Saturday morning parting shot

Hi Kids,
It is 0500 here in Haiti. A little warm but not humid yet. I am scheduled for a plane trip at 0700 to Port au Prince. They only decide to fly when they have at least 8 paid for tickets. If not-no fly.

Supposed to take about 45 minutes and I have a 0920 plane to catch in PAP. Hopefully have someone waiting to scoop me up at the small airport, drive to big airport and get through customs. Wish me luck.

Appears all hotels in Fll are booked this weekend as I could not make a reservation on line. May have to sleep at the airport and catch a flight home to ANC in the AM.

Looking forward to my own bed, warm shower and a few of the other finer things in life.

This trip was really rather surreal for me but looking forward to returning in Nov or Dec for another round....bye ,bye love..... jerry nase

P.S. my cell phone died this trip so kids I'll give you a call when I get home. PEACE

Thursday's parting note from blogland

I must say it has been interesting-this first time blog. Hope it wasn't too boring for you. Just trying to give everyone a little taste of this news making spot from a ground up approach.
I realize looking at NY Times online that it has kind of fallen off the front pages which was expected. I have seen things only get worse since I arrived.
People are down , I think. At least in Cayes with more people displaced here most supplies are generally more expensive and people are getting weary trying to take care of their families as well as extended families. The Times tries to make feel good stories out of some situations but they LIE. Not too many folks here are feelin' good.

I have seen a great deal of pathology in kids and adults and have taken many photos of these problems. Everyone I have asked to allow me to take pictures of themselves or their kids have been more than gracious in allowing me. For this I thank the Haitian people. The volunteers down here during my stay(from all over U.S.) have been superb in trying to get things done. The staff at ESPWA are "Crazy Dedicated" to this place and making it better for the over 800 kids here. The good thing to acknowledge is that most of the staff are Haitians

How about one more tear jerker story b4 I sign off for the night.
Into clinic today comes this nicely dressed Haitian women with a 6 month old baby.
Babe was covered with a light blanket at first so I didn't get much of a look at him.
Seems he has had a cold and a little diarrhea past few days and she wanted to have him checked out.....And oh by the way "is there anyway you could help me get him to the U.S. for his operation that he needs".

Well that perked me up a little and I started taking his blanket off for a better look. After many years in the pediatric trenches I had never seen a baby devasted by bilateral congenital glaucoma. He had a monstously swollen right eye that he could hardly close his lids over. This globe had an area that appeared to be pointing like a giant pimple. The cornea was completely scarred over. The left eye when he opened it was smaller with a complete corneal scar (kind of like Michael Jackson in one of his old Thriller videos when he used yellow contacts)

Seems his mom was 42 years old and had been trying for a babe for 11 years. This was her first baby. He had been seen at Brenda Hospital in town which if you can believe it is a very well known Eye & Ear hospital here. It is run by Belgians and they do cases from all over the country. She saw them in December and was scheduled for surgery in January. The earthquake hit and Hospital Brenda was turned into an Orthopedic field hospital and even now still is and is not doing eye surgery.

Not really aware of the involvement from birth but in the U.S. this kid would have had eye surgery on the 2nd day of life with the possibility of saving some vision in left eye

Instead he ends up as "collateral damage" from the earthquake

That should mess up everyone's maternal & paternal instincts for the night..bye..nase

If it's Tuesday, this must be Haiti!!!!!

Happy Tuesday people.

Very busy past few days in clinic. Kids remain the stars and I am getting used to seeing adults. Didn't say I liked it....said I was getting used to it. Some folks are down here with lots of vaccines , so they set up a separate area for giving them to kids. Working on the most recent 100 kids(since the EQ). They are using and old school bus for running the kids through a gauntlet of Quick exams, oral HIV test, TB skin tests. and DPT immunizations. Kids are not happy campers by the time they get off the bus, but that's life in Haiti. Some have never experienced the pointed end of a needle before...... New Beginnings !!!

Clinic issues continue around poor nutrition and associated problems as well as infectious diseases and skin problems. Lots of people displaced from Port au Prince but no orthopedic issues are showing up here. There are still ortho teams on the ground for these problems. they will require lots of solutions in the future...

