Sunday, May 21, 2017

The Greatest Payment


Quite frequently, fellow missionaries here in Haiti send patients to us for consultation.  The problems can be anything from a severe rash to massive pathology to unexplained illnesses.  Sometimes we can offer help and other times, there is nothing that can be done in this country. 

Last week, another such patient was sent our way from the mountains about 6 hours away from our hospital.  The thin 63-year-old lady, whom we will call “Wislande” (not her real name), came with her daughter, and was holding a small handkerchief in one hand and a Bible in the other.  She had a slightly tattered blue dress, a head scarf , and dusty black, ill-fitting shoes.  “I am the one who Madam Gail sent,” she said in KreyĆ²l.  As I was busy doing about a thousand things, I rushed by and asked her to wait, to which she patiently obliged, and sat on a cement step. 

After about half an hour, I returned to her on the step outside the clinic and said “Ok, let’s take a look at what you have.”  She opened her mouth and revealed a mass covering her left jaw, a little smaller than a tennis ball. She stated that she was having problems eating and was losing weight.  I again asked her to wait as I wanted to get her inside to do a better exam, but was fully expecting not to be able to do much to help.  Wislande obediently waited and eventually I escorted her and her daughter into an exam area and discovered that maybe, just maybe, this could be something that could be removed somewhat uneventfully.  I explained the risks, and asked if she would like for me to attempt to remove this mass.  She kindly said that she was fine with that, probably because there were not really other choices.  So, I recruited my faithful assistant, Kathy, who squeamishly agreed to help, and we set up an OR. 

The entire time we set up the room, Wislande was praying for us and for healing, and would occasionally break into a soft song.  Finally we were set up, we all prayed together, and then began the surgery.  Thankfully all went well and after about an hour or so, we were finished.  At that point, we assisted her to sit up and with no prompting, she began to “pay us” for our help.  She gave both Kathy and I hugs.  Not the kind of hugs guys give to each other with a slight pat on the back, but the kind of hugs that let you know that you are having your very soul embraced.  She then began praising the Lord for His goodness and asked for blessings for us.  As if this was not enough, she reached in her pocket and gave us all that she had:  150 gde (about $2.30 US).  I told her to keep it but she insisted. “Please! Please!” she said.  So reluctantly, we took the money (which we gave to the hospital), and she and her daughter walked away, to catch a tap-tap back to the mountains, some 6 hours away. 

Over the years of practicing in the US and working in Haiti, some days just stand out and some patients just stand out.  This was one of them.  I have never been paid so much for any procedure as I was that day.  I left the hospital richer after seeing Wislande because I had been paid with a touch of Christ.  That day I saw Him in the form of a small, blue-dressed lady from the mountains who was a giant in spirit, who paid me far more than any procedure is worth. 

Saturday, April 15, 2017

The Family of God


It was the last day of February when we got the news from our friend, Wisnel, that his 18 year old son, Anderson, had been injured in an accident upon leaving church.  Immediately after the accident occurred, Pastor Jean Marie was nearby, and offered both his vehicle and all the money in his pockets to assure that Anderson was transported to a trauma center in Port au Prince.  After a few weeks in the ICU with Wisnel sleeping on the ground outside of the hospital at night, both the money and the ability to effectively treat Anderson were in question.  Wisnel approached me and asked if I would be willing to transport Anderson back to the family’s house in St Ard to see if he could recover.  I had so many questions.  Is he able to travel? How can he be cared for at home with no electricity, running water or 24 hour care? How can he be fed?  With Wisnel tearfully asking, I agreed to make the journey to the hospital to stuff Anderson in the back seat of our vehicle for what would certainly be his final journey home.  Wisnel assured me that he would arrange everything so that Anderson would be ready to go when I arrived at the hospital in Port au Prince. 

