Hello from Haiti. Another month has come and gone and we are still able to operate despite the difficulties of the country. The weather is cooling here too. Often the temperature drops to the 50s during the night and our uninsulated houses can get chilly. But the days warm up into the 70s and are very comfortable. October brought a lot of rain, but the last week has been dry. There is no change to the security situation in this corner of Haiti. The main road to Port au Prince remains blocked because of the gangs. I am able to keep the clinic supplied with medications from the Dominican Republic, but our vaccines need to come from Port. Our supply was running low and our vaccine nurse, Mis Rachel, was not able to keep the vaccine program going. If you compare months you will see our vaccine numbers dropped a lot in September. MSPP (Haitian health department) tried to send them to Jacmel and then up the road for this area, but were not able to. I gave Mis Rachel the suggestion that they coordinate with Haiti Air to fly them here. They were able to fly a load to us for our clinic, Fond Verrettes, and Fond Parisien. This allowed Mis Rachelle to get busy again. She got several people to help her and spent 2 days walking through other zones giving out vaccines and letting people know to bring their children to the clinic. Her report showed about 80 people they vaccinated in the area. These aren’t in my report. So God keeps making ways to keep working.
Our ambulance made 3 transfers this month. 2 were for OB complications. The other one was for a 17 year old boy. He had gone to the little hospital in Thoitte for a fever and not feeling well. 4 days before he came to us he started having abdominal pain. The hospital told him they couldn’t do more for him and sent him home. He lives close to Fre Willy, so he came to the clinic. His abdomen was extended and firm and very painful. He didn’t have any bowel sounds. Ultrasound showed a very enlarged bowel in the right lower quadrant. I had several patients like this last year and they all died before I could get them to help. It was in the evening so a helicopter transport would have had to wait for morning. I notified one of our ambulance drivers and while they were getting it ready we gave him antibiotics, IV fluids, and pain medicine. I messaged the surgeon at the little hospital in Fond Parisien. I am never sure what they can handle, but he said to send him and they would be waiting. The next morning the driver returned with the ambulance and told me they were waiting for him and took him straight into surgery. Fre Willy told me he had another surgery several days later. He is still in the hospital and starting to recover. They left the surgical site open as it is still draining. From what Fre Willy told me the father said they told him the small intestine had entered the large intestine. Hopefully the boy will be able to make a full recovery. If so it is almost a miracle that everything came together and he was able to get to help in time.
Whether to send the ambulance or not is one of the most difficult decisions for me. The road is rough and long and the ambulance is old. Almost every time it comes back with something broken or needs to be towed back. Because of this and the limited help to be found, I have to decide if the risk is worth it. Or if the need justifies risking the ambulance on the road. We had a girl in labor at the clinic. She had been in labor for about a day already. Ultrasound showed everything was normal, but she was not progressing. Vintanie and I decided if the baby wasn’t born overnight we would send her in the morning. In the morning the baby hadn’t come yet, so we sent her in the ambulance. It made it about 3 miles and died. Jenel went to see if he could get it running. After several hours they towed it back to our yard. Now what to do with the patient? She was not in good enough condition to go by moto and they couldn’t find another vehicle. I sent them with Jean Fritho in our land cruiser. This is not something we want to do very much because if it breaks then what? We really would have problems! But she needed to go and it didn’t seem right not to. Another time we had a 8 month pregnant girl come in with some abdominal pain. I was able to find the baby’s heart on ultrasound and it definitely wasn’t beating. She needed to be evaluated in Fond Parisien, but her vitals were stable. They asked about the ambulance. So now what? The ambulance was working again. It had been an electrical problem a local electrician was able to fix. Do I risk the ambulance breaking down to send a stable patient? Then it might not be available for a real emergency? I told them they should find a moto. They complained that the road was bad. I’m very aware of that. But the girl was in no immediate danger so I stuck by that decision. Was it the right one? God only knows. A new ambulance would be great! But the cost is very high. And the clinic is facing other needs for money. The clinic batteries are starting to get old and weak. To replace them will be a big expense. Also, I was just informed the house we rent in town for our nurses from Port will not be available for rent after August next year. There is a bit of a housing crisis here now with all the people who came up the mountains for safety. It seems our best option might be to build a house next to the clinic. But that will be another big expense. Finally, our time here is coming to an end next year. We need to find another administrator, but so far no one has volunteered. Will we need to find a way to keep the clinic open with only Haitian staff? That would require hiring a doctor and another expense. And another person to find a house for. Surely God has a plan! Thank you for your support. The needs here are greater than ever. This means that your opportunity to help has never been better. Thank you.