HEART-FELT THANKS at the turning of the year!

HEART-FELT THANKS !

  • For a long vacation (all the twelve days of Christmas!) from any kind of work: time away, with Donnel, our kids Aidan and Chase, and the wonderful and wholesome companions of our kids and THEIR families. Life goes on!
  • For the spectacular vistas of coastal California, where we visited Aidan and Chase. How do those mountainsides and oceans stay so open and wild?  Raptors soar over crashing waves, as we hike up higher and higher.  The air is fresh and new.
lexi photographer-jan.2019

Lexi taking pictures by the California sea

  • For the deep sweetness of the connections with our Haitian friends.  By the magic of internet we have received lovable little videos, WhatsApp messages, blessings flying across the miles.  Love is in the air!

 

  • For YOU, the larger community of watchers and helpers, in the US, Canada, and Haiti: workers in the field of bringing rehabilitation education to Haiti.
    judith, gigi carnes-guest house

    Judith Straub, clinical social worker, and Medgine Carnes, OT, have both taught at FSRl this fall (2018).

    Who is it that said that the meaning of vocation is finding where the world’s deep need meets your own highest joy?  I think that is an ideal, as most of the time we have to compromise on that, but some sense of vocation can fit inside all kinds of lives.  And if you have found, as have I, that there is a high joy in this kind of work, with the possibility of freeing up those who, because of disability, are trapped in bad situations where help is scarce, then you have that vocation too.

  • What I pray in the new year is what I prayed in the old year. Thanks, heart-felt thanks.

In my litany of thanks, I want to take a moment to recognize Miselene Lafleur.  Miss Lafleur is a licensed nurse.  She graduated from FSIL, and was the valedictorian of her graduating class, in 2016.  Mme Alcindor referred me to her as a candidate for first administrative assistant of FSRL.  That was a good referral !  Miss Lafleur has a quick mind, Thinkns, an excellent memory, knowledge about medicine, insider knowledge about FSIL that helps us know how to work together, good leadership skills, lots of patience, and a strong ethic of service to her fellow man. Miss Lafleur knows everything about how FSRL functions.  She has now taken on the role of Administrator.  Miss Lafleur is applying to the U. of Laval, Quebec, for an online MBA program: she will do well in that program, I’m sure!

lafleur et jof at desk

And, my other prayer in the old year and the new is, “May there be enough”.

Enough of what?

Enough resources:

  • enough money to pay the bills
  • enough faculty to share syllabi and lectures for our courses
  • enough instructors and professors to come in person to teach
  • enough Haitian PTs, psychologists, and orthotist/prosthetists to teach the classes that need local
  • enough good will of FSIL which is our generous host
  • enough good will of UNEPH which is our accrediting university
  • enough good will of the Episcopal Diocese of Haiti, which is our undergirding support and our permission to even be in this role in Haiti
  • enough vision and provision by the Societé Haitienne de Physiothérapie (SHP) to continue to include FSRL in the planning for professional recognition for PTs and OTs (Thank you, SHP!)
  • enough attention and persistence by the already busy OTs of the Association Haitienne d’Ergothérapeutes (AHE/HAOT) to continue to do our important work of developing knowledge of OT in Haiti (Thank you, AHE!)
  • enough vision and provision by the Ministére de Santé Publique et Populations (MSPP) to give a path for graduates of FSRL and UNIFA to achieve professional status
  • enough patience and health among the more than a million people with disabilities who need therapists to come and help their situation
  • enough time and mental effort, that is, sustained attention, by the dean of FSRL, me, to continue to keep track of all the threads of this work OR
  • since the complexity of this project is beginning to be overwhelming, may the new year bring enough help to pick up some of the threads and carry them forward!

 

 

Guest Blog: Mme Stephanie Goodrich teaches Neuroanatomy!

FSRL second years 2018

Second-year students in OT and PT,  wearing their best scrubs, with Mme Stephanie Goodrich, center, and with M Emmanuel Occidor, interpreter, who is wearing a jacket: November 9, 2018.

Hello! Bonjou, bonswa! My name is Stephanie Goodrich. I am here in Haiti to teach Neuroanatomy, a 4-week course for the second-year FSRL occupational and physical therapy students. At home in North Carolina, I work as an occupational therapist in acute and inpatient rehabilitation facilities. I first learned of FSRL when searching the internet for opportunities to travel overseas and serve with my occupational therapy education. And what a wonderful opportunity this is!

