Saturday, November 29, 2014

A Tale of Seven Tummies

There were three paracenteses done at the clinic today.


The first one was on Wilfred, the young man that Whit mentioned in her last blog who had had one last Friday as well.  Dr. Felix was here again, and he had explained to Whit and I last week how to do a paracentesis, and apparently decided that this week it was time to get to the hands-on part of the lesson.  Whit performed this one flawlessly, and we ended up draining over four liters off him today.  He's still staying with us, and we're not really sure what we should do with him.  Dr. Felix's opinion was that whether we did the paracentesis or not, he doesn't have much time left.  We think he's in kidney failure, but without the labs to show for it, we can't be certain.  If he is, and in a case as advanced as his....We find ourselves almost hoping that he will be out of his misery soon.  Please pray for him- and for us, as we try to decide whether we should send him home to his family for his final weeks, or keep him here where we may be able to ease his pain a bit better.  He was telling me today that he wants to go to church Sunday, and I'm praying that he will be able to, as I don't know if he will have an opportunity again this side of eternity or not.

The second was on an older gentleman who had come in yesterday with what I first noticed when controlling him (the term they use for taking vitals- nobody get too concerned) as a really fast pulse that was sitting at about 180bpm.  After triple-checking it to make sure I wasn't going crazy, and noting his larger-than-usual tummy in the process, I went to notify Ro of the joyous news that I had someone for her to see.  She put him on furosemide, and added him to our growing collection of patients in the hospital room.  Doc decided today that he needed to have a paracentesis done as well, and he donated a lovely total of nearly four liters of fluid to our waste system.

The third and final one was a woman who had come in Wednesday with- you guessed it, a big belly.  She was also put on furosemide and given a bed, and was still here when Doc finished the second paracentisis.  We headed over to her bed from there to see if he thought she needed one as well, which he did.  He had a bit of trouble doing hers, and we were only able to drain off about 1L of fluid from her.  It did seem to bring her some relief, though, so I'm glad we were able to at least do that much.

But the big bellies that we've been doing paracenteses on aren't the only ones that we've seen quite a bit of lately.  Whit and Mali delivered a little boy first thing yesterday morning, then yesterday evening while we were playing Dutch Blitz up at Rhonda's where we had gone to spend the afternoon for Thanksgiving, we received a phone call letting us know that there was another woman in labor waiting for us at the clinic.  So Ro and I jumped on a machine with Mali and her parents, and hastened off to assist in another of life's greatest moments of wonder.  Ro and I were dropped off at the clinic, where we found that she wasn't very far along, so we decided to do our evening rounds with our small flock of patients, and go home and try to get a little sleep in before going back to check on her again.  That plan lasted until we finished getting ready for bed and crawled under the covers, when we heard the typical "laboring woman" knock at the gate, and her husband summoned us back to the clinic.  We ended up deciding to just wait it out with her down there, and I couldn't help but think when I glanced at the clock once around 1:00, of a different crowd of people somewhere who were also probably chilled, sleepy, and tired of waiting; but those were about the only things that I could think of that we had in common right then.  With the disconnection that being down here brings, Black Friday seems even more ludicrous, when I think about the throngs of rapacious people (if they can really be called people, when they don't act in a way that deserves that distinction) descending on stores across the U.S.; desperate to spend not quite as much money on an item that they never really needed in the first place.  I'm not sure how my little post here has morphed into this mini-rant on American greed, but as I sat down there last night waiting, with a woman and her sweet husband who hardly had enough money to pay us the less-than-$7.00 that we charge for a delivery, the contrast was pretty striking.  But anyway, back to the baby- she arrived a little before 2:00, and from her very vigorous cries, I'm fairly certain she wasn't thrilled about her new surroundings.  Forty minutes later we were finished cleaning up and settling them in for the night, so we turned our tired feet toward home and once again readied ourselves for bed.  I was going to try to get a photo this morning to add to our blog, since y'all have probably forgotten what everyone down here looks like by now, but they had left by the time I had a camera rounded up.  And then, in all the hustle and bustle of the rest of the day, I never really had time to take the rest of the pictures that I meant once again, y'all will have to read a photo-less post.

