10th of March- 5th of May 2011

10 March 2011 (0640)

There is something extra special about waking up early in the morning. My prayer today is that God will give me the right words to say to my patients, especially to my newly paralyzed 25 year old man, Francois Louis. He came here for spinal stabilization surgery, but has already completely severed his spine at L1. I guess no one told him he would never walk again, even after the surgery. So when they broke the news to him yesterday, it was heartbreaking to watch him and his mom cry. But, towards the afternoon he started asking me questions as to what he will be able to do so I think he has accepted it. I want to get the process going so he can go on to rehab.

This week we've had mostly outpatient surgeries, which is good because they plan on doing a lot of surgeries this weekend with the 2 hot shot doctors coming in. I pray for respect and teamwork.

I enjoy so much going to Orphee's house. She asked me if I could get there by myself next time, and I probably could but not sure if my boss would like that. I'd have to walk though because it's too hard to see out of the tap-taps to know where I am. I just love talking with her sisters and playing with her sister's 5 month old baby Sebestian. He's so adorable and playful. They are very generous with hospitality.

I think I forgot to mention that administrator Madam Clotaire never used to speak to me in Kreyol (only English), but last week she said "ou pale Kreyol net kouyne" (you speak kreyol well now) so now she only speaks Kreyol to me. It makes me laugh, but I enjoy it.

They finally put up dividers in the patients room. We were trying to keep men/women separate, but there's always more females than males. Plus visitors are often of the opposite sex. I guess they were worried about promiscuity, but I don't think that's really going to be a problem because it's still an open room.

11 March 2011 (0707)

I was so glad to hear yesterday that our paralyzed patient & his mom are believers in Christ. I gave him a bible study guide in French and then we all prayed with them last night before his surgery today. Marc asked if they wanted to sing first, which they did and then prayed a touching and beautiful prayer from the heart. They were so thankful for all of us workers, the beautiful clean bed, and God teaching them everything because without God they could do nothing. I hope as a team we can continue to pray with patients from time to time. I would like to minister to spiritual needs more. Especially to the patient's that stay longer because I get to know them. I'm glad we started up a bible study again and prayer time as a group. It will help us stay in unity and refocus us if we get off track.

12 March 2011 (2315)

What another blessed Sabbath day to honor You and grow closer. It's always a blessing to get a good nights rest, worship, fellowship, and bible study. I am really enjoying this book by Francine Rivers on 5 females of the bible (right now it's Tamar). I couldn't put the book down. She just expands on the details of the lives of these women, so it helps me understand the story better & relate it to my life somehow.

I watched the spinal surgery on Friday. That was interesting! He's doing fine now. Unfortunately they couldn't reduce him because his bones had already started fusing together, so they placed screws and pins. Other than that, I'm going to be joining the gospel Kreyol choir! I'm so excited. They sing mostly kreyol & french, but they sing a couple songs in English. It will be neat to be around the group and really practice my Kreyol. The director is an eye doctor who speaks english, but I want to ask him not to translate everything for me. I've been going to the french/kreyol service at the chapel, but the last 2 weeks the pastor asked if I needed a translator. It was kind of embarrassing today because it was in the middle of the sermon. But I know he was just trying to be thoughtful and make sure I understood.

15 March 2011 ( 0030)

Lord, I cry out for mercy. Things happen that just don't make sense or seem fair, but I guess that has happened since sin entered the world. We had a busy start to the day with about 50 clinic patients, 9 scheduled surgeries, and already 10 patients on the floor. So it was a stressful start of the day discharging patients and finding pre-op beds for everyone. I finally got all of that organized, so I went upstairs to have a meeting with the CEO (basically, I forget his official title) of the hospital. Just trying to figure out volunteer and orthopedic plans for the hospital.

Well, I went downstairs to check on everything. The nurses came running over to show me a patient, a 13-year old girl who had surgery earlier that morning that was unresponsive and not breathing. I yelled for all the doctors & grabbed the crash cart. The came within seconds got her intubated & doing CPR, and all other ACLS protocol. Unfortunately they could not revive her. I was just frustrated because there was nothing medically wrong with this child and she didn't have a big surgery. The doctors said everything went fine in the OR. They check a chest xray after and it showed nothing, just cardiomegaly (enlarged heart). But the anesthesia doctor said that will happen after every death (and she had been dead about an hour before they took the xray).