Every day, I am amazed by the dedication, intelligence, and focus of the FSRL students. Despite that my lectures, given in English and translated to French, are not in the students’ primary language (Haitian Creole), they maintain focus and absorb very challenging material. They are not afraid to ask questions (many, many questions!) to make sure that they fully understand. Even as new second-years, they constantly strive to make practical connections between what they are learning and how it pertains to disability and rehabilitation.

Stephanie teaching Neuroanatomy-9 Nov 2018

The neuroanatomy class meeting in the Common Room of the dorm.

Over the past few weeks, when not teaching, I have also had the chance to observe some of the “behind-the-scenes” work of managing a new rehab university program in Haiti. Needless to say, there are many aspects of the program that need tending to on a daily basis, on top of all of the big-picture planning needed to keep the program going into the future. Dean Janet is a real-life Superwoman! It is plain to see how both how much the students respect her and why. I have also been blessed to spend some downtime with a few of the staff members, who have gone out of their way to help me feel at home and even teach me some Creole.

As it is with any short-term trip, I wish I could stay longer and do more, but I am so very thankful for the time I have been given at FSRL to get to know the students, to spend time with Dean Janet, to meet a few of the program’s other important contributors (Kate Barrett, Julie Booth, several other volunteer professors and students), and to be a small part of something incredible. FSRL will be in my prayers and in my heart, until I return again (and again and again, I hope!) and always thereafter.

Guest Post: Dr. Kyle Feldman PT, DPT

I felt like a child on the first day of school. I woke up at 5:30 am ready to go. Sadly we did not start until 8 am so I did some personal reading and even reviewed some of my slides to make sure they were correct. After a traditional Haitian breakfast I made the walk over to the school to start the day.

Myself and the physiotherapy class:

At 7:55 am all of the students were in the commons of the school lined up. I learned that like in America they respect the flag before school starts. The entire school sang the anthem as the flag slowly ascended to the top. The passion in each students eyes and voices as they sang was so strong. I got chills on my arms as the song concluded and each student rushed into their classroom. I would expect this in grade school, but to see 20-40 year old adults doing this shows how much this country means to them.

I prepared 6 lectures for the day and knew it would be a long day for them. I started by getting to know the 7 students who are 4th year physiotherapy students. They have made it so far and I could tell from the first few minutes that they were all hard workers. After setting the objectives and going over the syllabus I started us with an icebreaker. I asked two very deep questions alongside the basics to help get to know them better. The first question was “what is your biggest fear” and the second was “if you won the lottery what are the first three things you would do”. I was very impressed with their answers and learned a lot more about their culture and emphasis on community.

 

During the first half of the morning we focused on Clinical Reasoning and reviewing concepts from the foundational courses. They have retained a lot of the content which made the conversation much more interactive.

After lunch we worked on expanding hypothesis generation to improve creating differential diagnosis lists. I learned that as an education system, the Haitian students have very strong memorization skills as this is the main learning style they are taught. They struggle with more abstract thinking and application of knowledge. These students in the physio program have been working hard on these concepts and I can tell they are beginning to learn this skill and will improve it as the year continues.

I was very impressed with their conversation about clinical experiences. Many of the students expressed that the way of thinking they have been learning in this physiotherapy curriculum is very different than how clinicians in the country are practicing. They were excited to apply all of the knowledge they have learned prior to the rotation, but felt many of the therapists were not doing thorough assessments and still using very outdated treatment styles. It was so inspiring to see motivated therapists who want to improve the profession and challange the status quo of current practice. I hope that this week only adds wood to that fire.

After class I shot the basketball around on the outdoor court near the campus. One of the students saw me and we played a little one-on-one. Not playing ball in over a year and being in 90 degree heat left me exhausted by the end.

Chicken, rice, and fresh vegetables was a great end to the night.

I spent the night working on some of the lectures and self reflecting. I have a long way to go with my skills as an educator but after doing it for 8 hours straight I can say I love it!

