A Haitian Education

About a year ago, I was invited by renowned plastic surgeon Dr. Craig Hobar of Life Enhancement Association for People (LEAP) to spend five days providing free medical service in Haiti with a team of surgeons and health care professionals. Dr. Hobar established LEAP in 1991 in an effort to provide free surgical care to children and adults with deformities. LEAP was responsible for organizing and sending the first surgical team to arrive in Haiti in response to the January 2010 earthquake. As an aspiring medical student, I was thrilled to receive such an invitation, and accepted immediately.

A Road in Port-au-Prince

A Road in Port-au-Prince

In July of 2011, I got on a plane bound for Port-au-Prince. I had seen video footage of the aftermath of the magnitude 7.0 earthquake that struck some 18 months earlier, but I was unsure of what conditions to expect upon arrival. The devastation to the infrastructure was evident to me immediately as our plane approached the runway at the Toussaint Louverture International Airport. The original terminal sat dormant. The giant cracks running through the concrete walls made it clear why no effort had been made to salvage the building.

As we drove away from the airport through pouring rain up into the hills of the city, I began to realize that I was witnessing a level of poverty more severe than anything I had seen in other parts of the world. We drove by sprawling tent cities where thousands of families were crammed into a sea of tattered cloth shelters, with no sign of sanitation or clean water. Collapsed buildings and rubble were just as prevalent as standing buildings.

How could these conditions exist 18 months after the earthquake? The United Nations estimated in September of 2011 that only 43 percent of the $4.6 billion of pledged earthquake recovery funds had been delivered. A few of the Haitians that I spoke to seemed to think that the inaction or disorganization of the government had also contributed to the slow recovery process. Haiti has a history of turmoil. During the second half of the 20th century, the country endured violence and instability under dictatorships, military regimes, and coup d’états.

In the midst of turbulence, the spirit of the Haitian people was evident to me as the saving grace of the country. In spite of the crumbling infrastructure, heat, or otherwise impoverished conditions of the city, the Haitians I met seemed happy, and all were welcoming and polite. I actually felt guilty for living in a place where I have running water, air conditioning, electricity, or a shower: all things that many Haitians would consider a luxury.

craniofacial procedure

The author and Dr. Hobar performing a craniofacial procedure

Upon arrival at the Espoir Hospital, we were welcomed with open arms by hospital staff. The hospital had suffered minor damage from the earthquake but was in working order. LEAP was able to secure this location in coordination with the Foundation for the Children of Haiti, which had generously arranged accommodations at the Espoir Hospital in the past.

As the sun was setting, I observed as the physicians started seeing patients immediately. Several patients were evaluated, presenting with cases requiring urogenital, abdominal, or craniofacial reconstructive surgery that would otherwise be unavailable to them. Of all of the patients that would undergo surgery over the next few days, it was a young girl who presented the most complex case. She had a congenital defect known as bladder exstrophy, meaning she had been born with her urinary bladder present outside of her body. The child likely would not have survived much longer without surgical intervention. Her surgical procedure took place the next morning, and I was lucky enough to observe the 4-hour procedure in its entirety. The inflamed, malformed urinary bladder was removed.  A ureterosigmoidostomy was then performed in order route the patient’s ureters into a surgically fashioned “Mainz II pouch” in the wall of the colon. I was amazed at the ability of the two surgeons and operating room staff to complete the procedure without difficulty, especially in absence of the technology normally available in operating rooms in the United States. The week continued on at a nearly non-stop pace while we worked through days running on little more than adrenaline.

The author with a patient in recovery

The author with a patient in recovery

The LEAP team was concerned with ensuring not only that the surgical procedures were completed with impeccable professionalism, but also that everyone involved learned from the experience. The patients and their families were educated on medical conditions and the steps to post-surgical recovery. The team worked side-by-side with Haitian health care workers, performing more than twenty surgeries in five days, including several hernia and cleft palate operations. LEAP is dedicated to training and education in several countries around the world, providing field and classroom training for local surgeons on state-of-the art practices and procedures.

Under the tutelage of the team surgeons, I was able to scrub in and serve as first assistant on several surgeries. One of the high points for me was being able to assist on a hernia repair surgery working simultaneously with both a LEAP team surgeon and a Haitian urology resident. Although I had yet to attend a single day of medical school, LEAP had provided me with an invaluable clinical education. The foundation is comprised of the some of the most gifted and talented medical professionals in the United States, which became increasingly obvious to me over the course of countless hours spent in the cramped operating rooms.

Haiti Baby Jackson Before and After

A young Haitian patient, before and after surgery

I also learned a great deal from the Haitian people about their struggles and their country. During the five days I spent in Haiti I had an experience that was — at the risk of sounding cliché — hard to describe with words. My personal definitions of the words “necessity” and “luxury” were changed forever. Often times, to truly discover or learn, one must be immersed in an experience or a culture. My experience in Haiti is certainly one I will never forget.

This experience only solidified my opinion that, as educators, it is our responsibility to instill in our students an interest in the sciences. The National Research Council recommends ways that leaders at all levels can improve K–12 education in science, technology, engineering, and mathematics (STEM) in a recent report. For more information, please visit the National Academies website.

If you would like to learn more about LEAP or the Foundation for the Children of Haiti please visit the websites below:

http://www.leap-foundation.org/

http://www.usfch.org/

What real-world evidence — whether providing medical care to underserved communities or balancing budgets — has shown you the value of a strong STEM education? Please share ways you or others you know have committed to improving kids’ interest in STEM subjects.

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