My Last Day At CURE Hospital

November 1st, 2015 by INMED
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Well, since the last time I wrote, both Jean David and Jackie Lynn have returned to Haiti.  Jean David left Sept. 14 and Jackie left the next day.  I was very sad to see them go, but I know JD and Jackie and both of their mothers were so excited to go home and see their families.  It makes me happy to know that they are at home and reunited with their families after all this time.  I would need to clarify this with Dr. Nelson – but I think JD and his mom were here for about three months; Jackie and her mom about 2-3 months.


Today is my last day at the hospital…I can’t believe it’s already here!  Time goes by so quickly!  Tomorrow was supposed to have been my last day, but today is a Dominican holiday and rather than have today off, the director of the hospital decided to give us a three-day weekend!  Anyway, I’m very sad that today is it.  I have made great friends here – with the patients, their parents and with the hospital staff as well.


The employees and administration of the hospital have been so kind and accomodating to me.  I have spent time with many of them outside of the hospital.  And, of course, there’s Felipe!!!  Felipe has also been an amazing friend – always looking out for me, always bringing me food, food and more food!!  🙂  I have spent so much time with her and her two kids that they are like family now!


I am sad that I won’t be around to continue watching “my kids” progress.  Every one of the children and teens that I have worked with have embraced me with open arms and have given me days filled with smiles and laughter….even though for many of them, therapy sessions were painful and/or hard work.


So, it’s time for me to head to the hospital now.  This last day is going to be difficult…I’m not a fan of good-byes.  But, this is not good-bye, really…I have exchanged email addresses with patients, their mothers, with hospital staff  – so we will be in touch.


Many thanks to INMED and CURE Dominicana! I am so fortunate to have had this experience.  It has definitely made an impact on my life.

Another Patient – Jean David

September 13th, 2009 by INMED
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This is seven-year old, Jean David from Haiti. Jean David has Arthrogryposis, a rare genetic disorder which is characterized by multiple joint contractures and can include muscle weakness, scoliosis and/or growth retardation, among other things.


Before Jean David saw Dr. Nelson, his legs were severely contractured with both hips in flexion, abduction and external rotation.  His hips may have even been dislocated, which occurs frequently with this type of deformity.  Additionally, his knees were in flexion and he had bilateral clubfoot deformities.  Therefore, walking was clearly not an option for Jean David.


Jean David underwent four surgeries to correct the bony deformities and was then casted from hips to toes.  Now, Jean David wears braces to keep the re-alignment going and in check.  The braces have to be custom-made and are super-expensive.  Since his family couldn’t afford them, these braces were donated to Jean David.


We began weight-bearing activities at the end of August, and on September 1, Jean David took his first-ever steps in the parallel bars!  Due to Jean David’s amazing upper body strength and determination, Jean David we have already progressed him to walking with a walker.  He is a such a hard-worker!!


On Sept 4, Dr. Nelson and our Drector of Clinics, Robbie Jackson, donated the money to buy Jean David his own walker.  They will be returning to Haiti this coming week, and Jean David will be able to walk at home now with assistance from his mom and with the walker.  (Just an FYI: the walker we got him cost $100 US dollars and doesn’t include wheels. I’m thinking Jean David may really benefit from wheels, but who knows how much wheels will cost! Anyone want to donate some walker wheels for a pediatric walker???)


Neither Jean David nor his mother speak English or Spanish.  Luckily, Jackie’s mom, who is also Hatian, speaks English, so when she is also at therapy, she provides translation assistance for us.  But, if she’s not there, we just use a lot of gestures and demos.  Jean David and his mother are so sharp, they usually understand what it is we’re asking.  And, I am actually learning a teeny tiny bit of Creole along the way!


I’m so happy to have been able to take part in Jean David’s therapy.  He is such a strong, motivated and intelligent child.  What an experience!

Still Amazed

August 29th, 2009 by INMED
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I just finished my fourth week here in the DR, and every day I find myself so happy, fortunate and proud to be here. Although I had previously lived abroad in a developing country, I am only just now fully understanding the desperate need for medical missions in developing nations. This whole experience reminds me over and over again how grateful I am to live in a country whose medical system, while definitely flawed in its own ways, demands regulation and standardization in the education of our physicians and of the delivery of health care in general.


I know when I go to a hospital in the US that I am going to recieve good medical care – whether I have insurance or not.  I naturally assume that the physicians are well-trained and competent.  I expect that if I need surgery, the surgeon will be well-educated and will have had years of residency and fellowship before practicing on his own.


Yes, we all have had experiences in the US where we disagreed with the physician. Yes, we have all had experiences where two physicians have given us two completely differing opinions or plans of care.  But, in developing countries, the discrepancy between a “competent” and “incompetent” physician is a whole other phenomenon that we usually don’t need to worry about in the States.


At CURE Dominicana, I see patients on a daily basis who were initially treated (or more accurately, not treated) at another hospital by an unqualified surgeon.  The patients then find out about CURE after the fact and come to our surgeons later for either initial treatment or for a correction of a first surgery.


For example, last Friday I met a patient named Yemen.  Yemen comes from a small town, about 1 1/2 hours from Santo Domingo.  He is 17-years old and the bread-winner for his family.  In March of this year, Yemen got into an accident while working and was taken to the largest trauma hospital in the country.  Yemen had a fractured jaw, broken ribs (?) and a shattered left hip.  The physicians at the hospital addressed the fractured jaw and ribs, but did not even take an x-ray of his hip.


