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Sunday, October 17, 2010

Teaching Aids for the Dental School in Haiti


These pictures are of my two assistants, Debbie Streeter and Karen Cashen who were responsible for helping to gather the teaching aids and many other items requested by the dental school in Haiti. The shipment included an emergency kit, models and manikins for practicing dentistry, root canal practice blocks and a host of other teaching tools .




Other victories this month included:

- The installation of 20 dental chairs at the school that were donated by NYU.
-A "memorandum of agreement" is in the process of being signed between the University of Maryland Dental School and the Haitian Dental School. This document, once signed, will allow for important exchanges between the two schools.
- Friends of Haiti will be bringing dental students on their mission to the mountains around Grand Boulage, Haiti.
-Tom attended the ADA Symposium on Overseas Volunteers and made all kinds of head way on many fronts.
- Karen Cashen and I toured the old dental school next to the new school and discovered a treasure trove of items that if moved to Haiti, would prove invaluable.
... and a host of other good things including the possibility of doing a documentary to help raise funds for the ADA Adopt-a-Dentist program.

Saturday, September 11, 2010

Triangle of Life - Internet Rumor

Everyone should read this brilliant research on the "TRIANGLE OF LIFE" and pass it on. Boy! Is this ever an eye opener, and directly opposite of what we've been taught over the years! I can remember in school being told to, "duck and cover" or stand in a doorway during an earthquake. This guy's findings are absolutely amazing. I hope we all remember his survival method if we are ever in an earthquake!!! EXTRACT FROM DOUG COPP'S ARTICLE ON THE: "TRIANGLE OF LIFE":
My name is Doug Copp. I am the Rescue Chief and Disaster Manager of the American Rescue Team International (ARTI), the world's most experienced rescue team. The information in this article will save lives in an earthquake. I have crawled inside 875 collapsed buildings, worked with rescue teams from 60 countries, founded rescue teams in several countries, and I am a member of many rescue teams from many countries... I was the United Nations expert in Disaster Mitigation for two years. I have worked at every major disaster in the world since 1985, except for simultaneous disasters.

Saturday, September 4, 2010


Plaquemines Parish LA. for the 5 year anniversary of Katrina





A good time was had by all on the New Orleans trip. The group that went down included Carol and I, three of my staff, Mary and my two sons Austin and Eric. Carol did women's health. Kay played one of the three most overworked hygienists ever. Eric took up his usual post in instrument cleaning. Austin ran the digital x-ray. Karen, Debbie and Debbie's good friend Mary all assisted multiple dentists.
The Remote Area medical group treated hundreds of grateful patients. RAM's equipment and operations were first class compared to any working conditions we have ever had in Haiti or elsewhere. They had 20 chairs all with suction and operative units. It was a treat to be able to fix a few teeth instead of just extracting everything.

Saturday, August 14, 2010

Next:Remote Area Medical Louisiana Free Clinic

Carol and I worked with Remote Area Medical(RAM)in Haiti after the quake. They were instrumental in flying in and delivering to us crucial supplies and logistics. When the governor of Louisiana asked RAM if they would provide medical care for those people suffering from the oil spill, they asked us if we would help round up volunteers. Carol, my sons Eric and Austin, and three members of my dental staff volunteered to go. It may be too late to sign up, as paper work for licensing needs to be done, but usually where there is a will there is a way. Some details below:

Remote Area Medical® has scheduled a free medical, dental and vision expedition to Louisiana. This will be a two prong clinic, the Oil Spill Coastline of Plaquemines Parish and Orleans Parish. We have a great need for doctors,nurses, dentists, hygienists and dental assistants at both locations.
The Plaquemines Parish location is also set. It is about 45 minutes south of New Orleans. There is really limited lodging there so we have arranged another civic center to be available and we are going to house volunteers there. There will be cots available and bathroom/shower facilities. We also hope to set up some type of shuttle services between the lodging areas and the clinics.

The airport has a shuttle to the downtown hotels, but not south to Plaquemines Parish. The cost of all transportation is the responsibility of the volunteer.

The most important dates of attendance are Friday, August 27th to Sunday, August 29th. If you want to attend set up on Thursday and tear down on Monday that is great, otherwise arriving sometime Thursday and departing late on Sunday or early Monday is fine. We are happy for any part of this you can make work out.

We need your help to make this two part clinic a success. Please email laurak@ramusa.org or call 865-579-1530, if you need any assistance.

Remote Area Medical
Knoxville, TN
www.ramusa.org

A report on The Haitin Dental school Meeting in July

n July 16th, 2010, the deans of the Haitian Dental School, Dr. Sam Prophete and Dr. Denis met with me at the school to discuss how our group might be of service to them and to assess what changes are already underway. I also had the opportunity to meet and spend time with some fifth and sixth year students.

please Go to Monday, May 24, 2010 blog post to see rest of report.

Sunday, August 1, 2010

The Haitian Dental School

On July 16th, 2010, the deans of the Haitian Dental School, Dr. Sam Prophete and Dr. Denis met with me at the school to discuss how our group might be of service to them and to assess what changes are already underway. I also had the opportunity to meet and spend time with some fifth and sixth year students. Dr. Prophete took me on a much more detailed tour of the facility than I had taken during my last visit to the school in the fall.

I must be clear from the outset that I make only observations, not to be taken as criticisms. I believe the fact that the school is up and running so well under these post-quake conditions is nothing short of miraculous. These are my findings:

Coordination and Transparency

These are two issues we discussed for some time, and we reached the following conclusions:

Coordination of efforts to improve and promote dental education in Haiti should be handled by The Oral Health of Haiti Coalition, formed by the Pan American Health and Education Foundation, for issues of a more global nature.

My thoughts were to create an internet portal or even a blog where the world community can come together and interact, exchanging information about what is being done specifically for the Haitian Dental School. This will avoid duplication, will prioritize efforts and will promote transparency and coordination.

Transparency seems to be the trend in relief funds management today. We discussed that issue, and the deans were more than happy to share their accounting methods as well as to generate any of their reports for analysis. It was thought that an accounting entity could be brought in to coordinate which computer accounting program would be best for the school, and to what standards would be used to ensure transparency in the distribution of funds.

We also discussed the creation of a completely separate fund, which would be accessed by the deans for emergency needs or very specific projects.

Educational Materials

The chief request has been and continues to be educational materials. The following is a list of needs that has yet to be satisfied in any appreciable way since my last report:

LCD Projectors – There is only one projector for the entire school.

Typodonts – Used to practice cavity preparations and root canals.

Practice blocks for endodontics.

Manikins – My assistant Debbie has procured donations of two dental manikins valued at $1,500 each. We have sent out inquiries to the University of Maryland School of Dentistry as to where the manikins and typodonts were disposed of from the old school facility.

Books – The library was locked and was without a librarian since the quake, as she is recovering from a leg amputation. The library has no computerized indexing and lacked sufficient up-to-date volumes, but the students nonetheless used it to its full potential. Here, one possible solution would be a book drive in the States, or better yet from a French speaking country, for a uniform set of textbooks that could be made available to the students.

