Day 1 as "Gwo Boss" aka "Big Boss"

I made it through the first day as 'gwo boss' which translates big boss. We've got a great group of talented practitioners who have already started learning Creole from the techs and are jumping in teaching them too.

Today we saw patients that came up from Port-au-Prince as well as some patients who live nearby. There were quite a few patients leaving L'Escale and others arriving to take their place. L'Escale is a small housing complex on the HAS grounds that provides temporary housing for our patients as they go through the rehab process. Port-au-Prince is a two-and-a-half hour ride away so it's wonderful for our patients to have a place to stay.

We had a heavy rainstorm this afternoon and now the air is cooler. It's been a very nice, relaxing evening. Oh, and tonight was spaghetti with hot dogs yet again. I'm going to keep a running tally so if you see a random number on future posts that will be the hot dog spaghetti meal count. It's currently at 3.

Tomorrow I get to get up and provide more prosthetic care in Haiti. How neat is that!

An exciting adventure with a grand purpose

On the way to Cange today I sat on the passenger side with the window open. There is a section with a paved road and as we drove along I felt a pang of remembrance of my childhood.

I am blessed to have a wonderful father who was a teacher from the time I was in late elementary school on. So, that allowed for two solid summers of piling into our old, big, black suburban with a tent and supplies in the back, headed off to see America. I got to see many of our nation’s national parks, state parks and a large portion of Canada as well. We camped almost every night with an occasional motel stay to do laundry and freshen up. One time I got to go swimming at a hotel and then we went up into the Grand Tetons and it snowed! So, we have a photo somewhere of me still in a swimsuit and jeans with snow around me.

We did a ton of driving on these trips. Many hours spent looking out the passenger side with the window rolled down and wind on my face.

Now, the scenery is different, the people I'm with are different, and I am different. But I am still on an exciting adventure – this time with a grander purpose.

A lot of things are on my plate now that Jay's leaving. But, for a small section of time today, I had the opportunity to just look out the window, let the wind kiss my face, and savor this time I have here in Haiti.

A send-off for Jay Tew

Today was bittersweet as it was Jay's last day at the Hanger clinic. It was full of goodbyes, warm embraces, the occasional shared remembrances and final photos. Here's one I took of him with the Haitian staff:


I know Jay is torn -- he is really looking forward to being back with his family but he has also grown so close to his surrogate family here.

Tonight there was a get together in Jay's honor and for a therapist leaving at the same time. From the large attendance you could tell the impact Jay has had here. There were even a couple of patients there which I know was special for Jay.

Jay left some big shoes to fill and no one can be him. He has substantially contributed to the creation of a top-notch prosthetics facility here in Deschapelles and I plan on seeing to it that we continue to excel in providing prosthetic care to the wonderful people of Haiti.

Needless to say; Jay will be missed here. We'll be in touch though.

He may be leaving Haiti for now, but Haiti will never leave him.

Another view of Haiti

This morning the whole team got up before the rooster to hike to the top of nearby hills to see the sunrise in its pink and orange brilliance over mountains on the other side of our valley.

I left to head back a bit early so I could make it back in time for the morning time slot that our house has running water. I got a bit off the trail on some rocky, sparsely vegetated terrain. I was a bit flustered trying to get back to the path when I saw a beautiful pink flower growing from a crack in the rocks; such beauty in the midst of a seemingly harsh hillside environment.

The patients I get the pleasure of working with each day here are like that flower. The beauty of their smiles just radiate! Yet, so many have suffered so much. My heart breaks to hear how one of our patients was the only one in her family to be pulled from the rubble alive or how another was the only major injury in her family (losing both legs above-the-knees) only to be abandoned by her husband and left with her four children to care for with no home or means of support. Yet, in the midst of such suffering there is the beaming smile of pride when she returned after making a lap around the block here-and it was a feat worthy of celebration! Rocky terrain, sweltering heat, humidity, an upward grade heading away from the clinic, a downward grade coming back and all on two above-knee prostheses, crutches for balance, and pure determination. Amazing!!! And a triumphant smile. To compare that smile to a flower is like comparing an expedition to the top of Mt. Everest with our little morning hike. It pales in comparison.

