It is almost impossible to think that I have been back to Haiti for 17 days now. It has been such a whirlwind. I apologize that I haven’t written a blog post sooner but hopefully by the end of this you will understand why!
I arrived back home on January 5th after a nice Christmas break back in Michigan. It was good to see friends and family over the holidays but I was ready to leave the snow as the temperature really started plummeting as I was leaving... I think it was just about 12 minutes after walking into my little room with my suitcases that I received a message from Amber, the orphanage director from up the road. “Are you back?” She was back in the U.S. and one of her kids was sick so she needed some assistance working though the problem from Haiti. And so, it began!
The next 10 days are really kind of a blur now but I will do my best to tell the story, while at the same time protecting her privacy and keeping it to the Readers Digest version. Octaline is the young lady that was sick and had already been taken to the hospital a few hours before I arrived in Haiti. It wasn’t very clear why she had been taken to the hospital so a more definitive diagnosis was the first order of business. It was almost dark by now and she will have to pay for the hospital room regardless, so it was decided that we would start first thing in the morning on this. I got to bed early in anticipation of a long day tomorrow but also having got up at 1:45 this morning to get to the airport. At 6:50 am one of the workers was at the school to pick me up (I was still on Michigan time and was thinking like 9 am would be a good “first thing”). So with part of breakfast and no shower I was off to the hospital. We went past the hospital we thought she was in to a small hospital I had never heard of. It was not too bad but reminded me more of a little hotel. And from what they had done thus far it was. I assessed her and felt like she most likely had appendicitis and its day 6 now. After a few phone calls a spot was secured for her at Bernard Mevs Hospital. We signed her out AMA and just as we were heading out the doctor showed up and was upset we were leaving. He said he was going to start caring for her now. We told him he had wasted 16 hours getting ready to do that and we were leaving! We loaded her into the van and made the trip to Bernard Mevs. We got her into the ER and she was seen by the accepting ER doctor. She quickly agreed it was appendicitis and she called a surgeon. The surgeon stated she was for sure a surgical abdomen and scheduled the surgery. I was keeping in close contact with Amber. She kept telling me to do what I though was best and don’t worry about money. Well, what I thought was best was not an option, were in Haiti, and how do you not worry about money when they bring you all the money the orphanage has for the next 30 days? So needless to say, my stress level was pretty high a short way into this. I told the surgeon that I would really like some diagnostic proof before we proceed. He said he didn’t need it, he knew. After he left I asked the ER doctor about it and she said she would do an ultrasound but she trusted the surgeon. Now your probably saying what’s the big deal. It’s just a quick appendectomy. Not in Haiti! A ruptured appendix would most likely be fatal. But the surgery itself probably only has a 50/50 chance of being successful and the patient surviving. Surgery is a very last ditch effort here. If we do surgery she could die, if we wait and were wrong she will die. So no pressure, just pick!
I am still trying to get used to the hospital setting in Haiti. It’s very different in so many ways. Like the bathrooms for almost the entire hospital are at the back of the parking lot. So each time we had to help her across the entire complex and back. After a while the ER doctor did an ultrasound. She was not able to find an abscess at the appendix. But she said she is not real good at finding the appendix on ultrasound. Her pain had also changed though. Now I was even less sure. The ER doctor said “let’s wait for the Typhoid results, I am not sure I would have surgery now if it was me”. So now there is more doubt of what to do. I will spare you the thousand other things and details that went into the day to help the stress level. We finally agreed upon admitting her with IV fluids and antibiotics for observation. A nanny from the children’s home came to take the night shift because it was already dark. I told her not to let them do surgery and call if they tried because we had already paid for it but we don't want it now.
