Final reflections from Jay Tew's most recent trip

Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. Following is his last blog post with reflections from Jay about the trip.

June 10, 2012

It’s time to depart once again. This time there is no one scheduled to greet the new person coming into Port-au-Prince; I am leaving and there’s no transition clinician to pick up the new person coming in. Joel realized this and asked if he could go and help with the new clinician pick up, “cause someone has to be there, right?” he says. I said, “Ok, that sounds like a good idea Joel, thank you”. The last I heard he is still making the Port-au-Prince run at 4am, headed over the mountain or down the coast to Port-au-Prince, greeting the new volunteer for Klinik Hanger.

I was there before the Klinik was built when Van (the founder of the Hanger Ivan R. Sabel Foundation and Haitian Amputee Coalition) introduced the mission and goal of the group. A sustainable clinic is the end result – send a focused group of professionals to a location in need, build a clinic, teach the people, and leave a sustainable clinic so the people of the land can continue to give care to their own in future times. Well Van, you did it. I couldn’t have dreamed it any better.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

June 8, 2012

This is a monumental day for Klinik Hanger and Hopital Albert Schweitzer (HAS). The rehab department led by David Charles has set up the first community outreach program. They have scheduled ten appointments with homebound patients in need of orthotic and physical therapy care. A group of us leave early in the morning including David Charles PT, a physical therapy assistant, Joel, Klinik Hanger technician, and myself. We head to the community of Leoncoeur through corridors, back alley-like roadways, and very rough terrain at times even hard for the land cruiser to pass. We have to head out on foot many times. We evaluate ten patients and head back with eleven casts. Our day lasted from 7am to 3pm. It was a long, hot day but worth every drop of sweat.

 

One of the best moments, and scariest for me, was our first patient visit. We got our gear and walked through alleyways to a cement-like structure of a home. The family helped bring out an older lady who was post-stroke with drop foot. I start placing our supplies out to cast for an ankle-foot orthosis (AFO) and as I remove the cast saw from the bag, it hits me like a freight train – there are no plugs here; we’re far away from any electrical source in this region. At this point I get cold chills (and it’s brutally hot); I’m trying to think what can I do. I still look at David and say with a quivering voice “guess there’s no electricity“. He just looks at me with a smile and says “no”. What an ignorant question but I had to try. Then I look to Joel and he says no worries boss I have my casting blade (utility blade that hooks away from patient to allow cast to be cut off safely). I cannot tell you how happy I was at that moment. I tell Joel he has saved the entire day my friend. He say’s “hey boss you always tell me be three steps ahead, so I bring it”. That was a great time and turning point for me because although I have had a great deal of time here, I still think like a foreigner at times. A Haitian practitioner understands the needs and situations best for their people; what the system is like and the needs once out of the protective walls of the clinic. I look at Joel and say, “Today is your day, I’m your assistant”. We evaluated everyone together and Joel applies and removes all casts today. I’m very proud to be here to assist the first Haitian rehabilitation community outreach program in this region we know of.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

June 7, 2012

The clinic is closed today because it is a religious holiday in Haiti, and the clinic observes the holidays of Haiti. Some of my Haitian friends invite me to a sacred religions waterfall to celebrate the day in the cleansing waters. We travel very far up the mountain to a magnificent waterfall called Seau d'eau. People light candle for prayer and bath in the pool beneath. We trek up the falls to the top where the fall feels like a load of gravel build dumped on you from above. We spend the better part of the day here. It still amazes me to see such despair and then see such beauty in the same place.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

June 5 – 7, 2012

There has been steady work in the Klinik, mostly fabrication and a few walk-ins these couple of days. Josef has left for Port-au-Prince. He is needed there to help with organization of a second prosthetic relief center. My German friend, I will miss you. I wish I had a little more time to work with him. It is a great thing to share your clinical and personal time with people from all over the world. You can learn so much from others whether it’s technical ideas or philosophical. Other than the purest form of giving and helping others who can’t help themselves, one of the most rewarding experiences is working over the past three years with all the Hanger and other volunteers here in Haiti. Getting to learn and take a little bit of each of them to make me into a better prosthetist and I believe, person as well, is priceless. I know I am not the same person who arrived in Haiti that Feb. 2010. I have been taken out of my bubble where my mind has expanded greatly and I’m a better person today. I wouldn’t trade it for anything in the world!