Mark visiting Anderson with Nurse Jen
I set out early the next morning, picking up Wisnel (armed with several pillows and blankets) and his cousin en route.  When we arrived at the hospital, I was allowed into the ICU and found Anderson on oxygen, with IV’s, a catheter, a tube from his mouth to his stomach for feeding, and a tube in his nose to assist with breathing if necessary.  Several medicines were being given to him through his tubes, as he remained unresponsive from (what I soon found out) his subarachnoid brain hemorrhage.  The ICU doctor was visiting from the University of Chicago and we began the conversation to turn Anderson over to our care.  The experienced US physician said that if I could ascertain that Anderson could survive on room air, then I could feel free to transport, as there really was not much else that could be done for him, other than to wait and see IF he might recover.  He gave me carte blanche to see what I could do.  As I weaned Anderson from his oxygen, checking his oxygen levels (O2 sat) he seemed to be maintaining well.  So after several hours, with all of his other “tubes and bags” in tow, we squished him and two others in my back seat to help hold his unconscious, limp body, while his dad and I manned the front seat.  Arriving at his house in St Ard after a couple of stops to help clear his airway, we were greeted by several members of the church, several extended family members and his siblings.  We carried him on a small mat, several yards down a dirt path, followed by several ladies from the church waving their arms and singing “What a Friend We Have in Jesus”.  We placed him on his bed, positioned his tubes, wrote a list of what was needed from our hospital to continue his care, had a rich prayer and petition time on Anderson’s behalf, and sent me on my way.

Family and friends frequently provide food
During the weeks following this scene, a family friend, who is an LPN equivalent, moved into the modest home and has rarely left Anderson’s side.  The church, his family and the community has provided meals, laundry, and an unbelievable amount of support for Anderson and his entire family.  The powerful prayers, songs and love shown to him, is only trumped by his mother telling me often how powerful Anderson’s testimony will be when he recovers.  At the writing of this blog, Anderson is still non-verbal, slowly gaining some responsiveness,  has no “tubes” and shows improved movement of all of his limbs.  His eyes flash open but do not react normally to light.  His arms and legs move uncoordinatedly.  He is still with us!!

I don’t know the final chapter to this story but I do know that these interim chapters have been incredible. To see the community respond at this level around a family in need is something that is rare in the US.  To see the hope that buoys the family given by the church has been incredibly touching.  To hear the songs, to feel the prayers, to know the love around Anderson has buoyed my soul as well.  As God continues to write the story of Anderson, I anxiously await what comes next.

Sunday, March 19, 2017

The Doctor Becomes the Patient


Mark and I are planners.  Me more so, but him too.  When we moved to Haiti more than 2 years ago, I wanted a plan in case we had a medical emergency while in our Port au Prince home (the hospital where we work is over an hour’s drive from our home).  So last month, when Mark became very ill, we tried what we knew to do at home, but finally realized we needed to implement our back-up medical plan.  Mark has a medical condition that flares up from time to time.  Sometimes it resolves on its own; sometimes we need to go to the ER.  This time he needed the ER.  He needed a surgeon to put him under for the short procedure that was required, or the situation could quickly become life-threatening.

So about 5:45pm, I began gathering things for the ER.  We had never visited this ER, but had heard that if you live in Port au Prince, this is the one to go to.  I wasn’t sure what to bring.  Would they have potable water?  Would they have food?  Did I need to bring our own sheets?  Would I have access to electricity to charge my phone, or did I need my external battery charger?  Would there be a surgeon on call?  Would he/she be familiar with this medical situation?  What medical supplies and medicine would I need to bring that they might not have on hand?  I understand firsthand the difficulties with providing medical care in a developing country, where certain medicines and supplies are not found in country, and procuring supplies can be a long and complicated process, and where medical facilities are often operating on a shoestring budget.  Been there, done that.
I rushed around the house, knowing that I would need to drive, and preferably not in total darkness.  When I finally had my bag packed, night was falling.  We loaded up and took off into the night as darkness surrounded us.  Driving in Port au Prince is difficult (if you want a visual, search “Don’t Drive Here Port au Prince” on YouTube).  In the dark, it is more difficult.  Although Mark was in great pain and quite nauseated, he tried as best he could to watch for the many approaching vehicles without headlights or lights of any kind, and warned me in case I had not seen them already.  I kept my eyes peeled for the throngs of people walking alongside or in the road, and for motorcycles weaving in and out of traffic.  Finally, we turned down the road where we knew the hospital was.  There was a myriad of people selling their wares on both sides of the road, leaving room for but one vehicle at a time.  Smoke from food vendors wafted over the road, casting eerie shadows in the headlights.  When oncoming cars approached, the people squeezed into tiny spaces along the road, leaving just enough room for the two vehicles to pass.  We saw a facility on our right through an open gate.  “I hope that’s not it”, I said under my breath.  It was indeed the hospital we were looking for. 
Photo Credit: "Night Scene" (Jorge Saenz, AP)
We entered the gates and parked in the area that held about 10 cars – not much parking was necessary as most patients come on foot, motorcycle, or tap-tap.  I helped Mark to the doors that said “Salle d’urgence” – Emergency Room.  I opened the door to a rectangular room, 15’x30’, with exam tables, cupboards, chairs, and supplies lining the edges to shrink it to about 8’ x 20’.  There were about 8-10 patients with varying ailments, and 6-8 medical professionals.  No admitting area or desk.  When we entered, a nurse looked up and in Haitian creole I said “I think we’re lost.  We need the Emergency Room”.  They told me I was in the right place.

