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Archive for February, 2009

life here in haiti. . .

one day at work back home, (that would be truman medical center labor and delivery to be exact in kansas city, mo.) i was talking with a couple friends.  i remember telling them, that there are days when i try to write about my day and the things that went on and really by about the third of fourth story i can’t finish because it is too long, or too sad.  i remember very clearly leslie (yeah, you leslie pierce!) saying, “no write it.  we want to hear, we want to understand.  it will help us appreciate it.”  so here it goes.  even thinking about trying to put today to paper (or blog, i should say) brings tears to my eyes.  i guess because then i have to process it and here that is really hard to do.  but here we go anyway.

this morning i awoke to the rain pouring down the drain pipe outside my window.  i had heard it rain much of the night, we aren’t talking a little rain, we are talking torrential downpour and all i could think about were my pour little seedlings that i had just started and that they must be floating away.  with that thought in mind i got out of bed around six.  breakfast was cream of wheat, which i can handle 100 times better than oatmeal!  oh and guess what, courtney had moved our little seedlings, so they didn’t wash away in the night!

annie (a medical intern here for a couple months) and i were heading to all staff devos and of course they weren’t starting on time, so we were going to check on the little preemie.  instead i ended up starting an IV on a mom who was pretty dehydrated and had been sick and throwing up overnight.  she has been here a couple days, but isn’t really in active labor.  but she is too far along to send home because she lives in tortuga, which is the little island across from haiti. 

we did make it to devo’s.  the song they were singing was heaven came down and glory filled my soul.  at the end the nurse who was leading the song sang out in such a deep voice, peace came down, joy came down, heaven came down.  how true that there are so many parts of heaven that are already here on earth and at times we don’t grasp them.

back to the birthing center after devos.  we had a mom who was about 25 weeks pregnant and bleeding.  there wasn’t anything we could do to stop her labor and as she continued in pain we questioned her about her health history, this was her 5th miscarriage.  tears welled up in her eyes as we explained that she was complete, there was nothing we could do and if she felt like she needed to push she could. 

then i remembered that i had needed to fill out the requisition for our maternity supplies.  that is always a juggling act between what we really need and what we have money to buy.  i filled that out, counted the money for it and sent smith on his way hoping that he could find everything and find it at good prices today because the prices here always seem to fluctuate.

on my way to fill out the requisition one of the little guys, christopher who i have known for a long time was at my door.  his grandma who has been taking care of him for years has been sick.  he wanted me to know that they had taken her to the hospital.  i had seen her yesterday, i knew that is what they were going to do.  i really think he wanted me to give him something to eat, with her sick, he hasn’t been eating as much.  i gave him a cereal bar and he put it in his pocket and said that he would take it home to his sister because she hadn’t had anything to eat yet that morning.  what an amazing heart he has!

oh, yeah, i had better get back to the birthing center i thought as i remembered the mom who was getting ready to deliver.  we actually had another mom show up while i was away.  she was 8-9 cm and hadn’t had any prenatal care.  i think she might weigh around 85 pounds.  she had a horrible cough and we all wanted to check her for HIV and TB immediately.  the TB test has to be done at another hospital, but it seemed clear from her cough and stature that she probably had TB. we quickly got an IV in her knowing that this being the 3rd baby that it wouldn’t be long.

the mom on the first table started pushing now.  she is pushing knowing that her little one isn’t going to live, just like all the other ones.  we are explaining to her that she should have come to see a doctor earlier, maybe she has a blood incapatability.  but really what can we do even if she does.  the haitian nurses tell her not to cry as they gentle stroke her arm.  i deliver her little baby, amniotic sac and all.  i take a clamp and tear open the amniotic sac and see him take his first couple gasping breaths.  his little body is just not ready.  his heart is beating.  i wrap him in a towel and ask if the mom wants to see him.  she says ” no” with tears streaming down her face.  anne marie (one of the haitian nurses) tells me that his heart is still beating and that he is still breathing.  we look to the other preemie who is using our only oxgygen concentrator and think that he could live without it a few minutes.  annie runs to the OR to get the other oxygen concentrator to see  if it would help him.  we all know it is futile.  he is too small to live here in haiti.  he only weighs one pound.  by the time annie gets back in the delivery room she is out of breath and our newly delivered one is gone.  anne marie cleans him off, wraps him in blanket and puts him in a box for the family to take and bury.

