"Service is the rent we pay for the privilege of living on this earth." Shirley Chisholm
I e-mailed Yanick at the clinic the week after we returned to see if the aunt had brought Loudna back and if they decided to let her go to the orphanage. The response I got was as follows:
Yes, she did come back, she is now with Bobby at the orphenage. She was happy to go, and her family, specially her aunt and her so call uncle, grand father, they are all agreed that she needs the change. She is happy, her aunt told me, God please let them come for me, I want to go.. Her prayer has been answer. God take cares of his children.
God bless you. Stay in touch.
I received an e-mail from Greg Roberts, our host in Haiti that read:
As for Loudna,we saw her yesterday and she is happy to be at the orphanage. Michelle and I spent time with her while we were there. As promised, I sent my first month's food check for $100 with a promise to send monthly for the next five years.
"In this life we cannot do great things. We can only do small things with great love."
Mother Teresa
I may not be able to change the whole world, but hopefully I changed the world for one little girl in Haiti.
Saturday, May 8, 2010
Heading Home
Our trip originally was to be from Friday, April 16 to Friday, April 23. However, Regions Bank changed their flight schedules and we were the transition team. We would be heading home a day earlier than anticipated. It was a blessing to me to have the opportunity to come and serve the people of Haiti, but I am ready to get back to the comforts of my home and the security of my family, friends, and community.
We got up at 5:45 am. The sun was well up in the sky, a few roosters were crowing, cows were mooing, birds were chirping, and doves cooing. Ezekiel, the hired man, was outside washing the trucks for our trip to the airport. For a country with such water issues, there is a tremendous amout of car washing that goes on here. There isn't a shortage of water, but there is a shortage of potable water. Either people buy water in little bags, jugs of water like for a water cooler or go to a community pump station and carry it to their homes in gallon or five gallon buckets. The pump station water is "clean", but still may not be safe from bacteria. Others are seen dipping water from streams of free flowing water that runs down the hillside - over trash piles and land where animals scavenge for food and also leave behind their waste products.
Driving through the streets to the airport was saddening. No one on our team spoke Creole, so navigating through the airport was somewhat of a challenge. Once through all the security we were told to stand at a window and wait. What a disparity between our luxury corprate jet with all it's amenities and what we have seen this past week. From an out house with no seat to a toilet with a leather seat. All men may be created equeal, but not all men have the opportunity to live equal.
We got up at 5:45 am. The sun was well up in the sky, a few roosters were crowing, cows were mooing, birds were chirping, and doves cooing. Ezekiel, the hired man, was outside washing the trucks for our trip to the airport. For a country with such water issues, there is a tremendous amout of car washing that goes on here. There isn't a shortage of water, but there is a shortage of potable water. Either people buy water in little bags, jugs of water like for a water cooler or go to a community pump station and carry it to their homes in gallon or five gallon buckets. The pump station water is "clean", but still may not be safe from bacteria. Others are seen dipping water from streams of free flowing water that runs down the hillside - over trash piles and land where animals scavenge for food and also leave behind their waste products.
Driving through the streets to the airport was saddening. No one on our team spoke Creole, so navigating through the airport was somewhat of a challenge. Once through all the security we were told to stand at a window and wait. What a disparity between our luxury corprate jet with all it's amenities and what we have seen this past week. From an out house with no seat to a toilet with a leather seat. All men may be created equeal, but not all men have the opportunity to live equal.
Loudna
I slept well when I slept last night, but I woke up several times. I walked out on our balcony about 3:30 am. It was quiet and cool. I kept thinking about Loudna Lambert, the little girl who was molested. I'm considering making the aunt an offer that if she will let Loudna go to the orphanage and be adopted, I will buy food for her family for the next five years. I keep thinking of the movie, "Sophie's Choice", I hated that movie. Sophie was a Jew. She and her two children had been taken in by a German officer. In the end the German officer told Sophie she had to choose which of her children would live and which would die. I can't decide if my offer would be like that to the aunt. Will she have to choose food for her family at the sacrifice of Loudna? Really, is she sacrificing Loudna, or offering her a better future? I questioned my team members as to whether this was an immoral offer. I was reassured it was not. I asked the host missionary if it was wrong for me to ask the aunt to choose, and he said, "no". When we got to the clinic, I again asked Yanick, the clinic director and she said she thought the aunt would agree to it. I asked about how much she thought it would cost to feed a family of six a month and she told me about $100 a month should do it.
The aunt and her four year old daughter came to the clinic before Loudna arrived from school for her medication. Yanick, Earla, and I took the aunt into an exam room to talk privately with her. I was surprised at the aunt's responseafter we made her the offer. She said this was an answer to her prayers. She said she would be 100 percent for Loudna going, but she had to talk to her husband first and to Loudna's father and grandfather. She said the grandfather was fond of Loudna and had wanted to "keep her for himself". Loudna had told her grandfather, "You are old, if you die who will take care of me? I want to go live with my aunt". The aunt told us she would have an answer by Friday. Our team members had collected food items they had brought for their lunches and we made a food care package for the aunt to take home. We had collected $85, but decided to wait until she came with her answer to give her the money.
Loudna arrived at the clinic after school with her 9 year old cousin (a daughter to the aunt). We gave her an injection and medication to take by mouth. One of the medications we gave her was for diarrhea, because all of the other medicines will probably make her have diarrhea. During her injection she flinched, but never whimpered. She and her cousin both said "I'm hungry". After Earla and I fed the girls from our backpacks the 9 year old cousin kissed Earla and I both on the mouth. I tried to turn so she would kiss my cheek, but she moved in front of me to plant the kiss square on my lips.
We saw about 15 - 20 patients Friday when we first arrived before the clinic was officially open, about 250 - 300 patients Sunday in the mobile clinic at the church, 102 patients on Monday, 97 on Tuesday and 70 today.
One young boy I saw today was about 14 years old and appeared to have hepatitis. I had Doc Eric come see him to confirm my diagnosis. His abdomen was tender and his eyes were very yellow from the jaundice and his liver was enlarged twice the size of normal. His urine looked like molasses it was so dark. The only normal indicator on his urine dip stick was his glucose. We wrote out a request for laboratory tests to be done. He was to take the request to a local independent lab then return Friday with the results to see a member of the team that would be replacing us.
A young mother came in with her 7 month old. She had conceived this child while she was breastfeeding her first baby (now 2 years old). Her complaint today was she was 17 days late for her menstrual period and wanted a pregnancy test. She did not want to be pregnant, but her test was positive. Such a look of sadness came over her. She said "This is not good." She had her other two babies by cesarean section and knew she would have to have another with this baby. I told her to be sure to tell the doctor she wanted to have her tubes tied with this surgery if she didn't want any more babies. I tried to encourage her by telling her "babies are a gift from God. Maybe she was carrying the next President of Haiti"! She smiled briefly.
The people of Haiti seem so gentle and appreciative. Most are very atractive and have beautiful smiles and teeth - despite a diet low in dairy products and calcium. The scarcity of sweets could contribute to their lack of cavities and the fact that they all breastfeed their babies could contribute to good teeth alignment.
It seems obvious to me that the government is not helping it's people. The way to make a change is not from the top down, but from the bottom up, one person, one community at a time and allowing it to spread.