Past few days very humid and still. We could use some rain but the folks in tent cities don't really need this right now.

Ending up my stay at end of week and must admit the month has gone by very quickly. Don't want to leave but need to go home and make some snow angels before it all goes away. Also have granddaughter #1-Miss Lilah- birthday in April to be home for.

Gave a short talk to the clinic nurses after clinic today about malnutrition. It was good. I learned more about Haitian breastfeeding habits etc...than I knew about previously. The nurses were polite and clapped at the end and asked me to do another one on Thursday. This talk was translated from English to Kreole by Dr. Jacob so he could have been making fum about me the whole time and I wouldn't know the difference.

Oh well....LIFE IS GOOD.... bye ... jerry

Sunday night again

Hello sports fans,
Hope all is well. Life is good here. Today started out with mass. The church/community house/warehouse for humanitarian donations has no circulation. With 200-300 folks there it can get sort of stifling. Anyway got some movies of mass and the singing. Hope they are good ones..

Lazy Sunday.some folks went to the beach, others hung out, others napped.Tonight a short Spectak by the kids of Espwa for the departing builders/architect group. Spectak is a show put on by the boys and girls. some sing,some dance. really very nice seeing as though there are no teachers of these talents. The kids do it all by themselves and some are very talented.

Spent a short amount of time preparing a talk for the clinic nurses on Tuesday. I will chat and it will be translated into Kreole for them.

Not much else new today. I will be here until Saturday , then try to get home.By the way don't ever patronize American Airlines again. They want me to pay $617.00 to fly from Port au Prince to Fort Lauderdale. Another $90.00 to fly from Cayes to PAP by local carrier. So It cost $715.00 to fly round trip on Continental from Anchorage to Fort Lauderdale and $707.00 to fly one way from Cayes to PAP. They really shouldn't be ripping folks off like this . Lots of Haitians in US are unable to go home because of the mighty bottom line.....THERE, got that off my chest

Type later...... jerry

saturdaY evening

Well how about that. Had a hard time with the internet and/or electricity supply all day today. Pretty quiet Saturday. Did laundry this AM and hung it out to dry. Very humid today so t-shirts still wet after the sun went down. Took a walk over to the warehouse where they are storing all the stuff that was offloaded from the boat last weekend. Most of the food and med stuff has been moved out. Today lots of clothes moved out. many got soaked with sea water from the boat trip and smell a little ripe. They will need to be washed before given out. Local folks acted kind of crazy today.

In Haiti, there is not a good concept for yours and mine. Lots of theft goes on but it is called "borrowing" .

So the folks here think nothing of taking something off the truck and giving it to others on the ground. I could understand if it were food and they were hungry...
Here if it is band aids and they can't use them they throw them on the ground. Lots & lots of waste by kids and adults this past week. Cans of Chef Boy R Dee spaghetti & raviolie are popped open , tasted and thrown on the ground if the person doesn't like them. So that is one of the ugly faces of humanitarian aide. Adults do this so that is what the kids see and do.

I am sure I give mixed messages about this place but sometimes it is confusing. I ask Father Marc how he does it and don't get any real good answers from him either. I guess we all must figure out our own coping mechanisms.

I will begin my coping with going to bed.... g'nite.... jerry

Almost forgot

A funny thing from Thursday at Charlote.

We saw lots of kids with scabies . we had only a limited amount of meds to treat them.

So in another room the guys who were working the meds were there lathering up all the babes with Benzyl Benzoate lotion. This is old treatment for scabies and not sold in USA any longer. We had run out of Elimite that we had brought from US.

So we stripped down the babes , lathered them up and made them all cry. Most of the moms had same problem so we gave them a bottle for about 4 of them to share at home. some of the families had 10 people at home -all scratching.

A nice invention for 3rd world countries would be some variation of a 55 gallon drum filled with the medicine so you could just dip the kids in it for treatment-sort of like a sheep dip on American farms.

