Belated Greetings from Milot

Have been at the hospital for 4 days. There is a single internet access, and I have been spending some time working on repairs, as well as helping our surgical team from Hartford and the MD/MPH students from Tufts. Rachel has jumped right in and is out in the community with the MPH students, completing a survey on maternal health choices. She's worked with one of the MPH students on a early childhood stimulation program in the nutrition center, and has travel to Cap to go to the orphanage with Sister Ann. It's hard not to feel exceedingly proud of her.



I've already been humbled again by the interesting diagnoses. A young man presented with clear cut appendicitis. As the students were coming over to examine him, we ran through the differential - don't forget typhoid I said, remembering a previous case. I was working with a Haitian surgeon, educated in Cuba. Communicating in French and Spanish, we explored the patient and found a mass in his cecum and very large lymph nodes. It didn't look like cancer, and I was pondering what to do next. "GI Tuberculosis" I heard over my shoulder.

It was my friend Jerry Bernard, who had stuck his head in at just the right time.



There's always more to learn...

I'm keeping notes and will update you as access permits.

Thanks for your support.

British Sensibilities

Long flight and significant time change from LAX through ATL on the redeye and on to the small airport at Turks. The last time, I was flying into Provo with Ed Constantine in the Baron, and the strip seemed adequate - on a Delta 757, it took full reverse thrust and left us with about 500 fet of runway. Interesting that there's no external power units, so we had to lower the window shades to keep the heat out - and the air stairs were attached to a truck.

I'd forgotten that we were in a British colony, until we pulled out and started driving on the left. Many traffic circles, and perhaps the best measure of being genteel - instaed of "Yield" the signs say "Please give way."

And of course there was a gin and tonic waiting - the quinine reduces the risk of malaria.

No wonder the Brits have survived so long...

Catch you tomorrow from Haiti.

The Night Before

We will be departing for Milot late Friday night. Last minute running around for supplies that seem mundane for us (printer cartridges, crayons for the kids) I've also been impressed by how willing my colleagues have been to help. Although I've only been here a few months, I sent out one email with a small list of basic supplies (ostomy kits and some scrubs.) Within a week, I'm at my desk, and someone who I've never met before rolls up with boxes and bags far in excess of what I asked for. Turns out she knows some folks at other local hospitals that chipped in. So my CRUDEM colleagues in Milot will have labeled scrubs donated from from Cedars Sinai, Santa Monica Hospital, The University Hospital, and St. Johns, among others. And patients requiring ostomies won't have to jury rig IV bags.

I was pleased to learn that we will be working with a group of medical and public health students from Tufts, as well as a surgical and pediatrics team. Tim Traynor and I will overlap toward the end of the week, and we've briefed what needs be done in the Sprung building. His engineering mind and my surgical outlooks aren't that far apart.

The one downside is that internet access is degraded in Milot for a variety of reasons. It sounds like I may be climbing in the rafters to trace the cables and install a router. Fortunately, between the X gens that will be in Milot, and some cell phone briefing from Ben back In LA, I should figure it out.

I found out that my expat friend Daven will be in CAP. You may remember my blog last September about his experience being buried after the quake, but returning to try and keep the company running and employ as many of the local populous as possible. We hope to visit each others compound.

We'll be posting from Turks on Saturday.

Thank you all for your support.