Woman after woman told me today she dipped water out of the sewers because the pumps were too far to carry water. A few people have wheel barrows which halps them transport more water at a time. Every day begins as the day before, searching for food and water. Until their daily basic needs of clean water, food, and shelter are met, no one can move forward to plan for tomorrow.
The aunt and her four year old daughter came to the clinic before Loudna arrived from school for her medication. Yanick, Earla, and I took the aunt into an exam room to talk privately with her. I was surprised at the aunt's responseafter we made her the offer. She said this was an answer to her prayers. She said she would be 100 percent for Loudna going, but she had to talk to her husband first and to Loudna's father and grandfather. She said the grandfather was fond of Loudna and had wanted to "keep her for himself". Loudna had told her grandfather, "You are old, if you die who will take care of me? I want to go live with my aunt". The aunt told us she would have an answer by Friday. Our team members had collected food items they had brought for their lunches and we made a food care package for the aunt to take home. We had collected $85, but decided to wait until she came with her answer to give her the money.
Loudna arrived at the clinic after school with her 9 year old cousin (a daughter to the aunt). We gave her an injection and medication to take by mouth. One of the medications we gave her was for diarrhea, because all of the other medicines will probably make her have diarrhea. During her injection she flinched, but never whimpered. She and her cousin both said "I'm hungry". After Earla and I fed the girls from our backpacks the 9 year old cousin kissed Earla and I both on the mouth. I tried to turn so she would kiss my cheek, but she moved in front of me to plant the kiss square on my lips.
We saw about 15 - 20 patients Friday when we first arrived before the clinic was officially open, about 250 - 300 patients Sunday in the mobile clinic at the church, 102 patients on Monday, 97 on Tuesday and 70 today.
One young boy I saw today was about 14 years old and appeared to have hepatitis. I had Doc Eric come see him to confirm my diagnosis. His abdomen was tender and his eyes were very yellow from the jaundice and his liver was enlarged twice the size of normal. His urine looked like molasses it was so dark. The only normal indicator on his urine dip stick was his glucose. We wrote out a request for laboratory tests to be done. He was to take the request to a local independent lab then return Friday with the results to see a member of the team that would be replacing us.
A young mother came in with her 7 month old. She had conceived this child while she was breastfeeding her first baby (now 2 years old). Her complaint today was she was 17 days late for her menstrual period and wanted a pregnancy test. She did not want to be pregnant, but her test was positive. Such a look of sadness came over her. She said "This is not good." She had her other two babies by cesarean section and knew she would have to have another with this baby. I told her to be sure to tell the doctor she wanted to have her tubes tied with this surgery if she didn't want any more babies. I tried to encourage her by telling her "babies are a gift from God. Maybe she was carrying the next President of Haiti"! She smiled briefly.
The people of Haiti seem so gentle and appreciative. Most are very atractive and have beautiful smiles and teeth - despite a diet low in dairy products and calcium. The scarcity of sweets could contribute to their lack of cavities and the fact that they all breastfeed their babies could contribute to good teeth alignment.
It seems obvious to me that the government is not helping it's people. The way to make a change is not from the top down, but from the bottom up, one person, one community at a time and allowing it to spread.
Woman after woman told me today she dipped water out of the sewers because the pumps were too far to carry water. A few people have wheel barrows which halps them transport more water at a time. Every day begins as the day before, searching for food and water. Until their daily basic needs of clean water, food, and shelter are met, no one can move forward to plan for tomorrow.
Friday, May 7, 2010
There is No Domestic Violence in Haiti
Usually children were brought to the clinic by their mother. I had one girl brought in by her father because her mother had died in the quake. So, when I had a twelve year old girl come in alone who was complaining of a discharge of her "virgin" (that is what they all called their vagina) i was suspicious. I learned her mother had died during the time of the quake. Her father had given her to an aunt to raise along with the aunt's four other children. After questioning and reviewing her her chart I discovered she had been raped by her twenty-four year old cousin and his friend. The little girl, named Loudna, at twelve years old weighed only sixty pounds and was about five feet tall. She had learned the English pharas, "I am hungry" very well. She repeated this phrase over and over. While Earla kept Loudna in the exam room and fed her snacks we had brought for our lunches I went to talk to Yanick, the clinic director. She told me "There is no such thing as domestic violence in Haiti". By that she meant there is no law against it, so it is not considered a crime. Girls in Haiti can be raped by their grandfather, father, brother, neighbor, etc. and nothing will be done about it.
Yanick told me she knows this family and the little girl IS hungry. She told me the family may eat every other day, and even then it is only rice. I returned to Loudna and Earla to find Earla still feeding her.
I have been to Guatemala to an orphanage where all the girls there have been sexually abused and I remembered something one of the girls there said one time. I asked Loudna if she knew what being a virgin is and she said "yes". I proceded to tell her what the young girl in Guatemala had said. I told her she is still a virgin until she chooses to give her virginity away. What happened to her was a crime, ot her fault, and those men could not take her virginity. I told her she is just a little girl and there is no way she could have stopped the men, this was not her fault. She seemed to comprehend what I was telling her. Loudna asked if she could come home with me. Apparently, she askes every team that comes through the clinic that question.
We did not have the medications we needed to treat all of the sexually transmitted diseases she may have been exposed to so we arranged that she would return the following day and we would have medications for her and food. After our dinner the team collected a love offering to give to her for food the next day. Twenty dollars will feed this family for a week and we collected $85.
This evening I noticed the two jars of peanut butter I had placed by the trash pile yesterday were gone. I can only assume the boy who was there watching us returned and got the peanut butter. I am so blessed to not have to scavange through trash piles and hope someone hasn't scraped or washed the peanut butter jar clean. We are truly a land of plenty and don't even realize how the rest of the world lives day by day.
Yanick told me she knows this family and the little girl IS hungry. She told me the family may eat every other day, and even then it is only rice. I returned to Loudna and Earla to find Earla still feeding her.
I have been to Guatemala to an orphanage where all the girls there have been sexually abused and I remembered something one of the girls there said one time. I asked Loudna if she knew what being a virgin is and she said "yes". I proceded to tell her what the young girl in Guatemala had said. I told her she is still a virgin until she chooses to give her virginity away. What happened to her was a crime, ot her fault, and those men could not take her virginity. I told her she is just a little girl and there is no way she could have stopped the men, this was not her fault. She seemed to comprehend what I was telling her. Loudna asked if she could come home with me. Apparently, she askes every team that comes through the clinic that question.
We did not have the medications we needed to treat all of the sexually transmitted diseases she may have been exposed to so we arranged that she would return the following day and we would have medications for her and food. After our dinner the team collected a love offering to give to her for food the next day. Twenty dollars will feed this family for a week and we collected $85.
This evening I noticed the two jars of peanut butter I had placed by the trash pile yesterday were gone. I can only assume the boy who was there watching us returned and got the peanut butter. I am so blessed to not have to scavange through trash piles and hope someone hasn't scraped or washed the peanut butter jar clean. We are truly a land of plenty and don't even realize how the rest of the world lives day by day.
Oh What a Day!
