International Aid Serving Kids (IASK) Introduction Welcome to the IASK humanitarian health team! IASK Board of Directors and the Humanitarian Task Force thank you and your family for donating your time, resources, and talents to help make a difference in the lives of vulnerable, orphaned, and poor children in Haiti from May 31th to June 7th 2008. The primary objectives of the humanitarian health mission are to provide health services (medical and dental) and health education to poor, orphaned, and vulnerable children and their caregivers in the remote village of Timo, between Leogane and Jacmel. This packet of information was compiled to help you prepare for the trip. Please become familiar with its contents. Pay special attention to information pertaining to the culture and language, travel requirements, health recommendations, and items to bring on the trip. The humanitarian team works together to find manpower, equipment, and supplies and to make the humanitarian health mission an excellent experience for the entire team and the poor children they will care for. The team leader is Marc-Aurel Martial, RN. He can be contacted via email at or by phone (801) 830-3043. Team members are assisting with trip preparations. As a member of the traveling health team, you are expected to:
• provide a valid passport, plane tickets, and one emergency contact at home
• lift 60 lbs. consistently (or discuss your situation with the team leader)
• help carry 1-2 pieces of luggage (filled with medications and supplies) • help inventory and pack the medications and supplies prior to departure • contact your family upon arriving in Hispaniola
• tolerate working in a hot and humid climate and less than ideal conditions
• tolerate unfamiliar food (rice, beans, fruit, juices, meats, fish, etc.) • share living and sleeping accommodations with other team members (men and women
are separated, except for married couples)
• provide a copy of your airline travel plans
• show proof of immunizations record (Hepatitis A & B, MMR, Tetanus, and Typhoid) • provide proof of professional health license
• provide proof of travel insurance (optional)
• begin your antimalarial medicine prior to departure and as prescribed • disclose medical conditions to the team leader and Team Nurse/Doctor • always travel in group or with guides or after consulting with team leader • complete the waiver form at the end of this packet Haiti To be better prepared to travel to Haiti and serve the people, we strongly encourage you to learn basic Haitian Creole sentences and facts about the country. A language handout is available upon request. The World Factbook on line will provide you with a nice Calendar of Events
• Team members are invited to a Haitian lunch on April 26th, 2007 at the Martial’s
• Team members are encouraged to hold a “Packing party” of medications and medical
supplies on May 24th at a location that will be determined by the team. .
Donations and Supplies Needed You can help identify a ward or scout willing and able to assemble the following items for the humanitarian mission: 500 hygiene kits, 200 newborn kits, 200 school kits, 25 soccer balls, small toys, bubbles, stickers, jump ropes, etc. You can help collect medical supplies or raise money for trip-related expenses. Donations are tax deductible. You can
Below is a list of suggested supplies and equipment needed for the humanitarian mission: Equipment
• Blood pressure cuff (children/adults)
• Glucometers, lancets, strips, control
• Sharp containers • Scale for infants and children/adults
• See Dr Tobler’s List for dental Supplies Travel Itinerary/Plans We prefer to travel as a group, on the same planes and days, whenever possible. If flying from Salt Lake City, UT, below is the suggested itinerary. If flying from a different city, please book your airplane tickets on-line (airline company below and emf possible, make arrangements to rendezvous with the rest of the team in a US airport so that the entire team can fly together to the final destination. A travel itinerary will be provided approximately 6 weeks prior to flying to Port-au-Prince, Haiti. General Day to Day Schedule (Subject to change) Friday May 30: travel, rest Saturday May 31: travel, rest Sunday June 1: planning and preparation for the week Monday June 2: work, evaluate, plan Tuesday June 3: work, evaluate, plan Wednesday June 4: work ½ day, evaluate, plan, relax/play Thursday June 5: plan, work, evaluate, relax/play Friday June 6: work ½ day, relax/play Saturday June 7: travel Arrangements for Housing, Food, and Ground Transportation Airfare is about $800. Team members need to reserve their own plane tickets unless other arrangements have been made. The estimated cost for food and ground transportation for 9 days is $200-$300. In 2007, the average cost for the trip was $ 1000. Sleeping bags are recommended. Security and Emergency Contacts We suggest that you register yourself with the US State Department prior to leaving the US. http://travel.state.gov/travel/tips/registration/registration_1186.html or https://travelregistration.state.gov/ibrs/home.asp. You will need to provide the following information: Name, Passport Number, Date of Issuance, Date of Birth, Place of Birth, Dates of Travel, Address in the Dominican Republic, Telephone Number, and E-mail.
