Home again...

      Oh, the drama of getting home this time! We left Oriani at a little before 5 am on Monday morning. Got to the Haiti/Dominican border around 8 am. Paperwork there only took a few minutes so we parked and waited for Samuel to come meet us. He got there probably about 30 minutes later so we traded passengers as he had brought several people who were headed back in the direction Jay was going. From the border at Jimani to Santo Domingo takes several hours but the roads in the Dominican Republic are much nicer than they are in Haiti! Samuel is a Haitian who lives in the Dominican Republic with his wife and family. He speaks 4 different languages- Creole, French, English, and Spanish. We drove several hours then he stopped at a little restaurant and got us all some food- chicken, rice, and bean sauce. It was delicious! It seemed to be seasoned mostly like the Haitians cook but maybe with a little different spice- probably some Dominican influence. While we were waiting in the truck for our food we were trying to decide what language was being spoken in the music that was playing. It seemed to be a mixture of Creole and Spanish. Keith had looked up a pharmacy/lab center there in Santo Domingo for us to get our COVID testing done. The rules have just changed for the USA, now you have to have a negative COVID test within 24 hours of flying- until last week the test could be with 72 hours of flying. Both Keith's and I had flights leaving at 3:30 the next afternoon and it was after 3 pm now so we got our testing done. I only needed the antigen test to fly to the USA but they needed the PCR test to enter Canada. Mine was supposed to result in about 30 minutes but theirs would take several hours. They were going to email us the results. If we could not get them printed out at our hotel we would have to go back there in the morning for a hard copy, just in case. (We were able to peint them at the hotel later that night) So we headed to the Old Colonial area of Santo Domingo. That was where we were planning to spend night. The first place we stopped only had one room available, the second place didn't look as nice so we checked out a third. They had rooms and a good price so we unloaded and Samuel went on his way. We were planning to get a taxi to take us to the airport the next morning. It was after 6 pm so we put our luggage in our rooms and walked several blocks to a restaurant for supper. I had a salad with grilled chicken, boiled egg, avocado, etc... Keith had fried shrimp and Candace got some stew with goat meat in it- all delicious. On the way back to the hotel we stopped and got some coffee. The next morning we walked around the shops there in the colonial zone then went to Kahkow- a little chocolate factory. I had been there a month ago when I came and enjoyed it so took Keith's there this time. We did the tour with the videos explaining how chocolate is made etc... and were really wanting some hot chocolate but it was getting late. After the tour we only had time to pick up a few chocolate bars in the gift shop then quickly went back to the hotel and called a taxi to take us to the airport. By the time we had our suitcases in the lobby the taxi was there. It was about a 20 minute ride to the airport. Keith's and I parted ways then as we were flying on different airlines. After checking in and going through security and customs I got some pizza and a coke for lunch. I was messaging back and forth with Keith- they were supposed to leave a few minutes after I  was. When it was close to time to board, there were 11 wheelchairs lined up with people in them to get on the plane I was to fly on. We were a little bit late boarding but not too bad. It seems like Keith's took off on time. It had taken them quite a bit longer to get through security and customs- Keith said they had to show all of their papers. They had asked me if I had a COVID test result but never even looked at it. Wifi was sketchy and that was all I had on my phone. I hadn't purchased a plan to use in the Dominican. Where it worked, it worked well! But at several of the "gate areas" along the terminal there was no service, usually no service at the gate where I was supposed to be boarding. We did get boarded, seat belts fastened, the whole nine yards, but on the final inspection someone noticed something out of place on one of the wings so maintenance had to come check it out before we could take off. That took a bit of time, but then they came on the speaker saying they were taking pictures of the problem to send to a mechanic in Florida.  