Monday, March 21, 2011

Preparing to go back - Saturday, March 12, 2011

So, I've been trying to get around to posting on the blog again. As the time draws near for going back, I was busy getting things ready, too busy it seemed to sit down and write about it. Now, I'm heading out tomorrow! Yesterday was a furiously busy day of running around picking up donations. I had started to worry that I wouldn't be bringing much down with me, but I should have never doubted how God would provide. By the time all was collected, there was a massive pile of boxes in our living room. Audrey and I spent all day unboxing vitamins and tylenol, then organizing into ziplock baggies. We also sorted through hundreds of onesies and nearly 80 baby blankets, washing them and organizing according to size. I was determined to be done with plenty of time to go to bed early, but somehow there was just too much work to do.

Audrey was adorable, though. She was thrilled to be able to help. She's been asking when she can go with me to Haiti, but she's made it clear she only wants to go to play with the babies. She's also asked if we can adopt a 12-year-old sister with a 6-year old brother. Nothing like making your wishes known!

We finished, though. Finally managing to get everything into three containers. We had more blankets than would fit, though, so we had to squeeze those in with our own clothing.

It seems surreal that I'm going back tomorrow. I've spent so much time over the last year thinking about Merline & Vlad, and the patients I saw. The night before I left last year I felt nauseated and scared. Tonight, I simply feel excited, like I felt last weekend when I flew to New Mexico to be with my girlfriends from college. I don't know what to expect, since we're not even going to be in Port au Prince proper this time. We'll be working in clinics in the surrounding towns. I'm grateful for God's blessing that I can go back. I'm looking forward to seeing the changes in the last year, but most importantly for providing a little encouragement. Last visit was about frantically trying to provide urgently needed medical care. This time I'm going to share hope. I want the folks to know they're not forgotten. God loves them and knows their suffering. I'm going down to help alleviate, for a little while, that hopelessness. If one patient, one Haitian staff member feels a little less burdened because of some dumb thing I've said, or because of me helping lug boxes back and forth each day, then that will make it all worthwhile.

Saturday, May 1, 2010

A Little Wish Tree

After some cajoling via email, I finally got Merline & Vlad to give me a wish list of needs. After sending a tent, which was an obvious need, I had no earthly idea what one needs most in the conditions they were living in now. The list was humble: watches, tennis shoes, scrubs, a lantern for her parents, toiletries. The one big ticket item was a laptop. At first, that may seem extravagant, but really, that's probably the most important item for their emotional health. With no other consistent form of communication (cell phone batteries die, no mail, lots of people moving around the country), email access meant knowing how they're friends and families were, meant keeping abreast of the news. I just wasn't sure others would understand why a couple living in a tent would need a laptop.

So, I went about trying to get the items on the wish list. I didn't want to hit up people at church again, because they'd already been so generous. But I spent three or four fruitless weeks trying to secure donations, or at least steep discounts, from various stores around town. Big fat no's all around. Plan B? Feel useless of a while and mope a bit, riddled with guild that I'd let Merline & Vlad down. They finally confided to me their needs, it became a little hard to fulfill those needs, and my busy day to day life threatened to water down the urgency I had felt for my Haitian friends after I first got home.

So, back to church. Our youth participated in a 30-hour famine, raising money to donate towards World Vision's feeding projects in Haiti. I was blessed to be able to share some stories of the lovely Haitians, to help these youth start to understand how important their cause was. It was motivating for me.

I wrangled up some persistence. I emailed the very busy coordinator of the NC Baptist teams until I had contact info for the next few trips. My ever-amazing husband did a 4 am run to the airport in Greensboro, a little over an hour away, so that two containers of baby blankets that Audrey's school collected could be taken to Port-au-Prince.

Most importantly, last Sunday, we placed a little Christmas tree in the vestibule at church. Audrey had helped me create little construction paper ornaments to decorate the tree, ornaments with needs written on them. We included donating "shares" of purchasing backpacks. We didn't want to send typical backpacks, we wanted them to have tough, water proof ones, good ones that would hold up. Those are expensive, even after Great Outdoor Provisions generous discount. So, the tree had many "shares" towards purchasing a backpack. Several of the ornaments were heart-shaped, in addition the stars and angels. That was Audrey's idea. "Let's make hearts, Mama, because we're loving Haiti". Looking at the tree just didn't seem to fully get across how heavy the burden on my heart was, but I think the hearts helped.

At the end of the day, we only had about $100 in needs still hanging on the tree.

Hopefully, tomorrow everyone will bring back the items listed on the ornaments, and next Sunday morning they'll make their way to Port au Prince. The laptop goes down tomorrow after another 5 am run to RDU. Then we'll be ready to meet the next set of needs as Merline & Vlad, like hundreds of thousands like them, daily work towards rebuilding their country.

All from one little wish tree.

Tuesday, March 16, 2010

To Make Our Dream Come True

I've been a little overwhelmed by trying to integrate Haiti into my life. The motivation to do so, though, is very clear. It took a few days for the tent and items we sent with Kristina to make it to Haiti, and another day or so to make it Vlad and Merline. Just about that time, I was starting to doubt whether my impulse to focus on these two was a good idea. Then I received these emails:


Dear Cathi,

We appreciate your effort to make our dream become true. Week ago, Merline and I were talking about how to have a bed and a tent like the one that you just send for us, now we have them.

Thank you so much and Thanks to your pastor for your wonderful support you are giving us.

May God keep Blessing you your family, your pastor and others.

THANKS AGAIN! Have a good week.

With Love & Peace,
Vlad
Haiti


2010/2/21 Merline Milien

Hello Cathi, i can't stop praising God for his deed. I knew he was great and noone is like him but i feel ashamed to see how great and powerfull he can act. I can tell you frankly every single thing you sent is was directed by God, he knew my heart and saw our needs. I was willing to ask for one of this but I felt to shy to ask, but even this morning I didn't know if I will see exactly what I wanted. All I can say is Thanks so much.

