Merry Christmas!!

     Nathaniel and Brittni left on Monday. Trevor took us down to the airport. Somewhere I got mixed up and thought Nathaniel's left on Tuesday so that is the day Keith had bought a ticket for me to fly to Jeremi. April and her family had left several days earlier to go there and I was going to spend Christmas with them. So Trevor dropped me dropped me off at Franctzy and Sallies. I spent the rest of the day and night there then they took me to the airport the next morning. The flight was supposed to leave at 9:00 so I was supposed to be there at 8:00. Got there right on time. This plane makes one flight to Jeremi every day. My confirmation was a piece of paper that had my name, destination, etc... on it. Immediately inside the doors my luggage and I went through scanners. The scanner didn't beep so no further checking. I don't know how it didn't because those machines always beep about my hair pins but ??? I went up to the little counter and showed them my piece of paper. They checked my ID and gave me a little slip of paper that was my boarding pass. They weighed my back pack and determined it wasn't too heavy for me to carry then directed me to a seat. Soon after I sat down two little blind boys were directed to the seats in front of me. Slowly the small waiting room got more passengers waiting for the flight to Jeremi. No announcements were made at all. Nine o'clock came, then nine fifteen and nine thirty. I knew I hadn't missed the flight because no other flight had left except for one that was boarding when I got there. A little after nine fifteen I did notice the stack of luggage had disappeared. A few minutes after 9:30 a lady came to the front of the room and said we would board for Jeremi now. They took the blind boys first. There was no such thing as a luggage compartment under the plane, it was all stowed in the back of the plane. No overhead compartments either so we each placed our carry-ons in the back then found a seat. One seat on one side of. The aisle and two on the other. Each slip of paper had a row only, we each chose our own seats after that. Keith had told me to sit on the left side of the plane for a better view. The cockpit was not closed off from the other passengers, there was just a panel there and in the middle of the passengers boarding the pilot and co-pilot came in. It probably only took fifteen minutes to board because there werprobably only twenty seats and all luggage except what could fit under the seat in front of you had to go in the back. The pilot said the flight would take 40 minutes and we would fly at about 8,000 feet. No announcements about electronic devices so we all kept our cell phones on. The pilot started the plane and we were off down the runway. It was a noisy but smooth flight. We flew over the coastline a lot of the way. It was beautiful! We left about at the time we were supposed to land but I was able to text April mid flight about when we had taken off. Partway through the flight the sun was getting rather warm for the pilot so he used one hand to hold a Manila envelope against the windofor a shade. Right before landing I had a good view of the runway- hard packed dirt in between some grass. It was a smooth landing and when we were slowed down appropriately we drove over onto the grass to deplane. Out the plane windows I had seen April's family waiting, there was no fence around the runway at all. I picked up my bag and that was all there was to it. We left probably 10 minutes after we landed and headed to Abricote for lunch and the afternoon then went back to Jeremi for supper and night. We got a nice hotel there that just happened to have no other guests at the time so we chose the rooms that suited best. This hotel had mosquito netting over all of the beds. It had running water also, no hot water but when it's that hot outside a cold shower feels good! We also had fans in each room. The next day was Christmas Eve, and we went swimming in the Caribbean Ocean. It was absolutely beautiful! No one else was on the beach that day except one lady who came down to watch the "blancos" for a while. The water was crystal clear. The beach definitely had the "look" of the rest of Haiti- there was a lot of trash scattered everywhere but the sand and water were amazing.
We ate lunch in Jeremi then slowly but surely headed for Previle. April and her parents had been missionaries there for seven years when she was younger. They left when she was seven years old. The house they had lived in while they were there was empty so they brought some food, towels, sheets etc... And we stayed there. It is very pretty on the west end of Haiti. Obviously the elevation isn't as high as Oriani because it was warmer and there were a lot of palm trees also. The next day was Christmas. We visited some of the locals in the morning then took the younger kids to the river to go swimming for a while before lunch. We had a special lunch of roast beef, ( April's mom canned it and brought it with her) scalloped potatoes and green bean casserole. They had also brought along a bunch of homemade Christmas candy that made a good desert. The homemade caramel was the best! On the 26th we headed back to Port-au-Prince. The road was pretty good, some very bumpy gravel but also some pavement. We could see the coast off and on the whole way. We stopped in Ocai for lunch. We asked if there was anywhere they had fast-food-- you know--already cooked ;) We were led to a restaurant called Hot Spot. It was supposed to be a Chinese restaurant but also had cheeseburgers, pizza, hotdogs, etc... On the menu. As usual, they did not have near everything on the menu but we ordered burgers and pizza and it was good! And we were only there an hour and a half. We were led upstairs where the dining room was labeled VIP. We didn't mind at all because they had an air conditioner up there that worked well. Back in Port of course there was a lot of traffic so the going as slow. I had never been to the EpiDor restaurant so we went there for supper. I had a ham and cheese crepe and ice cream for desert. It was awesome! We were at the liaison house in Ganthier for night. Saturday morning we were just around the house there because a couple of the kids weren't feeling very good. April, her sister Emily, and I walked to the orphanage and hung out there for a while. After lunch we went shopping in Croix-Des-Bouquet market. That is a big, noisy, SMELLY market but fun. This morning on the way to church of course there was a road block. A pole had fallen over the road so nobody could get through. We eventually found a road around but were 45 minutes late by then. Oh well, this is Haiti. Time doesn't mean as much here as in U.S. We want to do a little more shopping tomorrow before we head back up to Oriani. And I want some ice cream one more time before we head up too.
   No clinic info this time because I wasn't there...

Big nasty..... Cyst...

      Several days ago we did a minor operation at the clinic. A lady came in who had a large cyst between her shoulder blades. Apparently this mass has been growing for three years. It is bigger than my fist. It doesn't seem to hurt her so this lady hadn't been anywhere to even get it checked out. It had a place where it looked like it was almost to burst open so we got out some instruments and some lidocaine and started our "surgery." It was absolutely amazing!!! This thing was FULL of cottage cheese consistency goop. We got out about two cups of that stuff. Thankfully, it didn't have a smell!

So we decided it really was a cyst and not an abscess because of the lack of pain. An abscess that size would have been super painful. We did put a drain in when we closed the skin. This lady was supposed to come back on Thursday for us to do a dressing change but didn't show up. She doesn't live very far from here but who knows what happened.
     My brother Nathaniel and his wife Brittni are here visiting now so we have been having a very enjoyable time. They flew in the same day Keith's left so that worked out well. Trevor and Mirlene took us to the beach in Grand Gosier yesterday. It was beautiful, as always. Then today we took moto  and went to Foret market. Tomorrow evening we have an invite to Savann Mouton to the unit after church.
     The triplets' mom was back the other day to get more formula for her babies. She is so happy for the help we are giving them. A BIG thank-you to everyone who sent money to help her. She is so grateful.
   One other interesting case we saw last week. A local lady was in another town where she found a young boy with an injured leg. There were no parents at the house where this child lived, just several other children. He looks like he is about 8-10 years old but he doesn't know his real age. He has a sore on his upper leg that he says has been there a long time. He also has a scar further up on his leg that he says was just like this wound. He has so much scar tissue around his knee already that he can't straighten his leg. This lady took him in and brought him to the clinic the next day. We gave her supplies for dressing changes at home and so far it seems like that is working well. He came back after several days of dressing changes done at home and the wound definitely looked better. Here's hoping it will heal so that we don't have to pursue other options of doctoring. Maybe even the de-wormer and good food will help.
    It seems very unreal that Christmas is almost here. It is warm here and there aren't any Christmas lights or music except what we have been singing in church the past several weeks. I just don't remember ever being able to wear flip-flops on Christmas Day.

Blood pressure, headaches, etc...

