The baby that we transported down to Port-au Prince died. The way I understand, all of the tests that were done on him came back negative. I do not know if the hospital where he was has the capability to check bilirubin levels or not because his level surely was quite high.  

     Friday morning we left home at about 9 AM, headed down to Wahoo Bay. Of course it took several hours to get down the mountain so we had lunch from a roadside stand soon after we got off of the gravel mountain road. Delicious chicken, rice, bean sauce, and a couple of the girls had mayi kole. the mayi part is corn- almost like grits, but it is also cooked with beans and seasonings. It sounds sketchy, I know, but it is good! We had brought a cooler along with a few drinks we had stuck in the freezer overnight. My Toro was wonderfully slushy, I just wasn't paying 100% attention when I opened it so it fizzed out the top all over my lap. Oh well, we were on our way to the beach. If the clothes are sticky they can soon be traded for a swimming suit. We got to Wahoo Bay between 2 & 3 o'clock. They had one of our rooms ready so we changed into swimming clothes and headed for the beach. It was hot and sunny and beautiful! Wahoo Bay has a small cove with a sandy beach so we were all in the water for the next several hours. They had a swimming pool also but that water was almost too warm to feel good, it was like bath water. We ordered supper from the restaurant there at the hotel. We had turned the a/c on in our rooms so they were nice and cool for night. Saturday morning Jay had made an "appointment" for a guy with a small boat to take us all to an island that was 5 miles away -"the way the crow flies". The biggest island in the group of three had a small lighthouse on it- Arcadins Island Light House. That was where we got off.  The "captain" of the little boat we took had said it would take 25 minutes to get there, it took almost an hour but we didn't mind. It was absolutely gorgeous! The island had a lot of trash washed up on the shoreline but the water itself was beautiful. There was some sand but also a lot of rocks and sea urchins multiple different places. Jay and Brianna went snorkeling right there, they said it was absolutely gorgeous! I looked for shells for a while and the girls played in the sand. The lighthouse was small and surrounded by a low wall. The wall had a few openings so water wasn't totally surrounding it but the walls were low enough that it looked like waves could wash in if there was any type of storm. So, that area around the lighthouse had lots of conch shells. Not huge ones, the biggest I found was probably about 4 inches long, but pretty none-the-less. I collected some for us to bring back with us. After that I took the girls and we started walking around the island. I had been watching but hadn't even seen pieces of a sand dollar so I figured they must not be in this area, but I found one whole sand dollar, and it was not even broken! The odd thing is, I never did see any other broken sand dollars either... It is a different kind than I've found in North Carolina. The shell is a lot thicker, shaped almost like a rock instead of a coin. The girls had just found a beautiful sandy place where there weren't any sea urchins so they were having lots of fun in the water. After a bit Brianna came so I was going to try to go snorkeling. By the way, it really did not work out for me this time, but I will try again. The combination of trying to wade out to deep enough water- walking backwards because I had flippers on- trying not to step directly on any sea urchins, and not having even tried to use a snorkel/mouthpiece for several years along with being nervous because I was out there alone was too much. I am not a confident swimmer at all, and after having popped back up out of the water like a jack in the box several times because I felt like I couldn't get enough air, I decided to try it another time when I was not alone. I don't know why, but it never even entered my mind until a couple of hours later that there were a couple life jackets in the boat and I could have used one of them. That's okay though, it was a beautiful day and I figured why stress myself out trying to get the hang of this? We were only planning to stay on the island for about two hours and we had stayed a little longer than that already so the "captain" was chomping at the bit... we needed to go or else we would have to pay more, so we headed back. We had only been in the boat probably 10 minutes when the motor sputtered to a stop. The "captain" messed around with it for a while and got it going again, but we were unable to go as fast on the way back. By this time, it was almost noon. We had brought a cooler with some drinks and homemade granola bars so we sat back for a snack and enjoyed the scenery. The blue of the water in the Caribbean is hard to beat! We had been expecting the beach there at Wahoo Bay to be packed with people because it was the weekend but it wasn't. There were only a few other people there when we got back and they had put out the trampoline. The youngest two girls went in for naps and Brianna, Lydia, Ellie and I swam out to the trampoline. They had a lot of fun jumping off of it into the water, I just enjoyed the view and the sunshine. Later on in the afternoon there was a thunderstorm, but we didn't even care. We had had a very fun day already so we all took showers then ordered supper. The next morning we ate breakfast there at the hotel before heading to Blanchard for church. Brianna's cousin Quiara is married and lives there in Port so we went to her house for lunch and spent night there also. It was quite warm there in Port compared to what we are used to up here in Oriani but they had fans so we were fine. In the early evening we went out and got slushies- cherry or grenadia- from a vendor just down the street. Monday morning we went to see Wynne Farms in Kenscoff, ate a picnic lunch there, then Roseline and Chanchela (the 2 Haitian nurses who work at the clinic also) met us at Stop and Go (grocery store) and came back up to Oriani with us. It was late by the time we got home, a little after 10 pm, and there was still some partying and music going on in Oriani. The remains of the party from the Catholic church here this weekend. 