Computers

I believe the more important and more easily attainable solution would be to connect the school up to the internet and provide student access to computers in addition to online dental libraries and journals. The school had this capability in the past. There was a dish on the roof with a security cage and a room dedicated to computers, all of which was out of date and nonfunctional.

With little effort and minimal cost, I believe the school could be fully WiFi’ed, preferably with Apple computer products, as computer viruses are a large problem in Haiti. This could be achieved if funds could be made available to maintain the internet connection service. This connectivity would bring immediate improvements to dental education in Haiti.

Power Point lectures and educational materials - (again, preferably in French) enough to teach all six years of dental education - could now be gathered and stored on a large thumb drive!

It is my firm belief that there is an abundance of unused dental education materials in the States that could be brought in to Haiti, to eliminate Haiti’s lack of such materials. The Association of Dental Education (ADEE) in Europe and/or The American Association of Dental Educators (AADE) would be logical places to start this appeal and to follow it through.





The Mechanical Room

The mechanical room was undergoing some compressor repairs. The staff had just finished changing out a large capacity compressor for what appeared to be a different one with insufficient capacity. There were two larger compressors, and one of those had been almost completely scavenged for spare parts. I believe the other was in need of a coolant pump. My best guess is that they need the capacity to run more than 30 dental units and 20-25 lab handpiece units. The school only has five air driven laboratory units with need of twenty more. New York University was to supply dental chairs to replace the aging ones.

As Tobias mentioned in his report, there is no central suction for any of the units. The one single unit suction appeared to be inoperable.

Possible solutions would be to have engineers or dental lab technicians make a thorough review of the school’s future and current needs, and determine if their larger compressors can be brought back online. The plumbing and compressor capacity needs to deliver adequate suction to each dental unit. Perhaps the UN or engineers from other countries could be brought in to repair or assess the situation. The dental schools in the Dominican Republic could also be asked to send technicians.

Supplies

The supply room seemed to suffer from lack of shelving in order to conduct a proper inventory. A problem that we have seen in many medical facilities throughout the developing world is the inability or knowledge of what to save and what to discard as either obsolete or unfixable, under the best of conditions.

From our warehouse in Jimani, Dominican Republic, I was able to bring in about 5,000 doses of antibiotics. From the States, I brought in approximately 2,500 doses of local anesthesia and needles, along with 150 pounds of assorted supplies and two ultrasonic scalers.

My assistant has been able to obtain a new donated emergency kit for the school and is working on acquiring accessories for the existing portable oxygen cart. We will need to know what type of oxygen bottles are used so we can find the correct connections for the hoses.

Some of these immediate needs could be purchased in the future with the institution of the aforementioned emergency fund. The limited supplies and funds that the International Medical Alliance (IMA) helped us deliver in February seemed to make a significant contribution toward the continued function just after the quake. It has been our goal to be flexible and to meet the requested supply needs of the school in a timely fashion.

Infection Control

One of the two sterilizers that we had shipped through MedShare in their first container after the quake was there, but appeared not to be in use. The school was still using dry heat sterilization. From the provisions brought with us from the States, we supplied some sterilization pouches with indicators on them. It would be beneficial to use these to determine if their current methods of sterilization are working.

Infection control improvement is an area of great importance, and would be a Herculean task for any one person. My thinking is that before any visiting faculty or student exchanges could take place, this issue needs to be addressed.

A possible solution is to appoint some member of the staff or faculty to take responsibility for overall infection control implementation and to educate the remaining faculty or staff. That person could then be paired with their counterpoint in one or more US dental schools.

The issue of infection control issues is closely linked to the lack of infection control materials, such as sterilization pouches, barriers, paper products, distilled water, more sterilizers, cold sterilants and surface disinfectants.





Things That Need Follow-Ups

New York University’s equipment donation or transport and installation.

Commitments from Sullivan Schein, the ADA and Health Volunteers Overseas – what are they doing to follow up on their promises of aid? The deans are very discouraged.

Dental laboratory involvement – The students I saw had no way to place dowel pins in crown and bridge models or to bake porcelain onto metal.

Students expressed desire to interact and exchange with other students internationally. I met with some of them, and I believe that every effort is being made on the school’s behalf to provide a quality dental education. The students should be included in the process. They, as children of the internet, Facebook and other social media, may be able to help us in ways we old-timers could ever begin to comprehend.

Saturday, July 24, 2010

Six Months lLater




Haiti, six months later, is a continued lesson in extremes. Living side by side are the rich and poor, sick and healthy, living and dead. The frailty of life is so close to the surface of everyday living that it almost becomes invisible to the eye. Tent cities precariously appear everywhere as an immutable way of living. It scared me when even I passed them without seeing them in the midst of a bustling work day. Staying one night at the Plaza in Port au Prince was a surreal experience. An old Holiday Inn that easily withstood the 7.0 quake, the Plaza hosts celebrities like Sanjay Gupta, and Anderson Cooper who enjoy the good life of buffet meals, air conditioning and an indoor pool. Outside an amoebic mass of black and blue tarps surround the parks statues, where our attention was taken when a rock fight broke out in front of our car, necessitating our quick departure. It`s only been six months since the biggest urban disaster in the history of modern man. It took two and a half years to rebuild after the tsunami in Sri Lanka, so we need to keep the faith that the rebuilding will continue with conscious direction. There is little solace at least that major disease has not become rampant in the streets.

Visit with Nadia and Gaetan




We had a brief yet wonderful visit with Nadia and Gaetan last week at her home outside of Port au Prince. When Frantz, our driver, finally found the street after several passes, we arrived with big smiles and hugs for all. Gaetan is a perfect baby, with rolls and rolls of baby love. He barely cried when his Godmother gave him his 6 month shots. Their garden is large and flourishing and the house is rebuilding nicely. Unfortunately we missed Jonathon and Manasse who were out at school and work. We had planned to circle back and see them on the other end of the trip but had gotten delayed too much because of the fatal accident on National Hwy 1. I did get a chance to talk to Jonathon on the phone though. It didn`t matter that we couldn`t speak each others language. Language is incidental with us.

Sunday, July 18, 2010

Tragic Accident


Sent by Tom via text message, Saturday, July 17, 7:55 p.m.:

Just made the day even longer. There was a fatal accident on the road. Spent an hour stabilizing the driver for transport, with a broken leg and possible spinal injury. Made splint out of sticks and loaded him into our pickup truck - another day in paradise!

Saturday, July 17, 2010

Finally Made it over the Mountain



Tom by text message 2:08 p.m.:

Made it over the mountain and started surgeries three hours late. Going to be a long day ... very, very hot here, but at least we did not have an earthquake.

Should we fly in and help with bury survivors? Send private jet, please!