Hey maybe we could have the Defense Dept develop this instead of one of those $25 billion dollar fighter, killer jets...ooops , there I go again..type later....j

TGIF- Part Deux

Ok, supper is over. We had eggplant parmesan-very,very good. Currently 17 people staYING HERE IN QUARTERS. PRETTY BUSY FOR THE COOKS AND OTHERS WHO MAKE IT WORK.

Anyway to finish up on Charlote from previous post it went pretty well. Never did get to any adults but we billed ourselves in advance as wanting to see the kids so all went well as far as I was concerned.

Remember the story from Sunday the 7th of march about the little dude Stanley who managed to make his rectum go inside out. Got a call while I was at Charlote that he had done it again twice and they had managed to push it back in. I recommended that if they push it back in successfully to tape his butt cheeks together for about 4-6 hours aND LET HIM PLAY. They thought that was a rather odd recommendation but did it anyway-it worked. Not my idea. I read it on the internet when I read about his problem several days before. So new thought: instead of using a cork for certain GI problems just duct tape their butt cheeks together. Sounds like a Kodak moment to me.

Today's clinic was interesting, busy day. This PM into clinic walks young Stanley without his duct tape on and he was the staR OF THE CLINIC AND DOING FINE.

I HAVE GOTTEN TO KNOW A LITTLE BETTER a local doc who works here 3 days a week. We have spent a lot of time discussing interesting cases. He is trained in Haiti and their medical school standards are not quite up to snuff compared to US standards,
But he asks a lot of questions and seems eager to learn about stuff-mostly kids, so far. All in all I really think it is a benefit to have him here.

There is also a young man around who is trying for medical school slot in 2011 at home. Unfortunately there haven't been many docs for him to spend time with except me and I think I HAVE MADE HIM JUST AS JADED AS I AM by this time but we have seen a lot of interesting stuff here.

If I could sum up my time here so far I would have to say that 95% of the problems are related to MALNUTRITION. This was not a real important topic when I did medical school training during the previous century but it sure is currently in Haiti as it has been for a long time.

I have some sneezing and nose blowing to do so have a happy Friday evening.

Bye.... love....jerry

TGIF

Ok, Ok I Know I haven't written in a while and some of the natives are getting restless but if you actually wait to read this blog you kids need to get out more( Pence???).

Recently traded in my bowel problem for the other end with a runny nose and hacking cough. Always cool when the pediatrician is coughing all over the baby and his nose drips on the kid- OK I'm kidding.

It's Friday but let me tell you about yesterday - lots of fun!!!!

Drove to Charlote about 15-20 Km from here. Great folks but times a really tough. Village is being represented by young men who speak very good English and hustle for their people. About 150 folks all told. Lots & lots of kids. A pediatrician would never go broke down here. Anyway myself and 3 others went to Charlote. Set up a little assembly line with a local lady writing down names on forms. Myself examining and writing orders
and two fellows who were filling prescriptions with the few drugs we had. We saw 47 kids in about 4 1/2 hours. Most under 10. everyone had scabies along with their moms,
many had GI parasites (worms) as well Lots of ringworm of body & scalp.

Great folks who seemed relatively happy with their status in life as long as food was available. People always smile and try to laugh.

Speaking of smiling they just rang the dinner bell.... type later.... nase

Hey hey it's me!!!

Just when you think you have heard alot of stories more keep coming down the pipe. One little dude about 4 is here because his mom locked the whole family in the house and tried to burn it down. now I know that worse things than that happen all over the world but not in the numbers I see here. If folks think Haiti will have lots of emotio0nal turmoil after the EQ, They had lots,lots before.

The first babe I saw today was 2 yo and weighed 15 pounds (about the size of a nice 6 month old at home)or a chicken halibut. Had vomiting, diarrhea, abdominal distention and no appetite. I thought pretty straight forward case of worms except for the poor weight gain. also had red Hair. Back home red hair no big deal in a white kid or an Aleut but in Haiti red hair implies poor nutrition if not downright malnutrition. Black children by and large have black hair. Then his caretaker (aunt) relates the bio-mom is in Port au Prince, is very very sick and most probably was a prostitute.

