Labadee, Kayaking, Snorkeling, Starfish, and Priorities

Saturday, July 5, 2008

Today we got to go to Labadee again! This time we went to Columbus Beach, which is much more secluded than other beaches at Labadee, so it was almost like a private beach for us.

We brought kayaks, so I went kayaking couple times. Neil and I rowed out and met up with Evan and Nadine far from the shore. Nadine dared me to take a dip, so I took a dip in the deep water for the first time ever. I have no idea how deep it was. Kind of scary but exciting!

We also brought some snorkeling gears, so I went snorkeling with Neil and Nadine. We saw lots of little fishes, corals, sea urchins, etc. I had never snorkeled before, so this was another first time for me.

We found a big starfish, so I played with it for a while. I flipped it upside down and watched it flip itself over. It took like five minutes, but it was so cool that I watched it twice. It was a very exciting day at the beach.

During dinner at the Holiday House, the long-term missionaries take turns to join the short-term missionaries and share their testimonies. Today it was Gavin's turn for the first time since I got here, so I got to here how he decided to do medical missions. His testimony had a lot of similarities with mine in terms of wanting to do medical missions, so what he said really resonated in my mind. What especially struck me is when he talked about setting priorities straight. He told us how he had put so much importance in doing medical mission, but one day he realized that he needed to put God and relationship with Him first before missions. I realized that I had been putting so much emphasis and effort into preparing for medical missions that my relationship with God had come to a standstill. I believe that God has called me to do medical missions, but I need to let God prepare me for it and focus more on growing closer to Him.

Before serving dessert, the kitchen ladies called me over to the kitchen and told me that they made a birthday cake but didn't know who it was for. Apparently someone had asked them to make a cake for Vicki today (even though her birthday was Thursday). They weren't quite ready with the candles, so I just stood in the kitchen facing the dining hall, and everyone else just stared at me waiting for me to say something. I didn't know what to say because I didn't want to ruin the "surprise" so I just stood there smiling until the cake was ready. After a little bit of awkward moment, we celebrated Vicki's birthday again.

After dinner we were joined by Amy, and the seven of us played dutch blitz. Since we had an odd number of players, Laura played by herself. She had won every time we played, and somehow, even though she was on her own, she beat us all... How in the world? It must be the way she shuffles her cards... jk. Sorry for giving you such a hard time, Laura. You've proven to us that you're the best dutch blitz player in Haiti. For now anyway.

Afterwards we went over to Amy's house and watched first half of Chaos Theory. Kind of a random movie, but I'm interested to see how it ends.

Sickle Cell Crisis, Cannonball, and English Bible Fellowship

Sunday, July 6, 2008

Gavin was in charge of taking us to church this morning. There were Laura, Evan, Vicki, Nadine, Amy, and Steve, who is here for a week to work on some projects with the radio station.

Gavin had been up very early this morning because he had been called in to the clinic because a 10-year old girl was having a sickle cell crisis. He had relieved her symptoms and she was resting at the clinic when we left for church. A few minutes after, Gavin got a call from the mother of the girl saying she was in pain again, so we turned around to go back to the clinic.

Gavin and Amy rushed into the clinic while the rest of us waited outside. I didn't want to bother them, but I got concerned about what was happening, so I carefully went in. I watched Gavin and Amy as they started an IV and tried to calm her down.

A few minutes later the girl's father came in. While Gavin was out of the room looking for something, the father asked me, "Doc, in your opinion, do you think there's a cure for this?" All of a sudden I felt a huge weight on my shoulders, as if I had to deliver a bad news. I almost choked, but said in broken Creole, "Well, Gavin is the doctor, so he would know better than me, but this is a genetic disorder so..." The father understood what I wanted to say, and he responded, "But we can control the pain, yes?" "Yes, we can," I replied, and he accepted my answer.

It seems that the father had already heard that there is no cure for his daughter's disease, but I felt awful to think that I might be the one to tell him there's no real hope. I had learned about sickle cell anemia many times probably since elementary school, but actually seeing how it affected the girl and her family had a profound impact on me. It made me realize how serious the disease is, and that the people suffering from them are not just numbers in statistics.

Gavin and Amy were able to calm her down after a few minutes, and we let the family stay in the clinic with her while we went to church. Since we were running late for church, Gavin decided to go to the church next to the OMS compound. We used a little portable audio system so Gavin could translate into a mic and we could listen to him through an earphone. He started to translate for a bit, but he left in the middle because he was called by the girl's parents again. I could only catch a few phrases because they talked so fast, so I couldn't translate. I need to practice listening more.