 

—If you would like to follow Kyle’s Blog while in Haiti go to:  https://mobilizetheworldpt.blogspot.com/2018/10/travel-day-and-exploration.html

New students begin on October 5th 2018

The new students are here!  Even though classes have been in session since the beginning of September for the second, third, and fourth years, the students of the first year just arrived, on the 5th of October.

We have 14 students, and all have good reasons for coming.  For instance, one is already a rehabilitation technician, one has a brother in the US who is an occupational therapist,  and one is the daughter of a rehab technician from St. Vincent’s whom we knew years ago.  Altogether there are five students with sponsors from the US, and the others have support from their families.   This is a strong group!  The photo shows the brief ceremony of signing in, in the official FSRL book. 1ere Annee 2018 (1er jour)

 

We welcome them into the first year.  During the coming year they will take most of their classes with the Nursing students of FSIL.

Meanwhile, during that same Friday when the first years signed in, the rest of the FSRL students celebrated the third birthday of FSRL!  The FSRL birthday party is to celebrate  the 5th of October in 2015 , when the first students began their studies.  Those students are now in the fourth year, and planning to graduate in Dec. of 2019.

The celebration started wtih a prayer service in the auditorium.  The students then spent the morning working hard to prepare and serve a big lunch to the whole school.  And after lunch the students of FSRL went to the beach!  At La Galant, in Grand Gôave, we swam and danced and ate lots of cake.  It is wonderful to have three years of history  to celebrate, by now !  And we are finally a full university program, with all four years of classes present.  Hallelujah!

 

NEW new beginnings!

What a year! 2017-2018, all wrapped up!

What a summer!  I’ve been home for most of August in Montana and California!

O'Flynn family in Penngrove CA-Aug 4 2018

Aidan, Chase, Donnel, and Janet at Chase’s home, Dhammadharini Monastery in Penngrove, California

It’s Sunday afternoon, 26th August.  I’m in the plane on the way back to Port-au-Prince, ready to start the 2018-2019 academic year on Monday, September 10th.  The nursing school,

FSIL, does a lot of planning during August, so by returning for the last week of August I will be able to join in some of that planning.

The 2017-2018 year finished in July with final exams for the freshmen.  The clinical formation for the Sophomores and juniors continued into early August.

FRESHMAN YEAR

We lost three members of the freshman Class due to their failure in more than 2 courses: instead of 13 students, we now have 10.  These programs are not easy, and guidelines are strict.  The academic guidelines are requirements by MSPP, the Ministry of Health, for nursing programs. A student must pass all but two classes, out of more than 20 completed in freshman year.

The academic rules, even though they are harsh, are a protection against a big investment of time and money in an education that then cannot be completed by a degree.  In order to graduate, each student must design and execute, and then defend a research project that uses all the skills gained from FSRL.  If a student who cannot pass the earlier courses is promoted to fourth year, it could happen that after four and half years of effort that student would be unable to graduate with the bachelor’s degree: which would be a catastrophe!

The students who are not be going on will be missed. I dearly hope that another path to employment will open up for them.

SOPHOMORES & JUNIORS

Our students went in groups of two to four to a variety of outpatient rehabilitation clinics, some far away.  The sites, which we appreciate so very much, were

  • FONHARE (Fondation Haitienne de Réhabilitation) with Dr Ivens Louius and Dr Michael Falcon in Ouanaminthe in the north,
  • FONTEN (Fondation Tous Ensemble) with Mme Consuelo Alzamora in Les Cayes in the south,
  • Respiré Haiti with Mme Ashley Kahila in Léogâne,
  • and Healing Hands for Haiti with Mr Anani and Mr Paulin in Bourdon, part of Port-au-Prince.

Responses of supervisors and students were positive: our students felt well prepared, and the supervisors appreciated their preparation and their initiative as well.

Michaud clin ed-July 2018

Exercise to reduce pain and increase flexibility in the upper back, at Healing Hands for Haiti.  Our student is enjoying the patient’s relief!

IMG_6744

FSRL student providing manipulation for evaluation and for relief of symptoms.

IMG_6728

FSRL students learning how to make and modify orthotics

One situation that started off as a concern expressed by the students turned into a great learning opportunity.

At one of the sites, two PT students expressed surprise to me because their newly acquired skills in manual therapy for orthopedics (that is, hands-on physical evaluation followed by hands-on manipulation) were not being done at their clinic.  Then during the students’ mid-term evaluation, they received the feedback from their supervisor that they were at fault themselves for not teaching their colleagues the techniques they knew!

