Healing Hands for Haiti Foundation

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By Al Ingersoll, CP

Some of you may have followed a group of Minnesota professionals during a recent clinical trip to Haiti via The EDGE Online Journal. We were able to spend a week at the Healing Hands for Haiti Foundations' clinic in Port-au-Prince. While the political tension of the time kept us from clinic one day, it didn't stop our ability to educate the Haitian technicians studying orthotics and prosthetics as well as to treat many patients. Thanks, in part, to generous ongoing support from Otto Bock and the Barr Foundation, we expect continued success.

The website detailed our daily activities, so I wanted to take this opportunity to give you an overview of Healing Hands for Haiti Foundation (HHHF). (Editor's note: To read each day's journal entries and view photos, please visit the Healing Hands for Haiti Online Journal.) I would also like to extend an invitation for you to help the organization. If you are interested in what HHHF is doing and would like to join one of our teams, please call me directly at 763.546.1177 or contact via email at aingersoll@winkley.com.

Joining a Healing Hands for Haiti team is a great way to gain exposure in your community, broaden your horizons, give to those less fortunate, educate young Haitian rehab technicians, and work closely with other medical professionals. The Minnesota team has members from 11 different hospitals or rehab facilities. We were featured on a local evening news channel and interviewed by a radio show. Presentations about our trip have been given at schools, churches, Rotary meetings, and hospitals. An abstract has been submitted for us to give a presentation at the 2004 National Assembly of the American Orthotic & Prosthetic Association (AOPA) meeting.

Tom Bremer, CP, and two Haitian technicians work with Patrick and his new bilateral transfemoral prostheses.
Tom Bremer, CP, and two Haitian technicians work with Patrick and his new bilateral transfemoral prostheses.

A typical HHH team might consist of physicians, nurses, occupational and physical therapists, orthotists, prosthetists, technicians, wheelchair technicians, speech therapists, and support staff. Accompanying spouses can help too; often they will provide support by working clinic triage check-in, orphanage assistance, administration/computer help, etc. Check the Healing Hands for Haiti website to see when teams are scheduled to travel ( www.healingshandsforhaiti.org). I would suggest joining an existing team for your first trip, and then consider forming a new team.

Why Haiti?

Haiti is only 500 miles from Florida but is the poorest country in the Western Hemisphere, suffering under many brutal leaders for the last 200 years. Government aid to Haiti is virtually nonexistent; the country's natural resources have been plundered; and disease, malnutrition, and limited access to medical facilities contribute to staggering levels of disability.

The country is very mountainous, having the highest mountains in the Caribbean and more than Switzerland. Port-Au-Prince, the capital, with about two million people, is a very busy city, teeming with activity and traffic. Our clinic and guesthouse are in a suburb of Port-Au-Prince.

Haitians are known to be extremely kind, patient, and generous. Haiti has more artists per capita than any other country in the world. We brought back several thousand dollars worth of art and plan on selling this for a fundraiser.

Our Vision

Our vision is to provide treatment, physical and occupational rehabilitation, and education to the people of Haiti. Our goals include heightening the public awareness of physical disability issues (including prevention, acceptance, and care); educating the people of Haiti to care for the disabled with skill, dignity, and respect; and providing continued support with training, materials, supplies, medical treatment, and therapy. Healing Hands for Haiti encourages our patients to pay for services if they are able; however, no individual will be turned away for lack of funds.

Help Needed

O&P practitioners and technicians are needed to join existing teams scheduled to travel to Haiti this year and next. A medical clinic, O&P lab, therapy gym, and educational classrooms are being constructed at our new property and will be completed in the summer of 2004. When these facilities are finished, we will have the capability to diagnose, treat, fabricate, and teach at one location, which is on the same property as the guesthouse for volunteers. Two meals a day are cooked by an onsite kitchen staff, and the four-acre site, shaded by palm trees, includes a large swimming pool. Security is maintained day and night.

Healing Hands for Haiti has an educational program that is teaching Haitians nursing, orthotics, prosthetics, and occupational and physical therapy rehabilitation. These technologists will be able to treat their fellow disabled Haitians, thus helping to relieve an overburdened medical system. Professionals traveling from Canada and the United States have the opportunity to help teach these eager students. After the training and clinical are completed these technicians train in Canada or the US for six months.

Orthotics and Prosthetics in Haiti

The population of Haiti is estimated at eight million, with approximately 10 percent being disabled. These people have many adversities facing them, including difficulties obtaining medical care, lack of money to pay for care or to obtain medical devices, and geographic barriers.

Sarah Gutknecht, RN, CPNP, assists a young boy at an orphanage.
Sarah Gutknecht, RN, CPNP, assists a young boy at an orphanage.

The most common cause of amputation is infection, followed by motor-vehicle accidents. Other causes are birth defects, falls, work-related accidents, and gunshots. Above-knee amputees outnumber below-knee by an estimate of ten to one. Many of the transfemoral amputations are relatively short, with heavy scarring and adhesions. Because of the lack of access to medical care, infections are not treated soon enough, leading to the high-level amputations.

The population needing orthotic intervention is also varied. Many disabled children have developmental delays, suffer from malnutrition, and have genu varum, valgum, or recurvatum; adults were treated for stroke, spinal cord injury, motor-vehicle trauma, and overuse syndromes.

We have been very fortunate to equip our lab with a donated pizza and baker's oven, drum- and Trautman-style sanders, a vacuum-forming station, air compressor, and most necessary hand tools. If possible, most devices are custom- made and assembled onsite. Occasionally, more complex fittings require fabrication in the US or Canada. Team Minnesota brought a hip disarticulation test socket back, and Otto Bock Technical Services donated fabrication and a locking hip joint. A team from Utah will take this prosthesis back to be fit. Thermoformed plastic is used for fabrication of most devices. Locking knees or friction polycentric knees are preferred because of the rugged mountainous terrain, ease of maintenance, and relatively low weight. Silesian belts provide a safe, easily repairable means of suspension. Flexible keel feet seem to work best for the above reasons.

Costs and Travel

The costs for traveling to Haiti vary depending on airfare, team size, length of stay, and money spent in country. The 17-member 2004 Minnesota team traveled from Minne-apolis to Miami, Florida, on Friday, stayed overnight in Miami, and then flew direct from Miami to Port-Au-Prince on Saturday. We had intended to stay ten days; however, because of the political unrest against President Aristide, we came home two days early. Our airfare was $550, with the hotel in Miami for one night adding $70. The Healing Hands Foundation charges room and board to each team member staying at the guesthouse. This was $46 per day and is one of the ways the Foundation supports itself. Because of the very high cost of fuel in Haiti, we were charged $160 per person for the week. This included our pick-up and return to the airport, a day of sightseeing and shopping, an evening dinner at a very nice hotel, and two different teams to orphanages each day. We were the last team using the old rented clinic property, so we had to be transported there each day. Team members bring $200 - $500 for shopping, sightseeing, dinners, and other miscellaneous expenses. Team Minnesota raised funds to offset the room, board, and transportation costs. Most teams travel on American Airlines with Air Canada, Air France, and Dutch Caribbean also being options.

We try to carry as many supplies as we can with us, and we are working on obtaining goods locally. Shipping supplies to Haiti is very difficult because Haitian Customs is notoriously corrupt. Team members will carry on personal items and use luggage for rehab supplies. We have found plastic storage totes and large duffle bags to work well.