     Yesterday was a full day at the clinic because we had been closed on Friday and Monday. The man whose face I had stitched up on Thursday came in for a dressing change. So far the wound looks very good. Today we didn't have as many people so we didn't go home for lunch, just stayed and finished up. It was between

     On Sunday Jay took a pregnant lady down to Port in the ambulance so he was gone most of the day. After we got home from church Sunday morning an "emergency" showed up at the house. A young man who was carried here on his bed. He said he couldn't walk and his "malady" was his right hip. He had a large area on the side of his hip that looked like a burn. The skin was peeling away and it had some blisters. His leg was swollen also. the story is... No, he had not been burned. This just happened. He fell in a pit months ago and his leg has never been right after that. This wound had only been there a few days. I let Chancela handle this one also, but we really didn't know how to treat it. She gave a few medications and dressed the wound and told them to come to the clinic on Monday. Monday morning he was there on his bed when we got to the clinic. Jay was helping us see patients because Roseline was on her way back up from Port. He looked at this guy's hip and talked with them a bit. They admitted then that this guy had been to a "bone doctor" who pulled around on his leg and put some cream on his hip. I don't know if he had broken bones or what but we gave him some pain medication and told the family that he needed to go down to a hospital where he could get an x-ray to find out what was wrong. We really doubted whether they would take him down but that was our recommendation. The next morning someone told me he had died that night. I have no idea what actually was wrong.

     On Tuesday I saw a young man who was there with his mother for a consultation. Both he and his mother were trying to tell me the story of what was wrong and I was not getting it, at all. There were too many words that I was not familiar with. Then he asks "Can I speak to you in English?" Yes, certainly! He was fluent in English and explained to me that his mother had some mental problems and he was wondering if there was any medication we could give her to help decrease her anxiety. I did a little bit of research and decided to give her some Trazadone to take in the mornings and some Benadryl to take at night to help her sleep. Hopefully those medications will help her.

     Wednesday wasn't a long day, we probably finished at about 1 pm. I made some granola bars then was going to go back to the clinic for a while to try and organize a few things in my room.  Jay was working at the clinic and just when I was ready to leave the house he messaged that there was a lady there to have a baby and it looked like it would be soon so could someone come help with the delivery... So I thought I was going to help deliver a baby.  While we were waiting a moto pulled up with a sick baby. The baby had been born at the clinic several days before. The family had brought him back the day before because his eyes were yellow. They were very yellow! But otherwise he looked good, alert, well hydrated, etc...  We advised to cover his eyes and put him in the sunshine, also how important it is that he eats as often as he can, as the bilirubin is excreted in the stool. Now he looked horrible! Raspy breathing, gasping, oxygen sats in the mid 80's,  VERY jaundiced eyes and now his face was very yellow also. His hands and arms almost seemed like he was having spasms too. Brain damage from hyperbilirubinemia? ABO incompatibility? I don't know. We had him on some oxygen and Jay transported him down to a hospital that evening. I don't know what the outcome will be for him. Meanwhile, the baby still has not been born. Over the next several hours, Roseline and Chancela both came to the clinic also and we tried everything we could think of to help this mother deliver, without success. At about 10:30 pm she still had not delivered but we hadn't been able to find anyone to transport them down to the hospital. Our ambulance was already down with the baby. The baby's heart rate was strong and the mother wasn't in distress so we encouraged the family to find a ride down to the hospital and came home, tired. I haven't heard what happened since then.

