November at Confidence Health Center

November was an eventful month for our Confidence Health Center. We treated 1,487 patients this month, including a number of children with respiratory infections. Did you know that respiratory disease is one of the leading causes of death in children in developing countries? (https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/causes-of-child-death) Here in Oriani that definitely proves true, particularly in the winter season when viral illnesses tend to be more common. We treat many coughs, colds, and pneumonia. Our clinic does not have regular inpatient capability, but in addition to antibiotics and steroids these patients often need supplemental oxygen for a couple of days to get them “over the hump” and well enough to send home. Next to the clinic we have a little one-room house, called the ti kay, that gets used quite a bit for this. Unfortunately, our oxygen concentrators use quite a bit of electricity and easily overload our solar power system, so we run a small generator on the nights that we have overnight patients. Definitely more of a headache than keeping overnight patients in the States!

Malnutrition is unfortunately another condition we see from time to time. In children, malnutrition commonly presents in one of two different ways: marasmus, which is the more “obvious” form, involving muscle wasting and low weight; or kwashiorkor, which can be deceiving at first because the child has facial and limb edema that actually can make them appear chubby at first glance. Kwashiorkor is the most common type in this area and we have learned to identify the signs fairly quickly. Our neighboring clinic, Access Health Alliance in Forè de Pens, has a malnutrition program that we refer patients if they meet certain criteria. If the child is sick enough to warrant hospitalization we refer them to St. Damien’s Hospital in Port-au-Prince. Unfortunately, sometimes even our best efforts go in vain. This month we had a 16-month old baby with severe malnutrition. The parents seemed to be warm and caring and why the child was allowed to become so malnourished wasn’t clear. He was very weak and lethargic, although he was still able to drink. He had already been enrolled in the malnutrition program for several weeks but was apparently not responding to treatment. His legs and face were grossly edematous and his hair was thin and red colored, the hallmark sign of chronic malnutrition. We gave him fluids and nutrition, but a few hours after being seen in the clinic he passed away. Cases like these always challenge us to find more ways to help prevent these outcomes, while making us thankful for the ones we are able to help.

Continue to pray for the work here, that we can have the wisdom to face the challenges at the clinic, and that at the end of the day the patients can be pointed to the Great Physician who can heal the soul and body both.

Autumn 2020 Update

Hello from the beautiful, green mountains of Southeast Haiti! We are doing well here, for the most part enjoying good health, pleasant weather and peaceful surroundings. In the current world environment, where nothing is certain and fear seems to be taking hold of many people, life moves on almost unchanging here in Oriani. We feel somewhat insulated from the drama of the developed world, and we have to say that it’s a good time to be “stuck in a former time” in a developing country. We have been spared much of the turmoil of America these past few months and have been enjoying our time here in the quiet instead.

-Current Clinic Affairs-

            Our Canadian nurse Larissa returned home in June, her commitment here finished. Our new nurse, Carmina, had some big shoes to fill but hit the ground running. She already has a good hold on the Haitian Creole language and has a big personality with plenty of energy and enthusiasm to do a great job in the clinic, which is not always easy.

            Our other two consult rooms are still staffed with Haitian-trained nurses, girls who have grown to be almost family to us and become very close to our hearts. Chancela is bold and forthright, yet excellent with children and a very capable manager of our vaccination program. Roseline is gentle and soft-spoken with a great relationship with her patients, and one patient told our secretary recently, “I feel healed just going into her room, before she ever gives me medicine!”

-Recent Clinic Cases-

            We noticed a sharp decrease in the number of childbirths here at the clinic over the summer. In fact, the month of August was delivery-free! This can be construed as a good thing or a bad thing, depending on which nurse you ask. Some of us enjoy assisting in deliveries but others would rather stay away! However, in September the pregnant moms returned and we have already assisted in 3 deliveries in the first two weeks of the month.

            The very first delivery of the month turned crazy on us, but ended up with a good result. The mother had some physical deformities that appeared to interfere with normal delivery, so after several hours of unproductive labor we had to step in with the manual suction delivery assist device. Only several minutes later we had one healthy little boy and one very relieved mother on our hands!

