Wednesday, August 14, 2019

The Bus That Came One Friday


The large repainted school bus pulled up near the entrance to the hospital.  A flurry of activity ensued inside and a gentleman emerged from the bus’ door, stating that they had a man inside who was in very critical condition.  We prepared a gurney and rushed to the door of the well-used bus and two men carried the injured man and placed him on the gurney.  Noticing that our ER doctor was busy with other patients, I went to the side of the man on the gurney and tried to ascertain his story.   A distinguished lady exited the bus and began to share the events surrounding the day.  Pierre (not his real name) is in his mid-20’s and was being treated to a day at the beach with some friends.  As the friends were swimming in the ocean, Pierre was several yards away from anyone when he went under the water.  Noticing that he did not surface after a short time, his friends rushed to his side, saw he was unconscious, and pulled him to the shore and decided to get him to a local hospital.  After asking around, the Church of God hospital in Saintard was suggested, Pierre was loaded into the bus, and was brought to see the doctors at our ER. 
I yelled for a nurse to assist and both of us began assessing him.  His temperature was nearly the same as the ambient temperature, he had no pulse, no respiration, and his pupils were fixed and dilated—all signs that his life had slipped away.  A few hours had passed since he was pulled from the ocean.  As with emergency situations around the world, the decision needed to be reached if we should try heroic measures to resuscitate him.  After some brief conversations, it was decided that the harsh reality was that Pierre had passed from this life to the next.  His friends said that Pierre was diagnosed with a seizure disorder of some type several years ago, but the medicine he needed was not affordably available to him.  They believed that he had a seizure prior to his fatal descent into the ocean. 

We began to process our next step, since Pierre’s family was in Port au Prince, and the road between the hospital and his family was currently blocked due to riots.  The family was reached but inaccessible due to the situation.  The bus was sent on its way and we waited.  And waited.  And waited for the road to be open.  After several hours, we got the news that he could be transported through the road.  The relief that the road was open was certainly overshadowed by the reality of his passing, but taking one step toward closure of the situation was certainly welcomed. 

As I reflected on the day, I couldn’t help but wonder:
--What would have changed if Pierre had been able to get the medicine he needed?
--What would have changed if he could have gotten to the hospital a bit more quickly?
--How could things have been handled better as we need to account for roadblocks?
--Why did this life end so tragically?

I didn’t come up with any concrete answers to these questions but as I sat for a moment, wiped a tear away for what “might be” in a different world, I felt helpless.  So many times in Haiti, we feel helpless and too small to make the necessary changes to make this little island a better place.  BUT, we do not feel hopeless.  As long as there is a God who provides the hope, we will continue to try to make a change.  A change for hope.  A change for the voiceless.  A change for the sake of Christ.

Our prayers and condolences go out to the family of Pierre.

Monday, May 27, 2019

Walking Alongside Each Other

By Kathy

Earlier this year…

It had been an eventful couple of weeks.  We had a lovely team from Indiana that came for a week to learn and provide needed surgery.  Two days before their scheduled departure, a country-wide strike took place.  With the strike came violent protests, road blockades, and tire burnings.  The day of the group’s departure, we left under the cover of darkness for the airport, they arrived there safely, and we continued on to our home in Port au Prince.  From that moment and for the next 12 days, the rioting continued.  The US Embassy urged all people to “shelter in place”.  Markets were closed.  There were acute gas shortages.  Prices of basic necessities skyrocketed.  Each night we heard groups of motorcycles drive by, shooting into the air as they passed our home.  Though we thought we were handling the situation with calm and trust in the Lord, on the inside our nerves were frazzled.

We had previously purchased plane tickets, scheduled to depart a week after the rioting began, and had a full agenda of meetings and speaking engagements in the US.  We weren’t sure if we could find a safe way from our house to the airport 2.8 miles away.  We hired a Haitian driver who knew the back streets, and left before daybreak the morning of our flight.  Before we left we collected all the food in our house and gave it to our Haitian neighbor, who wasn’t sure when it would be safe to go out to buy food, and wasn’t sure if he could afford the now-higher prices even if he could get out.  On the way to the airport, we passed too many smoldering road blocks to count, swerving to dodge large rocks and other debris in the road.  Once there, we waited with throngs of others who had decided the situation was too unsafe to remain in Haiti.

