A Christmas Story

I am still not enjoying this Michigan weather but am getting a little more accustom to it.  It does seem a little more like Christmas with some snow on the ground.  I have been home less than a week and I already miss Haiti a great deal.  I worry about my kids and hope they are all doing well while I am gone.  The kids in the school have been keeping me busy with many medical issues lately.  It still amazes me that the kids will go for weeks before they complain about an ear infection or a sinus infection or something.  I really need to work harder on teaching them to be more proactive with taking care of issues involving their health.  I also need to work on proper medical care.  I had a student that had a Bluetooth speaker blow up while it was charging and it burn him.  When he came to me it was covered in toothpaste.  This is a common treatment in Haiti for many things.

On Sunday evening I was in my room when one of the kids came up and said there was someone at the gate for me.  I grabbed my stethoscope and went down to the gate, really expecting a man who had been there several times wanting money for his daughter’s medical bills.  I had told him several times that I don’t give out cash and since his daughter is in a hospital almost 2 hours away I couldn’t really help him.  What I found was a lady holding a little girl with a laceration to her forehead and who was all but unresponsive.  I had a hard time getting the story from them but it seems that she just fell and hit her head some how.  Her mom was at church and the only family with this little 2-year-old was a 11-year-old sister.  She was only responsive to deep painful stimulus and her pupils were not responding appropriately.  I told Edmond, who doubles as the school’s ambulance driver, that she probably has a closed head injury and we need to get her to the hospital.  So, I ran up to my room and got some money and a few things in-case things went bad and then I took the child and got in the truck for a run to the ER after a quick stop at the church in the Ravine to get Mom.  When we arrived at the ER she began waking up.  Of course, that’s how it goes so that no one in the ER sees her almost unresponsive.  At the very least she was minimally responsive to pain for better than a half hour. 

 This Is Daina after she woke up while she was hanging out in the ER.

This Is Daina after she woke up while she was hanging out in the ER.

When the first doctor came in I told him what had happened and he said that they would admit her for observation as there CT scanner was down and they could not do a head CT.  When the second doctor came in mom was talking to her and I could tell she was not getting the story right.  This doctor spoke very little English but I was able to get enough of the story across to her that she yelled at Mom for not knowing what was going on, as I assume she just told them that she fell and needs stitches.  Then a baby in the NICU crashed and everyone went running.  After a couple hours, a third doctor came in who did not speak any English.  He stitched her up without hardly cleaning it and with very poor sterile technique.  I don’t have the time to tell you all the things that I seen and experienced in the Peds ER but by this time I decided that being in the hospital was probably a bigger detriment to her health than not being in the hospital.  By this time she was running around and acting normally. 

They wrote her a prescription for Tylenol and said we could go.  It took over an hour to check out.  After over 6 hours and very little care I was more than ready to leave.  We got her home a little after midnight and I told mom to bring her to the clinic the next morning so I could reevaluate her.  As it turned out Mom never brought her and it took me 4 days to find her.  I was really worried that something had happened to her during the night but on the other hand I knew that I was probably there only source of medical care so I hoped they would have come to me if she was not doing well.  But she seemed to be doing fine now and did remember at least part of the ER visit as I had to help hold her for the stitches and so now she was hiding behind her mom and wouldn’t let me get close to her.

You never know what is going to happen next and it keeps it exciting not knowing what the next phone call or knock at the gate will bring.  Things are going well at the clinic up the street that I work at on Mondays.  There is no shortage of cute babies that like to be held! 

The week before I left, I was back at the clinic on Tuesday taking care of some things and one of the kids in the neighborhood came in with wound on his foot and ankle.  He had been running and stepped on a broken bottle.  He had a jagged laceration to his ankle.  He had been like this for 2 days.  It was still bleeding and he still had a piece of broken glass in the bottom of his foot.  Due to his living conditions, we decided that it would be better if we would clean it up, stitch it, dress it, and get him on some antibiotics.  So, I put 4 stitches in his ankle and removed the glass from his foot.  We got him the best antibiotics that we had and prayed that it would heal well.  After a couple days, it was looking good.  The second time he came back his dressing was wet and dirty and rather nasty.  The next recheck it was starting to look rather infected.  At last report, he hadn’t come back to the clinic since so I am hoping that he doesn’t have a bad infection going and he waits until it’s really bad before he returns for help.

