By Scott C. Nelson ’96 and Irma Henry, DPT, SAHP’18
From every direction we keep hearing about “uncertain times,” but at Hôpital Adventiste d’Haiti (HAH) there is nothing uncertain about what is happening here. People of all types are coming from near and far, and they are being healed. Our mission is, “To continue the healing ministry of Jesus Christ by providing quality care to all classes of people.“ Although our own capabilities are at times uncertain, there is nothing more certain than the source of these modern-day miracles.
Naika and her parents are among many who have heard about this exciting news. Naika is a 17-year-old girl who was born with a short right leg. When she was a little girl, it was a little shorter than her left leg, but she could walk on the tips of her toes and it did not bother her too much. However, as she grew, so did the difference in her leg length (as is normally the case). She has a severe limp and her back and hips give her trouble if she overdoes it. Here, these types of discrepancies are often thought to be caused by something the parents did or by some curse. With that in mind she chooses not to wear a bulky shoe lift as she doesn’t want to attract too much attention to it. In addition, shoe lifts cost money and it can be easy to twist your ankle on the rough streets of Port-au-Prince. She and her parents come to see me in our outpatient clinic, and I tell her about how we can lengthen her leg. Once she hears that, well, the rest is history. She quickly tunes out everything else I say while her mind fills with dreams of the future.
Limb lengthening is not an easy process. It involves an operation where the bone is cracked and a device is attached, which both stabilizes and slowly distracts. The most difficult part is the post-operative rehabilitation. This involves intense physical therapy (PT) five days per week in order to maintain range of motion of adjacent joints and make sure the muscles and neurovascular structures also grow with the bone. Bone lengthening surgery would not even be a possibility in Haiti without our PT department. Even in the United States, it is only done at a handful of specialized centers. At HAH our PT department, appropriately called “Chanje Lavi” meaning “life change,” is led by Irma Henry, DPT, a graduate of the LLU School of Allied Health Professions, who has done an incredible job of training and coordinating local staff.
Advances in technology have improved results and eased the discomfort after limb lengthening surgery. Recently, the development of an implant called the Precice® nail has allowed us to lengthen bone without the need for an external fixator. This device is implanted inside the bone. It has a gear inside that is driven by a magnet, which rotates with the influence of an external magnetic remote control. The patient typically holds the remote control on the front of the thigh for a few minutes several times per day which painlessly lengthens the bone. This avoids the painful pins that go through the skin and muscle into the bone and has minimized infection rates. Unfortunately, the $19,000 price tag makes it cost prohibitive in countries like Haiti.
This case brings many questions to mind as we navigate the priorities of medical missions in the 21st century: Are expensive magnetic nails appropriate technology for Haiti? Is leg lengthening important in an environment where even basic needs are not often met? Does this qualify as doing the most good with limited resources? I often contemplate these tough questions, but when a patient is in front of me, the questions fade into the background and I only have one priority: to give all I can for the case at hand.
This is where connections come into play. One can argue the role of mission doctors, but few would disagree about the importance of connections. Our local doctors have important connections in our community, which are complemented by my connections in the global village. Working together we can make things happen that do not happen at hospitals down the street. With the renowned limb lengthening program at Loma Linda University, it is not difficult to convince the Precice® nail vendor to take interest in Naika’s case. A few brief text messages seal the deal, and the company commits to donating the implant and sending their representative to deliver it.
After one month of physical therapy, Naika’s X-rays look great with one inch of lengthening. Every morning Naika comes in for her physical therapy session to both ensure that
she has full motion of her knee and to strengthen her leg for when she begins to walk. She comes in with a hesitant smile because she knows the session won’t be an easy one and that tears may be shed. Despite this, she’s motivated because she wants to go back to school to see her friends and finish her last year of high school. Naika wants to study to become an orthopedic doctor and help kids who have similar deformities. Even though she jokes and says that this surgery has changed her mind, she sees the impact it has made on her life and so do others around her. Over the next few months, Dr. Irma and her team witness not only the physical transformation but the increased self-assurance, confidence, joy, and independence that Naika has as she walks out of the clinic on her own two feet without crutches or assistance.
In French, miracles are called choses extraordinaires. The process of seeing new bone growing as it is lengthened is nothing short of extraordinary. Seeing bone grow is even more exciting than watching bamboo grow! However, we must remember that it is not the surgeon’s mallet or the physical therapists that makes this happen. With rare exception do any of our patients come out of an operation immediately feeling better than when they went in. But very quickly the healing power of Jesus Christ takes over, and our patients are restored. When we witness these daily miracles, we realize there is nothing uncertain about His healing.
These are unprecedented times at HAH. All types of people are coming here for treatment. It was not long ago that people without money were being routinely turned away. In years past, the healing ministry of Jesus Christ was largely extended only to people who could pay for it. Amid financial struggles it was uncertain what would happen if we opened our doors to those who could only contribute small amounts or possibly nothing at all toward the cost of their care. But we stepped out in faith and did it.
The results are remarkable. In spite of the pandemic, our hospital beds are full, our clinics are overflowing, and our operating room is setting records. We are not making a lot of
money, but we are surviving. Donors are showing their enthusiasm, and every day we are finding more ways to create efficiency. We are blessed to have Jeffrey Cho ’14, family practice and preventive medicine, join our staff with his wife, Michelle, an architect, and their 1-year-old daughter, Eden. Jeff is starting wellness programs for our staff and patients, which are unprecedented in a hospital and society that is largely in survival mode. Tim Cleveland, CPO, SAHP’15, recently joined our staff with his wife, Annika, MSN, SN’15, who is an ICU nurse. Tim is restarting our much-needed prosthetics and orthotics program that had been in place for several years after the 2010 earthquake. Jonrey Avellano, clinical lab director, recently married Jorielyn, an ICU nurse from the Philippines. Jorielyn and Annika are working on starting our intensive care unit as well as a number of other quality improvement initiatives. Jere Chrispens, CEO, works closely with Mackenson Christoff, chief of operations, to provide administrative leadership for our more than 200 Haitian staff. Although many challenges remain, we are grateful to have a wonderful team of people—local and international—and worldwide support that facilitate extraordinary and unprecedented good news. It is certain that God is blessing HAH in no small way.
As we move forward and accept the call to serve, we remain anchored and assured in Jesus Christ, the true source of all things miraculous.