Photo updates from Jay Tew & Anna Avakian

Business phone calls Haitian style

Dancing with mama while doing floor exercises at the Hanger Clinic

A patient at the Hanger Clinic kicking the soccer ball around

Hanger practitioner Ryan Russell on Sunday en route to a rare beach day in celebration of Jay's last week in Haiti

This was taken in Cange on a beautiful mountain tree top veranda area of the hospital where hearts were breaking after Jay broke the news to two of his patients Carmen and Mike that he's leaving Haiti. They responded in what has come to be the usual question, "When are you coming back?"
Carmen and Mike continue to do wonderfully.
At a weekly appointment at the Cange clinic

Seeing a different side of Haiti

Yes, I am still in Haiti but, if I wasn't here looking at this scene right now myself, I wouldn't believe it either.


This is Jay's last Sunday here so in celebration, we all hopped on a tap-tap and came to Indigo Resort for the day. It looks like we walked into a postcard or one of those beer ads on TV. I've not seen anything like it. It's truly an oasis amid the heat and mosquitoes.

In a little while, 12 of us will again hop in a tap-tap for the hour and a half dusty, bumpy ride back to Deschapelles. A tap-tap is the Haitian public transportation. It's basically a pick-up with seats and railings. It gets that name, I'm told, from the way someone lets the driver know they want to stop to get off. They tap a couple times on the side of the pick-up, the driver hears this and stops. There's a little joke here about tap-taps:

"How many people can you fit in a tap-tap?"
Answer: "One more!"


They also transport live animals and goods to the market in tap-taps.

Today is a wonderfully relaxing way to gear up for the busy week ahead. I'm looking forward to tomorrow because the cute little 4-year-old girl from Port-au-Prince that we cast last Wednesday is coming! I'll have my tape measure and hair ready (if this is confusing, scroll down to last Wednesday's post).

When in Haiti...

This morning I was too tired to hear the rooster, he took a day off from taunting us, or maybe someone had a satisfying dinner last night.

Well, you'd never guess what meal we had for breakfast -- you may have seen it all too recently here on the blog. Somehow no matter how delicious, spaghetti still doesn't seem like a breakfast food. For that matter, neither do hotdogs. But hey, when in Haiti...

Here's what our view was this morning:

Lunch was a tasty goat and okra dish over rice. Dinner was a quiche type casserole with carrots and possibly salami. Each new meal adds an element of mystery to the day. Kind of like those grab bags you'd get as a kid.

My dad is a math and earth science teacher who loves rocks so it seemed like we frequently went to gem and mineral shows when I was younger. These are basically events where one could buy any type of rock/gem/mineral or tools and accessories for working with them. Fossils were also common items sold. Other than spending time with my dad and seeing all the pretty colored minerals, my favorite part was the little grab bags that my dad would usually treat my sister and I to. We'd anxiously wait to open our bags sometimes not wanting to open them right away because our imaginations and hopes of what could be inside only existed when the little brown bags were stapled shut.

I used to always hope for a stone called tiger eye which is neat looking or a mineral called mica which peels off in little sheets providing hours of fun for a kid hanging around a gem and mineral show. Random tidbit of info on mica: they used to use mica as oven windows. I'm sure some poor bored little kid got in a heap of trouble after discovering that the oven window peeled off in little layers.

All that to say that you never know what will end up on our plates here, but one thing's for sure -- it's all been tasty!

Today the amazing teamwork continued and most of the 20 molds that were modified yesterday became full prostheses today. After work, Jay and I met with two PTs and the case manager. It's a regular team meeting to continue to coordinate care for all the patients treated by the Klinik Hanger (Hanger Clinic).

This evening we all got to experience a true Haitian party. One of the guys who works at the hospital has a band and they played while everyone enjoyed hanging out and some of us danced. Thankfully for us gals, Haitian dancing is fairly easy to learn. You just move your feet in rhythm with the music and follow your partner's lead. It was a blast.

Tomorrow Jay and I go to Cange to work with amputees there. It's about 2.5 hours away on a windy road according to Jay.

Spaghetti with hot dogs for breakfast anyone?

The rooster that previously annoyed the men waged war on the girls’ side of the house this morning. I think he gets some twisted satisfaction of waking us at 4am and taunting us as we try to savor the last hours of slumber. The guys swear he makes his rounds of the house though, so I guess it’s not personal.

