doing triage and pharmacy from a small church in the community. We treated a child for TB which is something which can cause great difficulty down here and will require followup for some time. I would think one of the most interesting things I have seen on this my, Wow, third visit is the young child who came in with an extra finger on each hand. While non-functional it looked just like an extra finger and who is to say that is not a bad thing ( a line stolen from Mr. Burns of the Simpsons). We offered the mother and child to opportunity to return to the clinic on Saturday where we could remove the extra appendages safely. We shall see if the come.

In Bas Limbe we met up with the delayed member of our team Kyle Phipps who never having been out of North America before has been baptized with a trip on Air Lynx himself and the entry into the Cap airport the ride by cab, school bus and then motor bike to catch up with us. I will leave the telling of this harrowing tale to him during his entry. I do understand that he did forget and brush his teeth with tap water this morning. We will see how that works out for him in a couple of days. Some of the team chose to walk the hour back to BML while the rest of us went ahead in the truck to get started on the charts and do some village visiting.

Jo as always never fails to impress with Italian for dinner and a lesson of Creole with our translator Jean and cards into the night while Tiffany met with the Sante Pou Yo village committee. Tomorrow is another day.

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Ask a question on any topic and get answers from real people. Go to Yahoo! Answers.

Wednesday With Mary Anne

2008-11-14T09:20:00.001-04:00

Hello from Bod Me Limbe! It is my first time back since the first visit in February of 2006. Wow what change. Well accept for one thing like the warm welcome offered by the local welcoming committee courtesy of bed bugs. No matter how many precautions you take from bug spray to plastic covers to silk sleeping sacks someone always gets it. This time it is me.

We did our first Peds Blitz day and saw over 110 children from the village. I am amazed by the change in their health from my first visit. Malnutrition is down, skin infections once a given are now few and far between. This is all due to the combination a available medicines and public health education. It really works.

We did see a few interesting things including one child with malaria and another to whom we provided money from our fund to send her to the clinic in Milot for a heart investigation. We provided the child with nutritional supplements and some support to the mother to deal with the underlying malnutrition.

We had a surprise and welcome visit from the UN today. An Eqyptian and Nepalese Police Officer along with their Haitian counterpart were on regular patrol and heard that we were in the area and decided to drop in an say hello. It is always heartening to know that there is someone out there should something unexpected occur.

It was great to see that the Guest House was completed. No more tents for me. I can not say enough about the benefit of a cold shower at the end of long day followed by a soft bed.

One of our new recruits, Katrina Hicks from Australia via Bermuda was "christened" today with the first pee shower from a child during the Peds day. Always a crowd pleaser to everyone but the one receiving the gift. We also had one afterhours emergency visit from a child with a head wound which was closed up nicely with some of the wonderful DermaBond like duct tape is there anything it can't do

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Now with a new friend-happy design! Try the new Yahoo! Canada Messenger

Peds Day 1

2008-11-13T09:45:00.001-04:00

Hi folks we did our first peds blitz day yesterday and I am extremely pleased to report that it is clear that children are healthier since the last peds day almost a year ago. This is great news!

We did over 100 kids before lunch so I can say that recruits both new and old are quickly into the swing of things.

One interesting story for the day. The teachers at the school brought to us a young boy with fever and aches and pains. We did some lab work and discovered that he had malaria. We medicated him and left him to rest in one of our clinic rooms. By the end of the day he was looking better but he has a recovery ahead of him

Until next time

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

All new Yahoo! Mail - Get a sneak peak at messages with a handy reading pane.

Day Two

2008-11-12T07:52:00.001-04:00

Today was the first clinic day and it was one of re-checks. I am pleased that we had only 75 patients for the day which indicates positive results from having our Doctor and Nurse, Mona and Iranese in place.

The team finished up with patients and organization by noon and took the unexpected opportunity to visit Isle Caramel for some swimming and Creole lessons with the translators.

Tomorrow is our first Pediatric Blitz. It will be a hectic one.

Tiffany

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Now with a new friend-happy design! Try the new Yahoo! Canada Messenger

Back in BML

2008-11-11T21:35:00.001-04:00

Hi folks just to let everyone know we have all (sort of) arrived back in Bod Me Limbe. I say sort of since Kyle Phipps did not make the connection due to Air Canada mechanical problems and ended up back in Halifax. He will be joining us on Thursday. I bet he did not plan on making his first trip to Cap Haitien on his own. don't worry we have one of our trusted local workers picking him up. If you are reading Kyle enjoy the Tap Tap!