That is a sign of a strong clinical program, a good health care facility,  when practitioners are open to learning.   One incentive for clinics to take students has always been that the practitioners  learn new approaches when students come in fresh from classes:  the other PTs and rehab techs wanted to learn what they had seen our students doing!

The experience will be repeated again and again as our students go out into the working world.   That happens in all countries, but especially I think it will happen in Haiti where practitioners have had to struggle so much to get their education, and where continuing education is hard to come by.  Our new graduates will need to be nurtured with continuing ed courses, and they  will also need to be always teaching.

EXCITEMENT ABOUT THE NEW YEAR

Even though few students are on campus, there is an excitement in the air for the new year.  FSIL has painted many walls, done a thorough cleaning (again) of the building, and revised and reprinted the very important Student Manual and Dormitory Manual.  For FSRL, we are making phone calls and sending emails to fill in missing slots in our teaching rotation (hey!  Maybe YOU want to come and teach!) .  We’re considering how to stretch our dorm space, how to reinforce the rules and customs of FSIL that are also required of FSRL, how to hold a “Saturday School” for a handful of students who failed just one or two classes.  We are looking forward to the return of Dr. Rachel Woodson, PT from Arkansas, who will help us with faculty coordination, some teaching, and some clinical supervision.  This should be the year when our students begin a weekly fieldwork visit to Hôpital Ste Croix, the local Episcopal hospital that has been asking us all along to provide a rehab service.  WE FINALLY HAVE FOURTH YEARS!  SENIORS!

Our 4th year students are ready!  We will ask Rachel to accompany them on their hospital visits as often as possible, and we hope to have another PT, a Haitian practitioner, to help us as well.

TWO “first days”; TWO BEGINNINGS

This campus has TWO beginnings.  In September the returning students begin (Sept. 10) and on October 1 the new freshmen begin.  The first-year student process will be described in a later blog – stay tuned!

Guest post from PT Rachel Woodson: A remarkable moment for our PT and OT students and the student nurses of FSIL!

Rachel Woodson is a physical therapist and missionary from Arkansas.  She has been helping us a LOT by supervising the PT students on “Stage” or fieldwork, at the Hopital Ste Croix.  Ste Croix has never had rehabilitation services, in its 40 years.
Thank you Rachel for permission to share this!

Tuesday, May 22, 2018

Yo Kapab (they can)

Today was a special day, an amazing day. We are taking 8 students (3rd year PT and OT students) to the local “public” hospital this week and next. We have primarily worked with 4 patients during these two days. One patient is an older gentleman, we will call him Jean, whom suffered a gunshot wound. Following the students’ initial evaluation the patient was found to have no movement below the waist and post op abdominal surgery. The surgeon came in shortly after and kindly spoke with us about the patient. When he and I were talking he said to me “I don’t think he needs to be here (ortho floor) anymore, I think he should transfer to neuro bc maybe he has a spinal cord injury from the gunshot but we don’t know.” Long story short we went in and sat the patient as the edge of the bed for the first time after his surgery 10 days ago and he was a little dizzy and VERY weak. He had not moved fromlaying on his back, however the nurses had done a good job of preventing pressure sores/ulcers.

When we came in the next morning we were informed that the patient was being discharged. The family had not been taught ANYTHING. No positioning, no transfers, no catheter changes, no infection precautions. NOTHING. So we began to work with the students on educating the family and getting the family involved in transfers and planned to teach the family to transfer Jean to a wheelchair (even though they did not have the money to purchase one) and some other basic spinal cord injury education. We started to discuss it and they were talking about how surgeons get tunnel visioned on their one issue and will sometimes discharge patients not understanding everything. I voiced what he had said to me and then the ball started to roll….

The nurses called the doctor and he confirmed that he did feel he needed to be transferred to the neuro unit but that the doctor on call would have to make that decision. When the doctor arrived he “conferenced” with one of our PT students and a nursing student that had been fantastic in caring for the patient as well (the photo above). They advocated for the patient and the doctor AGREED that the patient should stay on the neuro unit. They also talked to the director and he interviewed the family to determine if they needed a wheelchair without paying. The option also came up for him to go to an inpatient rehab center, which is still in progress as to if that will happen.