So the possibility of HIV in this babe looms large. No lab stuff for HIV test I was told, but tonight some docs are coming down bringing many vaccinations and about 100 HIV tests. Hope the kid comes back tomorrow, but really may be a mute point because trying to care for a babe with this disease here would be tooooo expensive (meds & lab tests)

If you are at all inclined to write your congressmen & congresswomen about this issue-please do. and tell them jerry sent you.

I am frequently reminded of that insane t-shirt that says
................" LIFE SUCKS and THEN YOU DIE"

I have felt good all day and my appetite is back.

Looking forward to tomorrow . Going out to a different village and community to see what we can find....bye now....... j

Time to change the previous topic of conversation

Happy Wednesday AM

It Is 0508 here, the roosters are doing their stuff and all is right with the world.

Why do you people force me to write about that stuff anyway????

Had a good night. For you non medicine takers I think that Cipro. really helped me a lot.

Oh well, a new day is dawning. I'll check back in later today if anything else occurs.

Meantime, Have a Great Hump Day jerry

I'm in LOVE

Hi kids,

This may sound sort of strange but I am "in love" with the toilet these days. Things got worse over the past 36 hours in the poops department. Diet got more elemental as appetite also bit the dust. Supper tonight was bread, water and bananas. Now my friends at home will consider this an obvious ploy by me to be invited over for dinner when I return to Alaska and I will admit that that may be partially true. I started some cipro today and feel a little better tonight. Slept all afternoon also, so probably won't sleep tonight.

Now you may think that this is weird talk for a blog-butt- Pediatricians talk about poop & pee & puke all day anyway. My daughter ,Aimee, said that people like to hear about the small stuff so this is my contribution to your knowledge!!!!!

Only worked for about 2 hours this AM and then back to my first love.
Tomorrow is busy clinic day and Thursday am supposed to go about 20 KM from here to have a clinic for a small village (about 150 folks there).
We will take some of our more common drugs and do whatever we can. These kids rarely see a doc but once a year a volunteer traveler goes through the place.

Not much else is new here. How about you guys out there in blog land. Haven't heard much from you lately. My internet connection has been fairly good, at least for portions of every day

Time to make the donuts!!!!....g'nite...jerry

It's all in the delivery !!!!!!

happy Monday night,

The haitian nurses in clinic are finally starting to get my sense of humor and are giving it back to me a little. I didn't think i was going to be able to crack them but. They speak Kreole/French and I speak whatever with an Alaskan accent. They are actually starting to smile a little. Mostly they smile when I try to pronounce Kreole.

New complaint for me. This great little old lady came to clinic today. She complained of everything but then she said she especially hurts in Right shoulder area. I asked if she did anything special that day and she related to me that she fell off her donkey earlier in the day. So you see everything is relative....

It happened , I finally developed the Haitian squirts. Won't bore you with the details . Just suffice to say I don't wander too far from the quarters area...all for now...Gotta RUNNNNNNNNNNN. jerry

What a breakfast !!!!!!!

this place cracks me up,

I was just putting milk on my cheerios about 0745 and a group of 10 of us or so were just sitting down. Father Marc walks in and tells me that the little boy with " the rectal prolapse" was here. for those of you who are not familiar with the geek talk, I recommend you google it.

Anyway here comes this little dude , walks up to me and holds out his hands like he wants me to pick him up. I won't bore you with the details of the procedure. Suffice to say after about 4 minutes of "trying to turn his butt outside in" he was not a happy camper and my cheerios were soggy. He screamed like I was pulling his fingernails out but after I got done he managed a wimpy high five. We don't have anything in the way of pediatric sedation meds here so I gave him a hit of whiskey and a bullet to bite on. OK I am kidding about the bullet and I had the whiskey.

Went to church and asked Marc to pray that I never see this kid again for the next two weeks. Mass was good, lots of French hymns and drumming (rockin' out)'

This afternoon the owner of the MV Sea Hunter came out to Espwa. He had some great stories about his "HUMANITARIAN TRIP" from MAINE.He planned for a 2 week trip and it has been over a month and he is still in Ayiti.