The Guest House is now officially completed and it is beautiful. To all of you who stayed in school rooms and tents thank you for your patience. To all those who may not have come because we were living rough this place is now luxurious! Relative term of course but everyone gets a bed, there is running water, flush toilets and all the electricity the sun can produce. Oh yeah and the official opening of Jo's Crappy Bar was last night. For those of you that know you know what we are talking about. Sentile has a new calling.

Well the pills got sorted the rooms rigged up and today was our first clinic day. All went well and we are very pleased to be back.

Blog to you soon

Tiffany

Tiffany Keenan, MD CCFP

Ora International

Director: Haiti Village Health

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

Bermuda. 441-599-9913

Canada. 506-474-2429

skype. tiffany.keenan.1971

Yahoo! Canada Toolbar : Search from anywhere on the web and bookmark your favourite sites. Download it now!

A Successful Trip

2008-09-29T15:29:00.002-03:00

Well I've made it back again safely to Bermuda. The trip overall was very busy but I was able to get a lot accomplished. On Tuesday I worked with Iranese at the clinic and finished the organization of supplies. She is doing well and enjoys her work at the clinic, however, she just announced that she is expecting but luckily has another RN to take her place for three months.

I was able to meet with the members of the Baptist Church sewing committee. The group is a little slow getting things off the ground. They have made arrangements for a teacher to come to the village. Now, the logistics of payment for the teacher/gasoline and supplies need to be fine tuned. It is difficult at the moment for people to find money for any type of schooling when the cost of food has increased greatly.

I also met with our Sante Pou Yo village committe. We discussed the upcoming project of Gift of Water, and they will search out an individual to be in charge of the program in the village. We discussed the mosquito nets, and the villagers are anxious for their arrival.

On Wednesday, Jo and I left Bod me Limbe for Cap Haitien where we met with Sharon Gaskill of the Starthrower Foundation. Sharon supports children and teens from Cap Haitien in school. She has a wonderful organization and has seen the joys of her hard work in many of her students attending post-secondary education.

I was also pleased to see Sister Rosemary, of Rayjon ShareCare, Cap Haitien Community Project. Our team first met Sister Rosemary at her day program and feeding center in Cap in February 2006. She recently returned from Canada and is working at the Missionaries of the Poor in Cap Haitien.

After a pleasant lunch with Sister Rosemary, Sharon and Jo I headed to the airport for my return flight to Port au Prince.

I met with friends there and discussed the present situation in Haiti. The whole country feels for those that have lost their families and homes, in the north, central and southern regions. There is actually a fundraiser planned in Cap to send support to those in most dire need in the area of Gonaives.

The situation looks bleak at the moment. With soaring food prices and the loss of Haitien crops, I believe it will get much worse before things start to improve. Food aid is coming to the country. Let us all hope that it gets to those most in need.

In our area, we will continue to push forward one day at a time. Helping as many patients as we can that present to our clinic. The children are anxious to return to school in October. It is the children....and their health and education....that will give this country hope for the future. They are the future of Haiti!

Our next group Medical Mission is planned for November 9th-20th. I will continue to send updates at that time.

Day 2 in BML

2008-09-22T22:01:00.001-03:00

Well last night we had the dinner with the village. Everyone got rice and beans and some pork. I ran the sauce station. We distributed 2 barrels of Juice! Everyone had a great time with dancing and music.

Worked today with Iranese and Mona once again and they are doing a great job.

Till next time

Did I mention it is really hot!

Tiffany

Tiffany Keenan, MD CCFP

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

cell. (Bermuda). 441-599-9913

cell. (Canada). 506-210-2477

vonage. (Canada). 506-474-2429

skype. tiffany.keenan.1971

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The Day In BML

2008-09-21T13:58:00.001-03:00

Got up in the heat this morning and started out with an inventory and audit of the clinic. Pleased to report all is well and Jo has sorted all of the donations and meds from the barrels we sent down this spring. In fact he has already made use of several as rain barrels. Did I say it was HOT!

Oh I should mention the villagers helping me capture and eliminate several of the largest cockroaches I have ever seen from the clinic.

The boys are setting up now for the dinner this evening and everyone is looking forward to it. I will post some photos when I get home.

Till next time

Tiffany

Tiffany Keenan, MD CCFP

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

cell. (Bermuda). 441-599-9913

cell. (Canada). 506-210-2477

vonage. (Canada). 506-474-2429

skype. tiffany.keenan.1971

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Haiti Update

2008-09-21T12:38:00.001-03:00

I arrived into Port au Prince on Thursday and was picked up by our good friend and angle Etienne Bruny. I spent the night with him and the 55 children to whom he is father, mother and protector at the orphanage. I am very pleased to say that the orphanage is in good shape and the children well. Great thanks from Etienne and the children to all those of you who help out. He also have 6 babies at this timw between 9 months and 2 years as well as 250 children who come to the day school. Before all went to bed all the children gathered around and sang bedtime songs and one child starts the bedtime prayer and all others join in. A very touching moment for me.