Okay... then more pictures to send to Florida... then they let us all de-plane to get food, drinks, bathrooms, etc... supposedly whatever the problem was it would take an hour to get it fixed. So we all got off, taking all of our luggage with us. Keep in mind all of the announcements here are in Spanish- with some of it translated into English afterwards. On the airplane they did very well with saying things in both languages,  after we got back in the airport- not so much. Just some of it and then you had to ask exactly what was happening. Soon they announced that the flight was cancelled. We would all need to go to baggage claim and get our bags and get re-booked for the next day. Then suddenly, everyone was lining up in quite an orderly fashion. I thought must be they had gotten the problem fixed and we were boarding again but when we all got to the tip of the incline we rather were sent back downstairs -not back onto the plane. We were just doing an orderly exit. Everyone headed to baggage claim... and there we waited for over an hour on our luggage. Thankfully, Wifi worked well in baggage claim so I could at least send and receive messages. After gathering our bags, we headed back upstairs to the Spirit airlines counter to be re- booked. I had gotten an email saying I was scheduled to fly out the next morning at 9 am- that was fine- but then my layover in Orlando was an 11 hour layover! I thought that was ridiculous! But when I got to the counter the lady (who could speak English well, thank-you Jesus!) said that was the only other flight that day to RDU from Orlando. She said though that our COVID tests would be extended through the next day so we wouldn't have to redo that test. They gave vouchers for a taxi, hotel, dinner, and another taxi in the morning. I wasn't sure how it all was supposed to work but had been told that the taxi that took me to the hotel should be the same one to bring me back to the airport in the morning. So I went down to the line of taxi's. There was someone there who knew some English also so I showed them my vouchers and said I needed a ride to the hotel. There was another older woman right behind me who had been scheduled on that same flight so she had vouchers also. We were herded towards a taxi and had our bags partly loaded but I guess this person couldn't pick us back up the next morning so we moved to the next vehicle. This other lady spoke English also! We verified that we needed to leave the hotel the next morning at 6 am- yes, he could do that, so off we went to a Quality Inn several miles away. There were probably 8 people ahead of us checking in but it was no big deal- it was beautiful weather outside so we waited out there. At check-in, they told us dinner would be served in 10 minutes so I was going to take my bags to my room then come back to eat. They gave me room 430. My key to the room worked, but the room was already occupied. Another gentleman I recognized who had been scheduled on the same flight. Thankfully, he had used the deadbolt on the door, so it only opened about 2 inches then stopped. And it was loud, so, even though it was a surprise that the door wouldn't open, at least I didn't walk in on him! So, after profuse apologies, I  went back down to the desk. The clerk seemed surprised when I told her that room was occupied- she verified that I said room 430- then looked at her papers or computer and said it was supposed to be room 439. That room was right across the hall but she had obviously made a mistake and given me the wrong room number and also activated the key for the wrong room. Back upstairs again, to the room right across the hall. I was a bit nervous I would meet the man from room 430 at dinner, but I didn't see him. Downstairs in the dining room they were serving chicken, fish, rice, bean sauce, muffins, and something else I didn't recognize. By now it was 10 pm. For most of the time, there was only one person serving the meal, so we actually waited quite a while on that also. It was good food though. When I got back to my room I found and purchased a one way ticket from Orlando to Raleigh for the next day- on American Airlines. Spirit really didn't have any other flights going to RDU that day. It only cost about $150 and got me to Raleigh hours before the Spirit Airlines flight was even scheduled to leave Orlando. I thought it was worth it. I would need to get my checked bags in Orlando anyway because of taking them through customs so could re- check them on another airline hopefully without too much difficulty. The taxi we had taken the evening before was at the hotel at a few minutes after 6 am so we got back to the airport in good time. Checked in and went through customs again then headed to the gate. Got something to eat and waited around- recognizing multiple peoe from the night before. Weird thing was, our flight was never posted on the board at the gate where we were supposed to leave from... it got closer and closer to 9 am and there were no Spirit airline employees at the desk and no airplane arriving. Finally a couple ladies came- people were going to talk with them- I suppose wondering where the airplane was- but there were no overhead announcements yet and they were speaking Spanish so I couldn't understand them anyway. How bizarre, I was at a different gate than the night before but still didn't have a Wifi connection in the gate area, I  had to walk down the terminal a ways to connect to send or receive any messages. By now I could tell people were upset but was clueless what was really happening because there were still no overhead announcements. Turns out there isn't an airplane here for this flight. I have no idea why, maybe they never even scheduled this flight with the airline...but they had definitely rebooked us all. People were getting upset now. Then it was mentioned that maybe we could fly on the plane that was supposed to have taken us the evening before- but it was undetermined if the problem had been fixed. So there were a bunch of people upset, the drama was ongoing, etc... I left the area for a few minutes to message Jay or Keith and see what their recommendation was for me but I didn't want to stay away too long and miss an announcement. When I got back I went and talked with a small group of people who knew English. Incidentally,  the gentleman whose room I busted up into at the hotel the night before was in this group. 