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!

                                                                                -Hans

















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