Wednesday, November 12, 2014

Rainy Days and Happy Endings

It's a little easier to write a blog post if you have a definite subject in mind to write about.  I don't really have one.  I just told Marcille this afternoon that I would take her turn for blogging today if she takes my turn for Friday since I'm planning to go out with Donny's tomorrow and won't be here Friday.  When she asked me if I had something to blog about, I said, "Eh, I'll find something."  So please bear with me on this rather scattered post, because I'm just gonna wing it. ;o)

For starters, it's good to be back.  After six months at home in the states, I wasn't entirely sure what to expect when I got back, but in a lot of ways, it feels like I never left....a lot of the people have changed out, but we once again have an amazing team here.  And I have enjoyed being back and working at the clinic again quite immensely.  The last month has been quite busy, but it seems to be winding down a bit, and the relentless rain this past week has definitely slowed our days even further.  The rain has also contributed to making our short walk to the clinic and back each day quite the adventure, as we slip and slide through the mud, praying that our feet don't betray us and send us crashing to our doom.

I was in the process of cleaning our house and Whit was washing dishes, when Ro called down from clinic yesterday afternoon to announce that a woman in labor had just come in.  Since it was Whit and Mali's turn for such things, Whit headed that way, and as soon as I finished sweeping, I followed, to see if there was anything I could help with.  The woman in labor was a little sweetheart, who simply wanted to sleep, regardless of the fact that we needed her assistance to deliver her little baby into this world.  She had been in labor since the day before, hadn't been able to keep anything down (something we found out when we tried to give her something to drink and it all came right back out), and was just basically totally exhausted.  She perked up a bit when Mali got an IV running and after repositioning her a bit.  Sometime later, after an immense amount of encouragement, we were greeting a blue and unresponsive little boy with a suction machine and oxygen mask.  He was covered in meconium, and his cord had been wrapped around his neck twice.  The three of us worked with him feverishly for several minutes until his color improved enough that Whit could take the time to cut the cord and move him to a easier place to work, then Whit and Mali continued working with him, while I stayed with his mother and prayed that nothing else went wrong.  Five minutes later, I was calling for Ro while trying to stop a growing pool of blood beneath the little mother.  Thank God there was no major problem, and after we had her lying in her bed, the bleeding stopped, for which I breathed a giant sigh of relief.  In the meantime, Whit and Mali were dressing a much-improved little boy who weighed in at five pounds and four ounces.  We ran up to the clinic this evening to check on how they were doing, since we were keeping them here for observation, and I couldn't help but marvel at how alert he was.  Thank God for happy endings, and may we never take these beautiful new lives for granted.

In other news, Mis Leda is back, along with her little baby.  She's only been working part time this week, but it's been wonderful to have her capable hands and beautiful voice around again.  And her little baby is cute. :o)

In still other news, we were working on doing some cleaning, organizing, and inventory-taking in the depot this week, and in the process I stumbled across a urinalysis machine.  We've been discussing the need that we have for more lab equipment, and this find was exciting enough to me that I was practically hopping up and down with glee.  And it works perfectly!  We're about running out of paper for it, but that's a small problem, and easily fixed.  Now we just need to find a few other treasures elsewhere...speaking of which, if any of y'all know of a place where we could get our hands on some old lab equipment, we would very cordially welcome hearing from you.  :o)

Once again, thanks for following us, and for all the prayers that are sent up on our behalf.  Sometimes I think that y'all will probably never know how sorely needed and much appreciated they really are.  We could not do our jobs without them, of that I am convinced.  So thank you.  And may God bless each one of y'all as you serve Him in your own little corner of the world, wherever that may be.