Once inside the crowded airport terminal, we waited over an hour in the long line at the ticket counter (the kiosks were out of order).  When we got in line, another American was standing near us and struck up a conversation.  He was an incredible man with an incredible story, who deeply loved the Lord and his family.  For over an hour we visited with each other and he shared stories and pictures of his family and the ministry where he worked.  Mark consulted with him about his current health situation, as he had all the classic signs of an ongoing heart attack.  There is little medical help available in Haiti in the event of a heart attack, so he was on his way to a US emergency room.  In line for security, we noticed he seemed to be doing worse.  With his permission, we flagged down an employee at the airport to escort him to the front of the line and get a wheelchair.  Though he was scheduled to be on our flight, we did not see him board.  We were worried about his condition.

We stepped off the plane into the Miami airport.  Normally we feel some of the stressors of Haiti fall off our shoulders as we enter the Disneyworld feel of the US, but this time the frazzled nerves of the continuing riots and concern for our new friend seemed to linger.  While we waited for our connecting flight, we learned that our new friend we had made just hours earlier had passed away shortly after we hailed the wheelchair for him.  Forty-eight years old.  Life is so fragile.

I tell you all of that to help you understand where my heart was when we arrived on US soil.  I felt like my nerves were on overload.  I would jump at small noises.  Was this, on a smaller scale, what PTSD feels like? 

The day after we returned, I went to a casual gathering of friends, most of whom I had known in our prior US life.  There was a lot of chit-chat, sharing each other’s stories of the day.  “Did we tell you, we got new kitchen cabinets!” “My last shopping trip to the grocery took 2 hours – they are remodeling and it is SO hard to find all the food on my list!” “My son’s soccer team won the tourney!” “We are planning our next vacation – do you think we should go to Florida or the Smokies?”  “The new Starbucks is such a pain – it took me 20 minutes to get my latte this morning!” and the like.  I tried to smile and enter into the conversation.  My heart was not present.

The next day I reflected on the prior evening.  Those used to be MY comments, MY thoughts.  Honestly, once I re-acclimate to the US, that still can be my kind of conversation.  But the intense events of my prior week were so fresh in my heart.  The conversations of the gathering felt so… TRIVIAL.

I continued to talk to the Lord about this.  And I thought about a dear friend of ours, Phyllis Newby.  She is a missionary from Jamaica and has lived in Haiti for 50 years.  She visited our family numerous times during the years when we lived in the US.  She came to our kids’ soccer games.  She went to kindergarten graduations.  She celebrated life’s little moments with us.  Who knows what she had seen in her own life in Haiti just before she arrived at our house.  She never made us feel that our lives were trivial.  She joined us where we were and celebrated the moment with us.  She made our victories her victories.  She made our disappointments her disappointments.  It is a great lesson I am learning.

I think of Jesus at the wedding when they ran out of wine.  Jesus surely knew that, in the scheme of all the world’s woes, running out of wine is certainly not a major issue.  Some could say it is trivial.  But when his mother came to Him and told him of the problem at hand, her concern became His concern.  And He used the situation to glorify His heavenly Father. 

Living with this whole world inside of me, the world that sprouted and grew within me while living in this wondrous and complicated country of Haiti, sometimes I am confused and conflicted upon re-entry.  If you talk with me shortly after I return and I stare blankly or have a vacant half-smile on my face, please give me some grace.  I am a work in progress, trying to learn these profound life lessons God has set before me.  I, as well, will try to give you grace, not knowing what world may be living inside of you.  I am trying to learn to walk alongside each person I meet, and join them in their journey, just as Jesus did.  And some days I do better than others.

Author’s Note: Haiti often is depicted as a financially poor country with only troubles and hardship.  It is so much more than that.  It is a beautiful place, with a rich cultural heritage and deeply passionate people.  This blog post is just one experience, and does not give a complete representation of a complex country.