I met Kristina tonight and she was telling me the story how she get to pass the customs without too much trouble and I was so happy and overwhelmed by how God can have control of things. I don't know the words to ask you to pass my gratefullness and thanks to your Church and your Pastor,

God will give all back to you.

Thanks again for your support and effort. I was scared to ask anything. When i see how God can arrange to give you what you need and he is the one, the provider. I love him.

Take care and I am glad for you because you let God used you in the way he wants.

God Bless you all, and my friend cathi, stay under his blessing.

Your new friend and her fiance Vlad


How can you even respond to something like that?

A few days ago, they sent me an email with a picture of them and the tent.


I've never lived outside. I've never even had a purse stolen or a bag lost on an airline. Where do you start when you've lost everything?

It took another three emails to get them to send me a list of what else they need, but they finally did. And it includes such simple things, like tennis shoes and scrubs, toiletries and watches.

So now that's my next mission. Collecting what I can and sending them down another package. One set of needs at a time.

Tuesday, March 9, 2010

Continuing Work in Haiti

Check out the HillSong Facebook page notes section to read about Dr. Tony's trip to Haiti.

http://www.facebook.com/note.php?created&&suggest¬e_id=359614196837&id=150531053116#!/notes.php?id=150531053116

Monday, February 22, 2010

For a Broader Perspective

An article one of our church members sent me offers a bigger picture of what's going on in Haiti. It is from the Fayetteville paper.

http://www.newsobserver.com/2010/02/22/351809/haitis-destruction-stuns-82nd.html

- Pastor Rob

God Provides

After returning home, I decided I needed to share the stories of the Haitians who were living this nightmare. I started with my church. They encouraged me before I left, and I I knew they had prayed for me in my absence. I wasn't prepared for how much they supported me once I returned. I don't even know that I had realized I would need support once safe and sound back at home. Like anyone who has gone to a developing country for the first time, much less a disaster scene, we just seemed to have so much here and don't generally don't appreciate our wealth as much as we could. I have a personal sore spot for how un-done my house is, for the paint swatches on the wall for more than a year now, for the projects not yet started or not yet finished. But in the few days after arriving home, my home very much seemed a castle. Fridge and pantry brimming with food, warm water coming from the shower, toilets that flushed around the clock (at Community Hospital in Haiti, the toilets only flushed from 7am to 7 pm). I found it hard the first week back at work.

So to make sure I didn't just return to my life as it was before, I spoke at church on Sunday, just 5 days after returning home. I struggled with what photos to show and which stories to share. I initially just wanted to show pictures of Merline and Vlad, and say "Hey! Help me get a better tent for these people!" I realized, though, that the full story would be something more than that, and in order to help those who weren't there understand like I did, I would have to tell the stories that hurt the most for me to think about.

How does one narrow down 447 photos to a 5 minute presentation? You don't, I discovered. I chose a dozen photos that for me conjured up very vivid memories. I tried to write down a script for what to say about them, but that didn't work. In the end, after a dozen practice runthroughs that ended up with a dozen different presentations, I decided to have no script at all. I simply spoke as the Holy Spirit led. That was the only way I could get my point across, if it wasn't my point at all, but God's.

I don't really remember actually giving the presentation now, at least not the words that I spoke. I do, though, remember seeing lots of people crying and that the time fly quickly. I only cried in fits and starts, which was an achievement. I ended with pictures of Merline and Vlad, and a plea for the church to help them. Then I sat down next to Jon and buried my face in his chest crying for a few minutes.

Afterwards, it became clear the church was moved. I had dared to hope for enough funds to buy them a tent, a dining canopy, and something to sleep on. I thought this would improve things for all five adults living with them, since Merline & Vlad could then have some space, as would their current tent-mates. God provided more than that, though.

I had made a few visits and some phone calls trying to find a camping supply store that would offer us discounts, something to help stretch the budget and provide as much help as possible. I had only minimal success, but one woman at our church, Tamara, helped magic happen. She contacted the folks at Great Outdoor Provision, who went to town. They generously provided discounts and helped work with a very quick turnaround time so we could get the tents checked as excess baggage on the next team's flight down, in just a few short days. The staff at Great Outdoor Provision was enthusiastic about helping and wanted to see some of the photos of Haiti and especially of the two Haitians in particular they were helping. I ended up leaving the store with three 6-person tents, six cots, a dining canopy, and six camp chairs.

The next morning, Pastor Rob and I headed to the airport to meet the team heading down. We arrived by 5:30 am and soon met up with Kristina, a lovely nurse who was leaving the country for the first time. She was nervous yet eager to go and do whatever her skills would allow her to do. We prayed before heading to the check-in counter. I had read Delta's baggage policy the night before and was distressed that they were significantly more restrictive and costly than American, which I had flown down on. For the three excess packages we were checking, they would have been justified to charge us $975. At the counter, Kristina's two bags were checked while we asked if there was any way the other three could also go. The clerk stated there was an embargo so we really could only send 2 bags per person. He asked if there were others on her team, but she didn't know who they were or when they were checking in. I asked the clerk if he would like to see pictures of Merline and Vlad and the tent they were sharing with three other adults. I pointed out we were sending them tents and cots.

"Would you like to see their pictures?"

"No, ma'am."

He then proceeded to place each of our extra bags on the scale and checked them through. No further discussion, no further pleading on our parts. I thanked him and told him that this simple act of kindness meant two grateful Haitians would be saying a prayer of blessing on him that night. He smiled.

Then we helped Kristina find some of her team. Gratefully, one of them was one of those characters you usually read about, but sometimes actually get to meet. Congenial, with a story about everything. No one was going to be nervous with him around. We prayed as a group, and they were off, with three packages of love that happened to take the form of tents and cots safely tucked in the cargo hold of the plane.