   The beginning of this week was a mental strain. I was on my own. It's just more strain on the brain... Keith was there off and on and I could always ask the other girls if I didn't understand something. But then I would have to go get them out of their exam room to come into my room to find out what was the matter with my patient then they would have to try to explain it to me in Creole. Tet fe mal! ( headache) There were a lot of patients those days too. Monday and Tuesday I was at the clinic until 5pm. Trevor and Mirlene went down last Saturday for her grandma's funeral. They stayed Sunday too then decided they would stay Monday also to work on her paperwork. They have this guy hired to do her paperwork and he is dishonest etc... He didn't get anything done on Monday so they stayed Tuesday also. On Tuesday Keith was on the phone with this guy for two hours, trying to figure out what the deal is, why nothing is getting done. Finally, Keith told the guy that the next day Trevor and Mirlene would be with him all day, Trevor would drive him around and be his transportation so they could get something done. So they stayed down Wednesday also. Drove this man around to different places and found out he hadn't even started on anything, but he did get started that day... By the way, Keith's got a paper for Ketli allowing her to travel to Ontario so they have tickets bought to fly there on the 17th. It doesn't look like Mirlene's papers will get through in time for them to go.
    Keith's really need a new vehicle so they had one shipped here. Today Keith, Zach, and Cam went to St Marc to try and get things there thru customs or whatever all needed to be done. The truck was packed full of stuff also. Some things for the clinic and then a few bigger things that aren't easy to bring by airplane. This process can take weeks. They didn't get the machine itself but got everything unloaded from inside it into a truck today. We thought everything was going good and we were getting somewhere until... Someone from customs stopped the truck. Now who knows what will happen. If the officials get upset over something they can seize the whole load and we will never see it again. Keith was trying to get this figured out before they leave on Wednesday because they will probably be gone about a month and then this stuff would all have to set somewhere, which could mean it may be damaged or stolen or who knows what.
   I had a lady come in to the clinic today complaining of a headache. It was the first time she had been to this clinic. Her blood pressure wouldn't register on the machine so I took it manually, twice. Her blood pressure was 280/160!! And she walked in... But no hospital and IV medicines for her. I gave her pills and she walked back out. I have seen one blood pressure higher than that. It was a patient who came in several weeks ago. The machine couldn't register hers either. The manual cuff I have goes up to 300.  I could hear the thumping the whole time. I had Githane come and double check her b/p. The closest we could guess was that her pressure was 300/200.  Neither of us had ever seen a blood pressure that high.
    April's family comes in tomorrow. Her parents, siblings, and grandparents are coming.

Nothing new...

   It's been a very busy week with a lot of patients but nothing really exciting. We did have a little girl with a badly burned hand and a burn on the bottom of her foot. I bandaged her up good and had her return in two days but that was a mistake. The dressing on her hand had come off the day before so that burn was all dried out and her fingers were stuck together. I covered it all with cream and another bandage and the next day it looked a lot better. Definitely didn't look good because a thick layer of skin was coming off but her fingers were no longer stuck together. I was very relieved that I didn't have to pull them apart. Her mom couldn't bring her for a dressing change the next day though because she had to wash clothes and now she has skipped several days. I hope she comes back soon because I think we could get it to heal nicely but??? I don't know where she lives so I can't go find her.
     Today we sent some people down to have cataract surgery. These people were chosen as good candidates back in July when we had an eye doctor up here. I think there were four people who went down. One lady was totally blind and was so very excited about being able to see again. She said if this surgery works and she can see she is going to come to our church and praise and thank The Lord for three days!
    Keith's are still trying to get all Ketli's paperwork figured out. Their family is hoping to go to Ontario for Christmas. Apparently with the paperwork they have she could enter Canada, the problem  is that Haiti won't let her leave. So they don't have tickets bought yet but are still hoping everything will work out. Mirlene is trying to get her paperwork through also but it is not easy. A corrupt government doesn't help either. People will say they can get the documents needed but then they are incorrect or something is missing.
   Ok, this is all for now...

Sad news...

     On Friday the triplets' mom came again. She had two babies with her so we asked where the third one was. She said he died on Monday. He was the smallest of the three and was quite malnourished. That is probably what he died from. She had the biggest one of the three with her this time too and I see now why she hadn't ever brought him before. He is big and healthy! I am still worried about the little girl though. A huge thank you to everyone who donated money for milk for these babies! Mirlene told the mom that some of my friends had given money to help her and that made her really smile. We aren't going to give her the money but rather told her she needs to return to the clinic as soon as the milk she has is finished and we will give her more. That way we know the money is being used for formula. She was a very happy mom when she left that day.
     I forgot to write earlier about the child who was born on the road while his mom was on the way to the clinic. This lady has mental problems. She has had one child in the past who died at 7 months of age from cholera. She is probably about 22 years old. She was working for a family, helping cook etc... She slept in their outside kitchen. One night the father of the house raped her. He is probably in his 60's at least. So now she has been living with her parents in a rented room. It is a very sad situation. Anyway, her dad came to the clinic saying she was in labor. We told him to go back home and get her and bring her to the clinic. He went but on the way back the baby was born and fell in the muddy road. Of course it was dark too. So they went back to their house and Trevor drove Mirlene and I and April there in the ambulance. Just try to imagine the scene for a few minutes. Chilly outside, and muddy. We were all wearing boots. It was dark. Someone led us around the least muddy side of the house with their flashlight. We came to a small room that was lit by a burning branch a young boy was holding. It was crowded full of people. There were only two chairs. The lady who had just given birth was sitting in one of them and her mom was holding the baby in the other. The baby was wrapped up in somebody's furry house robe so he was warm but he had a big muddy place on his head and other foreign debris on his body, leaves, dirt, etc...They hadn't cut the cord yet so the placenta is on the dirt floor under another piece of cloth. We had brought clothes and a diaper with us. Also gloves and a scissors. We cut the cord first then we tried to clean the baby off a little before we got him dressed. The mud was dry on his head so the part that didn't rub off stayed. We encouraged the family that the baby needed to nurse that night yet. Amazingly, the mom sat calmly on her chair the whole time we were there. We also told the grandma that she needed to bring the baby to the clinic the next day for us to check him out a little better. She brought him in the next morning. He was still wearing the diaper we had put on him the previous evening and the same clothes. The diaper was cloth of course so was pretty nasty. We did have warm water at the clinic that day so I decided this baby needed a real bath. The family hadn't had hot water so hadn't even washed his face. I gave him a good bath and got him some more clean clothes. They said he was nursing well.

Now that baby is probably a little over two weeks old. One day the mothers dad came to the clinic and said the baby's mom had run off in the night and he couldn't find her and they had no milk for the baby so we gave him a little bit of formula and some water to mix it in. Who knows where the water comes from that they drink. He was back the next day too for some medicine for the baby's mom. She had come back. We have given him some diazepam periodically for her so sent a couple more pills home with him. Ok, enough on that.
     This past week has been very busy at the clinic. There have been many patients every day. One man who came in on Friday had a cyst between his eyes. He had been to several hospitals already but hadn't gotten any help. I numbed it up and cut into it. It was a different kind of cyst than I've ever seen before but I drained it and then the whole sac the cyst had been growing in came out to so I don't think it will come back. He was very happy also. I didn't even have to stitch the incision because it was so superficial. I just covered it with steri-strips and he was finished.  One other thing that has happened this week- we had a nurse practitioner here who was testing women for cervical cancer. She was at the clinic Wednesday, Thursday, and Friday. It did slow us down a little bit because she was using one of our exam rooms but is a very good thing.
     On Tuesday a patient showed up with a large mass on his back. It was warm like as if maybe it was some type of abscess. I stuck a needle into it.... And got out 100cc of pus! We put him on big doses of antibiotics and he came back on Friday. It was big again so I drained it a second time. I got 50cc of nasty stuff out this time.  I am afraid this man will need this thing to be surgically drained but Fridays aren't good days to send patients to the hospital if you have any other options. Some of the hospitals don't want to accept patients in the evenings or on weekends. So he is supposed to return on Monday. If his back is no better we will send him down to a hospital.
   