IASK Representatives in Haiti: 1)Dieudonne Martial, 2)Augustin Jean Leptune, 3)Cantave Contact 1: Brochette 95 #20 Carrefour, Port-au-Prince, Haiti
Tél: 011 (509) 3-647-2123 ; 011 (509) 3-215-1133 Contact 2: 24, Rue Benoit Mahotière 85 Carrefour, Port-au-Prince, Haiti . Tél: 011 (509) 3-710-0382 E-maContact 3: Tél: 011 (509) 3-791-0219; 011 (509) 3-649-5423 IASK Representative contact information in Utah: Illens Dort (801) 687-2199. Task/Job Descriptions of Team Members
Assess patients, treat medical problems, prescribe medications, and refer patients to nurses for additional care and/or to local facilities. Provide training to natives and visit homes as needed. Services given depend on team skills, resources, and supplies available. Creativity and flexibility are a must.
Assess patients, treat dental ailments and injuries with the help of a dental assistant and/or support staff. Provide training to local caregivers. Services given depend on team skills, resources, and supplies available.
Triage patients, collaborate with MDs to assess and treat patients, dispense medications. Provide basic health education. Train support staff/translators in assisting with patient care.
Assess health needs and safety of team members prior to and during trip. As needed, help treat team members with MDs.
Assist with duties as assigned by team leader such as triage, patient data collection, supplies inventory, taking photos and videos, teaching native patients/caregivers basic medical care, making journal entries, etc.
Translate for medical/dental staff while triaging, teaching and treating patients. Assist with patient care and other requests for translation services.
Teach education module. Coordinate health education and health promotion efforts. Visit the Benson Institute.
Required and Suggested Items for Team Members Pack all personal items, except for liquids, in 1 backpack or carry-on bag. You are to use the 2 check-in bags to help transport medication, medical supplies, and equipment. The weight limit per luggage on international flights is 50 lbs. Please verify with the airline. Suggested items include: • Sleeping bag • Puncho, umbrella
• Fanny pack or day bag of some sort (used to carry personal items, water, and lunch during
• Water bottle (a durable container type such as Nalgene to carry with you on day trips)
• Hand sanitizer/wipes • Personal Medications—Notify team nurse
• Antibiotic ointment, immodium tablets, pepto-bismol, ibuprofen, etc. • Malaria medication (get a prescription from your doctor,--malarone: take 2 days before
departure, during and week after trip; OR Lariam: once weekly prior, during, and 4 weeks after trip)
• Flashlight, batteries • Personal products such as soap, razors, toothbrush, toothpaste, feminine hygiene, Toilet Paper
(Charmin sells small travel size rolls, find at Target or Wal-Mart)
• Small sewing kit • Large/small plastic bags • Travel clock
• Clothing: Sunday dress, shirts, shorts, pants, belt, underwear, pajamas, etc. Remember the
island is very hot and humid, so bring comfortable clothes and shoes
• Mosquito netting for around and over your bed
• Lightweight hikers, tennis shoes • Tevas or sandals • Nail clipper • Food items (snacks: granola bars, power bars, dried fruit etc.) • Spray bottle • Hat with brim
• Cheap wrist watch • English/Haitian Creole dictionary • Snacks-granola bars, dried fruit, energy bars, etc. to carry with you while traveling
• Personal entertainment – small items such as card games, DVDs, etc. Team Member Information (*indicates those who booked their plane tickets)
Last Name First Name International Aid Serving Kids Application For Clinicians, Health Educators, and Volunteers
You can’t possibly save all of the world’s orphaned and poor children. But you’ll be making a difference to the ones you will serve in Hispaniola (Haiti and the Dominican Republic). Thanks for taking the time to fill out this application.
3. Reference name and contact information: 4. Emergency contact name and information: 5. Occupation/Specialty/Skills/Interests: 6. Number of years of experience: 7. Population(s) you can care for: 8. Available for the humanitarian mission to Hispaniola (05/31/2008)? Yes No 9. Months available for future missions in (optional): 2008/2009 (1 2 3 4 5 6 7 8 9 10 11 12 10. All language(s) you speak: 11. Are you able to be part of an organizing committee?
12. Are you able to fulfill trip preparation assignments?
14. Are you willing to follow directions?
15. Are you willing to show respect for other cultures?
16. Are you willing to contribute to the success of the team?
17. Are you able to work 8 hours in a hot/humid climate without AC?
18. Are you able to lift 40 lbs without assistance?
19. Additional information/ Comments/ Questions (optional):
Note: Team members are expected to have a current valid passport, receive recommended immunizations prior to leaving the US, and provide for their own travel insurance, transportation, and room and board fees.
