Various Updates and Interesting Cases

Gentle and sweet Godly Man, such a pleasure
to have him around at the clinic. He smile
radiates the love of God.

  “Let me see, is that everything?” Anita picks up her water bottle and prepares to leave the clinic. I glance at the people sitting in the hospital room. Let me see, Batel shouldn’t be too hard to get along with. He is basically at  the maintenance stage of things right now. Changing his bandages and making sure he is getting his medication seems manageable. Even carrying a bit of food down for him wouldn’t bother me. But then, I’m not sure about the other man in the bed by the door.

     They call him Denis. Nobody mentioned that his other name is Menace. But he is confusing for sure. I sort of picture that after a person has been sick for a long time, that they would have these thoughts of how nice it would be to have a prescription for some medicine that could help them get better. Apparently Denis hadn’t been picturing things like that before he came to the clinic on Monday. I walked into the hospital room as Anita was trying to give him some medication and pedialyte through a syringe. His lips were tightly pursed and his cheeks were a bit bulging. But not for long.  Even with friends massaging his throat or pinching his nose to help the swallowing process, he didn’t choose to swallow. You guessed it. He spewed a long stream of those contents straight into Miss Anita’s scrub top. And I doubt that was exactly the good-bye she had been dreaming of from her patients in the hospital room right then.

Rhoda trying to squeeze some meds through
his clenched teeth, he would hold it in his
mouth for minutes and then suddenly
spit it all out.

    So Denis laid there all afternoon with an IV dripping into his arm. At about eight o’clock  we decided that it was time to make another attempt at giving Denis medications. We do not have the capabilities of giving all medication intravenously here. And since we were treating Denis for Typhoid Fever and Malaria, that included a few oral medications. With a prayer, I drew up the evening doses into a large syringe. In my other hand, I had a nice pile of white gauze waiting in case Denis decided that the meds were not to his liking.

     While Jon stood at the head of the bed praying, I continued trying to squeeze meds between the tightly closed lips, as I said, “Swallow it, swallow it.”

     After a very long time, some meds were swallowed. I asked Denis, “Do you want some rice?” Since Denis is not likely to feel compelled to talk, I took his nodding of the head as a very exciting event. He actually communicated with me. A lot of the time he lays on the bed, staring unseeingly into the distance.

     I asked Jon to please go home for some rice for him. Because, well, if he could swallow rice, that would be great. I wasn’t sure that he had eaten anything all day. Meanwhile I tried to finish giving him the remaining liquid in the syringe.

     It was great when Jon came with the steaming plate of food for him. What wasn’t really great was when he immediately spit all the food on the shirt he was wearing or refused to open his mouth for it, after we had gone to all the work of getting some for him.

     We shook our heads, gave the plate of food to his friends and decided to call our night at the clinic finished. Was this man in his right mind? Had he gotten so sick at one point in his life that his brain was not able to connect things? Or, Was there a spiritual battle going on?

    We started the next day with some of the same questions stuffed in our minds. I asked Fre. Noaz to help me hold the man while we squirted the crushed pills slowly into his mouth again. Fatigued after minutes of coaxing and reasoning, we left the room, with wet gauze's in the trash can to finish the story of how it went this round.

    As I walked into the room later in the day, to give Batel a new bandage, I was shocked to see Denis sitting there with bread and coconut candy, munching away happily. “Is it good?” I asked. I didn’t ask a million other questions that my mind wanted to throw at him….

Here is our friend Denis sitting outside
getting some fresh air!!!!!!

    So the days are passing. Each one surprises us with him. Sometimes our curtain gets a shower of juice or medicine during an episode, or sometimes he will actually swallow a pill just fine. Last night he decided that an IV was not what he wanted at all. He wasn’t begging for his medicine to all be put in the IV. Not now. Now the IV was NOT all right. Doctor Michael decided that it wasn’t worth the fight. Now this morning he is just fine with an IV. We are thinking, that maybe tomorrow he will be able to go home.That is, if we don't think about the fact that tonight, again, he stiffly refused to swallow his meds. He sat up. He said, "I won't take medicine, I won't eat food. I want to go home, now." I did not say, " I would love to send you home, too, when you are naughty like this." But like the human that I am, I did entertain some unsaintly thoughts.