            Another morning recently, the clinic day was starting on a normal note when suddenly the nurses began running here and there, collecting supplies for an imminent delivery. The mother had presented at opening time to the clinic and it became very apparent that the baby was only a few minutes from arriving! Fortunately, we were able to get everything in place and caught the little guy, who was covered in meconium and not breathing very effectively. With some quick airway clearing and brisk stimulation, he pinked up well and was soon wrapped up to be sent home with mom. Cases like these make us wonder what the outcome would have been had the mothers decided to try to deliver at home, like most do here. Very likely a dead baby and/or injured mom, or a neurologically impaired child at best. The first few minutes of life are vitally important, and if baby doesn’t breathe well at first, quick action is needed to get things headed in the right direction. In times like these we are glad we were in the right place at the right time and able to avoid a disaster.

            We often encounter conflicts when faced with the strong belief in the traditional medicine system of Haiti. Many times patients will tell us that they have been to the medsin fèy (leaf doctor) or ounga (a traditional healer who often dabbles in dark arts) before coming to us, or that they plan to go there rather than heed our Western advice. Back in the summer of this year, we saw a young man with badly displaced hip fracture from a motorcycle accident that chose to go to the leaf doctor rather than be transferred to orthopedic care in Port-au-Prince. Well, a few weeks ago that man came back to us. The bone had miraculously healed in the intervening months, but the leg was crooked and the muscles badly withered as a result of not using them. He said it didn’t really hurt at rest, but he was not able to walk or bear weight. Moreover, the place where the fracture had been now showed signs of having been cut or torn open, and the wound was infected. We told him there was really nothing we could do to help him in the short term since the fracture was long healed, but we gave him something for the infection and pain and once more recommended he see an actual orthopedic surgeon to see if anything could be done to get him back on his feet.

-COVID in Haiti-

            COVID-19 seems to still have a hold on the developed world, but it has almost dropped off the radar here in Haiti. The common belief among the people here is that Haiti simply doesn’t have COVID anymore. We doubt that is true, but it does seem like we have been able to move on from the fear and uncertainty that gripped the country when COVID was first identified here back on March 19. While the country’s testing and treatment capabilities were always limited and the reported numbers were likely inaccurate, it appears that Haiti as a whole has been spared the high case rate and death rate that some other countries have experienced. Here at Confidence Health Center, we have seen only a handful of patients that we even suspected could have been positive, and we have had no major outbreak in the community.

            Down in the capital city of Port-au-Prince, the basic isolation precautions are still in place. Many businesses are still requiring masks and handwashing to enter, and a few places scan customers’ foreheads for fever at the door. However, in the remote areas such as Oriani, life continues as normal and we feel very blessed to be able to continue church and school with no apparent public health consequences.

            Keep us in your prayers, and if you feel inspired to help, we always appreciate donations! We can’t do what we do without your help, and we appreciate each and every one who has pitched in to make this endeavor possible. It is worth it!

-Jay Giesel, RN, CEN, Administrator

September 2020

Dec 2018 Charlotte's Good, Gory, and Glory to God update

Clinic update: Dec 27-2018

Charlotte’s update is below, but I can make a few comments of recent developments….

From the administration things are working reasonably well at the clinic even though our administrators who came to replace Matt and Sheri had to go back to Canada due to some unforeseen health reasons. We thank them for the 6 months they were able to put in and wish them Gods blessings. Matt and Sheri Giesbrecht’s term of 2 years was over in July and they did a fine job in learning the language and getting into the work. We hope for more time from them in the future if God wills.

Since we are in between general administrators now (we have good prospects), the board felt I should go to Haiti and rearrange some of the admin responsibilities to different of the clinic workers to be able to keep a smooth flow of meds supplied, and leadership provided for the different aspects of the work. This went well. Charlotte is director of nursing, Ozias is managing the HR area, the workers and the patients etc,. Quentin Russel is managing the finances and purchasing, and Gareo and Maggi are running the household.  We feel a need for an admin family just to oversee things, but we are happy that things are in good hands in the interim.  Ozias told me that he congratulates the good workers we have there and said that this kind of shock (admin leaving suddenly) would not be sustainable without such exceptional team players. We are in close contact with them there.

