Report on Medical Mission to Cabaret
September 23, 2012 - September 30, 2012.

Any medical mission by AMHE in Haiti is always in the context of the accord and the norms defined by the MSPP or Ministere Santé Publique et Population.

Cabaret is a small town of 64.000 inhabitants, 30 miles north of Port-au-Prince. Cabaret is easily accessible, has adequate accommodations and convenient transportation is available. More than 45 lives were lost in the devastating flood of October 2007 in Cabaret.

As previously announced, this mission is a combined effort carried by four medical associations:

--AMHE (Association Haitian Physicians abroad):
Dr. Pierre Leger, Nirva Leger, Cynthia Leger, Dr. Frantz Moise, Dr. Paul Nacier, and Parnelle Nacier

--AMH (Association Medicale Haitienne):
Dr. Ginette Riviere Lubin, Presidente AMH; Dr Brigitte Hudicourt; Dr. Widner Jean-Louis; Dr. Mario Florestal*; and Dr. G. Roberson
*Dr. Mario Florestal is a gynecologist and last year was a participant in the clinical rotation for residents at Brooklyn Hospital, NY. This joint endeavor is an accomplishment of AMHE and SIMACT (Societe Immobiliere Agriculture Commerce Tourism).

--BRA (Batey Relief Alliance):
Dr. Thomas Beague, DDS, BRA President; Sara Beague; Dr. Matts Simon, DDS; John King, engineer; Dr. Paul Nacier; and Dr. Pierre Leger

--DHA (DuSable Heritage Association):
Dr. Marilys Ewa, DDS, MPH

The abovementioned organizations and their respective representatives collaborated to provide the following medical services to the community of Cabaret: dentistry, internal medicine, general surgery, gynecology, ophthalmology, pediatric, psychiatry. Additionally, public health inquests and assessments were conducted and analyzed.

On Monday, Tuesday, and Saturday we worked at the clinic in Cabaret*. Then we organized a mobile clinic to provide services to nearby communities. The mobile clinic visited a church in Guiton on Wednesday, a school in Source Matelas on Thursday, and a church in Cousanto on Friday. We examined 23 staff members of the hotel where we lodged on Friday evening. Two patients had a high diastolic pressure of 120mm Hg and above, totally asymptomatic and with no known history of hypertension.

*Dr. Ginette Riviere Lubin, president of AMH, dedicated a full day of work at the Cabaret center on Tuesday.

Over 1600 patients were treated during our medical mission in Cabaret. The breakdown, by medical subspecialty, is as follows:

-More than 1000 patients were seen for internal medicine examinations (Dr. G. Lubin,Dr P Nacier,Dr G Roberson) and pediatric examinations (Dr. R. Leger);

-400 patients received dental care with 600 extractions, 60 fillings, and 50 cleanings (Dr. T. Beague, Dr. M. Simon);

140 patients in ophthalmology (Dr. B. Hudicourt) with more than 20 cataracts, advanced cases of glaucoma, newly diagnosed cases of glaucoma, and one herpetic infection to the eye;

39 patients in gynecology (Dr. M. Florestal);

6 interventions in general surgery (Dr. W. Jean-Louis) and 10 more cases to follow; and more than 69 patients in psychiatry (Dr. F. Moise).

398 patients were thoroughly interviewed for the public health assessment conducted by Dr. M. Ewa.

A member of the AMH team was travelling by bus from his regular post to join us at Cabaret. At Morne Tapion, the autobus was held up and all passengers were robbed of their personal items. Our colleague’s wallet, cell phone, and personal computer were stolen from him. Despite this setback and inconvenience, he was able to join the team, move beyond the setback and make valuable medical contributions to the mission. We have requested the AMHE Foundation to procure a new personal computer for our devoted colleague.

“Providing psychiatric services was innovative and should be made available with every medical mission”. Please refer to the informative report written by Dr. Frantz Moise for details.

The focus of the public health interviews was to gather background information on patients such as level of education, household size, water source, and toilet usage. Patients were also interviewed about their chief medical and dental complaints. Data analysis on the public health aspect of the mission is pending.

Moving Forward
The medical mission to Cabaret was successful and we look forward to future medical missions. In order to experience continued success, we have outlined the following goals.

--Expand the reach of the Cabaret clinic to neighboring communities. ----- Arrange for onsite medical visits every 3 months. The mobile clinics can be very helpful in the care of many chronic conditions.

WE ARE CALLING FOR MORE VOLUNTEERS FROM ALL MEDICAL ASSOCIATIONS.

--Demonstrate the working harmony between different medical associations. Through continued collaboration, we will work together and we will continue to deliver quality care.

--Secure continuity in the care to the patients and the participation provided by the aforementioned medical associations. The work has just started. Cabaret is a location that we can “adopt”. By “adopting” Cabaret, we can become active participants in the delivery of medical care and well-structured public health. Looking forward, we will expand our reach through partnerships with an academic program.

--Leverage the public health inquiry to build recommendations for future program development; and prioritize investment of our limited resources.

Acknowledgments
Thank you to all who made the costly and courageous trip to Cabaret. Additionally, we would like to thank the following people, who contributed to the success of our medical mission in Cabaret:

The team at Centre de Santé de Cabaret:
- Dr. Francisco Noel
- Dr. Ancio Dorcelus
- Nadine Jean-Baptiste, administrator
- Nurses
- Pharmacy staff

Community leaders:
- Emmanuel Hilaire, President Association TET ANSANM
- Jean Eristene Gregoire, President TET ANSANM, New Jersey chapter

- Mrs. Petit at Source Matelas

Volunteers that assisted with the public health assessment interviews:
- Rodney Hilaire
- Michel-Ange Leger

Special thanks to:
- Mr. Kay Scott
- Mr. Jeff Williams
- Maria Astracola, RN
- Dr. Roger Duvivier
- Dr. Shirley Gresseau
- Dr. Ronald Jacques
- Dr. Daniel Laroche
- Dr. Henry Paul
- Dr. Julien Supplice