     This afternoon's emergency was a moto accident. I don't know exactly how it happens, but so often with a moto accident the wound or injury that needs stitching etc... is on the face or head. This one literally looked like he had a hole in the side of his face, by his eye. It was deep also. This guy was in a lot of pain so I gave him a shot but still couldn't really wash it out like I wanted to so I got out the Lidocaine and numbed it up. Then I was able to irrigate the wound and get it as clean as I could before I stitched it up. I had been unsure how the skin would come together as it seemed to have pulled apart quite a ways but I was able to get the edges approximated and sent him on his way after giving him pain meds, an antibiotic, and instructions to return on Tuesday.

     The clinic is going to be closed tomorrow and Monday. The Catholic church here in Oriani is having a big party that will bring a lot of people here from Port and will include a lot of drinking etc... So we are planning to get away somewhere before the party starts here. We were initially planning on going to the Dominican Republic to the beach but they say the border is closed today and tomorrow because of mourning for the president or something. So... I'm not sure where we will go, but we are planning to leave Oriani tomorrow for the weekend. 

      Some people have asked where I am staying. I have the same bedroom I had when I was here in 2014. The school teacher and the white nurse have bedrooms on the yard but not in the house. The building where our bedrooms are also has a school room on one end. The Haitian nurses stay in Keith's house and Jay and his family have a house on the same yard also. We have a garden, a small shop and some beautiful green grass. There is an outhouse and a cistern for each house. Then the whole area is surrounded by a fence. There are some banana trees close by the fence but they do not go all the way around the yard so it is partially private but not completely. 

     Jay and Brianna have four girls- Lydia is 8, Ellie is 6, Joanna is 3, and Adeline is 1. The weather has been absolutely beautiful! It has been getting into the lower 60's at night so a sweater is a must. During the day it usually gets into the 70's. Next weeks' predicted low is 55* and the high is 77* so the weather is gorgeous! 

      As life always does, plans change. Roseline's dad got sick and was in the hospital so she went down to Port-au-Prince Friday to be with her family. She didn't have a ride down first thing in the morning so she came to the clinic and saw a few patients before heading down. So I was on my own on Friday. I thought it went pretty well. When we were finished I asked the girl who works with me if she had a headache from working with me and needing to explain so many things to me and she said she didn't so... We did have a baby who needed oxygen that we kept at the clinic the whole time we were there, then took them to a small house nearby where they could stay for the night as the baby still needed to be on oxygen. Chancela pretty much took care of that and I observed. We checked back in on them just before dark and gave the baby some more medication and a neb treatment. She seemed to be doing pretty well, just needed a little bit of oxygen. I guess they sent her home the next morning, I wasn't there when they checked on her.

     Saturday was my birthday. It is also market day in Foret des Pins (forest of pines). We always went to market on Saturday when I was here before- to get lunch and the "outing" as much as anything. We normally hired someone to take us on moto- on Saturday the road between Foret and Oriani is full of motos carrying people and supplies back and forth. There are always numerous motos waiting on each end of the route. It was always the highlight of the week. The ride there is just beautiful, through the forest of pines most of the way. One interesting tidbit... so the roads here are not good at all. Huge potholes, washed out places from rain, you name it... I had the pedometer turned on on my phone and several times when we have been driving somewhere- either in the machinn or on moto- we have been going slow enough that the pedometer picks up and starts counting steps😆 I did some laundry in the morning. By that time, Chancela had already gone to Foret. I wanted to go but it has been six years since I was there so I didn't really want to go by myself. I was trying to decide if I was brave enough to go alone when someone came to the gate who had been in a moto accident. I guess another moto hit them and this young lady had a large wound on her head  that obviously needed stitching. Jay normally does the night and weekend emergencies but I stood around and tried to help him get this girl ready to be stitched up then gathered a couple of medicines for her while Jay did the stitching. I finally asked Jay and Brianna if Lydia could go with me to Foret and they agreed so we walked into Oriani and hired someone to take us. The "five star" restaurant has moved to the next building over but still had the same good food. They had more options available than I remembered. We chose mayi kole. The mayi part is almost like grits then it also has beans and legim (vegetables) and a chicken leg. Drink options are stashed in an old freezer with some pieces of ice here and there. They aren't cold, but they aren't room temperature either. Of course I chose a Toro. I didn't need to do any shopping so we wandered around the market for a few minutes then headed home. I studied Creole for a while in the afternoon. For supper Jay grilled chicken and Brianna made a lettuce salad, fried rice, and a chocolate cake. It was delicious! A good birthday- with people I have known for one week. 😊 They had even gotten a couple of presents for me- a candle, a pedicure set, (from Lydia) and some money. I told Lydia she is going to have to teach me how to use the pedicure set because I'm not sure how to use all the little instruments.  I think she is looking forward to that!

