jimani

Jimaní: January 20th- January 24th (as written for a magazine by PCVs, for PCVs)
When I first heard that PCVs had the opportunity to go to a boarder town to help out medically, I was really excited. I have some experience in health care, am a health PCV, AND people in my community call me Doctora which has to count for something. I, like most PCVs I’m sure, was hoping for the chance to help out in a hands-on, noticeable way.
Honestly, when Randi, Kenzie and I arrived to Jimaní Wednesday afternoon we had no clue what to expect. The extent of our knowledge was that there were two hospitals and an orphanage which were all being used as hospitals. Since the public hospital was located right in town and the others were together a hike outside of town, we went to the public hospital first. We walked in and were affronted with complete chaos. There was no one in charge, everyone seemed to be speaking different languages, probably ¾ of the injured had something amputated, people were in mats on the floor, and patients were moaning in pain… it was kind of what one should expect given the situation I suppose. There also seemed to be a lot of people just standing around, not sure what to do. Randi, Kenz and I went on a mission to find someone in charge so we didn’t become bystanders.
After some looking, we found someone who seemed important. We followed him to a patient lying on a mat. The man in charge had a handful of little bottles and a sharp. He handed all of it over to a random woman, turned to Randi (who we had already established as “the one who knows stuff”) and told her, “Teach her.” Then he walked away. We all looked at each other and Random Woman, who apparently decided not to loose any time, had begun trying to inject the poor, very awake man with some of the liquids in her hands. Randi, of course, mildly flipped out whereas Kenz and I decided to back off and began surveying the scene.
People were everywhere. There weren’t enough IV stands for people so their gravity flow IV bags were on the floor beside them. There weren’t any beds in the area we were, just mats on the ground. A lot of people hadn’t received lunch yet and it was nearly 5 pm. To be brief: this hospital was a hot mess and more patients were arriving by the truckload.
Overwhelmed with the situation and not knowing what could be done, we took the sharp from Random Woman and decided to visit what was dubbed as the “American Hospital”, the one on the other side of town. We got a bola in a truck and as we sat in the back we found out was the truck used to take away the bodies all week. (Did I mention I only had one pair of pants to last me the entire week?) While the American Hospital seemed crazy as well, it seemed more of an organized chaos (maybe it was because we were a little more adjusted).
Kenz and Randi absorbed their fill of the hospital and went back outside while I remained inside, contemplating the fragility of it all when someone asked me if I was doing anything. No. He asked me if I wanted to change a dressing. Yes. I gave him the warning that I wasn’t a nurse to which he laughed and said it didn’t matter, making me think of Random Woman giving an injection. I followed him over to the patient, a large woman on a mat on the floor with two long, visible rods in her- one in each leg. Lucky for the patient, and for my stomach, this doctor was an anesthesiologist and so he put her to sleep right away. I helped by elevating her leg while the doctor pulled gauze from a hole in her leg, the diameter being the size of a quarter, and judging by how much of the doctor’s finger disappeared while inserting the fresh gauze, it appeared to be at least 2-3” deep. He attended her other wounds and then she woke up. It was a thing of beauty. There was another doctor there, not from the US but not from the DR either. She was complaining that before the US doctors arrived there was more to do but now that they have “Americanized” the hospital, it was too organized and there wasn’t enough to do. What a complaint!
In the following days we found out that the second hospital, the “American Hosp.”, wasn’t actually being utalized as a hospital before the earthquake. It was being used to do some eye surgeries here and there but it was never set up to be a hospital. It amazed me to find that doctors from the US (and from other countries as well but mainly from the US) were able to come here and organize an entire hospital that functions relatively well, all things considered, in a matter of days- all while receiving more critical patients!
Randi, Kenzie and I ended up working night shifts, 7pm -7am but more like 6:30 pm- 9 am, the rest of our time there. That first night I worked in one of the two critical care trailers with some Dominican doctors. It was great that they were there to help but I hope I never need serious medical care in this country. I found several used needles in patient’s beds that were forgotten. A patient that couldn’t breathe was told it was in his head and was held down when he began to panic. Another woman was having problems with her IV, which was in her neck, and the doctor said it would have to wait until morning because she didn’t know how to change IVs. We couldn’t reposition patients with neck/back injuries unless an American doctor was present because the Dominican doctors didn’t know how to move a person with a spinal injury (imagine lying in the same position for 12 hours) It made me think of all the people receiving “care” in the public hospital and think of how lucky the patients here were that they ended up in the American Hospital.
A few times there were aftershocks and all the patients panicked. It was really sad. One man who wasn’t hurt in the earthquake was badly injured when he jumped from the second story because he had been trapped in rubble for 5 days in Haiti. Each time an aftershock happened the patients would scramble outside. One night they slept outside because the aftershock occured at 5:30 pm and another about an hour later at 6:30 so they moved all the beds outside and slept under the stars. I’m not sure how the doctors kept everyone straight. It was really amazing the work they did.
By the end of the week we were surprised to find that there were now a lot of empty beds. Despite the overall hesitation on the Dominican hospitals part (a lot of them said they wouldn’t accept Haitian injured), doctors were able to send patients to other, more equipped hospitals throughout the DR. The problem was that no new patients were coming in. Blame it on difficulty getting back and forth to Port au Prince with all the traffic, blame it on boarder control, no one could give an exact answer to the question. One thing is certain though: there were more people somewhere who needed care and were not getting it.
Overall, I am very happy I was given the opportunity to serve in Jimaní. It really gave me a new perspective and a new direction in life as I am 100% certain I want to study medicine when I return to the States. In my four days there, I grew prouder and more aware each day of how efficient the American medical system is and more impressed by the dedication and leadership of the American people. We can’t change racial tensions between Haiti and the DR any more than we can convince all of the Doñas of the world to use green leaves in cooking, but we can at least be examples. It’s easy to become overwhelmed by the enormity of any situation but feasible make a change one day at a time, one situation at a time. We are American Ambassadors here in our little communities and with each day that comes, comes an opportunity for change. Don’t let yourself get lost in it and let it pass you by. Its two years that pass quicker that you would expect and it’s your two years so make them count.