back to our other mom who is close to delivery.  i think she is going to have this baby quickly, no, 30 minutes later, 45 minutes later, an hour later, she delivers a screaming little girl.  mom and baby are healthy.  this little one weighed a little over 5 pounds and could breath on her own.  we realized that we couldn’t put this mom with our other healthy babies, so she went into a room in our new birthing center that we haven’t moved into yet.

ahhh, i realized that i had a few things i had planned on trying to get done this morning.  oh well, time for lunch.

on my way there a little guy widley and his mom were here.  i have a really long history with him, that would take pages to describe, but some of you know him.  he has severe bowel problems and is throwing up at night.  as i talked with his mom i realized that it may just be that he isn’t eating because she doesn’t have anything to give him.  hard times. 

anybody tired of reading yet??  that is to lunch!  oh, i also had figured out how to make copies for our charts.  our nursing manager had told me twice we were out and i needed to get that done.  not super easy here in haiti, but i knew i would get a lecture if they weren’t done, so that happened sometime in the morning!

lunch and then back to check on our little preemie.  i am so grateful that he is doing good. i can hardly believe that his IV we put in is still running.  i was talking with his mom about his name and we were giving her a hard time because she hadn’t named him yet.  we were all offering suggestions, but she wasn’t interested in them.  i was just thanking God for how grateful i was that his IV was running when i looked over on the floor and saw the little box that had the other preemie that had been born in the morning.  i sometimes don’t understand.

one of the lab techs yelled at me as i walked by the lab later on and wanted to be sure i had gotten the results on the other mom who delivered, she had a pretty serious infection we needed to treat or it could also effect her baby, so off to figure out what to do about that.  glad i have a pediatric infectious disease doctor who answers e-mails quickly as i tried to figure that out exactly what to do.

princess, the little one i had written about before was here most of today.  sometime this afternoon i just went and sat by her and her mother on their little mat on the gravel.  princess is slowly warming up to me.  there is something about holding a little one down for stitches and then giving them shots for days that makes them perhaps not love me so much.  but i almost got a smile out of her and she looks better every day!

i spent some of the afternoon trying to sort through this idea of putting a cast on a little one with a club foot.  our orthopedic surgeon  from arizona is helping me try to figure this out and it is all greek to me as i try to read through the anatomy of the booklet he had e-mailed.  but i think i had a breakthrough and feel ready to put the first cast on this little baby in hopes of reversing the club foot she was born with.

so i realized i probably wasn’t going to get to writing out the outline i had wanted to from a couple meeting i had this last week.  oh, well there are always other days.

i went to meet my sewing hope ladies around four and got an earful from them about how i was late, actually i was right on time, they were just early.  we read scripture together.  one wanted to read psalm one.  that reminds me of my dad, he made us memorize it as children.  i realize over and over again what a blessing i had with the parents God gave me.

one of the sewing ladies wanted to know if i could pay her in advance, she has to pay for school for her son, he is getting into all kinds of trouble fighting during the day because he isn’t in school.  she just needs $300 haitian dollars.  of course we will work out some arrangement.  after exchanging blankets and paying them i needed to go see jelous who was here because his niece was in the hospital.

i had sent his niece the day before yesterday.  she came in severe respiratory distress.  he didn’t have any more money to pay her bill.  the pediatrician had told him that if she hadn’t come to the hospital she would have died.

all of the sudden it is almost time for dinner.  i needed a shower.  but i also needed to figure out medication stuff for a mom.  both of those accomplished i went to dinner.  yes, we have pizza on friday nights, pizza and a coke.  what more could you want.  i got to sit by joey (one of our full time staff couples kids.  he is 2 and i love him!)  then him and i went to check on the baby downstairs in the birthing center and the babies in the baby orphanage.  joey kept saying, “little baby” not sure he had seen a three pound baby before!

i did devotions tonight spur of the moment.  but i shared something that is so true and is what gets me through days like today.  it is psalm 130.  i have a version written my a friend (thanks isaac a.).  the verse that sticks out to me is –

“For with the Eternal One lives the most stubborn compassion, and with Him comes the most profound redemption”

it is that stubborn compassion that i want.  i want it to flow in me, through me and out of me onto others.  i can’t make it through my life without it and want others to see and know that some compassion in their lives.  that compassion that God has to where He would seek us out like a sheperd, put us on his shoulders and bring up back from wherever it is we have gone. 

the evening ended with a movie night with some great friends here.  we even made brownies.  okay, vickie made the brownies.  we watched sisterhood of the traveling pants 2. 

and here i am processing it all.  another day in haiti. . .

i know two things –

one – i am extremely grateful for the people in my life who support me, encourage me, answer questions, listen to me cry, make me laugh and make life what it is.

tw0 – i am eternally grateful to the God who has stubborn compassion for me.  that He loves me so much and loves those around me who i hurt for, even more than i can imagine.

