Saturday, September 1, 2018

Today I Cried


BY MARK


Today I cried.

I am generally a pretty stoic person.  I actually have been described as “Spock-like” because in the battle of emotions versus logic/facts in decision-making, logic/facts wins every time.  It is not because I don’t feel things. I do.  But when it comes to making decisions, I was raised to believe that feeling should be taken out of the equation.  Weigh the facts.  Dwell on what can be logically accomplished and push forward.  That is how it is done.

…but today, I cried.

Our journey given to us in Haiti is filled with terrible heartbreak nearly daily as we work in healthcare and see some horrific situations.  To share a part of the journey with you, a couple of weeks ago, a bad accident occurred about 200 yards from the road which enters the driveway to the hospital.  Fifteen people were killed instantly as a small passenger-carrying truck went underneath a bus.  Several of the victims were beheaded.  Our ambulance transported 3 others from the accident to the hospital: one had severe injuries which led to her death soon after arrival, one was stabilized and transferred to another facility, and one had minor injuries as he jumped off the truck as it was crashing.  The day after this accident, a 3 month-old baby who was awaiting a surgeon to come from the US to get a heart defect repaired didn’t survive the wait.  Her dad works at our hospital and we had journeyed with the proud dad as he and his wife celebrated their new arrival.  Once the defect was found and the baby was transferred to another larger facility in Port au Prince, they said they had a surgeon coming in a few months to fix the defect.  Feeling that may be too long, a few phone calls made it possible for a pediatric cardiologist to visit in just three weeks to do the surgery.  We were all thrilled.  She passed away about 10 days prior to his arrival.  These things broke my heart.

…but today I cried.

Situations continued to occur: telling a caregiver that her hydrocephalic child really must wait for the surgical team to come and there was not much we could do until then, and then hearing that the child passed within the hour; a continuous stream of motorcycle accidents with severe injuries; special needs kids with nowhere to receive help; malnourished kids who passed away in spite of everyone’s efforts; and yet another child who arrived unconscious while awaiting surgery in Port au Prince and we transported her.  All of those situations tore my heart and made me sad. 

…but today I cried.

Today started normally and really the events of the day were no better or worse than any other day.  When I arrived at the hospital and looked in the ER, there lay a 64 year old lady, who had suffered a heart attack.  She was struggling for breath and even with a strong flow of oxygen her levels were not great.  She had been given the appropriate meds for her condition but she continued to struggle.  We felt she needed to be transported and made the appropriate arrangements, got the O2 tank ready to go, and prepared to load her in the transport vehicle.  At that point, the family decided that they really could not afford to pay at another hospital.  We said we would waive all fees from us, and just get her there.  The family stated that they would care for her at home and as she passed they would be there.  After all, they said, she was elderly.  The view of her being loading into the back of a pick up truck with sheets wrapped around her, as we unplugged her oxygen was not one I wanted to have.  She struggled for breath, and fell semiconscious on her make-shift mat as they drove off. I stood with my staff as they drove off, praying for her and her family and shaking our heads at the choice.  That was terrible, and made me heartbroken, but not tearful.

I walked into the inpatient area and talked to a first-time new mom, cradling her newborn who had entered this world eventfully with an emergency C-section the night before.  Our OB had done a great job.  The cute little guy was blessed to have such a loving parent cradling him.  I walked away sensing her joy, went into my office.

Then, I cried.

I am not sure why that was the moment after all of the rest of the events that caused the tear ducts to produce.  I don’t know why this moment was the one. Maybe the “circle of life” had been seen.  Maybe there was a cumulative effect.  Maybe I am getting soft in my old age.  I don’t know, but,

Today, I cried.

It somehow felt cathartic and somehow after pulling myself together, I re-entered the healthcare playing field.  After all, Jesus wept, so I guess it was ok.  I went downstairs in time to see a little boy with a high fever having some (presumably) febrile convulsions.  I watched the staff do the right things and readied myself for the next challenge.   Maybe today was the day that for that one moment, feelings trumped logic.  I am not sure of all of the details, or the “Why”s, and “How”s but God jumped in and gave me a little alone time and break.  It may not happen again, or it may, all I know, is that ,

Today I cried.

