HELLO FROM ORIANI!

Two weeks ago we took Quentin and family to the airport in Santo Domingo. He has done a lot for the clinic over the years. His knowledge and contacts here in Haiti will be sorely missed. It would have been very difficult to get started again without him. So a heartfelt thank you for everything he has done! Quentin and his family will be missed, but we are happy things are working out for them.

NOTE FROM MY WIFE JULIE

Friday morning. When the sun rises on Haiti it finds a white landcruiser, roof piled with suitcases, wobbling along flood damaged “roads” toward the Dominican border. Inside the landcruiser are two families watching intermittently the huge potholes and the blue sky, pink clouds floating, thoughts swirling. Anticipation. Apprehension. Hopes, dreams, and prayers. An American-Haitian family headed towards a new life in a new country. An American family still-new-to-Haiti wondering if they will be able to hold it all together. Nobody wants to read a post long enough to entail all that Quentin and Christelle have done for CHC. After 5 years they will leave a huge hole!

BIRTHS AND BUSINESS AS USUAL

Here in Oriani the clinic continues to operate and patients continue to come. Not sure what happened in Haiti 9 months ago, but we have had numerous mothers in labor come in over the last week. We do not have the staff or resources to deliver all the babies in the area. So we bring them into the clinic for a quick check of mom and baby. We check the mother's vital signs and fetal heart rate. Then we check the baby’s position both by palpation and ultrasound. We also check for placental placement by ultrasound. If everything looks good and the baby is not too far advanced, they can go home. We give them instructions of danger signs for when they should come back. There are local midwives that can assist in births. We have invited them to attend our prenatal classes with some success. We hope to provide a class at some point for these midwives. We delivered 2 babies last week. The first was a boy that was named after me! They usually don’t have a name picked before the baby is born. We give them a birth certificate so they have to come up with a name while they are here. The second took much longer than we expected. Poor Vitanie and Yollette ended up spending the night at the clinic. OB is not my specialty and I’m happy we have an experienced OB nurse in Vitanie. I definitely plan to go back to trauma when I’m home!

TRAUMA AND TROUBLE WITH THE LAW!

Speaking of trauma. We had a young man come in with a large laceration to the forehead after a drunken fight at a wake. Of course he said he hadn’t been drinking. The skull was exposed and the laceration was filled with a large blood clot. After thoroughly irrigating it, we were able to close the wound with sutures. The next day he came back handcuffed to the other party in the fight. The local posse under the authority of the magistrate had arrested them and were taking them to Fond Verrette for judgment. (I’m still not very familiar with the different departments in Haiti, but I think Fond Verrette is similar to a county seat back home). The other man had a deep slash across the fingers of the right hand. It was too late to suture, so we cleaned and dressed them the best we could. We gave an antibiotic injection and sent him on his way with oral antibiotics. We told him and his escort he should go to Fond Parisien to see the surgeon there. They all laughed. Somehow I doubt he will end up there. Having patients in handcuffs made me feel like I was back in the ER at Upstate New York. Even though these “police” (not sure what their official title would be) had machetes instead of pistols.

EMERGENCY AT THE GATE!

Several weeks ago I was eating breakfast before going to the clinic. Someone started knocking on the gate. I went out to find several people and a moto. They said there was an emergency at the clinic. I told them to go to the clinic and I would follow. When I got there I found a man laying on the ground writhing in pain. We brought him into a room. His abdomen was distended and firm. An ominous sign. His vital signs weren’t bad so I got the ultrasound. I don’t have much experience with it so I wasn’t sure if I would see anything to help with the diagnoses. I very quickly realized the problem. His abdomen was full of fluid and air. This made it a true surgical emergency. I went to message Haiti Air to see if they could fly him out. By this time the other nurses had come in. Carmina went to start an IV. The man vomited all over, and was gone. We put him on the monitor and I checked his heart. Nothing. At home we would have started CPR, but here there is no point. If we got a heartbeat back we have no ventilator to put him on, no ICU to admit him to, and no surgeons to correct the problem. We notified Haiti Air to cancel. But now what? They had come from beyond Thoitte by moto. Obviously he couldn’t go back by moto. There happened to be a local pastor in the crowd and he started making phone calls for them. However, they couldn’t find a vehicle. Fre Batelmi offered to drive them in our ambulance. So they loaded up and went. It’s sad that it was our first use of the ambulance since opening the clinic. On a more positive note, we were able to use the ambulance since then to transport a pregnant mother down the mountain. She had 2 other children by C section. Now she was at 9 months with a third. Far too high risk to consider delivering here!

LIFE’S HAZARDS AND HEALING WOUNDS

We had a poor boy about 20 months old come in with a 3rd degree burn to his neck and upper chest. He had 2nd degree burns to his face. Mom said it was from boiling water. We gave him a dose of ketamine for sedation and debrided the burn. Then covered it with burn cream and nonadherent gauze. We gave an injection of antibiotics. His mom has been bringing him in every day for a dressing change. Pray for him. We are doing what we can and his mom seems to be very attentive, but it will take time to heal. This puts quite a dent in our limited supply of bandage supplies. I haven’t found a local source of bandage supplies. So far we have to order them in through MFI. We have some chronic wounds we dress several times a week. So keeping our inventory stocked will be a challenge. We still have a good supply thanks to Jay’s efforts, but please let us know if anyone has adaptic or petroleum gauze dressings to donate. One of the wounds we see is a man in his 20s. He broke his leg in an accident 10 years ago and it has never healed. It is all crooked and deformed. When I first saw the wound, I thought there was a good chance the infection had spread to the bone. We told him he needed to see an orthopedic doctor. But, he has no resources and no contacts outside the area. If he went to a hospital he would be on his own in an area he doesn’t know. And he takes care of his blind dad. So, it’s up to us to do what we can. We put him on antibiotics and have been changing his dressing every 2-3 days. It’s been almost a month and it looks a lot better. With some debridement, I don’t think the infection went to the bone. He told Carmina that he can finally sleep at night as the pain has gone away. He used to smoke a lot of marijuana (possibly for pain control), but now he has stopped. We told him the wound would heal better if he didn’t smoke. And now he can work in the gardens to earn some money. Being able to help in some small way, makes up for the difficulties and stress of learning to operate in not just one but 2 foreign countries with languages I don’t know. Sometimes I don’t know if I’ll be able to make 2 years with so many people needing so much. But God is good and we keep on keeping on.

CALLING NURSES!

We see enough patients that we really need a 3rd nurse for the clinic. We would like to bring in another North American nurse, but volunteers are hard to find. The Church is devoted to follow the commandment of Christ to go into all the world. As healthcare workers, we are in a field called and trained to minister to the physical needs of suffering humanity. The clinic offers a unique opportunity to combine these into a mission of service. To show the love of God in action. By helping with physical needs, we can avoid the trap James describes. James 2:14-17 “What doth it profit, my brethren, though a man say he hath faith, and have not works? Can faith save him? If a brother or sister be naked, and destitute of daily food, And one of you say unto them, Depart in peace, be ye warmed and filled; notwithstanding ye give them not those things which are needful to the body; what doth it profit? Even so faith, if it hath not works, is dead, being alone.” As much as we need money to operate, we need workers to work. All the demands to travel to buy medications and supplies and the demands at the clinic are more than one administrator can do. Having another nurse at the clinic makes a huge difference. Now that role is filled by Carmina, but when she leaves, then what? In many ways giving money is easier than giving time. I know that not everyone is in a place to give time. We weren’t a year ago. But surely among the nurses of the Church, there are some who can be the Hand of God extended to those in need here in Haiti.

Jonathan Kurtz - Clinic Administrator