Sunday, February 21, 2010

Responding to Impulses

This morning at HillSong Church, the sermon is about Zacchaeus. He's the tax collector from Jericho we meet in Luke 19. Everyone in town hates him, but when Jesus come to Jericho, he invites himself to Zacchaeus' house for lunch. (Yes, I said, Jesus invites himself for lunch. Jesus can get away with that sort of thing.)

Everyone grumbles that Jesus is eating with a "sinner." But Jesus claims that's why he came - "to seek out and save the lost." What happens to this lost person Jesus has saved? He has a holy impulse and he gives into it and decides on the spot to divest himself of 1/2 of all he owns and to give the proceeds to the poor.

Not everyone gets that impulse! The Holy Spirit moves in different people in different ways. Some people are called to give a lot of money. In the aftermath of the Haiti earthquake, we've seen a lot of Christians, American doctors and nurses, give in to those Holy impulses. They are giving up a week of time (or in some cases more) to go in the name of Christ and save lives.

I hear the same thing over and over. I heard it from a young nurse who had never traveled outside the US. I heard it from an experienced physician who has traveled extensively and practiced medicine in many different contexts. Apprehension! Uncertainty! Fear! What am I getting myself into??? These professionals are the picture of confidence and knowledge in their practices here in the US, but when they are thrust into the chaos that is post-quakes Haiti, they are venturing onto unknown ground.

So, why do it?

In spite of the myriad concerns, each one I talk to says the same thing. They could do no other. These are people who are feeling deep stirrings inside them, the swirl of the Holy Spirit. And, they go.

Now, reading this, you might not be a physician or someone uniquely qualified to help Haiti now. So, what can you do? Try this. Call the NC Baptist board in Cary (http://bscnc.org/) and get in touch with Baptist Men, tell them you want to meet the next medical mission going to Haiti at the airport before the team leaves. You want to pray with the team before they get on their flight. It will require you to get up at about 4:45AM on Friday so you can go and be there and meet the team. But set your alarm clock and do it. Go, meet these missionaries who are feeling that impulse. See the fire of the Holy Spirit flickering in their fearful eyes. Pray for them as they go and you too will be part of the story.

Saturday, February 20, 2010

DAY EIGHT - Monday, Feb. 8, 2010: Going Home

I woke up to a sunrise I could photograph without leaving my sleeping mat.

We packed and headed to the airport. I made it back to RDU just before midnight.

I was grateful to my friend Nicki for picking me up at the airport and driving me home so Audrey wouldn’t get drug out of bed on a school night. And I was grateful to her for driving her husband’s car with heated seats. The transition from 90 degrees in the morning in the DR to 30 degrees that night back in NC was a little rough, and I didn’t have a winter coat with me.

As soon as I walked in the door and saw Jon, I burst into tears. Then I drank a tall glass of water straight from our tap.

DAY SEVEN - Sunday, Feb. 7, 2010: Echoes of church hymns

I started the day with a run around the compound, taking photos of the sunrise. Such mixed emotions. I miss Jon & Audrey, but there is so much work to be done here. I have gratitude that the replacement team is here, and that’s probably what will make it okay in my heart for me to go home.

We made it back to the DR after a brief tour in Haiti of Ti tanyen, where the mass graves are and a flour mill that’s Haiti’s second largest employer. They lost 100 employees the day of the earthquake. We heard whispers of the hymns being sung in church after church we passed.

My favorite moment from that day was hearing echoes from hymns that trickled down from a small shelter on a hill. You couldn't even really see the people worshiping, but you could hear their voices lifted up in praise.

The church fellowship hall back in the DR was extremely hot, so a half-dozen of us slept on the roof. That was probably the best sleep I’d had since leaving home. I sprayed my mat down with bugspray, hoping to ward off the mosquitoes.

DAY SIX - Saturday, Feb. 6, 2010: Merline and Vladamir, 2 Haitian doctors in love

Our last day of work at the hospital started with an uneventful ride to the hospital. I decided to go to the other hospital, St. Damien’s, to see how it worked. They had a much nicer facility, thanks to being Italian-run and private, but had similar stories to tell. St Damien’s had two other sister hospitals in Central America, and they had recruited their staff to come and help in Haiti. This was the hospital where Angelina Jolie and John Edwards came.

I did dressing changes in the morning, working out of a tent that was smotheringly hot.

The bus came to pick us up so we could join the rest of the group. Off we went for a bus tour of Port au Prince.

Driving through town with Merline and Vladamir, a pair of young Haitian doctors, made the devastation personal. They had made it to medical school in Haiti thanks to an American benefactor, who had wanted to be a nurse but never could afford it. After her rich uncle died and left her money, she set up a fund to put seven Haitians through medical school. Merline and Vladamir were two of those seven. They met through school and were now engaged with plans to marry in November on her birthday.

As we drove through the crumbled buildings, they shared where their favorite restaurant used to be, where they would take out-of-town friends when they visited. Merline told us the hardest part for her was walking around right after the earthquake. She could hear the cries of those trapped under the rumble. Worse yet was a few days later, when the cries stopped.

Realizing I was heading home, back to my cushy middle class life, and that this horror was their reality for the foreseeable future, the tears finally came. I cried off and on as we finished our tour. Towards the end, I asked Merline how she was holding up, really truly holding up. Her response? She told me she hadn’t dealt with what she’d lost. But for Haitians, 2010 had a lot of promise. A perfect score in school is 10/10, so 2010 was thought to be lucky.

Then the earthquake hit. Yet, she felt that God could somehow use this horror as a way of bringing the world’s attention to Haiti, and in turn help her become greater than she was before. She had such hope, something I saw in many of the Haitians I had met.