Thursday, July 19, 2018

Disturbing Dilemmas


BY MARK

The man in his mid-thirties hobbled up the ramp at the hospital in Saintard, and asked the security guard if “Dr. Mark” was available.  When summoned, I met the gentleman who was sitting on a bench beside his friend, with a pair of crutches resting across both of their laps.  After he introduced himself, this kind man who lived several hours from our hospital said that he had been referred to us by a mutual friend to determine if we might offer him some advice and/or help. 

His story unfolded that a motorcycle accident six months prior in Port au Prince had left him in another hospital for a couple of weeks.  Afterwards, his fractured leg had not healed correctly.  “Is this something your hospital might be able to help with?”  he asked.  “Maybe”, I sheepishly responded, knowing that I was not an orthopedic surgeon, nor was I an expert in long bone fractures.

After a quick exam and x-ray the problem was obvious.  Both bones in the lower leg (tibia and fibula) were fractured and the fractured segments were about 3 cm (about an inch) apart.  His leg dangled when not supported, but somehow, his pedal pulse was still strong.  I sent a copy  of the x-ray electronically to our orthopedic surgeon on staff who said he could help.  I was thankful. 

BUT THEN came the statement that we hear multiple times every day: “Unfortunately, I have very little ability to pay!”  I understand this statement, especially in Haiti.  Of the thousands of patients who we see each year at the hospital, usually fewer than 10  (not 10% but 10 patients) have any type of healthcare insurance.  (Could you imagine if you needed to pay for your healthcare without any insurance?)  Part of our ministry here in Haiti is to help subsidize healthcare so that those who cannot afford it may be able to access it. Our organization helps with staff salaries, supplies and facilities, thus making healthcare not free, but more affordable.  We are so blessed and thankful for those thousands of patients who have been helped.  A surgery for the man with the broken leg (above) will have many costs.  The metal alone to fix the leg may be about $400 US, the anesthesia, the medicine, supplies, a modest salary for the surgeon and the staff to care for the patient, and the facility will cost somewhere around $2000.  Thankfully we can subsidize that to a large degree, so that the patient may be able to afford the surgery.  But what about the emergency C-section that came in later that day?  What about the lady who came the next day from the mountains with a fractured thumb that needed pins? What about the child with pneumonia who needs to stay at the hospital several days to recover? The demand is always greater than the supply, but whom do we treat and whom do we send away, knowing that we cannot help everyone?

So it is with these types of questions that we struggle daily at our little hospital.  I have been through many years of sitting in classes of various levels, but not one of them has provided an answer to questions such as these.  Mark Twain once said “I have never let schooling interfere with my education.”  I must say that my “education” here in Haiti is huge as we have some of the most stretching and growing experiences I can imagine.  Some things that I am learning:

1) God is in charge. 
There is no way that many issues in our lives can be logically, economically, or educationally reasoned away.  The only solution is to seek guidance Spiritually from the One who created it all.

2) Don’t expect it to make sense.
Things make sense only if we try to rationalize it from our level of understanding, not a higher level.

3) Keep trying.
While our treatment modalities and facilities are far from what we would like them to be eventually, we continue to strive to improve lives.  If we can do so in the name of Christ, then we can not only garner some relief in the moment, but the sense of hope for eternity in Him.

I constantly struggle with slowing down and keeping these “lessons I am learning” in the forefront.  I hope to do better... but right now, I am being summoned to consult with another patient who fractured his leg.  My education continues!