    His temperature is fine, he seems mostly stabilized, and we planned to discontinue the IV permanently, along with stressing the fact that he needs to drink by mouth now. Of course, he needs to eat, too. So, since he doesn't want to do that, when he was SO close to being good, I guess we will need to decide if he is allowed to go home or not. Possibly it would be just as good for his family to take up the battle, I don't know at all... I hope you are happy to meet Denis from a distance. I think it is cleaner that way. Grin.

I just got a picture of the pregnant lady with the pre-
eclampsia in the back of the ambulance when Steve
left to take her to Laogone. Notice the IV hanging
from the ceiling?

     Then we had another lady joining Denis and Batel in the clinic one night. I will give you a brief run-down on her. She is pregnant, and pre-eclamptic, with approximately two months left until her due date. She was having pain, and didn’t take her Methyldopa one day. She ended up in the hospital bed here overnight, with a very endangered baby included. The baby lived through the night, thanks to God. Doctor Michael helped me transcribe the transfer paper for the hospital in town, where she could be closely monitored in the dangerous situation she finds herself in. I don’t know what we would have done if he hadn’t jumped in and handled the stress with these cases that showed up in Anita’s absence.

     Another Grandma came one day and spent the night in our hospital room, on IV.  
     

   Another young lady is currently sleeping in our 
hospital room, too. She seems to be fighting shigellosis. So, yes, our cleaning ladies are busy washing sheets, we are busy watching IV’s and the people who they are connected to. We are so glad you are busy doing the praying, which we feel gets so interrupted so often in our little compound here. God bless you!

The "grandma" right after she came in on a stretcher.

    

Scalp Abscess, Post By Megan, Edited By Jon

   Sunday afternoons are supposed to be relaxing and stress free…? This was not to be the case, though, on this particular Sunday afternoon. We had just finished lunch and the dishes when there was a knock at the door. Our gate guard came to tell us that there was a boy at the clinic that was in trouble, describing that his head was swollen and soft like intestines. His family was so sure that he was going to die that they had already started mourning his death! So beneath clouded skies and a drizzle that had begun a few minutes before, Anita, Katy and I headed down to the clinic in our scrubs. When we got there, Anita donned gloves and came out to examine the teenage boy. At first glance his swollen head looked like something resulting from a bad allergic reaction but as soon as Anita examined it closely, she knew it was something far more serious! Sure enough, if prodded or pushed, his head literally went in an inch at certain places! Underneath the skin, there was one large pocket encircling his head that was filled with air and pus. With that, Anita called Michael over the radio and asked him to come down to take a look.

   

   A few minutes later Michael walked in and, after a quick look, he decided to try something. Michael took a 3cc syringe and he poked the pocket, and drew out a thick brown liquid. It was a horrible infection that hadn’t been taken care of and had grown to present a serious emergency case! Taking the boy into the hospital room, we laid him on the bed and Michael prepared to make an incision to drain the pus pocket. I could only imagine the horrible pressure and ache this guy had to be enduring at the moment, but strong as he was he just lay there with his eyes tightly closed.

   

   We got the supplies ready then Michael first numbed the area with lidocaine, then, making a skillful cut through his skin, Michael quickly applied pressure to stop the bleeding. After this was done, he placed an IV catheter into the cut and, applying pressure to the boy’s skull, began draining this horrible looking pus and infection into a dish made to catch this type of stuff. Immediately, the room was filled with a horrible smell, bad enough to turn the strongest person’s stomach. After draining it for about a half hour, there was still a large bubble that we had not drained so Michael came up with a brilliant idea to use suction. So, we set the suction up, stuck one end of the tubing into the young boy’s head where Michael had made the incision, and started up the suction. After draining it for about ½ hour Michael could drain little else out and the side of his head still looked like a balloon at certain places. Then we discovered that the abscess was filling up again! We had been going to keep him in the clinic overnight but this is when Michael decided to do some pretty quick action. Taking the 18 year-old boy with him, Michael headed out on grandpa Harold's Bobcat on the 1 ½ hour drive to the Ti-Goave Hospital where a surgery could be done.

