Wednesday, April 16, 2014

Good-bye! and then Hello!

   “Good-morning,” says Mis Katie. And then she launches into a descriptive medical class, in which she shows the waiting patients some health tips and physical education. There always seems to be a need to educate the people here, and while they are waiting to be seen by the nurses is an excellent time to fill their minds with medical information.

Everyone is happy to see our new nurse Mali, who arrived last night. She is already helping with blood pressures and stocking our new med shipment into the depot. It is especially nice for the Haitians because she knows French already.
Nurse Kindra left us suddenly Monday afternoon. Why? Her mother was diagnosed with terminal cancer. Why her? Why now? Our tears followed her out the door. It definitely is not an easy time for her. She is now back in Tennessee with her family, blessing them instead of us. We miss her already, needless to say.
Jean Frantz is back! Pastor Levy surprised us and brought him up the mountain today. We are planning to keep him here and bandage him every day until it is safe to send him home. We were shocked when we realized the wound was wrapped in a bloody, dry cloth for the last day or so, but God helping us again, we hope everything will be fine, and his body will not reject the graft now, because of that.
We promptly cleaned it up with sterile water, and rebandaged it with sterile dressings and moist, non-stick bandages spread with B&W cream. Jean Frantz's friends in the neighborhood are already showing up to visit him and help him forget his misery.

     God is good, all the time. Even when we come to him with open hands, saying, “Poukisa?”

Monday, April 7, 2014

The Seventh of April

Not that that has anything to do with this post, other than that I'm posting it on this day, and didn't have any other ideas for a title, so...:)

It feels like a long time since I've written a blog, and I think it's because it has been.   Somehow the past few times I've been scheduled to blog, something else has come up and taken doesn't look like I'm going to get out of it this time.  ;o)  It's only hard to do when nothing out-of-the-norm has come in and we don't necessarily have anything new and exciting to show or tell.  But that's ok, 'cause that's life- sometimes full of adrenaline rushes, sometimes suprisingly quiet and normal.   More recently it's been the latter, with just a few special cases coming and going. 

Lately, as in the past month, I have moved from doing pharmacy/bandaging work, to taking over the blood-pressure program.  I've really enjoyed the extra patient-interaction, and the opportunity it's brought to exercise my Creole vocabulary.  It's often very amusing to hear how they describe the pains they're having.  For example, when they're telling me they have leg cramps, they'll often say that their calves are eating them.  :)

 In the picture below is a young lady who had had pregnancy-induced hypertension.   She came back for a postnatal check up, and brought her little Jenny with her.  Talk about a distraction!  But it was irrestibible, and I was very happy for it.  ;) 

Usually at least once, if not twice a day, Kin falls in love with a friendly little face she meets in the waiting room.  And she always takes the time to snatch them up for awhile and parade them around the clinic showing them off to all we other girls.  Today it was this little guy below.  When most of what you see and hear are patients waiting to share with you all their "maladies" and everything they need, sometimes it's just extra refreshing to see a perfectly happy face content to simply share a smile. :)

 And while we're talking about babies, I'll show you one more...  A little girl, born about 2:30 in the morning on the 20th of last month.   She was the first baby I delivered, so I thought is was special that she was a fifth-born girl, since that's what I am too.  (Just a silly sentimental thing...;)

She had a rough start, born with the cord tight around her neck, and covered in thick meconium.   Kate, Kin, and I worked with her for five minutes before she really started breathing and responding well.   After ten minutes of oxygen, suctioning, and lots of stimulation, we started to relax again! 
I s'pose I should wrap this up and post it quick before it's tomorrow, or I'll have to change my title...;) 
Hope you all have a good night.

Wednesday, April 2, 2014

Where's My Mommy?

     A big thank-you to our friends from the States for the wonderful, education-filled week-end we shared. And thanks for the toys! They are such a happy thing in a world where we can't fix everything.
    For example, on Sunday afternoon, we were just finishing up our lunch when we were called to the gate. I was "on call", so I grabbed a quick swallow or two of coffee, to quiet my tired head, and walked down to see what was there to see.
    Sometimes you just aren't emotionally prepared for what awaits you. As I opened up the bloody cloths that wrapped up a little girl's wounded hand, I swallowed my gasp.

    "They were playing, and another child cut her with a machete," the family and friends told me.
    On the third finger, the tip of the digit was totally gone. The second finger was cut through the bone and hanging together by the skin. I looked into the adorable eyes of the brave little four year old. That was a mistake. I waited until more of my team arrived and went into the depot to cry. She was too cute, and I didn't know how I was going to have the nerve to do anything for her.

    When Doctor Michael, Steve, and Kindra arrived, we talked through our options, and made the decision to send her out. We have some Doctor friends outside of Port-au-Prince, that we are hopeful will be able to pull that tendon together and help the second finger to move again. The third finger, will probably need to have the bone shaved off, so the skin can be pulled over the tip and sutured shut.

    We wet-packed the whole hand, and then wrapped it all in a huge wad of Kerlix for the trip. By now the little girl was able to sit up, and we gave her a little green match-box car to entertain her. She laughed and played with that for a long time while we got her transfer paper ready to send her out.
     Today it was a ball that saved the day. Two boys arrived for a malnutrition rendezvous. Katie took the time to tell us about the family of her two year old patient. Both parents left these boys to fend for themselves. The seventeen-year-old, who brought the toddler is left to care for his 7 kilogram brother.

