Clinic Update: Your Support is Urgently Needed

Hi from Haiti. The sky was clear in the morning with a beautiful view of Pic la Selle to the west. But it is clouding up by mid morning. This is the weather pattern moving into rainy season. Sunny mornings with cloudy rainy afternoons. This makes it hard to keep the clinic batteries charged and we have to rely more on generators. We had a little Honda generator that was much too small for the job. We worked with a businessman from Thoman, just above Fond Parisien, to help us buy a diesel generator from Port au Prince. They agreed to accept a check from the clinic's Unibank account in Port. We haven’t been able to use this account since our access to Port has been cut off. There was enough money in it to cover the cost of the generator. The first generator we arranged to buy was still in customs when the driver went to get it. They weren’t sure when it would be available. So we arranged to buy another one that was at a depot in Port. The driver was delayed for a week due to the violence in Port, but was able to finally pick it up and get it to Thoman. I picked it up and brought it to the clinic on April 10. The next day I went to the border to pick up Matt and his son Bodie. They spent a very busy week here working on installing the generator and on repairs and maintenance for the clinic motos and vehicles. It rained almost every day they were here. But they were able to get a lot done despite the rain.

The rain is very welcome despite the nuisance as the cisterns were getting dry. It also made the gardens grow. The locals have a lot of hope pinned to this harvest as the road to Port is still open. The gangs are forcing drivers to pay around 80,000 ($625 USD) Haitian gourdes for a truck to get into Croix de Bouquets. Despite this, this is their best market to sell their produce. Pray the road can stay open. The people desperately need the money. The man who buys medications for us in Port was able to come up from Croix de Bouquets with medications. He tells me the gangs are fighting in downtown Port, leaving his area quieter. The gangs attacked Mirebalais last month and looted the hospital there. It is another blow to the health care system in Haiti as this was a good hospital that provided reasonably cheap service.

With the quieter situation in Croix de Bouquets, MSPP is holding a meeting this week. Mis Rachelle is our designated coordinator with MSPP. She asked if she could go. I told her I wouldn’t tell her yes or no, but let her decide if she felt safe enough. She decided to go and will come back this weekend. The other nurses have been busy both with normal consultations and emergencies. They delivered 8 babies this month, including a set of twins!

In the last months I talked about different needs the clinic has. For an ambulance and for a generator. We have been able to solve the generator problem. People have also made donations toward the ambulance. This is greatly appreciated. However, we need operating funds for medications and wages. Everything is more expensive. To get medications from Port is more expensive as the gangs extract a toll. The Dominicans have also increased the cost of importing medications. The spike of patients we have seen this year has increased the amount of medications we need to purchase. Our operating fund is very low and barely able to cover for May. If you can donate, please do so. The need is greater than ever. Thank you very much for your prayers and support.

The Link Below Will Take You to Our Donation Page

Dry Season

Good morning. It’s been beautiful sunny weather here in Haiti the last few weeks. A few cloudy afternoons, but no rain. Monday was smokey from the fires in the mountains. Wind and trucks leave behind clouds of dust. Cisterns are getting low and the farmers have been hoping their gardens make it to the rainy season. Tuesday we did finally get about half an inch of rain. Rainy season starts about the middle to end of April, so this should give them the boost they need. Good news from Fond Parisien! The road to Port au Prince was opened 2 weeks ago! Hopefully it will stay open! The farmers are counting on it to sell their produce in June. We are counting on it to be able to buy medication  and other supplies from Port. The man that arranges medications is hoping to send us a shipment in the next week.

Mis Rachelle, our vaccine nurse, went to Fond Verrette ( a town halfway down the mountain) Monday for a meeting with MSPP (Haitian health department). She says we are second to Fond Verrette in vaccines given in this part of the mountains. This is due to her hard work and dedication. I also want to give a shout out to our other nurses. There have been a lot of after hour visits, or “emergencies” and they have done a good job of helping out with them. Sometimes it's hard to know if the people actually have a legit reason to come after hours or are just taking advantage of not having to wait. Either way they have done a good job of taking care of them and the locals often seek them out instead of coming to me. This hasn’t always been so…as sometimes people think the American gives better treatment. I am happy to see this as it shows the community trusts them. I still get some emergencies though. The other night I stitched up and bandaged an older woman that had a moto fall on her leg.