Sunday, November 9, 2014

New Guy

Hi everybody! I am Hans Hertzler and I'm the newest member of the Gospel to Haiti clinic team. I believe I am here to fill the role of clinic director/ patient transport guy and all around help-out-where-needed person. My primary medical background is working as an EMT for a busy ambulance service in Oklahoma for the past year and other EMS/Rescue operations with my local fire dept for the past several years. Understandably, I don't feel overly well equipped for the position that I am attempting to fill, but I have been experiencing a hands on crash course in Haitian Healthcare for the past three weeks since I arrived and have learned an incredible amount already. I also am working with one of the world's best teams of nurses who have been very understanding and patient with me as I try to learn the many interesting and un-american aspects of this clinic's operations.
  Here's a little news from this last week. We've had the normal regime of runny noses and pregnancies and digestive issues as well as a few more interesting cases. On Wednesday an older lady arrived at the clinic with severe difficulty breathing and edema in her legs. She was also experiencing some chest pain. We decided that she probably had congestive heart failure along with some pneumonia. Her blood pressure and heart rate were also way above normal. We put her on some oxygen and administered a diuretic via IV. It is hard to always get a very precise diagnosis with the limited diagnostic equipment available here, but it seems the staff here has adapted very well and does an amazing job with minimal equipment.
Me trying to find a suitable vein for a difficult IV start
The cut, before it started bleeding bad again.
Holding the knife victim down while Rhoda closed up the cut
  Last Thursday I was working here on the mission compound when Rhoda radioed from the clinic and asked me to come down and check out a lady who thought she was having heart issues. Apparently the rest of the nurses were busy with another case. There was complete chaos outside the door of the operating room when I arrived. A woman was throwing herself violently around on the floor and several men were trying to take her outside. The witch doctor came walking out past me when I arrived, leaving her dog behind in the clinic. I finally figured out that the nurses were trying to stitch up an approximately 2 inch laceration on the forehead of a 20 year old girl who had been cut with a knife in school while trying to protect her younger sister. The girl's mother was the one that had lost control of herself when she saw the cut. We finally managed to get the dog, who bit me when I tried
to reach for it, and the rest of the bystanders out the door. I went and checked on the sick woman that had just arrived. She was complaining of pain and weakness all over which had started in her stomach. Her close relative had died from a major heart attack the previous Saturday and she was worried the same thing was happening to her. Her vitals were all within normal limits and there was nothing going on that looked very cardiac related. I tried to reassure her with my extremely limited creole that she probably was not having a heart attack and went to see what was going on in the operating room. The  stitch job had been aborted due to excess bleeding from a small blood vessel that had been severed by the knife resulting in a large hematoma. After some discussion and attempts to find the vein the nurses decided to go ahead and put some stitches back in and control the bleeding with direct pressure and ice packs. Our patient did not seem to be able to keep from thrashing around and fighting when anything was done to the cut so we had to physically restrain her while Rhoda stitched the cut shut. We finally finished and put her on a hospital bed with an ice pack on the wound. She had completely worn herself out by this time. All in all, it was a traumatic experience for most of those involved.   
  Saturday morning a lady came in with severe dehydration, vomiting, and diarrhea. Mali started running IV fluids and several hours later it was discovered that she had cholera, a disease highly feared by the locals ever since the 2012 cholera epidemic. The nurses moved her to a separate room from the other patients and continued to work on rehydrating her. as of this morning her blood pressure has improved and she seems to be doing much better. Thanks for reading! We welcome any prayers or input that you may have!


Monday, November 3, 2014

Hold That Knife!

     Yesterday someone asked me what my dream day would be like. It seemed so funny. So out of context. It had been a busy Sunday, as usual, I might say. This person needing that medicine, that person wanting a few minutes to talk. Another person wanting something for a tooth ache. And then, a bandage or two at the clinic.
    Then the big cot came. A pale faced lady is found lying at the front door with a sheet knotted around her middle. The crowds are pressing in all around us, waiting for a glimpse of what is up. We try to get the woman to talk. She is weak, and her blood pressure is low. It seems that her husband cut her stomach. Or did she do it herself?! And why?
    As we unwrap the soggy rags, the contents  of what's inside of people began to show. We tried to hide our surprise at our first close up of intestines. They were pink, what did you think?
    So, some of us got a Ringers flowing into her veins while others of our wonderful staff hurried around finding sterile gauze, fluids, and bandaging supplies. We washed up the exposed inward parts, wrapped them in wet packing, and sent the lady out to get operated on. 
    Thank the Lord, Donny was able to get a place in the hospital in Laogone late in the evening, and the woman was safely put through surgery today. So that is the happy story. And if I was to talk about my dream day,anyway, it would probably include someone getting healed or saved.
    So much has happened in the month that you haven't heard from our team. It's probably been the busiest month in the whole two years since I was here. So many stories. A couple more trips to Mirebalais. Deaths, and births. And always one more mystery patient to keep us scratching our heads and praying. 
    Like Monet. He is the fistula boy who has been on our hands for a long time. Or the girl who we sent to TiGoave for tests, and she returned in basically the same condition we left her in. A swollen leg-warm to the touch. And supposedly it appeared overnight.
    We welcomed Hans Hertzler to our staff, so look for him on our blogs. He is our new clinic trauma director/emergency transport chief. We thank the Lord for what he has done for us already. 
                           -for all of us, Rhoda

