Issue 13 Fall 2009

Hôpital Sacré Coeur

C R U D E M

President’s Comments Our Christian faith teaches us to focus on theneeds of others over ourselves. Our mission atHôpital Sacré Coeur is the perfect example ofputting our faith into action.We welcomed a new order ofsisters, Sisters of St. Joseph ofPeace, to our hospital thismonth. They will provide thereligious presence that is soessential to our mission. Over the past 6 months ourHaitian administration andstaff, under the guidance of DrChalumeau our CEO, havedemonstrated the ability tomanage the hospital on a daily basis. They takepride in what has been accomplished and aredetermined to make the future better for thepeople of Northern Haiti. Dr Previl’s article describesthe challenges and successes of pre and postnatal care. One of our priorities for the coming yearis to expand our neonatology unit. As you read this newsletter you will notice thatone of the unique aspects of Hôpital Sacré Coeuris the variety of volunteer opportunities andinteractions with the Haitian staff that are available. You will read of the experience of a medicalstudent who is exposed to quality medical care

delivered despite the lack of moderntechnological aides such as CT and MRI. You willalso come to understand that nonmedicalvolunteers have as fulfilling an experience asmedical volunteers when you read about parentsand their children from Massachusetts andMissouri who helped paint the hospital. As we look to the future we realize the need toimprove our facility and expand. We aredeveloping plans to add a third operating roomto help us handle the volume of surgery. We arealso planning to add an emergency room andnew delivery room. Negotiations are taking placeto acquire land next to the hospital for expansionof our inpatient beds and construction of primarycare clinic space. All of this is possible because ofyour continued generosity! When we look back over the almost 25 years ofHôpital Sacré Coeur’s existence we see the handof God creating a beacon of Hope for the peopleof Haiti. At a recent town meeting in Milot, themayor, government officials and health ministryofficials each spoke of the importance of HôpitalSacré Coeur and how it has become a model ofhealth care delivery for the rest of the country.You should be proud of the fact that through yourcontributions you are making a lasting differencefor the people of Haiti!

Peter J Kelly, MDPresident

STATISTICS

2002 2004 2006 2008(Patients, Patient Visits, &/or Units of Service)

Outpatients 29,692 53,223 55,694 56,701

Inpatients 2,419 2,821 4,270 4,182

Newborn deliveries 580 832 1,526 1,268

Surgeries 846 859 1,190 1,227

Prescriptions 68,418 106,992 159,765 136,517

Lab & Radiology 34,110 73,527 76,031 78,769

Community Health 1,750 3,256 6,846 10,075

A medical Student’s JournalAs my 19 passenger Metroliner flew into Cap Haitian,

Haiti for an eight-day medical mission, I looked out thewindow to see sparkling turquoise water embracing themysterious, mountainous coastline, and had a feeling I wasabout to embark on a great adventure. After passing throughcustoms I met up with the team of physicians that I would beworking with that had arrived earlier that day. There were 11of us in all: two surgeons, an anesthesiologist, a neonatologist,a family physician, a psychiatrist, two nurses, two socialworkers, and me, the lowly first-year medical student. Webounced like popcorn in the seats of the safari style jeeps aswe dodged the potholes in the primitive roads, which madefor bumpy, but jovial introductions. The team had goodchemistry, and I sensed working with them would beenlightening and enjoyable.

Our caravan took us into the lush forest, headed for thetown of Milot, the location of the Hôpital Sacré Coeur as it iscalled in Haitian Creole. We made ourselves at home in thehospital’s dormitory style residence and then went to the dininghall for dinner, after which we discussed our plans for theupcoming week. That night, I climbed into my mosquito-nettedbed, closing my eyes wondering if the noise I heard was thatof the insects, or myself, buzzing with excitement.

I eagerly awoke the next morning and jumped into scrubs,grabbed my journal and headed to the hospital. Between 8am and noon the lead surgeon and I saw 18 patients andscheduled 12 for operations. I learned to say some basicphrases in Creole such as “COUSH-AY” (lay down) and“TOOS-AY” (cough), as I examined some of the patientspresenting with hydroceles and hernias. Our third case wasone of the most interesting. A young woman, appearing to bein her third trimester, presented with lower abdominal pain. We reviewed her history and examined her to find that sheactually was not pregnant, but instead had a 35-poundabdominal mass the size of a watermelon, that she had been

living withfor twoyears. Wedecided tooperate onher and aswe liftedthe massiveg r o w t hfrom herabdomen, ahush fellover theope ra t i ng

room and everyone’s eyes widened in disbelief. She recoveredwell over the next several days from the large incisionnecessary for the procedure, and was now free of the tumor,much to her relief.