As much as we were trying to say we're not sure what happened (and of course you can never be 100% without an autopsy, which apparently there is no doctor in Haiti currently to do that), the most logical cause of her death was not coming out of anesthesia. She probably wasn't getting enough oxygen, went into respiratory acidosis & eventually her breathing & heart stopped. She didn't have a pulse when we found her, and afterwards the doctors guessed she had probably been dead about 20 minutes before we even started CPR. Lord...it was a breakdown of a system and quality nursing care. We had no recovery room, so my guess is she was brought out of the OR still too early and the nurses didn't keep a close eye on her. Usually the family is good at watching them, but I guess we've just been taking the risk everytime. Although usually anesthesia doctors are aware we have no recovery room so they keep them back there longer.

Lord, in the last 2 months I've helped with 3 cardiac arrests and all 3 of them were basically dead already when we were called and started CPR. I can take one quick look at the patient & tell that they've passed already, but we still try to resuscitate then. Lord, it's hard to accept these types of deaths that I feel shouldn't have happened. Well, the biggest change it made was deciding to make a recovery room that they will be starting tomorrow. Lord, help us improve the nursing care and quality of this hospital.

17 March 2011 (0045)

Heavenly Father, You are perfect. If only we all could exemplify that then things would run better and smoother. But, Lord, I can't beat around the bush now. It's been a stressful and frustrating week. Realizing some major flaws that had to be taken care of; Doctors that are only here for a couple days so they're overworking the system and not taking into account the hospital wishes and capacity. The recovery room was set up the next day and today there were Haitian nurses to work in it. The only thing is we will have to train them what to watch for. But, there's been a lot of in-patients and new surgeries, so it's just been a lot to keep up with. And just trying to deal with a system that is developing but even parts that are developed are not always done right. Even we are not doing everything that the hospital has established. While granted some things medically are excessive in my opinion in the U.S., it's not good to not have basic order & protocol for things. But, I know it's not all the nurses fault. That's administration's job. It's interesting to hear the nurses perspectives on how things were before the earthquake in the hospital.

We had a debriefing M&M (morbidity and mortality) on the girl that died. I believe it sparked some change. But at first the 2 doctors wanted to put all the blame on the nurses, which I don't feel it was all their fault and it wasn't getting us anywhere. Help us God to improve and make things run smoother. Then the medical director had a meeting with the family. The family is still confused why she died, but they only asked for the hospital to help pay for the funeral (apparently it's over 1,000 USD for a funeral). I realized I have a picture of the girl who passed because she had come to clinic a couple times & always came up to me. It saddened me to look at it.

We visited the general hospital today while waiting for blood at the blood bank. It wasn't as dirty as people have made it ought to be. Just one big room with lots of patients and not many nurses & doctors. The smell was similar to any hospital (hospital's never smell good). The worst smell is on the sidewalks were men pee in the still water. A couple patient's with oxygen & NG tubes. Families were doing a lot of the care. We even saw a NICU (neonatal ICU). But, I will say after seeing that that our hospital has potential and we can be thankful. The nurses get paid more than 2 times more at the General than at Adventist hospital, but I'm sure it's stressful there too (they get about $400 USD per month at the general & $125 USD per month at the Adventist hospital)

We rounded up lots of us to donate blood at the General Red Cross so we could get 2 units of blood, but apparently the donation place was closed. We pleaded to get blood in exchange for people donating tomorrow. So we waited and just chatted. I guess the anesthesiologist went back to ask about how long it will take and they told him to get out, they won't answer any questions. (He only went back there because there is never anyone sitting at the receptionist area to ask questions). Well, the doctor is 6 feet and 9 inches and told them he's not going anywhere until they give an answer. Lol, so I think intimidation worked although they were mad and came out yelling that everyone had to sit out here. He even said "and I remember you" lol OK- I said "Sir, we are sitting out here so you don't need to yell at all of us." The anesthesiologist said they were not processing anyone's blood even though about 10 people had been waiting hours for blood. Apparently they didn't feel like it, so they were making everyone just wait. They told our doctor when he asked what if this is an emergency that "We don't care. We've seen lots of people die already so what does one more death matter." So unfortunately that really is the Haitian (or maybe more Port Au Prince) mentality sometimes and it's very unfortunate. But, if it would be there family it would be different.

After all that, we got our blood in 10 minutes. But of course, all the Haitians who had been waiting anywhere from 4-12 hours were upset the "blan" got their blood before them. We apologized to them about the unfairness. I hope they all got their blood. I don't want it to give blans a bad rep (altough it's cultural to show favortisim). Well, time for bed because 12-in patient & 12 surgeries scheduled. Give me strength, Lord.