Twins... And a piece of bone...

    Last Thursday Keith and Candace left for a week to celebrate their 25th wedding anniversary. In the afternoon, after the clinic was closed we were called back for a lady in labor. While we were checking her out a pickup pulls up with another patient in the back. This is a lady who is trying to have twins. Actually she had had one of them at about 10:00 that morning and now it is almost 5:00 pm. They haven't cut the cord yet, I'm not sure why, but the baby is warm and breathing well. The other baby has been stuck with one arm out all the way to the shoulder, for hours... The arm is a dark purple. Mom is exhausted. I didn't think that baby would be able to be born without a c-section but we called Githane to come see what she thought. We were unable to reposition the baby but somehow it was born. I'm still not sure how. If I hadn't been there I wouldn't believe it was possible for a baby to be born with one arm out then the rest of the baby's body then his head last, but it happened. The second baby was dead. We were all relieved that they didn't have to go down to the hospital. We gave the mom several antibiotics and some IVF's. It turned out the first lady we were called to the clinic for actually wasn't ready to have her baby quite yet so we sent her back home. Finally we get the other patient on her way home too so I came home and showered. I had just finished when we heard that a kamyon had tipped over and there were people injured so we headed back to the clinic. There were actually only two people injured this time. One man saw they were tipping over so he jumped off the truck. He had a very obvious fracture to his leg/ankle. The other lady had a head injury. We splinted the man's leg and then sent them both down to Port in the ambulance. We were so thankful we hadn't had to send it down an hour or two earlier with the twins' mom. The ambulance was almost ready to leave when someone says we have another patient from the same wreck. He supposedly hurt his back and can't walk. The true story is... He was on the truck earlier that tipped over but wasn't seriously injured. He lives close to Port and just wants to get home. We gladly piled him in the back of the ambulance too and away they went. This time when we went home for the evening we stayed home.
     On Friday a young boy came in with a sore to his left ankle. He didn't complain about it hurting just said it was a wound that had a lot of drainage. I started cleaning it ... And found something hard in the middle of the wound. It almost looked like a piece of bone. I pulled...and out came a splinter of bone about two inches long and half an inch wide.

Apparently sometime a long time ago he hurt his leg and now the piece of bone had worked itself out causing an abscess. The child couldn't even remember when the earlier injury might have occurred.

Does anyone have $20 a week that is burning a hole in your pocket?

 

 This picture is two of the triplets. They are six months old now and mom no longer has breast milk. I only have a picture of two of them because two is all she can carry at one time. That is, she holds both of them while riding on a moto to get to the clinic. These two are the thinnest of the three. They are suffering from malnutrition. The little boy already has swollen feet and legs from the lack of protein in his diet. The babies' Dad died so Mom has very little help and no way to make a living. She has asked us if we know of anywhere she could work to make some money so she can buy food for her children. She is from quite a ways away and we don't know of a suitable job at this time. We estimate it would cost about $20 a week per baby to buy formula for them. We don't want the mom to start feeding them food yet as they are already malnourished and we are afraid the food they would get would be rice, which doesn't have protein in it.
       P.S. I fear I am turning into a true Haitian- ask every white person you ever meet for money or a gift- but I do feel sorry for these babies!

Update- Here's the third triplet!

Family visits...

    We had a good weekend with the orphanage girls even though it was short. It didn't really suit for them to come until Saturday morning so April and I went to Foret ( market) on moto. Trevor and Mirlene dropped the girls off in Foret then we ate lunch together there at the little restaurant we try to visit every Saturday for lunch. We can get a big plate of rice, beans, and chicken for about $2. Then we all took moto back to Oriani. In the afternoon the unit boys from Savann Mouton met us in a clearing in the forest and we rigged up a volleyball net and played several games of volleyball.  We took the ambulance to hold up our half of the net. It has a rack on top so we had a lovely ride in the warm sunshine on top of the ambulance.
   Sunday morning was time change. I thought I had the time all figured out and didn't think I had made breakfast early until I sat down at the table and realized it was only 6:30 instead of 7:30. We ate then anyway then just had a longer morning.
     Wednesday Craig's and Amy came. April and I got to go down with Keith to pick them up. It was the first time since April came that she was able to go back down and the first time she really got to see the road down and the scenery since when she came up it was dark. We went first to get medicine for the clinic. While Keith was getting meds April and I went shopping in the iron market. We got some souvenirs and each got a wooden press to make fried plantains. Traffic was bad in Port that day so we didn't get groceries or lunch until after we picked up Craig's at the airport. That was ok though as they hadn't had lunch yet either. We stopped and got chicken, rice and sauce for lunch. Then headed to the grocery store and stopped in at Sallie's house for a few minutes before heading back up the mountain.
    Thursday and Friday we were just here at the clinic and around the house. Thursday is market day in Orianie so we explored there a bit also. Saturday morning we went to Foret market then on to the beach at Grand Gosier. It was a beautiful day! Only found a few shells but had an enjoyable time in the ocean then in the cold springs afterward. It can get chilly up here in Orianie but is always warm down by the ocean. On the way back home we stopped in Thiottes for supper.
    Sunday afternoon in was cloudy and raining off and on then we got a call that there was a lady in labor on her way to the clinic. It was her first baby so I was afraid we might be there for hours waiting on the baby but I think we were only there about 2 1/2 hours in all so she did very well. Keith took Craig's down to Ganthier this morning. They wanted to see the orphanage then were going to spend night with Lyndsey's uncle Virgil and Delma. They are in charge of the orphanage but don't live in Haiti year around. Then tomorrow morning they won't have to leave so early to get to the airport for their flight back to NC.
   A big thank-you to everyone who sent supplies for the clinic or chocolate for me! It is greatly appreciated!
   

Not much news today...

    The little girl who had burns on her back etc... Hasn't been back. She came three times and I was happy with how it was looking. I don't know if the family just decided it was getting better so they didn't need to come any more or what.
      On Sunday morning we had another long church service with 28 baptisms. This one lasted a little over four hours. We were very ready for lunch by the time it was all finished. During one of the baptismal prayers a "crazy" lady came in the church and marched right up front then pulled her bag of cheese puffs out of the back of her pants and deliberately started eating them. Then she wanted to put some money in the collection basket. I was sitting by the aisle so got a prime view of what all things happened during that prayer. It was rather humorous to say the least. She gave up on finding the collection basket finally then threw down her chip bag and walked out, leaving a trail of the remains of her chips on the way.
    One interesting thing, last Thursday in the night there was another kamyon accident. It was the same driver as tipped the truck near here earlier. Apparently he tipped his truck over the week before last too but nobody was hurt that time. This time sixteen people were hurt. It was further away from here but we went in case people would need transport to the hospital. He lost brakes going down a hill and all the people were thrown into a ravine. So far we haven't heard of any deaths from this time. By the time we actually got there another kamyon had loaded up everyone that was injured and they were already on their way to the hospital. It is a good thing too because it would have taken hours to clear the road enough for our ambulance to get by. We are all hoping this time the truck will be totaled  but don't know for sure yet. It looked bad that's for sure.  Of course the driver ran again. Seems kind of strange that he never gets hurt.
    This morning when we got to the clinic there was a lady there in labor. As soon as she came in the exam room we knew she had a bad infection because of the bad smell that came with her. She has four children already. We started IVF's and washed her up a little then gave some oxytocin. She did well until the baby's head was born but then his shoulders were stuck. We tried everything we could think of to help but his shoulders wouldn't budge. He had the cord around his neck too so when we realized the baby didn't really have a chance anymore we cut the cord then slipped it over his head. The cord had a greenish color. Finally after a lot of pushing and pulling the baby was born. He didn't have a heartbeat anymore though. We think if this mom had tried to have this baby at home they both would have died. I think the baby probably would have been pretty sick too because he had an awful lot of nasty green fluid coming out of his nose. The whole placenta was a greenish color too. This mom had been to our clinic the first of this month and had gotten antibiotics so we don't know if she didn't take them or didn't take the whole dose or what. We gave the mom IV antibiotics right away the wanted to watch her for a while before we sent her home. Turns out she was bleeding quite a bit and we finally got the family convinced that she needed to go to a hospital in Port. Meanwhile another lady was carried in on a bed. We couldn't figure out exactly what her problem was but we suspect tetanus. She had gotten a cut on her leg a month ago. We had stitched it and given her antibiotics but decided if the ambulance was taking one person down it might as well take two patients. They left right before lunch. One strange thing about these two pregnant ladies recently with terrible infections. They had both been to see some priest or pastor in he days before they had their babies. We don't know what all he gave them. This lady had been treated with "many bottles" though. I don't know what he could give that would affect the babies this way though because at the beginning of the labor both babies had a good heart rate. We hope this mom makes it.
  This weekend the orphanage girls are coming up for a short weekend. Then next week Craig, Lyndsey, Zoey and Amy come so I am very enthused!