That afternoon, after several minor procedures, an

emergency trauma case came in. A three-year-old boy hadbeen struck in the belly with a rock, and we suspected he hadr u p t u r e ds o m e t h i n gi n t e r n a l l y ,judging by hisrigid abdomen. Without the aidof imaging likeMRI and CT,we had top r a c t i c emedicine as ifwe were back inthe 1950’s. Thelead surgeondecided our only option was exploratory surgery, and we hadto act fast. The next thing I knew I was scrubbed in andgowned, with a pair of scissors in one hand and a retractor inthe other, with absolutely no idea what I was about to do witheither one. Everything was explained to me on the fly, and asa vertical incision was made down the midline of his belly, Iopened the cavity with the retractor. We systematicallyexamined his organs and found a perforation in his smallintestine, just distal to the ligament of Treitz. We repaired it,sutured him back up, and as I snipped the last thread, the leadsurgeon reached out his hand to shake mine. I felt an amazingsense of satisfaction come over me. I checked on the boylater in the week and saw him walking with his parents, havingrecovered amazingly well from the surgery that he mostcertainly would have died without. Our last case of that daywas another emergency surgery for an elderly man with anincarcerated hernia. We opened his peritoneum and releasedthe strangled loop of bowel, preventing further ischemia andnecrosis. Without the surgeries both he and the boy wouldhave surely become infected, and in Haiti, sepsis is a deathsentence. There simply are not the life-support resourcesavailable there, like we have in the United States.

Throughout the rest of my stay, I also got to know someof the hospital staff and locals. After work one day, weattended a local soccer match that was in the courtyard of thehistoric palace ruins. The crowd members were colorfullydressed, high spirited, and eager to charge the field with pridewhen their team kicked the ball through the makeshift bamboogoal. Though I did not speak Creole well, the cheeringtranscended all language barriers, and it made me feel right athome.

As I climbed back aboard my 19 passenger Metrolinerto depart for the U.S., I paused for a moment to look back atthe week, at the bright smiles and warm hearts that had sharedtheir lives with me during my stay. All the Haitian peoplewere very friendly and hospitable. I received from them, somuch more than I could ever possibly give of myself on thetrip.

Student Doctor Benjamin Cox attends Lake Erie College of OsteopathicMedicine in Bradenton, Florida.

CRUDEM Foundation Board of Directors

Peter J Kelly, M.D, Wilbraham, MAPresident

David G. Butler, M.D ,Norwood, NJVice President

Stephen M Reese, St Louis, MOTreasurer

Timothy O’Connell, M.D, St Louis, MOSecretary

Hope E. Carter, New Canaan, CTJulie Condon, San Marino, CA

Charles T. Dubuque, St Louis, MOPaul H. Durnan, Rockville Center, NY

Carol Fipp, Jacksonville, FLSister Louise Gallahue, DC, Bridgeport, CT

Joseph Giere, M.D, Potomac, MDWilliam B Guyol, Jr, M.D, St Louis, MO

Charlotte Kiesel, Burlingame, CADeb O’Hara Rusckowski, Andover, MA

Richard B Perry, M.D, Potomac, MDDale Peterson, M. D., Wenatchee,WA

Susan Reese, St Louis, MOThomas F Schlafly, Esq, St Louis, MOCarmel Shields, Chestnut Hill, MA

Stratford C Wallace, Esq, Greenwich, CT

Development of the HSC Laboratory

2000 -2008 When my phone rang in December 1999 a voice on theother end said, “This is Dr. Ted Dubuque from CRUDEM andI wonder if you could come and help us improve our laboratoryin Haiti”? I was stunned because I had been retired for fiveyears. But as I was listening to his story, in my mind I wasthinking “is this God calling” He told me that the lab resultswere so bad they were incompatible with life! I wonderedhow he had found me. He said it was through Project Hope,where I had worked in Port au Prince in the 1980’s. Thus it was that in the spring of 2000 I answered the calland made my first trip to Hôpital Sacré Coeur When I was introduced to the technicians, they asked“What are you going to do?”I said “I want to see what needsto be done, but I know for sure that I’m going to teach youto do tests properly”