DAY FIVE - Friday, Feb. 5, 2010: The Endless Night

A bumpy, hot, loud 2-hour ride later, we returned to the compound. I showered, tried to email home to let them know I arrived, and crawled into my cot. Two hours later, up, back on the bus to go to the hospital for another overnight shift in the ICU. I went straight to the ICU to take sign-out from the day time doc. My heart fell as he told me we were taking a transfer, who was intubated. The hospital had two ventilators, neither of which was working as of yet. The hospital had used one the week before to help save a patient with paralysis from tetanus. They tried to tweak the vent into working while the patient was on the vent; the patient died.

Tonight, though, an outside clinic had seen this man, who was having fever and respiratory problems plus was combative and not responding appropriately. He was very ill, and they had heard we had a vent. They intubated him in the field, hand ventilating him, and carried him (literally) to us. The physician signing out to me accepted the transfer to give us a chance to see if our vent worked. “Don’t worry too much; we don’t really expect him to be alive in the morning. We just need to see if we have the vent working yet.”

When the patient arrived, it was like something out of a movie. A crowd came in with him, including someone with a cameraman. Chaos. I pretended I knew what I was doing, tried to be in charge and run the code. I attempted to ask all the right questions, tried to chorale unnecessary people out of the ICU. And in the midst of this, tried to explain to his wife what was happening, again in my limited French. The trick was, I had no idea what was the matter. All we knew was that he had a fever and headache early in the week. He could have had everything from bacterial meningitis to a stroke.

The other patients and families in the ICU didn’t seem to register that I was having a personal crisis trying to keep this man alive and kept on coming over to me. They would dutifully request pain meds for the family member and ask questions about them. Not more than an hour after my ventilator guy arrived, another patient was brought in who was having crushing chest pain and other symptoms that seemed very much like he was having a heart attack. Two ill patients, neither of whom I could get labs for or even a chest xray or EKG. We could only process labs in the morning. We had an EKG machine, but no cord to plug it into the wall. I have never felt so helpless in my life.

In the midst of this, around 2 am, one of our post-op patients began complaining her chest hurt. She had come in the day before for help with her right arm, which had clearly been broken since the earthquake. While they had her in the OR preparing to fix her arm, the surgeon noticed her left ankle was at an odd angle. An xray revealed a compound fracture of her leg, which they repaired the next day. So, there she was hours after her second surgery, with chest pain. My mind whirled with possibilities, dutifully creating my differential diagnosis as I began to assess her.

After what seemed like forever, I managed to figure out she was telling me her heart ached. Literally. Sometime since the injuries, since the earthquake, she had suffered a miscarriage. "Lost her womb." It was the closest to crying I’d come so far. I told her I didn’t have the words, in French or English, to help her feel better. And that was all I could do. The language barrier, and two seriously ill patients, prevented me from doing more than periodically patting her on the head as a hovered over the patients in the ICU.

In the US, I would have spent 30 minutes on admission asking every detail about the patient’s past medical and social history. Here, I could barely figure out the major problem they had. I had always found names difficult to understand in French, and the Creole accents made it nearly impossible for me to figure out. Here, I barely knew anything about the folks I was in charge of caring for.

And so I spent the night. Trying to keep my ventilator guy alive and sedated, panicking a little every time my chest pain guy flinched. I so would have liked to have done an EKG, get some blood, an xray, anything. All I could do was give him aspirin and morphine, lots of morphine. So helpless.

Betty found a cot so we took turns for an hour or two laying down for 30-45 minutes at a time. I curled up on a chair beside my patient with the ventilator, periodically giving him morphine and diprivan to keep him sedated. Everytime he groaned or flinched, I’d try to say something comforting to his wife. Mostly, I just kept apologizing to everyone for how terrible my French was.

In the morning, we found a large jar of applesauce so we gave everyone, including family members, a urine specimen cup filled with water and another filled with applesauce. Otherwise, no one would have had breakfast. In Haiti, patients only eat if family brings them food. Part of the team coming after ours had folks who were designated the “feeding team.” They would start feeding us, then would progress to feeding the hospital. For that night though, our ICU patients had little food. We had given them Pop Tarts the day before since Kelloggs had donated many boxes of them for the aid workers. Applesauce for breakfast was all we had, but they were incredibly grateful for that small thing.

In the morning, relief came. The intubated patient stabilized, ended up being extubated and stable just with additional oxygen. That meant he could potentially be transferred to the USMS Comfort or to Miami. Just somewhere with the capacity to find out what was wrong with him. Apparently, something we did for him helped. Whether that was the antibiotics, the medicine to remove fluid from his lungs, time, prayer, who knew.

We finally got labwork at least on my chest pain guy, and he didn’t appear to be in the middle of a heart attack. He felt better, so we sent him home with some aspirin and blood pressure medicine, as well as a prayer. I went to check on the folks working triage and found one of the girls I had treated earlier in the week was here-waiting for me. She wanted me to change her dressing. I told her I was working in a different part of the hospital today but that one of the others would care for her. She told me she wasn’t afraid as long I changed her bandage. So, I sat down on the concrete and dressed her wound. She still teared up in pain while I changed her bandage, but she never said “hey” and she didn’t flinch.

That moment, those 5 minutes, are among my favorite memories of my time in Haiti. For that young lady to have one dressing change where she wasn’t afraid, that alone would have made the effort and exhaustion worth the trip. Helping that one little girl made it worth it for Audrey to be missing me.

Shortly after that, one of the US Virgin Islands team members asked for help from across the courtyard from our team. She was in the middle of a dressing change and needed someone to finish taking care of her patient since she was an hour late to leave to catch her flight home. I went over to find a 14-year-old named Louis Randolph, who had had most of the muscle from the front of his arm and forearm sheared off in the earthquake. He had received skin grafts from his thighs and was supposed to be doing daily dressing changes, but his family couldn’t get him there for a few days.