WAIVER OF LIABILITY
I am furnishing this Waiver of Liability in exchange for (a) my opportunity to travel to Hispaniola as a volunteer with International Aid Serving Kids (IASK). 1. I acknowledge that traveling to Hispaniola with IASK, associating with IASK and its partners as a volunteer while in Hispaniola, and making use of the facilities made available through IASK are entirely voluntary acts on my part.
2. I further acknowledge that to the extent that traveling to Hispaniola as a volunteer with IASK and serving as a volunteer for IASK is accompanied by any risk, I am aware of such risks and acknowledge and agree that my traveling to Hispaniola is entirely at my own risk and without any liability whatsoever attaching to IASK and its partners.
3. I further acknowledge that IASK has made no promises or representations to me which are not contained in this Waiver of Liability. THEREFORE, IHEREBY AGREE to waive and to hold IASK exempt and harmless from any and all liability for any damage or injury that I may sustain during my travel to Hispaniola as an IASK volunteer. This Waiver of Liability is made on behalf of and shall be binding upon myself and my heirs, executors, administrators, and any other representative or claimant. This Waiver of Liability shall extend to and protect IASK and its subsidiaries, affiliates, successors, assigns, officers, directors, employees, servants, representatives, and agents. Without limiting the foregoing, I agree to waive and to hold IASK and its their subsidiaries, affiliates, predecessors, successors, assigns, officers, directors, employees, servants, representatives, and agents exempt and harmless from (1) any liability for any negligence, acts, or omissions of myself or any other person or entity while in Hispaniola; and (2) any liability for any negligence, acts, or omissions by IASK while facilitating this humanitarian health relief mission. In the event that any provision, or portion thereof, of this Waiver is determined to be void or otherwise ineffective, the remaining provisions shall continue in full force and effect. This Waiver of Liability may be modified only in writing signed by an authorized representative IASK I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THE FOREGOING WAIVER OF LIABILITY AND THAT I ACCEPT AND AGREE TO ITS TERMS. SIGNED AND AGREED TO, DATE: ______________________
______________________________ Print Name
Patient Triage Record Name: (last)___________________(first)______________________________________ Age: ________ Gender: M F Allergies: Penicillin Others: _______________________________________________ Current meds: (Anticoagulants?) ____________________________________________ Current Immunizations:
__ Other: ________________________________________________ Patient History: Heart problems (Rheumatic Fever, Heart Murmur, __________) Blood clotting; ___________________________________________________________ Family History: __________________________________________________________ Social History: ___________________________________________ Smoker? Y N (years _____ packs per day ____
Anyone in household smoke? Y N Drink Alcohol? Y N (how often _______ how much ________) COMPLAINT: ____________________________________________ _________________________________________________________ BP:_____ Wt:_____(kg) HR: ____ RR:____ Temp:____ Sat %:____ EXAM: __________________________________________________ _________________________________________________________ Diagnosis.:___________________________________________________ Plan (treat., med., education): _______________________________ _________________________________________________________ _________________________________________________________ _________________________________________________________ Signatures: ____________________________________________ Humanitarian Team Satisfaction Survey Timo, Haiti May 31th- June 7th 2008
Thanks a lot for making a difference. We really want to learn from you while you remember your experience. If you need more space for answering and feedback, feel free to use another page. Please email your responses They will be kept confidential. Thanks again.
Overall, how satisfied were you with this trip?
11. How long did you wait to be picked up from the airport? How often did the team fulfill its mission in providing health education to poor children and their caregivers? 12. How often did you feel safe? How often did the team fulfill its mission in providing health 13. Did you feel the service experience was rewarding? services to poor children and their caregivers? 14. Were your trip expectations met? Would you consider going on another trip with IASK? 15. Was there something that you wish were done differently?
Would you recommend IASK to colleagues, sponsors,
donors, and volunteers?
16. How much did you spend on airplane tickets, AND food, AND hotel, AND transportation? Would you like to write a one-page summary of your main assignment? 17. Does the triage record need modification? If asked, could you give a 5-minute oral report at a fund- raising activity sponsored by IASK? 18. What is the best day to travel to Haiti? Did the information packet help you prepare for the trip? 19. What is the best day to travel back to the US? Did you wish you knew something prior to leaving on the 20. Would you like to email me you trip pictures?
10. Did you have any difficulty with customs in Haiti?
_____________________________________________ 21. What was the most memorable moment of this experience? Please describe.
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