And I thought I had a lot to write about last time...

    Friday afternoon we were supposed to have a members meeting at church to hear the converts tell their experiences then we would vote to see if they were all ready for baptism. Friday afternoon when the meeting was supposed to start it was raining. So we waited... When it quit raining about an hour later then we were going to have church so all of us from this household went. The ministers were still finishing up with a few visits so we sang... For an hour and a half... Then the ministers decided since not even half of the members were present we couldn't proceed with the meeting so we scheduled another meeting for Saturday afternoon. Saturday afternoon it was raining off and on so we went to church but once again not even half of the members were present... So we sat and talked, and talked, and talked... Until the decision was made that we would try one more time to have this meeting. This time we would have it after the Sunday morning service. So... To make a long story short... Sunday morning's service lasted from 9 am until 1:30 pm. There were 28 candidates who told their experiences and they were all approved for baptism. So this next Sunday will be another long service with 28 baptisms...
      For some reason I wasn't even present for half of the service Sunday. We had just finished Sunday school when a moto comes to the church with an injured man. This man got between a man and his wife when the man had a machete. Apparently the lady wanted to leave her husband and he was upset about that so was going after her with his machete. This other man stepped between them and got a whopping big wound to the side of his face and jaw. He lives a long ways away from here. He walked an hour up the mountain to get to someplace where they could get a moto. Then he had another hour ride to get here. When we got him to the clinic his blood pressure was 50/???. He was almost dead. Isaac and Heather had come up for the weekend so I was very glad for her help because Todd stayed at church. One of us held pressure to his face and the other one got two iv's started. When the fluids were dripping in as fast as possible we started to repair his face. He was cut from his ear to his lip.

Two places were through into his mouth. Several teeth had been knocked loose also. When we removed the clots we found some spurting blood so it hit an artery. We couldn't find two ends to sew together so had to sew it closed. It took several stitches but it worked. Then we could go about cleaning the wound a bit more and sewing it closed in two layers. We don't have blood products at our clinic so this man got 4 liters of IVF's. This brought his blood pressure up nicely. We used lidocaine where we stitched but that was the only anesthesia he got. I did have a couple of hydromorph pills that I gave him when we had finished stitching. He did amazing. We had just started stitching when this guys pregnant wife showed up. Someone had brought her on a moto. I think she was pretty much in shock about the whole thing too, probably not sure if she would find him alive. She watched the whole thing though and did well after we got her something to drink. I would really like to know what this guys hemoglobin and hematocrit was.  He had to have some stitches in his one arm too and some superglue to a cut on his thumb. After a short recovery time he headed home on a moto. He came back on Tuesday for dressing changes etc... And looked good. His blood pressure was good too. He is to return again on Friday.
    Sunday early evening a little girl and her dad show up at our door. This little girl somehow got burned. I don't know for sure how, the story seems rather sketchy. She has burns to her upper arm, shoulder and lower back and buttocks. They also come around close to her belly button etc... Pretty
much she has dressings all around her abdomen then part of one arm and part of one leg. Second degree at least.

One more strange thing, this child is three years old and she didn't make a sound while we dressed her burns. I didn't scrub them. I have found if I cover them with a thick layer of burn cream and dressings and change the dressings often that works as well as anything I've tried. Plus it is much less painful. She came again on Monday and Tuesday and got her dressings changed. Tuesday she did cry a little but it has to hurt terribly! She didn't come today so I sure hope she comes tomorrow. One thing the people here all have in their heads is that a burn should never be covered. They think it needs to be open to air. I do not agree with that. Even cold air hurts a burn and they need to be kept moist to heal properly. So that is always an education issue.

     Monday morning at 4:30 Keith got a call about a patient with cholera. Since I had had several cases on Sunday he called Githane to handle this one. I was very thankful. This was an adult man who had gotten cholera the night before at about 8pm and he was almost dead from dehydration. They got him IVF's etc... Were at the clinic with him for a couple of hours then came home for breakfast then we all headed back there again. We moved him and his bed outside so we could start normal clinic operations. Several hours later another family showed up with cholera too. So now we had four cholera patients plus the rest of our normal patients. We got them settled with IVF's if needed or lots of oral hydration then once again went back to our other patients. This family had lost two girls (a 8yr old and a 26yr old) on Friday from this same sickness but they still wouldn't believe that it was cholera. They said the other girls had something else then the "devil" got them. After numerous phone calls to the health agent where there is supposed to be a cholera center opening back up we got a health official of some kind to come visit the clinic and our patients then they told us where we could take these four patients. So late in the afternoon the ambulance headed down the mountain with them. Luckily since then we haven't seen more... Yet...

     There was a baby born at the clinic that day too. It wasn't too bad of a delivery, the mom just wasn't the most cooperative person I have ever seen. The baby was fine though. Hooray!
    Monday while I was home for lunch we had a storm. It rains here but that day there was thunder, lightning, and hail with the rain. The lightning hit the house too and messed up the inverter.
   Then today I had a grandma bring in her grandchild who was 17 months old, and weighed 5 1/2 pounds! It was terrible! I asked what she fed the baby and she said soup. I asked why she had waited so long and her reply was that the baby's mother is in Port-au-Prince and she kept phoning her to ask her what to do. I'm not sure what changed but she brought the baby in today. He has swollen feet and hands and eyelids from malnutrition. I hope it isn't too late for this little one.
     On Wednesdays Githane always has classes with the pregnant ladies so I see most of the rest of the patients. She usually sees 50-80 pregnant ladies on those days. Today while she was in class a lady came in in labor so I took her into my exam room. She had three children already and soon everything was set to go. This lady was very quiet and cooperative and after about two good pushes the baby was born. We surprised Githane by taking the newborn baby in her room to show the class. She hadn't even known there was anyone there in labor. Wow! That mother was amazing!
   Ok... Enough said for now...
P.S. I really enjoy reading those comments!

I was just reading over what I wrote the other day and decided there were a few more details I need to add. On Tuesday also the little boy with the prolapsed rectum came back in. He hadn't had any more problems until that morning when he prolapsed again. This poor little child knows he has to relax his body for us to get it back in and he tries hard, but it hurts so bad and your body's reflex is to continue to push. We finally gave him some water to drink to try and distract him. He was laying on the table on his stomach so couldn't really drink out of a cup so we were giving him water with a syringe. It wasn't long and he was refilling the syringe himself and having as good of a time as he could with all that was happening. When we finally got it back in this time he was squinching his butt cheeks together for all he was worth. He didn't want that problem again! We gave him some more Benadryl to help him relax and so far he hasn't been back. This day though his mom had brought his little brother to the clinic too for vaccines. We didn't want to risk another prolapse so mom took the baby home and then came back so she could carry him home too. Thankfully they don't live very far away. The little boy must have walked to the clinic that morning very painfully...
     Also, the little girl who we suspect had meningitis died the other day at the hospital. They did no further testing ( that is what we were afraid of) and I don't know if they kept giving her IV antibiotics or not.