All the medical personnel in the room were indigenous, plus 2 women from Canada, a nurse and a physician, who has just arrived with a team that morning.  Although I know there are excellent Haitian nurses and physicians in Haiti, it was somehow comforting to talk with medical professionals I could communicate with completely, in English, who were most likely familiar with the condition Mark has that is rare in Haiti.  They told me a surgeon and anesthesiologist were with their group and would be returning shortly.  I explained to the Canadians Mark’s condition, and the medicines he would need.  The ER there did not have what he needed, but the Canadian ER physician reached into her fanny pack and pulled out one vial of exactly what he needed that she had brought into the country with her that morning. 

Payment was required before medical treatment could commense.  I took the appropriate forms out the door, around the corner, and down an alley to the cashier office.  With the generator humming and people surrounding me talking loudly in the hot, humid night, I could barely hear the cashier’s low voice through the small hole in the glass.  I asked the armed guard next to me to help me understand her.  Two thousand, five hundred gourdes.  Could I pay in US?  I asked.  Yes, $38.  I handed her two $20s.  “I don’t have change now; you will have to come back later”.  She stamped my paper and I took it back to the ER.  Now Mark could get his ER consultation and x-rays he needed.

At this point I saw my world through two sets of eyes.  From my American perspective, I saw a whole emergency department crammed into one room, where each person saw every other person’s condition, where bodily fluids, gauze, and other medical disposables were on the floor.  I thought of how far we were from sterile, wondered if someone might bump into a nurse giving Mark an injection in the crowded room, and wished I had US standard of care here.

The other set of eyes I looked through were the eyes of someone living in Haiti, where I am aware that most of the people I know could not afford this hospital, even the $40 I paid that night to cover consultation, IVs, pain and nausea medication, and the surgical procedure.  This set of eyes was tearfully appreciative that this facility was in existence, as a man who had had a motorcycle accident was being sewn up, as a woman who had a stroke was being cared for, as an elderly man with hypertension was getting the medication he needed to survive, and where my husband would be delivered from a life-threatening situation.  How fortunate we were to have access to all of this.

After we waited a couple more hours, the surgeon entered and I expressed my appreciation through tears.  They got special permission to use the recovery room to do the procedure rather than do it in the ER room, with the crowd of people there.  He brought his anesthesiologist with him.  Although the recovery room looked much different than what we would see in the US, I knew Mark was in good hands and that this team understood what my US perspective was as far as quality of care and pain management.  They finished the procedure and waited for Mark to awaken.  Forty-five minutes later he was released, not because that was ideal, but because there were no more beds available in the hospital.