Plan B on the Container




Tom by text message at 11:46 a.m.:

My phone is finally working again. Since my last e-mail, we could not get the right paperwork for the container, so we took three small trucks to no mans's land at the border and unloaded it. We sent half to the DR and food to the orphanage in Haiti. Dorothy was very happy, but a lot of IMA money was spent.

Today, we headed out with Sheila. One hour north of Port au Prince - it took us 1/2 and hour to climb up into the hills. One truck fell off the road, but we were able to get moving again. The road is washed out - we need to go back down and start over on a different road - nothing is easy here.

Friday, July 16, 2010

Still Stuck at the Border

E-mail to me from Tom:

As usual, when I need this Palm phone the most it decides not work! Dorothy is off to see if she can get papers to cross the border. She doesn't want to put pressure on the powers that be as it makes people with jobs work even slower when pressed from above. So hopefully they will find an answer but time is ticking and the truck is costing $500 a day. If needed, I can be reached at the Plaza Hotel. Wish I could send pictures - they say a thousand words easily.

The plan is for Carol and Eric to join me here tonight. We will see. I told Dorothy to pack supplies for us to take to them to NLO in August. Off I go. Love to all - Tom

Thursday, July 15, 2010

Text Conversation Between Carol and Tom Today


Carol via text message at 7 p.m., detailing text conversations today between she and Tom:

Tom: Things are looking grim for our mission. We're stuck on the border - there are changes in the law and need for paperwork. Still waiting. Call me now, please.

Carol: Ruth got a room for you at the Plaza Hotel tonight.

Tom: That's great. We are still not across - going to make a run for it at the border without proper paperwork. Say a prayer.

Carol: Are you across?

Tom: No, but we hope to be within the hour. Rattle your beads.

Carol: Hail Mary.

Tom: Call our driver tell him to return to car - do it now. Leslie here.

Tom: Still in between DR and Haiti. Still hope to cross after dark. Leslie went away - he did not see us but saw Cedric and Widza - Leslie went in to Haiti.

Carol: Did the trucks cross?

Tom: No, we are still waiting but we have not been thrown out yet. Do not stress Dale with details - I'm teaching Dorothy to breathe - I just bribed another person $160.

Tom: No luck - gotta go to Port au Prince to get the right paperwork. I'm going to rest at the Plaza Hotel.

Stuck at the Dominican/Haitian Border


Today we loaded up the truck with gloves and drugs for the dental school. We found our 40 foot container, but they have changed the law about bringing in humanitarian supplies without charging taxes, and we need more paperwork. We sit at the border trying to get clearance amongst the worst chaos - you can't even begin to imagine. Carol will be doing surgery into the night.

We need a miracle to allow the truck to enter Haiti. I wish we still had a team of people to call on to research with their higher connections.

Warehouses of Unused Supplies

Tom via text message Wednesday, July 14, 5:42 p.m. :

After the OR was set up, Dorothy, Eric and I went to their warehouse where a small amount was obtained from the tons of supplies sent down for the quake, that either came too late or were too much of a wrong thing at the time. Mountains of them need sorting and need to be sent to a clinic of hospital that can use them. We already prepared one mountain for distribution. All in all, a good day.

Thursday we head back to Port au Prince with a 20 foot container of supplies and food for the orphanage.

Wednesday, July 14, 2010

Initial Impression of Port au Prince Six Months Out

It is just not the same crossing the border without Dr. Marc Pinard. What would have taken five minutes with Marc took at least an hour, with lots of hand gesturing and loud voices. There were road blocks every two to three miles.

Some 200,000 Haitians have fled across the border. Our initial look at Port au Prince does not seem as bad as I had imagined. The Haitians are getting on well. It's surprisingly normal, except for the presence of huge tent camps everywhere.

Tuesday, July 13, 2010

Our Arrival in Haiti Six Months Post-Quake

Tom and Carol via text message:

We arrived and made a successful rendezvous with Dr. Dennison (the dean of the Haitian dental school) and Duplan at the Port au Prince airport. The streets of Port au Prince are hot and dry with fewer people than I remember before the quake.

Cement blocks are stacked along the roadsides with many men shoveling piles of rubble to the other side of the road. Attempts at rebuilding are slowed to a snail's pace due to the oppressive heat.

It was great to see Nadia and Gaetan in the home they are rebuilding. Gaetan barely cried when his godmother gave him his six month old shots!

Luggage Issues at BWI

Tom texted me at about 8:45 this morning. He, Carol and Eric arrived at the airport to discover that each one of them could only check in two bags instead of three and not be able to pay extra to take on additional luggage. This caused them to sit on the airport floor and do a little creative rearranging! If you've ever been on one of these trips with the Ritter's, then you know that every square millimeter of their luggage space is utilized to the max!

One of their first stops after they land today is to visit Nadia and her family. Gaetan is 5 1/2 months old now - I'm sure he is just chunkalicious. I miss holding that little bundle! and look forward to seeing them soon.

Friday, July 2, 2010

Carol ,our son Eric and I leave for Haiti on July 13th

Some good news from Haiti
People often ask Carol and I "Are things getting better in Haiti?"
I think this report from NPR says a lot about the current conditions in Haiti.
http://www.npr.org/templates/story/story.php?storyId=128245622

Saturday, June 19, 2010

Isn’t it odd that while in Haiti, in the midst of all the chaos and very long days, Carol and I had “more time” to post to blogs than we now seem to find time for back home in Baltimore?

I want to share with you what Carol and I have been doing since our last blog posts that came more frequently- not as some kind of lame excuse for not blogging more. However, I think our schedule has been a testament to the unwavering focus and outpouring of compassion that continues as strong as it ever was, just after the Haitian earthquake.

Perhaps in reading over the many varied groups that ask us to meet and talk with them about Haiti, you’ll come across an area where you or someone you know may want to get involved.

January 19th-24th: Tom was supposed to be in Port au Prince for a conference of groups interested in stoves and alternative fuels. Had he been there one week earlier, he would have been at the Hotel Montana - and dead.

January 25th: Returned from Haiti.

January 31st: Bruce Winand’s funeral. Bruce was a local Towson hero who ran most of the Towson Recreation Council sports programs. He coached or managed leagues for all three of our children. He died suddenly of a heart attack at age 51, and is an almost irreplaceable member of the Towson community.

February 2nd: Nadia gives birth to Gaeten Thomas at GBMC in the middle of Snowmaggedon.

February 4th: Ignite talk. Five minutes of discussion of a subject during a slideshow that advances automatically. When five minutes is done, you are done. See “Talk about Stoves” on this blog on February 4th.

February 5th: Nadia and Carol gave a press conference at GBMC. Nadia says all the right things like such as “GBMC cares more about people than money”.

February 6th: Real Simple Magazine fights their way thru Snowmaggedon to do a photo shoot of Carol and Nadia for the March issue.

February 11th: Baltimore Acts benefit concert at Meyerhoff gets cancelled on account of Snowmaggedon. Carol and I are actually somewhat relieved that we do not have to speak publicly so soon after our return.