Wednesday, April 10, 2019

Of Feet, Cow Dabs, and Easter

By Mark

When I was a young boy, I would often play outside barefoot.  Certainly my mom discouraged me from doing this, but I was a normal kid who sometimes pushed the envelope of obedience.  In the pasture by our house where the cows grazed, I would run around and joust with imaginary creatures and generally have some fun.  Occasionally, I would squish my feet in what we (and many others) called “cow dabs”.  Now you really don’t need to be brilliant to be able to define “cow dab” nor to realize that oozing this stuff through your toes is probably not a good thing. I can’t even imagine the micro biome of a cow dab and how many diseases I risked by dancing that barefoot squish.  Thank goodness my feet didn’t seem to mind, after the hose rinsed the bulk of the goo from them.

Feet go through some gross stuff! In addition to cow dabs, feet walk through all kinds of nasty things.  They are prone to fungi (i.e. Athlete’s foot), corns, bunions, hammertoes, diabetic microvascular issues, neuropathy, trauma, and so many things that only a podiatrist can truly appreciate. It was only in the past few years while serving in Haiti that I have been able to see even more things that occur with feet.  The staff of the emergency department at the small country hospital in Saintard, Haiti sees foot and ankle “issues” nearly every day.  Machetes mercilessly mangle feet and remove portions of them.  Motorcycles burn them, run over them, and twist them in directions that I never knew possible.  Thorns can pierce inadequately covered feet, allowing the indigenous dirt and grime into an open wound, creating some incredible infections. In addition, cysts, tumors, and cancer all seem to have somewhat of a preponderance for the Haitian foot. 

A few years ago, I was made aware of a disease in Haiti that most often starts with a foot.  The locals call it “chik” and I initially had no idea what it was.  After seeing chunks of feet that were literally falling off, I knew that I needed more research.  I asked our local doctors and some “smarter than I am” missionaries whom we know.  After doing an internet search and being able to define “chik” as something called Tungiasis, I discovered that the causative agent was a small insect.  The insect, which is like a small flea, lives in the dirt and enters the foot through any opening, then during its reproductive life cycle, ends up destroying the vasculature in the foot and the resulting necrotic toes eventually can just “fall off”.  It is horrific to see and worse to treat.  If, when attempting to remove the fleas surgically from the wounds the creature is ruptured, the eggs invade the wound even more, further complicating the possible recovery process.  It is ridiculous to treat, but that is a whole different blog!

So before you start believing I have an abnormal fascination with feet, let me get to my point.  I come from a church that celebrates Maundy Thursday (the Thursday before Easter Sunday) each year with a ceremonial foot washing.  To symbolize and celebrate the humility of Jesus and to follow his example, we would take a pitcher of water, a basin, and a towel, and wash each other’s feet.  While meaningful at the time, it is even more so today.  With the frequent lack of adequate foot covering here in Haiti, the ever-present dust and grime, the necessity to walk for great distances, and the pathology found in Haiti, feet can sometimes be “not pretty”.  If I could extrapolate this back in time a couple thousand years ago, I wonder if the feet in Jesus’ time had some of these same issues?  How sturdy were their sandals?  Did they walk through thorns?  Did they experience infections?  Were there disease states such as “chik” or Athlete’s foot or other traumas?  I can’t begin to imagine that the God of the universe loves us so much that He sent His only son who humbled Himself to wash “those” feet.  Not only that, but He continued to humble Himself on the cross.  He did this for you and for me and for all of us.  I am certainly excited to serve this kind of God: a God who loves me in spite of my sins, my flaws, and my icky, “cow dab” squishing feet.

Happy Easter everyone!  He is risen!

Thursday, January 31, 2019

Another Day in the Emergency Room


It was Friday in January, and the patient flow to the emergency department of the Church of God hospital in Saintard, Haiti could be described as typical, but busy: a man whose finger had been severed by a machete, a child who had been vomiting for a couple of days and was dizzy and a bit dehydrated, an elderly lady who had experienced a stroke, a mom who was in the early stages of labor, and a man who had fractured a femur from one of our many motorcycle accidents.  The load of patients kept the small staff of the ER quite busy, as the outpatient department across the courtyard, the optometry department, radiology, laboratory, vaccination area, intake staff, and the many support personnel buzzed around managing the daily patient load. 