1/18- 1/20: How I ended up in Jimaní, a boarder town
In a nutshell: I went down to the capital Monday morning, the 18th, unsure if I should even be going since I had been out of my site so much in January. But, it was for a meeting to coordinate the next regional Escojo conference and so I packed a couple days of clothes, extra undies (because you never know what’s going to happen) and headed out. I went to the meeting that afternoon and later found out that there was an opportunity to help package boxes with USAID or some NGO the next day, aid relief boxes to send to Haiti. As I had only done a mini food drive in my community and wanted to help out, I decided to stay an extra day. After all, I was already here, may as well.

The next day we were all waiting around to go and package the boxes when Romeo came down and told us to go up to his office. We sat down and he gave us each a list of 4 places that needed volunteers to help out. One was in Jimaní, one in another boarder town, and two in Santo Domingo. I immediately said I would like to go to Jimaní, and noticing it said it wanted medical personnel I pointed out that I was a nurses aide for several years. Romeo immediately shot the idea down and said gruffly that they were just going to send an RN and an EMT there. The only other place on the list that was ready to receive any volunteers was in Santo Domingo. Then Romeo rudely told us that the meeting was over and we could leave. I definitely got the feeling the entire time that he wanted nothing to do with the aid effort.

We all went down to wait for a driver to take us to the warehouse when Randi rushed into the office and grabbed Kenzie. I knew they had some meeting with Romeo and then remembered that Randi is the only PVC who is an RN in PC. When they came back from their meeting I asked if they were going to Jimaní and they were all secretive about it! I was getting really annoyed. The driver was ready to take us to the warehouse but I wanted to go to Jimaní. I was afraid if I went with the driver I would miss my opportunity to go to Jimaní so I stayed behind.

Later I was talking to my friend Rachele and she said her APCD, Adel, had INVITED her to go to Jimaní! Rachele has NO health background (but then, neither does Kenzie and she seemed to be going). I went up to Adel’s office, slightly nervous that I would get in trouble for all this after Romeo specifically told me no. I told her that I have a background in health and would really like to help in Jimaní if possible. She said she thought that would be great and she would talk to Romeo.

Later that day she called me and said she had spoken with Romeo and convinced him. I was the only other person allowed to go for now and we were to leave in the morning!!! I was so excited!!! It turns out that the EMT in the group is married and she said she would like her husband to go with for support. Because of that, PC said Randi could take one person for support too. She asked Kenzie because she knew Kenz wants to be a nurse after PC. They weren’t supposed to tell anyone because Romeo didn’t want a stampede of PCVs headed for the boarder. I was still annoyed with them for not telling ME for crying out loud but, at least it worked out in the end. The PCVs who went to pack the boxes said that when they showed up, the people weren’t ready for them and they had nothing to do still. So, I made the right decision. Persistence pays off:)