😄 We both had rebooked for later that afternoon so we hung out together over the next several hours (while getting another COVID test there in the airport, waiting for results then going to check in with American airlines, but I am getting ahead of myself here in this story) Apparently now the airline wanted to rebook everyone again-- this time from another airport! They wanted to put all of us on a bus and send us to the airport in Punta Cana- which is supposedly 2-3 hours away. My question is- if you cannot get an airplane to Santo Domingo- the capital city of the Dominican Republic- how are you going to get an airplane to a smaller airport??? Several of us in the English speaking only group did not relish the thought of a bus ride, another rebooking, etc... some of them had found flights out later that day on different airlines- I had looked also and found several reasonable options - but now I had to go find Wifi once again so I could book one of these tickets. Here I should have just taken a little more time and changed the one way ticket I had purchased several hours earlier feom Orlando to RDU- but I didn't. I didn't want to be way off down the terminal if something new came up with my flight and I was afraid everyone else was probably frantically trying to get booked on other airlines also so I just bought a new ticket- all the way from Santo Domingo to Raleigh. This flight went through Miami. There were 2 options I was looking at- one left at 1 PM that day and the other at 3 PM. I chose the 1 PM flight- that was 3 hours away, surely that was doable... in the end it was- barely! I had to ask to go to the front of the line going through security and through customs because my flight was supposed to board in 10 minutes. But that is getting ahead of myself. Once again we were all led down to baggage claim to get our bags. We waited a while, but not as long as the evening before for our luggage. Then back upatairs and to the line by American airlines. We clarified- yes, we needed a new COVID test to fly on American.  The extension was only good for Spirit airlines. So to the office where we thought the tests were done. No, this was results only. Testing was done upstairs, so we headed upstairs, got tested, then back down to rhe office to wait for our results. They were supposed to be back in 30 minutes and they were. I was getting nervous though, it was 12PM  and my flight was supposed to leave in an hour. After getting a print out of a negative COVID test, back to the line at American airlines. It was long... we slipped in the shorter line for first class passengers or something and didn't get turned down. Now came a passport check, then security and customs. I found an emplyee and asked if they could help me because my flight was leaving soon because the lines here were long also. He got me through pretty quickly then I searched out another employee at customs to help me get through. I had filled out an online form the day before to exit the country but I had to do another one today and the lady only knew a few words of English. Someone else tried to help me, it wasn't working because I wasn't on the correct page so of course when I tried to scan the QR code it didn't work. The customs lady just pointed to the code again and was telling me I had to fill it out. When someone else told me where to go to find the form, it scanned without a problem, now I just had to fill out the rest of the form. I had to keep reminding myself that I was the foreigner in their country- I was the one who didn't know their language- because it was getting frustrating! Early that morning going through customs I had had no problems whatsoever but now I needed an additional form filled out. When I got it completed, they stamped my passport again, for the 3rd time in about 18 hours, and I hurried to the gate. I got there just before they started boarding the flight so got a coke to enjoy on the flight. No problems this time, thank the Lord! I hadn't had a chance though to cancel the one way flight from Orlando to Raleigh-  and now once again, I was on the plane so had no Wifi connection to do it online. I cancelled it when I was in Miami then sent an email requesting a refund or airline credit because of circumstances.  They only allow 200 spaces though to explain your problem so I couldn't give all the details I wanted to. I'm still waiting to hear if they will give airline credit or not. If not, oh well, it wasn't that expensive. I got into Raleigh at a little after 8:30 PM.  Larry and Sharolyn were there to pick me up. I cannot remember the last time I have been that exhausted! Mentally and physically! But I am home...sweet home...