Friday, May 25, 2018

Green Like Kermit


By Kathy

I am sitting at the Toussaint-Louverture Airport in Port au Prince, Haiti, waiting for a flight back to Indiana.  It is hard to sum up all the feelings I have when I go back to the US.  Our work takes us to the US about 10-12 weeks per year, so I am back and forth between the 2 countries frequently.  Mark and I thought we would get used to the transition, and the emotions would diminish.  We were wrong.
Source: La Nouvelliste
When I travel back to the US, I am ecstatic to see my kids, grandkids, siblings, mother, extended family, old friends.  I am very grateful for today’s means of communications, although Facetime doesn’t come close to a real live snuggle session with my grandchildren, or an intimate conversation with my sister over coffee.  Many of the daily stressors I feel in Haiti melt away when I am in the US, including the uncertainty of navigating a foreign culture and language, never knowing when a protest may spring up on our way to work, being asked for money or other commodities at every turn, being stared at wherever we are, and never really having the privacy we know in the US.  Being back in a familiar place, the town where we raised our kids and developed our life-long friendships, is comfortable and reassuring.  Knowing that there are a zillion benefits our country provides every day that we don’t even think about, like smooth roads, a well-developed justice system, free public education, and so much more, makes life in the US easy on many levels. 

All of those warm and fuzzy feelings are mixed in with a variety of very uncomfortable feelings.  I am privileged.  I was born into privilege.  There is no denying that.  I have the ability to whip out my passport and credit card and fly to a developed country where I am a citizen with all its rights and privileges.  In Haiti, I interact with people on a weekly basis who are bright, ambitious, educated, but can’t find consistent work.  I leave them to go to the US, where I see “Now Hiring” signs at every turn.  That feels weird, and unfair.  I leave a country where a large percentage of people go hungry on any given day, to see an airport food court full of food, more food in one place than many of our Haitian friends have ever seen all at once.  Just in one food court.  That feels weird, and unfair.  And I could go on…

on Flag Day, Haitians' pride is seen
But Haiti has long been viewed by many as a country full of poor, helpless people that need foreign help to survive and advance.  Haiti is a financially poor country, it is true, but rich in a vast variety of other ways, ways often overlooked by foreigners.  The sense of community here is something we don’t often see in the US, not to the extent we see in Haiti.  The resilience of the Haitian people is something from which the rest of the world can learn.  The pride Haitians have in their country, their heritage, their culture, despite years of patristic and superior attitudes from other people groups, is something to be revered.  Haiti is a place that the rest of the world would be bettered by visiting, with the sole purpose of learning about the Haitian people.

And living in Haiti, honestly, for the first couple years, I was stretched so far and tight I thought I might break.  But now, Haiti has become a part of me, my second home.  I continue to be stretched, and am learning more about God and myself than I ever have before.  I am not Haitian, and can never be.  If I lived the next 30 years of my life in Haiti, I would continue to learn new things about the Haitian people, the language, and the culture here every day (and I would also be very old!).  No, I am not Haitian, but neither am I the person I was before I moved here.  I have heard it said that living in a foreign country is like this:  In the US, everyone is yellow.  I was once yellow.  Haitians are blue.  Living in Haiti, I now am a shade of green.  Green like Kermit.  And sometimes it’s not easy being green.  But I wouldn’t have it any other way.

Tuesday, April 3, 2018

13 Pounds and 29 Inches


BY KATHY

Written December 2017

Yesterday at the clinic was a “typical” day.  It started with my trying to copy some data from our server.  Seems like an easy task.  IT folks are hard to come by here, and with the way things are networked, inavailability of the proper cables, and my lack of tech savvy, let’s just say I had to put that one back on the back burner. 

Then I tried to untangle an accounting snag I had.  I stared at my numbers, tried various permutations, told Mark I didn’t think I had the accounting prowess, and then was suddenly inspired to try something different.  It worked.  Success!

I decorated for the monthly staff birthday party, then sat down to my desk to write a report from a recent speech therapy evaluation.  After frequent knocks on the door from a wide variety of folks with a wide variety of requests, I decided today was the not the day I would be able to finish that report.

Clinic nurse instructing families on nutrition
Eventually the line of patients dwindled, so I went downstairs to host the party.  At that point, a tap tap rolled in with a load of patients.  The clinic participates in a malnutrition program in conjunction with another nonprofit, and the health department in Haiti, and USAID.  Eleven small mountain clinics are manned by local Haitian nurses, who identify severely malnourished children and refer them to this program.  From there, children are sent to many clinics throughout Haiti that have agreed to see the children, monitor their progress, provide education, and supply families with Plumpy Nut (a fortified peanut butter with research to back its effectiveness with malnutrition).  It is a great program, but there there are not enough places in Haiti to send the kids in need, so our particular clinic is always stretched when the families come, trying to see more children in need than our resources would suggest we could.