     

      Monday, Tuesday, and Wednesday I worked with Kay. I wanted to overlap a few days with her because it has been so long since I have been here and things have changed- medications that are available, protocols, etc... Monday I pretty much observed and asked questions. Tuesday I saw a few patients and Wednesday I saw over half of the patients that came through our room. There are 2 Haitian nurses working at the clinic too. I didn't hear the numbers for all of the days but Mondays are usually busy days and 105 numbers were given out so we probably saw a few more patients than that. The patients get a number according to what time they arrive at the clinic and will be seen in that order unless there is an emergency. Jay's took Kay down to Port today- also Jay's folks and two of his nieces who were here visiting. Kay leaves today, the rest leave tomorrow so Jay's will come back tomorrow evening sometime. Today and tomorrow I will be working together with Roseline- one of the other nurses who works here. She knows English well so that makes it easier to communicate but I am trying my best to speak Creole because I will not have an interpreter working with me next week.

     We saw a pretty sick boy yesterday who was about 12 years old. He had a high fever and it seemed like pyelonephritis or some kind of kidney problem. He had a lot of pain in his lower back and abdomen and his urine looked horrible, 4 + protein, blood, etc... We gave him a shot of Rocephin and some Tylenol and observed him for a few hours. When his fever broke he did look better. He looked to me like one of those kids that are so sick they don't make a peep when they get a shot but he sure did holler and carry on when we gave him an IV, he was quite dramatic actually! Sent him home with instructions to return to the clinic on Friday. Yesterday there were several malnutrition cases that looked pretty pitiful. One was 2 months old, the other was 11 months old. The baby was supposed to go down to Port-au-Prince. The other child was already enrolled in the nutrition program in Foret. We did give him some antibiotics though for a gut infection and tried to stress how important it is that they follow-up  with the nutrition program. I don't have a good feeling about him though- 1 1/2 months ago he was seen at our clinic and weighed 6 kg, yesterday his weight was 5.2 kg. Today a lady came in who had 3-4 + pitting edema from her abdomen on down. Her abdomen was so swollen she looked like she could be pregnant. Her vital signs were pretty good, respiratory rate was definitely elevated and she had shortness of breath but her heart rate and blood pressure were good. We started out by getting an IV in her and a catheter to measure urine output. After two doses of IV Lasix she had put out 3900 ml of urine, and that was just in the first couple of hours. We sent her home also with medication to take and a follow-up appointment for Monday. She wasn't out the clinic door yet when a lady came who was in labor. She delivered after probably 45 minutes. She needed some encouragement to really push, she was getting tired it seemed, but she rallied and delivered a baby boy. The cord was around his neck but it didn't take him long to come around. After a while they walked home, the proud daddy carrying the baby. 

     

 Hello,

     I left Grand Rapids, Michigan at 5 am on July 10. My grandma passed earlier in the week and her funeral was on Friday in Michigan so I was able to change my ticket so I could be there at her funeral. It was a sad time, but wonderful to be able to see most of my family. I flew from Grand Rapids to Charlotte, NC - then to Miami, Florida. My connections were pretty tight but I made it. I arrived in Port-au-Prince at about 12:45. Of course going through customs took a while- then I had to go collect my luggage. Quentin and Chrystelle were there at the airport to pick me up. We made a couple more stops then headed up the mountain to Oriani. We stopped for a few minutes in Fond Verrettes and got chicken and fried banans. It was amazing! It was so pretty driving through the pine forest again! We got here at about 7:30 in the evening...more later.

 The airport in Port-au-prince opened back up yesterday so everything is on schedule. I fly out at 5 a.m. this morning. 

 Hello everyone,

     I was planning on going to Haiti to work in the clinic in Oriani for three months. My flight was scheduled for July 10th. Currently, with the situation in Haiti, I do not know when I will be able to go. I am planning on using this blog for updates though when I get there.