The other side of The Coin

     By now, I fear, some of you will never come to work in or visit at this clinic. Why would you after seeing all the red, smeary, battered legs, arms, and heads that we faithfully post?

     There is the other side. There are the mornings, even in November, when the flowers bloom so bright as you walk to work, that you grab a couple to look at all day.

     There are the moments when you walk in to say hello to the patients in the hospital room, and after seeing their maladies, you get the brightest smiles, and think hopeful thoughts of health and recovery. The first picture here is a man who seems to have suffered a stroke. The other little princess of a girl is the top half of the foot picture you saw on our last blog. She seems to like her little Bible story book pretty well.

The stroke victim

The foot girl--what a cheery smile

     Or you might be taking blood pressures in a noisy, crowded, smelly waiting room; and there is this little cherub of a child, fast asleep. It might be worth soaking the sight up...

The little cherub

     And then, you are just about to walk out the gate and head for some rice and beans. Who is that chubby, healthy baby? Remember her from a blog way back?!

A previous patient looking very healthy now

     She didn't look quite this way a while ago. That's why you need to wait. Look at the other side of the coin. Only God knows what the outcome of a day's worth of looking at wounds and illnesses may turn out to be. Maybe there will be a bonus smile or a chance to speak a word for the Lord. If not, stick on the band-aid anyways and wait. Good things take time! 

     

A girl with a really sore foot...

Warning: Viewer discretion advised. Images below are graphic and potentially disturbing.  

Tuesday morning, I came into clinic, I happened to be the first one there.  I noticed a girl sitting on a cot - a whole group of people had carried her into clinic. They showed me her foot - it was wrapped up in a piece of gauze. I could see her one toe was completely black and dead.  Her foot was further infected, but I wasn't sure how bad. The other nurses arrived shortly, and we brought her into the examination room, wondering what we would find under the gauze. We peeled it off, and the second picture down is what we found. 

When we first brought the girl into the examination room (above)

Her foot as soon as we peeled off the bandage (above)

We found out that this wound started about a month ago - she fell and injured her toe.  Two weeks ago, it had progressed so far that she couldn't walk.  The family was actively taking her to some "bush doctor".  Evidently, they finally decided it was time to come to the clinic because that doctor couldn't do anything more for it.

As you can see from this picture, it is so rotten that this instrument can just be stuck straight in (above)

Michael removed excess dead tissue last night. She will be taken to a larger hospital down the mountain for further care and amputation as the doctors there see fit. Currently, the road down the mountain is closed due to road construction. In the meantime, we are trying to prevent the spread of the infection until we can move her on.

At Work. . . .

Here are some sites you'll see on a normal day as you walk into the clinic.

Direk at his desk where he writes up the patients' charts for the day 

Waiting room full--Rhoda busy in the background

Fre Adolph weighing a patient

Fre Noes at his post--He gives number cards to new patients as they come and helps keep order

Mis Breanna doing a consultation

Mis Virginia, Madam Leger, and Zita in the pharmacy

Busy outside the clinic too--on the left patients are waiting for their medicine at the pharmacy window

~Mis Anita

A Delicate Stitch Job

This girl came in a few days ago with a wound on her eye lid.  The story was that she fell out of bed and hit a rock.  (We were suspicious that the story wasn't true.)  

Cleaning and preparing to stitch.

There was this glob of tissue that needed removed before I could stitch.

All stitched up!

A few days later when we took stitches out--see the stitches on the gauze?

Almost healed

What a busy morning!

Bright and early, Anita and I were up and about, drinking our coffee, and preparing to go to clinic to dismiss a cholera patient we had allowed to stay in our hospital room over night.  When we initially kept the patient, she did not have a confirmed case of cholera.  However, close to evening we discovered that indeed, she did have it. We choose to let her stay the night even though we are not prepared currently for such cases. It could potentially have meant her death to send her away. 