Our First Scheduled Clinic Day
Monday, April 19, 2010 evolved into the most eventful day of our trip. There were two almost empty jars of peanut butter on the table at breakfast, so after eating I donated my new full jar, took the two almost empty jars (one had a plastic spoon in it) across the road, and placed it near the trash pile. Earlier we had noticed a young boy hanging near there who took a trash sack when he thought we weren't looking. I hope he comes back and finds the peanut butter.
My second patient of the morning was a 42 year old woman named Michele. She came in stating she was about 4 weeks away from delivery of her baby, but hadn't felt her baby move since yesterday. According to the size of her uterus, she measured about 30 weeks gestation, not 36. I was afraid she may have not noticed exactly when her baby stopped moving. I was unable to hear fetal heart tones with the doppler we had brought with us. When I did a pelvic exam, I noted she was 4 - 5 centimeters dilated and there was something protruding from her cervix into her vagina. I was not able to identify exactly what these fetal parts were, but felt it was an abnormal presentation.
I went to Garlene, who is a registered nurse from Haiti, living and working in Boston, MA who happened to be here for a family member's funeral. I told Garlene we needed to get Michele to a hospital. Garlene told me "You are the hospital". Garlene told me we should deliver her here because she would not get good care at the hospital and that the patient could not afford to go to the hospital.
After much thought, I told her IF the malpresentation was legs or feet, I could probably deliver the baby. However, if the presenting part was an arm, she would probably need a cesarean section. I reminded her that another concern I had was that the baby may have been dead longer than the mother thought since her abdomen was measuring smaller than should be expected. If her baby had been dead for a long time, this increased Michele's risk for a serious bleeding condition after she delivered. Michele" blood pressure was 152/84 which made her borderline hypertensive and at risk for more complications related to the elevated blood pressure and again raised her risk for postpartum hemorrhage. Garlene agreed, maybe we should take her to the hospital.
In the meantime, while I was caring for Michele, a young man in his twenties came in to the clinic with a blood pressure of 50/20. He had a fever, abdominal pain and appeared to be in extremely ill - maybe from a ruptured appendix. Doc Eric started an IV and could not get him stabilized. After about seven bags of IV fluids, he was loaded into the back of the clinic's pickup truck and off they went to a hospital.
Since our only means of transportation was now gone, Garlene told me we should TRY to deliver Michele's baby at the clinic. I reminded Garlene I was afraid of a postpartum hemorrhage. We did not have any medications available that I could use to stop a hemorrhage. Garlene told me to come with her and we walked about one quarter of a mile to a nearby hospital. She went to the pharmacy window, explained our situation, and they gave her two vials of Pitocin which could be used to stop bleeding after delivery. We then walked back to Michele at the clinic.
I instructed Michele in how to do nipple stimulation in an effort to stimulate uterine contractions to bring on active labor. No amount of stimulation resulted in contractions. Garlene wanted me to use the Pitocin to induce Michele's labor. I was reluctant to use the Pitocin to induce labor because I continued to worry about postpartum hemorrhage. If I used the Pitocin to bring on labor, I would not have any to use after delivery if she hemorrhaged; and I feared Michele would die if this happened. Garlene then went in search of more Pitocin.
As Michele rested on her stretcher with her IV infusing, Earla and I continued to see patients together as a team. We saw one child with a temperature of 103 degrees who had an ear infection. One girl came in requesting a pregnancy test, hoping it to be positive. The test was negative and she was disappointed. Several children and adults with what I coined the "Haiti Syndrome" of headache, cough, dry eyes, poor appetite, insomnia, and nervousness were seen and treated. Many of the patients we were seeing needed to just know someone cared about them personally and would listened to them tell what was happening to them and in their lives right now.
Garlene returned with 12 vials of Pitocin in hand. I could not come up any more excuses that would please her as to why I should not deliver this baby from this woman. I began relying on my memory of protocols I follow in Alabama in a hospital setting for circumstances such as this. In addition to high dose Pitocin infusions, we gave her IV Cefazoline to decrease the risk of infection that could be associated with her carrying a dead baby for an extended period of time. After nine of the fourteen ampules of Pitocin we had and 3 bags of IV fluids, I told Garlene I was not comfortable doing more. I felt she may have a serious malpresentation and be at increased risk for bleeding and dying and needed to be in a hospital setting. So began our quest for a hospital.
"Can't Waste It on a Dead Baby"
Since our only truck had left to take the young man with the possible ruptured appendix to a hospital, we were forced to rely on the tap tap system. This is either a truck or van that is the Haitian equivalent to our taxi system. You tap on the vehicle driving by to get it to stop, then you tap once you are on it and want to get off. Hence, the name, tap tap. Garlene had tried to stop a tap tap, but they didn't want to assist us. I told her to let me try. I walked into the middle of the narrow dirt road and the next van had no choice but to stop for me. I'm sure this white woman with spikey hair was quite a sight to him. Garlene then came out and explained to the tap tap driver our delimma and asked that he "do his part". He agreed to drive us, but she had to pay him $20 to cover the lost tap tap fares he would miss out on.
The driver, his wife, Garlene, the patient with her IV in tow, her friend, and I all loaded into an old van of which the sliding side door didn't close. We were headed to the UN Hospital run by the Brazilian army. Once we arrived we had to convince the guards to let us through. They made the patient's friend get out and wait at the gate until we returned for her. We were met by soildiers in uniforms outside a tent that reminded me of one I used to see on the old TV show M*A*S*H. The female soldier said she spoke a little English. We explained our situation and her replay was, "We only do 12 surgeries a week. We can't waist one on a dead baby. You must take her to the American hospital since this is an American clinic and you are an American", pointing towards me. No amount of talking, pleading, etc. would convince her otherwise. She finally walked away from us, back into the M*A*S*H tent and closed the door shutting us out.
The tap tap driver had a vague idea of where the American hospital was located. This is actually a hospital run by the University of Miami. The driver located a break in a concrete block wall and turned our van into the narrow opening that had barbed wire on each side of the opening. We were met by another gate and guards in uniforms. They wouldn't even approach our van. A man in civilian clothes, who we must have passed as we drive in, walked up to our van, stuck his head in my side window, and said, "What ya got?" When I explained the situation, he said, "We don't have any beds or fuel; you'll have to take her to Doctor's Without Borders hospital. They are doing all the maternity patient's in Port-au-Prince." Garlene began to argue and plead with him. He began saying something like, "I've risked my life more than anybody in this truck ever has or ever will, I don't want to hear how hard this is." I told her she was wasting precious time and we should just go.
Garlene called Greg Roberts, our American host in Haiti. Greg was at a gas station near us. We had the tap tap driver take us to the gas station where we paid him another $20 and got in the truck with Greg. It was here that we got the phone call that the young man with the ruptured appendix had died in the back of the pickup sitting in a hospital parking lot while Al, one of our team members, performed CPR on him to no avail. It was a very sobering moment for all of us.
Between the American hospital and the Doctor's Without Border's hospital we passed another hospital, called Merz. We stopped and Garlene ran in. She quickly returned and said we could leave Michele to sit in the lobby all night, but there were not any doctors there again until morning. We headed towards our fourth hospital with Michele.