February 14th: Shower for Nadia and Gaetan.

February 16th: Mia Farrow’s “people called our people” to see if we wanted to have dinner with her, accompanied by John Waters. An interesting dinner conversation ensued with John Waters wanting to talk Hollywood, while Mia Farrow wanted to talk to us about our work in Haiti and her work in Darfur – a very unforgettable evening.

February 20th - March 6th: Carol and Sarah in Thailand.

February 23rd: Tom spoke at the Baltimore County Dental Meeting about Haiti and the work with the Haitian dental school.

February 25th- 27th: Brought Samuel Prophet, the Dean of the Haitian Dental School to Chicago to meet with dentistry’s movers and shakers, such as the ADA, Sullivan Schein and the global outreach heads of several dental manufacturers. The Dean was able to deliver a speech to the ADA. Many promises of aid made - we will see.

March 5th: Met with Mrs. Needles and her middle school class at GBMC to sort medical supplies, and had the crutches they collected shipped to Haiti by Med Share.

March 6th: Carol returned from Thailand and was appointed as VP of MedChi.

March 11th: Met with dental students at UMD interested in helping the Haitian dental school.

March 28th: Spoke at the Episcopal Church of the Redeemer (these are the people who continue to support the work we participated in for many years in Honduras).

That same day, Nadia spoke at Pleasant Hope Baptist Church, where the Reverend Heber Brown, III has committed his churches’ social activism to Haiti for the whole next year. What an inspiration Reverend Brown is. Visit his website at Faithinactiononline.com.

March 30th: Memorial Service for another great man – Sean, a scrub tech at Hopkins. We were working with Sean to bring Med Share to Hopkins, and whom just the night before his untimely death at age 32, invited us to work with his surgical team in Ghana.

April 11th: Had a meeting with Dave, past CFRE Vice President of Development and Marketing for Med Share, to discuss bringing about a Med Share sorting, shipping, and receiving warehouse to Baltimore.

April 18th: Patricia Arquette’s “people called our people” to ask if we would like to have breakfast at her hotel in DC where she is filming her show “The Medium”. Carol and I discussed Haiti and kids.

April 30th: Dental Access Day at the University of Maryland. My assistant Karen and our intern Nicole spent the day providing free dental work for Baltimore’s citizens in need.

May12th: Baltimore Acts Fundraiser for Haiti, at Nick’s Fish House. These were the folks who tried to pull off a large concert fundraiser soon after the quake but had to cancel due to the snowstorms.

May 16th: Spoke at the Church of the Good Shepherd in Ruxton. This church was a huge supporter of IMA and Med Share after the quake and continues to raise money.

May 14th-16th: Eric stars in the musical “Curtains” and it’s a smash hit. He is a smash hit, of course.

June 13th: Mount Washington Yoga holds an open house and donates 10% of sales to IMA.



The following June 9th trip was canceled due to the death of my mother Nancy Ritter . On June 13th Carol and I wheeled my mom's hospital bed outside at the hospice center in Wisconsin and 30 minutes later she simple flew away. So ended a life that provided so much love to so many. She was buried on Thursday June 17th



June 9th-14th: Carol and Tom and RN Mandy head back to Haiti to do some GYN surgery. While there, we visit with Nadia and Gaetan Thomas. We also brought much needed supplies to the dental school and clinics in Port Au Prince.



Monday, May 24, 2010

The Hatian Dental School


On July 16th, 2010, the deans of the Haitian Dental School, Dr. Sam Prophete and Dr. Denis met with me at the school to discuss how our group might be of service to them and to assess what changes are already underway. I also had the opportunity to meet and spend time with some fifth and sixth year students. Dr. Prophete took me on a much more detailed tour of the facility than I had taken during my last visit to the school in the fall.

I must be clear from the outset that I make only observations, not to be taken as criticisms. I believe the fact that the school is up and running so well under these post-quake conditions is nothing short of miraculous. These are my findings:

Coordination and Transparency

These are two issues we discussed for some time, and we reached the following conclusions:

Coordination of efforts to improve and promote dental education in Haiti should be handled by The Oral Health of Haiti Coalition, formed by the Pan American Health and Education Foundation, for issues of a more global nature.

My thoughts were to create an internet portal or even a blog where the world community can come together and interact, exchanging information about what is being done specifically for the Haitian Dental School. This will avoid duplication, will prioritize efforts and will promote transparency and coordination.

Transparency seems to be the trend in relief funds management today. We discussed that issue, and the deans were more than happy to share their accounting methods as well as to generate any of their reports for analysis. It was thought that an accounting entity could be brought in to coordinate which computer accounting program would be best for the school, and to what standards would be used to ensure transparency in the distribution of funds.

We also discussed the creation of a completely separate fund, which would be accessed by the deans for emergency needs or very specific projects.

Educational Materials

The chief request has been and continues to be educational materials. The following is a list of needs that has yet to be satisfied in any appreciable way since my last report:

LCD Projectors – There is only one projector for the entire school.

Typodonts – Used to practice cavity preparations and root canals.

Practice blocks for endodontics.

Manikins – My assistant Debbie has procured donations of two dental manikins valued at $1,500 each. We have sent out inquiries to the University of Maryland School of Dentistry as to where the manikins and typodonts were disposed of from the old school facility.

Books – The library was locked and was without a librarian since the quake, as she is recovering from a leg amputation. The library has no computerized indexing and lacked sufficient up-to-date volumes, but the students nonetheless used it to its full potential. Here, one possible solution would be a book drive in the States, or better yet from a French speaking country, for a uniform set of textbooks that could be made available to the students.

Computers

I believe the more important and more easily attainable solution would be to connect the school up to the internet and provide student access to computers in addition to online dental libraries and journals. The school had this capability in the past. There was a dish on the roof with a security cage and a room dedicated to computers, all of which was out of date and nonfunctional.

With little effort and minimal cost, I believe the school could be fully WiFi’ed, preferably with Apple computer products, as computer viruses are a large problem in Haiti. This could be achieved if funds could be made available to maintain the internet connection service. This connectivity would bring immediate improvements to dental education in Haiti.

Power Point lectures and educational materials - (again, preferably in French) enough to teach all six years of dental education - could now be gathered and stored on a large thumb drive!

It is my firm belief that there is an abundance of unused dental education materials in the States that could be brought in to Haiti, to eliminate Haiti’s lack of such materials. The Association of Dental Education (ADEE) in Europe and/or The American Association of Dental Educators (AADE) would be logical places to start this appeal and to follow it through.

The Mechanical Room

The mechanical room was undergoing some compressor repairs. The staff had just finished changing out a large capacity compressor for what appeared to be a different one with insufficient capacity. There were two larger compressors, and one of those had been almost completely scavenged for spare parts. I believe the other was in need of a coolant pump. My best guess is that they need the capacity to run more than 30 dental units and 20-25 lab handpiece units. The school only has five air driven laboratory units with need of twenty more. New York University was to supply dental chairs to replace the aging ones.