Continue to pray that the needs of the clinic are well supplied. We have nurses lining up but we still need funds. Things are in tight supply now. We have a Toyota sitting in customs that we are waiting for money to be able to pay the bill and get it out. (long story of how 6000 dollars tax owing suddenly became $29,000 tax… but we are working on bringing that down as low as possible yet).

May God bless your compassion and generosity.    Keith Toews

Canadian Donors make checks out  to …
“Confidence Health Center”, OR if a Canadian receipt is needed then to… “Mapleview Church”
And send to …

Confidence Health Center
PO Box 1202
St Marys Ontario
N4X 1B8

Donors from USA please send checks to our board member Dave Wenger at…
Friends of Haiti (checks can be made out to Friends of Haiti)
2024 AL hwy 25
Faunsdale, AL
36738

 Now below here is Nurse Charlotte’s recent letter. It’s Good, Gory, and a Glory to God!

 I'll try to give you a touch of our lives here at the clinic in Oriani Haiti. 

 Tonight, in church a brother had a testimony... Friday night his wife had put their baby to bed and shortly after his 5 or 6-year-old boy went to bed too. Not long after they heard the baby cry out. They went to check on her and how he explained it seemed like she was having a seizure. Shortly after the boy also started acting in the same way, body stiff, teeth clenched and urinating on himself. His wife becomes quite upset as she starts thinking perhaps both of their children were going to die. They prayed and at 11:00 at night they both got better seemed to be fine. Later he noticed a big blood stain outside their front door and he had not done anything or killed any animal that could have caused that. I was telling that story to our Haitian nurse, and she said that when the devil tries to get a child or kill someone and if he can't do it… he vomits the blood outside the door, otherwise he keeps the blood and the child dies. Did someone try to put a curse on them? These people have so much to live with and through. I sat in church with my mouth open listening to his story and the members just sit there like this is normal stuff. In our clinic, so many times we are not aware of how often people have tried devil worship or witch doctors before they come to us, or if they go home from our clinic and still go there. It pays to be close to God’s Spirit and listen to his promptings and then also rely on the Christians that work at the clinic for advice. Since they are familiar with these things they also can sense and see it in someone better then we can. Oh, the hopelessness in a person when there is "no hope in Jesus"!

   I got a call one early morning for a baby with respiratory problems, once I got to the clinic by 7 or shortly after and checked her oxygen it was registering 20%! Did some fast work and it slowly started climbing, come to find out this was the same family who had a boy with seizures Matt and Quentin we're taking down to Port au prince a couple months ago and suddenly he had a turn around and was totally normal! A miracle and now they are needing another miracle! It took a while to arrange a ride down to Port for this baby. When we finally did the family was threatening to take her home, (possibly to go to a witch doctor rather) but at the last minute a well-respected uncle called and encouraged them to go to the doctor, rather unusual as the older ones usually prefer the witch doctor. So, they agreed to go. They found help and the child got better, a Sunday or two later the mother brings her two children to church to testify and thank God for the miracle and the help they received. Once again, we thank God and praise him, so often it is despite our weaknesses and what we try to do. It’s very frustrating when it seems like you must convince them to go for professional help for their child. Lacey and her dad Wally, and Ilome helped with all this too and got the ball rolling to send them down. It takes a team effort. 

   Gareo and Maggie are here living with us and running the household, Maggie was from Rosewood Manitoba and married a Haitian a little over a year ago. They are waiting on papers to come through, and since we are still hunting for new administrators, they graciously are helping us out for a while. Maggie wanted so badly to assist with a baby delivery so Sunday morning at 4:40am before Lacey’s wedding, she got her wish. Shayla, one of the orphanage volunteers was along too. Maggie and her knew each other well. So Gareo is driving me to the clinic and Maggie is texting me, "if a baby is to be born make Gareo come back to get me!".  I can see it probably wouldn't be too long, so they came to cheer us on. It sure made the getting up at night more fun. An 8.8 lb baby boy was born to a first-time mom!  Quite unusual for them to be that big! So that started the wedding day... just sat up and drank coffee and talked and waited for the day to begin when we got home.