19 March 2011 (1320)

How excellent it is to have a day away from my job & secular worries. Lord, while caring for Your sick children is not secular, I cannot work 7 days a week. It's been a very busy, stressful, and frustrating week. I could go on and on about how workers & systems are not functioning well and need to change, but today is my day away from worrying about these things. And there is no use complaining, just have to push through it and change what I can. Today is my day to occupy my mind with Christ because I have the rest of the days to occupy myself with the work You have placed in my life. Days off are the reason I can keep going, once I renew my mind and have a rest. Then, I am ready to handle the next week and it's problems.

I hope I can get out in nature again soon. I think getting away from the city really does something for our spiritual and physical health. Our only get away in the hospital is on the roof because you are surrounded by mountains and the ocean. It's a breath of fresh air (except when the generator gas is blowing towards you) and time to quiet my mind. The message today was about taking that quiet time with God. We can't be so busy that we don't have oil in our lamps. Oil represents the things needed to sustain us, the word of God and meditating on it. And the burning of our oil is our prayers.

I'm happy to be a part of Gospel Kreyol. I'll try not to be so shy and make friends. It's just a joyful part of the week to bring music to our Creator's earers. I am thankful for God allowing me to each day understand and speak Kreyol a little better.

20 March 2011 (1115)

I thank you for another day, Lord. Gospel Kreyol sang at Herob SDA church. They sang beautifully. Man, I can't go many places without sticking out. I was the only blan amount hundreds of people and when they were talking they were saying there's 1 person in this room who doesn't understand. You can imagine their shock when I told them I do understand them. And I think I'll certainly improve my Kreyol spending time with this group.

25 March 2011 (0700)

How different are my days when I spend enjoy quality time with You. Forgive me Lord for the days I wake up late and don't have enough time for quality devotion. The work week has been better though. I'm just catching up on sleep because last week I had 2 nights of only 3 hours of sleep so feel exhausted from that. We've changed to only doing clinic Monday, Wednesday, & Friday now. And surgeries Tuesday and Thursday so that helps to have a more normal schedule.

I transferred Francois Louison, the spinal cord patient, to St. Bonface. Glad I could go and get him settled. It was a breath of fresh air to get in the country. There were miles of just green!! And I love watching how the country people live and work. I think it is a better environment for people. It made me miss being out of the city. I got to see Mamie, one of our other spinal cord patients from November that got transferred to rehab at St. Boniface. Hopefully I'll get to go back and see them both again. You connect to these patients, so it was hard saying goodbye but I know this place will be much better in getting him progressing to normalcy. His mom didn't want me to leave, but they will be fine once he makes friends and learns how to do everything by himself. He won't feel so helpless then.

26 March 2011 (1400)

Gracious Father, I thank You for getting us safely here to Gonaives. Forgive my complaining. I guess all in all I am used to more comfort so to be in a 2-seater with 3 people & all of our belonings when it's 95 degree and you're tired it's testing. We stuffed at least 60 people in the bus plus all of our bags and musical & sound equipment. But, we made it and I'm sharing a room with 3 other females. 2 of the females have really welcomed me so I was glad to bunk with them, Rose and Yonie. They make me feel so comfortable and help me out.

So, embarrassing story. We stopped on the side of the road to use the restroom. I was going to hold it, but decided I shouldn't stop the bus later on so I better go then. I got up and asked where they we were going to the bathroom (I guess which bush we were going behind) and they said against the side of the bus. I was mortified, but every other girl did the same thing. So with a bus full of 60 men and women, I squatted beside the bus to pee! It took awhile to get started because I was trying to keep myself covered up and then it seemed like eternity. And then, when I got back on the bus the guys had to joke about the blan peeing on the side of the bus; a sight they clearly don't see often. Oh dear, there are some things I don't know if I'll ever get used too. I'm cool with squatting in a private area, but never in public.

But anyway, we arrived & took a shower which felt amazing because we were all sticky and sweaty. Now, we're just relaxing until it's time to go. It's definitely good for me being around all Kreyol. I am quiet in a large group, but in smaller groups I speak up more.