After the service, we went to Christoph Hotel as we usually have lunch there on Sundays. We took a dip in the pool afterwards. We did a few cannonball dives, and Laura and I threw Nadine and Gavin in the air like we did last time when we were at Christoph.

Later in the afternoon, we went to English Bible Fellowship, which is held at the Radio 4VEH station every Sunday at 4:00PM. There were a few short-term mission teams with different mission organizations. It was cool to see them and to be able to worship together in English.

On Sundays we are on our own for dinner, which just means that we don't have a cook to prepare us food or wash dishes, but they make pasta salad or something we can heat up in advance. We also don't have a long-term missionaries scheduled to join us, but Amy joined us for dinner tonight, just because she can.

Afterwards, we hung out in Vicki and Nadine's room as they packed their bags because they are leaving tomorrow. We watched the rest of Chaos Theory, which had a pretty good ending. It's going to be so sad to see the two leave tomorrow morning.

Malnourished Baby, HIV Test, Wadner's House, and Vicki's Birthday

Thursday, July 3, 2008

Today was Well Baby Clinic, so Nadine and Vicki helped out by admiring the little babies taking weights and temperatures, giving vaccines, etc. Amy and Evan consulted patients (mostly babies today) together as they have been doing this week. I shadowed Dr. Rodney this morning, so I got to see sick patients including babies. We saw one 8-month old girl who weighed a mere 5kg, which is way below normal (lower limit is 6.5kg). She was so skinny and small, and it was heartbreaking to see her. Her mother brought her in because the baby was having fever and diarrhea. We gave her medicine for the symptoms, and put her on the nutrition program (part of the World Food Program) to help her gain the much needed weight. I'm so thankful that we have these programs to help little babies like her.

Another patient we saw was a young man who had headaches and some kind of rash on various parts of his skin. I can't remember exactly, but I think he also had a little abscess of some sort on his neck. He reminded me of a Haitian friend from last year who turned out to have syphilis. Just as I was thinking this patient might have some kind of sexually transmitted disease, Dr. Rodney asked the patient if he wanted to get tested for HIV. The patient seemed hesitant and concerned about the cost of the test, but I could tell that he was relieved when Dr. Rodney said the tests are free of charge. Dr. Rodney explained to the patient about the pre-test consultation where they educate patients about STDs and HIV as well as ask risk assessment questions. I didn't get to see the results (I was probably eating lunch when Dr. Rodney saw him again with the results), but it was good to see how cases like this was handled in consultations (and that my instincts weren't far from Dr. Rodney's line of thought).

In the afternoon, Amy, Nadine, Vicki (three Canadians), Laura, Evan (two N. Irish), and I reorganized the operation room into an emergency room. While we were going through stuff around the room, we found some circumcision kits, and had a little laugh while Amy explained how to use it. It's basically a metal clamp that cuts the circulation to the foreskin and act like a stencil to direct the incision. The others almost seemed appalled to see it, but I wasn't surprised at all because I had seen one similar to it at my pediatric preceptorship last quarter. Apparently they had never seem those in Canada or Northern Ireland... but I bet they use them, too.

Vicki and I reorganized the little storage room next door. I was impressed by the variety and quantity of stuff we had, but it was a bit difficult to figure out what should go where. Also the room wasn't well ventilated, so we were kind of sweaty. Overall, I think we got a lot of work done in both rooms.

Afterwards I had a Creole lesson with Wadner for an hour, then the six of us (three Canadians, two N. Irish, and me) took a walk outside the compound walls. We briefly visited Wadner's house. Wadner is 25, and since his father passed away, he's been looking after his mother, his three sisters, and his niece. He's building his own house on the land given to him by his grandfather. Wadner also built a pretty intricate workout machine in his uncle's house next door. I was thoroughly impressed by how he maximizes the little resources that he has.

Today is Vicki's birthday, and we had planned to give her a little gag gift. The plan was to steal some of her clothes, put them in a box, and give it to her as a present. I got this idea from my birthday two years ago in Kenya when some of the missionaries pulled it off on me. The entire time we were reorganizing the operation room (now emergency room), I was looking for a small cardboard box, which we eventually found. Luckily, just as we got back from the walk, a few of the local kids showed up wanting to play some football (soccer), so Vicki enthusiastically went out to play with them. Meanwhile, Nadine (Vicki's roommate) helped me steal some of Vicki's clothes. Actually Nadine ended up stuffing the box with most of Vicki's clothes. We taped it up and hid it up at the Holiday House (that's where we eat our meals). Soon after that, I realized that, since Vicki was playing football, she'll want to come back to her room to change before dinner. So I decided to join her to keep her playing until dinner time and convince her to go straight to dinner instead of changing. It worked out just as I had planned. Oh, the power of suggestion!