Today was cool. The people tried to rush the big boat in small boats and board it. CHAOS.
The captain pulled out his pistol and fires 3-4 shots into the air and starts to cut their lines. Then the U.N. peace keepers showed up and things settled down. They have lots of firepower. Hollywood couldn't write a better script!!!!!

They finally got off all the cargo in the 10 trailers as well as the empty trailers. This was the end of Espwa stuff. The cargo holds will be emptied tomorrow for the local folks. Could be bad. Hope no one gets shot. I am not letting my cheerios get soggy a second time !!!!!!!

that's it, see you later....same time, same station.......j.

It's Sunday at 0400 and the roosters are singing

Hey sports fans,

Early Sunday am and having trouble sleeping. cool night, didn't need a fan at all.

Yesterday went to a small village near here named Charloti. Really cool spot. About 150 people and lots of kids. Got a tour of the village and the young people sang for us for about 30 minutes b4 we left.

Plan to go back this Thursday and try to run a clinic at least for the kids & possibly see some adults as well-SHUDDER, SHudder, SHUDDER...

Won't bore you today. For a good read see www.pressherald.com. See article on Sunday about the adventures of the M.V. Sea Hunter. Bill Nimitz wrote it. He is a reporter from Portland, Maine who made the trip with the crew. His take is frustrating as well but he gives a little better narrative.

Shower time, bkfst, ?church (really want to go to Sunday school and hear the little ones sing their songs). The Church area is crammed with stuff so if Father Marc says mass it will have to be outside under the mango tree. Everyone who attends church is issued a hard hat in case of falling mangoes.

Have a good week and drive safely...... jerry

Saturday 06-03-2010

Good morning breakfast clubbers,

All is well. The ship of which we spoke has off loaded some cargo as of last night.

Mini-Chaos happened as the truck was unloaded here at Espwa. Lots of boys to help and even they carted off some stuff while unloading. Cases of bottled water, peanut butter disappeared into the crowd. I think they like the bottles more than the water . They use them to make toy cars and such.
The goods were put in the church/dining area/storage spot.This morning they went back to the dock area(even though there is no dock in Cayes for more stuff. They will unload the 20 ft. trailers and bring here. A good picture of this is at Fr. Marc's blog. See

pwojeespwa.blogspot.com for current photos as my MAC is not interested in showing me how to do this simple task.

Espwa will probably end up getting about 1/3 of the goods donated here from U.S.
The rest goes to local gov't and federal gov't.

About 6 architects arrived 2 nights ago. They will be involved with building a home for the ladies(girls) here at Espwa.

They (Fr. Marc) are doing this so they don't have to split up brothers & sisters, I think. Could be good , could be bad (we'll see how this turns out).

Quiet clinic this am. Usually most Saturdays just has a nurse here-no docs.

I have met some good kids this trip and reconnected with some I have known for past 5 years ( some are all growed up) but they still come up and give me a big hug when we see each other.
I know , sounds kind of schmarmy, but it's good stuff -really.

Trying for a beach run tomorrow if the ships unloading is finished today....

See you in the funnies....love....nase

That title obviously didn't work

Ok, let's try this again
Thursday am with French toast for bkfst....

Clinic had a somewhat happy ending . the kid who I thought had Diabetes the other day came back to see me with some lab results that he had had done. We couldn't contact him past 2 days because cell # didn't work.His labs showed a blood sugar of 571 with normal electrolytes and no numbers consistent with dehydration. We referred him again to the hospital. The family has no cash and will have to sell their belongings to get him in. Basically people have to pay for hospitalization up front here. If they need IVs and fluid and meds and INSULIN they have to buy it and bring it to the hospital. Fortunately at home The services of social workers are available to help out with this issue but here-NO SUCH THING - as a social worker

I thought of asking the older brother to go out and steal someone's cow and sell it
but that plan might backfire, ssssssooooooo any suggestions from you guys!!!!!

Just kidding but this is how Haiti works. No health insurance or entitlement programs here so we should all consider ourselves fairly lucky DUDES-REALLY.