 

We need an orthopedic surgeon...

   

 This little boy is about 18 months old and just came to see us yesterday. He has severe club feet. I told the mom she needs to buy him some 'hard' shoes and he needs to start wearing them on the wrong feet a couple of hours a day. She is supposed to return also with a phone number where we could possibly get a hold of her if we do find out an orthopedic surgeon is coming. He is trying to walk and the way his feet are now he stands on the outside part of the side of his foot and not on the sole of his foot at all. But I'm hoping if she will do what we ask her we can maybe help his feet to straighten a little because they weren't stiff in that position that was just how they bent without support.
     It has truly been a week of unusual maladies. Monday morning started with a 3 year old with cholera in my room and then an 11 year old who was mostly unresponsive and was having some seizures in Githane's room. So we didn't see any other patients for quite some time. The three year old was so out of it when I started her IV she didn't even flinch. Actually she was unconscious for a little while. She was VERY dehydrated and was having vomiting and diarrhea of course. We don't know for sure what the 11 year old has. The nearest we can guess is meningitis. She had a history of a bad headache a day or so before but when she came in she couldn't even talk. Her pupils were unresponsive to light and she didn't blink either. The problem is, there isn't an MRI scanner in Port-au-Prince that we know of, only a CT scanner and we do not think whatever she has would be revealed on a CT scan and we aren't convinced she would even get scanned. Her prognosis did not look good at all but she is still holding on and is definitely coming around. We are giving her IV antibiotics every twelve hours. She can possibly see some light but can't see much else but she can talk now and answer questions appropriately. So... We really have no idea how this one will turn out. We have tried to warn the family though that if she lives she may never return to how she was before this sickness.
 

Little cholera girl got IV fluids for several hours then was conscious enough she could start drinking too. She was able to go back home that afternoon. One interesting point about her- her mom said all the rest of her family wanted her to take the little girl to the witch doctor. They didn't want her  to bring the child to the 'hospital'. Actually her husband was so upset with her that he wouldn't even come with her. She was a very grateful mom, hopefully the rest of the family is too.
  Of course before we were finished with even those two patients a lady came who was in labor. It was her seventh child so didn't take long and wasn't a difficult delivery. That baby was an angry little thing though... And she had a big mouth and a fat face. It is so much less stressful though when the baby opens it's mouth and howls!

     Tuesday started about 6:00 with a lady in labor. First time mom, ready to deliver in the near future but not immediately. So Keith and I came back to the house for breakfast then went back and started the day in earnest. We thought there would be a baby born early but this lady refused to push so... The baby's heart rate was good so we just waited a while. Gave her some oxytocin too. Still she wouldn't push. To make a long story short, she had the baby about 11:00 and the baby was dead. The cord was around the baby's neck and I guess it had just been too long. It's very frustrating when I think of what would have happened in the U.S.  This lady's baby would have been monitored continuously and when the heart rate started to decrease or if anything funky was happening the lady would have just had a c-section. No questions asked. Here she is stuck with what we can do or else she has a three hour ride to a hospital. Discouraging, never the less.
    Also, the lady from last week who had a baby that died then came back in herself several days later ... We sent her down to Port, and the next day she died. I think she was septic. Depressing...
   Then on Tuesday right before we left for lunch a six year old boy came in with a prolapsed rectum. Todd helped me with that one. It took three or four of us to hold him down then some skillful maneuvering by Todd but we did get his problem solved, for the present. They stayed at the clinic until I returned from lunch and as everything was still in its normal position we sent them home. At 2:30 he was back with the same problem. This time it didn't take quite so long to return it to its normal anatomy but then we made him stay on his stomach for at least 30 minutes and gave him some Benadryl so he would relax. He fell asleep so we sent him home again. This time with more Benadryl for when this wore off and his mom carried him with one hand clenching his butt cheeks together. It looked rather humorous but it must have worked because he hasn't been back.
    We also had another little girl in with cholera yesterday but this one didn't need IVF's just oral rehydration and monitoring. This little girls' mom told Mirlene though that this child is always sick. She said if she can find anyone who will take her she will give her child away because she thinks the devil is tormenting her or something like that...
    By the way, I do enjoy comments on my blog. Makes it much more encouraging knowing someone is reading it...
   One more funny incident that happened to April and I last Saturday. We went to the market in Foret- des-Pins as we do almost every Saturday. It just happened that this time we didn't get home before the rain came. First thing, when we went to market we didn't see any moot drivers that we knew so just took a ride from the first person who offered. This guy didn't seem to be real experienced with driving but did okay. Probably part of his problem was that he just wanted to talk with us and seemed to really 'like' white girls. When we got to market he wanted to know if he could just wait for us so he could take us back too. We told him he really shouldn't because we didn't know how long we would be there... And we were thankful he took our word for it. So on the way home we were riding with one of the church brethren. We told him how the guy that morning really enjoyed taking us and he said that guy was "naughty" :) about half way home it started to rain... For real! I was glad I wasn't the one driving because the rain was coming down so hard and fast that it was hard to see. It didn't let up either. On the last hill coming into Orianie the water was several inches deep all the way across the road, not so easy to dodge potholes when they are not visible. Anyway, we were all laughing pretty hard by now. Going through the town people were huddled under their tarps or little pieces of plastic. We laughed and waved and kept on going. My phone has a very bad attitude when it gets wet so I was trying to clutch my bag closed under my arm for all I was worth. The hill just before our house is not a good hill to drive moto on when it is muddy. It turns into a mudslide. Sorel just put on the gas and away we went though

And then some babies are born with a tooth... But what about being born with TWO MOLARS??

  The other week a two month old baby came to the clinic for immunizations. This child was apparently born with two molars, at least they sure were bigger than any baby teeth I've ever seen! The teeth were loose though, like they should be when they are close to coming out. We didn't pull them though. We left them alone and hope the baby doesn't choke on them when they do come out!

  On Sunday there was another baby born at the clinic. This was this lady's first baby. She was in labor a long time so I'm sure she was exhausted, but the labor and delivery didn't turn out at all like we hoped. She had come to the clinic on Saturday too but wasn't close enough to delivery to keep her there. We thought surely she must have had the baby Saturday night in the night some time until we got a call late on Sunday afternoon that they wanted to bring her in again. So we headed to the clinic, started an IV and some fluids and gave her some oxytocin. This was about 5:00 in the evening on Sunday. Progress was slow, but there was some progress so we decided we would keep her a while to see if she could have the baby here before we attempted to take her down to a hospital. That always takes some time to get arranged anyway since we have to determine if the ambulance is running well enough to make the trip or if someone will have to take Keith's machine. Lately Keith's machine has had more issues than the ambulance though... Then we have to find a driver. Hopefully by then the patient's family will have come up with enough money to cover the cost of the gas for the trip. We had decided to give her some medications though and hope for a successful delivery here. About 7:00 we were thinking the baby would be born soon. Well, the baby's head was born and then things started going backwards. There were several family members in the next room watching. We had sent them to the other room when the time got close so we would have room to work. The mom was exhausted and the baby was stuck. We were trying everything we could to help this baby be born. All at once one of the family members comes hurrying in the room with some " witch doctor oil" that was supposed to give the mother strength. Problem was, it was very strong and Githane got a big whiff of it and she started coughing... And coughing... Until she was gagging and throwing up. Another family member was doing some sort of motions over the lady's belly. Trevor was at the clinic too but had no idea we were even having problems until he heard the commotion. None of us knew there was any kind of nasty smelling oil in their possession either.  Meanwhile the baby was still stuck and turning more and more purple. Mirlene started getting after the lady who had brought in the oil and she wasn't easy on her. It wasn't long and she left the room and that was the last we saw of her
that evening. Trevor said she tried to come in the room again but he wouldn't let her. She still smelled very strongly of "oil". We got the mom to change positions but still the baby was stuck. Finally we decided there wasn't any more hope for the baby so we would attempt to cut the cord to see if that would help at all. I had been able to feel that the cord was around the baby's neck but couldn't loosen it enough to slip it over the baby's head. It seemed like something loosened up when the cord was cut.  Several minutes later the baby was born followed by a huge gush of nasty, green, very foul smelling liquid. The baby didn't have a heart beat any more at that time. But then there was this awful smelling fluid to compete with the oil smell in the room. Then the placenta wouldn't come. Once again I had to stick my hand WAY up in there and help it loosen. It also had a greenish tinge to it. There hadn't been other obvious signs of infection until all this stuff came out. We sent her home with antibiotics instructing her that if she got a fever she needed to return right away. Well, today she came back with a fever, a high heart rate and her blood pressure was on the low side of normal so we sent her down. I'm afraid she has a massive infection.
   Now for a better story, Monday morning at about 7:00 another baby was born. This one took a couple of gasps of breath then yelled at the top of her lungs. That was beautiful! I had to laugh at her, she was mad at the world!