   

   The only hope for him is for the doctors to scalp him, fix and clean it all up and put his scalp back on, which if it is successful will need a huge amount of care after words for months. This morning we heard that nothing has been done for him in Ti-Goave and the family wanted to bring him back up to die, this is where it hurts, help is possible but they don’t have money, we are stuck with that thought, but don’t have funds to help people like that and for the continued care afterwards.

   Steve took a pregnant lady with significant issues to Laogone for further treatment today and pick up Anita and Katie in Laogone as well. We found out that the American doctor in Karfu, where Steve had taken Alex would look at the case, and I just heard Steve just dropped the young man of there, we don’t know how it will all go, and what will become of it, we are asking for lots of prayer support for this case especially, I can only testify of the amazing, amazing miracles that we have experienced in a lot of areas the last week, AND WE KNOW FOR A FACT IT IS ALL THE PRAYERS, FROM THE ALLEGRE CHURCH HERE AND ALSO ALL OF YOU AT HOME. LET US CONTINUE IN PRAYER, THE LORD IS HEARING AND ANSWERING.  
                                                                                                                           Megan

    

   

Michael making incision.

Puss is just flowing out of the abscess.

Notice how much is in the collecting unit?

Suction hose attached to his head.

"My Life in Haiti"- by Megan Stoltzfus

 

    When I first came here to Haiti, I had no clue about what to expect! I knew nothing about life in a third world country, nothing about the work in a clinic, and nothing about the Haitian people and their culture. All I knew was that I was coming to lend whatever help I could in the clinic. The only training I had was EMT Basic and I only had the head knowledge. I had never been at an accident, had never watched someone receive an intravenous injection and I did not know how I would react to the sight of blood. I knew when I got my EMT license, however, that I wanted, someday in the far off future, to use my medical training in the mission field. Little did I know that I would get my chance so soon.

   On March 1, three months after my training, I was asked if I wanted to come down here to help short-term because it was a desperate time of little sleep and tons of stress for the two nurses here. I was shocked yet delighted that I was getting a chance like this! And sure enough, a week later, I was on my way in my first plane flight, first out of the country jaunt, and my first time of being away from home for more than 2 weeks. I was so excited! When I got here, it was 11:00 on a Friday night so I had the weekend to settle down and get to know the family I am staying with.

   Clinic started at 8:30 on Monday morning. My first responsibility was to take the vitals of the people that came in to the clinic. So, armed with a blood pressure cuff, a thermometer, and a pen, I started with the first person. As each person was “controlled” the nurses called them in and had a consultation with them to figure out what “maladi” they had. Then the nurses prescribed medications for them. These medications were written on the dossier that each person received as they came into the clinic; then the people were sent to the pharmacy window to hand in their dossiers and receive their medication.

    As I finished taking the vitals of the people lined up on the benches against two walls of the main room of the clinic, I went in and watched the pharmacists as they bagged and gave out the prescribed meds to each person lined up outside the pharmacy. Over the next couple of days and weeks as I watched these ladies faithfully do their job, I got the gist of what they were doing and how they did it. I learned to decipher the nurses’ handwriting's, how to count out 20 pills of hydrochlorothiazide and bag them, and what “swa” and one dot means on the pill bag. I love to see Zita, one of the pharmacists, laugh and twist up her face as we try out the new calcium chewables that are in stock. The more I work in the clinic, the more I love the comfortable corner of the pharmacy and the ladies that work there. So in between taking vitals and giving out medications, I am usually kept pretty busy.

   Since I am not a main nurse though, I won’t get to do a stitch job by myself or put an IV in someone. I still get to see all the emergency situations that come in, though, and the accidents that people have. The grossness of bad wounds is still gross but it doesn’t gross me out near as much anymore. Now I know that I can stand the sight of blood… I won’t go cold turkey on someone who needs a bandage job. My time here has made me realize that I do love medical things and maybe eventually will pursue the idea of more training.

