Stories From the Field:

HAITI

Rehabilitation Medicine in Haiti

Dr. Rachel Lampros was awarded the prestigious Durant Fellowship to work with STAND Haiti which provides general medicine, orthopedics, pediatrics, neurology, women’s health, wound care, and prosthetics services in Port de Paix. Dr. Lampros is a staff physical therapist with the Sports Medicine Center in the Mass General Department of Orthopaedics.

At 7:00 am in the morning, the air in Port de Paix is heavy and still. It is already 82 degrees and humid. As clinicians walk through the entrance of the clinic, they are greeted with a sea of somber faces, both young and old. We see babies crying while mothers combat mounting fevers, fragile fathers, too weak to walk, carried in their son’s arms, and children bent in spastic postures on the ground. Many have travelled days to be treated. Many haven’t eaten in days to afford the travel.

Haiti is the poorest country in the western hemisphere where 80% of Haitians live under the poverty line and 54% live in abject poverty. There is no public health infrastructure making access to basic healthcare impossible for the majority.  Half of the children in Haiti are unvaccinated and more than 10% die before the age of five. Mothers provide two numbers when asked how many children they have: how many born, and how many living.

This October, I embarked on my third trip to Haiti to work in a small home repurposed as a rehab clinic every four months.  We provide multiple services including general medicine, orthopedics, pediatrics, neurology, women’s health, wound care, and prosthetics. We sleep, eat, and treat in the community. Our presence is tangible.  This marked my first trip as a Durant Fellow, revitalizing my purpose and polishing my practice.  Unbeknownst to me, Hurricane Matthew would craft a different narrative.

When we arrived early Saturday morning, Mathew was still a tropical storm warning.  Our team anticipated some rain, road closures and flooding; a recipe for inconvenient travel days at worst.  Located in the north-west region of Haiti, our clinic boasts "beach front property,” a coveted luxury during oppressive days but a dangerous site looming a storm surge. 

As Matthew manifested into a Category 4 hurricane, we were shocked to learn many of our neighbors were unaware of the storm’s imminent arrival.  Unlike the States where we were inundated with latest satellite imagery on Matthew’s trajectory, there was little to no awareness that we were on the threshold of possible disaster.

Despite closing the clinic for the day, we were swarmed with patients seeking medical attention.  We triaged the patients that required emergent care and sent the remainder home emphasizing the severity of the storm.  Projected winds of 145 mph and 25 inches of rain meant our neighbors living in tin sheds and tents would literally be swept away.  The forecast was devastating.

After Matthew decimated the southern peninsula, it took a hard westward turn away from our clinic.  We sustained little to no damage and minimal surge.  Our community was spared and our clinic reopened.

It is the “disease of poverty” that has chronically enveloped this struggling nation. The lack of indigenous resources, integrated resource management, and emergency medical response magnifies the impact of natural disasters and facilitates the spread of illness.  In the wake of Hurricane Matthew, this devastated country will become even more vulnerable to disease outbreaks and less equipped to manage its long-term sequelae.

As more post-hurricane relief efforts respond and the devastating aftermath of the hurricane manifest, our work in Haiti surges to the forefront.  I would like to thank the Durant fellowship committee for their assistance to the people of Haiti, for keeping me safe, and keeping my loved ones informed.  It is a privilege to represent the fellowship and to serve the victims of humanitarian disasters in our life, garnishing the spirit of Dr Thomas S. Durant.