My veins are pulsing!

We will soon be presenting mirror box therapy to the physical therapists as well as other hospital staff so that patients can continue to be treated long after we have gone. There is a problem in the region of worsening conditions after donations or money runs out so we have been brainstorming how the mirror box therapy can continue after the mirrors that we have brought have all been given out. This could involve utilizing sensory referral - massaging the residual limb, watching someone else's limb be massaged and massaging the ipsilateral face for upper limb amputees.

Another factor that must be considered is evolving materials for best use in Haiti. For example, many of the wheel chairs sent to Haiti patients can't use because the tires aren't strong enough for the roads here. The best tires for the wheelchairs are tires for rough terrain like those on a mountain bike. We believe that by utilizing the durable, shatterproof acrylic mirror sheets rather than glass, our materials are well suited for the environmental challenges of the region.

We've learned that after the earthquake the clinic was extremely busy and people were working 12 hour days to make enough prosthetic limbs. This clinic was the busiest and biggest physical therapy and rehabilitation clinic after the quake: 27-30 patients/ day were fitted with prosthetics and treated in the period of time after the earthquake.

There appears to be a high incidence of phantom sensations in Haiti. This may be due to the nature of the amputation (many of the patients' limbs were in great pain before the amputation due to being caught under fallen rubble and during the operation as anesthetics weren't available). We have had no problems in describing what a phantom sensation is to the amputee community here: every patient thus far has immediately known what we are talking about. The patients have been very willing to try the therapy and are incredibly relieved— overjoyed to feel pain alleviation in their phantom. Many patients continue to tell us they will show all their friends with phantom sensations and phantom pain the therapy. This is probably one of the best ways to spread word of the therapy beyond our clinic.

A new phenomenon we have noticed is that when many patients are in front of the mirror and feeling their phantoms move for the first time, they report they “feel their veins pulsing.” We've never heard this description used in the States—we are researching if this expression means something different in Haitian Creole than the direct translation.

-Phantom Outreach

Roasting coffee in the mountains and riding in a tap-tap

On Friday after the morning hospital staff meeting, we head to the Hospital Albert Schweitzer's (HAS) PT clinic to speak with Verna, a young PT who hosts a local radio show La Familia each Saturday (similar in style and variety to NPR). We ask him about the prevalence of phantom pain in his patients and about the local nomenclature. He replied that numerous patients have complained of such pain. We also discover “phantom” is the commonly used term. We craft our ad that Verna will present for us on his show asking patients with painful phantom limbs to come for free mirror therapy services at Klinik Hanger. We describe our non-invasive therapy and Verna promises not only to present our information on La Famili but to teach his friends from other areas and share the news with other radio shows as well.

We begin the next day with a more in-depth tour of the hospital and meet several physicians working there. They are supportive of our project and let us know of other amputees staying in the hospital. They also invite us to shadow them and observe surgeries. We hope to fit some time in to do this as it would be a great experience-- there is so much to learn here!

On a break from our responsibilities at the Hospital and clinic, we visit the home of Stephan who shows us the fresh green coffee beans and roasts them for us on a small charcoal grill. We are introduced to his young daughters ages 10 and 6 and even shown their report cards. We ask to see their school later. Meanwhile as the coffee roasts Liz and Nicole have their hair examined and braided by the curious girls. Later we notice the infected toenail of the youngest and their lack of closed toed shoes. We take note to speak with some of the pediatricians we know. and email our colleagues in the US to bring a few extra pairs of shoes when they arrive.

On Sunday we are introduced to the surrounding area by locals with other volunteers at the hospital. We take a tap-tap, the local transportation. Tap-taps are old pick up trucks where people squeeze in the bed of the truck. Its common to see tap-taps with thirty or more people hanging on. On the drive, I notice several non-profit microcredit loan stations. Its pleasing to see that microcredit is available. Something else of note is that all the little stands labeled banks are actually lottery game stands – pas des banques!

In which we spread the word of mirror box therapy

Of all the places we have traveled we have never met people as welcoming and as kind as the ones we have met in Deschapelles. Although we have only been in Haiti just a few days the adventures we have had are numerous. After seeing many patients at the Hanger Clinic on Thursday we took a trip to the local market with a paintings vendor, self-appointed as our guide, who took us beneath tarps and around the maze of shops. Stephan, our guide, then took us to exchange USD into Goudes the local Haitian currency. Next our trip to the barber called Nice Barbershop for Claude, who received about four hair cuts each of which got shorter and shorter until the barber had nothing left to cut. Outside the 6' X 6' barbershop Liz and Nicole sat chatting with the locals. When our guide asks if we know about Haitian coffee, ears perk up. He says he can procure some fresh coffee beans from a woman up in the mountains. He'll roast it himself. We ask if we can watch – “bien sur!” It's raining now heavily and we are walking down the unpaved road to the hospital, walking with new friends— it's only our first full day.

Arrival in Haiti

Dear friends and families,

We have arrived safe and sound in Haiti! We got to PaP airport at noon and arrived at the hospital (HAS) just after sunset. Immediately we were welcomed by our fellow volunteers who are all very kind. Many of the locals who work at the hospital took us out last night for an annual end of summer festival. So far we've had a wonderful time drinking Prestige the Haitian beer and dancing with friends. Today we woke up early for the daily meeting where physicians discuss the most interesting cases of the last 24 hrs and give presentations. After tour of the hospital and the cholera ward we got settled in the Hangar clinic where physical therapy and prosthetics are located and also where we will be working from. Our first patient, a young woman spoke French so we were able to communicate without a translator. Her phantom pain is intermittent and she took immediately to the mirror! Our first patient and first success.

More to come soon,

-Phantom Outreach

Florida to Haiti

Liz, Claude, and Nicole are in Florida preparing for the flight in to Port-au-Prince later this morning.In the parking lot of a Vegas CVS We Tetrised our bags such that all the mirrors fit and nothing had to be abandoned! A small roadblock when a tattered passport bothered an attendant at the front desk of the airline was resolved with persistance and politeness.Now we are sipping coffee and reading our new copy of Lonely Planet's guide to the DR and to Haiti which has just been updated post-quake in its 5th edition and is not yet available in print (you will have to wait until October for the book)but can be purchased by chapter as a pdf on their site.The chapters on Haiti are informative and upbeat. We look forward to immersing ourselves in this vibrant and complex culture.
It is not clear when we will have internet access so hang tight for our next update- our first of many from Haiti.
A plus tard!
-Phantom Outreach

Au Revoir!

We are trying to get our bags as light as possible to fit 200 mirrors which is proving difficult. After that it's off to Las Vegas where the first members of our group will meet to fly to Port-au-Prince. Our second group will be joining us in a week. Currently we have a member in San Diego who is collecting donations we can bring to the women's shelter in PaP. Information about the shelter founded by founded by Eve Ensler can be found at: http://www.vday.org/our-work/safe-houses/haiti . Please contact us through this blog to arrange donations. We need contraceptives, feminine items, pregnancy tests, prenatal vitamins and letters of support.
Merci beaucoup,
Phantom Outreach

Welcome to our new site.  We are headed to Haiti tomorrow— check this site often for updates and feel free to comment below. We look forward to hearing from you.
-UCSD Phantom Outreach