A home visit

Once a month I have been doing a home visit with a lady that is paralyzed. She was in a kamyon accident several years ago and had a spinal cord injury and can no longer walk. This is a very poor family with eight children. Last time I went there was in the afternoon after the clinic was closed for the day. Several of the children were there in the yard so I asked if they were out of school for the day. Most schools around here let out at noon or very shortly after. One of the girls, I am guessing she is about 14 years old, said "Nou pa gen lajan pou lekol"- (we don't have money to go to school). It doesn't seem like it would cost a lot to go to school here but it costs more money than they have. I don't know how old the oldest child is but the youngest one is 4 years old so there would be numerous children to buy school uniforms for. This lady is always sitting on her bed in her dark, little 2 room house. It doesn't seem like she has any bed sores so she must be able to reposition herself fairly well but I have never seen her up out of bed. I don't know where all the children sleep because it is quite a small house. Amberly and I went to see her Tuesday afternoon after clinic. When we had finished our visit we decided to continue walking on down the trail past her house. About a quarter of a mile farther on we found an absolutely beautiful place to sit and enjoy the scenery. From our perch on a relatively new tomb, we could look out over numerous hills and we could actually see the waves of the ocean! It just happened to be a very clear day and we could see a long ways. I wish I knew approximately how far it was to the water but I really have no idea. It was the clearest view of the ocean I have seen from Oriani though. Sometimes on a clear day we can see the ocean from a hill behind our house but I had never been able to actually identify ripples on the water from waves.

Jay went to the border on Tuesday to get Keith's. They got back in time for supper. It was my day to cook. I made tacos, black beans and sopa then peanut butter no bake cookies for desert. 

Wednesday was a shorter day than usual but as I was attempting to lock up another patient showed up. A young lady, probably 18 years old, who had had her first child the day before and had been pretty much unresponsive since shortly before delivering the baby. She was carried in and placed on the exam table in my room. Apparently she had been totally normal until she went into labor. Then someone gave her "ginger tea" to drink. These people belive that ginger tea gives the mother "force". We have not identified any clear way that this tea helps - it just seems to cause intense pain, pain that does not speed up labor. But many people are firm believers in it. Someone also gave her "remed fèy" (herbs, leaves), we have no idea what kind of a combination that was. Then there was some "mistic" (magic) involved and someone "passed oils" over her body. Apparently she had been in this unresponsive state ever since being given all this treatment. The way she was acting, I have no idea how she even birthed a baby. Normally is a person is faking unresponsiveness they will not let their own hand fall onto their face if you lift their arm and drop it right over their face. Her hand dropped right on her face, three times. Her vital signs were stable, except for an elevated heart rate and her glucose was a little high. I'm not sure what that was from because apparently she hadn't eaten or drank anything since the day before sometime. She did not appreciate a sternal rub though! It was a very strange situation. We sent all of the family out of the room and tried to get her to talk but she would not. I truly do not know if she could not or would not. We did not think she would be able to swallow but when we gave her a drink she swallowed without difficulty.  Without knowing what she had taken there really wasn't any treatment we could give. We ended up sending her home with some tylenol and a multivitamin. I have no idea if she will come out of this whenever the things she was given have worn off or if this is her new normal. If it is, I'm afraid she won't live very long. 

Thursday morning they had a little farewell party for me at the clinic. Brianna made Haitian spagetti, boiled eggs, and coffee. It was delicious!

Friday night we packed up food and headed to the forest for a weiner roast. Amberly and I rode on top of the machin with the girls on the way there. We had hot dogs and macaroni salad, then roasted marshmallows and hot chocolate for dessert. It was an enjoyable time. When we got back home there was a patient and numerous of his friends and family waiting at the gate. He had been in a machete fight and had several large gashes to his right arm and a cut on his head. It took several hours to get him stitched up and bandaged. The biggest cut was on the inside of his right wrist. It looked like there were tendons severed but he was able to move his fingers so obviously his tendons were still intact. 