A few weeks ago we had a 5 year old girl brought in. She hadn’t been feeling well for a few days and had nothing to eat the day before. She was not responding. A check of her glucose showed 49. I started an IV and gave her dextrose and fluids. After about an hour she was able to sit up and drink some gatorade. Her glucose was over 200, so I told the mother to get her some food. Mis Yollette gave the parents some education on the importance of eating and drinking small amounts even when they aren’t feeling well to give them energy. Haitians do not drink enough even when they feel well. So if they are sick, they often need fluids to help them recover.

April promises to be a busy month. We are working on buying a generator from Port au Prince. I was hoping I could write in this update that we had it, but it is still in transit. Given that the route is “fragile” to use the term of the Haitian businessman that is arranging the purchase and transportation for us, it is a risk that we will lose it. Pray that we don’t and that it can make it here next week. We are looking forward to having Matt Giesbrecht here next week. Hopefully we can get the generator setup and the Ford fully roadworthy while he is here.

Jenel took the ambulance to Thoitte last week to a boss to weld together and reinforce some cracks developing in the body. He also found someone to repair the seats as they were falling apart. This was very necessary but expensive. Funds are running a little low and please consider making a donation if you can. Thanks again for your continued prayers and financial support.

Projects and Funding Needs

Hi to everyone. It is dry season here and the dust has been getting deep and the cisterns empty. However, the last week or so has been cloudy with some rain. This has allowed people to start planting gardens for May and June harvest. This is a faith venture as the road to Port is still closed and there is no promise they will be able to sell to the markets in Croix de Bouquets and Port. The road being closed also makes it so we can’t send patients to Port by ambulance. Thursday the 27th we had a man brought into the clinic. He was a forest ranger and had been checking out a place where someone had cut down a tree. A branch had stayed stuck up in another tree and fell on his head. He was not responding appropriately and clearly needed a head CT and an evaluation by a neurosurgeon. But, there is nowhere I can send him. Haiti Air is still out of the country and even if he could get to Port the hospital there that had neurosurgery was burned by the gangs last year. I could only keep him quiet and watch his BP and hope he would wake up. After a bit a pastor came in to see him and told me if we could help him get to the border, he could get him to the hospital in Jimani, DR. I doubt Jimani has any neurosurgery capabilities, but sending him at least felt like we were doing something. Jean Fritho took him in the ambulance. Unfortunately, he died before being able to cross the border.

The ambulance did manage to make it up the mountain under its own power. But Jean Fritho said he had to go slow because it was shaking so much. Also it is developing some cracks in the body. It is very much showing its age. Jenel took it to a mechanic in Thoitte. He said he needs it for 2 days and isn’t able to weld the body now because he doesn’t have any oxygen. The ambulance will need to be replaced soon. It is one of the biggest services we offer and is very important as too often people can’t afford transport to hospitals down the mountain. The other 2 ambulance transfers were OB emergencies. One was a teacher at a school beside our house. The presentation wasn’t right. The doctors in Fond Parisien weren’t hopeful, but they were able to deliver 2 healthy twins by C section and the babies and mom are doing well.

Other news from the clinic. The surge in patients with swelling to their throats seems to have slowed a little. But we are now seeing more patients with viral respiratory infections. I had a 4 year old girl who died from a severe case. No doubt she would have been intubated and admitted to a Pediatric ICU in the US. We don’t have those here. She had stridor with limited air movement in her lungs. Nothing I did seemed to have much effect. Most of the time they are not too sick and respond well to treatment.

In January we were able to go across the mountain above Port au Prince to get medications and vaccines from our agent. I was hoping to be able to do this again in March or April. But, the gangs came up the mountain and are currently blocking that road and the road to Jacmel. The good news is that we are still able to buy medications from the Dominican Republic.

Ok, so we have several projects we need to work on. We need a new generator for the clinic. During rainy season often our solar panels can’t keep up and we need to use a generator. Especially if we have emergencies over night. Next, as you can tell our ambulance is getting to the end of its life and needs to be replaced soon. Also, we still want to build a cistern at the clinic to be able to provide water during rainy season. And finally, at some point we might need build a house for our nurses that come from out of the area and need a place to live. We did find a rental house for now, but this still might need to happen at some point. All this takes money and our funds are not sufficient at this time. Please consider donating if you can. Know your money is going to help the poor people of the mountains here in southern Haiti. Thank you and God bless you.

