NSVI (No-Scalpel Vasectomy International) in Haiti
September
2, 2010 - Day 4 -
Cap Haitien

After another hearty breakfast, we waited for our drivers, Wolf and Laurore, at the entrance to the Mont-Joli Hotel.

Not scheduled to arrive at Justinien Hospital for our vasectomy mission until later in the morning, we took advantage of the extra time to drive along the north coast of Haiti west of Cap Haitien. There was an impressive series of columns ... some grand idea unfinished apparently. And one of the best "beach" hotels was at the end of the coast road that stretched north from Cap Haitien.
We saw some of the worst shanties with some of the best views in the Caribbean ... and a few old cannons, surrounded by broken walls and wet laundry, served as reminders of a time when inhabitants of the area might never have predicted that it would someday be the poorest nation in the western hemisphere.
On this map, one can see that dead-end road extending north from Cap Haitien. When we returned from that short drive, we decided to see the famous Labadee Cruise Ship docks. To get there, we drove overland to the north coast.
View Larger Map
The north coast had some very pretty spots. The road, the main supply route for cruise ship workers and goods, descended through sparse forest to ... ... the administrative entrance of the port and resort. But the entrance was closed because there had been a power outage and workers were too busy for visitors.
On the way back, we noticed an entryway arch that we had not investigated coming in. This time we investigated and were rewarded with an fascinating surprise. A walkway led up to the most impressive vista we had seen in all of Haiti.
A special platform served as the take-off spot for a massive zip line that brought fliers right into the heart of the resort.
And one brave soul was being taught by a trainer who obviously knew the ropes. First the trainee then the trainer. I was very envious. Next time maybe.
Coming back down from the hills, we caught some beautiful views of Cap Haitien and its harbor. Then we went straight to Justinien Hospital, the largest health care facility in northern Haiti.
Much is written in Creole, but formal signage is often in French. The old impressive building must have a colorful history. We parked our MSH vehicles off to the side,
and we were joined by Juline Mauricette of the Cap Haitien Health Network Support Team
Juline has been working for the last 2 years with Food for the Poor in Cap Haitien, starting as an intern with Father Duken and rising to a project manager for that important agency. She returned to Haiti in 2008 after completing high school in South Florida, and speaks English really as her primary language, while her Creole has returned and improved during her return to her country.  She resigned from her work with Food for the Poor to join the CHHN team. Her primary function is to solicit the needs of area health care providers and see that donated supplies (primarily pharmaceuticals) reach the sites where they are most needed.
Pictured are drivers Wolf and Laurore, Dr. Lolagne, Lisette, Dr. Revolus, Juline, and Dr. Suarez.
While we all waited for our audience with the hospital administrator, and for our patients to arrive, Dr. Suarez and I strolled down the street that leads up to Justinien Hospital, tucked in the foothills of the mountains surrounding Cap Haitien. It was lined by numerous clinics providing a variety of services from breastfeeding classes to laboratory and pharmacy.
Before heading to the OR, Drs. Stein and Suarez demonstrate the preparation and use of the MadaJet and review the NNNSV technique with the help of a DVD video and still photos on Dr. Stein's computer. The man in the green scrubs is Randy Moore, ARNP (Pediatrics), who may prove to be one of our most enthusiastic promoters, assistants, and vasectomists. See his blog at "A Healthier Haiti". Randy has his own ambulance service and lives and works part-time at Hopital St. Francois de Sales (more later).
Despite efforts at promoting vasectomy by "experts from the USA", we had only one patient in Cap Haitien, so it was important to show NNNSVs by video to maximize efficiency of teaching in the OR. Dr. Dugue ties the pink gown of Dr. Suarez.
In the procedure room, the operating table is broken and cannot be elevated. In addition, the operating light is not working, so Dr. Stein uses a battery-powered headlight when he demonstrates use of the MadaJet for no-needle anesthesia. Finally a procedure light arrives. The low table is fine for Dr.Suarez to demonstrate the 3-finger NSV technique ...
... but at 6'8", urology resident Dr. Jory Desir has to bend at the waist almost 90 degrees.
Dr. Suarez helps Drs. Lolagne and Dugue (left and center) lift the vas into position then guides Dr. Dugue in dividing the vas.
Our vasectomy team gathered around Dr. Jean Gracia Coq (center), Directeur Medical Hopital Universitat Justinien.
Drs. Ramon Suarez, Fritz Lolagne, Guy Dugue, Jory Desir (Urology Resident), Getho Dube (the only urologist in northern Haiti), and Obelson Revolus.
Obelson Revolus, MD, Guy Dugue, MD, Juline Mauricette (CHHNST), Randy Moore, RN, Fritz Lolagne, MD, Ramon Suarez, MD, and Ralph Louis (CHHNST). As mentioned above, Randy Moore has his own ambulance and 911 service.
Randy immediately appreciated the simplicity of NNNSV and how valuable it could be to Haiti, where aid can barely keep up with population growth. He asked us to consider using the hospital/clinic where he stays as a vasectomy site. When we said, "Let's take a look!", he said "Jump in," and were were off through the streets of Cap Haitien in his ambulance and our MSH SUV, always careful not to drive into the deep drain sewers that border so many streets.
A few miles west of Cap on National Highway 1 in Veudreuil, we came to Hopital St. Francois de Sales.
Father _______ _______ runs the show and Randy is the Medical Director.
The facilities are superb, with a modern operating room and open-air waiting area. Hopefully, in the near future, these chairs will be full of men waiting for us to simplify their lives (and the lives of their partners) through vasectomy.
 During our return to the city, the day grew dark and the skies opened up with a torrential downpour, flooding the streets and delaying our entry into a restaurant serving traditional Haitian fare. By the end of the feast, the rain had subsided, the flooded streets had drained, and we had an easy ride back to Hotel Mont Joli.
On to September 3, Day 5 - Fermathe
Use the links below to go to any page about Haiti:
First trip to Haiti: April 2010  Second trip to Haiti: August/September 2010 
Preliminary trip to Haiti
April, 2010
Monday Aug 30
Arrival and MSH
Tuesday Aug 31
Cange
Wednesday Sep 1
Ouanamithe
Thursday Sep 2
Cap Haitien
Friday Sep 3
Fermathe

Third trip to Haiti: May/June 2011
Fermathe & Plaisance