One Saturday Amberly and I walked to market in Forèt des Pins one last time. First though, we had a moto accident to treat. Two people were hurt but one only needed a couple of stitches on his head and bandages for his scrapes and the other needed his scrapes washed and some triple antibiotic ointment and a few band-aids. As usual, the walk to Forèt was beautiful. There is one ravine to climb but after that it is a very easy walk, just follow the path through the pines. It is about 3 1/2 miles. We wanted to do a little more Christmas shopping- and we were very successful! We had mayi kole and Toro for lunch then bought some fruit before taking moto home. 

Today I am going to pack up. We leave early tomorrow morning for the Dominican Republic. We will get to Santo Domingo in the afternoon and can hopefully get our COVID tests done before places close for the day. Keith, Candace and I all fly out on Tuesday afternoon.

As far as the clinic goes, Jay has the names and phone numbers of several Haitian nurses. He has already started contacting them and offering them a job at the clinic. So, no, we do not have a firm plan in place right at this moment as far as workers for the new year, but there are several options being explored. 

 

Treatment completed

 

     This little guy who had the burns to his face, head, neck, chest and arm came back today. They look so good! I gave him another course of antibiotics because he had an ear infection but then I told his mom he didn't have to come back to see us for his burns anymore. His treatment is completed.  His mom had also brought a younger sibling for a consult today. This kid was just chattering away to his little brother as they ate their crackers and I figured out what medications to send home with them...

      It is kind of hard to imagine Christmas is only a few weeks away when these beautiful flowers are blooming beside the road... they are sooo pretty. The bushes are several feet taller than I am. I picked a big bouquet to put on the table on Thanksgiving Day but they don't last more than a few hours after they are cut, so it didn't turn out as planned. 

     School has just let out for the day... so some of the boys are playing a quick game of "football" (what we call soccer) before they go home. The building in the background is the school where these children go. It is a one room building with no desks that I can see, only backless benches and/or cement blocks to sit on. 

     Keith and Candace are coming this weekend to visit for a week. Hopefully some decisions can be made while they are here to determine what to do from here on out. We have been able to get an order of medications delivered. One of the local brethren has a kamyon to haul produce down to Port-au-Prince. Jay got it worked out for the medication order to be delivered somewhere and this man picked it up and brought it up the mountain in his truck. This week we are trying a grocery pick up service to get some groceries for our house. They will also be brought up on the truck. The challenge currently is what to do about nurses to work in the clinic after Christmas. Everyone is in agreement that now is not a good time to bring in a new American or Canadian nurse. So the nurse from Missouri who was planning to come in January is tentatively on hold. Right now we don't know if either of the Haitian nurses will be coming back or not. Roseline is engaged to be married at the end of January. Chancela has worked here for 3 years I think. She hasn't said yet if she will be coming back or not. But the clinic can't operate without nurses... so this is something to add to your prayer list. 

     I have a ticket to fly back home on December 14. I will go back to the Dominican Republic with Keith and Candace on the 13th and we will all fly out on the 14th. 

Stinky feet

      The 18 month old with burns to her hips, thighs, lower abdomen, and diaper area came back today. Her burns look okay. I gave the family more antibiotic ointment and pain medication. The sad thing is, I don't think the story about her falling in the fire is true. Another lady was still in my exam room, waiting to get her medications when the dad brought this little girl in. Of course she asked what had happened and the dad gave a slightly different story. I didn't catch all the details of the story but what I heard fits the pattern of her burns better. It sounds like someone was going to clean her up after she used the bathroom and they submerged her in water that was too hot. That would make sense why the burns are all the way around her thighs, etc... 

     I had another child come in today with burns on her right arm. This one also does not seem to be deep, full tissue injury. It appears like they must have used some kind of cream that probably kept it from getting so dried out. I did not clean it too thoroughly because it didn't look horrible and we don't have strong enough pain meds available here. I put silver cream and a bandage on and gave her a randevou to come back in several days. 