On Friday I hopped a plane to Cap and was met by our friend from Montreal Pierre Minn who guided me around to my meeting with Dr. Calil of the Justinian Hospital ER. These are the Konbite Sante folks from Maine with whom I am working to reestablish emergency service in Cap.

I met Jo the next day and we spent most of the morning in the markets gathering the food and provisions for the grand opening of the clinic. In reality it is an opportunity, at least for 1 day to feed the people of BML who are in dire straights of late just like the rest of Haiti with skyrocketing food prices and Hurricanes. For instance a bag of rice is now over $60 and a gallon of gasoline is $10. The usually crowded roads of Cap are erily quiet.

I went to Labadie with Jo for the night and we invited the new Cuban Doctor, Lianne over for dinner at the HTFH House along with the nurse. She informs me that the vitamin distribution went very well and was well received and we agreed to do a peds blitz at the end of the next trip in November.

Arrived to a very hot BML with Jo. The Guest house is nearing completion and Jo has painted murals in the kindegarten classrooms at the school. Iranise is doing well and I will be spending a couple of day with her this week.

More updates to come

Tiffany

Tiffany Keenan, MD CCFP

www.haitivillagehealth.ca

7 Marley Beach Drive

Warwick WK08

Bermuda

cell. (Bermuda). 441-599-9913

cell. (Canada). 506-210-2477

vonage. (Canada). 506-474-2429

skype. tiffany.keenan.1971

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On my way

2008-09-18T14:18:00.002-03:00

Just preparing to leave Miami for Port au Prince. It will be an interesting week. The main goal of this trip is to followup to the clinic opening in July. As well, I will be meeting with the director of the Emergency Department of the Justinian Hospital to followup on my work with Konbite Sante.

This evening I will be staying at the orphanage Espere D'enfant, with Etienne Bruny. It has been almost 2 years since I have seen Etienne and the children. It will be interesting to see how they have grown, and the building as well, with it's second story.

I will be travelling to Cap Haitien tomorrow then off to Labadie and Bod me Limbe on Saturday. I'll send updates from Jo's Blackberry when I can.

Tiffany

Update

2008-07-23T13:30:00.002-03:00

Just wanted to give an update to our blog followers.

The clinic officially opened on July 10th. We have a full time nurse, Miss Iranese and part time physician, Dr. Mona Alexis working for us.

The Medika Mamba or peanut butter program is continuing as is our family planning program.

Miss Iranese will continue the vitamin distribution program in the village as well.

I will be travelling to Haiti in Mid-September to ensure that things are running smoothly before the team arrives in Mid-November. Jo's guest house will be completed shortly giving everyone lovely accommodations for the next trip.

Second week

2008-05-17T12:51:00.000-03:00

Sorry for the delay in posting again but it has been extremely busy. In the last few days we have done a series of minor surguries courtesy of carl vitamin visits to bouchi guiotan and bml conducted a baby blitz started the manba (a locally made nutritional supplement) program for malnourished children courtesy of yoella and had a record day of 250 patients.

We set up a data projector that pat brought and he and mat showed photos of previous vists and the real highlight shrek. Now we will make movie night a real occurance. Last night we did the village choir concert and at the request of everyone showed the photos again. James did a excellent turn as a broadway director and his production of how to not get diareaha was better than cats

Maybe most importantly mariana barboasa was christened yesterday with rola amy and myself standing as godparents. We were so proud and extremely sweaty. 200 people in a concrete box generates a lot of heat on a 30 degree day

Well off to work it is a bouchi baby blitz day and we are expecting 120 people. There is already a line and it is 6 am
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Beware the blitz

2008-05-17T12:50:00.000-03:00

Hello out there in the blogosphere! Another morning begins in haiti. I am sitting on the landing of kay jo which we have dubbed the hotel like second floor of the new guest house. I am pleased to report that we now have electricity two showers, three if you count the al fresco one which seems to be the hands down favourite, running water, flush toilets and now actual beds! Kudos to those who are still sleeping at the school until the other half of the kay is complete

Again all are well and none the worse for the week of baby blitzes and vita mornings in the various villages. Pat contines with the assistance of lab leon and his protege chris to formally test the waters so to speak. The results are nasty lending support to our quest to find the proper means to improve water quality here