(A few words on the wedding of Lacey Toews (from Pincher Creek Alberta, and Ilomi a Haitian from here). Lacey has been volunteering and working in Haiti for the clinic as well as local schools since 2011 and is very familiar with this country and culture. - Keith.)  It was so fun to have all the visitors here for the wedding. Matt's were back, Todd's and Kay too so it felt like old times seeing them all here again! The wedding was very large. It was hard to calculate exactly how many people, but they said they served about 800 meals. Brutus had the sermon and Dallas married them. The school children all had deep coral color uniforms and they sang "Seek ye first the kingdom of God". Very pretty, Lacy has helped and taught in the schools here for years, so she has touched many children's lives. 

    One day we had a long day at the clinic, 8AM -7PM. We had just been ready to leave and a pregnant lady showed up. It took several hours before baby was born, just as we were cleaning up from that, a child is brought in with a rag wrapped around his wrist. I can tell it's not good but don't know how bad until we get him in and check it. His wrist is cut through the bone, he was chopping food for pigs and chops his wrist instead, the brave boy is not crying, maybe 6 or 7 years old? We stabilized the wrist and bone and sent him down on a motorcycle to a hospital that hoping they had a pediatric bone surgeon. Seen him back since and he seems to have movement of all his fingers! So, they must have found a good doctor. By the time we got home, we thought we deserved some ice cream and Doritos! Lucky for us, we had the essentials to make ice cream and still had Doritos from our trip to DR! 

   Time would fail to tell of the drunk child we gave IV fluids to help him come out of his drunken sleepy state, the many skin rashes and skin diseases that have us scratching our heads at times (literally)   . The many babies and children with respiratory problems, as well as adults with their own set of minor and the occasional big problem. We saw a young girl once who had been living down in Port with extended family and had been abused by the people she was living with. So many sad stories. A husband killed by the fighting that's been going on in Port au Prince lately, parents who are worried about their children who live in the city for schooling, and etc. Thankfully the unrest seems to have settled down now. 

    Now it's several days later… Dave Wenger from Alabama (on the clinic board), Jay Geisel from El Campo TX (an RN that's interested in maybe coming here someday as administrator), and Eldon Schmidt (from Mississippi and who has a heart for the clinic) are here visiting right now. It feels good to have visitors. It's been a very relaxing weekend as far as extra clinic calls go...but I guess the weekend’s not over yet... last weekend we had a fun weekend. I guess we thought we deserved a getaway after all the wedding company and busyness so Gareo’s took my uncle Dallas's to the airport and Agatha and I went along. We went up to Fairmont the mountain above Port, sat in traffic a lot on Friday getting there and getting back down, bought a beautiful poinsettia up there, so now it truly looks like Christmas! Is that what it takes?   Spent night in town and went to a beach before heading back to Oriani Saturday.   Fun times! 

    PS: if I'd only finish this and send it on I could quit writing... last night we had a baby delivery that took a long time and then still ended up sending her down the mountain, final diagnosis was possible pelvic abnormality, too small to have the baby... but I would like to hear what the doctors actually said. That made for a very short night, so a nap was in order this afternoon. Those three gentlemen that came to visit brought lots of beef jerky, supplies, parts, and even a nice non-stick pan! Thanks! Along with a real boost in spirit again...

And now it's time to close this letter and move on. Wishing you all a very blessed Christmas season and many happy family gatherings. 

    Love and prayers...  Charlotte Nightengale RN

Update from Charlotte April 2018

Hello once again. It is a beautiful day here in the mountains of Haiti. Hiked to the pine Forest and so will try to do a little update on what's been going on while it's quiet and can think. 

    An 18-20 year old guy came into the clinic one evening about 11:00 at night with signs of tetanus, his jaw was locked tight and his arms were a little rigid too, no history of a wound though that we could get out of them. The ambulance was down, and they were willing to wait till morning to go down as the excursion was going down with a load of people anyway. We gave him antibiotics and muscle relaxant and they stayed at a friend's house in Oriani there for night. Well they never showed up the next morning for the ride so didn't know, did he die or get better? A couple days later he shows up at the clinic a little worse, the excuse was he got better so why go down to a hospital? We gave him more antibiotics and fluids and kept him in the little clinic house for the day and night, offering him a ride down the next day. That evening the father wanted to take him home for night and bring him back the next morning, it was all very strange, and we were sure he was wanting to take him to the witch doctor. Todd and Matt talked with the family and explained that we don't mix our treatment and the witch doctor treatment, if they take him home they didn't need to bring him back to continue treatment here. The father swayed the group and they ended up taking him home, we were sure that was the end of him unless we had been able to give him enough medicine to start his system working again. Kept asking about him and one story was he was worse but what do you know a few days later he shows up at the clinic and is totally well, except he said his head was spinning, he hadn't eaten much for a whole week so of course your head would be spinning! He doesn't remember much of what happened that whole week, claimed to be a Christian and agreed with the thought that God had saved him and given him another chance. Very glad for him as it seemed like his dad was the one pushing the witch doctor thing and he was out of it enough to not make his own decision.