So, I performed 2 times yesterday with Gospel Kreyol. The first time was at the big university church with 4 other choirs so I could blend in better (if you want to call it that. I was standing in the back so no one could see me). I also saw a lot of the nursing students. I pushed Sondy in a wheelchair up the big hill to church in my heels, but it was a joy to see his excitement to be in church with us. I enjoy him being around so much. I know it won't be long until he leaves again. It's hard because I don't always make enough time for him, but I need to. Oh how dear he is to us and to You. I pray that he stays strong in his faith.

The 2^nd time was in another church in the evening. So, apparently the director's way of deciding songs is the moment we get on stage he decides one song at a time. You learn what song you will sing next by him either making reference in his talk to the church or the music will just start playing and you have to figure out the song. So I got up there and had no idea what were singing and I hadn't practiced many of the songs with the choir. I only had the songs for 5 days to practice. But I prayed about it and there was no reason to stress. I was able to sing 7 of the 10 songs. It was fun and the girls beside me helped me out a lot. For once, I didn't get pointed out as the blan (ZJ did mention I probably wouldn't after I start singing with the group).

On the way home, we saw a motorcycle accident where the driver turned to fast and they fell off. The drive drove off and the left the passenger's body on the ground. He wasn't moving, so I wanted out to check on him. They wouldn't let me out at first, so by the time I got over there was a large crowd trying to pick him up. I was just trying to figure out how to get him to the hospital when the police showed up. They seemed to just watch these unmedical people try to care for the guy. So I just let the police do their routine because I don't know how it works around here. You wonder if there are more complete paraplegics because of uneducated people moving the bodies are an accident without spinal precautions. I guess there's nothing you can do to stop that. Then today, Ginel in the choir told me not to get out of the car again. I guess I just don't know the culture well enough. It's hard not to do what we do for emergencies in America because that's all I know. But, I guess they can try to pull you into a legal mess here, so I don't want that. I don't think there's any Samaritan's protection here.

3 April 2011 (1000)

How fast the time passes! Lord, help me to manage my time better so I'm finishing work at a decent time as well as what I do in my time off so I'm getting enough sleep. I don't want to be the sister that was busy with so many preparations, but not choosing what is better (sitting down at the feet of Christ). We are so much more vulnerable to temptation and our interactions may not be as glorying to Your name as they could be when we don't spend enough time in Gods word and prayer. I want my work, gsopel Kreyol participation, friendships, interactions, etc to not be selfish and self-seeking but to be focused on You and loving others. No wonder Jesus said to us "seek ye first the kingdom of God and all these things shall be added unto you."

I finally am caught up on sleep. I slept through my alarm clock (which almost never happens for me unless I'm totally exhausted) and had an off work week in terms of my productivity. But, I was glad to be able to go to Gonaives and getting to know the people of the choir better. Random stories- I forgot a towel so all 3 of us shared a towel (and no one makes a fuss of that here even though they didn't know me that well). I sang all but 2 songs Sunday. It was neat when the electricity shut off in the middle of the song. It was a church the seemed financially better off than most in Haiti. They had nicer pews, lights & fans that worked well most of the time. Afterwards, everyone was being silly playing games. I choose to talk to this one 18 year old female in the choir but everyone kept calling my name so eventually I went over. I'm still slightly timid, especially not being 100% fluent in Kreyol, but it's fun. But being around them will help me pick up Kreyol fast. Even the piano player, Wilmyr, wouldn't translate for me because I think he wanted me to try to figure it out on my own and see how much I understood. He lived in the U.S. for 5 years and played with the Broooklyn Tabernacle Choir so his completely fluent in English. He's an amazing piano player.

Afterwards, we stayed up until midnight talking and the one guy Johnson was cracking jokes. It was a smaller group so I felt more comfortable speaking up. Then all 4 of us girls slept on the mattress until 4am. I was exhausted and thought everyone else would be on the way home, but nope, the jokes kept going from 4am until we got home at 7am. I get intimated in a large group to speak, plus I could barely keep my eyes open so I slept the whole way home. They stopped to use the restroom again, but I refused to go, even though they asked.

We ran into a strike on the way home. Apparently gas went up 40 gourdes (about 1 USD) so now it's about $4.08 USD/gallon. So the public tap-taps were not allowed to run and if they did people were throwing rocks at them. So, until they figured out we were a private tap-tap, we got stopped and people were yelling to the driver to turn around. After awhile, we were allowed to keep going. Apparently they were throwing rocks at public tap-taps who weren't following the strike. Clinic was slow that day because of lack of transportation.