    After nearly two months of being here, I am almost totally familiar with the normal run of things. This is feeling more and more like home. I love the people… the hug of faithful Maricome, our clinic cleaning lady, the warm handshake of Noez and his grin each morning, the friendly morning greeting of Fre. Dolph as we walk into the clinic each day and the smile of Miss Joselaine and Miss Leida when we tell them,“Mwen kontan we ou.” (I am happy to see you.) I love the mountains; the hot summer sun; the cool, crisp mornings with the sounds of roosters, donkeys, goats, and the occasional voice of a child breaking the stillness; the walk down to the clinic in the mornings with the sun shining full on your face; the cheerful greeting of the witch doctor as she walks past the compound; and the smiles and giggles of the little children that you meet on the trail every day.

   All in all, this experience has made me want to throw myself more into the medical world and use it for the glory of God. Being here in Haiti and working among and with these people have made me realize that life is so much more fulfilling and satisfying when you are pouring yourself out for others. Giving yourself for others lends hope and purpose to life. Being a servant, even only in very small ways, gives a peace and satisfaction that nothing else can give. Isn’t that what Christ did here on this earth? Why not live life like He did…and give your all?

 

Megan take vital signs.

Working in pharmacy counting and packaging pills with Madanm Lege and
Madanm. Jean Marc.

This Post Written By Megan Stoltzfus

Flying Hat

 
  The sun was shining beautifully this morning as I finished my big mug of coffee and headed to clinic to start on my usual row of bandage patients. I love the cheerful banter of morning greetings... the glow of the sun on the mountain after the rain... the beautiful smiles of the children along the trail.

 Halfway through the morning I noticed a commotion outside. A group of worried folk gathered around a young man who was slumped over a bench. A quick assessment showed a very swollen, bloody, face wrapped in a thick layer of gauze. I stooped to look into his face and ask a question and was met with a myriad of answers from the onlookers. " No, No, Li Bebe! ( He cannot talk.)"

 Indeed he could not. I found out quickly that he was deaf and 'dumb'. We helped him shuffle into the exam table and apon investigation found his left side covered in nasty brush burns...with a gash above his eye. They told us he was in a car in Ti Guave and tried to catch his hat when it flew off...and somehow ended up flying off WITH his hat.

 This poor man could not cry out in pain as we dumped peroxide over stinging wounds. He could not tell us about his discomfort or how we could help him. He only lay there, writhing in pain, as I cleaned the dirt out of all the abrasions. I tried to look into his swollen eyes, and saw that he was crying. I couldn't tell him I was sorry, or that the stinging peroxide would prevent infection. All I could do is wipe his tear stained face with cool water, and stick a lollie pop in his mouth. After I cleaned and bandaged him, I helped him to a bench where he slumped down on his 'un-wounded' side. Though it felt hopeless to even try to communicate, I pray that this man felt the love of Jesus through us today...maybe just through a gentle touch or a kind smile.

                                             Posted by: Miss Katie

Twins

This story started a long time ago already, but with all that's been happening at the clinic the last while, I guess we missed blogging about it.  I thought we had, but I can't find a post on it.  So if we did and I'm repeating, sorry!

Toward the end of March this small undernourished but very pregnant looking lady came to clinic.  She had been to the clinic a few times before but hadn't done well with prenatal check-ups, and now she was showing signs of pre-eclampsia.  At this point as near as we could tell she was around 7-8 months pregnant.  After trying to get her pre-eclampsia under control with no success, we decided to send her out to T-Goave.  We were also concerned because she was measuring larger than she should have been for 7-8 months and was suggesting premature labor.  All this combined made it pretty urgent to get her out to T-Goave.

As normal, days past, and we knew no more of her.  Then a week after we sent her out to our surprise Mama, and Babies show up!  Our sneaking suspicion of twins had been true, and she had safely delivered the babies in T-Goave.  Although premature, they had survived.  They were a boy, Deyei, 5 lbs 2 oz and a girl, Deunia, 4lbs 2oz.  By the time they came to the clinic at about 5 days old, they both had badly infected umbilical cords, and Mama still had high blood pressure with a lot of edema.  They spent 5 days at our clinic as we treated them and watched to see if things would start looking up or turn worse.  Upon arrival, they were all in critical condition.  I have to admit, it's a little scary to treat teeny, tiny babies who should be in the NICU in a small mountain clinic.  Mama wasn't responding well to the blood pressure treatments either.  Finally after maxing her out on the meds, she leveled out.