Overwhelmed
This hospital was referred to by the locals as the Doctor's Without Border's hospital, because it is here that organization sets up their major operation. However, we learned at this time of night, in the hospital that delivers all of the babies born in Port-au-Prince, the Doctor's Without Border's doctors had left and it was staffed by three Haitian doctors, one midwife, two aides and a janitor. The hospital sits at the edge of Sol City, the largest slum in the world. There are about 250,000 people living in this tent city slum and about 250 of them were here on this night having a baby!
I was overwhelmed as we entered the hospital. If I were blind, I would have thought we were entering an insane asylum or a torture chamber. There were gutteral moans and groans, cries and pleas for help in French. Even though I couldn't understand the specific words spoken, it was obvious what was being requested by the body language and facial expressions of the nearly 250 women here, all in some stage of birthing their babies. Michele hesitated and did not want to enter. As I patted her arm and tried to reassure her everything would be alright, I'm not sure if I was trying to convince her or me.
We were directed through a pair of wrought iron gates. I saw a row of plastic chairs and about ten very obviously pregnant women in all stages of labor. This was their admitting area.
We then were taken into a small room where a young doctor sat on a stool at the foot of 2 exam tables watching two women in labor. Both were nude from the waist down. Michele entered and said she needed to pee. There was a five gallon bucket sitting near one of the tables that had a woman on it. Michele was directed to use the bucket. Michele proceded to walk over the bucket, lift her dress, and void. No privacy, no dignity here.
Garlene and I then were taken down a hall where there wre five cubbies with women on beds and about three more women on the floor in the hall. One woman in the floor was sitting in a pool of blood. She was quiet, but looked defeated. I asked if she was laboring or if she had delivered. I was told she had already delivered. Not wanting to overstep my bounds, I reached down and massaged her uterus in an attempt to stop her bleeding. She looked into my eyes and said, "Merci". I wanted to cry, but I had sweat out any tears I may have shed. It was so hot in this hospital my clothes were drenched with sweat. Most of these poor laboring women had stripped off their clothes due to the heat and their bodies glistened with perspiration.
Turning the corner heading into another hall we saw six more cubbies and women in the final phases of the birthing process. One woman was being assisted by a midwife. A second woman was beginning to crown her infant and no one was near. I grabbed a pair of gloves and craddled this baby up as it was birthed by it's mother, preventing it from dropping about 36 inches to the floor below. A woman I assumed to be an aide then came and double tied the cord with umbilical tape and gave me a sterile knife blade to cut the cord. Garlene then brought a sheet of paper and we dried the baby and handed it to the mother. The placenta was then expelled and the janitor came and took it and mopped the floor around the new mother's bed.
The babies were taken, swaddled and laid on a counter under heat lamps that were mounted from the ceiling. I'm only assuming they had a system to identify which baby belonged to which mother, but my guess is many mother's went home with another woman's baby accidently.
Garlene then summoned me to come and see. We went to the end birthing bed where a yound scared girl lay. I could see a tiny hand protruding out her vagina. I examined her and she was dilated about 5 centimeters. The baby was premature and transverse with a arm/shoulder presentation. I managed to reinsert the arm into the mother, but couldn't turn the baby into a better position. The young doctor appeared and smiled noting I had delivered the one young mother. He told me I could deliver this one also. I told him I couldn't since it was transverse.
The young girl in the same cubbie as the mother with the transverse lie baby began to crown her infant. Again, I grabbed a pair of gloves and repeated the delivery process. The young mother I delivered said, "Merci". The mother with the premie looked at me with hollow eyes that said, "Surely, I must be in hell."
I went to wash my hands in water I'm sure wasn't clean, dried them on my pant legs that were drenched with sweat, and returned to find the premie lying on the delivery table between the young mother's feet. The baby was dead. One of the staff had gone to tell her husband.
These poor women were alone, no family was allowed to be with them. They were hot, sweating, no pain medications, no privacey, no kind words, looks, or touch. My heart was breaking for them. I didn't even have the ability to say "I'm sorry" since I don't speak French Creole.
Garlene decided it was time for us to leave. As we were walking back out the way we came a girl was in the floor, her water broke. I checked her and she was completely dilated. We assisted her onto a nearby empty bed, but were told they didn't want her to birth there so they made her get uyp ad walk around the corner to another bed. I was prepared to deliver her until the Haitian midwife said "excuse me", and took over. I felt she was trying to make a point that her way was best. She did not like that I encouraged the patietn to push. She never spoke to her patients. I had prepared my supplies to do this delivery, and the bulb syringe I had collected was missing. When I asked for another she said, "No". I stepped aside to allow her to assist the mother with her birth. The midwife used a big wad of cotton to wipe the baby's face after it was born, but did not suction out any mucous or stimulate it to cry. The baby was getting bluer and bluer, so I rubbed it's back to stimutlate it to cry and clear out the mucous. The midwife shot me a displesed look, but the young mother said, "Merci", which was all I needed.
The doctor then took us on a brief tour of he hospital. He took us to the two operating rooms. One was still bloody from a previous surgery. Their ability to clean and get the room ready for the next case was very limited by supplies and clean water. He told us that it is difficult to get surgeries when needed. Even if they have surgeons, there is a shortage of anesthesia personnel. He commented that the only way they can get anesthesia people to come is to pay them, and they have no money.
He then led us into the postpartum unit. This was one large room with about 25 trundle type beds along each side of the room. Most beds had a mother and newborn at her side. There were a few beds with a woman lying in it and a man sitting on the floor next to her. I could only assume the men were allowed to come sit with their wives if their baby had died.
The doctor asked if I didn't just want to stay and work all night. I told him I couldn't, but I would come back the next day to work if he really wanted me to. He said he ended his shift the next day at 2 pm. I asked when his shift had started and he said he worked from 8 am one day until 2 pm the next day - a 30 hour shift! When I asked him how many babies he thought he delivered in a night, he said, "Maybe 25"? I laughed and told him I had delivered 2 in less than 30 minutes. I felt sure he did more than that. Garlene got the phone number of the young doctor we had talked to most of the evening so we could check the following morning on the status of Michele. We picked up and ate Dominoes Pizza on our drive back to the mission compound. I never knew pizza and diet Coke could taste so good!
The Truth About Michele
Garlene got the telephone number of the Doctor we befriended at the Doctor's Without Border's Hospital so we could call and check on Michele. The truth about Michele was she was not pregnant. Even though she came to us claiming to be pregnant, had not had a period in eight months, had felt her baby move until the day she came to see us; she was not pregnant. The verbal ultrasound report we got only stated she did not have a pregnancy. Now, trying to piece all the information together I have come to the conclusion that she either has a uterus full of fibroids or may have cancer. Either the fibroids or cancer is growing and protruding through her cervix into her vagina and causing her pain which she had mistaken for labor. The tumor must have been flopping around which she mistakenly thought was fetal movement. As the tumor enlarged, it no longer moved about and she thought the fetal movement had stopped. Her uterus was enlaraged to approximately a thirty week pregnancy leading me to believe the "fetal" growth had stopped some time ago. Once Michele was told she was not pregnant, she walked away from the hospital without receiving treatment for her tumor. Hopefully, it will not begin to bleed and become a life threatening condition for her, or be cancerous which could be the death of her.