Did I just turn into a labor and delivery nurse???

    I didn't realize that was my specialty... But the past several weeks it has been. This month so far there have been nine babies born at the clinic. And the month isn't quite over... The last baby to be born there couldn't quite wait until we got there. It was in the evening so Keith had driven us to the clinic. As we were driving in there was some frantic activity under and around a blanket by the clinic door. The baby had just been born so they carried mom, baby, and mattress in and put the whole kit and caboodle on the exam table. Thankfully this baby wanted to breathe so there were no problems there.
     But, the baby that was born before that... Is a different story. This mom came after hours also so I was the only one there (besidesApril) at first. I asked if this was her first child and she said " No, this was her fourth baby" and she was at nine months so I checked her. Instead of a head I felt a finger then a hand then an arm. Uh oh... But the baby didn't seem to be all the way against the mother's pelvis so I was hoping if I could get that hand and arm back in maybe the baby could still reposition.  So I decided to try that. It took several tries but finally I thought I was successful. Meanwhile Mirlene came and was trying to find the lady's file and was not having any luck. The lady said she had been to the clinic twice before. Come to find out after more questioning, this lady had never been to the clinic before and she already had five children. I'm not sure what the point of the previous lies was. I had also asked our Haitian nurse, Githane, to come as this was not a normal presentation. By the time she got there the baby was head down and in good position. I had checked the baby's heart rate also and it was good. But now the mom would not work with us! We gave medication and repositioned  and encouraged her to no avail. She did not want to push - so she didn't. Finally there is only so much you can do in a situation like that. We had her on the exam table then finally let her get on the floor because " she couldn't have a baby lying down." Finally, after several hours, she did have the baby. He did get stuck for a few minutes with only his head out but not for very long. Initially he had a heart rate but he refused to breathe. I suctioned some nasty stuff out of his nose and mouth but he still wouldn't breathe. We were giving him some oxygen too. The next time we checked his heart rate... It was no longer there. He also needed an intensive care unit. It was frustrating for me, we had been able to help reposition him so he could be born without too much difficulty and then ???
It seems like these ladies have a sixth sense about when there is something wrong with their unborn babies and they will come to the clinic but we still weren't able to save this one.
    There is a " frequent flyer" patient who has bad asthma that comes in frequently. She is non-compliant with her medication. I don't know how she takes them but they are always gone too soon. We asked her to bring someone with her to the clinic who could help her with her meds but she won't.
We have also asked her to bring any medication she has left with her when she comes to the clinic so we can see it but that doesn't happen very often. Finally, several of the meds we have been giving no longer seem to help her symptoms. It's like her body has become used to them but we really don't have a lot of options for asthma here. Today we heard she has died, not from her asthma though. She was apparently gathering sticks so she could cook when she fell over the edge of a ravine. She was found several days later so we don't know what really happened. I thought one of these days she wouldn't be able to breathe but...
     Yesterday April and I went to clinic to stitch someone's hand. Turns out these guys are drunk and keep telling us they love us and want to marry us etc... The one guy who was the worst off thought he needed to help us so when I get out the lidocaine to numb the guys hand he takes the other mans head and practically shoves it under his arm telling him " don't look, don't look!" Then I guess he thought it would help with the pain if he squeezed the guys wrist so he squeezes and squeezes. I don't think he ever even realized that my fingers were getting in on the squeeze half the time too. It made for an interesting time but we were glad when we could tell them we were finished, they could go.  I wonder if they will remember what day I asked them to follow up on.
    As soon as we finished stitching the hand it was time for church so we headed there. When we get there church had just started so we sat toward the back. A lady who is "tet fou" ( has mental issues) was there also. She had a lot of attention until she was "chased" out of the building. She ran and one of the brethren walked quite rapidly after her. She was making obscene gestures and talking and moving from one bench to another as often as she pleased.  During the morning service she marched in after church was started and sat on the front bench. Then she had to put her drink can ( evaporated milk) down on the floor. One of the little boys had great joy kicking that can all the way out of the back of the church when the children left for Sunday school. It puts a new twist on church at times...

More babies...

So far this month there have been five boys born at the clinic and two girls. On Sunday we were at the clinic waiting for a baby to be born when Keith called and said some twins that had just been born were on the way to the clinic also. So he and Candace came too, as we were thinking the baby would be born any minute. So... The lady in labor delivers a healthy nine pound girl and before we were finished with her the twins were there too. They each weighed a little over three pounds. They were both crying when they came in but it was obvious they had just been born also. They were about two months early. The mom didn't come, two uncles just brought the babies. They were partly dressed and wrapped in one blanket each but they were still too cold. The one didn't have good color at all but the other one was nice and pink. We washed them up a little then dressed them and wrapped them together in several blankets. When we were washing the one whose coloring wasn't good he had something strange all over him. We asked what it was and they said they had rubbed him with mayi moule ( grits) because he didn't want to breathe. They were identical boys, down to each of them having a small extra digit on each hand. We didn't do anything with the extra fingers now, we can later if they live. I don't think the one will make it but the other seemed strong so far.

We sent them back home with instructions to put them skin to skin on mom's chest, no clothes between and get them warmed up. Then try to get them to nurse later that evening. In United States those babies would have went straight to an intensive care unit... And we sent them back home... But there are no neonatal intensive care units near here.
    Last week on Wednesday we sent a patient down to Port. I rode with in the back of the ambulance with her because we wanted to keep her on IVF's. Two family members went with also. For those of you who don't know, the back of the ambulance does not provide a smooth ride at all! By the time we were 20 minutes down the road one of the ladies was sweating already and feeling quite car sick so I handed her a trash bag. I had warned them that they might get sick, and that I might too. I did okay, just every time after I spent a minute or two changing a bag of IVF's or checking her oxygen saturations I  would have to look out the front window and concentrate pretty hard on not being sick. The poor family member though, she threw up off and on all the way down the mountain. We were taking the lady down because she had had a baby at about eight o'clock that morning and had come to the clinic at 1215 because the placenta was never born. The baby had died. Well, by that time, everything was happening as it should and I just couldn't get my fingers in far enough to get a hold of the placenta. The more I tried it kept breaking into pieces so we took her down for a d & c.
   The little girl with the burned arm is finished with her dressing changes. I am very pleased with how well it healed.