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gardening. . .

farwest1

courtney and i worked on our garden on sunday. 

we started some seeds and are excited about possibly having some different fresh vegetables here.  maybe even some flowers.

i am glad that we didn’t get the actual garden seeds planted yet. we have had complete downpours the last couple nights and i think our seeds would have washed away. i am not so sure about our seedlings even!

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some of the things that are different here versus at home in kansas. . .

i am almost always awake before 6:30 in the morning.  that doesn’t always mean i jump right out of bed.  sometimes maureen has to tell me it is time to get up!

i had a curly tailed little bug in the shower with me this morning.  needless to say it didn’t live.

i drink coke out of a 1/2 liter glass bottle.  mostly when i have a headache and somehow i convince myself it is better than ibuprofen.

i sit in the warm sun and soak up the vitamin D!

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still in my pajama’s

last sunday i was woken up and told that they needed me in the birthing center. 

i arrived there to find a little 2 pound 11 oz. preemie.  they had said that they needed me for a little one who had been born and i really prayed on the way down the hall that it would be clear, clear whether or not we would be able to do anything for this little one.  one of the hardest things here is at times knowing when or how to try to help in situations.  unfortunately, it wasn’t that clear.  the nurses had already called to have the generator turned on and we all quickly attempted to get the little one out of her wet clothes and into dry ones and under our heat lamp.  let me tell you that i am more than ready for us to get our incubators that are in a container waiting to clear customs.  we stabilized the little preemie for the time. 

i was still in my pajama’s and two of the nurses said that they were wanting to talk with me.  they stated how they were going to have to quit because they weren’t making enough money to cover the increased costs of living.  they went on about how they couldn’t provide for their family and they were going to have to try jobs that would pay them more.  i thought about it and realized that most people have these discussions in suits and business clothes and take care of preemies in scrubs, not their pajama’s.  life here is a little different.

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Princess

Last week one evening I was called to come to maternity because there was an emergency that they needed help dealing with.  The nurse who had called me explained some of the situation as we were walking.  The parents had been in a fight and were throwing rocks at each other.  I seemed that their daughter got in the middle of the fight.

 

Princess is a little 18 month old who was hit with a rock on her leg and it looked horrible.  We had one of our intern physicians here and he was talking about how there was no way that he could close it because he was concerned that there was probably a fracture.  It was around 8 or nine at night.  There was no way for the family to get to the local hospital and really no guarantee that once they were there they would even be able to have x-rays done that night.  We talked about how serious it was that the family would take care of this situation that night if we referred them.  It didn’t seem like they would be able to do that.  Dr. Simone then put his gloves on and said, fine I will stitch it.  He manipulated her leg to see if it was fractured and was content that it wasn’t.  He did a beautiful job stitching up a very ugly wound.

 

The problem is that Princess didn’t only have the problem of this injury, but was obviously in the early stages of Kwashiorkor (a protein malnutrition).  She is 18 months old and weighs 18 pounds. 

 

It was obvious that there was more that we could do in this situation.  Princess has come every day this week to be part of the nutrition program.  We have been giving her a World Health Organization formula for malnutrition and every day she looks just a little bit better.  We have a medical intern here right now and it is awesome to watch Annie jump in and help and make the formula and be so responsible for taking care of Princess.

 

Yes, Princess is her real name.

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long days. . .

the last couple days have been long, but good.

we have a little one who is coming every day because she has malnutrition, her name is princess. i will share her story sometime, but needless to say, what a fun name!

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widley is better. . .

mr. widley was discharged from the hospital yesterday and went home. i was extremely excited to see him and hear his little laugh and hug and love on him. his problem is not completely solved, but i am so grateful to God for working as He has so far. thanks for your prayers!

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