Haiti

1. Haiti STUDENT MANUAL

2. Course Description • The clinical experience in Haiti is organized by Justin Dunaway, a graduate of the DPT program, who is a founding member of Phoenix Rising for Haiti (PRH). PRH is a non-profit organization with the purpose to provide a multidisciplinary approach to the rehabilitation of the injured and disabled people of Haiti. • This clinical offers a hands on/direct patient care experience in an rural, economically disadvantaged area of Haiti that has many healthcare system related challenges. The patient care provided by the student is supervised at all times by either the YSU graduate, Justin, or his designated physical therapist. Any therapists designated to supervise the student will have had prior experience in Haiti.

3. Course Description • The clinical experience offers the YSU student the opportunity to: • Provide care for a diverse array of patient problems including amputation, congenital deformity, wounds, and neurologic and musculoskeletal related limitations and dysfunction. • Providing physical therapy care to a person from Haiti offers the student a culturally different experience than that available in our other YSU affiliated clinics. • Experience the challenges and benefits of working through an interpreter to develop a successful method to communicate with the Haitians in their country

4. Course Description • During this clinical, the YSU student will work alongside PTs from other geographic areas of the USA as well as throughout the world. The experience also allows the YSU student to collaborate on patient care with other providers such as the prosthetist, orthotist, occupational therapist, wound care specialist and orthopedic technician. • The student who attended the last clinical experience in Haiti was able to work with PTs from Canada and Australia as well as coordinate the making of splints and mobility/positioning devices with the OT and orthotist. She also worked with a carpenter to literally design and make a mobility device for a child who otherwise was immobile. Lastly, the YSU student will learn the true meaning of collaborative pt care because team ‘meetings’ to problem solve solutions to patient problems occur constantly in this setting.

5. Learning Objectives • Develop a culturally competent POC for a person with a familiar musculoskeletal, integumentary, neuromuscular, and/or cardiopulmonary problems. • Communicate effectively via a translator during a physical therapy evaluation and treatment session. • Modify patient education to include unique local considerations of Haitian patients. • For example, Haitian people with diabetes often are unaware of the need to wear shoes besides ‘flip/flops’ when walking including when walking inside on the dirt/rocky floors of their homes. • 4. Collaborate with other team members to develop a POC for a complex patient condition.

6. Learning Objectives • Compare differences and similarities of treatment techniques among PTs from different geographical areas of the USA and possibly the world. • Become proficient with a prior unfamiliar technique taught by a PT from another geographic area or develop a POC for an unfamiliar diagnosis common in Haiti. • Develop a list of local barriers and supports to modify disability impact in Haiti. • Formulate a solution to a system/clinic level problem that occurred during the experience. • 9. Prioritize curriculum needs for the YSU PT Program in regards to teaching cultural competence.

7. Student Requirements • Finish the second year of DPT curriculum • Approval by staff • Self fundraise • Present on experience upon return and write for YSU PT newsletter as well as other potential requirements

8. FINAL DESTINATION ARRIVAL

9. PRH Facility/Housing in Port-du-Paix

10. Accommodations • Housing Conditions • Provides clean water for drinking and showering • Meals provided by cook with clean water • Bathroom/shower- 2 upstairs, 1 downstairs • Community living • Sleeping Options • Inside with windows • Outside with tent • Suggested to sleep with mosquito net • Security • Property surrounded by fence with security guard

11. TYPICAL “Schedule” for Trip • Friday- • Travel • Saturday- • Land in Port au-Prince Saturday morning and either fly (40 mins) or drive (6-8 hrs) to Port-du- Paix depending on travel availability • Set up clinic and team meeting to discuss the details of the week to come • Sunday- “Down Day” • Boat to Tortuga and spend the day on the beach, we have also done days in the market in local towns, sight seeing, hiking, etc- depends on what we can make happen • Monday through Friday- • Eat breakfast- treat till lunch- treat till we are out of patients • Saturday- • If flights are available, fly back to Port au-Prince and then home by Saturday night

12. Typical Day in the Clinic • A student will shadow Justin the first day-day and a half. • You will then shift to treating and then treating independently by Wednesday (potentially earlier or later). • You will also be required to shadow other PTs because there are a lot of people with multiple different skill sets to get many perspectives. • Students will also follow one amputee from casting, through fabrication, to fitting, to gait training to see the whole process.