This morning we all descended on the casts from yesterday like anxious children opening presents on Christmas day. There were only 3 modifying stands in the cast room but practitioners spread to other rooms for modifying as well. Throughout the day we saw the normal influx of patients at the clinic (or Klinik Hanger) and were able to modify all the casts. Many are already in production! Such teamwork!

Until this afternoon I was starting to think that I’d been spared the rainy season since I hadn’t seen any rain. But, it poured this afternoon! A wonderful change because it cooled off the lab.

When I read blogs I always like pictures so I’ll give you one of an interesting meal we had a couple of days ago. Apparently, this meal is served for breakfast and we saw it for dinner that day. It’s a spaghetti with hot dogs and some spice.

A productive day in Port-au-Prince

For some reason, mornings here seem to be both too early and yet full of excitement and enthusiasm for what the day holds.

This morning, Jay and I hopped into the back of a small van headed to Port-au-Prince with the type of AC that consists of opening all possible windows and being grateful when the van is moving. The other practitioners stayed at HAS to see patients there. Thankfully, we moved most of the 2+ hours down to the New Life orphanage in Port-au-Prince where a constant stream of amputees were waiting to be cast.

We saw some children from the orphanage, but it also serves as a location to see patients that come in from the Port-au-Prince area. We saw a total of 24 patients and came back with 20 molds. Not a bad day's work! Especially since we didn't start until around 10 and left around 3. Here's a photo of all the casts Jay and I took today:



There was one 4-year-old little girl with an above-knee amputation who was brought by another charitable organization accompanied by her mother. She was a bit shy at first, but after a blown-up rubber glove was transformed into a chicken for her and we played with a retractable tape measure, we became fast friends. She seemed enthralled by my hair and just liked touching it. Very cute! Schneily definitely has some competition. :)

Tomorrow, the morning may greet me earlier than I want but with 20 casts and Haitian coffee waiting for us, it should again be a great day!

Art therapy

Jay Tew takes a quick break from fabricating prosthetic limbs to color with some of the younger patients at the Hanger Clinic located at the Albert Schweitzer Hospital in Deschapelles, Haiti.

Anna's first day at the Hanger clinic in Haiti

Wow, what an amazing first day!

It seemed quite early this morning when a confused rooster welcomed the guys around 4am. Such friendly wildlife :)

The deluge of patients started at 8 and we didn't even break for a quick lunch until after 2. But, such rewarding work! The smiles here melt your heart.

Speaking of amazing smiles, I got to see Schneily today. If you don't know who that is, he's an amazingly cute 4-year-old that msnbc.com has been following. A ball of joyous energy and your friend right away. He is doing wonderfully! There was even a visitor today who asked which side his amputation was on! Here's some video of Schneily playing soccer ("football" here in Haiti) with Jay.

In the afternoon I got to work with a wonderful woman who lost a leg above-the-knee and an arm above-the-elbow on the other side in the earthquake. This afternoon, she got her prosthetic leg for the first time and was walking without her crutch by the end of the day! Wow!

*The above is a blog post e-mailed from Anna Avakian.

Arrived Safely

"You have to rethink normal". That was Jay's comment after telling us some of the unique patients, experiences, and challenges that he's faced here.

So, as you may have gathered, we arrived safely. A smooth meet-up at the airport with Jay followed by a 2 hour or so windy drive up to Deschapelle, unloading bags, tour of Kay (house) Hanger, tour of the amazing clinic/lab, a quick nap, a flavorful lunch. Afterwards, we went on a tour of some of the village surrounding our clinic and L'Escale – the small community where our patients are staying. It's wonderful for there to be a place for them to stay and to build relationships with each other. Almost like a built in support group.

One neat piece of Haitian ingenuity we saw was what they do with some of the goats. I'm told that if a goat gets into another person's garden then the owner of the goat has to pay restitution. So, to keep the goats from sneaking in between the cactus fences here, they put a big 'ol stick on them hanging from the neck. Ingenious! Here's a photo: Well, that bed is calling my name. Tomorrow morning bright and early the patients arrive!

*The above is a blog post e-mailed from Anna Avakian.