I was amazed and started to tear up thinking how these students are changing this country starting with that man. They are doing it respectfully and dignified. They are doing it by working TOGETHER as a healthcare TEAM. They are doing it because they care about their patients. It is a long road ahead, but THEY ARE DOING IT!!! I was so proud to be part of FSRL/FSIL today. That man would have likely laid in a bed at his home, never moving, and had no quality of life if these students (PT/OT/nursing) were not there. He would have likely died in the next 3-6 months due to wound infection, pressure sores, pneumonia, or some other related illness secondary to his apparent spinal cord injury…. But now he will have some time and physical/occupational therapy to live a better quality and more dignified life. This profession of physical therapy that I get to call a job will always give me pride because I get to watch peoples lives change. Because I beleive that quality of life is as important to a person as actual life.

Today was refreshing and I am so excited to see rehab professions become a more common part of the healthcare team as it demonstrates progress in Haiti from pure survival to giving quality of life to the patient and family through respect, dignity, and improving independence.

Live Foolishly
Rachel

Rara, and how the whole evening made me feel so valued! How unexpected, for this particular event!

I am sure you are wondering how the rara evening turned out!

It was last Sunday, just HAPPENED  to be Easter Sunday. Actually, it is always a big rara weekend on Good Friday, Holy Saturday, and Easter Sunday.  The FSRL students and I were invited to join FSIL nursing students on a reviewing stand right at the beginning of the parade route, where the bands started off on their musical march.  We were there at dusk, but the parades were destined to go all night and into the morning light.

rara 13-daylight-FSILstudents on rev stand

FSIL nursing students (and a couple of Rehab students too) peering over the rail of the reviewing stand, at the rara parades below.

One of the Americans staying in the Guest House during Holy Week said that having all the families outside in the streets, and flags, and glow sticks, made her feel just like on the Fourth of July back home, and that is a good way to express the mood!

Here is a photo of the staging area in the street as night fell:rara 16 - twilight to night crowd

As you can see in the earlier photo, the prime viewing spots at the rail were taken!  I climbed on a chair behind this row and could see a lot.  But after an hour or so, I was invited (by gestures, since the sound was overwhelming and conversation was nil) to squeeze right into the middle and get the best-ever view.  Here’s a short video clip (1 seconds) of the announcement for a band, and the start up of the bluesy rhythm.  I have been told that Haitian music is a prominent part of the background for New Orleans music, and it certainly did have that sound.

 

But still, after four hours of this (by 10:30 or 11 pm), I was flagging and started wondering how on earth to get across town in all the crush of humanity.  There was a van available, and there was  a driver (a wonderful nursing student, Jephté, who also drives ambulances), but it was just going to be impossible to move that van even an inch in the crowd.

So, as I was thinking this and wishing for a helicopter, one of the nursing faculty spoke to one of the guys, and almost immediately four young men, three of them our rehab students, came up to me and (over the music and crowd noise) told me they would walk me home.

rara 4- night-3 gallant guys

Selfie with three gallant guys, Rehab students at rara!

I was to stay in the middle, and the four guys on the four corners, and we would just go right through the crowd all the way back to campus, about one mile away.

It was great! With two in front and two behind, striding purposefully, hands on shoulders when needed so not to be separated, we struck out through the crowd.  As we were SO close (inches away) to all the other partiers, I did get some surprised double-takes – but by the time someone could wonder why an American was there in the crowd, we were already gone.  When the crowd began to open up a little, we hit a good walking stride and covered the distance back to campus in good time.  It was cool.  It was like being a Jet, in West Side Story.  Me and the guys, cool and confident, walking fast, safe and sound, all the way home.   They were talking and joking and making sure I didn’t fall into any potholes in the dark – all good.

I hope you can feel that too, that sense of being valued and protected.  In spite of any ambiguities about how our two countries get along, the people with whom we share this audacious project to bring rehabilitation professional education to Haiti are on our side!  We have allies, from the patients to the students to the faculty  to the university administrators to the Episcopal clergy in the Diocese.  It is good to see, concretely, that this is working!  We DO have a team!

Happy Easter (all seven weeks of Easter) to you all!