As I tried to unwrap his dressings from his thighs, he cried and asked me to stop. His wounds bled. It quickly became clear I was causing him excruciating pain. Never before had I so directly inflicted suffering, and I had no alternative. We didn’t have meds I could give him, we couldn’t sedate him because he wasn’t ill enough, although in the US he would definitely have been medicated somehow.

A psychologist named Winston saw what was going on and ended up staying with me and Louis for the nearly two hours it took me to treat him. I ended up injecting nearly 50 ml of lidocaine into his thighs to numb him enough for me to remove the bandages on his legs. Applying the new dressings was much easier. I finally took off the bandage on his arm and saw 110 (I counted them as I dug them out later) embedded staples on a swollen arm that he couldn’t bend or use in any way. We ended up admitting him to the hospital so he could keep his arm elevated. Hopefully, improving the swelling would make him more comfortable. He just can’t keep his arm elevated when he’s living on the streets with a little sheet for a roof.

When we were done, some of the other patients sitting around waiting for their turn applauded. I gave him 3 dum dum suckers, one for each body part I treated, and two bottles of water – one for each hour I spent with him. I have never inflicted so much pain on another human. Throughout it all, he kept apologizing for crying, for needing time. Then he’d thank me for helping him. Those two hours were the closest I think I’ll ever come on earth to being the hands and feet of Christ.

I was so relieved to see the bus make its way to the hospital. It took us 3 hours to get home. Everyone was a little punch drunk, and there was much singing and goofiness. Once we arrived at the compound, I guzzled down several glasses of water. I was thirsty much of the time I was in Haiti. Our bottled water was rationed to make sure it would last until the next team came with replenished supplies, but we could drink water from the well at the compound since they had their own, clean system. So that night, after 2 days with a few bottles of water, I drank my fill.

A quick shower, and into bed for a wonderful, fabulous 7 hours of sleep.

DAY FOUR - Thursday, Feb. 4, 2010: Long day, long night

The bus left at 6 am in an attempt to miss traffic, but the plan didn’t work very well. It still took 2 hours. There is simply more traffic than Haiti’s already overburdened roadways could handle.

I worked in triage all day, with more dressings, and wounds. I got to play a little with Elefan, a little 3-year-old living in the hospital with his parents, 2-year-old brother, and baby brother while the youngest received intravenous antibiotics for an infected skin graft. The little baby almost died last week, and the team before ours was very preoccupied with him. We inherited that concern, plus an immediate affection for Elefan. He ran freely around the hospital, and I think everyone on our team has at least one photo with him. His brother was discharged the last day we were in Haiti, and the entire staff was grateful for his brother’s health but worried about what the family would do now that they were re-entering the world of the tent cities.

At 5 pm, I went to staff the 7-12 bed ICU. How many beds were crammed in there depended entirely on how busy the hospital was. I’d say capacity by American standards was about 6. I had agreed to stay overnight and work to staff triage, but didn’t realize until everyone was leaving that the intent was that I would run the ICU, too. The ICU wasn’t like where I’d trained in the states, it was basically just patients waking up from late afternoons surgeries and anyone who actually required monitoring, since the Haitian nurses who staffed the hospital wards at night were grossly overwhelmed. We were supposed to have a Haitian nurse as a 3rd person to help us, and to translate, but that nurse never materialized. So, we frantically tried to get our patients to the bathroom, get them pain meds, assess how they were doing, all with my limited French.

I had been fluent in French 15 years ago, after I studied abroad for six months. I had never known any medical French, though, and my French was really spotty from lack of use. I quickly learned how to give IV meds, look up how to mix meds in a pharmacology book, and struggled to find the right French words to take care of patients. It was non-stop frantic activity until after midnight, then we slowly got the patients settled in.

Betty, the lovely nurse with whom I was working, who was 62 and hanging right in there, literally tucked each patient in and sang lullabies. The ICU was air conditioned, per US standards to keep infection down, but we were freezing the Haitian patients, most of whom didn’t have blankets since it was expected they would bring linens with them. We scavenged the hospital and ended up using some packing material and drapes from the OR to get the patients comfortable.

Around 2 am, we had drawn up a list of supplies we needed, and I went to explore the pharmacy. I managed to find extra bags of IV fluids, although some in Russian, some in Spanish, some were from Korea. In the US, different specialties argue about which IV fluids are best. In Haiti, it didn’t matter. If it was fluid, you hung it.

In the US, we would generally have an IV in place but not have fluids constantly running unless necessary. In Haiti, we didn’t have the right supplies to “hep lock” IVs, since we didn’t have heparin. If IV fluids weren’t running, the IV would clot off. That worked out ok, since nearly every patient was dehydrated. I think I figured out we gave every patient 3-4 liters of fluid overnight.

Come dawn’s early light, our patients were finally pain free, we were exhausted, and we gladly toppled on to the bus at 9 am to go back to the compound. Before I left, though, I prepared one final patient for discharge. He was a 6-year-old little boy named Pierre who had an inguinal hernia. He had been seen in triage a week or so before, and was told to come back for the surgery to repair it. However, fractures and amputations picked back up and so he was sent home. His mom brought him back once more to see if his hernia could be repaired now. They had squeezed his surgery in at 9 pm, and since there was no way for the family to get back to their patch of dirt in the park after dark, they had stayed the night.

The mom had a baby at “home” who was nursing. Again, my French lacking much, we fumbled through a conversation where she requested some sort of container to manually express milk into. I wondered if the baby would have something to eat while his mom was at the hospital.

In the morning, the baby brother appeared. His mom asked me for a diaper. I traipsed around the hospital, asking if we had any. One aid worker showed me a semi-hidden room with a stash of random donations and boxes that hadn’t yet been sorted through. One corner of the room had boxes of diapers wrapped around baby food, and some bottled water. I found a little box and filled it with jars, water, diapers, and water. I took it back to the ICU and pulled Pierre’s mom outside, away from the rest of the patients and families. We had been told to be very careful when distributing things like this, because if we didn’t have enough for every patient around it might cause frustration. Worse, if word got out we were doing some sort of distribution, crowds would quickly form.