   On Friday morning a lady came into the clinic with abdominal pain. She was seven months pregnant. This was her first pregnancy so she didn't know if she was in labor or not. I checked her and yes the baby was going to be born soon. I was unable to find a fetal heart rate though and the mom said the baby had stopped moving that morning. Shortly after she delivered a little girl, still born, no heart rate at all and bad coloring. I don't know what happened for sure but for one thing the mom had a bad infection.
   After hours that night another lady came in in labor. She had eight children already and really made quick work of the whole deal. I think we were at the clinic a total of one hour. April came with me to that delivery, she is turning into a nurse very nicely... And quickly.
   One other thing that happened last week,  a little boy had come in with some kind of an abdominal infection. We put him on antibiotics and it was looking much better, until that morning when the mom brought him in. I guess she wanted it to heal faster or something, anyway, she put some kind of leaves on it. Now it was infected worse than ever, and there were even a couple of openings in his skin. Zach was taking the ambulance down that day so we sent this boy and his mom down with him. The mom didn't have a cell phone. Several days later this boys dad came to the house very worried. He had been down to Port and couldn't find his wife and son. They weren't at the hospital where Zach  had dropped them off and the dad couldn't find them. It took several days to work that one out, but they were found at another hospital.
   That's all for tonight...

Don't you think the asparagus is ready?

 

This is one delivery I didn't stick around for...

One of the few suicide attempts I have seen here...

    A young boy, probably 14 years old, came in a couple of weeks ago with the complaint that he couldn't eat. He had sores around his mouth so I  told him I needed to look in his mouth. His tongue was covered with big sores which we found out were burns. He had tried to swallow some chemical used to spray in the gardens to kill himself. We don't think he swallowed much but he definitely got a lot in his mouth. The sores on his nose and around his mouth were from that too.

So we tried to find out what made him want to kill himself. His sister had brought him in and she said he tried to kill himself because he got spanked too often. Well, up here there isn't much we can do unless we actually see signs/symptoms of abuse and his symptoms were from the burns so... We couldn't really do anything except give him pain medicine and some protein drinks. He hasn't been back so only God knows what is happening there.
     Last week we had two children come to us with old burns. The first one was a three year old brought in by her grandma. She has burns all around her elbow and a few smaller  places on her torso. The grandma said she wasn't there when it happened but apparently the child fell onto a pot of food. When we asked how many days ago this had happened she didn't know for sure, probably eight or ten days ago. The burn was all dried out and had nothing on it and they had no pain medicine. I really can't imagine how painful that must have been. It was too dry for me to even attempt to clean the wound so I put some cream on it and a bandage and told her to come back. We never know if these people will come back for burn care or not because the first thing we do is put a dressing on it and they are taught to NEVER cover a burn. I'm not sure why they feel that way but I think they really have to have faith to come back for more dressing changes. This lady did bring the little girl back though and she has had 3 dressing changes so far. I am very happy with how it is healing.

 Today I had to laugh at the little girl though. While I was getting everything ready to do the dressing change I gave the little girl a sucker. Her grandma unwrapped it for her and handed it to her. She knew what was coming next and knew a sucker couldn't stop it so she threw it all the way across the room.
    The second child came with a burn to his hand, wrist, and arm. He is 11 years old. His burn was only five days old when they first came but they brought him because it was so painful he couldn't sleep at night. He has had one dressing change. This one looks like it will heal very nicely also. I'm just trusting they will keep coming back.
  Last Friday a young man came in and his complaint was that he couldn't hear. I looked in his ears and decided I would clean them with q-tips to start with. That didn't cut it. I had to wash them out and got amazing results from BOTH ears. I wouldn't have been able to hear either. It was just like as if he had had ear plugs in. Then I remember that these people have probably never even seen such a thing as a q-tip, let alone having money to buy them!
   Another man came in last week with a puncture wound to the back of his leg. It was very dirty. Then he says he can't tell us a lie so he will tell us what he did for it. First he had someone pour battery acid in it... I don't know why... Then he put sand in it! We got him some antibiotics and he is coming several times a week for dressing changes. Today I got more sand out of it when I cleaned it.
  Ok, that's all for now.

FYI - I am planning to stay here through December or January,  hopefully by then we will have found someone to take my place. I will gladly read emails if anyone cares to send them ;)
atoews5225@gmail.com

... A very infected arm... And another tooth abscess

 

This man came to the clinic with a very swollen, red, hot arm. Two of his brothers own a brothel in a local village. Apparently a girl that works there wasn't happy with this guy for who knows what reason, so she pokes his arm with a pin or needle that was obviously dirty. That had been 8 days ago. Around here a lot of people think if something causes you pain it helps to tie it up with a cloth or rag. It looked like his arm had been tied because it was so swollen then abruptly stopped but he denied having ever tied it. He had been poked around his elbow. Now it was swollen almost to his shoulder and all the way to his finger tips. We did get a lot of pus from his arm but it was still very swollen so we put a drain in his arm too then wrapped it up and put him on some strong antibiotics. We told him to return in a couple of days for us to change the dressing. He came back but for some reason got upset when Todd was re bandaging his arm and just got up and walked out without even letting Todd finish. We thought the swelling had gone down some and there was definitely drainage on the old bandage but I guess he thought the swelling was worse or something. So he leaves, with the drain still stitched in and his arm partially bandaged. He has never come back yet. We are afraid he could lose his arm but just today someone who was at the clinic who knows him said his arm is all better... So maybe he continued to take the antibiotics we had given. We don't know...
    Today an eight year old boy came in with an infected tooth. His mom said it had only been swollen for three days but it looked like it had been a lot longer than that. He couldn't even really close his mouth his cheek was so big. I was going to try and pull his tooth but Keith came and looked at it with me and we pressed on his jaw and got a lot of very foul smelling pus out. It seemed there were several teeth loose and infection several places so we didn't pull teeth, just put him on strong antibiotics and told him to return in a week. Hopefully by then the swelling and infection will have gone down enough that we can check his mouth out a little better. By the way... This was one case that Mirlene did not want to assist with. She felt too sorry for the little guy and left the room so I was glad Keith was there to help. She would have helped if no one else was there but since someone was, she got out of the room.
   More another day...

Is this just a freak coincidence?