As Tobias mentioned in his report, there is no central suction for any of the units. The one single unit suction appeared to be inoperable.

Possible solutions would be to have engineers or dental lab technicians make a thorough review of the school’s future and current needs, and determine if their larger compressors can be brought back online. The plumbing and compressor capacity needs to deliver adequate suction to each dental unit. Perhaps the UN or engineers from other countries could be brought in to repair or assess the situation. The dental schools in the Dominican Republic could also be asked to send technicians.

Supplies

The supply room seemed to suffer from lack of shelving in order to conduct a proper inventory. A problem that we have seen in many medical facilities throughout the developing world is the inability or knowledge of what to save and what to discard as either obsolete or unfixable, under the best of conditions.

From our warehouse in Jimani, Dominican Republic, I was able to bring in about 5,000 doses of antibiotics. From the States, I brought in approximately 2,500 doses of local anesthesia and needles, along with 150 pounds of assorted supplies and two ultrasonic scalers.

My assistant has been able to obtain a new donated emergency kit for the school and is working on acquiring accessories for the existing portable oxygen cart. We will need to know what type of oxygen bottles are used so we can find the correct connections for the hoses.

Some of these immediate needs could be purchased in the future with the institution of the aforementioned emergency fund. The limited supplies and funds that the International Medical Alliance (IMA) helped us deliver in February seemed to make a significant contribution toward the continued function just after the quake. It has been our goal to be flexible and to meet the requested supply needs of the school in a timely fashion.

Infection Control

One of the two sterilizers that we had shipped through MedShare in their first container after the quake was there, but appeared not to be in use. The school was still using dry heat sterilization. From the provisions brought with us from the States, we supplied some sterilization pouches with indicators on them. It would be beneficial to use these to determine if their current methods of sterilization are working.

Infection control improvement is an area of great importance, and would be a Herculean task for any one person. My thinking is that before any visiting faculty or student exchanges could take place, this issue needs to be addressed.

A possible solution is to appoint some member of the staff or faculty to take responsibility for overall infection control implementation and to educate the remaining faculty or staff. That person could then be paired with their counterpoint in one or more US dental schools.

The issue of infection control issues is closely linked to the lack of infection control materials, such as sterilization pouches, barriers, paper products, distilled water, more sterilizers, cold sterilants and surface disinfectants.

Things That Need Follow-Ups

New York University’s equipment donation or transport and installation.

Commitments from Sullivan Schein, the ADA and Health Volunteers Overseas – what are they doing to follow up on their promises of aid? The deans are very discouraged.

Dental laboratory involvement – The students I saw had no way to place dowel pins in crown and bridge models or to bake porcelain onto metal.

Students expressed desire to interact and exchange with other students internationally. I met with some of them, and I believe that every effort is being made on the school’s behalf to provide a quality dental education. The students should be included in the process. They, as children of the internet, Facebook and other social media, may be able to help us in ways we old-timers could ever begin to comprehend.

Funds and Forceps for Haiti

In a matter of 35 seconds, on January 12th, 2010, 80% of the government buildings in Haiti became a pile of rubble. One of the few buildings still standing is the Haitian Dental School.
The school has been producing twenty dentists a year to treat a population of nine million people. Having been helping the school over the past few years, I found it to be lacking in almost everything necessary to teach and practice dentistry before the quake - except commitment.
The school needed a helping hand before the quake but needs to keep operating, especially now - so that the building is not requisitioned by some other governmental entity. If the school is closed, I can’t only imagine how long it would take to get another dental school up and running.
From us they have requested forceps, oral surgery instruments, oral surgical and operative handpieces, and of course, monetary donations.
Instruments can be dropped off at the MSDA office or at my office at 8320 Bellona Avenue, Suite 110 in Ruxton. Tax deductible donations can be sent to imaonline.org. Carol and I will be leaving on JUNE 8th - (that’s sooner than you think!) to personally see that the funds and instruments get to those who need them.
For questions or for more information, you can reach me at tom@tomritter.com, or go to carolandtominhaiti.com. If you have made a donation by either PayPal or by mail, please send me an e-mail so that those funds can be designated for the Haitian Dental School.

Saturday, April 17, 2010

Dr. Marc Pinard - Death Notice



It is with the deepest sorrow that the International Medical Alliance of Tennessee announces that Dr. Marc Pinard, with whom we have worked closely for the last ten years, collapsed and died suddenly on Thursday, April 15, 2010, at Jimani, the Dominican Republic.

Dr. Pinard selflessly devoted the last fifteen years of his life to providing charitable medical care, feeding programs and hospital and orphanage

Tuesday, April 13, 2010

email from Manesse

Thirteen weeks from the quake...
Eleven weeks since landing in the states...
Ten weeks from Gaeten`s birth...
Their journey returns to Haiti.
Nadia and Gaeten returned to Haiti yesterday with the Friends of Haiti Green Bay.

I just received this text and email from Manesse.

Thursday, February 25, 2010

concert at jackie's benefits haiti charity

(from just up the pike, Read more there)Last weekend, Jackie's Restaurant hosted an acoustic concert benefitting a hospital in earthquake-ravaged Haiti. About eighty people turned up to see a number of local musicians and support the International Medical Alliance, currently providing health care on the border of Haiti and the Dominican Republic. As always, local photographer and friend of JUTP Chip Py was there to capture the event for posterity.(from just up the pike, Read more there)

Monday, February 22, 2010

HAITI BENEFIT
TOWSON UNITARIAN UNIVERSALIST CHURCH
TUUC Friday Concert Series

PRESENTS
ROCKIN’ JAKE
3/5/’10

March 5 – Rockin’ Jake www.rockinjake.com
Its dancing time again; come enjoy this raucously wonderful New Orleans band. Come enjoy this infectious music as these musicians lay down those funky rhythms. Jake rules the Blues Harp; he’s 5 time winner of the "Best Blues Harmonica" award in the Best of the Beat, New Orleans Music Awards. Rockin' Jake has been hailed by many as one of the premier harmonica players in the country. His original sound is a hybrid of second line, swamp funk, blues and zydeco with influences from Paul Butterfield, Big Walter Horton, James Cotton, The Meters, WAR, J. Geils Band, Clifton Chenier, and the Fabulous Thunderbirds. Jake has conjured up this formula that is blowing crowds away from coast to coast.

Let’s help our neighbors in Haiti; 100% of the proceeds from funds raised from the silent auction and raffles will go to provide relief to Haiti

Haiti earthquake damage estimated up to $14 billion

(read more at Washington Post) Haiti's massive earthquake could be the world's most devastating natural disaster since World War II in relation to the country's size and economy, causing as much as $14 billion in damage, according to a study released Tuesday by the Inter-American Development Bank.