Friday, October 10, 2014

Mirebalais Madness........... we come. Our good ole ambulance chugs up Goat mountain and then thru the countless switchbacks. Some of the patients are starting to feel nauseous and we hear the lids being ripped of the marmites. Soon we are rolling down the windows and Whit and I are fighting for a breathe of fresh air. One lady starts laughing and then soon we all join in. Haitians are great to accept the situations they find themselves in!!
   After 1 hour we pull in thru the gates of Mirebalais . Everyone jumps out and we try to make ourselves look half decent.
 "Alright everybody... here we are, follow us." Whit and I lead 5 of them off towards the archives. Julian stays with Jean Louis and our little hernia  in the surgery waiting room.  Lines of people waiting, nurses flying around, security milling through the crowd,  important looking doctors, surgeons, lab techs walking with a sure purposeful step... Whit and I look at each other. Where do we begin?? This place is huge. We get to archives and get things sorted out. Whit heads off towards the place where they get CT scans with some of the people. I head off towards to get an x ray done. Beginning of a looooonnngg crazy day. Running from one place to the next.  
  " Sorry, we cant help you today, our x-ray machine isn't working. Go get a signature from a doctor. This is the wrong place sorry,ect..."
       My phone is ringing in my purse, "Alo." "Mis Mali, I need you, I don't know what to do anymore, I am lost, where are you." " I will come, stay right where you are." I meet Whit in the one of the long halls. She is marching off with 3 other patients. We grin and exchange stories.
        At about 2 in the afternoon one lady whisks the little girl off (that was patiently waiting since 9 for a CT scan,) and bathes her. Whit suddenly realizes the girl  is gone when she hears the doctor finally calling out her name. Here goes our chance. We now need to wait till tomorrow morning to get her in again.
    All day we run and then we sit waiting for tests, scans, results, doctors.... By 6 both our patients that had operations pending  are in pre-op . As much as could be accomplished  has been done. Tired and hungry we jump in the ambulance and head back to P.A.P for the night. Thanks to Blue Ridge we had a relaxing evening.
  Next morning we find ourselves once again in Mirebalais.  It doesn't seem as huge and strange anymore. We quickly find our patients. Its touching to see how happy they are to see us. One lady threw her arms around us and cried. "Oh Mis, you didn't leave us alone,you came back."We laugh and try to make them forget the operations that are ahead of them. 
    The old man grabs my hands and tells me with a very  decided air. "Mis, I will be going home with you because I have 7 marmites of peanuts to plant and I need to get it done." I laugh...."Well,if the doctor says you are doing well enough to leave, but if not you are going to have to wait." I hear him mutter as I leave. "I will go back, those peanuts need to be planted." I smile at Whit... I love every one of them. They colour our lives up so much!!!
    At 12:30 pm the little Hernia girl is wheeled off into the operating room. Her mom hugs me and cries. She is worried she will wont come back out. After 3 hours of waiting they wheel her back into post-op. She is doing fine and still sleeping.

  A half hour later the old man is wheeled in. At 6:30 pm  he is wheeled into post op. We walk in to see him and he is already sitting up,asking for his normal clothes.  I am sure he wanted to prove that he COULD plant those peanuts!! Even the other nurses smile and laugh as they see his very decided look.