     Several days ago - on Friday I think it was- we had an after hours delivery here at the house. Jay had checked her and she wasn't quite ready but was getting close so he had her up walking. We all thought she would deliver pretty soon, this wasn't her first baby and she was fully dilated but it ended up taking several hours before she delivered. She had a very full bladder so we cathed her to try and help move things along. It didn't seem to help speed things up but I'm  sure she felt better afterwards. Suddenly she said she had to throw up. Of course, we had nothing available but the chux pad she was sitting on. That little bit of drama sent Chancela into the house gagging also but she returned pretty quickly. A lady had been with the laboring woman but finally Chancela asked for the "baby daddy" to come help support the mom through the delivery- to help give her strength. It had rained recently so it was muddy outside. The dad had his black rubber boots on, he stopped at the gallery door to take them off because they were quite muddy. When I saw bare feet emerging from those boots I knew the smell was not going to be pleasant,  at all! It wasn't! I appreciated him trying to keep the mud out of the gallery but this presented a new, smelly, challenge. Thank the Lord that the gallery just has bars across the front so air could circulate. He didn't have socks on and there were several places on his feet where the skin was all white from being exposed to moisture for an extended amount of time so it was a smelly situation... After a while she successfully delivered a screaming little boy... 

     On Saturday Amberly and I walked to the market in Forèt.  It is about 3.5 miles. There is one ravine to go down and back up but for the most part it is a beautiful walk through the forest. We ate lunch there and did a bit of shopping then came home on moto. It was Brianna's birthday so the rest of us worked together to make a delicious supper of grilled chicken sandwiches, macaroni salad, onion rings , and gingerbread cake with butter syrup and whipped cream for dessert.  

     Roseline went down to Port-au-Prince on Friday afternoon after work and is going to be gone through tomorrow. I guess they are working on some things for her upcoming wedding- which is planned for January.  Then today Chancela wasn't feeling well so it ended up being just Jay and I seeing patients today but it went very well! We had one of the medication aids take vital signs on everyone before they came into our exam rooms so we were able to move people through a bit faster. I think I saw 36 patients- several of them were just dressing changes- and Jay saw 31 patients- he also gave 11 Depo (birth control) shots, so that equals about 75 patients. 

    

Joe Biden

      My most interesting patient today was 3 1/2 months old. His name was Joe Biden. I saw it written on the dosye but I didn't know if maybe the pronunciation would be a little different so I asked the mom what the baby's name was. She pronounced it exactly the same as we say it- Joe Biden. He was sick. He had a temperature of 38* celsius and his heart rate was 200. I think his heart rate was that high simply because of his fever because overall he looked quite good. I gave his mom Amoxicillin and Tylenol for him. 

     The second most interesting case was an 18 month old little girl. I guess she fell in the fire on Tuesday evening. This scenario could very easily happen here as fires used for cooking are usually built on the ground or the charcoal is placed in a small metal "stove". She had burns to both hips, both thighs, her lower abdomen, and her diaper area. Thankfully I think the burns are just 1st degree, which is lucky because it would be a challenge to keep any kind of a bandage on in the diaper area. On her hips the blisters have popped but some of the other places the skin is still intact. I gave the family several tubes of triple antibiotic ointment to put on it several times a day and gave them a randevou for Monday. 

     There is a very active church right behind Jay's house. Pastor Jean conducts services at all hours of the day and night- these services include many different types of worship- preaching, singing, speaking in tongues, shouting, praying, music including a keyboard- you name it... at times a song or several phrases of a song can stretch out to last longer than 20 minutes. FYI, the microphone/speaker system at his church works quite well, sometimes to our dismay. Honestly, sometimes they are having a service when we go to bed at night and already at it again the next morning when we get up. Pastor Jean has brought several patients to the clinic in his machin this week. One of them was a 15 year old girl. She was mostly carried in, writhing in pain. Her complaint was that her back hurt, so bad! They said she was pregnant, that actually her baby was "due" a month and a half ago- toward the middle of October actually. The problem was, she did not look pregnant, for sure not 9 months pregnant! They put her on the exam table in my room, but she didn't stay on the table. She got down off the table and was writhing around clutching at her back etc... Her vital signs were stable, heart rate and blood pressure both within normal limits. I was very suspicious that she was not pregnant at all- so we sent her to the outhouse to provide us with a urine specimen so that we could do some "tests". Her urine specimen showed that she was NOT pregnant and she didn't  have any signs/symptoms of a urinary tract infection either. When I told her that her urine specimen showed she was not pregnant, her reply was something to the effect of " take me home!" I asked her then if she had any other complaints or if her back was the only place she was hurting. Yes, it was just her back, and she wanted to go home. So I gave her Ibuprofen and several doses of a muscle relaxant and sent her home. This happened several days ago and she hasn't  been back so I guess she must be feeling better. 

