Suggestions for future missions:

1)      Accept no more than 10 participants.

2)      Our system of assigning major areas of responsibility was effective.  The pharmacy coordinator (Henry) managed our donated medicines and oversaw our medicine counting sessions.  The logistics coordinator (Mark) worked with Fr. Valdema to assure secure transport.  The spiritual leader (Joan) arranged and coordinated our devotions.  As general coordinator, I focused only on the overall project.

3)      We selected the air itinerary about 5 months before the project.  Participants were required to make their own reservations.  This allowed us to get better pricing than would have been available had we registered as a large group.

4)      Our professional pilot participant, Mark Dehart, made these suggestions: I reviewed the suggestions so far and as logistics coordinator I have only a couple thoughts. When booking ticketsI would be on the lookout for business class fares that may be as little as $50-$60 above coach so that the amountof free checked bags would be of help if there were a lot of meds donated. Also I would look into traveling out ofRDU as opposed to ORF so that there would be some available flights on mainline 737 or MD-80 aircraft so as not tohave a problem getting the checked luggage on the flight.  It didn't bother us this time, but the agents I spoke with atORF said that about 1/3rd of the time they need to limit the amount of passengers that can be carried out of ORF toMIA because of the length of the flight and the amount of fuel they need to carry. 

5)      The health and safety of the team is critical to a successful project.  All participants should be fully educated and compulsively compliant in matters regarding health and safety.  I have a separate document that addresses health and safety issues.

6)      Arrive at and depart from Haiti as a group.  Stay together.

7)      Assure that you will be picked up at the airport.  Do not leave the airport without your contact.

8)      Maintain contact numbers for Fr. Valdema and have a functioning cell phone to call him if needed.

9)      Mark luggage containing donated supplies with Pere Valdema’s name.  Maintain a list of all donated medications and supplies.  Medications should be in their original containers.  Attempt to get official approval to bring these medications for donation.

10)  Villa Mamika is an excellent hotel for most purposes.

11)  Try to take 2 physicians.  A third physician may be possible, but this will stretch available resources. A helper assigned to each physician would be useful.  Because many female exams are needed, a female helper is preferred for a male physician.  In addition to assisting with exams, the helper can escort patients from intake before the evaluation and to the pharmacy area following the evaluation.

12)  Translators are critical to success.  At least one translator per physician and one more in the intake area are needed.

13)  It would be useful for someone to inventory the available medications in Lespwa Timoun Clinic at the beginning of the project.  We left patients untreated because we were told that the needed medications were not available, yet these medications were later found on the shelves in the clinic.  Communication about medications is unreliable.

14)  Consider adding vision checks and donated inexpensive eyeglasses.  This can be assigned to a participant with no medical experience. 

15)  A dental component including fluoride treatments and dental education is easy to add if we have enough non-physician participants.

16)  Peripheral locations lacked areas for private examinations.  Rope, 2 shower curtains, clothes pins, and duct tape allowed us to construct an adequate examination area.

17)  Brightly colored custom t-shirts helped us stay together as we traveled, and they added to the team spirit.

18)  Group devotions in the morning and evening provided an opportunity to discuss meaningful experiences.

 

 

Dr. Bart Resta added the following suggestions:

 

1)      I only gradually developed a good concept of what was happening in the pharmacy as the week developed. In future missions, would recommend that we work out potential issues with the pharmacy at the beginning of the trip, and have at least one of our mission participants monitoring how the pharmacy is functioning.

2)      We were absolutely deficient in educating our patients. This was because of the limited time available for each patient, the language barrier, the lack of medical knowledge on the part of our patients, and the lack of knowledge of the patients' living circumstances and available resources on the part of our mission team (or at least me). The idea of encouraging the Haitian team members to develop an educational program is a great one, and it seemed to be well-received by Carmel.

3)      The need for dental and vision services is great. Providing that care would be an excellent way to extend the mission, even if we are short on medical practitioners. Teaching simple dental hygiene to patients, including children and the parents of babies and toddlers, might go a long way to preventing dental caries and the pain and poor nutrition that it causes. Developing a vision program using some simple tools and donated glasses could improve sight for hundreds of people.

 

5)     We need to keep tabs on the status of Fr. Valdema's resources. He may eventually have access to more translators and vehicles. If that is the case, it would allow us to enlarge our team. However, I thought that we did great with the numbers that we have. If we have more trained providers who want to go to Haiti, we might do better by increasing the frequency of the missions rather than by increasing the size of the teams.

6)     I would recommend that future medical providers brush up on the list of medical problems that might be encountered in the months preceding the trip. It would also be useful in that time to learn a bit of Haitian Creole for the sake of politeness to those who provide for us as well as to help our patients feel a little more comfortable.

 

 

Honor Montgomory, our Pharmacist, added the following suggestions:

 

1)     Just recalling some of the other things we talked about and one of them was printing labels that had pictures of the sun and the moon for those patients that probably can't read. This can be important because there's so much activity on clinic days that instructions get forgotten and are useless if you can't read.

 

2)     Team size was great, but there's got to be a way that everyone who comes gets to participate somehow. There are malaria tests available as finger prick tests that can be done in the field, and it would be a great way to use some of the EMS resources. And also conserve other resources as far as malaria treatments.

 

3)     A lot of the children we saw were actually quite healthy, but mom was telling us they had fevers every night with chills but they presented with no fever. Better thermometers would be good, maybe the digital ear ones if possible. I didn't really follow the armpit idea....

 

4)     My other concern is dosing. I'm thinking the pharmacy didn't pass out cups or oral syringes (just a wild guess here since I saw approximately zero), so maybe we should be looking for those devices for future missions. 50lbs of that would help tons of people. Also, if the team takes their own critical medications, it's advisable to take their own liquid bottles in 2, 3, 4 oz sizes. We took purified water with us to clinics in Niger for mixing liquid antibiotics, not sure if you've done/seen that before.

 

5)     I don't think you need to take as many antacids as we did. The tums are great, but a lot of dyspepsia is a result of their eating habits and menus. We can assume they're calcium deficient anyway and load them up with Tums, you can get by with OTC Prilosec, Zantac, or Pepcid. To accommodate different clinics (eye, educational, etc), I'd advise only taking one PPI or h2-antagonist and a lot of tums. My guess is it's not being taken properly anyway or with water since it's scarce or in the morning, etc. And famotidine is available there already, so for continuity of care, we could consider that. And tums. Always Tums.

 

6)     Staying healthy was a definite bonus for me and Dad this trip, I would continue to advise people to take Cipro once or twice daily while there and the snacks and protein bars were definitely appreciated at times!

 

7)     Oh, and if we're gonna do the whole miami thing again, let's make a day of it and go to the beach or something!!!