Week 2

9/14/10 (0640)

How soothing and peaceful it is to wake up to a beautiful sunny day, ocean, & bel mon (beautiful mountains). There is something about being by what Bondye (God) created that brings me closer to Him. My prayer is that today we provide the medical and spiritual care needed. Help me to use the medical knowledge You have granted me to the fullest. I lift up my family, friends, and enemies to You today. In Christ Jesus name, Amen.

9/14/10 (2304)

I am up late! I've got to get up early for another day of clinic, but I always want to take time to Thank You Lord and write about my day. I am going to enjoy working with this group. We saw 107 patients with 2 doctors in 6 hours. Most of the similar issues as yesterday, but more sick children. 3 cases of malaria were seen today.

We were off the side of the road in a tent, so it was much hotter and muggier today. We are in Cibidom. (Monday the clinic is in the mountainous town of Paptoma). There was no twalet (toilet) so we had to squat behind the building to go the bathroom. I practiced the phrases today, but I still need lots more practice. I started to feel a little more comfortable with being the pharmacy nurse.

The food and fellowship is always a nice way to end the day. I am thankful for skype to call my family. Laura and I even went on a run on the beach this afternoon! There is a group that runs in the morning, but we both would rather exercise in the afternoon instead of the morning. I've learned it's best to shower at nighttime too. Well, time for bed! Another clinic day tomorrow.

09/15/10 (2011)

Good evening Heavenly Father! How good it is to come before You tonight. It has been a wonderful day to serve, love, and fellowship. I stayed up too late last night so I was tired today. It was another very hot and muggy day. We were inside a church building- which kept out the sun, but also kept out the much wanted breeze. We are in the town of Meyombe.

We saw 113 patients today in 6 hours. And I was the only discharge nurse. If it wasn't for my excellent translator Charles, I wouldn't be able to do it! The thing that takes the longest is measuring out the kids tylenol & chloroquine (treatment for malaria). I don't want to mess it up! I'm feeling more comfortable on where things are the normal doses (since I haven't done pediatrics before). The patients were not as sick today- a couple malaria cases; highest blood pressure was 200/120 (crazy- they would definitely we put on a monitored floor in the hospital back home). After giving the enalpril 10mg 30 minutes to kick in, the systolic blood pressure was 160.

There was a little girl who had this rock hard lump on her neck that was apparently infected pus from a neck surgery she recently had. She also tested positive for malaria. Poor girl- I know she was feeling miserable!

Oh side note...there is not such thing as water temperature control- it's whatever comes out of the sink. It is not ice cold, more lukewarm since the sun heats up the water tanks. We are lucky enough to have running water. There are water wells that the Haitians have to walk to get their water. A lot of them bathe in the streams, which is probably why we see a lot of fungal and scabies infections.

Nurse Jean was thinking right when she brought 17 soccer balls. We bring one to clinic each day & leave it with the community pastor for the neighborhood to share. It is fun watching them play soccer! It seems that most children do not have a soccer ball, so it was such a good idea to bring soccer balls. I wish I could have brought more! Like on Monday in Paptoma, the little boy had a notebook with his school notes. He didn't have a pen, so I ended up giving mine. But timoun lo (the children) are very creative in making toys- I've seen a car make out of plastic coke bottle & then lids were used for the wheels. He was carrying rocks in the little car with a string attached.

It's interesting to hear other visitors to Haiti stories- how the Chaplain couple also ran into an encounter with seeing a dead body in the street. I've been told that if you touch a dead body, you take ownership of that person's family/house/etc. I've also heard that is a myth, so I don't know! There is one translator (that usually goes with the other team) who grew up in America and was forced out of America in December for legal trouble. He's about 50 years old, but his perspective of Haiti is very different (there is nothing to do in Haiti, people were not friendly, people don't do anything all day)- but the thing that came out of this move in his life was growing close to God because he said that's the only friend he has and he reads his bible a lot.

God sometimes really does place us in uncomfortable situations to get our attention and life focused back on Him. Not saying we are less tempted to sin, but we can lean on His strength and understanding. Hopefully, I will grow closer to God on this trip.

I guess I try to see the more positive side of the culture, but it seems that a couple of the other long term (year long) American staff are very frustrated with the culture. I just try to adapt and realize no culture is perfect. There are a lot of things about the American culture that I do not like. I can see why this culture is more laid-back and not as “go-go” all the time like we are in America- it's just too hot! It can get hot in America, but we have air-conditioning and many appliances that make our life easier. I am used to three 12-hour shifts in a row, but after 6 hours at the clinic, I am already exhausted here- because of the heat, humidity, and sweating all day.

I feel like there is so much more I wanted to say, but I can't remember. So I am going to call it a night. Bonwet! (goodnight) Thank You again Lord for providing. In Jesus Christ name, Amen.

P.S. I saw a tarantula today in the woman’s shower. Poor Nurse Jean looked all around the floor to make sure there were not bugs so she started undressing to shower when she looked up on the wall and saw a huge tarantula. She said she almost ran out butt-naked lol. I know I would have screamed. I have pictures of size proof (it was bigger than my hand). Also, apparently there was a demonstration somewhere down the road today and the road was blocked off by the demonstrators.

9/17/10 (0646)

Gracious Father, You know me better than I know myself and I thank You for that. You know what life experiences, trials, and tribulations I need to mold me more like You. I thank You for a good nights rest and feeling a little better. I've had jarre (diarrhea) for 3 days and on top of all the sweating I was feeling drained. So I took some Imodium and drank an electrolyte drink.