In the best French I could muster, I told her she could not say anything to anyone, but showed her the contents of the box. She smiled a huge smile and got teary eyed. I told her she absolutely couldn’t smile that big or cry. It didn’t do any good. She hugged me, kept saying “Grace a Dieu” and we went back to her son’s bedside. About $20 worth of stuff, maybe 2 days of supplies. I wondered how long she would make it stretch to.

One final run through of the discharge instructions once the interpreter was found, and they were off.

DAY THREE - Wednesday, Feb. 3, 2010: Broken bones

Up very early, on the bus by 6:15 am. Interesting to watch the city wake up. We could see the women carrying large bowls on their heads while walking. They would set up shop by unloading the goods in their bowl along the sidewalk and sell them to folks walking by. This is how what little food, clothing, furniture is made available. We also could see each morning long lines of people in lines for rice distribution, or water distribution. Even longer were the lines of Haitians waiting to plead their case at the U.S. Embassy. They had constructed awnings along the waiting line to help shield them from too much sun.

Over the course of my time in Port au Prince, more than one person suggested Haiti would be better off if the US or some other country just took over. One of our team mates, who actually came with the team before me and stayed to work with us, warned us to be careful what comments we made to the parents of Haitian children. She had made a comment to the effect of “she’s so cute, I wish I could take her home.” Her parents paused for a moment, then said “Okay. We’ll miss her, but her life would be better in the U.S.” I can’t even imagine.

At the hospital, I worked in “triage,” which really meant we saw, evaluated, and treated whatever walked through the entrance. For the first few hours, we were furiously doing dressing changes. Many, many Haitians sustained amputations because the resources don’t exist in Haiti to try and save a limb. It would require hospitalizations that are too long and medications that are unaffordable. The risk of infection, though, is so great that most crushed limbs were amputated to ensure a greater chance of survival.

Many Haitians also have broken bones from structures falling on them, and I saw a half-dozen patients myself who were coming in to seek care for fractures that had not yet been treated; this was three weeks after the earthquake. One was a 14-year-old boy brought in by his mom. He was injured in the left ankle and foot the day of the quake. He was seen initially a few days after the quake, but the xray machine wasn’t working. He didn’t have a compound or open fracture so they gave him an Ace wrap and told him to come back if it didn’t improve.

Three weeks later, it was still too swollen and painful to walk on. Our x-ray equipment had become functional again the week before. The verdict? A broken tibia and metatarsal. The kid was walking on a broken foot and ankle for three weeks. It wasn’t aligned perfectly, but the orthopod felt the kid was better off just being casted for three more weeks. To re-break it in order to achieve perfect alignment would have forced him to have additional time unable to bear weight, and since we didn’t have crutches or a wheelchair for him, it would have been too much of a hardship. So he got a cast and I gave him a few dozen ibuprofen.

I changed so many dressings. I couldn’t always tell what I would find underneath. One little girl, about Audrey’s age, had adorable pig tails and a bandage on her left hand. She brought her stuffed bear with her. She was all smiles on her daddy’s lap until I began to unwrap her bandage. She began to cry and ask, in French, for “de l’eau, s’il vous plait.” Water, please. She had had her bandage changed enough to know it was going to hurt, and if I poured water over it, it would hurt less. She whimpered while I finished unwrapping her bandage. When I was done, I felt like whimpering myself. She only had a thumb and pointer finger. The rest of her hand had been sliced off at such an angle that her remaining fingers were mostly gone. After a few minutes of studying her wound, I finally figured out that what I thought was maybe infected material was actually what remained of her proximal phalange.

I remember catching my breath, trying very hard to not look shocked. For all the wounds, we cleaned them with peroxide, put betadine on them, then Neosporin, replaced the wrapping, and said a prayer that it wouldn’t get infected. We wrote the date of the dressing change and any other important details actually on the bandage, so other healthcare providers down the line can have an idea what had previously been done. When I finished her wound, she then pointed to her left knee and wanted me to care for the scrape. Just as tenderly and thoroughly that I had dressed her mangled hand, I cleaned her little-girl-scraped knee and put a Diego band-aid on it. She was thrilled and said, “Merci madame doctor.” I gave her dad an extra band-aid for her knee, and he had tears in his eyes.

The next patient was a little girl about 12, who had her left ankle in a cast. She had a wound on the front of her leg so the cast was left with a hole in it so her wound could be cared for. She was brought in by her dad and aunt and they were very attentive, very interested in seeing the progress her wound was making, and very worried about infection. She was nervous, and clearly was afraid. I stopped cleaning her wound and told her, in the best French I could muster, if I hurt you, say “Hey!” saying the “hey” in English. From that point on, whenever she flinched, I’d stop, look up at her, and ask “Hey?” She’d giggle, say no, and back to work I’d go. I gave her a hug at the end, which started me on a roll of giving out lots of hugs.

The rest of the day went much like that, with dressing changes, xrays, and setting bones. A few patients trickled in with headaches, belly aches, and depression, but mostly under control. At 5:30 pm, back on the bus for a 2-hour ride home. Leftover rice & beans, and into bed well after midnight. That was my last sleep for quite some time.

DAY TWO - Tuesday, Feb. 2, 2010: Finally in Haiti

The Dominican country side was beautiful. Crazy traffic and drivers abound, because there isn’t any insurance and no police enforcement. Traffic lights and lanes are simply guidelines. It’s about 100 miles from Santo Domingo to Port au Prince as the crow flies, closer to 130 miles driving the roads. We were told it could take up to 10 hours to get there. And we were prepared to have no where to pick up food or use the bathroom.

Turns out, we found a truck stop type of place in DR. Although we weren’t really hungry we ate some sandwiches for breakfast anyway because we knew food might be harder to come by for the rest of the trip. Our trip leader, Scott, bought us Dominican doughnuts for the road.