The estimate is based on comparisons with about 1,700 other disasters around the world in recent decades. A more detailed, official estimate is expected in a few weeks. But the preliminary study gives a sense of the extraordinary rebuilding task that awaits the hemisphere's poorest country.  (read more at Washington Post)

Friday, February 19, 2010

NYTimes - Doctors Haunted by Haitians They Couldn’t Help

(READ MORE AT NY TIMES) PORT-AU-PRINCE, Haiti — The foreign doctors who performed the first amputations after the earthquake used hacksaws. They relied on vodka for sterilization, substituted local numbing for generalanesthesia, jury-rigged tourniquets from rubber gloves. Working around the clock in improvised operating rooms, they sacrificed limbs and lost patients to injuries that are no longer supposed to be disabling or deadly. 


Now back in their antiseptic, high-tech offices in the United States and elsewhere, the medical professionals who initially flew to Haiti’s rescue are haunted by their experiences, “overwhelmed by conflicting feelings of accomplishment and guilt,” as Dr. Louisdon Pierredescribed it.


They witnessed what Dr. Laurence J. Ronan ofMassachusetts General Hospital described as a “mass casualty horror show.” They practiced what Dr. Dean G. Lorich of the Hospital for Special Surgery in Manhattan called “Civil War medicine.” They saved lives, probably by the thousands, but their accomplishments were limited by the circumstances.  (READ MORE AT NY TIMES)

Friday, February 12, 2010

The Month Anniversary


On the month anniversary of the Haitian earthquake, Nadia and I remembered the world changing event in a prayer spread by the Haitian Diaspora around the world.

**May all Haitians around the globe pause for five minutes on February 12th between 4:50pm-4:55pm ,kneel & send their prayers up to Heaven. You can say the following prayer or one of your own.
"Almighty Father, pour out on us your mercy & compassion as we feel broken inside. We ask you for solace and comfort for those who lost their loved ones & their material belongings. Grant us the strength and courage to rebuild a Haiti where all Haitians will live and love each other as brothers & sisters regardless of their differences, we ask you in the name of your son Jesus Christ. Amen".

It seems more like one long continuous day since the quake. We have been living, breathing, dreaming Haiti 24/7 since Jan 12th.

CEO of Medshare on CNN talks about Haiti



Embedded video from CNN Video


Carol and Tom appear in a section of this video on the bus.

Thursday, February 11, 2010

Meyerhoff Concert Postponed

The concert at the Meyerhoff hass been cancelled and a new date and time will be announced. The Brewers' Arts has been rescheduled on Monday, February 15th! Stay posted!

A Benefit for Haiti - Saturday, February 20th

Hey Tom,
You still matching the Medshare donations? If so, we will dedicate the
proceeds from this benefit to the organization.
-Tony & Claudia

Saturday, Feb 20th, a Benefit for Haiti at Jackie's Back Room. Bands will play unplugged (acoustic). It's going to be a unique night. When was the last time you saw a bunch of punk rockers playing this quietly? Performances include 7 Door Sedan, Sister Ex, Beatnik Flies, Ottley and many more. It starts at 8 pm with performances beginning immediately. Suggested donation is $15.

The Back Room is behind Jackie's Restaurant at 8081 Georgia Ave, Silver Spring. Use the Sligo Ave door entrance to the restaurant.

Sunday, February 7, 2010




It was hard to say good bye to Austin today as he heads back to Middlebury, Vt with the snow still making travel challenging. As a mother, feeling the sadness creep in because of the distance between me and my son, I can only imagine the pain Nadia suffers being separated from Jonathon in an unstable Haiti with an uncertain time to reunite.

Tom and I are trying to find a way to work the visa paper work one more time, this time for Jonathan. Manasse, who forgot that his birthday was yesterday, says the school in which he worked is being rebuilt and plans on opening early next month. But what will he do with Jonathon when he restarts work? What will happen when the rains come and they are still lining in a bug tent? How can we send a newborn to that inhumane environment and expect him to survive? If 3 y/o Jonathan could be here with his mother and brother everyone would be safer and more productive. Time to rally all our immigration connections again.



From the Big Earthquake to the Big Snow, Nadia and Gaetan survive the elements with grace and curiosity. Still in the hospital is not a bad thing since a tree fell on the neighbors house and another took the power lines down. Nadia wondered about the homeless during these conditions and what will happen in Haiti during the rainy season. Our networking for earthquake proof homes is progressing on multiple fronts. www.mdue.it is very promising.

Saturday, February 6, 2010

Rice + Beans = Medicine

Carol and I would like to express our heartfelt thanks for your overwhelming response to support our relief efforts in Haiti. Although there is not yet a final tally, we believe that donations to MedShare totaled between $35,000 and $40,000, matching our initial $5,000 challenge many times over. In addition, another $10,000 was generously donated to our friends at the International Medical Alliance (IMA).

Our hearts are filled with gratitude; however there is a continued, desperate need for help. IMA is still on the ground in Haiti with an immediate need to buy fuel to keep the hospital running and rice and beans to feed their patients. While the doctors were able to successfully treat many victims of the earthquake, it has become increasingly difficult to provide them with proper sustenance. It’s estimated that another $30,000 is urgently needed just to feed recovering patients between now and the end of February … and each month thereafter.

If at all possible, we urge you to reach into your hearts and into your wallets once again as we face this ongoing crisis…we must remain vigilant in our follow-up care. With your support, we will continue to do all we can to ease the pain and suffering of our friends in Haiti.

Peace,

Tom and Carol

UPCOMING EVENTS TO SUPPORT ONGOING FUNDRAISING EFFORTS:

Please visit www.baltimoreacts.org for more information about Rock to Rebuild, a Gala Concert Celebration uniting the spirit of Haiti and Baltimore and featuring Melky and Farel Jean (siblings of Wyclef Jean), Mario, Mya and the Morgan State University Choir.
February 11, 7:30pm
Joseph Meyerhoff Symphony Hall

Tickets on sale now.

Brewer’s Art in Baltimore will host a fundraiser for a Haitian hospital on Monday, February 8. Please visit http://www.thebrewersart.com/new.html for more information.

Friday, February 5, 2010

A US Helicopter Crashed and Killed Two Doctors in Haiti

Two Americans were killed in the Dominican Republic while on board a U.S.-owned helicopter involved in Haiti aid efforts. Pilot John Ward and co-pilot James Jalove were returning from Haiti on Thursday night when their R44 II helicopter crashed into a mountain in the western Dominican province of Dajabon, said Dominican Civil Aviation Institute spokesman Pedro Jimenez. Jimenez did not release the men's home states or towns.

One of the firefighters at the scene, Angel Belliard, said one of the two men was dressed as a doctor -- he did not elaborate -- and that emergency responders found medication scattered around the crash site.

U.S. Embassy spokesman David Searby said he could not confirm the crash or the reported identities and nationalities of the victims. Protocol requires that the Embassy contact next of kin before confirming the deaths of U.S. citizens.

The helicopter was owned by JAJ Investments Limited in Naples, Florida, according to U.S. Federal Aviation Administration documents. The company could not be reached immediately for comment.