     We had several families over for lunch today to celebrate Thanksgiving. One family are missionaries from Gwo Cheval, another couple are staying at the mission house in Savann Mouton for a couple of months. Then several families from here in Oriani. It was an enjoyable afternoon and evening. Jesse's stayed later than most of the rest and we played several games with them- escape room and forbidden island- they are both games that are played as a team - so either everyone wins or everyone loses. 

     More another day.

Wednesday's after hours clinic

      Wednesday afternoon at about 3:00 a lady came to the gate in labor. It was her first baby and she wasn't quite ready. She had been having pain since the evening before and was now dilated to about 6 cm so I sent her back home, telling her she wasn't quite there yet. She lives not far away and the family that was with asked if they could bring her back when she got closer. I told them that would be fine... so they said they would come back around 6pm. It isn't often someone can estimate an accurate time of when a baby is going to be born but they were pretty much right on. We went to Wednesday evening Bible study from 4-5pm. Jay left a few minutes after the service started to see an "ijans" at the clinic- a lady with abdominal pain. He never came back to church. We came home after the service but were planning on going to Quenton and Chrystelle's house for supper to celebrate their little boy's first birthday. Roseline and Chancela had gone there already in the afternoon to help with the cooking etc... Jay had messaged that he was going to be at the clinic a while,  the lady with abdominal pain was still there and now he had a man there who needed a bunch of stitches in his hand. In a few minutes there was a man at the gate at the house with a child that had something in her nose. We sent them to the clinic and told them I would be there to help out in a few minutes. We didn't know if we would need to give Ketamine to remove whatever was in the child's nose or not and we had better tools available there anyway. When I got there Jay was busy stitching the guy's hand in Chancela's room, the lady with abdominal pain was in my room, and the kid and her dad were waiting on the bench in the entry. I gave the lady with abdominal pain a shot of IM promethazine then took the kid into Roseline's exam room. She had a blue bead lodged in her nose. She was 3 years old. Since I could see the bead very well I wanted to at least attempt to get it out without sedation. One of the youth guys had walked to the clinic with me so I employed his help and the child's dad to help hold her still while I tried to get the bead out. I was able to get it out in just a few minutes. While this all was going on, the lady who was in labor had showed back up at the gate at the house so Brianna sent her to the clinic also and called Roseline and  Chancela to come help us out. Roseline, Chancela, and the lady in labor all arrived at about the same time. I wasn't quite finished with the kid yet, but that was the only exam room with the bed available so the lady in labor came in there also. After the kid and her dad left, I checked her. The baby's head was right there and it was time to push! I happened to glance at the clock... and it was about 10 minutes after 6 pm. Jay had just finished stitching the hand- of a very drunk man- had sent him home, and was mopping all the blood up off of the floor. Then he sent the lady with abdominal pain home also. She wasn't pain free but it was better, and we had given her everything we had available. Meanwhile this first time mom did an amazing job with her first baby! It was a boy and his lungs worked just fine. He was an angry child until we had him dressed and bundled up, then he chilled out. When they were ready to go, one of the ladies who had come to the clinic with the mom tucked the baby under her jacket and they walked home. We went to Quenton's. It was 7 pm. It was a full afternoon/evening but there were no more calls that night so nobody was overworked. 

     The little 3 year old boy with the burns to his face, chest, and arm is healing well. Instead of coming 3 times a week for dressing changes like they had been doing, on Wednesday I gave them a randevou for next Tuesday,  for us to look at his burns and give more antibiotic cream if needed. He no longer needs a dressing on his arm, his face looks really good, and the places on his chest and the side of his head are slowly getting better.                                          

I don't know of a good way to keep a dressing in place to the side of a face so they are taking a bit longer to heal than the others did.