The road was filled with buses that had brightly colored curtains and themes. Like the bus that was bright pink with fuchsia curtains and sequin tie backs. These were carrying Dominicans from one city to the next. I never did get a good picture of one. As we got within 20 or 30 miles of the DR-Haiti border, the traffic became pretty thick. For a long while we followed a Canadian army convoy with dozens of vehicles and large excavation equipment, semi-truck after semi with aid. A few cars and trucks were coming out of Haiti, but the preponderance of the traffic was going in. Slowly.

There were "no passing" signs everywhere (“No rebase”), which was a complete joke. People passed at any time, at any speed. If there happened to be an oncoming car, you either tried to gun it and get by, or reluctantly got back behind the vehicle you were trying to pass. Lots of polite beeping on the part of the passer, to warn the pass-ee that they had company. All in all, it was very nerve-wracking.

The DR countryside, at least at this point in the trip, seemed to highlight pretty little brightly painted houses. Small, but neat. Evidence of disseminated poverty abounded, but kids were in their uniforms going to school and it didn’t seem so bad. Smaller communities were more densely populated with poorly constructed shacks built from salvaged materials. This, we though, was the poverty that would greet us in Haiti. We had beautiful scenery, though, of mountains and Lake Enriquillo.

After about 4 hours, we reached the DR-Haiti border. My pitiful medical Spanish had gotten us through our overnight stay at the church, and was mostly getting us by with our drivers, who spoke little English. We encountered a problem at the border that meant the car being driven as a third vehicle, whose purpose was to enable the Dominicans to drive themselves back home after they dropped us off in Port au Prince, lacked the paperwork necessary to get it in to the country. So, we parked the car, consolidated our stuff into the two remaining vehicles, and headed into Haiti. We weren’t stopped really on either side of the border. On the DR side, they looked into the van full of white people and supplies, and waved us through. On the Haitian side, they didn’t even look inside the car, or make us stop. We slowed down, they waved us in.

The roads immediately went from poor to horrible. Not paved in most parts, large potholes in many places. The road leading into the country from the border was narrow, and in places bordered on both sides by water from Étang Saumâtre, also called Lake Azuei. It’s Haiti’s largest lake, and it’s salt water. I was surprised by the beauty of the view, if not equally surprised by the treacherous roads. Our brave driver, though, was unphased and kept passing the semis in front of us while going around curves on the dusty one lane road. I don’t think I’ll be unnerved in US traffic ever again.

Shortly after crossing into Haiti, the driver, Milton, looked at me and asked in Spanish if I knew where we were heading.

”Sure,” I said, “we’re going to Port au Prince. First, we’re going to the mission compound at Global Outreach.”

“ Yes, but I understand you have directions.”

A few panicked moments later and it became clear that our group leader had been told the drivers knew how to get to the compound. Evidently this driver didn’t. Janet had the address of the compound. Global Outreach, rue 1, km 25, Titanyen, Haiti. We stopped a few times to ask if any of the locals had any idea where the address was; my French plus their Creole = no idea. My guidebook had a rough map of the area, and I since we knew it was northeast of the airport, off we went. All along, we tried to use our various cell phones. None of them worked. At one point, we were stuck in traffic and asked a truck driver next to us if he heard of Titanyen. He said no, let us use his cell phone. We called the compound. Someone answered, but had no idea how to give us directions. We gave the cell phone back.

We ended up in downtown Port au Prince. In the dead center of the devastation. Stunning. Building after building in a crumbled pile, sometimes pouring into the streets. A few buildings on each block stood, sometimes leaning over the street. One building had pancaked down and you could clearly see the mattress crushed between 2 floors, the couch crushed between the floor above. No way on earth someone sitting on that couch, or resting in that bed, could have survived. Buildings had folded over and were laying in the street, blocking the way. Our little caravan kept having to turn around, back down streets.

We were too stunned to take many photos, plus we were worried about our safety. We saw no UN, police, army. Nothing but hundreds of Haitians sifting through the rubble, trying to scavenge building materials, clothing, shoes, pieces of wood for fires. Anything. Small kids, some who I’m sure were Audrey’s age, barefoot and ragged, gathering tires and sticks. At one point, we drove over some debris and got stuck. Haitians walking by jumped right in and removed the stuff from in front of and under that car.

We were so lost. Just at the point when we realized dusk was falling, we saw some UN soldiers. I hopped out of the car and shouted “Parlez-vous francais? Habla espanol? Do you speak English?”. The lovely Colombian soldier answered “Oui! Si! Yes!” Not sure I’ve ever heard sweeter words. They were doing some excavations at Fort National, a national landmark as a former fortress, and the site of an UN post that was devastated in the quake. The kind fellows directed us where we might find the hospital (we figured we’d have better luck with that than this mythical city where the compound was located).

In the end, I gave them hugs, they gave us a map. This probably wasn’t my most sophisticated moment, but before we left, we said thanks, faire-d le bise, with the soldiers (the European tradition of kissing on the cheeks is called faire le bise) out of gratitude. The soldiers then decided to give us an escort into the neighborhood where the hospital was, Petionville. For the rest of the trip, the group teased me that the only reason we made it out of Port au Prince was because I kissed the soldier. They led us out of the devastated area, into the limits of Petionville. They pulled over to make sure we could make it the rest of the way. We used the remaining water we had to fill up the radiator of the van, which was now overheating. Situation now sort of under control, the soldiers returned to their post and we drove another 20 minutes into Petionville.

This “rich” suburb of Port au Prince is where many of the elite Haitians live. This would be the 1% who control 50-75% of Haiti’s wealth. There were nicer homes in this area, perched on the hills, but still poverty was everywhere. While the earthquake damage wasn’t as all encompassing as in downtown, the neighborhood had definitely not been spared. Buildings were down on every block here, but at least you could see street vendors selling fried meats and plantains, and bottles of water and juice. Signs of normalcy.