And now tonight, somewhere during the course of my writing the first couple paragraphs of this post, Whit and Mali were once again called upon to catch a new little life as it made its way into the world.  A little boy, this time, which seems to be the dominant gender for this week's rush of babies.  Things went smoothly again, and after cleaning up, they were able to join us at the house again, shortly before Ro and Hans arrived back from town with ice cream in tow.  Coffee-flavored ice cream, mind you. :o)

On a bit of a side note from today, and for my seventh stomach person; Monet (the fellow blogged about in Don't Untie That Knot!) finally left for home.  He was given a rendezvous for Monday, and after making his rounds to everyone to say goodbye, he left on the machine with Hans and Rhoda shortly after lunch today.  The clinic feels like it's missing something somehow since he's not there to laugh at my awful Creole and I no longer hear him calling for his "sister" whenever I walk through the hospital room.  One of our other patients that was observing the farewells asked Whit if she thought that love could make a person well, to which she replied the affirmative; and we believe that Monet is the perfect example of just that.  I can hardly remember that the funny, round-faced friend that told us farewell today is the same skinny guy who so disliked me when he first came and I gave him his first IM shot (he held a grudge about that for a long time).  I wish him the best, and pray that his time here can forever alter his life, as it didn't seem too bright before.  He told me when he left that he's planning on coming to church in Sunday, and I hope he finds a way to make good on that promise.

Well, I'm still running a little short on sleep, so I think I'm going to wrap this up.  I hope you all have a wonderful, blessed, and restful weekend...and that you all had a wonderful Thanksgiving with big family get-togethers, good food, and fun games.  God bless!


Wednesday, November 26, 2014

A Piece From My Perspective

  Ok.  I'm just trying to write a simple blog post.   Not a big deal, right?  But getting it started has felt like trying to start an engine on an empty tank.  Despite a little fooling sputter (or perhaps a sputtering fool, as I'm beginning to wonder about in my case), it simply doesn't get anywhere.  :/    So why do I keep trying, even after the um-teenth futile attempt?  I guess I'm still hopeful that somehow it'll just start going.   I think maybe it's starting...though I haven't proved to myself that it isn't just a downhill coast yet.    :]  Usually when the going gets this hard, its cause I've taken a wrong turn, trying to force my train of thought to fly on the highway, when I really just need to find the tracks again.   And since I wasn't intending to write a blog about blogging, let me get back on track...

Clinic life.  People.  Medical cases.


 Ah, much better.   

  It's no wonder I'm feeling so sidetracked, considering *public confession* it's been a couple months since I've blogged!  :/   And not just a normal couple of months.   I'd say crazy, but that's standard, and I think "standard" has been raised.  So it's been CRAZY.  But rather than employing every excuse that I feel is applicable in my defense,  I'll just include you in some of the craziness and hope your sympathetic response will be summoned to the cause of my blog negligence.  ;)  But I won't waste my time trying to revive my memory from two months ago, instead I'll test my short-term memory ability and see if I can still pull up last week. That ought to give you an ample sample of recent clinic culture!   

  Rho and Hans were gone with a group of heart patients seeing a visiting heart doctor in another hospital.  Had a very busy day at clinic with around 100 people, but thankfully no real emergencies.

  Not quite as many people, but two strange cases involving one two year old girl who seemed to have nothing wrong with her other than that she refused to swallow anything but water.  We tried multiple times to put in an IV, but never were able to get one that ran well.    We wondered what exactly we were working with...physical sickness or spiritual problems?  We've seen and heard of cases where there's been a curse put on someone simply making them unable to swallow till eventually they die.  It's such a demonic tactic, to cut off our source of life and kill like that!
  The other case was a very sick, very fat 15 month old baby with very congested lungs and trouble breathing that we put on meds and oxygen. We kept both little girls in our hospital room to stay so we could continue monitoring them.

