Thursday, December 14, 2017

From Pressure to Prayer to ER


It was sometime in September when the “last straw” was piled on that tipped the balance.  I do not know the young lady’s name, but I do know that she was a 20-year-old who attended the local Baptist church in Saintard.  She was an asthmatic who was in the midst of a respiratory crisis and our facility was closed for the day.  Her family transported her to the under-funded government facility about 30 minutes away that did the best they could for her, but being financially strapped, they were without a working nebulizer, without oxygen, and without many of the things that we take for granted as a “given” in an emergency room.  After they did all that they could with what they were given, the young lady succumbed to her asthma attack. 

Her story quickly spread through the village and someone or someones asked why the Church of God hospital was still not open 24/7.  After all, the Church of God hospital has oxygen.  The Church of God hospital has nebulizers and albuterol.  The Church of God hospital has a lot of medications that the government hospital is unable to obtain.  The Church of God hospital has also been telling the citizens of Saintard for years that they have a desire to open an ER.  Why has this not happened??  So the community decided to discover why the Hôpital L’Eglise De Dieu Réformé (Church of God hospital) was still not open around the clock to service those in need and to find out what they could do to “make it happen”.  The inquiries began.  Local leaders began to visit.  Government officials asked questions of us.  The UN stopped by.  All of them emphasized that because of our inability to open 24/7, people are dying.  As I tried to explain that we needed more education for our staff and we needed more funding to make it happen, the answers fell upon deaf ears.  People are dying, they said.  So, the Haitian hospital board, along with the US hospital board, began to pray more earnestly.  What are the barriers that keep us from opening?  The barriers fell into four main categories:

1)   Finances
2)   Facility limitations
3)   Trained staff to complete necessary treatments
4)   Ongoing procurement of necessary supplies

All of us, the Haitian component as well as the US component, bathed the issues in prayer.  After weeks of praying, and hours upon hours of crunching numbers, discussing logistics, making plans for continued intensive education, and identifying Haitian staff, we all felt led to open Hôpital L’Eglise de Dieu Réformé as a 24/7 facility in January 2018. 

We are all excited…and some of us (namely yours truly) are scared!  Scared of failure.  Scared of inadequacy.  Scared of the mistakes we will make.  Scared of this and that.  We only have funding to cover the expenses of the ER for a few months and maybe God will choose to close the doors after that.  We only have supplies that will last a matter of months.  Our staff is still unsure where they will sleep and how it will work.  The facility and training may never be finished adequately.  I don’t know.  The only thing I do know is that we serve a God who is bigger than finances, facility limitations, and staffing and supply issues.  We are jumping off of the proverbial cliff with our limitations and baggage in hand and pray that we are making the right choices. 

I am told that when people trust God in situations like this, that they grow.  I don’t know about you, but sometimes I have growing pains.  Maybe I don’t want to grow right now.  For me, it is often tough to let go and “jump” for fear the landing will be ugly.  I am afraid of the landing, but the only thing that I know for sure, is that there is a landing somewhere, sometime, and God will be there too.  I only hope that after I land, I have the faith to say “…and now what should I do?” and be willing to jump again, before someone piles on another “last straw”???.

I hope that you, my friends, “jump” with the faith that God will help you land .

Monday, November 6, 2017

Just Another Day: A Bird's Eye View Into our Daily Life in Haiti


We often get asked what a typical day is like for us living in Haiti.  It is hard to answer, because our life here is wildly different each day.  When we look back on any given week, it often seems like we have lived a month’s worth of days!  But to answer this question, I picked a day at random (several weeks ago) and recorded the day’s events:

5:00am     Our alarms go off.

6:00am     We load up the car, today with some suitcases and bags of items we purchased in the US for the hospital, since we just arrived back in Haiti the evening before.  (We buy what we are able to in Haiti, but many necessary supplies and medicine are not available in Haiti.)

6:15am     We leave our house in Port au Prince to drive to the hospital in Saintard.

7:00am     We stop at a guesthouse on the way and pick up a lab tech friend who works at a non-profit that helps equip medical labs in developing countries. 

7:45am     We arrive at the hospital.

8:00am     I sneak to my secret spot to have devotions, then my morning prayer walk around the hospital.

8:30am     I make arrangements for an interpreter to come for the training our lab tech friend is providing for the laboratory staff.