I have a devotional book called "Jesus Calling" by Sarah Young that speaks to me daily. On this particular day I shared the information with my team. We have talked about how difficult life is in Haiti, especially for the women who must scavange daily for food and water. Today's devotion made me think about the Israelites who wandered around for forty years and had to depend on Jesus for their manna.
Early this morning in the clinic Yancik, the clinic director, came to me and said she had two girls in labor. Even though I deal with girls in labor on a regular basis in the States, it was a very different situation here in Haiti. Especially after the incident with Michele the day before, I was afraid we would be spending our entire day again traveling from hospital to hospital. One girl was forty-two weeks gestation by her history and had been hurting all night. The other girl stated she was not hurting. I examined both girls and determined they were both about 1 centimeter dilated. I told the girl who was forty-two weeks gestatin to go to the hospital. Going two weeks past the due date puts her at high risk for losing her baby if her placenta decides to quite working and giving the baby the food and oxygen it needs. I hated to send her or anyone to the hospital after my previous evening there, but felt I had no choice. Even in it's poor state, the hospital was better then nothing in an emergency. The other girl was not in labor and not due for another couple of weeks. I told her to go home and to come back to the clinic in one week to see the provider who would be here. I told her the signs and symptoms of labor and advised her to go to the hospital should labor begin.
Monday, April 19, 2010 evolved into the most eventful day of our trip. There were two almost empty jars of peanut butter on the table at breakfast, so after eating I donated my new full jar, took the two almost empty jars (one had a plastic spoon in it) across the road, and placed it near the trash pile. Earlier we had noticed a young boy hanging near there who took a trash sack when he thought we weren't looking. I hope he comes back and finds the peanut butter.
My second patient of the morning was a 42 year old woman named Michele. She came in stating she was about 4 weeks away from delivery of her baby, but hadn't felt her baby move since yesterday. According to the size of her uterus, she measured about 30 weeks gestation, not 36. I was afraid she may have not noticed exactly when her baby stopped moving. I was unable to hear fetal heart tones with the doppler we had brought with us. When I did a pelvic exam, I noted she was 4 - 5 centimeters dilated and there was something protruding from her cervix into her vagina. I was not able to identify exactly what these fetal parts were, but felt it was an abnormal presentation.
I went to Garlene, who is a registered nurse from Haiti, living and working in Boston, MA who happened to be here for a family member's funeral. I told Garlene we needed to get Michele to a hospital. Garlene told me "You are the hospital". Garlene told me we should deliver her here because she would not get good care at the hospital and that the patient could not afford to go to the hospital.
After much thought, I told her IF the malpresentation was legs or feet, I could probably deliver the baby. However, if the presenting part was an arm, she would probably need a cesarean section. I reminded her that another concern I had was that the baby may have been dead longer than the mother thought since her abdomen was measuring smaller than should be expected. If her baby had been dead for a long time, this increased Michele's risk for a serious bleeding condition after she delivered. Michele" blood pressure was 152/84 which made her borderline hypertensive and at risk for more complications related to the elevated blood pressure and again raised her risk for postpartum hemorrhage. Garlene agreed, maybe we should take her to the hospital.
In the meantime, while I was caring for Michele, a young man in his twenties came in to the clinic with a blood pressure of 50/20. He had a fever, abdominal pain and appeared to be in extremely ill - maybe from a ruptured appendix. Doc Eric started an IV and could not get him stabilized. After about seven bags of IV fluids, he was loaded into the back of the clinic's pickup truck and off they went to a hospital.
Since our only means of transportation was now gone, Garlene told me we should TRY to deliver Michele's baby at the clinic. I reminded Garlene I was afraid of a postpartum hemorrhage. We did not have any medications available that I could use to stop a hemorrhage. Garlene told me to come with her and we walked about one quarter of a mile to a nearby hospital. She went to the pharmacy window, explained our situation, and they gave her two vials of Pitocin which could be used to stop bleeding after delivery. We then walked back to Michele at the clinic.
I instructed Michele in how to do nipple stimulation in an effort to stimulate uterine contractions to bring on active labor. No amount of stimulation resulted in contractions. Garlene wanted me to use the Pitocin to induce Michele's labor. I was reluctant to use the Pitocin to induce labor because I continued to worry about postpartum hemorrhage. If I used the Pitocin to bring on labor, I would not have any to use after delivery if she hemorrhaged; and I feared Michele would die if this happened. Garlene then went in search of more Pitocin.
As Michele rested on her stretcher with her IV infusing, Earla and I continued to see patients together as a team. We saw one child with a temperature of 103 degrees who had an ear infection. One girl came in requesting a pregnancy test, hoping it to be positive. The test was negative and she was disappointed. Several children and adults with what I coined the "Haiti Syndrome" of headache, cough, dry eyes, poor appetite, insomnia, and nervousness were seen and treated. Many of the patients we were seeing needed to just know someone cared about them personally and would listened to them tell what was happening to them and in their lives right now.
Garlene returned with 12 vials of Pitocin in hand. I could not come up any more excuses that would please her as to why I should not deliver this baby from this woman. I began relying on my memory of protocols I follow in Alabama in a hospital setting for circumstances such as this. In addition to high dose Pitocin infusions, we gave her IV Cefazoline to decrease the risk of infection that could be associated with her carrying a dead baby for an extended period of time. After nine of the fourteen ampules of Pitocin we had and 3 bags of IV fluids, I told Garlene I was not comfortable doing more. I felt she may have a serious malpresentation and be at increased risk for bleeding and dying and needed to be in a hospital setting. So began our quest for a hospital.
"Can't Waste It on a Dead Baby"
Since our only truck had left to take the young man with the possible ruptured appendix to a hospital, we were forced to rely on the tap tap system. This is either a truck or van that is the Haitian equivalent to our taxi system. You tap on the vehicle driving by to get it to stop, then you tap once you are on it and want to get off. Hence, the name, tap tap. Garlene had tried to stop a tap tap, but they didn't want to assist us. I told her to let me try. I walked into the middle of the narrow dirt road and the next van had no choice but to stop for me. I'm sure this white woman with spikey hair was quite a sight to him. Garlene then came out and explained to the tap tap driver our delimma and asked that he "do his part". He agreed to drive us, but she had to pay him $20 to cover the lost tap tap fares he would miss out on.
The driver, his wife, Garlene, the patient with her IV in tow, her friend, and I all loaded into an old van of which the sliding side door didn't close. We were headed to the UN Hospital run by the Brazilian army. Once we arrived we had to convince the guards to let us through. They made the patient's friend get out and wait at the gate until we returned for her. We were met by soildiers in uniforms outside a tent that reminded me of one I used to see on the old TV show M*A*S*H. The female soldier said she spoke a little English. We explained our situation and her replay was, "We only do 12 surgeries a week. We can't waist one on a dead baby. You must take her to the American hospital since this is an American clinic and you are an American", pointing towards me. No amount of talking, pleading, etc. would convince her otherwise. She finally walked away from us, back into the M*A*S*H tent and closed the door shutting us out.