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

June 4, 2012

Today is a great day – everyone works the day through like a well-oiled machine. We are picking up orthotic pediatric patients every day. We had two more today for night splints, and one of the children was a little girl. She was nine-years-old, but about the size of a four-year-old. She was a sweet child with nothing but smiles.

One of our prosthetic practitioners, Alex, hurt his back at home. I believe it to be compression fracture of the lumbar (lower spine). He saw a doctor at the hospital and he said to brace it and don’t lift anything for a few weeks. This was a perfect time for him to learn about custom lumbar sacral orthosis (LSO). We all got together and casted Alex for his LSO. We filled, modified it, and instructed the whole way through the process using a broken branch from a tree, two pieces of a ½ round rasp and electrical tape. The guys learned the basics of bracing, above and below the injury. Then we pulled the LSO and trimmed it out to fit Alex. I only explained what and why we were doing the steps but the technicians did all the measurement, modifications, fabrication and fitting. The LSO fit very well and Alex is pleased and very proud of the work.

  

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

June 2 -3, 2012

This weekend I have off, so I have time to meditate and scout around the town and countryside. I take long walks and visit my friends down the corridor of Deschapelles. A group of friends are going to the public beach and ask me to come along. I agree and we take a tap tap to St. Marc then to Armani beach. We sit most of the day talking and enjoying our solitude. The UN soldiers are here and having their r & r. It all seems so normal to be here; I never thought I would be doing this in a million years. Then I remember the guy walking down the wall behind me whistling, twirling a shotgun and it merrily brings me back to reality; I think he’s the security guard.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

June 1, 2012

Today is another consistent day of patient flow. It consisted of adjustments, walk in patients, a new bilateral below-knee patient, and a new above-knee patient. Our pediatric population is growing; we had three more knee-ankle-foot orthosis night splints for the hospital today. Rickets, a disorder that leads to softening and weakening of the bones, is still commonly seen here.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

May 30, 2012

Today we fabricate most of the day and see a few walk in patients. One of the big projects of the day is reorganizing components, mainly feet. We have a great deal of boxes of feet from Physicians for Peace that we need to organize in the bins. If we don’t take time to organize, things will not flow when we’re busy.

May 31, 2012

Feet, feet and more feet! We try to finish our feet project today; even Roselean and her friend are helping. We finally finish later in the day. We spend most of the day talking about our objectives for the future. We go over orthotic principles of control and stabilizing of the body. We have mainly seen amputees in the clinic, but now we are starting our orthotic objective.

Reflections from Jay Tew – 4

Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.


May 29, 2012

Today the Catholic Medical Mission Board (CMMB) brings a van load of patients from Port-au-Prince. We see mostly adjustments of below– and above–knee amputee patients with a few new castings, just like a normal orthotics & prosthetics clinic.

We finish up our humeral fracture orthosis and go to hospital to fit the patient. Joel took charge of this case. We modified and he independently did the rest of the orthosis. I feel confident he will be able to handle the next one on his own. Everything went very well with the fitting; the patient is stabilized and in more comfort than before.

Reflections from Jay Tew – 3

Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.


May 28, 2012

Well, Haiti is still hot! I start my day as always – totally drenched in sweat early in the morning. It usually takes about three days for my body to acclimate. As I walk to Klinik Hanger I see my old friend along the way. I walk in and it’s like being home. Joel, Tchoe, Alex, Cira, Roselean and Yvener are all as before, sustaining the clinic.

For my first day our patient load is a consistent flow of below– and above–knee amputees, and now, pediatric patients in need of ankle-foot orthoses (AFOs).  

We get a call from the hospital about an unstable humeral fracture in the ER. So Joel and I are off to evaluate and treat. We arrive at the ER and the patient has a left spiral fracture of the proximal humorous (also known as a broken shoulder) and distal break, so we cast and start fabrication immediately.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.

May 27, 2012

I arrive in Port-au-Prince to be greeted by Josef Dobler, a German prosthetist from medi who is the current lead clinician at Klinik Hanger in Haiti. I get settled into our new home, Kay 11. It’s a little different than our last accommodations, but I’m thankful to have it. We live in the general volunteer area now and share our home and meals with all the volunteers from around the world. I like the change – it’s nice to live and learn with people from many different walks of life. My roomies are from Switzerland, England, Haiti and Germany.