Here is Deunia when she first arrived

And here is Deyei

Carolle feeding both babies

The mother, Carolle, didn't have enough milk either so we put them partially on our Nourishing the Needy program.  After being hospitalized for 5 days, I sent them off with a bit of fear and trembling.  Would they take good care of preemies?  Would the mother keep up on her meds or be careless and still die from pre-eclampsia?

It was April 7th when I sent them home with an appointment to come back April 15th.  Just this past Sunday, April 21st, I told Rhoda that it was nearly a week past their appointment and I was concerned that the twins hadn't made it.  You can only imagine my excitement when on Mon, someone came to my room at the clinic and told me the twins had come!  Carolle, was looking much better, and the twins were doing well.  Deyei now weighs 6lbs 1.5oz, and Deunia 4lbs 8oz.  Carolle always says that Deyei is fussier.  I tell her that she needs to make sure Deunia gets enough too even if she doesn't complain as much.  :-)  It seemed like they were taking good care of them as we found them clean and in good health.

All of the nurses, Carolle, and the babies when they returned for their check-up this week.  

Do pray for them.  Taking care of such fragile babies in this land is no small task.  Carolle really appreciated the care she received here, but I don't know that she is a Christian.  I'm glad they could find good healthcare, but most of all pray that she would be willing to let the Great Physician direct her life.






There has been a lot of other things going on at the clinic that got missed in the busyness of the cholera surge so I could help but at least drop a picture on of one of the other babies born at the clinic lately.

                                                         Baby with her happy mama

Brother Batel

Greetings in Jesus most precious Name, the One that came and died for each person, and for Batel to, we have had a number of updates over the last year posted on this blog of Batel, and his abscess on his hip, and you probably noticed more posts then usual lately, well here is another one.

Batel came in 2 Friday's ago quite sick, he hadn't showed up for a few days because he couldn't walk, he lives back by the water falls, a few hours strong hike, anyway he came in on a horse, and the nurses put him on IV and strong antibiotics right away, they noticed his abscess, the was covered over and well filled, so Rhoda had to cut it open and a huge amount of puss comes flowing out, Brother Batel was in pain, but so lovingly bears it, at times 2 of the nurses had to hold him down because it is so painful, but even in the midst of pain he'll say something funny and laugh and cheer everybody up. 

But since he is to weak he's been here now over a week in the hospital room, and although his abscess looks better, we know that it is moving up into his hip to. We are not sure what it is, but we suspect bone cancer.

We are in the process of making the decision of putting him of intravenous so as not to prolong the inevitable,  Michael and the nurses don't think he has many more days to live, although he is spiritually very happy and rejoicing, his physical body is going down hill fast.

Rejoicing in His Savior!!!

Here is a testimony about Batel that has really touched us in a special way here at the mission. Michael came home one evening from Grafu, he decided to just stop in at the clinic at talk to Batel and pray for him, it was around 9:30 PM and he noticed Batel was asleep, so he shook him gently to wake him up, and Batel set up suddenly quite startled, and he said to Michael, "it's you, it's you," and he proceeded to share the dream Michael woke him up from, this is the dream.
I was someplace in a house, and I went out of the house and started walking, suddenly a cat came walking up to him, with fire coming out of it's eyes, and he said, I am the devil and I will kill you, Batel said, No you won't kill me, I will kill you, and he grabbed the cat by the neck and tried to kill it but couldn't, suddenly close by a man comes walking from behind a rock pile a little way of, and Batel tells him he can't kill that cat, the man comes up to him and touches the cat and the cat was suddenly dead, he threw it away beside the trail, and the man told Batel he needs to talk to Michael, but Batel said, "No, as long as your here, I'm fine," once more the man told him, he has to talk to Michael, and just then is when Michael gently woke him up, that is why he says, "it's you, it's you."
 It has been encouraging to see such a joyful man, and he freely talks about death, and that he is not scared at all, I walked to the clinic this morning, and took this picture and his big smile really touched me, he was so joyful, and then I spent time praying for him, his tears were rolling down his cheeks over his big smile, and before I left I gave him a hug, and he just kept saying thank you.
IT IS WORTH ALL CHEERING ONCE SOUL, IT IS WORTH TO SHOW JESUS TO ONE PERSON, IT IS WORTH IT ALL. LET US SERVE WHERE WE ARE AND GO WHERE HE ASKS US TO, DO NOT WAIT, IT COULD BE TO LATE FOR THAT SOUL.