The tap tap driver had a vague idea of where the American hospital was located. This is actually a hospital run by the University of Miami. The driver located a break in a concrete block wall and turned our van into the narrow opening that had barbed wire on each side of the opening. We were met by another gate and guards in uniforms. They wouldn't even approach our van. A man in civilian clothes, who we must have passed as we drive in, walked up to our van, stuck his head in my side window, and said, "What ya got?" When I explained the situation, he said, "We don't have any beds or fuel; you'll have to take her to Doctor's Without Borders hospital. They are doing all the maternity patient's in Port-au-Prince." Garlene began to argue and plead with him. He began saying something like, "I've risked my life more than anybody in this truck ever has or ever will, I don't want to hear how hard this is." I told her she was wasting precious time and we should just go.
Garlene called Greg Roberts, our American host in Haiti. Greg was at a gas station near us. We had the tap tap driver take us to the gas station where we paid him another $20 and got in the truck with Greg. It was here that we got the phone call that the young man with the ruptured appendix had died in the back of the pickup sitting in a hospital parking lot while Al, one of our team members, performed CPR on him to no avail. It was a very sobering moment for all of us.
Between the American hospital and the Doctor's Without Border's hospital we passed another hospital, called Merz. We stopped and Garlene ran in. She quickly returned and said we could leave Michele to sit in the lobby all night, but there were not any doctors there again until morning. We headed towards our fourth hospital with Michele.
Overwhelmed
This hospital was referred to by the locals as the Doctor's Without Border's hospital, because it is here that organization sets up their major operation. However, we learned at this time of night, in the hospital that delivers all of the babies born in Port-au-Prince, the Doctor's Without Border's doctors had left and it was staffed by three Haitian doctors, one midwife, two aides and a janitor. The hospital sits at the edge of Sol City, the largest slum in the world. There are about 250,000 people living in this tent city slum and about 250 of them were here on this night having a baby!
I was overwhelmed as we entered the hospital. If I were blind, I would have thought we were entering an insane asylum or a torture chamber. There were gutteral moans and groans, cries and pleas for help in French. Even though I couldn't understand the specific words spoken, it was obvious what was being requested by the body language and facial expressions of the nearly 250 women here, all in some stage of birthing their babies. Michele hesitated and did not want to enter. As I patted her arm and tried to reassure her everything would be alright, I'm not sure if I was trying to convince her or me.
We were directed through a pair of wrought iron gates. I saw a row of plastic chairs and about ten very obviously pregnant women in all stages of labor. This was their admitting area.
We then were taken into a small room where a young doctor sat on a stool at the foot of 2 exam tables watching two women in labor. Both were nude from the waist down. Michele entered and said she needed to pee. There was a five gallon bucket sitting near one of the tables that had a woman on it. Michele was directed to use the bucket. Michele proceded to walk over the bucket, lift her dress, and void. No privacy, no dignity here.
Garlene and I then were taken down a hall where there wre five cubbies with women on beds and about three more women on the floor in the hall. One woman in the floor was sitting in a pool of blood. She was quiet, but looked defeated. I asked if she was laboring or if she had delivered. I was told she had already delivered. Not wanting to overstep my bounds, I reached down and massaged her uterus in an attempt to stop her bleeding. She looked into my eyes and said, "Merci". I wanted to cry, but I had sweat out any tears I may have shed. It was so hot in this hospital my clothes were drenched with sweat. Most of these poor laboring women had stripped off their clothes due to the heat and their bodies glistened with perspiration.
Turning the corner heading into another hall we saw six more cubbies and women in the final phases of the birthing process. One woman was being assisted by a midwife. A second woman was beginning to crown her infant and no one was near. I grabbed a pair of gloves and craddled this baby up as it was birthed by it's mother, preventing it from dropping about 36 inches to the floor below. A woman I assumed to be an aide then came and double tied the cord with umbilical tape and gave me a sterile knife blade to cut the cord. Garlene then brought a sheet of paper and we dried the baby and handed it to the mother. The placenta was then expelled and the janitor came and took it and mopped the floor around the new mother's bed.
The babies were taken, swaddled and laid on a counter under heat lamps that were mounted from the ceiling. I'm only assuming they had a system to identify which baby belonged to which mother, but my guess is many mother's went home with another woman's baby accidently.
Garlene then summoned me to come and see. We went to the end birthing bed where a yound scared girl lay. I could see a tiny hand protruding out her vagina. I examined her and she was dilated about 5 centimeters. The baby was premature and transverse with a arm/shoulder presentation. I managed to reinsert the arm into the mother, but couldn't turn the baby into a better position. The young doctor appeared and smiled noting I had delivered the one young mother. He told me I could deliver this one also. I told him I couldn't since it was transverse.
The young girl in the same cubbie as the mother with the transverse lie baby began to crown her infant. Again, I grabbed a pair of gloves and repeated the delivery process. The young mother I delivered said, "Merci". The mother with the premie looked at me with hollow eyes that said, "Surely, I must be in hell."
I went to wash my hands in water I'm sure wasn't clean, dried them on my pant legs that were drenched with sweat, and returned to find the premie lying on the delivery table between the young mother's feet. The baby was dead. One of the staff had gone to tell her husband.
These poor women were alone, no family was allowed to be with them. They were hot, sweating, no pain medications, no privacey, no kind words, looks, or touch. My heart was breaking for them. I didn't even have the ability to say "I'm sorry" since I don't speak French Creole.
Garlene decided it was time for us to leave. As we were walking back out the way we came a girl was in the floor, her water broke. I checked her and she was completely dilated. We assisted her onto a nearby empty bed, but were told they didn't want her to birth there so they made her get uyp ad walk around the corner to another bed. I was prepared to deliver her until the Haitian midwife said "excuse me", and took over. I felt she was trying to make a point that her way was best. She did not like that I encouraged the patietn to push. She never spoke to her patients. I had prepared my supplies to do this delivery, and the bulb syringe I had collected was missing. When I asked for another she said, "No". I stepped aside to allow her to assist the mother with her birth. The midwife used a big wad of cotton to wipe the baby's face after it was born, but did not suction out any mucous or stimulate it to cry. The baby was getting bluer and bluer, so I rubbed it's back to stimutlate it to cry and clear out the mucous. The midwife shot me a displesed look, but the young mother said, "Merci", which was all I needed.
The doctor then took us on a brief tour of he hospital. He took us to the two operating rooms. One was still bloody from a previous surgery. Their ability to clean and get the room ready for the next case was very limited by supplies and clean water. He told us that it is difficult to get surgeries when needed. Even if they have surgeons, there is a shortage of anesthesia personnel. He commented that the only way they can get anesthesia people to come is to pay them, and they have no money.
He then led us into the postpartum unit. This was one large room with about 25 trundle type beds along each side of the room. Most beds had a mother and newborn at her side. There were a few beds with a woman lying in it and a man sitting on the floor next to her. I could only assume the men were allowed to come sit with their wives if their baby had died.
The doctor asked if I didn't just want to stay and work all night. I told him I couldn't, but I would come back the next day to work if he really wanted me to. He said he ended his shift the next day at 2 pm. I asked when his shift had started and he said he worked from 8 am one day until 2 pm the next day - a 30 hour shift! When I asked him how many babies he thought he delivered in a night, he said, "Maybe 25"? I laughed and told him I had delivered 2 in less than 30 minutes. I felt sure he did more than that. Garlene got the phone number of the young doctor we had talked to most of the evening so we could check the following morning on the status of Michele. We picked up and ate Dominoes Pizza on our drive back to the mission compound. I never knew pizza and diet Coke could taste so good!