I was too tired to journal last night, so I'm journaling this morning about yesterday (Thursday). We drove about 45 minutes to the clinic in Cavanac. We saw about 85 patients today. We had a boy with a bad heart murmur (Doctor Dan was suspecting Rheumatic Fever so he wanted the boy to have a heart echo-cardiogram. Unfortunately we learned there is not an echo-cardiogram in this area, only in Port Au Port (PaP), so we just gave him antibiotics and told him to come back next week.

Then there was an 18-day old baby with lots of lesions all over its body. I had to give her an IM (Intramuscular) shot. 1^st time I've given a shot to any kid, and of course it was such a little one! Good experience since I want to pediatrics next. Dan wasn't sure what the lesions were, so he wanted to take her to the hospital at the end of the day. The mom never showed up to take her to the hospital at the end of the day. The Haitian translators told us it is taboo in their culture to take a young baby on the streets. They said most babies are born at home. Even though we mentioned that the baby might not survive, the Haitians said she would rather not take the baby on the street. To me that was a little frustrating, but I had to remind myself that's their decision. It's just sad for the baby.

I'm starting to feel more comfortable with the phrases and teaching, but I'm still learning. Dr. Bordes had to leave early to drive 2 hours to a mountain village where an older lady was that broke her pelvis. So Dr Dan had to see the rest of the patients! He did a great job!

This morning I am excited for the group devotions because there are 3 Haitians playing in a band- flute, trombone, and clarinet. It is so wonderful to start the morning with group devotions. Well, off to another days hard work.

9/17/10 (2141)

Eternal Father, You have kept me through another day and I can't praise You enough. It has been a busy day, but a productive one. We saw 128 patients in 6 hours- good thing we had 4 nurses and 2 doctors. I am really starting to remember the phrases, but I still need to work on pronunciation. I'm able to learn more now. Today in the village of Fort Liberte we had our clinic under a white tent that was next to a huge tree that kept the clinic shaded and much cooler than usual. On Tuesday, we had no bathroom, but today there was a “tent” bathroom- which consisted of a hole in the ground and a spot that showed you were to put your feet. I had to hold the tarp door other-wards the whole town could see me! It's always an interesting experience going the bathroom.

I really enjoy the teamwork aspect of the day. When we run out of a medicine or I think a different amount of pills should be given, the doctors work with me. I'm learning from them too. I'm not very knowledgeable at knowing what antibiotics are given for what infections (which is fine since that is out of my realm of practice anyway), but I'm learning.

Doctor Dan really wanted the 18 day old baby from yesterday to get antibiotics, so he sent some with the driver to take to the mom during the day. I guess the mom had a change of mind and decided to ride over with the driver to our clinic to get the baby more treatment. Dr. Dan said the baby looks better today- so Praise Jesus! The baby got another rocephin IM shot and sent home with pill antibiotics.

We get a lot of patients with anemia, so we give our ferrovit often, Another common issue is upset stomach, so we give out a lot of rantidine (zantac) and contracid (tums and simethicone combined). I'm really getting pediatrics experience here. I gave another IM shot to a 3-month old baby. Also, I get practice getting young children to take liquid medicine and not spit it up. I am thinking of better ways to teach. It is hard at times because it is fast-paced and not what I'm used to doing (I don't as knowledgeable about medications) but I know the basics and thankfully I have a great translator.

I don't know if I mentioned it, but there are still a bunch of tent houses. I wish I could have seen Haiti before the earthquake to contrast and compare in my description. I'm not sure what these communities looked like before the earthquake. All these villages we go to seem to have a community leader (usually the Pastor)- he hands out the cards to get seen in the medical clinic. Samaritan's Purse has a base (renting space from Global Outreach Ministries) outside of Port Au Prince- and they help out in the standing clinic in Cite Soliel and also have a mobile clinic. Then, they are renting space for a base on Jax Beach (which was a nice hotel that collapsed in the earthquake). Jax Beach is in Leogane. There are 2 mobile team clinics that go out in the surrounding areas. They each go to a different spot each day of the week, but repeat it the next week.

There was an older lady today that apparently has dementia (I didn't know this when I was giving her the medicine, but I could tell she seemed confused) and she was going around wacking people with her stick. It's never a good thing when dementia patients have sticks! But the community knows her. First time I've seen dementia here- not sure how common it is in Haiti. I have not seen any obese Haitians (some overweight) and only 2 or 3 cases of Diabetes. The only lady had a blood sugar of 509- no evidence of DKA (diabetic ketoacidosis), but still back home she would have been sent to the hospital to be started in regular insulin. We didn't have any insulin, so all we could give is metformin. Good diabetic teaching is not done in 5 minutes (more like an hour), so I know I didn't teach her all that she should know.

After we got back and restock the medications (we're always exhausted when we get back, but we work together to restock in about 1 hour), we went out of the compound to walk on a trail through the surrounding neighborhood. It was approved by the SP Staff. It felt so wonderful to amongst the people. The houses were made of cement, tin, or tents. They were constructing a house out of wood frame; women doing the laundry, and kids playing. There were lots of farm animals tied up and banana trees. Well, it is late and I should be sleeping for our day tomorrow. Mesi Jesus, Mesi. In Your name, Amen.