9:00am     I check in on the lab training to make sure they have everything they need.

9:30am     I make my rounds to greet each staff member.  This greeting time is more important culturally in Haiti than in the US.  Today I greet longer than usual since we had just returned from the US.

10:00am  I am visited by a soon-to-be father asking for a present for his baby.

10:30am  I work on financial reports for the hospital.
11:00am  We are visited by a community leader asking for help with a local need.

11:30am  I arrange for food to be brought to the lab staff during their training.

12:00pm  We have a meeting with the non-medical director about payroll.

12:30pm  We check in on the gentleman who lives at the guesthouse.

1:00pm    I work some more on financial reports.

1:30pm    I distribute printer ink and other supplies purchased in the US.

2:00pm    We are visited by another person asking for financial assistance.

2:30pm    I begin organizing and gathering things for the trip home.

2:45pm    We begin to leave, when 2 patients arrived with minor injuries.  The staff has already left, so Mark tends to the patients.

3:25pm    We leave the compound.

3:30pm    The traffic is stopped by a protest.

4:00pm    The traffic is still stopped; passers by warned us of  guns, burning tires and vehicles, and to turn around.

4:15pm    We see riot police with guns, masks and armored vehicles driving toward us, so we know they have broken up the riot and we can continue again.

4:45pm    We arrive at the compound to drop our lab tech friend off where he is staying.  We see another friend there who works with that nonprofit, and catch up a few minutes.

5:00pm    We continue on our way, and get stuck in a traffic jam due to a broken down vehicle.

5:30pm    We continue on our way, and again we get stuck due to a broken down vehicle.

6:30pm    We finally reach our house in Port au Prince and unload the vehicle.  The electricity is on (unusual for that time of day!) so I quickly shred some papers while I have electricity.  The electricity is on for a couple of hours.

6:45pm    I get the laundry off the line while Mark puts more duct tape on the loose fender on our vehicle.

7:00pm    I gather supplies for a hospital staff birthday party the next day while Mark mixes the cake batter.

7:15pm    We both catch up on emails.

7:30pm    Mark fixes salad for dinner while I finish the financial reports.

7:45pm    We read our hometown newspaper online while eating dinner.  (Our favorite part today is the word jumble!)

8:15pm    We make pb & j for our trip to the hospital the next day.

8:30pm    Mark washes dishes while I prep for a language evaluation the following day for a 2 year old child who is nonverbal.

9:00pm    I start boiling water to cook some vegetables for soup the following day, but we run out of propane for the stove.  It is too late to walk to the corner gas station to buy more propane, so we abort.

9:15pm    I have a FB Messenger conversation with a Haitian friend to arrange for drop-off of 
some items that we carried into Haiti from his US friend.

9:30pm    We watch an episode of Star Trek: Next Generation on my computer, then go to  bed.

10:30pm  The Haitian electric company gives us a few hours of electricity, allowing us to cool 
down enough to sleep and get ready for the 5:00am alarm the following morning.

During this particular day, Mark was busy doing all kinds of things I didn’t list above, like helping a patient jump start his car, helping coordinate a new malnutrition program, tracking down a problem with our computerized patient record system, arranging for repair of a sickle for the groundskeeper, gathering some medicine to send to a Haitian nurse who works in the mountains, and fixing a toilet. 

Many days are very different from this one.  We try not to work this many hours every day; some days that works, others are long ones like this one.  Sometimes we live in a guesthouse for a week to host specialized teams, like the team that came to implement an inventory system and teach a new employee to maintain it, or medical teams that can teach or work alongside our Haitian staff.  Some days we stay at home the whole day just to catch up on paperwork.  Some days we run errands, like renewing our residency permit, or visiting other medical facilities to learn from their experiences, or just buying groceries.  Some days I walk to a nearby school and provide speech therapy. 

I hope my description of our sample day doesn’t sound like I am complaining or looking for sympathy.  When we have had people visit us at our home in Port au Prince, some have said “This is much nicer than I anticipated!”, and others, surprised at the conveniences that we don't have, have said “How do you live like this?!”.  We are grateful for things like indoor plumbing and a kitchen with a propane stove; these are things that most Haitians do not have.  We are grateful to live in a place where we feel safe.  We are grateful to own a car.  We are grateful for God’s protection.  We are grateful that friends and family are in the US, praying for us, and supporting the ministry in so many ways.  We are grateful God can use our education, past experience, and the talent he has placed within us to serve in this way.  And, if I am being completely honest, some days I just plain feel sorry for myself that I live so far from our family and long-term friends!  But mostly I try to stay focused on the incredible blessing it is to know the Lord.