  We're beginning to wonder if having 100 or more patients a day is going to be the new normal! Makes for a very full clinic.  We've already been dreaming of adding a few more rooms to move around in and getting more meds for the growing need.   Not hinting, really. :)
  Mali and I took a hike with Fre Noaz in the afternoon after clinic to visit an old man, Aginol, whose wife recently died.   As soon as we got back, we went with Hans on the machine to pick up Fre Gevan, the man with the broken back so he could spend the night in our hospital and leave early the next morning to get back surgery in Mirabale.
  Hans and Rho left at two in the morning for Mirabale!
When we got to clinic in the morning,  Fre Noaz was already almost finished praying, which meant that we didn't have any time before clinic opened to get most of our bandage patients through, which we usually try to do.  Then there were people everywhere, overflowing the benches and lining the fences behind them.   We had close to 140 patients that day!  
  We often get a lot of pressure from patients to get them seen quickly, not because it's late in the day, but because many of them have a few or more hour hike home and want to make it there before dark.  We do our best, but on days like Thursday, the pressure can get a little hot, testing our patience and endurance with impatient patients and with each other.   I think for the first time that I remember, I sat down at the end of the day and just let the stress run from my eyes! :]  
  Besides the crowd of regular patients, the fat baby that had come Tuesday took a turn for the worse and we ended up sending her out to town, only to hear she died shortly after getting there.   Mali had checked her blood sugar when she first came, to rule out diabetes, but her sugar was normal.  They checked it again in town, and it was 500.  But it was too late. 
  Another very sick-looking 24 year old boy, Wilfred, was brought in on a cot. Everything from his stomach down was swollen so tight with fluid it seemed like it'd be impossible for his skin to stretch any farther without bursting.  He's seen other doctors before, and came to us asking if we could drain the water off his stomach again.  I told him the doctor was coming the next day, but I wondered how much longer he could live in his condition.  I asked him if he was saved.  He said he was.  
  In the afternoon, another old man was brought in with severe stomach pains.  We treated him as much as we could and gave him a bed to stay the night.  
Rho and Hans made it back just at the tail end of clinic, exhausted from their virtual all-nighter trip, but happy to be back!  
  Around 10:00 that night, we got a knock on the gate reporting a man with a cut on his head. They told us it was caused by a rock.  We girls had been in the middle of having a girls' night, so we all went down together and had a blast whipping up a stitch job with all hands on deck! :) In the process, we found out that the cut was actually the result of a fight over one dollar that another guy owed him. :]

  Woke up early morning to a knock on the gate by the husband of a woman in labor, who came wondering if we could come pick her up on the trail.  We questioned him out a bit and, learning it was her first, we explained that it'd probably be better if she walked here to help her labor increase.  He seemed to understand that well and went running back to help her walk here.
  Shortly after that, as we were eating breakfast, we heard loud wailing start up at the clinic. We knew that meant someone had died.  My first thought was Wilfred.  Mali and I jumped up and ran down to find out.  We were surprised to find it was the old man that had come in with severe stomach pains the day before.   It seemed so strange, and saddening that we couldn't do more but put his body in a body bag and comfort the family before heading back home to finish our breakfast in preparation for the rest of the day ahead.
  When we got back to clinic, the mother in labor was waiting for us, and we, surveying the sizeable crowd of patients again overflowing the benches, were quite grateful to confirm that she wouldn't be having her baby too soon!  
  The DR came and performed a parasinthesis on Wilfred.  We kept a close tab on his vitals as he drained off 12,000ml of fluid!   (And no, that's not a typo)
  As soon as clinic was over, Mali and I left on the machine with Donny to go to the funeral of the baby girl who had died, and also to give a ride home to a dear little old man who was so crippled he could barely walk.
  A ways up the trail we passed a moto driver who yelled in passing something about the road being blocked ahead.  Sure enough, a couple-foot high blockade of rocks around the next bend forced us to stop.  We got off and walked far enough past it to see several more road blocks farther up the road, along with a very rowdy crowd of young guys that came running down the road toward us.  
  We started to wonder if maybe we shouldn't be there.   They quickly made us know we shouldn't be.  
"Go!" "Go fast, and get out of here!"  And we did.   They were adamant that nobody would be passing the road, no matter what the reason.  We were able to get some explanation as they marched us back to our machine.
  They told us that the former mayor of Ti Goave was up in the mountains for a party and would soon be going back down.  They were full of hate for her, and pretty much told us that they would be doing us a good service if they could kill her. 
  We did get out of there fast, driving back the trail quite a ways and up the next mountain, giving us a clear view across the valley to where they were waiting for her convoy of machines to confront them.   Many excited Haitians gathered with us to see what would happen.  Before long we heard them coming behind us, soon passing us in a cloud of colorful chaos...a swarm of honking motos, surrounding two go-cart looking rigs blaring music and flying recklessly fast down the trail.   
  Wild story mild, they roared past us and we watched nervously as they wound up the trail across the valley and came up to the road block.  The group of guys there quickly spread out across the steep hill overlooking the road and began hurling rocks and stones down at the exposed drivers, one of which was the mayor lady.  
  We shuddered as we heard the threatening sound of gunshots being fired into the air and watched all the stone-hurlers drop to the ground for safety, except for a couple who stood undaunted, ready and willing to die on the spot.  The road blocks were soon moved and the caravan continued on till the next village, where we heard there was another confrontation, a closer call for the mayor as it sounded.
  We followed on far behind, the funeral we originally left for being long-since over, but we went ahead and visited the family after we had taken the little old man home.  We were so glad we were able to stop and spend time comforting the mother, who was still pretty distraught.  The father kindly assured Mali that she wasn't to fault.  He said they saw how she did her best doing everything she could for their baby, and that it was in God's hands.  
  We got home just in time to eat supper, over which we got another knock on the gate, someone telling us that the mother in labor was getting close.
Another jog to the clinic, another check confirming that the baby would be coming soon, and then the wait... till baby was born at 10:00.  Other than the mother needing a couple stitches, everything went very well, and we were glad it was over before too late.  
  That same night, however, Rho and Marcile got called down to another birth, this one being a neighbor lady who came and had her baby without them and went right back home a few yards away after they cleaned things up! :)  We were all grateful the third woman in labor who also arrived Friday and was staying at the clinic didn't decide to have her baby that night to. :)