Funny moment of the week was magda slipping in the mud at bouchi and the being hosed down by the village women in the limbe river. Not sure if that actually made her cleaner

Oh leon and chris during down time of course tested jo moonshine for potentcy and found it to be 100 proof which might explain the spirits that walked on the night of the voodoo dancing once again complete with firewalking

Pat chris and jame continue to work on the brulle or burner where we will destroy our trash. All is well after the initial challenges such as missing tools a wheelbarrow with a flat tire and a pump with a broken valve. All hopes are to have it complete by weeks end

Carl has been doing procedures and trying to train our haitian nurse which brings to mind the phrase paitients of job

Must go now as it is 530 am and the crowd is already growing

Mesi anpil pou ou ecoute
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Beware the blitz

2008-05-14T07:09:00.000-03:00

Second week

2008-05-13T19:47:00.000-03:00

Second week

2008-05-13T08:07:00.000-03:00

Saturday, Sunday, Monday updates

2008-05-12T22:53:00.001-03:00

Just an update from the team in Bod me limbe. Apparently Jo's Blackberry is down so I'll relay the messages for now.

Saturday, part of the team did a vitamin distribution program in 2 nearby villages. They then returned to help the others finish up clinic seeing over 250 people. The evening was a social night with Haitian drummers and singers just outside Jo's house.

Sunday, the day of rest and the Christening. Marianna Lara Barbosa was christened at the Catholic Church and Marie-Claude's baby Sterlove at the Baptist church....both with Canadian Godparents of course. The events were followed by lunch for the team and families at Jo's house. later in the evening the team held the second Concert Night in the village. Steve says the performances were entertaining.

Monday, this morning started out with the Guioton baby Blitz. They got through the Guiotan village children by 10 am and were able to see children from the more distant villages of Titoit and Noman. After lunch more adults with appointment cards with a finish time of around 4:00. In total 84 infants and 54 adults.

Pat and Chris started working on incinerator today. The main purpose of which is to dispose of our medical waste. Chris has also been doing a great job in the lab, having been trained by the master leon. He also observed Dr. Carl doing medical procedures. Dr. Magda has given up her office to our new nurse, Miss Iranese who is following under Carl's careful guidance. Magda is now floating between the 3 triage stations and apparently is doing a great job replacing me.

Steve said the heat was unbearable today as well. I checked online and Cap haitien registered at 33...and plus there's humidity on top of that. Let's hope it cools off a little for them the remainder of the week.

Tiffany

Tiffany Keenan, MD CCFP

5630 Highway 108

Derby Junction, NB

E1V 5J1

cell. 506-624-8637

home. 506-624-9913

skype. tiffany.keenan.1971

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Friday Peds Blitz

2008-05-12T09:14:00.000-03:00

Well after such a long day on Thursday we weren't sure what to expect with our First Peds Blitz. This idea came as a result of the January trip when I asked parents to bring their sick kids and Dr. Magda and I ended up seeing 85 in 2 1/2 hours, over 75% of which received antibiotics.

So, the morning started off as usual with our registration and soon the kids were lining up. We doubled up our registration staff and changed our room arrangements. In general pediatric histories are a little shorter so we teamed up an MD, RN and support person for weight checks. It was a busy morning with a constant flow of children under 5.

One child particularly touched me, just 2 months old and born 2 months premature she was still only weight 2 kg. The mom was young as well and as this was her first baby she is at very high risk. For the first time, I'd seen a tree leaf on a child's head. The fontanelle was quite large and they felt it would protect the baby. Also, for the first time I saw a small child's sock used to keep the baby's head warm. The infant was so small the sock stretched enough to cover the entire scalp. Seeing this small neonate, I understand why infant mortality, at 12%, can be so high in Haiti.

We also identified 5 children for our new Mamba progam on this day. They will return on Saturday for group education about using this new peanut butter vitamin/nutrition supplement.

So by 12:30 we had seen 150 children under 5. I was surprised to finish up so early.

Everyone was a little exhausted from yesterday so we could it easy in the afternoon. Nancy did some education with Iranese, our new nurse, about dressings and the rest of the team helped organize the charts.

Around 2:30 we headed over for a needed break at Isle Caramel. The water was refreshing and it gave the team time to discuss the week's clinic to date.

During the evening, I got news about a family medical emergency so I prepared to make arrangements to travel home. The team is in good hands with Karen Cimer, RN from Newfoundland and my husband Steve.

Tiffany

Tiffany Keenan, MD CCFP

5630 Highway 108

Derby Junction, NB

E1V 5J1

cell. 506-624-8637

home. 506-624-9913

skype. tiffany.keenan.1971

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