So the next morning after that affirmation, Anita and I were up and ready to send our cholera patient on the road to another hospital and bleach down the clinic and room as fast as we could before others arrived at around 8:00am.

Before we got out the door of our apartment, we got a message that there is a woman in labor at the clinic waiting for us! Oh no! We ran over there and quickly got her into our clean examination/consultation room.  Our cholera patient was quickly sent off.  The hospital room she stayed in, and everything else she may have touched was thoroughly bleached, as were our shoes, etc.  

We no sooner got her sent on the way, when baby was coming! Fast! It was a great delivery, and baby was fine - despite the fact that the cord was wrapped around his neck two times!!  Anita always does a wonderful job at midwifery and God is definitely good!! Below are two pictures of the nurses and mom with baby. 

The nurses and baby

Mama and baby

Notice the hole on the heel

Later that same morning, a boy came in with an abscess on the bottom of his foot.  His foot was very sore obviously.  In order to let pus and infection out, I had to cut through tough callous on his heel with a scalpel.  That was the first time I'd seen an abscess on the bottom of a foot like that!  

~Mis Breanna

     The morning was chugging right along at our little clinic, when Agenal, a bent over old man came hobbling into the clinic. He seemed quite distressed and began to pour out his woes to Anita and Fre Noes.

   Between the two of them, they understood that poor, partly blind Agenal's wife had fallen out of bed that morning. Agenal seemed to think that she needed blood pressure medication to fix the problems.
    Anita told Agenal that if he returned later on in the afternoon we would come up the mountain with him to see how his wife was faring.

    Don't you worry, Agenal surely did come back, for the love of his wife. Anita, Nate, Julian, and I followed the bent over man over the mountain and stream to his little house. Nate was hauling a backpack with water bottles, etc., and Julian was carrying Anita's medical backpack.

A man grinding corn along the way

Haitian sawmill

    Our hike was great. We had a few shady spots and some breezes to break up the hot mountain climbing. Every now and then, we would stop and take a look back over our progress. Lots of gorgeous yellow daisies were growing all around the path.

Walking into their compound

     After about 45 minutes, we were introduced to Agenal's wife. She was sitting quietly on a bed in the corner. Anita donned her gloves and began to do a mini exam. After asking quite a few questions, it seemed difficult to really pinpoint a specific cause for the fall in the morning. It seemed like the fall had been preceded by a seizure, but that was a bit elusive as well.

Mis Anita checking Madam Agenal

     Anita gave a bit of Ibuprofen to the tired looking Grandma, and the family seemed pleased with that. Anita reminded them to tell us if anything else went wrong in the future. Then we had a little prayer, and told them we needed to go home again.
     One little boy from the compound there at Agenal's led us down the path way towards home. By then it was cooling off, and the hike didn't seem long. Hopefully, for Agenal's sake, though, he won't need to take his tired bones over the mountains to the clinic very soon again.

~Mis Rhoda
   

An Afternoon's Activities

We saw around 50 patients at clinic this morning.  Finally the last dossier was made, the last consultation done, and the last pills handed out.  Now it's time to head home for lunch!

Or is it?  Here comes a crowd of school children, and one girl is holding something over her head.  They are headed to clinic. . .  

Virginia is on call for after hour things today, and so she checks it out.  Apparently the girl had a rock thrown at her, and it hit her in the forehead.  We're not sure of the all the whys of the incident, but rocks seem to be the blame for a lot of injuries around here.   

Virginia preps and stitches it up with Breanna and Rhoda assisting her in turn.

A close up at the wound.  

While Virginia was still stitching up the school girl, a lady came in labor.  She and Rhoda checked her out, and as she was soon to deliver, Virginia came and called me.  I was there maybe 45 min when a big baby boy was born.  He weighed 8 lbs 5 oz 

Here's the little cutie

Putting in the eye ointment

Mis Virginia with the baby.  