An update from Miami

Well, I successfully packed and am now in Miami. This morning I took a break from last minute preparations to have breakfast with a friend and seemed to be saying goodbye to people all day. A flurry of last phone calls and an occasional hug goodbye.

I also savored creature comforts all day. The bacon with my breakfast, the DC sights I walked by, the diet soda with ice on the plane. Even the air conditioning on the plane that made me thankful for my one sweatshirt I've brought was a reminder of all the comforts we take for granted that I may miss. Kind of reminds me of that book some of my friends read to their children, Goodnight Moon.

I ended the evening by grabbing a snack with two of the other practitioners coming in for a two week rotation. I said goodbye to ice cream. One of the first times I spoke with Jay I vividly remember asking what he missed most. "My family!" was the first response but shortly followed by ice cream.

Here is a picture of me with all of my bags.

Tomorrow begins another exciting chapter in my life-can't wait!


*The above is a blog post e-mailed from Anna Avakian.

Anticipation of the big departure

The following is a blog post from Anna Avakian who over the next two weeks will be transitioning into the role as lead prosthetist at the Hanger clinic in Haiti:

Wow. In only one day I will be on a plane heading for Haiti to help provide prosthetic care for those affected by the 7.0 magnitude earthquake that struck the country the afternoon of January 12, 2010.

Life forever changed for so many in such a short time. I cannot begin to imagine what living through that would be like. Nor could I imagine surviving such a horror, only to be told hours, days, or weeks later that my injuries would result in amputation. But, I have the amazing honor to be able to make a difference to those dealing with limb loss in Haiti, thanks to the Hanger Ivan R. Sabel Foundation.

One thing I will miss is my regular letters back and forth with my grandmother who lives in California. She's a spry 94 years old, plays piano for church as well as a local choral group, and walks at least a mile a day (most days more but always at least a mile). Yep, she's wonder woman!

So, since the internet is much faster than a letter from Haiti, this blog is kind of a way for me to write her. Everyone else gets to eavesdrop :)

Here are answers to some of my grandma's questions:

Who will you be working with?
Short answer: Many talented people who share the goal of providing sustainable, long-term, high-quality prosthetic care and rehabilitation for Haiti's amputees.

A little background for this answer: The Hanger Ivan R. Sabel Foundation is a 501c3 charitable organization that has partnered with Hospital Albert Schweitzer (HAS), the Harold and Kayrita Anderson Foundation, Physicians for Peace, Catholic Medical Mission Board, and Donald Peck Leslie MD. Together, they have formed the Haitian Amputee Coalition. I could go on but the websites are much better at explaining it – plus they have photos. There's a great one of a little boy fist-bumping Kevin Carroll CP – the VP of lower extremity prosthetics at Hanger. And one of a girl smiling. Here's that site: http://haitian-amputee-coalition.org/

This effort is run on donations. It may not be possible for people to go to Haiti and make prostheses themselves, but your donations will buy the fiberglass to take the mold of a patient's residual limb, the plaster to fill the molds, the plastic and resin to make the sockets (the part that's custom-made for each patient to fit their residual limb), and donations send the prosthetists, therapists, and others who have the privilege of working directly with Haiti's amputees and restoring mobility. The Foundation has also hired four Haitians and is training them as prosthetic technicians. One technician is a bilateral amputee (meaning both legs) from injuries sustained in the earthquake. Now, he is learning and helping his countrymen! What resilience!

Where will you be?
The prosthetic clinic and lab that has been set up is located on the campus of Hospital Albert Schweitzer (HAS). HAS is located in Deschapelle, Haiti which is about 60 miles north/northwest of Port-au-Prince. The hospital buildings were unaffected by the earthquake.

What will you be doing?
The same thing I do in the US with the added challenges of heat, humidity, and mosquitoes to name a few. But, it comes with the added reward of helping amputees who live in the poorest country in the Western Hemisphere, who have come through so much since that January day.

Are you excited?
Yes!

What are you most concerned about right now?
Right now I'm concentrating on packing well and finishing up with patients here in the US so that they have a smooth handover of care while I'm gone. I work with excellent practitioners and staff who are all stepping in to take up the extra load. Thank you Heather, Robert, Hannah, Johnnie, Edie, Jonica, John and Terry!