The Truth About Michele
Garlene got the telephone number of the Doctor we befriended at the Doctor's Without Border's Hospital so we could call and check on Michele. The truth about Michele was she was not pregnant. Even though she came to us claiming to be pregnant, had not had a period in eight months, had felt her baby move until the day she came to see us; she was not pregnant. The verbal ultrasound report we got only stated she did not have a pregnancy. Now, trying to piece all the information together I have come to the conclusion that she either has a uterus full of fibroids or may have cancer. Either the fibroids or cancer is growing and protruding through her cervix into her vagina and causing her pain which she had mistaken for labor. The tumor must have been flopping around which she mistakenly thought was fetal movement. As the tumor enlarged, it no longer moved about and she thought the fetal movement had stopped. Her uterus was enlaraged to approximately a thirty week pregnancy leading me to believe the "fetal" growth had stopped some time ago. Once Michele was told she was not pregnant, she walked away from the hospital without receiving treatment for her tumor. Hopefully, it will not begin to bleed and become a life threatening condition for her, or be cancerous which could be the death of her.
I have a devotional book called "Jesus Calling" by Sarah Young that speaks to me daily. On this particular day I shared the information with my team. We have talked about how difficult life is in Haiti, especially for the women who must scavange daily for food and water. Today's devotion made me think about the Israelites who wandered around for forty years and had to depend on Jesus for their manna.
Early this morning in the clinic Yancik, the clinic director, came to me and said she had two girls in labor. Even though I deal with girls in labor on a regular basis in the States, it was a very different situation here in Haiti. Especially after the incident with Michele the day before, I was afraid we would be spending our entire day again traveling from hospital to hospital. One girl was forty-two weeks gestation by her history and had been hurting all night. The other girl stated she was not hurting. I examined both girls and determined they were both about 1 centimeter dilated. I told the girl who was forty-two weeks gestatin to go to the hospital. Going two weeks past the due date puts her at high risk for losing her baby if her placenta decides to quite working and giving the baby the food and oxygen it needs. I hated to send her or anyone to the hospital after my previous evening there, but felt I had no choice. Even in it's poor state, the hospital was better then nothing in an emergency. The other girl was not in labor and not due for another couple of weeks. I told her to go home and to come back to the clinic in one week to see the provider who would be here. I told her the signs and symptoms of labor and advised her to go to the hospital should labor begin.
A New Day, A New Location
Our second day in Haiti was a Saturday so we planned a mobile clinic. We loaded as many supplies and medicines as we could and traveled to a nearby neighborhood church to conduct a clinic. The minister knew we were coming so had informed the people who lived in nearby houses and tents. When we arrived around noon the patients were there and waiting on us.
Since we had a shortage of translators this day, we decided to pair up. Mark and Sherrie set up a pharmacy in the back of the church to fill the prescriptions we would write. "Doc" Eric set up a table on the alter as did I. Earla was on the alter with Doc and me, she was going to be an over the counter medication pharmacy - giving out such things as Tylenol, Ibuprofen, worm medication, etc. Al and Sonia were outside under a tent under a tree seeing patients.
The most interesting patients I encountered this day included a young man I think had Hepatitis, probably from drinking contaminated water and a woman with a thyroid tumor the size of a softball that was causing her pain and difficulty swallowing. Both of these were referred to local hospitals for further treatment.
About 2 o'clock in the afternoon I needed to go to the bathroom. Patients were going behind the church and peeing in a cup for us if we needed specimens for pregnancy tests, etc. I could not bring myself to just stand behind the church and pee in plain view for the whole world (or at least this corner of Haiti) to see. Our host, Greg, came and said "follow me". One of the women who lived across the street from the church and ran a photography studio offered to let the women use her bathroom. She pulled back a blanket that was the front wall to her one room studio/house. Inside was a twin size bed, a chair, and 3 shelves on the wall. We walked into this room and out a back door. Here was a small walled off area. On one side was a piece of corrugated tin standing upright. The woman handed me a small piece of toilet paper then she moved the tin aside to reveal a concrete box with a small raised box on top that had a 10 inch by 10 inch hole. I didn't know if I was supposed to try to sit on it or climb up on top and squat over it. I chose the latter. The whole time I'm trying to decide the best way to utilize this "facility" I can see her fingers wrapped around the tin to afford me privacy. I also knew, she, Earla, and the woman's son where just on the other side of the makeshift wall. When I exited from behind the tin, she was there to offer me a chip off a bar of soap. She demonstrated to me that she wanted me to hold my hands out over a galvanized washtub so she could pour water over my hands while I washed with the soap. After I washed and she rinsed my hands to handed me a small white towel to dry my hands. Then Earla repeated the process I had just done. To me this was such an act of kindness and hospitality. She didn't have much, but was willing to share with us all she had. I saw Christ reflected in this woman.
In the evenings after we ate the dinner that was prepared for us by the hired staff, we showered and prepared supplies for the next day's clinic. We would sit and discuss the day's events, read books we had brought with us that in the States we often find ourselves too busy to read, or journal to remember the events when we return to our daily routines. This particular evening there was going to be a baptismal service at the church. Twenty-five people were being baptised. We were invited to attend. Al and Mark decided to go, but since no one had any idea how long the service would last the rest of us decided to stay and prepare for the next day and rest from the busy day we had completed.
First Baptist Church Pernier, Haiti
Sunday morning we prepared to attend the twenty ninth anniversary of the church. We left later than we had expected. When we arrived the service was in full swing. We were greeted by one of the young translators. He said he needed three of us to follow him. Earla, Al, and I followed as directed. He took us down the center isle to the second row from the front. There must have been 400 people in this service. I had taken my video camera and was told it was OK to video. There was a man with a camera who moved about the entire service videoing, so I didn't feel so obvious sitting in my seat with my camera rolling. Every choir and praise band performed this day. I especially liked the group with an accordion and the men had worked out dance routines. The singing lasted about two hours. The twenty five people who had been baptised the night before were recognized and given their certificate of baptism. Then the minister began his sermon. He spoke in Creole, so for the next hour during his message, I just looked around at the faces of the people in the choirs in front of me.
After the service we were invited to attend a church wide luncheon that was part of the anniversary celebration. We were ushered into a room in the basement of the church. This area had previously been used as a school. There were still math equations on the blackboard. We were told that the church members wouldn't come back into the basement after the quake. As I sat looking around I began to feel uneasy being in the basement. There were places in the cement block ceiling where the rebar was exposed and the mortar had crumbled. We walked from classroom to classroom and noticed there were areas where the wall between the classrooms had crumbled and fallen to the floor.
We usually divided up and traveled in two trucks. So, we divided, climbed into the tucks then headed to "Hot and Fresh". A few men said they were still hungry and wanted to buy a burger. The rest of us decided to splurge and ordered varying flavors of ice cream.