When Yemen continued to complain of hip pain, they x-rayed his hip and found it was badly fractured.  But, they told him they could not operate since he would likely die on the OR table.  So, instead, the doctors put a cast on Yemen’s CALF.  Obviously, the cast did nothing for his fractured hip and later the doctors removed the cast and sent him home with a brace for the calf instead.


Luckily for Yemen, he was fortunate to meet Kristin, a missionary here, who had worked with a previous CURE patient, and directed Yemen and his family to CURE.  Approximately five months after Yemen’s injury,  he finally had surgery to reconstruct his hip.  Yemen is now approximately three weeks post-op and he came to physical therapy for the first time last Friday for gait training with crutches.  He will be non-weight bearing on the left leg for at least three months, but  walk again.

My First Week In The DR

August 9th, 2009 by INMED
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Well, I made it to the Dominican Republic and have finished my first week here! And I can honestly already say that this experience has been and will continue to be eye-opening and a wonderful learning experience.


First, let me say that I am a physical therapist from Kansas City, MO. I have ten years of experience working in adult outpatient, inpatient, skilled nursing facilities and home health physical therapy. I have spent the last five years working at a large inner-city trauma hospital as an inpatient therapist seeing all types of adult patient populations. Prior to working at my last hospital, I lived in Quito, Ecuador for about ten months and volunteered in the outpatient department of a large hospital in Quito. Although I did work with some children there, most of the patients were in their late teens and up.


In the Dominican Republic, I am working at Cure Hospital, Centro de Ortopedia y Especialidades. This hospital specializes in pediatric orthopedics and provides inpatient and outpatient surgical and rehabilitative services. I will be here for eight weeks, assisting the hospital’s only physical therapist in the post-surgical rehabilitation of the children treated by Cure’s orthopedic surgeons.


So, since I have had very little exposure to pediatric physical therapy, I have spent the last few months worried that I may not be of much help to the children and to the physical therapist here. I knew that the need for therapy for these children is critical in helping them to regain function and a sense of “normalcy” and that the availability of professionals is limited, and I didn’t want to disappoint the people here. But, within the first few hours of my first day at the hospital, I realized that first of all, there is not enough time to worry about such things, and secondly, that I didn’t have to be a pediatric therapy expert in order to be able to help these children.


I am staying at the Ocean Breeze Apart-Hotel located in the Zona Colonial of Santo Domingo. The Zona Colonial is a tourist area, close to the main tourist street of El Conde. My room has air condition, my own bathroom, a refrigerator and stove. It is very comfortable here, and the administrator, Alex, is very kind and accommodating and speaks both English and Spanish. There is a medical student named Matt staying at the hotel as well. Matt arrived the same day as me and will be here until next Sunday.


On Monday morning, Don Jose arrived at 7:30 am to take Matt and I to the hospital. Matt and I met our host, Orfa Gonzalez, and then were introduced to the Executive Director of CURE Dominicana, Steve Bostian, and the Medical Director, Dr. Scott Nelson. Then, Matt and I went our separate ways. I was taken to the physical therapy department and introduced to Altagracia Felipe, the hospital’s one and only physical therapist. As therapy is extremely busy, Felipe, as she likes to be called, and I immediately got to work.


Felipe has worked with CURE since it was established in 2003. She does not speak English, but since I have a Spanish background, this is not too much of a problem – except that my Spanish is rusty and the Dominicans speak quickly and with an accent which is very different from the Spanish I heard in Quito. Despite this, I was able to communicate with Felipe, who is a very patient and kind woman with a heart of gold!


For most of the morning, I shadowed a very busy but very calm Felipe. As the day progressed, I eventually worked with a couple of patients on my own, both of whom were straight-forward ortho cases. I went home that day, feeling a mixture of emotions – sad because of the number of children I had seen in therapy but relieved and happy because I felt I had been able to help and grateful for the chance to work with such amazing children. My heart was so warmed by the smiles, resilience and toughness of these kids. The therapy is often times very painful, and some of the kids cried during therapy, but at the end, they still give Felipe a hug and kiss good-bye.


The patients we see have congenital deformities, deformities which have developed insidiously, orthopedic trauma which occured during birth, after a fall, etc. Some of these kids have had previous surgery elsewhere to correct deformities or broken bones, but that did not heal correctly after surgery. We see a lot of children who, post-operatively, have external fixators that they will have for months after surgery since they are used to correct club feet, genu varus or valgus, etc or to promote leg-lengthening. The fixators are color-coded so that parents can easily make adjustments to them so that over time, the bone is restored to its correct position or length. The children are allowed to weight-bear and get the device wet. In addition, we see many patients with various degrees of severity of CP who have needed tendon-legthening procedures in order to be able to sit, stand and/or walk.


By the end of this first week, I was seeing my own caseload of patients and assisting Felipe with re-organizing the patients’ records. I’m already understanding the Domincian accent with more ease, and I have all but shaken my worry and fear of not being able to help these children and the staff at the hospital. I had a great week and am looking forward to going back to the hospital tomorrow. I am so thankful for the opportunity to be here. I am, once again, reminded of how fortunate we are in the States. And, I would encourage anyone thinking of volunteering for a medical mission to do so. It is truly an amazing learning and life experience.

Introducing Myself

August 1st, 2009 by INMED
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fish-amyHello! My name is Amy Fish. I am a physical therapist at Research Medical Center in Kansas City, and I’m starting my INMED service-learning experience at CURE Hospital in Dominican Republic beginning in August 2009.