On my first visit, I found so many problems, worst of whichwere no functional refrigerator and no distilled water source.Further assessment showed the need for more space, moreequipment and better trained technicians. A grant from theFlatley Foundation provided funds for a splendid new lab but

we had nothing worthwhile to move/transfer into it. But onceagain providentially, everything in the lab was donated. At the outset the most encouraging factor was finding agroup of nine interested technicians who were eager to learn.Right away I began to teach theory in formal classes andtechniques at benchside. Eight of these technicians are stillemployed, and they along with six additional technicians

regularly received continuingeducation and training

during my visits. WhenI said, “I hope you willnot leave HSC nowthat you are welltrained” the answerwas, “Sister,where would wego? There is noother place likethis”! The addition ofseveral pieces of

s o p h i s t i c a t e de q u i p m e n t ,

generously donated,has led to an

expanded test menuand exploding test

volume - from 20,000 testsin 2000 to 78,000 tests in 2008.

The PEPFAR program for HIV treatment andprevention, along with the newly established HaitianRed Cross Blood Bank housed in the lab have alsoadded greatly to the workload and proved the value ofan excellent laboratory. I will sorely miss going to Haiti, working with all thefine people at the hospital and interacting with all thewonderful volunteers whom I have met through theyears. I also want to thank all my supporters who have

given generously to support my work at HSC.

The above article was excerpted from a report submitted by SisterMarie Vittetoe CHM, a member of the Congregation of Humility ofMary in Davenport, Iowa. The entire report is at www.crudem.org.

Sherry VanMeter, Ladera Ranch, CA

Theodore J Dubuque, Jr, MD, St Louis, MOFounder

Thomas G. Flynn, M.D., New Canaan, CTPast President

Elizabeth B. Flynn, New Canaan, CT Mission House Coordinator

Bernes Chalumeau, MD, Milot, HaitiExecutive Director, Hôpital Sacré Coeur

Denise Kelly, Dublin, IrelandExecutive Director, CRUDEM Foundation

Mid-Wife Program at HSC Pregnancy for a lot of woman in Haiti is a journey todeath. The risk of a woman dying because of apregnancy is estimated to be 630 per 100,000 livebirths. This rate, the highest in the western hemisphere,is associated with a very low economic status and, toa large extent, a lack of good prenatal care anddeficient delivery facilities. Hôpital Sacré Coeur, in its mission to help andsupport the poor is fighting to make a difference inthe northern part of the country. Through thedevelopment of policies and anintegrated plan of pregnancycare (where our Nurse Mid-Wives play the mostimportant role) weare beginning toaffect a change!Our mid-wives,on a 24 hour, 7days a weekbasis, providepatient careto over 500woman eachweek throughthe deliveryof pre andpostnatal care,

screening of STD’s (including HIV) and counseling onnutrition and future pregnancies. Almost all thedeliveries at the hospital are done by mid-wives whoare often asked by the grateful mothers to be thegodmothers for their babies! Empathy, respect and competence are present atevery step of their contact with their patients. Despitethe many challenges, our mid-wives will always gratifytheir patients with a smile or a word of comfort whenthey are grieving the loss of a baby. The demands forour services are constantly increasing. People from allover the north, desperate to receive good pregnancy

care, have made our prenatal clinics one ofthe most crowded in our part of Haiti.

Our mid-wives continue tobattle (a battle we have not

yet won because somedeterminants are

beyond our control) tomake our facility a

place where apregnancy will bewhat it is supposedto be: A HappyEvent !

Dr. Harold Previl(Dr. Previl, an Ob/Gyn

specialist, is theMedical Director at

Hôpital Sacré Coeur)

About a hundred Sisters of St. Joseph of Peace andAssociates gathered at St. Michael Villa,Englewood Cliffs, New Jersey on Saturday,October 3rd for a day of prayer, reflection and study,and to say “goodbye” and “God go with you” toSisters Ann Crawley, Marilee Murphy and