Rough Roads

Back road to Port

Well it’s been a very busy month here in Haiti. We came back from our little vacation in the Dominican January 6. Kelson Weibe, my wife’s cousin, came to spend a month with us. We were able to cross back into Haiti without difficulty. I noticed from the first week back at the clinic we are seeing an increase in patients. On the first vaccine Wednesday this year, we vaccinated 65 children. This of course uses up our vaccine stock, and getting more is a challenge!

Vaccine Wednesday

I spoke with our agent in Port and he said the road above Petionville through the mountains is now passable by landcruiser. He was able to get 2 large foam coolers full of vaccines, a medication order for us, and one for the clinic in Foret. Kelson, Roosevelt, Jean Fritho, and I headed out early in the morning to meet him in the mountains above Kenscoff. Google maps said it was about 105 kilometers. The road goes along the coast before heading up over Mon Kajac. It is a very beautiful route, but the road is very rough. It took us nearly 8 hours to travel the 105 km. Coming over the top of Mon Kajak is incredible. I am used to steep mountain roads, but this is another level. Since the main roads into Port are blocked, the Haitians have been working to widen and smooth this road. It isn’t too bad now, but very steep. Nearly 10 km of what felt like 20 - 30 degree descent with a cliff on one side and 2,000 foot drop offs on the other. I put the land cruiser in 4 low and eased on down. At one place the road crossed a narrow saddle with 1,000 plus foot drop offs on each side. The views were spectacular with steep mountains covered with gardens dropping off on every side and the ocean in the distance. We met our agent and loaded up the landcruiser. His drive had been even more interesting than ours. Coming through Port they started hearing gunshots, but accelerated and made it through. He says the big stores in Port are mostly still open and he can get whatever we want. He just has to wait for lulls in the shooting. We headed back up over the mountain, the land cruiser handling the grades well. About half way back home we stopped in Belle Anse on the south coast for a meal of fresh fish from the Caribbean. We made it home after 16 hours on the road. A very long day on some very rough roads. Thankfully we can get most of our medications from the Dominican with a much shorter drive, but this is an option too…for now.

Transporting medications and supplies

January 21 Keith and Candace came to visit. They have their Haitian residence so the border was no problem. It was very good to have them here. The locals were very happy to see them and they kept busy visiting people. Keith and Kelson worked with Jenel to put the transmission back into the Ford. It is now able to move under its own power for the first time in about 4 years. It still needs new tires and a thorough going over, but that is something Jenel can work on as he has time. Keith and I discussed the need for another nurse’s house. He was able to find one in town to rent. We might still need to build a house at some point, but this gives us more time to plan. Keith, Kelson, and I went to Fond Parisien to buy medications and visit friends. Keith and Candace weren’t here very long, but I think they accomplished a lot in their time here. Kelson went back with them to Santo Domingo. It’s always good to have people here to help in the clinic and the Haitian staff enjoys it too.

As you can see from the monthly report we are seeing a lot more patients. This trend has continued into February. I am not sure what causes the increases and decreases in numbers. I keep a spreadsheet to track them, but so far have not been able to identify a pattern. One recent trend I have noticed is an increase of patients, often children or teenagers, with swelling under their jaw. They present with fever and sometimes inflammation and white spots on the back of their throat. Our lack of a lab makes it hard to diagnose, but it seems to respond well to a course of amoxicillin or augmentin for older patients. The nurses report this in the “tonsillitis” section of the monthly report. One of the nurses told me yesterday of reports of children dying from this and not being brought to the hospital. So we are working on getting the word out.

Another frequent complaint in the clinic is wounds. We aren’t seeing as many chronic wounds as a year ago. Maybe we made a dent in the number of nonhealing wounds walking around the mountains since the clinic reopened? But it is still a steady number of visits. We had some people come to the gate one night with reports of an injury from a moto accident. I was busy, so Kelson and Heidi went to the clinic to help Mis Vitanie. The primary injury was the woman’s ear was partially torn away. Kelson and Vitanie did a good job reattaching it.

Thank-you for your continued prayers and support. Hopefully this gives you a little idea of what it takes to keep the clinic supplied. Sometimes the news from Haiti can be discouraging, but it is still possible to keep working here. Before Keith and Candace came, they went to a Haiti benefit auction in Florida. There they met other organizations still working in Haiti. It is still possible. God can do miracles if He has willing workers. If anyone is interested in helping, please contact us. Even if you are not a medical person, there is work to be done.