Nadia and baby had press conference today at GBMC. She thanked everyone at the hospital for helping her get here and deliver baby Gaetan safely and for treating her like a queen. The snow storm started shortly after the conference and is expected to continue through tomorrow evening. There is a sullenness with this snow as we get news of the pathology on the supposed fibroid; a desmoid tumor, and news from Jimini about a copter crash in the mountains with unsubstantiated loss of life. The patients in Jimini are coming through the surgeries well, but food for them is minimal. IMA is struggling to buy food with what they have. Monetary donations are slowing and are more desperately needed now for the people who have survived the earthquake; the "lucky" survivors now trying to survive the famine and disease that often follows an acute disaster.
IMAonline.org

Thursday, February 4, 2010

A B Short, CEO of Medshare, Travelled with us to Haiti:

When the news broke that a 7.0 earthquake had rocked Haiti, there was no question that MedShare would respond. Traditionally, we are not an emergency response organization, but over the past 10 years, we’ve shipped 37 containers of medical supplies and equipment to Haiti, and had established relationships there. The cry from that disaster was a personal one from our Haitian friends that were suffering. They desperately needed our help, and MedShare had the ability to do it.

Before the earthquake struck, I already had plans to go to Haiti to look at a project that we were going to do jointly with Project Medishare and Partners in Health. Two days after the earthquake, a company out of Florida offered use of their plane to MedShare for shipping medical supplies. We decided to use the plane to fly a medical team from International Medical Alliance of Tennessee to Santo Domingo, along with our medical supplies, and in an instinctive decision, I decided to go with them. I was already physically and emotionally prepared to be there, and being that MedShare doesn’t have a history of emergency response, I saw this was as an opportunity to learn about the issues and challenges of doing it.
So I traveled down with the team from IMA, who had a working relationship with a Haitian doctor who ran the Good Samaritan Hospital in Jimani, Dominican Republic. This was a 100-bed hospital just minutes across the Haitian border. Hospitals in Port-au-Prince were overcrowded and injured people were waiting days without treatment, so many Haitians were being transported by the truckload to Jimani. When we arrived there were over 300 patients needing emergency treatment.
I’ve traveled to 38 countries, and I’ve never witnessed the mass pain and suffering like I did on this trip to Haiti. It was emotionally draining, but incredibly inspiring to see the strength of the Haitian people, both the victims and the family members supporting them with love and care. There’s no way the medical staff could have met the needs of the patients without the family members there to help tend to them.
The Haitians had an insatiable spirit of survival that I’ll never forget. I remember seeing one young woman who had her right arm amputated at the shoulder joint. She just sat in the hospital just staring, patiently waiting and wondering what’s next for her life.
Then there were those patients like Erick, whose injuries were too critical for our hospital to treat with what little resources we had. Erick had been engulfed in a propane fire in his house during the earthquake. He had 35% of his body burned, and was stuck under the rubble for two days. He then spent another three days waiting outside a hospital in Port-au-Prince to be treated, before his family brought him to us. His wife and daughter stayed by his side the entire time, comforting him and nursing his wounds until we were able to get him airlifted to the USS Comfort to receive proper treatment. None of these people deserved this, but they don’t dwell on that; they go on.
In the midst of this emergency situation, I witnessed firsthand the success of MedShare’s operations. When donations from some organizations came in, I saw medical professionals having to take time away from the patients to sort and organize the various medical products. In contrast, MedShare donations would arrive and go immediately to use, because they were already sorted, labeled and ready to go. We get needed medical supplies into the hands of physicians, and it made me proud to know that our staff, donors and volunteers helped make all this happen.
I’m going to be emotionally processing the 10 life-changing days I spent in Haiti for weeks and months to come. As for how we can continue to help, I see where MedShare can have a pivotal role in the rebuilding of Haiti. It’s time to continue our efforts and assess how we can use our skills and resources to have the greatest impact on reestablishing a new, quality health system in Haiti.

Wednesday, February 3, 2010

A Good Link For Pictures of Jimani

http://onlineministries.creighton.edu/CollaborativeMinistry/Haiti/

Nadia's Delivery - by Dr. Merryman

Dr. Duroseau and I initially met Nadia on our first mission trip to Haiti last October. We worked together in the mountains of Noyeau with Friends of Haiti; seeing 2000 patients in 5 days. Nadia was an interpreter and pregnant. Carol Ritter had known her from previous trips and began planning to have her deliver in the US. She asked if we would do the delivery and provide her care. Thus began the journey. Upon arriving home, we all wrote letters in support of her VISA to no avail.

Then the horrific tragedy occurred. The Ritters left for the DR to work on the border. Dr. Duroseau followed. They got Nadia to the border. Only after this tragedy and the extraordinary efforts of the Ritters did the VISA come through. She returned to the US with them. I was reunited with Nadia last Thursday when Dr. Natalie Blagowidow performed her sonogram. I knew the basics of her history; 36-37 weeks, previous C-section and fibroid tumors. Nothing could have prepared me for the picture on the sonogram. Dr.'s Duroseau, Ritter, and I were shocked to see an 18 cm fibroid tumor enveloping the front wall and left side of the uterus. The remainder of the front wall of the uterus was covered on the inside by placenta. The bladder was skewed to the right and the head was wedged behind the fibroid.

On Monday Nadia had an amniocentesis for lung maturity. Later that evening we got the news that the lungs were O.K. and we were on for Tuesday. Over the previous days I had given extensive thought to the surgical approach; strongly considering the need for Cesarean hysterectomy. We prepared Nadia that she may well lose her uterus. Until I made the incision, I was not at all certain how we would get the baby out of this grossly distorted uterus.
I had to make a large vertical skin incision. After getting into the abdomen all we could see was fibroid. I had to extend the incision so that I could palpate the uterus. I started to manipulate the fibroid and it began to peel off the uterus. We keep dissecting until we were uncomfortable about its attachments to underlying blood vessels. With Dr. Duroseau pulling up the uterus, and Dr. Ritter deflecting the fibroid far to the left, I found a spot on the uterus to make my incision. I delivered the head with difficulty but it ran directly into the fibroid making the delivery of the shoulders our biggest challenge. We delivered a healthy baby boy. We then delivered the placenta and closed the uterus. The fibroid was a large parasitic mass on the anterior abdominal wall. After much dissection it came free. The uterus looked relatively normal and the blood loss was as expected. We finished the case without any problems.

With the current state of medical care in Haiti, I am convinced that Nadia and/or the baby could have been lost if she delivered there. To all those who made it possible I salute you. Everyone rose to the occasion in support of our goal to provide Nadia the safest delivery; from the nursing staff, to the anesthesiologist Dr. Tom Pesar, to Dr. Blagowidow and her staff, to our department chairman Dr. Khouzami, and finally to the hospital administration. Dr. Ritter, Dr. Duroseau, and I all trained at GBMC and did our residency under Dr. Khouzami. I have spent my entire twenty year career at this hospital and I consider it my second home and the staff, my family.