Working in the CTC...

Greetings in Jesus' name to each one!

It's been a while since I contributed to the blog here, since leaving last October! Coming back for a bit has been such a good experience- seeing old friends, hearing familiar songs, living in the old quarters and being back in the Haitian culture... it's been very good!

Originally my cousin Ben and I were supposed to be here for a week, tagging along on a medical equipment delivery team headed up by Brian Eveleth from Wellman, IA. He was teaching afternoon classes at the clinic, so we were learning a few things about clinic work and just enjoying the short visit. But our nice, short, week-long visit suddenly became much more than just that...

One day at clinic we were beginning the afternoon classes, when a woman came through the clinic gate; her husband supporting her as she half walked, half staggered into the sitting area. She was severely dehydrated.

Anita got an IV going immediately and realized very quickly that we were dealing with cholera. A decision was made to utilize the depot building (affectionately referred to as the "CTC" during the cholera epidemics) again in order to contain the disease. The guys quickly cleared out the porch and we placed her there for treatment.

A couple days later Steve and I went to northern Haiti with Pastor Levi for a family visit, but while gone we got reports about few more cholera patients coming in. Unfortunately the mission was already under staffed, so starting another fully operational CTC would be difficult for everyone. So it was decided that Ben and I would stay longer and help out, if the need would arise. When we got back they had a tent set up in the depot courtyard and several people languishing on beds inside. The need had arisen: we were starting up a CTC again...

In the following week and a half, Ben helped out where needed in the day time, while I took the night shift. The clinic nurses worked hard, taking turns each day, rotating their time between the normal clinic and the CTC. It was definitely a stretching experience, but a very good and rewarding one. The time spent there was rewarding, not only because we were saving people's physical lives, but we were able to show them the light of Christ while they were there. I had to think about this as an opportunity to "wash people's feet"(as it were): changing bed pads, clothes and blankets when soiled, dumping buckets full of cholera waste, refilling people's ORS drinks and trying to make things as comfortable for them as possible while they were recovering. Several of us had opportunities to pray with the patients.

Now, today, the short epidemic is stayed and the CTC is empty; we haven't had anyone come in with cholera for several days, praise God! The government and various organizations have done a good job going into the infected area, treating water sources and educating people on the prevention of the disease. If they continue to have cases, they will put up their own CTC, thus freeing us up from ours here.

Many thanks to everyone who prayed for us during this time. As I said, it's been a good few weeks. The amazing thing to me was seeing everyone at the mission pitch in and give their all- above and beyond their normal service and pressing themselves to do more for the good of these dear people...

Continue to pray for the missionaries here, that they'd quickly recover from the exhaustion of running extra hours and dealing with the hardships of CTC maintenance during the last 2 weeks! God is good.

Thanks again for your support! Blessings to each one of you!

-Nathan Grice

As Steve and I traveled back from the north, we picked up CTC supplies at CAM.  

Thankfully they had many of the needed supplies on hand.

We loaded up Pastor Levi's truck and headed for the hills.

Beautiful morning sunrise...

Laundry drying on top of the depot.

We did wash each day, so this was a regular sight up there :)

The front of the CTC:

Waste buckets on the left, trash in the tall red bins, wash water in the large, black drum.

The tent is barely visible behind the building.

Some of our first patients, recovering on the now-enclosed porch.

This is the supply room-

All the IV fluids, ORS, bed pads, bleach, HTH and lots of gloves.

A nice place to take a snooze...

More patients inside the depot building.

We had about 3 people on average, per day.

We also had a few people come that didn't have cholera.

These people mostly had some sort of flu, so they were treated and sent home the same day, usually.

The other day we had one of the final people come in:

A little old man, practically deaf, 95 years old, complaining about stomach cramps.

We were able to treat him and send him home, though, because he ended up not having cholera.

We were thankful for that, and so was he :)