I have really enjoyed this group, the Lovejoy's, because they have been respectful of hospital wishes and willing to help with whatever. And they asked before scheduling cases on Sunday. And they didn't expect me to work on Sunday. There were the usual joys and frustrations of working here this week, but I can say that I'm enjoying having all the pediatrics babies. Dr. Lovejoy is a pediatric orthopedic surgeon. Plus the babies leave that day or the next so the bed situation has been easier. We only ended up with 3 patients this weekend so we quickly did rounds together. I placed a wound vac on the BID dressing change order so now we don't have to worry about that.

We learned 2 new songs with Gospel Kreyol. It was nice to learn new songs with them instead of me catching up on ones they know already. And, then I guess the first sabbath of every month Dr. Greger does a program for the youth. The praise team sang and Dr. Greger did a presentation on the nervous system and the eye. He then talked about the negative effects of television because of how our brains analyzes, integrates, and stores everything we see. It was good and I'm glad God is using him to educate the youth and provide them what God has to offer instead of the world.

Well, it's hard to remember all the stories. But I did hear the hospital has been trying to move everyone off the grounds (all the families still in tents). And there has been a family living in a building on the grounds for 10 plus years because a previous administrator allowed them. But, now the hospital wants them to leave so the hospital can use the building. I guess the family is refusing and this week someone poisoned their 3 dogs to death as a threat. I was disgusted when I heard that story because that should not been happening in a Christian hospital. But Marc warned me that not everyone who works at the hospital is Christian so they may try to poison you if they don't like changes you're trying to make. Well, it's not worth dying over as Marc said, so I just need to be careful who I take food from.

5 April 2011 (0716)

Even if I wake up tired, I always feel refreshed & joyful after spending time with God. You are a good God, lord. We just have to put our trust in You. I enjoyed going to Orphee's house as usual to spend time with her family. I brought banana bread and they they wanted to know if they could sell it in the market. That would be hilarious if they started selling my family's banana bread recipe in Haiti. As always, they are generous in providing food, clean sheets, and their company.

9 February- 6 March 2011

10 February 2011 (0710)

Sunday was a wonderful day! I went to nurse Ophree's house. It was a nicer house with running water and a loving family. Her 2 sisters, brother, cousin, and brother-in-law lived there. Her sister has an adorable 4-month old baby boy. We cooked, played with the baby, Orphee did her laundry (and I watched how they do it by hand), and talked. I just bring my dictionary to help facilitate any words I don't know. What is so amazing is how hospitable and giving people are who have less than me versus Americans who have way more. Granted all of her family seemed to have well-off jobs, I know the nurses make equivalent to about $125 USD per month at this hospital. Orphee refused to let me pay for anything (the tap-tap ride, food, etc) even though I'm the one who asked to visit her. When I got there she gave me a different outfit and shoes to cook in. All of her siblings spoke a little English. And her house had a beautiful view of the ocean.

And then when I got home, everyone was heading out to watch the superbowel. So we stuffed 8 people into a 5-seater car to drive up to Penionville (where all the rich people live). It was a 1-hour crazy drive with Sam. But, we got there and back. I mostly was just updating my blog, especially since they couldn't get the superbowel until the very end. They had blocked in over the satellite, but finally they figured out they could get in on the local TV, go figure haha! Some carnival things were going on that night, so the streets were packed at 10pm.

This work week has been a nice relaxed pace because there has been no anesthesia. Dr. Terry left yesterday for 2.5 weeks and the next ortho doctor comes tonight. We have only 2 patients here- one car accident with femur fracture and another women who had her femur rod replaced. She needs blood today, but that's about it. It will be a good day to catch up on random things.

I've been staying over at one of our younger female Haitian doctors house, Spendie. Her younger brother and sister live there too. Their mom lives in the states, so she keeps an eye on them (one is 18, the other 22). I have to say, the way people have respect for their parents & older siblings is nice. It just keeps things functioning better. We have lost that in many American  families. Spendie said she knows it's harder on her young siblings to not have their mom, but she's trying her best to get them through school and find a decent job. Again, the hospitality she provided me you would have thought I was someone important lol. She gave me a scarf she bought for herself, food to eat and to take home, and a pillow to sit on the chair. It's fun to get away from the hospital and get to know her. Their house also has running water and electricity (when the government puts it on). It's got a quaint courtyard. I've been enjoying doing bible study, prayers, and hymns together with them every morning and night. They all have bed frames with huge pieces of foam for the mattress that are comfy. She can now afford to pay a lady to come clean and cook in the morning she told me, which helps her out working full time as a doctor. They all still do their own morning and evening chores though. It's just a simpler life here, but I think that's good sometimes. Spendie has lived in the US for a little, and her 1 ½ year old lives in the US with her mom, but she says she prefers to live in Haiti. She knows there is more comfort in the U.S., but she feels more at home in her mother country and knows there are more needs for doctors.