The next morning, we were back at the hospital by 7 am. I won’t share all the details but there were many times it was evident that the staff in the hospital were going to use their position to let the white guy know that they are in charge. So, we stood in the street in front of the hospital gate with the guards smirking each time they let other people in. Finally, after 80 minutes, and with no reason for the change they waved us in. We were really hoping to get her home but we couldn’t get the doctor to come in until after noon. At noon, your next day starts for paying a second day of hospitalization, very convenient don't you think. Some of the tests were back and she appeared to have a very bad infection of the GI tract. The surgeon said he didn’t believe she was a surgical candidate any more but she would need to spend several days in the hospital for IV antibiotic treatment. I told him who I was, what I did in the US, and told him that she lives in an orphanage. I told him that we had already spent a month’s budget worth of food for all the kids on the hospital bill (it sounded about right but I was guessing?!) and could I please take her home and care for her there. He smiled and said “I did not know, I will do that for you!” He wrote all the orders and prescriptions for the next day for us to take her home to complete her treatment.
Then next morning we came to pick her up. We assumed that we would be refunded for the surgery and would use that money to pay the bill. That was not the case. They do refunds by check. We needed even more money to get her out of the hospital. But, we finally got enough together and got her home! Again, I was worried if I had done the right thing. We were following the course of treatment the doctors had given and the first day she was doing well. But the next day she got very sick again. Her symptoms seemed to be evolving and I was still worried I wasn’t making the right decisions. Her IV went bad and it took a while to get another one started because she hadn’t been drinking and had gotten very dehydrated again. Her IV from the hospital was also infected but they do not use clear tape or op site dressings so I could not see it until I took it out. I spent over 13 hours in her room that day with her. But there were a lot of people praying for Octaline both in the US and Haiti and she started to improve again. We switch from IV antibiotics to oral antibiotics but continued some IV fluids to keep her hydrated and feeling better. About the time it was fairly certain we had gotten her though this, I had about done all I could do. For the last 8 days, I had spent a minimum of 12 hours a day working with her or dealing with issues or traveling to and from the hospital or finding medications, or researching things, but most days it was more. I hadn’t even unpacked my suitcases since I had gotten back or even had time to eat lunch (my good friend Sally had made me a big batch of Monster Cookies just before I left and they are what I survived on for 8 days!). I wasn’t sleeping well either as I was always running over things in my mind wondering if I was doing the right things. It was a little too much and it took its toll and now I was sick. I gave Octaline her morning medications and told her I wouldn’t be down in the morning because I really had to get some rest and take care of myself for just a little bit.
I took the necessary precautions to try to sleep as late as possible Saturday morning and try to recover from being sick. I woke up to a facebook message alert on my phone. I had a conversation in the back of my head that I had with a teacher the day before. So at 7:30 am I checked the message and he said that his wife was having trouble with her pregnancy and he asked it I could come and help because they couldn’t afford the hospital. It sounded like from his description that she could be in preterm labor. I quickly got up and got dressed and grabbed what I thought I might need not really sure if I could be possible delivering a 16 week baby today. Edmond drove me to see her and I was thankful that she was doing much better than I had been anticipating. She had been sick and was dehydrated but the baby seemed OK and it was just her not feeling well. I started an IV on her and gave her 2 liters of fluid and went over some things she needed to work on. Her last baby was born at 29 about weeks. I am going to be helping them out with as much prenatal care and possible and will try our best to the this little one to full term!!
In the meantime, Meredith went to a training for her malnutrition program so I ran the Monday morning clinic with Makayla as my assistant! She decided that medicine and especially the pharmacy are not going to be her field of choice once she graduates! We seen about 35 patients that day. Sometimes I start to feel like a broken record but they really would have less health problems if they would drink more water. Was able to see this little Angel in the clinic.
Noella was brought in by her mom because she said she fell off the bed and now won’t use her arm right. She said it had been 10 days since she fell. We had her bring her back the next day and I was going to take her for an X-ray but there was a medical team in the neighborhood and we had one of the doctors look at her and he said she had a Nurse Maid dislocation of her elbow. He reduced it but said it didn’t go back very well due to the time. The little kids get picked up by their hand or wrist a lot in Haiti and they get injuries from it. Hopefully she will have full use of her arm in the future.