  I was on call for the weekend, so I went down in the morning to check on our full hospital room of patients.  Rho and Marcile came down to check on the laboring mother, who despite all her so "woi-ing" was still not very far along.  
  As a growing number of non-emergency people continued wandering in from the road to buy meds for headaches and coughs, and asking to be seen for other such maladies, I finally just walked off to hide in the depo for a few minutes and deal with my exasperation before coming back and calmly taking care of the patients I could and then explaining to the rest that the clinic is only open for emergencies on Saturday.    Ah...Lord give me patience to be unselfish with my weekend! :]
  A major bright spot in the morning, as I was taking Wilfred's vitals, his mom told me that he said he'd like to talk to a Pastor and be converted!   
"Is that true?!?" I asked him.  He nodded seriously.  "You remember when I asked you the other day if you were saved and you said you were?"
Yes, he remembered.  He said he had lied to me, but now he was ready to get saved!  We called Fre Noaz down and he came and talked and prayed with him.  It's a real encouragement to see the peace of his countenance despite the pain of his condition!

  So what became of the last laboring mother?  Rho and Marcile ended up spending most of their Sunday afternoon working with her till she finally delivered a big baby boy that evening, a very scary birth they said.  They were very grateful that after all her hemorrhaging she made it through fine.
  I wonder how many paragraphs ago your attention span timed out... Admittedly, I've begun to feel more like a drone plane, passing over many experiences at a less personal distance for sake of time, so maybe I oughta start looking for a good place to land... :)

 There's much, much more from the last two months... Early October had Rho leaving for ten days with Janette Musser here to help fill in, followed by a two-week visit from two of my 15 favorite siblings;), our dear Kin coming back to work with us, many different patient cases...and everything else in between!   :)  I'd share some pictures, but with the way the internet is right now, I'll be doing well just to get this posted.  

  Thank you all for your interest and support!  Remember us in your prayers!  We often feel our weakness, and recognize that the only strength we have is what we find in the Lord.   He knows how much we can handle, and though He stretches us to fill the shoes He gives us, He'll never make them too heavy for us to walk in!  Have a blessed evening! 

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

Update from Marla

This post is written by Marla, almost a month ago and I made a mistake and didn’t get it posted. I’m sorry. Enjoy her words almost a month l...