Tuesday, October 3, 2017

Helpless But Hopeful


The clinic day was drawing to a close, as our OB/Gyn was finishing up his last few patients.  Two nurses were still hanging around, talking and laughing with a few of our check-in staff.  The generator had been turned off and locked up until the next day.  The common sound of a motorcycle grew louder as the driver and his passenger stopped in front of the hospital. 

A 20-something young man, who looked pretty “street tough” quickly got off of the motorcycle and approached me.  “My child took a whole bunch of his mom’s pills and won’t stop crying!!”  he quickly and breathlessly shared.  “Where is the child?” I asked.  “Can you bring the child here? And any information about what medicine he took?” I asked as he turned toward the awaiting motorcycle, got on and said “I will be right back!”  I started looking at our inventory of what we had for such an event and realized we were dreadfully unprepared, but nonetheless, we were the only facility near to where the child lived.

After several minutes, the young man, the child and the child’s mother returned on the same motorcycle. The sound of the child’s moaning and wailing echoed throughout the hospital.  I carried the child into the hospital, and placed him into the arms of one of our nurses and asked her to take vitals and monitor him.  I then started quizzing the parents: 
·      “When did he take the pills?”:  About 10:00-10:30 (4-5 hours prior)
·      “What kind of pills?:  We think they are called  <a brand name I did not know>
·      “How many did he take?”:  We think he took 10
·      “What are his symptoms up to this point?”:  Crying without stopping, writhing, not able to focus

…and the questions continued, vomiting?  Diarrhea?  Fever? Etc etc.

So as I recalled back to my days in the ER in the US, what would we do?  Among other things we would contact the Poison Control Center and get their advice.  I was afraid to induce vomiting because of the time since the ingestion and the risk of aspiration.  Maybe the Poison Control Center would know.   So off I went to find the number.  I grabbed my phone, and, the internet was not working.  I kept trying but to no avail.  I finally found the number on a drug pamphlet in the pharmacy and dialed the number. 

“Poison Control Center.  You realize you are calling New York?”   “Yes, Ma’am, I really don’t care where you are if you could give me some advice.” 
By this time, I had contacted a Haitian pharmacist friend who had given me the generic for the med, and wished me good luck.

“Sir, what is your situation?”  With as much brevity as I could muster, I explained the situation medically.  “According to our toxicologist, here is what we suggest.”  She began with a list of things for us to do, and to most things she suggested, I responded with, “we can’t do that here.”  “Oh!  Well let me have you talk to someone else.”

After another conversation the second MD finally said, “well, what do you have there?”  I gave him the short list, he muttered some expletive and said,  “Well, what you have done and not done so far is good.  At this point, I would monitor and if things get worse, then move onto more aggressive emergency measures.  Good luck!”  That was the second “good luck” I had received.  I think they are like strikes:  3 and you’re out!

So, we waited.  Time crept slowly as the child screamed.  We continued monitoring, and watching,…… and waiting.  Finally, the wailing subsided.  The writhing slowed, and monitored sleep crept over him.  I put my arm around his father, who had been sobbing, and he slowly smiled, as if hope had once again found him.

We waited some more and  the little one asked for a drink of water.  Some sips were given and we watched some more.  Eventually, we had just a sleepy, normal 3-year-old with us, and mom and dad asked if they could return home.  After a little longer, we dismissed them, adding that they should bring him back immediately if anything changed. I am not sure what we would have done, but at least we had a few options.  Dad asked our security guard at the hospital to call a motorcycle to pick them up.  As they left the building, the dad gave me a hug and said two things in broken English:  “thank you!” and “God bless you!”

I am still not sure what I had done.  I really offered no real solution.  I had only made several calls and confirmed that we were doing the right things and not the wrong things.  Our staff and I had done our best with what we had but still felt woefully inadequate.  This had a happy ending but, what about the next child?  The next patient? We knew we had some work to do so we could be prepared for whatever came the next time.

The Poison control center was wonderful!  Not only were they attentive and offered help when I called, but they called again a couple of hours after the initial call and then again the next day.  They, like me, felt helpless, but wanted to offer me some hope and encouragement.