When do you leave?
This Sat. I'll fly to Miami and Sunday morning I'll fly to Port-au-Prince. So close!

A new face at the Hanger clinic in Haiti

Hanger Prosthetics & Orthotics practitioner Anna Avakian from Washington D.C. will board a plane tomorrow en route to Deschapelles, Haiti, the place she will live and work for the next three months. Anna has volunteered to serve the next three-month term as lead prosthetist at the Hanger prosthetics clinic at the Hospital Albert Schweitzer (HAS) located 60 miles from Port-au-Prince in Deschapelles, Haiti. Fully functional since February 22, 2010, the Hanger prosthetics clinic in Deschapelles has already achieved notable success and outstanding patient outcomes under the leadership of Jay Tew, a Hanger practitioner from Baton Rouge, Louisiana. Jay, who is currently serving the first three-month term as lead prosthetist, will transition his role to Anna during a two-week training process.

To date, nearly 300 Haitian amputees are walking tall with new prosthetic limbs created at the Hanger clinic in Haiti.

Get to know Anna Avakian, the soon-to-be new lead prosthetist, by watching her talk with her local TV stations about her upcoming departure.

In this news clip Anna talks with her local NBC station in Washington, D.C. and here, Anna talks with her local ABC affiliate.

Stay tuned for blog posts from Anna about her experience and work in Haiti.

An inspiration

The following is an update from Jay Tew as told to a member of the Hanger team over the phone:

In Haiti, it is very typical for people to carry items on their head. We’ve been working with a lady who had her leg amputated below-the-knee. After we fit her with her new prosthetic leg, she came walking up to the Hanger clinic, up the ramp and onto the porch with a giant bowl containing all of her supplies including food and everything she needed for the day. She had no cane, no crutches, and was just walking with her new prosthetic leg carrying this bowl on her head that weighed probably 20-30 pounds. This is a great example of her returning to a productive lifestyle, consistent with local culture and customs. It was amazing to see.

Welcome to Haiti!

The following is an update from Jay Tew as told to a member of the Hanger team over the phone:

One day at the Hanger clinic we had a bilateral above-knee amputee come up to the clinic on a horse. We tried to figure out how to get him off but the horse wasn’t cooperating! Once we finally got the patient inside, I told someone, “You think you’ve seen it all – what else will top this today?”

Not two minutes later, a bilateral above-knee amputee rode up to the clinic on the back of a motorcycle. He pulled up to the porch, put his arms up, swung around on the porch and used his arms and body to fluidly walk into the clinic. I thought – "There you go; welcome to Haiti!" That has been my new catch phrase – “Welcome to Haiti!” Because whatever norms you have or whatever you believe your life should be like or what others lives should be like, you just have to adjust and take it all in.

Hugs that will melt your heart

The following is an update from Jay Tew as told to a member of the Hanger team over the phone:

We’ve gotten the Hanger clinic up and running like an office; everything is flowing and working nicely. We also have a clinic in the mountains in Cange that is also flowing nicely. We travel to Port-au-Prince every Wednesday to see amputees at New Life Children’s Orphanage and we’ve seen some real special guys and girls from there. One girl in particular lost her family and had her leg amputated below-the-knee. When we first met her she was a shell of a little girl just sitting on a couch and not responding or speaking to us or anything. We took her back to the Hanger clinic in Deschapelles and got her fit with a new prosthetic leg and up and walking. Now, she hugs on to me and won’t leg go and hugs everyone! She is playing with the other little kids now too. We just brought her back home after spending a couple of weeks with us at the Hanger clinic and now she is a star at the orphanage!

We met another little boy at the orphanage who is hilarious! We were trying to explain to a little girl what her new leg would look like. We tried to explain that it wouldn’t be covered during the fitting process, but upon delivery of her final leg, she would have a cover on it. She was concerned and said she didn’t want a “pipe” leg. The little boy, who had his leg amputated at the hip overheard this conversation and in his native French Creole language said “I do, I do! I’ll take it!” He just wanted a leg so he could get back to being a little boy. We made him a prosthesis complete with a cover and he immediately started walking on his own; he’s a happy, playful kid again!