~Mis Anita

     Thursday morning started with a persistent knock on the gate. Shana stuck her head out the door, assuring the person that she would come, but the knocking did not stop. What could be the hurry at this time of day?

      Mis Leda was asking if we could pick up a lady for her. She was having some complications and Mis Leda wanted to check her out at the clinic. It sounded like a baby was on the way.

     One of the guys rumbled out of bed and went off to pick up the patient. By the time all the workers were assembled, the lady had arrived. It was a busy morning already since Mis Leda wanted to leave early, but it all worked out okay. The baby was in a hurry to come, so we stopped in the middle of what we were doing, and caught the child. 

Notice the sixth finger on the mother's hand.  That is very common here.

   It was a cute little boy, who seemed well from the start. We cleaned him up, and grabbed a few photos with Mis Leda before he left. There wasn't much time to cuddle the little shaver, because there were chairs full of people waiting for blood pressures out in the waiting room. I hurried back to my job.

    One man was looking at me strangely and wondering why I didn't do his blood pressure and temperature like I did for everyone else. I looked at him strangely because I couldn't figure out why HE didn't have a dossier. Poor man. I had carried it back with me to the delivery room.

     Friday was a busy day with odds and ends of bandage patients showing up. One girl showed up with an abscess on her cheek. Another little girl whom we had previously drained an abscess for, came back with what appeared to be yaws in her mouth. Michael gave her a shot to target the infection. It was good to have the rest of the staff back on board again to tackle the unpredictable turn outs.

    We met Saturday morning nice and slow. A few patients were waiting out at the clinic for us about mid-morning. Breanna got in for a stitch job. I learned a lot by watching her calm, composed approach to the cut on the little fellow's upper leg. Anita was a great teacher, and after another hour, the cut was nicely pulled together with suture.

The cut before Breanna stitched it

     Our week is almost over. We are thinking of getting some sleep before answering another knock on the gate. Please pray for our ministry to the Haitians here. We hope that the love of Jesus goes deeper than the medications we prescribe, or the stitches Breanna carefully sews into cuts.

~Mis Rhoda

     

    

Patient Send Off

Well, here is the medical team with Efadel and his mother.  It was a sad and happy day when we sent them off.  He is now walking some on his own, and the infection sights are almost totally healed.  They are still changing the bandages every day and coming back for check-ups every few days.  

We kind of got attached to him and them to us so it was hard to see them go, but it's so exciting that he's doing so well AND that his parents found the Lord while they were here.  

Mis Rhoda, and my brother Jere taking vitals in the waiting room.  

Jere and his family were here for 6 weeks.  Jere worked in the shop mostly and in the clinic a few times.  He's a volunteer EMT in WI so enjoyed getting his hands in on a few medical things.  

Mis Breanna and I draining a nasty abscess

Michael, Virginia, and I were able to attend a radiology class that Christian Aid Ministries (CAM) offered at their base out by Port Au Prince.  We really enjoyed the class, but needed to get back yet Thurs evening so we could be here for clinic Fri.  It was probably 4:30 pm or so till we left the CAM base.  We still had some stops before hitting the trail out of T-Goave toward home.  I was about 8:30 pm when we were leaving T-Goave.  It looked like we should be home before 11--not so bad--but half way home, the picture below is what met our eyes!  Notice the angle at which the truck is setting.  To his right was a steep bank, and he was barely 2 feet from it, to his left was a 3 foot drop off into a river.  He was stuck in the river with his empty two wheel drive dump truck--couldn't back up or go forward.  Thus we were stuck too on the "away from home" side of the river.  We tried pulling him out, no success.  After a while some of us got in the back of the dump truck for a little weight and bounced as the driver rocked the machine back and forth.  Finally after pulling, rocking, filling in ditches with rocks, we were successful in getting him out, and we all went on our merry way.  

Stuck dump truck

This is the view from the bed of the dump truck looking down toward our Land Cruiser after we got the trucked backed up.  They were filling in the ditches for him to try to go forward again.  We finally got home just before midnight.  