We then were driven into downtown Port-au-Prince to view firsthand the devastation caused by the earthquake. I chose to ride in the back of the pickup so I could better see and take photos. The air was thick with dust. Everywhere is dirty and dusty. I am amazed how the people were so clean and dressed in their whites, suits, heels, etc. for church today.
One of our first stops was high above the port along the fault line that had shifted causing the quake. I can't begin to describe what I saw and felt. I was so overwhelmed for the people who live here. All I could think of while driving through Port-au-Prince was "they must feel like they live in a war zone." We saw the Presidential Palace - being guarded by UN troops. Haiti was a country of poverty before - now it seems hopeless.
As I read my daily devotion in "Jesus Calling", it reminded me that "God's peace is His continual gift to us. The day-to-day collecting of manna kept His people aware of their dependence on Him." The people of Haiti must daily collect their food (manna) as there is no refrigeration available to most of them. They are dependant on God to provide.
My precious daughter, Sara, sent a note along with me to read one night while in Haiti. I had planned to read it Monday night after our first full day in clinic. However, I was feeling overwhelmed from the sights, sounds, and smells of our tour and decided I needed her encouragement tonight. She reminded me a verse in Matthew "WHAT YOU DO FOR THE LEAST OF MY PEOPLE YOU DO FOR ME." I needed to hear that.
I brought the book "The Power of Half" by Kevin and Hannah Salwen to read on this trip. I want to learn from them. "I want to turn the good life into a life of good."
Needless to say, we were all pleasantly surprised when we learned we were having Domino's Pizza home delivery for dinner this night.
Since we had a shortage of translators this day, we decided to pair up. Mark and Sherrie set up a pharmacy in the back of the church to fill the prescriptions we would write. "Doc" Eric set up a table on the alter as did I. Earla was on the alter with Doc and me, she was going to be an over the counter medication pharmacy - giving out such things as Tylenol, Ibuprofen, worm medication, etc. Al and Sonia were outside under a tent under a tree seeing patients.
The most interesting patients I encountered this day included a young man I think had Hepatitis, probably from drinking contaminated water and a woman with a thyroid tumor the size of a softball that was causing her pain and difficulty swallowing. Both of these were referred to local hospitals for further treatment.
About 2 o'clock in the afternoon I needed to go to the bathroom. Patients were going behind the church and peeing in a cup for us if we needed specimens for pregnancy tests, etc. I could not bring myself to just stand behind the church and pee in plain view for the whole world (or at least this corner of Haiti) to see. Our host, Greg, came and said "follow me". One of the women who lived across the street from the church and ran a photography studio offered to let the women use her bathroom. She pulled back a blanket that was the front wall to her one room studio/house. Inside was a twin size bed, a chair, and 3 shelves on the wall. We walked into this room and out a back door. Here was a small walled off area. On one side was a piece of corrugated tin standing upright. The woman handed me a small piece of toilet paper then she moved the tin aside to reveal a concrete box with a small raised box on top that had a 10 inch by 10 inch hole. I didn't know if I was supposed to try to sit on it or climb up on top and squat over it. I chose the latter. The whole time I'm trying to decide the best way to utilize this "facility" I can see her fingers wrapped around the tin to afford me privacy. I also knew, she, Earla, and the woman's son where just on the other side of the makeshift wall. When I exited from behind the tin, she was there to offer me a chip off a bar of soap. She demonstrated to me that she wanted me to hold my hands out over a galvanized washtub so she could pour water over my hands while I washed with the soap. After I washed and she rinsed my hands to handed me a small white towel to dry my hands. Then Earla repeated the process I had just done. To me this was such an act of kindness and hospitality. She didn't have much, but was willing to share with us all she had. I saw Christ reflected in this woman.
In the evenings after we ate the dinner that was prepared for us by the hired staff, we showered and prepared supplies for the next day's clinic. We would sit and discuss the day's events, read books we had brought with us that in the States we often find ourselves too busy to read, or journal to remember the events when we return to our daily routines. This particular evening there was going to be a baptismal service at the church. Twenty-five people were being baptised. We were invited to attend. Al and Mark decided to go, but since no one had any idea how long the service would last the rest of us decided to stay and prepare for the next day and rest from the busy day we had completed.
First Baptist Church Pernier, Haiti
Sunday morning we prepared to attend the twenty ninth anniversary of the church. We left later than we had expected. When we arrived the service was in full swing. We were greeted by one of the young translators. He said he needed three of us to follow him. Earla, Al, and I followed as directed. He took us down the center isle to the second row from the front. There must have been 400 people in this service. I had taken my video camera and was told it was OK to video. There was a man with a camera who moved about the entire service videoing, so I didn't feel so obvious sitting in my seat with my camera rolling. Every choir and praise band performed this day. I especially liked the group with an accordion and the men had worked out dance routines. The singing lasted about two hours. The twenty five people who had been baptised the night before were recognized and given their certificate of baptism. Then the minister began his sermon. He spoke in Creole, so for the next hour during his message, I just looked around at the faces of the people in the choirs in front of me.
After the service we were invited to attend a church wide luncheon that was part of the anniversary celebration. We were ushered into a room in the basement of the church. This area had previously been used as a school. There were still math equations on the blackboard. We were told that the church members wouldn't come back into the basement after the quake. As I sat looking around I began to feel uneasy being in the basement. There were places in the cement block ceiling where the rebar was exposed and the mortar had crumbled. We walked from classroom to classroom and noticed there were areas where the wall between the classrooms had crumbled and fallen to the floor.
We usually divided up and traveled in two trucks. So, we divided, climbed into the tucks then headed to "Hot and Fresh". A few men said they were still hungry and wanted to buy a burger. The rest of us decided to splurge and ordered varying flavors of ice cream.
We then were driven into downtown Port-au-Prince to view firsthand the devastation caused by the earthquake. I chose to ride in the back of the pickup so I could better see and take photos. The air was thick with dust. Everywhere is dirty and dusty. I am amazed how the people were so clean and dressed in their whites, suits, heels, etc. for church today.
One of our first stops was high above the port along the fault line that had shifted causing the quake. I can't begin to describe what I saw and felt. I was so overwhelmed for the people who live here. All I could think of while driving through Port-au-Prince was "they must feel like they live in a war zone." We saw the Presidential Palace - being guarded by UN troops. Haiti was a country of poverty before - now it seems hopeless.
As I read my daily devotion in "Jesus Calling", it reminded me that "God's peace is His continual gift to us. The day-to-day collecting of manna kept His people aware of their dependence on Him." The people of Haiti must daily collect their food (manna) as there is no refrigeration available to most of them. They are dependant on God to provide.
My precious daughter, Sara, sent a note along with me to read one night while in Haiti. I had planned to read it Monday night after our first full day in clinic. However, I was feeling overwhelmed from the sights, sounds, and smells of our tour and decided I needed her encouragement tonight. She reminded me a verse in Matthew "WHAT YOU DO FOR THE LEAST OF MY PEOPLE YOU DO FOR ME." I needed to hear that.
I brought the book "The Power of Half" by Kevin and Hannah Salwen to read on this trip. I want to learn from them. "I want to turn the good life into a life of good."
Needless to say, we were all pleasantly surprised when we learned we were having Domino's Pizza home delivery for dinner this night.
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