M a u r e e nB o g g i n swho left thef o l l o w i n gday to go toMilot, Haiti. Sister Ann,a nurse and

midwife by training, has most recently worked withhomeless people in Nottingham, England. Sheministered for several years in Africa, in bothCameroon and Liberia, and with Romanianorphans. She looks forward very much to joiningwith the staff at HSC and the people of Milot ingiving witness to God’s love and care for everyperson. Sister Marilee has ministered for the past 24 years

as a hospital chaplain and pastoral worker inAlaska, first in Ketchikan and then in Anchorage.Her move to Haiti will involve a huge change inclimate - but she does have previous experience inthe Philippines. Sister Marilee paid an initial visitto Milot a few months ago and is delighted to return. Sr. Maureen, a teacher by training, also hasexperience of working in Cameroon, West Africa.In recent years she has ministered in London,England where she taught English for Speakers ofOther Languages (ESOL) to refugees and asylumseekers. She also helped individuals and familiesnegotiate the intricacies of governmental and legalregulations related to their status. This year the Sisters of St. Joseph of Peacecelebrate the 125th anniversary of their foundation,and their mission to Haiti is a special project to markthis occasion. The gathering concluded with a very movingritual to mission the three Sisters to Milot and tomission all present to their work of service. Allassembled raised their hands in blessing over thetravelers.

CRUDEM Welcomes

First time readers of this newsletter areprobably wondering what CRUDEM means.It is an acronym:

Center for the

RUral

DEvelopment of

Milot When the Brothers of the Sacred Heartcame to Milot in 1968 and started buildingroads and bridges, constructing schools,medical clinics, a tile factory, a lumber milland bringing electricity and clean water tothe vil lage; they called their missionCRUDEM. In 1986 they built an 8 bed hospital withan operating room and called it Hôpital SacréCoeur. St Louis surgeon, Dr Ted Dubuquewas the first volunteer to arrive, and shortlythereafter with his childhood friend, CarlosReese, Dr Dubuque formed the CRUDEMFoundation in St Louis to support thehospital. It is a 501(c) (3) corporation.

Sisters Ann Crawley, Marilee Murphy and Maureen Boggins.

CRUDEMFOUNDATION

NewsletterEditor: Thomas G Flynn, MDDesigner: Helen C. Bergner

362 Sewall StreetPO Box 804

Ludlow, MA 01056(413) 642-0450

www.crudem.org

Medical volunteersplease contact :

Peter J. Kelly, M.D.President

(413) 596-2692lppjs@aol.com

Non-medical volunteersplease contact:

Betty Flynn(203) 966-1959

ebtgf@optonline.net

Other contacts:Susan M. Reese

St. Louis, MO (314) 994-9158sreese8log@aol.com

Barbara MurphyArlington, VA (703) 536-6393

bpmurphy98@verizon.net

Charlotte KieselBurlingame, CA (650) 344-4960

ckiesel@prodigy.net

Dale PetersonWenatchee, WA (509) 663-2225

dalep@charter.net

Denise KellyExecutive Director

(413) 642-0450crudemdenise@gmail.com

Joni Paterson, PhDDevelopment & Administrative Services

(413) 642-0450jmpaterson@charter.net

Area News The 3rd grade class at St. James School in Basking Ridge, N.J.held a bake sale that raised $560 for HSC. Along with the checkwas a note from Katie Butler, granddaughter of Dr. Dave Butler“.... my grandfather told me that people in Haiti are in need of

supplies. Ithought it wouldbe a good idea tohold a fund raiserto help..... I amalways worriedabout mygrandpa when heleaves for Haiti.But I know he isdoing the rightthing, and that

makes me proud to be his granddaughter.” Dr. Butler, a member ofthe CRUDEM board, is finishing up his 7th year of speaking at allthe Masses in 4 different churches each summer in the Archdioceseof Newark bringing the wonderful story of HSC to the parishioners. The Boston, Massachusetts area hosted its 2nd Taste of Haitievent at the elegant Hampshire House. Michael Gillis reported thatover 100 people were in attendance. His committee included ChrisPilalas, Tammi Halley, Marta Downing, Deb O’Hara Rusckowski,Michael Gillis, Carmel Shields and Tim Nolan. From the state of Washington comes word of an exciting gift of$100,000 for CRUDEM. The donor, Mr. Mark Pigott stated that hewas motivated by the good works being done by Dr Dale Petersonand his urology teamfor the sick poor atHSC. On October18th inPasadena, CA theCatholic Doctor ofthe Year award wasgiven to Dr. MichaelFitzgerald by theMission Doctors’Association. DrFitzgerald, who hailsfrom Liverpool, N.Y.,is a CRUDEM volunteer. The spring meeting of the CRUDEM Board of Directors was heldin Washington D.C. in June. Dr. Richard Perry, CRUDEM Boardmember, writes that as part of the weekend events, Dr. AndrewUmhau hosted a dinner at the prestigious Cosmos Club. The 70guests received an uplifting update on the hospital’s progress.Washington DC will hold their 2nd Taste of Haiti on October 25th

