I recall the images that came across my television after the 2010 Haitian earthquake. The country was yet again devastated after another natural disaster. This time it was a magnitude 7.0 earthquake and approximately 54 subsequent aftershocks that would bring an already dysfunctional country to its knees. The quake affected 3 million people and killed approximately 220, 000. To understand how the earthquake affected the county and its people it’s important to understand Haiti’s history. The country which has a long standing history of natural disasters, corruption and a nonexistent infrastructure magnifies any disaster many times over. The beginning of the fall of Haiti’s infrastructure began when Haiti became independent from France. In order to become its own republic the country took out loans from US, German, and French banks to pay the French reparation from 1825-1947. After this came a time of governmental corruption whereby tens of thousands of Haitians were beaten and tortured until 1986 when those in power exiled from the country with an estimated $900 million.

Since then the country has dealt with poverty, overcrowding and deforestation. The country in 1950 had a population of 3 million people and today that figure stands at nearly 9 million people. This coupled with the fact that Haiti is now 98% deforested as its impoverish people have cut down the forest to cook with. This deforestation which makes the makes the soil unstable makes the country incredibly vulnerable to any assault by Mother Nature.

When the earthquake hit it destroyed 70% of buildings in the country’s capital city Port-au-Prince due in large part to unregulated construction standards. Sixty percent of the health care system was destroyed in an instant. In addition, 10% of Haiti’s medical staff were either killed or subsequently left the country. It was a catastrophic event. Medical aid came from around the world and one agency that is still there to date is Doctors Without Borders (DWB).  DWB has been in the country for the last 24 years aiding to fill pre-existing health care gaps due to the poor health care system. After the earthquake they set up temporary shelters and set up inflatable hospitals.

Today there is still a large need for medical aid and funding. While a great deal of donation money has gone directly to building hospitals in Haiti, quite a few still stand empty because of inadequate planning to ensure properly trained staff, sufficient drugs, maintenance, and medical supplies. It seems that a country with money without infrastructure is no better off than it was before. While I am well aware that the US health care system is not without its faults, it makes me appreciative of the layers of infrastructure that surround it in order to check and balance varying agencies along the way. It has been personal mission of mine to provide medical aid in Haiti and I hope to do so in the very near future as a Registered Nurse.

Henley, J. (2010, January 14). Haiti: A log descent to hell. The Guardian.

End of life is something that I have had experience with over the last several years through my volunteer work with Dream Foundation. Dream Foundation is a non-profit organization that grants wishes to adults who are terminally ill.  One aspect of my work is making floral deliveries to terminally ill patients on hospice, at local facilities, and to their home. I’ve watched and listened to these patients and learned a great deal about what it means to live and when it’s time to let go. It was a few months after my work began with DF that I had the conversation with my husband, Scott about what constitutes “living.” We agreed that neither of us would want to prolong life simply because the technology is available to sustain our life. I know wholeheartedly, when the time comes, that we will be able to carry out each other’s wishes.

A few months ago I was faced with this conversation once again as my oldest sister and I began to bring up the topic to our parents. My mom whose been declining cognitively over the last year just isn’t the same woman she once was. Her dementia makes her forget just about everything. Last August, she rescinded her driver’s license after she walked out of a Target and could not remember how she had gotten there and where her car was. The decision was a tough one for her and for us, as we watched her become increasingly more dependent on those around her. Growing up, the conversation about death and dying has always been an approachable topic. My mom, who lost both parents before the age of 2, grew up understanding what death meant because of her maternal grandmother. She raised us kids the same way.

My sister who was apprehensive at first about starting the conversation was having a hard time, so I initiated it. When the time came to asking those difficult questions, my mom who has been dealing with her declining health daily was much more open to talk about the end of life. My dad however was not so ready to discuss it. I realized that for the first time in their marriage my mom is the one that needs to be taken care of, as she had spent a lifetime caring for a husband while also raising 6 children. I don’t think that this new role is one that he is completely comfortable with yet. I assured them that it wouldn’t be just one conversation in time but an open dialogue about what they want when the time comes. I do my best to get home on a regular basis to see my family and continue this conversation. I am always surprised by my parent’s candor and humility. I believe that culture and family plays a great role in the types of decisions made and who is willing to make them. Family and the roles we assume within that unit influence every aspect of life and the end of life.

Interestingly enough, last week my husband witnessed someone getting beaten and robbed in broad daylight while getting our car serviced. Without giving it a second thought, he sprang into action and tackled the guy. He was able to hold the guy down long enough until police arrived and arrested the guy. He was hurt as he had also taken a beating (to a lesser degree) and had some contusions to his head and hand. I urged him to go to see a doctor at Urgent Care and after he checked out ok, he was given a couple new scripts for medications (Diclofenac Sodium & Cyclobenzaprine) to help alleviate the swelling and pain. I thought this was the perfect opportunity to see how much he knew about his meds.

With my trusty med app in hand I asked him 5 simple questions about each drug: What is the name of the drug? What is it for? When do you take it?  How do you take it? And lastly, is there anything that you need to be aware of while taking the drug? I have to admit, I was pretty impressed by how much information he had retained from his meeting with the pharmacist.  He was able to answer my questions and tell me that he also checked to make sure that there were no drug interactions with his daily beta blocker. I was able to help him identify some OTC NSAIDs that he would want to steer clear from while taking Diclofenac sodium. He did ask why he needed to take it with food and I explained the potential adverse effects of NSAID use.

But it seems to be a mixed bag when it comes to med knowledge. Over the weekend, I also asked some coworkers about some of the common OTC medications that they take such as Advil, Tylenol, and Alleve and I was surprised to find that the majority of the group could not tell me how they were alike or different from one another. Secondly, they didn’t really get the gist of how hard NSAIDs are can be on your stomach, as they all said that they usually take them on an empty stomach. I explained to them the importance of taking them with food and also which drugs are NSAIDs so that they could better understanding how easy it is to overdose on medications such as Aspirin, Advil and Alleve.