There weren’t a lot of street signs, so we still couldn’t find the hospital. We asked a man who was sitting next to us in his truck at a stop light if he knew of the hospital (again, my French is pitiful now). He couldn’t explain it to me (my Creole is non-existent) so he drove us there. I ran inside what turned out to be a little clinic. A British doctor and nurse were treating wounds and had no idea about any hospitals nearby.

However, a Haitian patient thought he knew where we meant and offered to go with us to show us. I gave up my spot in the front seat, and let our new Haitian friend give directions to our Dominican driver, occasionally filling in the gaps that their language difference produced. ("Izquierda! Izquierda! Left! Left, not right! Gauche! Gauche!"). After another 20 minutes, we rounded a corner onto a steep, curved driveway. At the top, l’Hopital de la Communauté Haitienne. We found the entrance, and the five of us hopped out of the van, hardly daring to get our hopes up. I wandered in and with great joy saw a few workers wearing the characteristic red t-shirts.

The first team member we saw was a nurse named Kathy, who was clearly startled by how exuberantly we greeted her. She didn’t figure out until 2 days later the context that led to us being so thrilled to see her. We all jumped right into working.

I ended up helping out with a woman in labor, trying to track down supplies. I learned that the hospital doesn’t have blankets for newborns, and that the families have to bring something in. In one case, I saw a father of a newborn taking off his shirt to wrap his new baby in. I learned that we had some medicines for neonatal resuscitation, but that essentially, if babies aren’t vigorous within the first few minutes, that’s about all we can do. There are no resources for babies who need extra help. Just oxygen.

There were two babies who ended up dying while we were there, both of whom would have easily lived in the U.S. One baby was born right before the earthquake and her mother died during the quake. She was found by passers-by, who did the best they could to care for her, but by the time they got her to the airport, she was severely dehydrated. We didn’t have the supplies or skills to get her hydrated, no NG tubes to feed her. She died in the arms of one of the volunteers. Another baby was born about a month early, but was just too small and needed a little extra help we simply couldn’t provide. She died with her parents.

One of my teammates, Amanda, asked where the baby’s body would go. She was directed to the morgue, which was just a blocked off room like any other. The baby’s body just lay on a table. After some discussion, she found out that the body would be thrown in the trash. To Amanda, this wasn’t acceptable, and she went to our team leader. Together they approached the Haitian head of the hospital. She stated she “would take care of it,” but none of us are optimistic that the outcome will be any different. There just isn’t any money to bury the baby of poor Haitians while in the middle of the devastation.

A little before 6 pm, we boarded the bus and headed home. The ride took a long time due to traffic. Apparently it’s normally an hour to Titanyen, but it took us nearly two hours. I was surprised at how dark it was since most of Port au Prince is without electricity. Just at sunset, I saw two kids doing cartwheels across the empty area of a tent city; I was amazed at that contrast.

The compound where we stayed belongs to Global Outreach. We stayed in a 3 bedroom house that recently was vacated. A missionary family lived there, and they had been serving in Haiti for a number of years. They had 4 children, plus had two Haitian children they had long since been trying to adopt. For the past few years, the parents would alternate taking their biological children home to the US to visit, since they couldn’t take the Haitian children out of the country. After the earthquake, the government gave a limited number of reprieves for adoptions already in progress. So to take advantage of that, the family packed up and left within 24 hours. They will have to stay out of Haiti for >2 years. I can only imagine.

A quick cold shower, then I passed out for a few hours.

DAY ONE - Monday, Feb. 1, 2010: Our journey begins


On Monday morning, Jon & Audrey drove me to the airport. I met up with the four others who were delayed due to snow. We each donned a red t-shirt, the uniform we would wear each day that marked us as members of NC Baptist Men and Rescue 24. The organization had worked hard to establish ourselves as a reliable part of the relief effort at the hospital where we’d be working, and the red t-shirts identified the ever changing faces as part of that group. We said our goodbyes to the US for now. Audrey was not pleased I was leaving her. My mom asked at one point how I could leave, knowing Audrey would be upset the entire time I was gone. I explained to her the same way I explained to Audrey. I kept envisioning some little Haitian girl in need of medical help. And that she had a mama who was praying help would come. I could be that help, and if that was the case, then I’m sure it would be worth the sacrifice of Audrey crying in her safe, warm, well fed home with her amazing, loving dad to keep her amused.

(It turns out they ate junk food and he bought her a Barbie refrigerator for the doll house she got for Christmas. Plus, she had 3 snow days and they played outside in the snow everyday. She talked Jon into sleeping on my side of the bed at least once, because my pillow smelled like my hair. She told me she was a little sad I came home.)

We flew uneventfully to Santo Domingo, Dominican Republic (DR), where we were picked up at the airport by Christopher, a member of a local Baptist church in Santo Domingo, l’iglesia Bautista Ozama. Pastor Luis and the staff at the church had been letting our team members sleep overnight in their fellowship hall on our way into and out of the country. Until Port au Prince Airport recovered enough to allow in commercial flights, Santo Domingo would be a necessary stop on the trip.

The church members provided a meal for us (yummy sandwiches with mixture of beef, ham, mayonnaise, who knows what, plus some sort of fresh orange drink) and a humble shelter, sleeping on mats on the floor. There was a shower, cold water but a shower nonetheless. They had also helped the first half of our team purchase the food we would need while in Haiti, since everything needed to be brought in with us. We slept poorly that night, in part because we arrived so late and in part because the nightclub behind the building was in full swing. After a few short hours of sleep, we got up and headed out for Haiti at 5 am. Our Dominican drivers would take us in a used van, recently purchased to facilitate traveling around in Port au Prince, as well as a pick up truck that was also recently purchased. We were off.