As we were finishing up with the stitches I got a call that Karen (she owns the building were the clinic is held on Mondays) asking if she could bring a girl by to be looked at.  A few minutes later she arrived with Benjie and was very frustrated with the Haiti medical system by this point.  Benjie was in the hospital but the doctors went on strike so they stopped caring for her.  Now they can’t find another place to take her.  In the 2010 earthquake Benjie had concreate fall on her crushing her pelvis.  She now has a permeant catheter directly into her bladder. 

 Benjie with her Mom and Grandmother

Benjie with her Mom and Grandmother

The catheter became plugged and had to be replaced.  She had surgery about 9 days before to replace it.  I removed her dressing and found that she has a bad infection.  There is also the possibility that urine is leaking around the catheter.  Her entire abdomen is very painful to touch indicating that the infection has spread to her entire abdomen.  She is on oral antibiotics but is probably close to becoming septic from her condition.  Her stitches were pulling very badly and I am fairly certain that she did not have any internal stitches placed after the surgery.  It was time for the sutures to come out but I am sure that if they were removed the entire site would reopen.  They also had put a “surgical drain tube” in during the surgery.  This was a piece of plastic tubing, which I believe is probably cut from a nasal cannula, and placed as a drain.  The end of the tube was open and left hanging so it was a great avenue for infection to enter the site.  I redressed the area and told Karen that this was way beyond what we should attempt to do here.  She really needs a surgical debridement and to ensure the tube is in place and well secured.  She also needs IV Antibiotics.  I told her I would use my contacts to see what we could do.  I contacted my friend Stacy with HERO Ambulance.  She said that she couldn’t find any beds in Port-au-Prince in an appropriate facility due to the hospitals closing from the doctors being on strike.  She was able to find an accepting surgeon in Hospital Boniface in Fond Des Blancs.  She also arranged transport through Haiti Air Ambulance.  This is only about a 15 -20 minute flight but would have been a 4 hour drive which would have been very difficult for Benjie to tolerate due to her pain with any kind of movement. 

 Benjie being loaded into the Helicopter for her flight.

Benjie being loaded into the Helicopter for her flight.

I have not received any further updates but please join me in praying for Benjie as she is a very sick girl.

One of my last few days at school I was called for a student not feeling well.  A girl was complaining of a severe head ache and chest pain.  I moved her to the office and started to evaluate her.  She has not been drinking much water, like many people in Haiti.  Her vitals indicated that she was very dehydrated.  I asked her if she wanted to lay down and she shook her head no.  I told her that she would feel better if she laid down.  She again shook her head no.  I asked her why she didn’t want to lay down and she responded by passing out.  I caught her and got her laying down.  I started an IV started on her and began giving her some fluids.  It took about a half a liter before she started to respond to questions very well.  She is from the children’s home up the road and I found out that she has H Pylori and so she doesn’t like to eat or drink very well due to frequent abdominal pain.  She also stated that she had a heart issue when she was younger but was unsure what it was.  She seemed to have a very slight abnormality to her heart tones so I told the director of the Children’s home to be sure to have the pediatrician that is coming next week look at her.  After 2 liters of fluid she stated that she felt pretty good and was ready to go home.  It’s amazing what being well hydrated will do for you but it’s so hard to get the kids to believe you.

Two nights before I left Haiti Stacy called me about 11:45 and asked if I was available.  I said sure, what’s up?  She said a friend of hers had messaged that his wife was in labor and they were at the hospital and the hospital would not let them in.  She was trying to get more information from them as dad was kind of in a panic.  As we got more information they were going from hospital to hospital trying to find a place where she could deliver.  We were trying to figure out what to do for them.  After the 4th hospital turned them away we tried to convinced them to go home and I would come to their house and deliver their baby.  They weren’t too sure if they wanted to do that at first but Stacy told them that they could always just drive around in the middle of the night until he got to delivered the baby in the car!  Then they decided they would go home.  As I started to get ready Stacy called back and said that they had stopped by a clinic on the way home and they let them in.  So, they were going to stay there.  She delivered a healthy baby boy that night! 

It sounds very similar to the Christmas story, with Mary and Joseph and no room in the Inn for baby Jesus to be born.  But sadly, this is the everyday reality in Haiti.  I hope that today you remember the real meaning of Christmas and you can share some love and kindness to those around you.  Because it truly is better to give than receive.  But in giving you will always be blessed.

Until No Child Dies,

Kelby