I wheeled Mark out to our car, past a few dozen people sleeping on the ground, waiting on their loved ones who were admitted and staying in the open ward.  Mark got in the car, and after I went back to the cashier to get paperwork stamped, we were free to go.  I maneuvered my way through the night, easier this time since it was after midnight and the streets were fairly clear… until I saw a car stopped in the middle of the road, with police officers nearby.  I began to pass, but was flagged down by an officer – one of the many checkpoints we encounter from time to time.  I gave him our papers and my Haitian driver’s license.  He said something in Creole that I didn’t understand.  I asked him to repeat himself.  Where is your Passport?  Where is your Permis?  Most of the police officers we encounter in Haiti are good folks, just doing their job.  Once in a while, we encounter one who hassles us to try to get bribe money, or maybe just honestly doesn’t know the law.  We explained in detail the papers we had and that they were what was required.  When he saw we knew the law, he rolled his eyes and waved us on.

I backed into our space in our neighborhood and helped Mark into our house.  A Haitian friend in our neighborhood accompanied us, helping carry our things.  He asked how things went.  We told him we were so grateful a surgeon was available, but he would be leaving in a few days.  We hoped this procedure would get Mark back on his feet.  Our friend, who has never been out of Haiti, looked at us with genuine concern and said that maybe we needed to go back to the US to get medical help, because Haiti doesn’t have all that it needs in the world of medicine.

I entered the house and closed the door and fell apart.  How blessed I was to have the surgical team!  How shocked I was at the condition of the ER!  How grateful I was that we can afford the $40 I paid to get the medical care we received!  How troubled I was that so many in this country could not afford the same!

…and our friend who helped us in that night.  If he were in the same condition, and if he needed medical care beyond what was available in Haiti, he would not have the opportunity to seek care in the US.  And yet, knowing that we do have access, he honestly wished for us that we could access the high quality medical care he knew we could receive in our home country.  I saw the face of Christ in him that night.

So what do I take from all this?  First of all, I am thankful for answered prayers that night, that my husband is alive and well and was well-cared for.  Beyond that, I will never make sense of why I have so much privilege, and why so many live without.  I just can’t wrap my mind around that.  I believe one day, in heaven, Jesus Himself will help me understand.  But until that day, we continue here, to try to provide quality healthcare in Haiti, in Jesus’ name.

Thursday, February 2, 2017



Last month we were privileged to host a surgical team from a partner organization: Community Health Initiative (CHI).  Their annual trek to our facility allows their skilled medical professionals to perform multiple surgeries and procedures.  

In the recent past, one of this year’s visiting surgeons and his wife, a physician's assistant, had hosted a Haitian girl in his home since her necessary surgery was unable to be accomplished in Haiti.  What a blessing he and his family had been to the girl and her family!  As part of the CHI trip this year, the surgeon and his wife wanted to follow up and reconnect with the  young patient they had hosted.  

The day arrived for the patient to greet the surgeon and his wife, but the hours passed and she did not appear.  Time marched on until late in the afternoon, when I was asked to summon the surgeon and his wife as his “star” patient had arrived.  When I accompanied them to translate during the time of reacquaintance, the patient’s mom presented our surgeon friend with a “thank you” present for all of his kindness.  As the gift trotted over toward the doctor and his wife, they were humbled and puzzled simultaneously, as they were unsure what would be the best thing to do with their newly gifted billy goat. What a huge present and a wonderful gesture!!  The hugs were exchanged, the stories were recapped, the follow-up exam was completed and the patient and her mom returned to their home.  
The goat remained.  This marvelous gift was graciously received but left under a tree outside of our clinic until the surgeon finished his day of surgery.  At the end of the day, a suggestion was made to find a family in the area of the hospital who could especially benefit from the gift of a goat.  A local pastor agreed to ask a needy family in the area and the goat was led off to “spend the night” with one of our hospital employees.  

The next day, the goat returned to his place under the tree near the hospital and soon, a lady from the community, who was invited by our pastor friend, came to receive an incredible gift to her family:  a goat.  This lady had birthed 12 children, but only 2 remained alive and lived with her, along with many grandchildren.  This gift could be the start of something big. 
Some other friends were staying nearby, and upon hearing our account of the goat story, felt moved to continue to help this family.  A donation was made in the name of a recently deceased family member of one of the team so that the family in need could not only have a male goat but this donation would allow them to purchase a female goat.  This combination can support the family for years to come!