Josef with a Klinik Hanger patient.

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Jay Tew recently returned to Haiti for a fourth rotation as lead clinician at Klinik Hanger. The next several blog posts are reflections from Jay about his most recent trip.


May 26, 2012

Happy Birthday to me! I left New Orleans to travel to Miami, and then I’ll continue to Port-au-Prince the next morning. We have a layover in Miami as we always do. There, we typically meet our teammates, organize supplies and prepare to hit the ground, ready for our mission.

There are usually three to four of us that come in together, but this tour is much different for me. We have moved to our next phase of relief at Klinik Hanger. We no longer need teams of three to four now that the Hanger Clinic has evolved to a sustainable prosthetic, and now, orthotic clinic as well. I am not concerned going in alone since this is my fourth tour. My thoughts are filled with anticipation of seeing the progress of the clinic and all of my friends. The only way I can describe it is like having a child and having to leave them behind. You know you have to leave but will return and the excitement is overwhelming as you arrive back. Clinically my thoughts are to help further education, assess needs and assist.

On a lighter note, I decided to take myself out for my birthday. My plane arrived earlier than usual so I went to South Beach for a walk and dinner. The best part was when I grabbed a cab back to the airport hotel my cab driver was an older gentleman whose name was Joseph Jean St. Pierre. I recognized this name so I said “koman yea” (how are you). He looked back in surprise with an intrigued look. He says “pa pe mal” (not so bad). “Mwen rele Jay”, I say. He says “mwen rele Jean; Ha Ha ou pale creole?” We started speaking to each other about how I can speak Creole. Jean was very excited learning about our efforts in Haiti. I was able to bring him back home even if it was for a very short time. When we arrived at the airport hotel he wished me well and said the ride was on him, “Mesi zanmi mwen” (thank you my friend).

Welcome to the “Hanger Haiti Relief” blog

Welcome to the “Hanger Haiti Relief” blog, developed as a way for our practitioners who are working in Haiti to communicate their experiences. A little background – On February 17, 2010, Hanger Orthopedic Group and its philanthropic organization the Hanger Ivan R. Sabel Foundation partnered with Physicians for Peace, Dr. Donald Peck Leslie of the Shepherd Center, and the Harold & Kayrita Family Foundation to create the Haitian Amputee Coalition (HAC) in response to the immense need in Haiti for prosthetic care since the earthquake devastation on January 12, 2010.

Since then, the HAC has created a long-term prosthetic and rehabilitation center on-site at the Hôpital Albert Schweitzer (HAS), an undamaged local hospital with a high clinical reputation located 60 miles from Port-au-Prince in Deschapelles, Haiti. This clinic will be a sustainable program of medical care, training, education, and supplies for the people of Haiti.

Staffed by U.S. prosthetic experts from Hanger Orthopedic Group and Physicians for Peace in conjunction with local Haitian medical professionals, the Haitian Amputee Coalition prosthetic and rehabilitation center at HAS is fully functional and, in its first week, has already fit local amputees with custom-designed prosthetic devices. More than 13,000lbs of prosthetic fabrication equipment and machinery have been shipped to Deschapelles to create this facility. A mobile prosthetic care unit donated by Otto Bock Healthcare, a global manufacturer of prosthetic products and services, will soon enable the delivery of care to those who are unable to be transported to HAS.

This blog will be from the perspective of John "Jay" Tew, CP (certified prosthetist) from Baton Rouge, LA. Jay is a Hanger practice manager and recipient of the Hanger Excellence Award for Clinical Leadership. Additionally, Tew was awarded the Louisiana Distinguished Civilian Service Award, the Louisiana National Guard’s highest civilian Medal of Honor for his service to wounded soldiers returning from the Wars in Iraq and Afghanistan.

Jay volunteered to serve a three-month term at HAS as lead prosthetist for the Coalition's patient care delivery. He arrived February 22 and has already fit several amputees with prosthetic limbs and orthotic braces.

In honor of full disclosure, the posts within this blog will be the voice and perspective of Jay Tew, sometimes typed directly by Jay himself, other times emailed or dictated by Jay and typed into the blog by members of the Hanger team in the United States. Transparency and accuracy are critical components of this blog; if the perspective or author changes, we will make note of it.