Went to town this P.M. with some other volunteers and a driver to get some parts to fix a tractor. That was fun. Les Cayes was bustling today. Lots of folks out and about

Still no news about the ship but haven't talked with Father Marc this P.M., yet

See you later.....jerry

Another day, another

Another day, another ------

Wednesday-dermatology clinic day

Hey- what's up???

If you all think I have gotten used to the cold Haitian showers and they are ok- think again. They are so cold in the AM I still hate them but need them to wake up. I really need something to gripe about or I am not happy

Father was at at a meeting today with the powers that be about the ship with all the goodies but I haven't heard much yet. Has anyone heard about this on their news back home, yet???.

Today was like a derm clinic at home. I saw about 7 different variables of ringworm of the scalp and took lots of pictures for posterity. Saw several adults with scabies. Saw several kids with multiple pus containing lesions and one kid with a kerion...Really good stuff if you like that sort of thing !!!!!!!! wish I could figure out how to get pictures on to this blog and I could share all this good stuff.

Had chef boy-R-dee raviola for lunch. MMMMMMNNNNN !!!! Good (NOT)

About all the news that's fit to print...be well.....jerry

Tuesday Night

Hi Kids,

Internet acting up all day so this will be short and sweet or it may get lost!!!!

!7 yo young man walks into clinic with his older brother and sister this AM.They said he is too skinny and eats like a horse, drinks a lot and pees multiple times through the night. He is indeed very thin with an otherwise normal exam. His blood sugar by quick machine in clinic is "too high" to read and his urine has 4+ sugar.
Having Type 1 diabetes is bad enough but to have it diagnosed in Haiti at this time seems somewhat cruel. Had to send him in to town for evaluation , stabilization, and chronic care. the family has no money. they are from the local community not the orphanage. Will be interesting to see how he does-have some good thoughts.

The saga of the boat with donated supplies continues with the latest news that President Preval has directed the ship to land and offload some of the cargo. Stay tuned for the next episode......

I am well....life is good...and Haiti has many beautiful children as well as an over abundance of strange adults..... bye..... jerry

Almost Forgot

The good news I talked about a few days ago is true and ready for release.

My baby boy, Michael J. (tomorrow is his birthday) was just accepted into medical school at University of Washington(WAMI) today. Tana and the whole Nase family is very proud of him

I am not trying to steal his thunder. We already discussed adding this to my blog.

I can't believe he wants to get involved in all this crap!!!!

Be well....jerry

That's Haiti !!!!!!

Mondasy night. had homemade Mac 'n Cheese for supper (haitian style_ really good)

Clinic today , pretty busy. Lots of kids. What I was worried about is happening. All the crud we had last week and now there are coming in with clinical pneumonias...No X-rays---too pricey & very poor quality anyway. Lots of skin diseases and infections continue as well. Fortunately we have enough meds so far to treat all these problems.

Remember the ship with all the supplies and all the paperwork the local politicians wanted b4 delivery. Latest is ship hasn't been allowed to move since last friday.

Father Marc will meet with captain of ship, himself , mayor of Les Cayes & another Haitian gov't representative in AM.. Apparently all of the relief supplies that were meant for Espwa and some other nearby orphanages will now be split 3 ways and the Espwa kids get one third of what was collected and intended back at home.....THAT'S HAITI

Real humanitarian of the local gov;t here, HUH!!!!!

One really has to wonder about directed donations that all countries are continuing to give. The other 2/3rds of the items will probably be sold to the people or go onto the black market, locally. The whole situ is too ridiculous to cry about, so might as well make lemonade.

lots and lots of kids with parasites down here. here is something I learded last week from an older Haitian Grandma. She told me that her granddaughter was grinding her teeth so she probably had worms, and would I treat her. The kid was distended with diarrhea and poor appetite so I treated her for worms. Then I googled parasites and teeth grinding and guess what...grandma knows best. Apparently all the grand-people in Haiti know this fact except for dr.jerry.

Either I slept through this lecture in med school or Haitian grandmas are smarter than my parasite lecturer.

Old dog.....new tricks (How About That)

Type tomorrow....jerry