~Mis Anita

You never know what you'll see next!

This is a case that came in yesterday--a 14 day old baby with an odd lump on it's head.  We're not sure what is is, but it's beyond us so we told them that they need to go out to a bigger hospital.  The lump started a few days after birth and has been growing.  Other than that the baby seemed fine.   

  "Good-morning, scrubs. I hope you have more energy than I do at two o'clock in the morning. Because I hear Anita calling me on the radio." It's Thursday, and there's a lady at the clinic waiting to welcome a baby into the dark world. I grab a flashlight.
    Then the scrubs and I walk out to join Anita in the courtyard. There are plenty of people talking and sleeping in the clinic entrance. They wait and watch with us until the baby comes about three-thirty in the morning. The little girl is decidedly cute to compensate for our lack of sleep. She is a good six pounds plus an ounce. Janell and Elissa bathe her and bundle her up. We are glad for their help as we get the mom back on her feet. Anita is just putting the last odds and ends away from the birth when the mom comes back in. She tweaks Anita and I under the chin and thinks she is ready to walk the four or more hours home with her friends. "Thank-you," she says.

The nurses, assistants, and the new little baby

    Anita and I shake our heads. But why not? If she's feeling up to it, what white people can stop her? As for us, five-thirty sounds like a good time to go back to bed.


    Later on, during our calm clinic day on Thursday, Breanna was shaking her head over an ugly elbow abscess. Mis Leda had lanced it open on Wednesday, but it was still looking rather angry. Something needed to be done. Mis Leda kindly came over and helped Breanna cut away some of the awful infection covering the deep bottom side of the hole. Although you see only the elbow on the picture, you can imagine how the face of someone with a knife carving into their flesh could look...

Breanna working at the infected elbow

   
As the clinic day comes to end, we have time to think about the lady who came to the clinic earlier this week. As she lounged around on the hospital bed waiting for delivery, we began to suspicion that something was strange about this case. Twins? Maybe? Possibly?
    After more inspection and more questions, the lady told us that she was indeed having twins. Interesting news at this point of the game. We decided it was a good time to send her out to the hospital down at T-Goave.


     Friday ended our official clinic week with Michael and Virginia back on staff. We just about needed to ask them to introduce themselves, after their long absence with the mobile clinic and hurricane.

All in all you can see we've had a very full week!

~Mis Rhoda

Just a snap shot of a stretcher being carried in to the clinic on Fri

 with an older man who was too weak to walk

   

   

-My Week at the Clinic-

   Hurricane Sandy welcomed us to Haiti with torrents of rain and wind. We made it back to the mission just in time for the rain to begin in earnest. And there we sat. Clinic was closed for the next two days while we sopped up buckets of water and tried to stay dry. By day three we were doing push-ups and jumping jacks to ease the lack of exercise.=) We ended up deciding to just get wet and donned huge rain coats for a hike. We got soaked to the skin but it was definitely worth it. =) 

 The rest of the week was full of some pretty incredible happenings. A women with eclampsia came in seizing seriously. We strung the oxygen cord out thru the people to where she lay on the ground and kept checking her oxygen levels before they took her out to town.

 We had four laboring women come in the last two days. Two,beautiful, baby girls were born. Anita discovered the one women was carrying twins and sent her out to town...and lady # four's results are still pending! 

I was amazed at the amount of infections and abscesses.  The nurses do an amazing job of stitching and cleaning terrible looking wounds. 

Rhoda, Emma, Janelle, and I on our hike. 

I spent some time in the pharmacy trying to help the Haitian pharmacist distribute meds. We communicated by signs and wonders. =) 

    Effadel came to the clinic around six weeks ago with a terrible abcess on his leg. He almost died as the infection went systemic. This week he made incredible progress. His legs are down to normal size and both abcesses are closing up and healing nicely. 

                                   

   Rhoda cleaning up an infected foot. 

~Katie Lapp