A sad case we had this week was a 2 month along pregnant lady came in with severe stomach pain, low blood pressure, all signs of an ectopic pregnancy but with no ultrasound… how do we know for sure? We gave her IV fluids and by the time we got a ride arranged she ended up dying 30 minutes later, actually right at the turnoff of where she would go to go her home, so they just went a different way to take her home. That made everything more traumatic for everyone as the deceased mother's little children were wide eyed and staring and couldn't figure out what was going on. It’s hard to think of them not having a mother now. Kind of haunts me, but it helps to remember this is God's work and we are just helping him, and He loves those children more then we can. Several cholera cases lately...the natives are surprised as the sun is shining and no rainy weather yet... hopefully it's not a sign of what's coming. 

     Bethany's parents came to visit! They were kind enough to invite me the beach with them and Matt's were kind enough to let me off two days! It was awesome! Decameron is an awesome place, seemed like plenty of people there though, I was surprised as Matt's said when they were there once they wondered how it could keep going as not many people. Awww smoothies, sunshine, ocean waves pounding, relaxation, gives you courage to face the work again. 

    Several more suspected tetanus cases. We need to keep on vaccinating... trying to be more proactive with that. 

    Dominican Republic bound! We headed to the DR in the ambulance because it needed new tires We felt very redneck in the DR driving around with that rough looking vehicle, surrounded by all the nice vehicles on nice roads. We spent one night at Joe and Monica Withers, went to a church member’s place for evening service. The next day headed to the capital and did some shopping. Slept at a motel there that night and then toured some of the old part of the DR the next day. For Friday night we headed to Andrew and Melissa Koehns the other missionary couple, so made many new friends. Saturday, we headed back across the border...once again a breeze and back to Oriani. Sunday Fre Willy preached in the morning about how Jesus arose for us and how are we living for him. In the evening we had a singing and testimony service.

Now this week has been busy and normal I guess, today we saw a 5-6 month pregnant lady with sky high blood pressure, 260s/160s. The baby’s heartbeat was very slow so once again the long slow process to get them ready to go down to Port au Prince. Quentin ended up taking them in the ambulance once they finally regulated all their affairs. Todd's are going to spend several weeks on the West end in Jeremie area again so us girls, Bethany and I and Se chalet will go spend some time holding their house down, I think it will be fun to have a girl’s party there for a while and Matt's can have some nice family time. 

   And here it is again a while since I've written anything. Sunday morning at 6:30 was awakened to a man knocking and states the lady we saw yesterday still hadn't had her baby, could we check her again? Chrystelle and I go check it out and it seems like it's time for it to be born. At 10:00 or so a healthy yelling baby boy is born! Quick cleaned up and went to church yet to catch the tail end of Sunday school and the rest of the service. Matt's had also had a baby delivered at the house in the back of a pickup! They came from a long way away, Barrassa, and it's born just as they pull in.

Amanda, (Karlins teacher) came to spend the weekend this last weekend and so us girls took her back Sunday evening. Just as we left Oriani, the NEW tire on the ambulance let out a loud hiss and went flat, we had hit a sharp pointed rock wrong and there went that tire! Jenel was close by, a very handy man that works for Matt's and he started putting the spare on. Matt came on moto and brought some tools to finish it. Today Matt and Sheri made another trip to Port au Prince with patients to doctor’s appointments, mostly goiter surgeries that need done, and one with oncologist appointment. Those days are extremely tiring and sometimes it feels like you don't accomplish a lot, but it sounds like maybe this one was fairly successful. 

   Miss you all...love Charlotte