     Last week on Thursday we had a young lady come into the clinic in labor. She came at 11:45 so we were expecting to have a late lunch. But her delivery was amazing! We got her up on the table and  checked her and it was time to push. We did start an IV for a few minutes but didn't need it for long because at 12:15 we left for lunch. The baby was born and taken care of and we had the mess all cleaned up already.  I did catch this baby, Githane didn't quite have her gloves all the way on! Everything went very smoothly and there was very little bleeding. We did have the mom lie down though while we ate just in case there were problems. We were going to check her after we ate then probably send her home. I got back before Githane  and they called me in there right away, the lady had stood up a few minutes before and was now losing a lot of blood. They had her on the table already so I checked her. There was definitely something going wrong. It was like her uterus was full of blood.  Finally I got most of it out then checked her again. Something didn't feel right. It didn't feel like more blood clots I was feeling, it felt like it was intestine! Then I could feel that my fingers had gone through a hole. Surely this lady didn't have a hole in her uterus too! She is only 19 years old but this is her third child. I started another IV and got some fluids running then called Todd to come and double check my diagnosis. Githane was back now too so she used the ultrasound machine to see if she could see a problem. She found a black hole right about the place where I thought there was a problem. So... I call Keith and tell him I have a patient that needs to go down to the hospital now for a surgery. That day it was Candace's birthday and we had a small party planned for that evening. He finally got one of the unit guys from Savann Mouton to agree to drive her down. One interesting thing we noticed about this baby, his ears were two tone. Both ears were dark until the earlobe then they changed to a lighter color. I have never seen that before. The patient got to the hospital okay but we haven't heard anything since. We are all very curious to know though, seems very strange that we would have a patient with this same problem so soon again. I guess the difference was that she had her baby at the clinic so we realized her problem several hours earlier than the lady the other week.
     Friday morning the whole family left for Port-au-Prince. We were supposed to pick April up at the airport that afternoon then we were planning to go to a beach resort for the night and part of the next day. On the way down we were stopped in the road because there was a vehicle coming from the other direction that was trying not to fall off the side of the mountain. It was a Land Rover or something like that so wasn't a small vehicle but the driver's side wheels were completely off the road. The driver was still in the vehicle but all the passengers had gotten out. If the driver would have gotten out he would have had to crawl out the passenger side. There was a kamyon there that they were trying to hook up some ropes to so they could pull it out. They got the ropes hooked up and started to pull... And one of the ropes broke and suddenly we could see the whole underside of the vehicle. The kamyon had stopped by then but the force of the one rope breaking was tipping the vehicle over. A bunch of guys who were standing there watching ran up and grabbed ahold and pulled the vehicle back right side up then they pulled again with all the guys there to help steady it. It worked this time so when they got back up on the road about twenty people were running to get in the land rover... So apparently it was a pretty full vehicle. Then we could continue on our way.
   When we were almost all the way down the mountain Keith got a phone call from April that there had been a flight cancelled so she wouldn't come in until the next day so we headed out for the beach several hours earlier than we expected. We went to a resort called Moulin Sur Mer. It was pretty
windy that evening so we didn't really swim in the ocean but swam in the pool. The next morning was beautiful so to the beach we went. After lunch we went to a museum on the resort then headed back to Port for Sallie's wedding the next day. We met April before supper then her and I spent night with the orphanage girls. It was an enjoyable evening with the girls. I grossed some of them out with a video of the cheek abscess we dealt with a little over a week ago. Right now the orphanage has twin
 boys that are one and a half months old then the little girl who is nine months old that we sent down from up here. The other orphanage workers are there on duty 24/7 so the girls had been keeping the babies at their house for night. That night they had the nine month old too because they were going to take all three babies with them to the wedding the next day. They don't have air conditioning down there and only sporadic electricity for their one fan. They run their fan at night so hopefully they can get some sleep in between the heat and taking care of three babies. Half way through the night the electricity went off but it does cool down a little at night. The babies were up at 6:00 so we got up too. Actually, April and I didn't get out of bed until 7:00 but the other girls each had a child to tend to.
The wedding was nice but long. It lasted about three hours and started about thirty minutes late because the bus bringing the choir had broken down. It was a very warm day and the babies got really hot. The amount of people that can sit on one church bench really increases over here. The ushers just keep bringing people in and we would all try to move a little closer so one more could sit but soon they would be there again with someone else. I helped with one song and the minute I got up someone came and took my place on the bench. I decided I didn't need to sit that bad so went to the back of the church and stood. Then I could at least feel a little breeze.  The reception was outside at a hotel by the ocean. It was breezy and beautiful.
    FYI- we just got a phone call saying that the man with the broken back died this afternoon. He is so much better off now.
    We came back up the mountain Sunday evening. We would have been back in good time but had some problems with the machine so we didn't even get started back up until after 7pm.
 Ok, that's all for now... Waiting to see what this week holds.

Another house call...

  It has probably been a little over two weeks since we heard about a young man with such a bad sore on his leg that he couldn't get on a moto to come to the clinic. One afternoon Todd, Donna (his wife), Keith and I got into Todd's machine to go to this boys house. We didn't really know what this wound was from, only knew that he had a large wound, so packing a box of supplies to take with us was a guessing game. We could drive almost all the way to this house also, just had to walk a few minutes. We found a decent house with cement floors and walls. In the one bedroom was a 16 year old boy on a small bed. The house didn't have electricity and we went in the afternoon after clinic so it was pretty dark in the house. Luckily I have a flashlight on my phone that we could use to see his wound. It was on the back side of his leg just below the knee. It had apparently started as a blister then progressed possibly into an abscess that had already drained large amounts. Now it was a big hole. It didn't look infected really but did have some deep places especially on the sides. We cleaned it and put a dressing on it then gave him some antibiotics and pain medicine. We left a few dressing supplies at the house too for the mom to change the dressing in a couple days. We really thought for this wound to heal properly though this boy would need to go to the hospital and get it cleaned out good and the dead tissue cut away. So we took some pictures of the wound and sent the pictures to a Dr who coordinates surgeons, etc...from other places that will come to Haiti periodically. There was an orthopedic doctor coming in about a week who could do surgery on this wound so we set them up an appointment and everything... And thought that wound would be taken care of. But the family didn't take the boy to the appointment. So, several days later the family again wonders if we can do anything to help them? They say the wound has gotten a lot better with antibiotics and more frequent dressing changes. I'm sorry, we had things set up to help them when the surgeon was here, now he is gone ...
    There is a family here where the grandmother has two of her daughters and their children living in her home. The one daughter has had a lot of problems since having her children. Her one little girl is probably three years old and her other little girl is nine months old now. Their mother is unable to even take care of herself at this point so the grandmother has her hands full. They come to the clinic often it seems like. The children always seem to have coughs and colds and are malnourished. We give them rice almost every time they come. I have been worried about the baby for several months now. She simply isn't gaining weight, rather she is slowly losing weight. When I asked the family if they were giving the baby the food we sent home with them I never could get a direct answer.  Now this little girl is nine months old and weighs nine pounds. She used to be able to sit up by herself but I don't think she can anymore. She has had numerous antibiotics etc... Finally I told Keith that if we don't do something this baby is going to die. Our church has an orphanage in Ganthier so Keith said he would talk with them. They accepted her! So two days later she goes to the orphanage. Now I know she will get good food and enough of it, I just hope we didn't get her there too late. They say she doesn't know how to drink from a bottle and besides she is too weak for that anyway. They have had to feed her with a medicine dropper so that all she needs to do is swallow and she still tires very easily.
      Last Friday was a very eventful day here! It started out normal until a lady came in in labor. She has four children already so didn't expect any problems.  She wasn't quite ready to push yet so we had her walk a while then started an IV to give her some fluid. When she was closer we gave her some pitocin. Not too long after this we suspect problems. She just isn't advancing like she should. So we check her again, and something feels different! We think the baby is breech and instead of a round head we are feeling a round baby butt. We get the Doppler out and confirm the baby's head is not down. Ok, so, in the U.S. this news would probably mean an automatic c-section. Actually a c-section would probably already be scheduled because from ultrasounds, etc... They would know the baby is breech. What now?  Trevor and Mirlene were planning on going down to Port so they go home to prepare to go, and if the baby hasn't been born before they leave they will take this lady down to the hospital also. Meanwhile, the mom is still having contractions and we think maybe we are getting a little closer. We try changing the moms position to see if that will help. It doesn't. The baby is too far down to change its position, and the mom is in pain. Remember, we don't have epidurals here...
After much drama and stress the baby's body is slowly born, but then the baby is stuck again. Her whole body has been born except for her head... And it is stuck! We try everything we can think of plus whatever hairbrained idea comes into our heads that we think possibly might work... To no avail... We even did an episiotomy but still the baby wouldn't be born. By now we are afraid that the baby won't be alive. But we can't really send the mom down like this! Finally, after many prayers and more sweat than I've lost any other day since I've been in Haiti, the baby is born. We suction out her nose and mouth but she doesn't have a heartbeat , so we let her go. It seems if she would have lived she surely would have had brain damage from lack of oxygen. Only God knows...
This paragraph really doesn't do justice to all that did happen that day...
     Saturday it started raining. It is supposed to be rainy season now but has been very dry. Cisterns were getting empty, crops failed etc... It rained off and on all day Saturday then all day Sunday and now off and on today. It has been wonderful! Now our cistern is only a few inches from overflowing. But rain here takes life to a totally different level. There were only a handful of people in church in the morning and we didn't have church in the evening. Many people have to walk and not near everyone is able to afford a pair of boots. Plus, the mud here is very slippery. A four wheel drive is a must for some of these hills. And pretty much the only umbrellas I've seen belong to the "whites". Several of the clinic workers didn't even show up today, I'm sure because it was raining. We had few enough patients show up that we didn't have to go back after lunch.
   This weekend the children's school teacher will be coming and it is Sallie's wedding...