We are also seeing a young man in the clinic that injured his toes. By the time he got medical help it was too late. They amputated the front half of his foot. They did a very poor job and didn’t even close the end of the amputation with skin. When he came to us it was all infected and not looking good at all. I won’t post a picture as it’s pretty graphic. Although I did use the picture as motivation for a student in the school to let me work on his infected toe. I told him he would end up like the picture if he didn’t let me help him now! Anyway, we are trying to keep him well while we wait for an orthopedic surgical team from the US to help him. I am sure they will have to remove it above the ankle but we are just trying to prevent gangrene and keep him from getting sick until he can have another surgery.
I did have a lady come to the gate at the school with a toe injury. She went to the hospital and now was looking for some help. She actually had gotten an X-Ray but that is all they did for her. They let her leave with a dislocated toe. So I reduced her dislocation buddy taped her toes and sent her on her way.
Do you remember Jean? He is the guy that had the wound on the back of his heal and we took him to the hospital back in the middle of November and they didn’t do anything for him. I am happy to report that he is almost healed!! He just has a very small area that is still open. We should be able to stop dressings in a couple more weeks! Thanks to Meredith for taking care of him while I was in Michigan.
Are you seeing a recurring pattern here with hospitals? Are you understanding the level of stress I had trying to decide just how long to leave Octaline in the hospital to help her but not let it be a detriment? The struggle is real.
Let me continue…
On Thursday I was planning to go to HERO Ambulance and help put together a presentation to secure funding for our “Baby Bus” that we are trying to get started. This will be the first ambulance dedicated to just Pediatric and Neonatal patients as well as high risk OB patients in the history of Haiti. I got a call just before I was supposed to be picked up and was told there was a change in plans. There was one of the very patients that needs this ambulance in need of our services. They said they would pick me up and we would go and do the transport. I was expecting an ambulance since that is often what you make ambulance runs in…. Today was a little different.
So it’s Haiti, what every it takes!! The ambulance was in for maintenance and it would be a faster response by Moto. They had a vehicle and just needed portable O2 and someone to provide care. So, we loaded up. Stacy on one bike with a huge jump bag full of medical equipment and Steve and I on the other with an oxygen tank (in an OSHA approved securing system of course)! And we were off. It was about an hour response by moto. It would have probably been at least half again as long by ambulance or more. Stacy later told me that I should just play on my phone and not watch were we are going because it’s harder when I try to “help” the driver! We found our way out to Onaville Community Health Center. There we found Deborah, our patient.
Deborah is a 31-week Preemie that was born in the local hospital yesterday. This hospital apparently only offers one delivery service. Mom delivered her first baby alone. When Deborah delivered, she fell on the floor, landing on her head. The hospital came and tied the cord with a piece of string, cut the cord, and handed her to her mom and said thanks, you can go now. Her mom brought her to the community clinic the next day. She was about 44 hours old when we arrived. Her forehead was black and blue, her Fontanels (the “soft spots” on the top of a baby’s head) were bulging, indicating a head injury. Her oxygen levels had been very low when she arrived and she required continuous oxygen to keep her levels up. She had been accepted at Bernard Mevs Hospital which is the only hospital in Port-au-Prince that provides Pediatric and Neurological services. So after a quick assessment we were on our way.
So the baby and I along with mom and Rachel from the clinic loaded up in the clinic's SUV and we were off for a fast and bumpy ride to the hospital. Stacy and Steve escorted us on the moto's clearing and blocking traffic as we went. When we arrived at the hospital the ER staff started working on her. Even with a hospital that has a NICU in it, things are still very different in Haiti then I am used to in the US. The nurses were a little irritated with all of us filling up the little one room Pediatric ER. I was asked to leave by one staff member and when I left another nurse came and got me to come back and help.
After a while we really needed to get going so reluctantly we left. Shortly after getting home that evening I learned that about 2 hours after we arrived at the hospital Deborah had found her healing in the arms on Jesus.
I seen Octaline today for the last time as a patient, hopefully. I am so very thankful for your prayers and for God’s direction in caring for her. I truly was worried that I would lose her for a while. I am thankful that God allowed me to be involved in His plan to restore her to health. It continues to be a blessing to be able to serve here in Haiti. I am further blessed by the part you play in this work so that together lives can be changed!
Until No Child Dies,