After lunch today I had asked the kitchen ladies to put some candles on the dessert tonight. They said that if I had asked them earlier, they would have made a cake, but instead they had already made some jello. So after dinner, we lit up a few candles on a bowl of jello and sang happy birthday for Vicki. Then I brought out the box and gave it to her. She looked excited and nervous because we were all giggling. She opened the box and the first thing she said was, "Oh, my skirt!" She dug further and said, "This is all my clothes!" We had a good laugh.

After dinner, we went over to Amy's house, and Vicki, Nadine, and Laura got a pedicure from one of Amy's Haitian friends while we watched August Rush. I really liked the soundtrack.

Healing Wound, Square One, and Ping Pong

Friday, July 4, 2008

First thing at the clinic today, we saw Madelene, the girl with a big machete wound behind her left leg. We had brought her down from Souffrier (site of mobile clinic) on Sunday. She has been coming here every day to get her dressings changed. I had seen her at the clinic all week, but this was the first time since Sunday that I got to see her wound, which was healing surprisingly fast and well.

Today was Hypertension & Diabetes Clinic, which we have two Fridays a month. Laura and I took weights and blood pressures, lots of them. Some patients had such high blood pressure (around 210/130) that I had to double check to make sure I got it right. It was a good practice taking so many blood pressures.

After we finished taking vitals, I sat in with Ms. Ketlye as she consulted patients. Mostly we just made sure patients were taking their meds regularly, and prescribe them meds for another month. Nothing too exciting, but sometimes it's frustrating when patients don't come for a few months until they get sick because they couldn't afford to come. In that case it's impossible to tell if the medication was working or if we should change the dose. It's as if we're back to square one every time they come in.

As I mentioned before, the clinic has been seeing much less patients since January because of rising food prices. It is sad that fewer patients at the clinic doesn't mean a healthier community but rather a poorer and sicker one.

Vicki and Nadine decided to do some manual labor at the seminary construction site, so they were painting the new library with Gordon and Neil all day today. At lunch there were only three of us: Laura, Evan, and me. It was a bit sad to think that it will be like this everyday from Monday when Vicki and Nadine leave.

In the afternoon, Laura and I sat in with Amy and Evan while they consulted. I got to practice abdominal exam on one of the patients who was having some lower abdominal pain. At school we learned all these physical exam skills, but we haven't got to practice them much, so it was good to refresh my memory.

Welcome Inn, the place Evan and I are staying, has a ping pong table. So after the clinic was over, Evan, Laura, and I played some ping pong. I'm really not good at ping pong (as a matter of fact, I'm not good at any kind of sports involving spherical objects), and I hadn't played in forever. Evan beat me, but somehow I beat Laura.

It was nice to have Vicki and Nadine back for dinner. They seemed pretty exhausted from a full day of manual labor. After dinner, we played some UNO, then watched 3:10 to Yuma in Laura's room. Lights went out near the end because it was after 10:00PM. Good thing we were watching it on my laptop. The movie was pretty awesome.

Oh, did I forget that today is American Independence Day? Yeah, pretty much... I'm surrounded by N. Irish and Canadians, and I'm not even American. And we don't have any fireworks. So no point celebrating, I guess.

Goodbye Julie, Blood Drawing, Car Accident, and Augusma

Wednesday, July 2, 2008

Julie (physio from N. Ireland) left this morning. It's always sad to see people go because we all quickly become like family. She was the first person from Northern Ireland that I had ever met (then I met three more within a week). Now she's the first person from Northern Ireland whom I said goodbye to. It's been really cool getting to know her.

Today was prenatal clinic. Before seeing patients, Ms. Ketlye gave an educational talk to all the pregnant women. Vicki and Nadine helped out with weighing and taking blood pressures, and Laura sat in with Amy and Evan. Meanwhile I shadowed Dr. Rodney until he left to see Julie off at the airport. Then I went to the lab where I drew some blood and did a bunch of finger sticks. I drew three blood, two of them from little boys (about 10-12), and all of them went smoothly, so I think I'm getting better at this. But I still need more practice on patients with veins that are hard to see (Laura, are you still up for being a guinea pig?).