at the Haitian embassy. On November 21st westernMassachusetts area support group willhold a New Orleans jazz night at theHampden C.C. featuring southerncuisine and carnival games. Another successful Taste of Haitievent was held in St. Louis, Missouri,the birthplace of the CRUDEMFoundation. The event raised $52,000for the hospital. The winner of theAltidore soccer jersey was Laura Boldtpictured here with Co-chair StevenReese.

Wish List

Note: If you would like to donateany of the above, please contacteither Denise Kelly or Joni Patersonat the CRUDEM Foundation offices(413) 642-0450. They can help toarrange for the purchase anddelivery to CRUDEM of any item(s)you want to provide. Thank you.

So many ways to help...

The Dr. Theodore

Dubuque Legacy

Society...

Angel of the Day...

Pledge Program

Supplies forDiabetes testing

- $75

Supplies for bloodchemistry analysis

- $300

Sterilizer

Bobcat- smallversatile excavator

Oxygen per week- $438

STAFF PROFILES Jean Jerry Bernard, M.D. a surgeon, joined the hospital’s full time staff in Julyafter completing four years of residency at Universitiare Justinian dun CapHaitien where he also interned. His social service year was spent at Bassin Bleuin the west of Haiti. Dr. Bernard is a native of Port-au-Prince and graduated from medical school

at the Universite Notre Dame there. He and hiswife who is an internist at HSC have a son. Theylive at the hospital. He is described as very good worker, alwaysavailable and never tired - and the only timehe says NO is when he says “NO problem”!Because he is fluent in English, he interacts verywell with the visiting specialty teams andprovides them with critical follow up care fortheir patients. His goals are to help improve thequality of health care and to make sure that allpatients receive the attention they deserve.

Fernande Michel Toussaint grew up in Grande Riviere du Nord and receivedher degree in nursing from the EINDS - Cap Haitian School of Nursing. Aftergraduation she worked at HSC as a floating nurse. In 2001 - 2002 Fernandeattended Nurse Midwife School in Port-au-Prince, and on her return became the ChiefNurse Midwife, a post she currently holds. Fernande is married and lives in Cap Haitienwith her family. Her duties includecoordinatingthe hospital pre-natal clinics, aswell as the Mobile Clinics and arrangingappointments for the GYN patients. She isdescribed as compassionate and a hard worker.Her goal is “to achieve the highest level ofhealthy women in the community”.

Hôpital Sacré Coeur

C R U D E M

CRUDEM FoundationPO Box 804Ludlow, MA 01056

When I asked Charles Dubuque last year“what was new in his life” little did Iimagine that I would embark on my

second trip to Haiti with my second son? My eldestson Tommy accompanied me last year, thepurpose of which was to determine what a personwith a non-medical background could possiblyoffer. Charlesresponse was “justcome on down,something will cometo you”. The“opportunities” wereendless. June marked thelast week of medicalvisits for the summerat Hôpital Sacré Coeur. My son Winston and Ijoined Bob Downing and his daughter Martaassisting Tim Trainer in the painting of the hospitaland CRUDEM’s exterior buildings. The effortemployed fifteen local painters from Milot whowere trained by John Gilbertie and JustineStokowski. Although there was a considerablelanguage barrier, the international language ofsigning and demonstration got the job done withfew misunderstandings. For those who are preparing to visit soon, thebuildings look fresh and crisp and the localpainters who accomplished the bulk of the workare clearly proud of their accomplishments.

Sunday was a day of rest for the painters, so wehad an opportunity to attend mass and visit theCitadel. We had a crystal clear day and enjoyeda spectacular view from high atop the fort.Evening activities included a spirited game ofsoccer between two local high energy teams. For those who have thought in the past that onlymedical personnel can contribute to the successof Hôpital Sacré Coeur, let there be no doubt inyour mind that you too can make a contributionthat will be meaningful both in your mind and inthe minds of the people of Haiti.

Thomas M. BoldtBoldt Brothers Building Maintenance

St Louis, MO