13. The line of patients waiting outside the PRH facility

14. Typical treatment areas

16. AVAILABLE EQUIPMENT • Always in need of: • Thera-bands • Little use for: • TENS • Goniometers • Gait belts • Treatment tables • Acupunture needles • Electro-acupuncture machine • Cupping/vaccuum therapy • TASTM tools • Thera-bands • First aide/wound care supplies • Orthotic supplies/bracing • Prosthetic workshop with power tools/hand tools • Antibiotics (pills/topicals) • Saline/ IV kits

17. Always one day to KICK BACK and RELAX!!!

18. Planning • All trip planning, booking, accommodations and payment are made via Phoenix Rising for Haiti. • www.phoenixrisingforhaiti.org

19. Preparation for Trip • Consult your physician well in advance for medical needs and when to begin immunizations. • Immunizations • Up to date Tetanus, flu, MMR, and Varicella shots (Takes 4-6 weeks) • Also recommended Typhoid (at least 2 weeks in advance) and Hepatitis A and B (series of 3 shots, needs to be started ~7 months in advance) • Medications • Malaria- ‘Chloroquine’ or other anti malaria medication • Cipro- optional antibiotic • Anti-nausea/ motion sickness- Phenergan • Anti-diarrheal medication http://wwwnc.cdc.gov/travel/destinations/traveler/none/haiti

20. Preparation for Trip • Consult your physician well in advance for medical needs and when to begin immunitizations. • Physical Condition and Medications • Obtain a thorough physical exam • Medical identification tags, bracelets, cards etc. should be carried • If taking any prescription drugs bring enough for the entire trip • Bring extra medication to be safe http://wwwnc.cdc.gov/travel/destinations/traveler/none/haiti

21. Paperwork for trip • Copies of: • Medical Insurance (2) • Passport (2) • All prescriptions (2)

22. Carry on Items • Toilet paper • Moist Towelettes • Passport • Money- USD • Ladies-female items • Watch • Pillow and sheets • Water bottle • Alarm clock (battery operated) • Medical kit/Toiletries--any prescription meds you are taking • Flash light • Sunscreen • Extra-strength bug repellant (DEET) • Snack food • Phoenix Rising T shirt (wear it) • Underwear and socks for 4 days • Shower shoes (flip flops) • Towel and washcloth

23. Luggage • Extra wet ones • Photocopy of passport • Hat (ladies-something to pull hair up) • Hat (ladies-something to pull hair up) • Plastic bag for laundry • Roll of duct tape and permanent marker • Shower curtain liner • Swim suit(ladies- one piece) • Package of paper plates • Toilet paper • Roll of paper towels or napkins • Clothes line and pocket knife • Littler hand sanitizer • Snack food • Extra pair of comfortable shoes and sandals • Hiking boots • Light jacket for evening • Light weight blanket or sleeping bag • Mosquito net • Underwear and socks • Work gloves • Towel and washcloth • Backpack • Tent • Beach towel

24. Costs and Fundraising • Costs: • Average trip cost= $1,400 to $1,800 • Most be fully paid 1 MONTH before departure • $500 nonrefundable deposit due 3 MONTHS before the trip • Fundraising Ideas: • Spaghetti dinners or pancake breakfast • 50/50 • Raffle baskets • Max and Erma’s or Chili’s Dinner • Connect with your place of worship • Write letters to friends, families, and colleagues • Contact Local businesses • Coupon Books • All donations payable to Phoenix Rising for Haiti are tax deductible. Be sure to send thank-you notes to your supporters.

25. YSU Support • Any funding through YSU requires travel forms • PT Department • Department Deans • Provost • **Keep ALL COPIES TER completed after travel • Will need to be able to pay up front and will be reimbursed upon returning

26. Things to remember • Water will be provided by the clinic, however do not drink or brush your teeth with any water in Haiti • Only eat foods prepared by PRH. When eating in public places, avoid eating salads or fresh fruit • Wear comfortable modest clothing (scrubs is a good idea). Bring a swimsuit and sturdy closed toed shoes • Bring less than $100 for souvenirs or emergencies (do not bring large bills; $5 bills or less) • Bringing a laptop will not be necessary

27. In case of an emergency • Most common Illnesses: • Vomiting and diarrhea • The conditions are treated by starting a saline IV at the clinic , which many volunteers can do • If additional care is needed- a hospital is located down the street and the clinic has relationships with 2 surgeons • Trauma: • Partnered with an ortho-surgeon down the street and have a relationship with a medical director of a hospital 10 minutes from the clinic • **Everything at the hospital is paid for in CASH (there is a bank in town if additional cash is needed)

28. contact • www.phoenixrisingforhaiti.org • Phoenix Rising for Haiti on Facebook • Justin Dunaway • Jdunaway@phoenixrisingforhaiti.org