When I came back to the clinic from lunch, there had been a car accident where three people were brought to the clinic. In the treatment room (a.k.a. injection room) we had a 75-year old man named Augusma who fell on his right side and had people pile on top of him in the accident. I heard there were two girls from the accident in some other rooms crying very loud, but they were not in as serious of a condition as the old man.

When I came in, Augusma was lying quietly on the table as Dr. Rodney cleaned his wound. A big flap of skin on the back of his right hand had been teared open, so we could see his muscles and tendons. We could tell that he was in pain, but he was moaning very quietly. Gavin told us that in accidents like this, it is important to look for people who are lying quietly among others who might be screaming for help, because often times those who are silent are the ones in more serious conditions.

Gavin sutured his hand, including an artery that had teared under the flap and a small laceration on his right palm. Laura, Vicki, and I took turns keeping the big overhead lamp in place and holding Augusma's other hand. Meanwhile Nadine and Evan helped out with the prenatal clinic. After Gavin finished suturing and bandaged the wound, Augusma still had pain when moving his right arm, and the elbow was swollen, so we took him to the X-ray clinic, which is 10 minutes down the street from us.

As we waited at the X-ray clinic for the film to develop, Augusma shared how thankful he was that he survived the accident and praised God for sending us to take care of him. He prayed and gave thanks to God, and then started singing "Mwen renmen Jezi, mwen renmen Jezi, pou tout sa li fè pou mwen" (I love Jesus, I love Jesus, for all that he does for me). I was really inspired to see how much faith he had in God.

The X-ray showed that he had fractured the proximal neck of radius (bone of forearm on thumb side) and the olecranon (tip of elbow). So we went back to the clinic and put a cast on his arm. Augusma once again shared how thankful he was, sang the song, and prayed. He has such a bright personality. He'll be frequenting the clinic for further treatment. I'm looking forward to seeing him again.

Today was a very long day.

Tears, Baby Fever, Ankle Sprain, and Canada Day

Tuesday, July 1, 2008

After devotions at clinic this morning, we had a farewell party for Julie (physio from N. Ireland) because she's leaving tomorrow. She has been here for 6 months, and had become an invaluable part of the clinic. Dr. Rodney, who is one of Julie's best friends, gave a little speech and presented a certificate of honor and merit to her. Julie also gave a speech in Creole, then per her request we sang "Ala m kontan wè Jezi renmen m" (How happy I am to see that Jesus loves me) in the upbeat style. Tears were exchanged among many.

The rest of Tim's team (Tim, Mary, Christina, Carly, Anna, Emily, Beth, and Jen) left after lunch. It was really sad to see them go. They had become like family to me. It won't be the same without them. Lots of tears were exchanged here as well.

I shadowed Ms. Ketlye at the clinic today. One of the patients we saw was a little baby boy with a fever. I don't know exactly what was going on, but I assisted Ms. Ketlye by fetching whatever she asked me to bring. We did what we could to reduce his fever and then referred him to a hospital. I was impressed by how well Ms. Ketlye handled the case even with the limited time and resources.

In the afternoon we (those of us still here are Laura, Evan, Nadine, and Vicki) played football (soccer) with some local kids. While playing Evan sprained his ankle, so we didn't play for long.

Soon after that a truck from the World Food Program arrived, so we went over to help unload. Today is Canada Day, and most if not all of the food (rice, beans, soy/corn meal) that we unloaded were from Canada, so we, especially Vicki and Nadine, felt patriotic for Canada. Later on after dinner, Vicki and Nadine sang the Canadian National Anthem. Then we went over to Laura's room and watched Hairspray together. There are only 5 of us left now, but we still manage to have fun.

Manual Labor, Hyperhidrosis, and Broken Bed

Monday, June 30, 2008

Today ws the last day of work for Tim's team. They will be leaving around noon tomorrow. Carly, Anna, and Jen decided to work with Gordon at the new seminary construction site, so I joined them for the day. We transported three truck loads of paint, roofing materials, tiles, and lots of other heavy stuff. During the day, we were joined by Neil, a construction consultant from Washington DC. He just arrived today, and he'll be working here for 2 months working with Gordon.

Gordon is one of the long-term missionaries here, and he works for the construction project. I had always heard that he changes his shirt several times a day because he sweats so much, so it was fun to see him actually go through 5, 6, or 7 t-shirts today. Jen claims to have hyperhidrosis (i.e. she sweats a lot, too), so she went through couple shirts during the day as well. I also sweat a lot today, but I just wore scrubs, and let myself dry on the back of the truck as we went back and forth from the old compound to the construction site. I wish I could just wear scrubs everyday for the rest of my life. It makes life so much simpler. Anyhow it was a good work out.