A Report From Doctors Still On The Front

A team of Creighton doctors and nurses that returned from Haiti described a horrific scene but a scene they'd return to without hesitation."There was pain and suffering everywhere," said Dr. Tommy Lee. The team spoke to the media Wednesday afternoon.The tired group, Omaha's first team to the country after the earthquake, said its members pulled 15-hour days.Team members said they helped about 800 patients in 10 days. Between 20 and 30 percent of the patients were children, said Dr. Brian Loggie. Most of the care involved performing surgeries, amputations and dressing wounds.Loggie said the conditions upon their arrival were primitive. Medical supplies were limited. Amputations were being performed without narcotics."I mean it was Civil War, bite-the-bullet stuff," Loggie said.The group hit the ground running from the moment they got there, members said, but they still felt helpless before the crowds of injured."We would have patients back in the same rooms two to three minutes later ready to cut off more limbs," said nurse anesthetist Timothy Glidden. "It was something we've never seen."As conditions improved, the health of some victims didn't. Creighton nurse Theresa Keefe -- nicknamed Mother Theresa -- struggled with the huge number of suffering children."Crying out, crying out for help, in pain -- that was tough," Keefe said.Despite it all, they said they'd return."I don't know about tomorrow. I need some sleep. But we'd go back," Keefe said.

Tuesday, February 2, 2010

New Baby Is Here! A Message From Gaetan's Daddy

UNEDITED VIA SMS/ TXT: Dear Dr. Tom and Dr. Carol - I don't find the appropriate words to thank you but I thank God that He put you in our way. I know there are good doctors in the USA - you and your team are the best in the world. I knew Nadia had a pregnancy with a very high risk but with your expertise and your know-how, you have succeeded the mrs, the team and anyone who help us for grace of you, my sweetie and my baby are safe and healthy. So I thank Lord . Once again thank you. - Manesse

Baby Gaetan 7.6 lbs 21.5"
Mother and child doing great after very difficult surgery. Everything went well.

Sunday, January 31, 2010

Teams Poll Haitians to Learn What They Need After Earthquake

Title:
ComposeEdit HtmlTeams poll Haitians to learn what they need after earthquake
By David BrownWashington Post Staff WriterSunday, January 31, 2010;
PORT-AU-PRINCE, HAITI -- How do you find out what the Haitian people really need now, nearly three weeks after the earthquake? You ask them.
Three-person teams, each including at least one member who speaks Creole and French, are fanning out to 152 sites across the country this week, asking a long series of questions to "key informants." When they are done, they hope to have a clearer picture of the food, shelter, water, sanitation and health-sector needs of the Haitian population.
That's the intent of a week-long project run by the U.N. Office for the Coordination of Humanitarian Affairs, the World Health Organization and the U.S. Centers for Disease Control and Prevention.
It is an experiment in another way, too. The data are being collected on hand-held computers (PDAs) as well as on paper forms marked with pencils.
Much as truth is the first casualty of war, reliable information is one of the early casualties of natural disasters. Until fairly recently, disaster responders relied on their senses, and their common sense, to identify problems. The notion of measuring what you could see was viewed as an academic and slightly effete response to things such as earthquakes, hurricanes and tsunamis.
That view has changed.
The "evidence-based" paradigm slowly remaking medicine has crept into disaster medicine, too. So has the drive to make this field, like much of the rest of medical care, more democratic and responsive to the consumer and less paternalistic and responsive to the expert.
It is true, though, that time is of the essence, even a few weeks after a disaster such as this. Methodological rigor has to wrestle with the need to get things done.
The survey this week didn't ask questions of a random sample of Haitians in the way that a medical trial would. That would have been a huge and time-consuming undertaking. Instead, it sought out individuals expected to know what was happening to the people in their area: mayors, village directors, health officials. The places weren't chosen randomly either. The designers chose fairly evenly spaced sampling sites, with extra ones in the heavily damaged Port-au-Prince area.
There is also the matter of what to ask. Too little, and it's worthless. Too much, and it tries the patience of interviewer and informant. "This is a not-so-rapid rapid assessment," Carl Kincade, a CDC epidemiologist, said as he fluttered the 10-page questionnaire while waiting in the mid-morning heat for interviewers at a dusty lot in a centrally located neighborhood.
One of the teams went to Kenscoff, an administrative district of six villages south of Port-au-Prince. Reaching it took an hour of steady uphill driving. Part of the way, the road traveled the edge of a gorge-like valley, with lush terraced fields on its slopes. The destination was a village called Nouvelle Tourraine.
Relatively speaking, Nouvelle Tourraine was spared. Of its 7,981 residents, one person died in the earthquake and one was injured. Two Catholic churches and 64 houses were destroyed; nine other houses were damaged.
The chief interviewer was Jules Figaro, a 31-year-old graduate of Haiti's state university, where he studied ethnology. He lives in Cite Soleil, the capital's famous slum, with his parents, five brothers and three sisters. He has never had a job. Assisting him were Alex Guerrier, 24, a fourth-year student of administrative sciences, and Anne-Marie Saint-Victor, a 21-year-old medical student. The team leader got $50 for the day, the assistants $30.
They spoke with the appointed director-general of Kenscoff, a 40-year-old man whose crowded desk included a Haitian flag on a dowel that he had put at half-staff. He answered the questions with confidence.
The temporary housing's protection from weather: poor. Privacy: acceptable. Security: poor. Sheltering households with water purifying chemicals: less than 25 percent. Ones with necked water containers that make water storage safer: 50 to 75 percent.
Then it was around the corner to the Sanitary Bureau, where a public health doctor and infectious diseases specialist, Dorothy Posy, provided the information.
Number of births in Nouvelle Tourraine, in the last week: 10. Number with trained attendants: nine. Cases of diarrheal disease: one.
She was happy to report that the 10 people on antiretroviral therapy for HIV infection and the four under treatment for tuberculosis had no interruption of treatment.
There were some problems with the PDA, and Guerrier couldn't keep up with all the answers. So he would copy down the ones he'd missed from the paper form later on. Consequently, the analysis of how similar the two sets of data are -- paper vs. digital -- will be muddied for this team. And then there was the problem of running into another survey team as they descended the stairs from the Sanitary Bureau.
Scott Dowell, head of CDC's efforts here, speaks Creole and spent much of his childhood at the Albert Schweitzer Hospital, about 50 miles northeast of the capital, where his father worked as a pediatrician. He said the problem of bumping into other teams was bound to happen occasionally. If a team finds no reliable informant at the place it is assigned, it is instructed to go the nearest place there is one.
"So two teams are going to end up in the same place some of the time," he said.
It turns out, though, this duplication was intentional, a random test of the "reproducibility" of the data.
It will be into next week before the survey findings are compiled and considerably longer before the PDA experiment is judged a success or failure.
But there are some experts who think that the brief day of the PDA is over and that there's only one way to efficiently collect epidemiological data in the field. It's with a cellphone, the hand-held computer just about everyone in the world can afford.