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?”

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 priority...but...it 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.

~Whit

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!
   
   
   
   

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

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

One Hundred Thirty-Four

-That's the number of maggots that Whit pulled out of an ulcer on a little old man this afternoon.

We all started noticing a  rather offensive odor creeping into the clinic this afternoon.  Lo and behold, "Whit's little man" had shown back up, smelling quite strongly of rotting flesh.  He had been coming to the clinic for dressing changes on an ulcer on his lower back that he had in January, and we always liked to tease Whit about her "special friend". :o) He had been fairly faithful in coming every other day, but we didn't think that it would be able to heal without the granulated tissue that had built up around it removed.  Steve came down to the clinic on the last day of January, explained this to him, and arranged a ride out to town for him the next day.  I guess he freaked out.  He never never came back.

Until today, that is.  While he waited for the exam table to be free, Miss J trailed in his wake, spraying air freshener in an attempt to cover the smell- which resulted in a much worse smell as the two scents combined.

When I finally finished the bandage job that I had been working on, and the room was free, Whit called him back to take her first look at his ulcer in close to two months.  We debated whether or not to actually post a picture, because it, quite frankly, is nasty.  So, please, if nasty pictures make you sick and you want to eat supper, don't look at this picture too closely.  Because if you do, you might see all the tiny little maggot heads (or tails- I really don't know which they are) that are hanging out in there.  It's a little disturbing.

Mis Whitney pulled out maggot after maggot with her tweezers....then did her best to clean it with peroxide, iodine, and sterile water.  There were so many little crevices around the edges that it was very difficult to find and remove all the maggots and then clean the crevices out.

And, finally, the bowl with the maggots in it....

We were thrilled when Pastor Levi, who was up at the church and was heading back out to town, agreed to take the dear little man along.  We were even more thrilled when the dear little man agreed to go, and then actually went.  I guess he realized that he really did need more help than we could give him here...so now we can only hope and pray that the doctors at the hospital can give him the help that he needs.  

Have a fantastic weekend, and God bless y'all!

-Kindra

And so Our Week Begins...

It's amazing how quickly Monday rolls around again.  I'm just glad that I have a job that I can actually look forward to going back to, rather than dread it.

We were introducing a new prenatal form today, and Kate suggested that we use the occasion to get a group photo of all the nurses at the clinic, so here we are, ready to start another week of playing doctor, pharmacist, and counselor. 

While I was out front in the waiting area cooing over a (completely adorable) baby, the man sitting next to her asked me to look at something.  When he moved the towel that he had wrapped around his shoulders, I could see the large abscess protruding from the side of his neck.  Consequently, as soon as his consultation was over, I found him lying on the table with Mis Katie and Mis Whitney preparing to open and drain the abscess.  The few times I popped in the room, the stench was astounding, and enough to make me almost happy that I was too busy to stay and watch. :o)

 Rho and I were in a bit of a flurry over the same time with a young boy in the hospital room who's oxygen levels had dipped down close to the sixties.  We put him on oxygen for a bit, but that didn't seem to bringing his levels up as quickly as we would have liked, and neither did the inhaler that we tried.  Our nebulizer was back at the mission house, so I ran down to meet Steve's dad at the gate to get it to try giving him a treatment with it.  Twenty minutes later, his oxygen levels- while still not good- were staying in the low nineties to eighties without an oxygen mask.  We weren't certain of his diagnosis, though Rho suspected typhoid, but the decision was made that he would be able to get better treatment at a larger facility, so he was sent out this afternoon.

Rhoda was on call this afternoon when a young man that had had an incident involving a machete and his left pinkie came in.  She called back to the house to see if I would like to come try my hand at stitching for the first time.  I replied that I would very much like, and headed back down to the clinic.  I got a glimpse into what kind of teacher Rhoda must have been, as she coached me through the sutures, and I was duly impressed.  I also discovered that I thoroughly enjoy sewing people's fingers back up. :o)

Thank you all for your prayers and support...we would not be able to do what we do without them.  God bless you all, and have a fantastic week. 

-Kindra