Wednesday, March 19, 2014

Help at hand with Ferno² Fingertip Pulse Oximeters

Our nifty Ferno² Fingertip Pulse Oximeters will soon be deployed in the field in Haiti following our donation of two of the devices to the Hospital Bernard Mews/Project Medishare, an organisation dedicated to sharing its medical and technical resources with the Western world’s poorest country.
It runs a volunteer programme where foreign doctors and other medical personnel (mostly from US and Canada) travel to Haiti and work with Haitian medics to give free emergency aid to the local community.
Ferno’s Business Development Manager Darren Sharman presented the Ferno² Oximeters to Dr Joanna Cherry after being approached by Madeleine Radburn, Medical Devices Advisor at the South Central Ambulance Service. Madeleine supports the Hospital Bernard Mews/Project Medishare through her local Lions Club and helps keep Joanna supplied with a range of medical equipment to help with the care of the spinal patients she treats there.
Joanna says: “Thank you for your donation of the pulse oximeters. I will be taking them to Haiti next week and will let you know where they are used there. The Hospital Bernard Mevs/Project Medishare is a trauma hospital in Port au Prince and we work with local doctors and patients to try and ease the burden of high level trauma in Haiti.
“We have a four bed intensive care unit, a ten-bed medical surgical unit and three operating rooms with surgeons specialising in Trauma, general surgery, neurosurgery and maxillofacial surgery. There is also a high level paediatric unit with picu and nicu facilities and an eight-bed spinal cord injuries unit - my area of work - as well as outpatient clinics for all specialities in medicine and surgery.
“We treat high level trauma, medical and surgical conditions in patients from all backgrounds and are proud to serve the Haitian people in their time of need.
We continue to rely on donations of equipment to keep our facility running and our standards of care high and your pulse oximeters will be put to good use.”

In a recent blog piece for BBC Oxford Joanna wrote:
I didn't know what to expect when I arrived in Haiti - I had worked across Oxfordshire the year before I went continuing my junior doctor training and had covered GP, Psychiatry and Trauma in my rotations - I would later be grateful for this wide range of specialities.
I soon learnt that each day was unpredictable and you could never tell what cases would come in the hospital gates.
My main duty for the first two months at the hospital was to be the doctor responsible for the Spinal Injuries Unit.
This unit has 10 beds for patients who have suffered spinal injuries that have left them incapacitated to varying degrees from recovering neurological injuries to permanent quadriplegia.
Many of the injuries are as a result of trauma in the earthquake but there are also many that are from everyday activities and accidents.
I have worked at the trauma unit at the john Radcliffe Hospital in Oxford and seen how spinal injury patients are treated carefully and quickly to minimise the damage done to their bodies and function.
Patients in Haiti do not have the luxury of early surgical treatment and hospitals do not always even have the means of diagnosing injuries via CT scan (extremely expensive) or MRI scan (there is no functioning scanner in the entire country).
These are things that are readily available to patients in the UK. When patients are discharged from hospital in Haiti there is no district or community nurse system to help them and there is no established GP or primary care system - this means that patients can develop wounds and illnesses at home that can progress to life threatening problems.
Many Haitians are living in tent cities following the earthquake in January.
It is difficult to mobilise around the cities by foot due to overcrowding and hazardous terrain let alone by wheelchair so patients returning home in chairs have a poor prognosis for leading a full life physically and for returning to school or work which affects their mental health.
I was lucky to work closely with a Charity (SCI Haiti www.scihaitiproject.org ) working to find housing and sustainable jobs for spinal patients after their discharge from hospital. They are enabling spinal patients to lead a fulfilling balanced life when they return home and reduce the stigma attached to spinal injuries.
One such patient, a 14-year-old boy, fell from an avocado tree a week before I arrived, fracturing his spine and rendering him unable to walk. During his stay on the spinal unit we managed to improve his nutrition, increase his mobility, heal his wounds (caused by not being able to move after the accident) and arrange spinal surgery in a nearby hospital by a visiting American surgeon.
He is now walking with crutches and his future is bright.
The patients in the spinal unit not only have to deal with their injuries, pain, immobility and resultant wounds from not having good mobility they also have a background of severe malnutrition when they come to the hospital - this slows down their healing ability.
I have never seen patients who are literally starving to death in the UK. Through the generosity of my group of friends in the UK I was able to start a programme on the spinal unit which provided sources of nutrition, particularly protein, to these patients. I hope to continue this funding indefinitely.
Half way into my stay in Haiti cholera struck the country. The healthcare system in Haiti was already, at its best, on its knees due to a lack of equipment, personnel and funding.
Cholera has put a massive strain on an already overburdened system.
Before I saw patients presenting with severe symptoms of cholera I had never in my career or training seen such a large number of people on the verge of death.
They can lose up to 10 litres of fluid in hours and this can cause cardiac arrest and so death.
Cholera itself is not fatal it is the dehydration from the symptoms of the disease (diarrhoea and vomiting) which kills.
Rehydration saves lives and with the help of a massive government public health push this message was beginning to reach the public who began to present to hospital earlier and so lives were saved - the pubic health drive also informed patients how to minimise risk of transmission of cholera.
However, at the start of January 2011 over 2000 people have died from Cholera, thousands more have been affected and the disease shows little sign of slowing down.
During this time I saw that the Haitian people want their country to be rebuilt and to have better lives - but are frustrated at the slow progress by their government at achieving this.
The emotional strain of the earthquake, recent hurricanes and Cholera, have pushed an already unstable country to dangerous levels of volatility. However, the Haitian people were extremely welcoming to the volunteers both at the hospital and outside.
Things that I hadn't experienced in my medical training but had to learn in Haiti included how to deal with a man presenting with a machete in his head at 3am; how to find space for patients presenting at the gate when we already full; how to deal with children dying of diseases that we would vaccinate against in the developed world; how to cope with a family wailing with grief for 11 hours after their relative died; how to tell a man in a crowded clinic via a translator that he had terminal cancer and there was very little we could do for him... the list goes on.
Due to lack of resources I was forced to use my medical knowledge, examination and diagnostic skills rather than laboratory tests and imaging to make diagnoses.
I feel that all of these things have made me a better doctor and probably a better person but they have also shown me that there is still so much to be done in Haiti.
The country is in desperate need of aid - including that which was promised to them after the earthquake. The people of Haiti deserve our help.
I will return to Haiti in March to volunteer my services as a doctor and hope to be able to take over donations of medical supplies, clothing and funds.

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