TMC PULSE

t m c » p u l s e | m a r c h 2 0 1 9 16 The doctors packed 50 pairs of medical gloves, 40 surgical gowns, Foley catheters, IV fluids, needles and a portable cystoscope—a tube inserted into the urethra that allows them to see inside the bladder—into 15 pieces of luggage. "It was actually the same equip- ment that we use in the operating room here," Muir said. "We were able to take all of that with us, but if we had not done that, I think we would've been hard-pressed to be able to do anything." On Oct. 29, the team flew from Fort Lauderdale, Florida, to Haiti's capital, Port-au-Prince. From there, they boarded 5-seater planes for the last leg of the journey, heading 87 miles north to Pignon. "We couldn't even take all of our luggage with us on the plane. We ended up getting ground transpor- tation—eight hours from Port-au- Prince to Pignon—to get the rest of our supplies. The weight was too heavy. We had too many supplies to make it fit all on the plane," Lindo said. As the plane descended into Pignon and landed on a small, grassy runway, the doctors looked out the window and soaked in the landscape. "There's just one building that serves as the airport, with basically no security or anything like that," Muir said. "It's completely different than anything we have in the United States. Just going into town, there are huge potholes that could almost swallow a car." When the doctors arrived at the local hospital, Hospital Bienfaisance de Pignon, they found a modern- ized 65-bed facility equipped with two operating rooms, a laboratory, X-ray machine and pharmacy. Still, resources were limited. The team soon discovered the hospital had no antibiotics or anesthesia. "We had to pay for and procure that over the course of about 24 hours," Muir said. "It's definitely a very different setup than what we're used to, where everything's at our fingertips." The Methodist team found the medication after calling around to hospitals that were a half-day to a full-day drive away. Finally, their operating room was ready for patients. One of the first women treated was a 37-year-old who had devel- oped a 3.5-centimeter cyst around her urethra, causing excruciating pain during urination and inter- course. Another patient, 34, had suffered a severe straddle injury that had become infected after two months and damaged her sphincter muscle. Many women in Haiti endure discomfort and even embarrass- ment because of untreated pelvic floor disorders. Over four days in Pignon, the Houston Methodist team evaluated 13 patients and performed six surgeries that vastly improved each patient's quality of life. "Every time I take care of a patient and I see the joy on their face because they don't have a prob- lem anymore, it continues to push me to continue to offer care," Lindo said. "It takes a lot of time to do these trips, but the fact of the matter is, women here in Houston have access to physicians who can help them, but there are a lot of women in a lot of places in the world who don't have access to care." Another goal of the trip was edu- cation. The doctors worked along- side local surgeons, training them on specific procedures. In addition, the Methodist doctors delivered lectures to medical residents from Port-au-Prince on topics including urinary incontinence, fecal inconti- nence and pelvic organ prolapse. "The most poignant part [of the trip] is creating the relationships with the physicians there in Haiti and being able to, by establishing those relationships, reach more and more women in the future," Muir said. "That was probably, to me, the number one accomplishment." The team flew back to Houston on Nov. 2, 2018, but have already committed to returning to Pignon. "The success of this trip will be the fact that we'll be going back," Lindo said. "Once you plant a seed, you have to go back to water it so it can grow." Antosh walks with a local family in Pignon. Lindo, Antosh and Pai in the operating room in Pignon, Haiti. It takes a lot of time to do these trips, but the fact of the matter is, women here in Houston have access to physicians who can help them, but there are a lot of women in a lot of places in the world who don't have access to care. — FIONA LINDO, M.D. Medical director of urogynecology, Houston Methodist Willowbrook Hospital

• Cover