     We had some minor complications so we ended having to go back to P.A.P for the night instead of heading homeward. Wednesday signs their discharge papers and we all pile back in the ambulance....
    SO ready to head home, home to our Aylegue family and hospital. We are so thankful for our 2 first successful operations and the joy its brings to our patients.
    The verse in Mathew that takes about "when I was sick and you visited me" kept running through my mind and giving me courage to keep going. If I can see Jesus in my patients sad ,hopeful eyes....that's enough to keep my going!!!
-Mis Mali


Tuesday, October 7, 2014

Don't Untie That Knot!

It is Friday. Ninety or more people are thinking that they should be seen sooner rather than later. The beds are full. One lady is in labor. And then, this boy shows up.
    He looks not too bad from the start. But he has these rags around his stomach. And they are oozing intestinal stuff. And we need a hospital bed.
    By afternoon we had a bed for the white-faced boy. We started to unwrap him, and then the doctor said, "Just leave it go. Don't untie that knot. He needs a surgery."
    The big problem is that they are having demonstrations on the Streets by the hospital, and we don't know if it is possible to arrive safely in the hospital.
    And then, to heighten the dilemma, the dad leaves, and walks off with the mule he came on. Now what? This man could be dying! Should we put in an IV or not? One doctor says do, the other one says don't....What if he dies on our hands?
     Donovan and Mali jumped on the one machine and tried to go find the father of the 20 year old boy so that we could get help for him.
     Finally, the dad was found walking down the road. We were so glad he was showing up. But not for long, soon he walked out the gate again, just as we were loading the ambulance to go to town! A helpful neighbor went and made him return.
      Finally, at about seven o'clock in the night, we had a ride ready to go to Port-au-Prince, to see if we could find someone who would receive a man with intestinal fluids running out of his umbilicus. The ride was as crazy as usual. Bounce. Bump. IV pulls loose. Machine stops. IV is repaired. Bounce. Bump.
    Nearing midnight, we arrive at our first prospective hospital. The doctor says they don't have the machines to operate on the man, and that we need to go to the general hospital. We go.
   We find one helpful man who gets in to see the doctor. The doctor says we can stay. But then a crime scene is brought into the hospital, and among all the yelling and noise, the doctors are all obligated to leave for security reasons.  The young doctor apologizes, tells us that he can't help us, and the patients who are sprawled here and there in the emergency room get ready to leave, without having been helped. We find someone to show us out the back door, to avoid walking by the yelling, blood, and danger zone.
    We sit in our machine with our angry, hungry patient, who is hungry, full of IV fluids, and in pain. A rat walks by.
     We sigh, pray, and wonder how we got here. Hours away from home, turned out of the second hospital.
    God gives us one hopeful thought at this moment, as the stench of our patient washes over us. How about Bernard Bevves hospital? It is expensive, but what are we going to do to save this man's life?
     We go out on the road, drive through the dangerous streets, and honk our horn as we arrive at the third hospital for the night.
    "We can't help you," they say. I got out of the machine, and walked by a man with a gun.
    "Where can I give some information?" I asked.
     They showed me to an office, and opened the gate for Donovan to pull in the machine. By a miracle from God, there was a team from Canada on campus, and they seemed very helpful.
     We were able to get a CAT scan, a surgery lined up, and leave that spot by about 2:30 am. But the story was not over that easy. The next day, after the Canadian team was gone, and we were on our way, trying to get home, the phone rang.
    "We don't have a place for your patient," the voice rambled.
    I couldn't believe it. He was supposed to be in surgery! Will I ever understand this country????
    By the mercy of the Lord, our patient was able to stay the week-end. We made a lot of phone calls, prayed a lot, and waited. This is Tuesday, and our patient was finally able to see a doctor today, I believe.
    We are hoping to bring our patient home sometime this week to continue recovery.
     Just for fun, I am throwing a picture of our present team in here. We ran away from the compound Saturday evening about sunset, tired of emergencies, bandages, IV's and blood. Those who were here at home had quite a time as well, and we couldn't wait to feel fresh air in our hair.
     Today, being Tuesday, Mali, Whitney, and Julian are in Mirebalais again, helping two other patients realize some long awaited surgeries. Their trip is turning into a three day experience. Hopefully when they get back, you will get an update from one of them!
    Good-night! Rhoda for the team