It is truly amazing to us how God can take a single gift and multiply it so many ways.  Think about it:  the surgeon came to offer his gift of service to the patient, which expanded to a gift of hospitality and service in his home in the US.  Out of gratitude, a gift of a goat was given to his family, which was the gifted to another family.  This sparked an additional gift, which again will be multiplied to be a gift to many over an extended period of time. 

One act of kindness, continued to grow and multiply to encourage and help so many people.  One person willing to give selflessly to help another affected the lives of so many.  One God who gave His son, continues to give hope, for generations. 

May we all be moved to give ourselves away so that someone else may know that there is hope! 

Saturday, January 14, 2017

Could Be Worse!


When our kids were young, one of my favorite books to read to them was entitled “Could Be Worse” by James Stevenson.   In the book, “Grandpa” always responded to any complaint from the grandkids with the same phrase: “Could be worse!”  Whether the grandkids had a splinter or were bemoaning a lost kite, the response from imperturbable Grandpa was the same:  “Could be worse!”  As the kids began thinking that Grandpa was “one dimensional”, he fabricated a fabulous tale about being attacked by the abominable snowman, being carried away by a giant bird and being trapped under the sea.  The adventure continues as the grandkids hang on every turn of the story until Grandpa arrives back to his home.  Shocked and amazed, the young ones were asked by Grandpa what they thought of his fanciful story.  “Could be worse!” they responded in unison.

Kathy and I returned to the US from Haiti for Christmas this year just a couple of days prior to the big day.  The hustle and bustle were close to frantic level, with our friends, family and us performing at our peak velocities to get everything completed.  As all of us began tiring of the “seasonal pace”, we started hearing some all–too-common complaints: “The stores don’t have what we want!”  “I’ll be glad when this is over!”  “The traffic is crazy!” and—well, you know the list.  Sometimes I was the one complaining as well and wondering what had happened to me in the short time after I returned to the US.  Kathy and I had just spent significant time with Haitian friends who lived daily with food insecurity, with untreated medical conditions, with inadequate shelter, with abusive situations, and with governmental instability.   Why was I whining that the guy in the 10 items or less line actually had 14 items??  As I reflected I realized that so often I lose the perspective of how fortunate we are to have an abundance of our physical comfort and physically necessary materials so easily accessible.  I so often allow a minor inconvenience to take on a life of its own, and overshadow the abundant blessings that are so obvious, but overlooked.  Definitely, it “could be worse”!  Prosperity does not buy happiness any more than poverty defines unhappiness.  To me it seems that the happiest individuals whom we have met are the ones who are “blessings aware” with hope that the next day may be even better than the one before. It is easy to lose that perspective and believe that I am in the “worse” category of  “could be worse!”

We have a friend who physically lives in poverty but spiritually lives in prosperity.  Five members of her family live in a small hut with a dirt floor, and sleep huddled on mats.  They have a happy family and feel blessed.  One of the family members saw an old, somewhat tattered, twin mattress that we had in storage at the clinic and wondered that if we couldn’t use it, could she have it.  Our friend expressed that she realized that other people might need it more than they did (aka “could be worse”), so if we needed to keep it that was fine with them.  After debating this request for about 3 milliseconds, we decided to give the mattress to the family.  The gift of one, well-used twin mattress for five people was received with not only a hug, but with tears and a small dance of joy.   They now could take turns sleeping on their mattress! The family was excited for the gift of comfort for each other.

This story (and many others like it) makes me realize just how poor I am!  Yes, you read that correctly, how poor I am. For some reason, I am often “joy impoverished” as I forget just how blessed I am.  I am poor in spirit as I complain about the minor things of life and forget the hope that we are given for a better day ahead. I forget that there is a God who personally cares about each breath I take. 

My prayer for all of us in 2017 is that we are “blessings aware” and remember those around us who are physically and spiritually impoverished.  “Grandpa” ’s perspective is correct in that it nearly always ”could be worse”, but I hope that we can put a more positive spin on it and remember that we serve a God who, no matter how “worse” it is, can always give hope for an impoverished one-- like me.