So, the families filed in.  One of our nurses in charge sent for me and asked me to take pictures.  I told her I never take pictures of anyone without permission first.  She assured me she would get permission first, and explained that we need to make sure people in the US know the depth of the need so they would be moved to help fund the program.  We need another nurse or two to run the program, to see more kids.  I started to take pictures of some of the kids and moms she had spoken with.  One caught my eye in particular.  A beautiful little girl with an older woman, her grandmother?  The little girl was too weak to stand without help.  This 4 ½ year old weighed 13 pounds, 29 inches tall.  Thirteen pounds, 29 inches.  She was the same age as my granddaughter.  My granddaughter, who is 40 pounds, and 44 inches tall.  The comparison haunted me, and left an indelible image in my mind.
 
Our granddaughter, during a Facetime visit
I thought about this child’s life, and the difficulty with which the parents must have in procuring enough food for their children.  I thought about what her living conditions must be like.  I thought about how long the family journeyed that day to try to get help for their little girl.  I thought about the injustice of the chasm between the “haves” and the “have nots”.

Clinic nurses taking arm
circumference measurements
I tried to turn my focus back to the job at hand.  The picture I took of this little girl.  What do I do with this picture?  Do I plaster it all over Facebook, in an effort to help others understand the dire need for help for kids in this situation?  Does that reduce this little girl’s life to a set of statistics, to a heart-wrenching photo, objectifying her?  Conversely, does using this picture make her life matter more, by using her image to help other children?  How do I respect her?  How do I show her dignity?  How do I honor her family?

It would have been wonderful if the clinic had the capability to keep her under our care until she became stronger.  Again, the layers became apparent: 
o   At this point we were not open 24/7 and did not have the capabilities to keep this child overnight, which threw us into another layer of seeking care.  Since this little one is but one of several at the clinic, which child from that group would we choose?  The child who was the same age as our granddaughter especially touched our heart, but what about the 22 others?  There were 5-6 of that group who were similarly malnourished.  Which one would we choose?  And the next week, when another batch comes in, and the next week, and the next week…
o   If the arrangements could be made for other kind souls to care for the girl until she regained her strength, what would that look like?  Would they care for only the girl, without her family?  What if the girl passed during the time they kept her, without her family at her side?  How would that feel to the family?  This particular question came to mind because we have lived through a similar scenario in the past, when a Haitian child was taken to the US for life-saving surgery.  After the surgery, she did not recover, and passed while still in the US, without her family by her side.  In that case, the father thanked us profusely for the quality care her child received, though her life could not be saved.  The mother, however, blamed those who tried to help for her daughter’s death and grieved deeply for years after.  How would I feel if I were that mother?
o   If arrangements could be made for others to care for the whole family, rather than just the one child, what would that look like?  “Family” in Haiti has a different definition that in the US.  “Family” here means mom, dad, kids, cousins, grandma, grandpa, aunts, uncles…  How many family members would we be able to find care for?  To help this one child.  While the others are not chosen.  Important for that one, for sure, but the situation continues on…

So I continued on that clinic day, taking the pictures our Haitian nurse requested, trying to maintain my composure, praying for more resources to make a positive impact for these precious ones.  Just another typical day.

The story continues…
As of January 15, 2018, the Church of God Hospital in Haiti opened its doors 24/7.  The malnutrition clinic continues, and emergency care is now available around the clock. 

The public has a special opportunity to learn more about this medical ministry during an evening of fun and purpose at the Bare Toe Ball on April 28th, at Madison Park Church of God from 4-7.  Tickets can be purchased at missionhaitimedical.tickets.qtego.net.

Want to make a difference each month?  Our Malnutrition Program costs $500 a month. We currently have supporters for half of this amount monthly, but are in need of more support to ensure that this program can continue.  If you would like to help with this need you can make a one time donation at https://www.missionhaitimedical.org/giving/ or email chelsea@missionhaitimedical.org  to give a monthly gift for this program.