It is in situations like this that all of the medical training in the world can’t help, especially if all of the resources are not at your disposal.   It is especially frustrating because you know what to do, you are advised what to do, but you don’t have what you need to accomplish it. 

Photo Credit: 
Hope.  It is so important!   Sometimes even if we don’t know what to do, or what to say, just caring and being there can offer that modicum of hope. 
We as Christians are lucky!  We realize that so often we don’t know what to do or what to say, the feeling that we don’t have what we need to fix the problem.  If we simply ask, there is someone always around to buoy us and give us hope.  May we never forget that hope can be found if we just look for it.  Jesus guaranteed it!

“….for I am with you always…..”

Tuesday, August 29, 2017

Taking a Back Seat


It was a hot, busy Monday afternoon at Hôpital L’Eglise de Dieu Réformé in Saint Ard. Over 100 patients and their families were waiting and receiving care in the main area of the hospital as the all-indigenous staff directed, managed, and guided the needed treatments. The noise and activity flooded us with the awareness of the needs of the people around us.  

We soon buried ourselves in a quieter small office on the second floor of the facility, as the leadership team of the hospital began a necessary planning meeting. The discussion was focused on two main items: defining and funding the payroll taxes as described by the Haitian government, and defining the funding needed to move the hospital from a Monday to Friday urgent care center to a 24/7 hospital with inpatient services. The discussions began and the 30-minute meeting spread into an hour and then continued on.  

If someone during my career life in the US had asked me to attend a leadership meeting like this while there was patient care going on around me, I would have said “No, thank you! I am really too busy!” or “What are you, nuts?” But this time, it was different. This time as Kathy and I sat behind the other members of the leadership team, who are all Haitians, we listened. We provided less than 10% of the conversation but still found the all-in-Kreyòl meeting to be maybe not exciting, but definitely rewarding. This time, the staff was taking the leadership role. The staff was directing the conversation. The staff was getting excited about the possibilities. The staff was taking ownership. It seemed that a corner had been turned!  Kathy and I were taking a “back seat” in the project. Taking a back seat doesn’t come naturally to me (or many US folks) but has always been and continues to be a goal as we work toward indigenous sustainability here in Haiti.

As the meeting went on, the funds needed to sustain and grow the hospital were determined as closely as humanly possible. The reality of the financial magnitude of the project placed a small damper on the enthusiasm of the group but not to the point of making them overwhelmed. At one point, it was stated that, “We <Haitians> cannot always be dependent on Mission Haiti Medical <outside influences> but need to be as independent as possible.” If I could dance, I would have danced! Some additional expenses were fleshed out and the goals were determined. The meeting was adjourned.

The reality of the outcome of the meeting is that neither the Haitian staff nor Kathy and I knew exactly how we would meet the entirety of this new financial goal. No one had voiced that it seemed beyond our current scope but sensing that obstacle, and without saying a word, one of our good friends on the leadership team stayed behind, grabbed my hand and Kathy’s hand, making a circle of the three of us, and began to pray. He prayed that, if it is God’s will, that the hospital have what it needs to open 24/7 soon. He prayed that while some things seem impossible, with God all things are possible. He articulated the difference that a hospital in the area could save the lives of so many but still, God, we bow to you and your control. 

When the “Amen” was said, we embraced and parted ways. As we opened the door, the din of the hospital patients below the office re-entered our lives. The physical needs of the patients were once again brought to the fore as those with different medical crises were seen awaiting care. As we saw the needs spread before us, we again realized that the ability to care for all of them was far beyond the long-term scope of a couple of US missionaries. The ability for the indigenous Haitian staff to shoulder the whole responsibility of healthcare, at least in the current financial state of the area, is a ridiculous request. The amount of money needed to quickly improve the facility is just an outlandish thought. BUT regardless of the outcome, our job is to join hands, pray, believe, and follow the one who can make it all happen.

We continued to watch as the patients in front of us, one at a time, were cared for. The busyness and noise subsided. The line had finally disappeared and, at this moment, all there had been helped. One day at a time. One patient at a time. One prayer at a time. So until the next step, we work, often impatiently, to turn all of the projects over to God, the original “indigenous personnel”, who was, and is, and is to come.

Jesus looked at them and said,With man this is impossible, but with God all things are possible.”
Mt 19:26 (NIV)