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doi: 10.1097/01.NT.0000407228.13126.5f
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Global Neurology: Neurologist Anthony Alessi, MD, in Haiti: A Nation in Recovery

Rukovets, Olga

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Marie, a sixteen-year-old girl whose home was destroyed during the earthquake that shook an already unstable Haiti in January 2010, has weathered more than her share of storms — and life challenges.The first in her family to complete middle school, she was studying for her high school entrance exams when the tropical storms hit last summer. The home her family had worked hard to rebuild began to crumble as the winds and rain raged around them; there had not been enough money to buy the cement to hold the cinder blocks together. The young woman saw the walls collapsing — right over her younger brother, and dove to protect him. The debris crushed her spine, rendering her paraplegic.

DR. ANTHONY ALESSI w...
DR. ANTHONY ALESSI w...
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She was rushed to the St. Philomena Hospital in Port-au-Prince. Local and volunteer physicians — neurologist Anthony Alessi, MD, among them — communicated with their affiliates at the Mayo Clinic in Rochester, MN, where Marie was transferred and is still being treated — though she likely won't ever regain full movement in her limbs.

Dr. Alessi, who has a private practice in Norwich, CT, has now made ten trips to Haiti since the earthquake hit, and he and colleagues continue to see many patients like Marie — young and old. Most have been injured physically and emotionally by the natural disasters that have ravaged the country in recent years, he explained. The immense poverty he has observed there and the shaky infrastructure for health services compel him to return again and again to the poorest country in the Americas. (Read more about Dr. Alessi's work in Haiti here: http://bit.ly/m5jujQ.)

Since the earthquake, “it's really been interesting for me to first observe the disaster phase and now the recovery phase and what the progress has been.” He returns often to Saint Damien Hospital, a pediatric hospital in Port-au-Prince. The 80-patient pediatric facility, which had strained to meet the needs of 250 adult patients after the earthquake, now has an adult trauma center and a rehydration center for patients with cholera, made possible with donations after the earthquake.

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CURRENT CONDITIONS, PROGRESS

The rubble is starting to be cleared away, but in terms of “meaningful construction,” Dr. Alessi said, we're not seeing much of that. And there are hundreds of thousands still living in tent camps, “where disease breeds and violence breeds, and there's frustration, there's rape; there are so many problems going on in the tent camps.” And that's a major barrier to recovery that has not been addressed yet.

Another concern: In all of Haiti, there are only two neurologists — one pediatric and one adult — and both are in Port-au-Prince, Dr. Alessi said. From Jeremie, Haiti, where Dr. Alessi stayed for a period, some patients have to make the 140-mile trek, a 12-hour journey, to receive neurological care.

“We see a lot of children who have cerebral palsy or kernicterus — a rare neurological condition that occurs in some newborns with severe jaundice, and have seizures,” he added. Epilepsy, traumatic spinal injuries, and stroke are common. Stroke is a big problem because they don't have the facilities — “we assume everyone has access to a baby aspirin every day when they have all these risk factors, and that's just not the case,” Dr. Alessi said, so it may often go untreated. The pharmacists at the William W. Backus Hospital in Norwich, CT, came together and used their own money to purchase several cases of bulk-aspirin.

Of course, cholera is another major concern right now, and we don't expect that to end, he added.

THE PHYSICIANS and n...
THE PHYSICIANS and n...
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“People always ask why do we have to go there to help them? Well, because many of their physicians and nurses died in that earthquake — and there's a tremendous shortage in Haiti.” With this loss, the patient-to-doctor ratio has risen dramatically, he said. The role Dr. Alessi and other experienced volunteers initially played as direct care providers has shifted, he said, to that of teachers for the local nurses and physicians.

During his recent trip in July, this time with his daughter Catherine, a third-year medical student, Dr. Alessi saw a great hope — in the form of young Haitian physicians who are so eager to learn; “they're eager to do anything.” Working with these physicians, he said, and overall, it is “almost like you are part of rebuilding a health system. It's an amazing feeling and it's hard to relate that to people.”

Before the earthquake, there were only two CT scanners in all of Haiti. Now, thanks to the McDonald's Foundation of Germany, there's a third on the grounds of St. Damien's. So, the availability of basic tests is a major improvement, Dr. Alessi said.

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AAN CALLS FOR VOLUNTEERS IN HAITI

In July 2011, the AAN released a statement on their Web site inviting Academy members to volunteer their time and expertise in Haiti (http://bit.ly/qD3wxn).

“We did that because the AAN wanted to make sure we had a safe environment for our members to go to, one where we knew they would be asked to practice quality medicine in a good environment,” said Dr. Alessi, adding that they were able to establish just that in working with the St. Luke Foundation (www.compassionweavers.com) and with Operation Blessing International (www.ob.org), a nonprofit, humanitarian organization with a mission to alleviate human suffering in the United States and around the world.

Seven or eight neurologists are already scheduled to come down. It's not an easy decision to make, he said. “You're not going to stay in a luxury facility by any means. You have to get the profilax treatment for malaria. And it's hot, it's hot, it's hot,” Dr. Alessi added. “There's clean water, but you are living in a tent with a bunch of other colleagues and we have outside latrines and showers that don't have hot water — so you do have to rough it a little bit.”

Dr. Alessi wrote and published a book about his time in Haiti called, Lift Up Your Hearts: Healing Haiti, Land of Hardship, all proceeds of which go directly to the St. Luke Foundation for Haiti.

©2011 American Academy of Neurology

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