After dinner we played a few games (hand tapping game, dutch blitz), and hung out in Laura's room. There were 10 of us running around her room posing for pictures (thanks to self-timing multiple shutter), and at one point we all got on her bed and accidentally broke it. Fun times. I'm really going to miss them all tomorrow.

Mobile Clinic, Day 2

Sunday, June 29, 2008

We went to Ms. Prudence's church this morning. Her husband is the pastor there, and this is the church where we did our mobile clinic yesterday. During the service Gavin introduced us to the congregation, and each of us said something briefly. I said something in Creole, and I almost choked up, but I hope I said what I meant to say.

Just as we got out of church, there was a crowd of people gathered around something on the ground. It turned out to be a 14-year old girl who had been carried in on a stretcher from a village far away. She had a big laceration behind her left thigh. Some old man hit her with a machete on Tuesday, so she had an open wound for the last 5 days. Since it's been too long since the injury, we couldn't suture it. Instead we cleaned the wound, bandaged it, and brought her down with us. She'll be treated at our clinic everyday.

I'm in awe of how people here can just carry heavy loads on their head and trek over a mountain barefoot. Many of them were so willing to help out as well. On the way back, it started to rain a bit, and then it poured when we got on the truck. It reminded me of the time when I went to Zanmi Lasante, and rode through the pouring rain on a open-back tap-tap for over 2 hours. It felt good to be in the rain.

We got back around mid-afternoon, and I took a nice hot shower. Oh, I never mentioned, but we have hot shower here. It's amazing. After dinner we finished watching Enchanted at Laura's place. I think we all have the song "How does she know that you love her" stuck in our heads.

Mobile Clinic, Day 1

Saturday, June 28, 2008

Today we went up to a place called Souffrier to do a mobile clinic. Tim (lab professor) got sick this morning, and there was another extra spot on the truck, so Carly and Emily, two of the girls on Tim's medical team, came instead. Our team consisted of Gavin (doctor for N. Ireland), Amy (nurse from Canada), Julie (physio from N. Ireland), Evan (doctor from N. Ireland), Mary (lab technician from the US), Ms. Prudence and Ketsey (Haitian nurses), Joel (Haitian evangelist), Carly and Emily (girls on Tim's team from the US), and me.

On the way there we stopped by an ice factory to fill up our icebox. I had seen so many people selling ice on the street, so it was cool to see where they were getting the ice from. It took us about 1.5 hours to get to the foot of the mountain, then another hour and 45 minutes to hike over the mountain. There were many volunteers from the village we were going to, and they carried our boxes and bags for us. The guys who carried our boxes on their heads, most of them barefoot, took a shorter but steeper path, while our team took the longer and easier way. We walked along a stream, which we had to cross several times. Near the end we had to cross a river on foot, so we took off our shoes and socks. The girls made fun of us guys because the Haitian guide "helped" us cross the river by holing our hands, which we totally didn't need at all. In fact it would have been easier to cross if they just let us on our own. Anyhow, it was a fun hike.

Our hosts had prepared brunch for us when we arrived. It was about 9:30AM. We were told that we won't eat until we finish the clinic, so I ate a lot, but then we ended up eating lunch at 1:00PM. They had slaughtered a goat for us so we had it for lunch and dinner. It'll probably be our breakfast tomorrow as well. Usually when people slaughter a goat, they use every part of it. They make soup out of the gut and bones, which we had for dinner, and they even eat the head, which fortunately wasn't served to us.

We were able to set up the clinic surprisingly fast. We used the church building for the waiting room and consultation rooms, and the storage for the pharmacy. The lab was setup outside next to an amazing view. Gavin and Ms. Prudence consulted on their own while Evan and Amy worked together (they either say Amy was translating for Evan, or Evan was helping Amy confirm her thoughts). Julie, Carly, and Ketsey worked in the pharmacy. Mary, Emily and I worked in the lab. Joel walked around talking to people about Christ.

I greeted the patients that came to the lab, checked what tests needed to be done, and drew blood if needed. There were a few patients, especially kids, whose veins were so small that I couldn't draw blood from them. b helped me out by using the syringe technique. In all, I drew blood from about 20 patients and did finger sticks on a few. Emily did the screening tests. We had a lot of patients with H. pylori, a few with malaria, and a few others with Hep B. Mary did everything involving the microscope and all the rest. Since Tim wasn't there, she was quite busy.

Joel, our Haitian evangelist, did an amazing job, and lead 25 people to Christ today. That's 10% of all the patients we saw. Praise God!