  Dear people. No school for big brother as he helps scavenge for food. They live with an older
brother who is not married. Thankfully Katie was able to continue them on the Plumpy Nut program and we are hoping to see progress in the two year old before long, if we can afford to keep using Plumpy Nut.
    It was so fun to see a smile on the face of the older boy as we gave him a ball for an incentive to continue taking care of his brother. Toys to the rescue!

Saturday, March 29, 2014

Two are Better then One

...especially when it comes to legs. :) This poor man has an amputated leg due to a terrible infection he got after a fall. A few months ago he came in with 2 deep slashes in his head, right to the skull. We stitched him up and sent him home after a few days and he healed up beautifully.

 Unfortunatly it was his bloody face again outside the clinic doors this week. He had fallen the day before while he was trying to work in his garden and it was too late to stitch him. I used more steri strips then I ever have before trying to close up 4 deep lacerations on his forehead. We're keeping him in the hospital room and he's actually healing up well, thank God!

  We were very fortunate this weekend to have two wonderful nurse practioners and 2 RNs from the states come to visit. They worked with us through a very busy day yesterday and then came back today to teach classes on a few of the major problems we see. We were very grateful for their time and patience with all our questions. :)

 Have a blessed weekend! -Mis Kate

Wednesday, March 26, 2014

Bone Irrigation and other Projects

    It is 1:30. Kindra is sleeping. But not much longer. This is her last dream before a knock clangs on the compound gate. Our cute little neighbor lady is in labor.
We met each other in the beautiful light of such an hour. An hour when the world is asleep and adventure awaits the rest of us. Adventure comes in all sizes. This time it included a close-to-tragic birth. I never get tired of saying births are miracles. But the thing is, working so closely with life and death is like tight-rope walking. One minute life progresses in full swing. The next it loses it's vibrance and fades. And then it is not retractable.
    After hours of coaching a weakening woman, we were tired. I went for a lollipop. The woman began begging for Oxytocin. I began resisting. I respect that stuff. I was still fighting against it, as morning dawned, and all the rest of the world woke up. The lady was hugging me, begging me, and crying for the augmented labor. Finally fear overtook fear, and we started an IV. Then, in due respect, we pushed a small syringe of Oxytocin into the IV bag. We waited and waited. No progress, but the mom's strength was beginning to wane. Kindra and I started praying out loud. The witch doctor, who was present, by default, stood there looking on, and coaching. The baby, another night patient, who was throwing up outside, finally inhaled enough of medicine to leave us to tend the pregnant mom. Things became somewhat quiet and tense.
Finally, at about 8:15, in a whoosh of ugly meconium stained debris, a baby writhed into the world. Not breathing. By now, the two of us sounded rather desperate and drained as our prayers begged the Lord for one more miracle. That silver thread of breath. And, praise the Lord, He did the miracle. Kindra and I were singing as if we had overslept. Our adrenaline was overdosed. Kendra assured us that the swollen faced baby was the cutest one she had ever seen.
   By now,it was truly morning, and the kind folks at the mission had bequeathed us with 2 mugs of coffee apiece. Which was just what we needed. It was not too much. A huge day awaited us.
     More Adventure? Adventure in the form of a dying little boy this time. As we hooked up the oxygen to a baby whose eyes were wobbling around in his head, we felt hopeless. Eyes are not meant to be marbles. Kate's face told the story as she called us over to look. Not much hope. Stats were unstable.
    “He's dehydrated,” she said, and went to ask our Haitian senior nurse to start an IV. She couldn't do it. The little veins were hiding or collapsing.
      Was this baby even able to make the road to town? He was slipping away. Time went stalking, and stopped. Kate and I looked at each other. “Is there a death angel in this room?”
     I looked at Steve and Katie. “We have one more option,” I said. “I've watched a video on giving Intraosseous infusion. Do we want to try it?”
     “We are a team,” they agreed. Time went stalking again as we looked at the papers to refresh details that I had forgotten. In slow motion, we each took part in encouraging, administering, and securing the scary, life-saving device just below the little child's knee cap. The little red drill buzzed away, determined to stare death in the face and at least put up an honest fight. Kate flushed the bone with clean, pure saline, and I felt the liquid flowing into the bone through his thin skin.

     Another miracle. We watched the fluid drip-drop into the tibea. That leg bone. That long, dying bone. We stared, and blinked. Our minds stepped out of trauma into turf again as we loaded the little peg-legged boy into a waiting transport machine, and covered his toes with socks.
     We don't know. We will wait to hear. Is he alive? Did the doctors help him soon enough?
And then we went finish our work day with everyone else who was waiting with little purple rendezvous papers.
     And, Kate, well, she flew right into a big stitch job. Let it up to Steve to sprinkle in the cayenne pepper and stop the bleeding. Thanks for that natural remedy. It worked, happily.

     I don't know what to say, because God is so good. I love this staff we have and I love these poor Haitian people. That's how I am feeling right now. God bless you all for your prayers for us. -Mis Woda