In the early afternoon, a pick-up truck sped to the door of the ER.  Stacked in the back of the truck were three men, bleeding, moaning, and in various states of consciousness.  The passengers and driver of the vehicle quickly described that an accident had occurred about a mile from the hospital and more victims were on the way.  The next vehicle arrived and then the next, and then the hospital’s transport vehicle traveled to and transported from the accident scene until all eight of the injured arrived and quickly overwhelmed the two nurse, one physician staff managing the ER.  I normally prefer that the Haitian staff at the hospital take care of the daily routine, but they came and asked if I might lend a hand. 

Entering the area where patients were arriving, I noticed that the security guards were donning gloves and had already asked permission of the ER staff to move some of the patients to another part of the hospital, since all ER beds were full.  They quickly did so and then other beds were wheeled into the area to hold the newly arrived injured people.  The physicians and nurses from the outpatient clinic and staff throughout the facility stopped what they were doing and soon there were two more physicians, two more nurses, and even a few from the Saintard community who were waiting with sick family members, who helped to move patients around to other beds in the inpatient area of the hospital.  The small ER was buzzing with activity and another of our staff, who was leaving work at the time, came back to help, as did some of our lab techs.  Pressure was being placed on wounds, fractures were being stabilized, IV’s and pain meds were being administered and in general it looked like a scene from a re-run of M*A*S*H. 

I was working with the most seriously injured patient, a young man in his early twenties.  He was quickly deteriorating, in spite of what we could do.  Soon, I found myself doing chest compressions as the defibrillator was attached.  After a few minutes of doing all that we could do, we all stubbornly agreed that this would be the first casualty of the accident. Moving on to the next patient and then the next, the staff of the hospital used what resources that were available to patch, splint, x-ray, medicate, and stabilize each of the victims.  Wounds were still in need of suturing, fractures were in need of surgery, and transports to larger facilities still needed to be done in our one bed-equipped transport vehicle, not in the back of a pick-up truck.  There was still a lot of work to be done, but the initial assessment had passed and the staff started to dissipate back to their regular jobs at the hospital.  The patients were, at the moment, stable. 

Toward the end of the ER “push”, the mom who had begun labor prior to the influx of accident victims began to show signs of more advanced labor.  As I left the hospital for the day, the family of the one accident fatality had arrived at the facility.  The all too familiar survivor’s wail cut through the air and entered into saddened hearts.  The family of the mom in labor sat near the grieving family and waited with anticipation of a new life in their midst.  The antithetical emotions seemed as if they should not belong at the same facility concurrently, but somehow they defined the “normal” so many times in Haiti: such tragedy juxtaposed against so much joy. 

As Kathy and I drove back toward our home that Friday evening, we didn’t talk that much, even though the traffic snarls kept us in the car about an hour and a half longer than normal.  Sometimes, we grow tired.  Sometimes we are overwhelmed.  Sometimes we wonder why in the world we just aren’t sitting in our living room in the US watching M*A*S*H re-runs instead of living them.   As we have time to catch our breath, and reflect on situations such as this we realize and learn many things:  we are thankful for the staff that God has provided to care for situations like this accident, we are thankful for the so many people in the US who have donated so the facility can even be available to the public, we are thankful that the generator was working so that we could take x-rays, we are thankful that we had medicine to help with infection and pain, we are thankful for God’s provision. 

The overworked, underpaid staff of Hôpital L’Eglise de Dieu Réformée deals with situations like this all of the time, utilizing what limited resources they have to make the best of each situation.  They have my admiration and my gratitude. Most of all, however, I am thankful that God has provided so many of His people to come together to form the beginnings of a beacon of hope to those in need in the underserved Saintard area. May these hard lessons allow us to grow and to be more determined to serve God and others to the best of our abilities.