15 February 2011 (2200)

How often we ache for Christ's return when we see tragedy and pain. There was a 28 year old female medical patient that cardiac arrested in the middle of the day. I was eating lunch when they came to get me. Angela, the CRNA was bagging her and the Haitian doctor on call was doing chest compressions. No one knew the patient at all, but it appeared she had been having seizures because there was foam coming out of her mouth. The crash cart was messy so you couldn't find anything and they were doing compressions without a back board, so we had to run to find epi (the med to try to start the heart again) & a back board. We tried, but were not able to save her life. I didn't know this patient at all, but it's hard to see so much death. I've seen 4-5 deaths in the last 4 months (that isn't including the 2-5 deaths in the neonatal ICU they seem to have every month). Back home, I only saw 2 years in 2 years (granted I also didn't work in an ICU). I can't imagine dealing with the amount of death they did after the earthquake and even with this cholera outbreak. It's nothing you can truly prepare for. There are not that many ICU beds for PaP (maybe 1 or 2 hospitals have ICU beds). This was a pretty tragic death that could have probably been prevented. The doctor on call wrote death from a seizure secondary to severe dehydration. But 2 problems: She had been in the hospital 4 days so how can someone be that dehydrated in a hospital after 4 days and also apparently the family kept telling the nurse something's wrong but the nurse didn't do anything about it. If they would have fixed her seizures right away, she would never have gone into cardiac arrest. So basically, it was most likely a preventable death. So that's a hard fact I learned today, even though we have most of the supplies, we don't have all the training here. I have experienced more codes here than ever before and I'm learning. It's hard for us to accept these things from our American perspective. But you can only do what you can with supplies and training available. We are here to try to improve training though because a case like this should not have happened in a hospital that was equipped to deal with it.

Saturday, we climbed up a mountain with Jean Kelly. It was beautiful and a nice get away from the city. There was even a small cave. Saturday night we spent reorganizing and cleaning the kitchen. So needless to say, I was tired sunday morning. But, it was worth it to have a clean and organized kitchen. Sunday I rode with Mac's family to his graduation. The service was all in french, so I only understand a couple words. For some reason, I had been craving a coca-cola all week and his mom bought me one! I had fun talking to his sister.

Afterwards, I met up with my friend Stella. Her brother graduated law school with Mac and they're best friends. It's a small world! I went their house and met all of her family. 3 of her sisters are doctors. I think most of the doctors in Haiti have a parent in America to afford medical school. Their mom lives in the US, so they are slightly better off than most. Then, we had a celebration party for Mac back at the hospital.

So, other than that, work has been busy as usual. Still trying to fit in exercise every night. I bought buckets to wash my clothes in, but I haven't found the time. Instead, I heated up warm water on the stove to take a warm bath. Boy, has that been feeling really good. Oh, I forgot to mention Saturday evening, a 27-week old baby was born (basically born 2 months to early)  and they came to get me because Marc (the nurse with NICU experience) was not there and there was no doctor available. I was like well, haha, not sure what they wanted me to do without NICU experience. So ZJ came and helped me. When we got there, the OB doctor said OK good, thanks, and left. We called the pediatrician and she told us what medications to put the baby on. The baby was soo little. He was a fighter and breathing on his own. It's just a crazy system that there was no pediatrician available to see a brand new premature baby. I have to balance my thinking between well they're doing what they can here, but also this isn't really acceptable. So far, the baby is still alive. I pray for the system to be able to be changed.

18 February 2011 (1317)

I'm excited to see my family and Klair. I'm waiting at the airport for 4 hours. There was bad traffic because of some flooded roads, so we left early. Elinor, the nurse who was here for 6 weeks before, came back Thursday and she'll be covering me while I am gone. She has a good way with the patients, so I'm glad she'll be here to cover me. I'll miss speaking Kreyol for 1 week. I still have a lot ot learn, but I'm getting there. I;m probably learning slower than I want to because I'm around so much English.

Last night, Marc and I were heading to Spendie's house, but we got stopped in the ER because a motorcycle accident patient was brought in and only the OB doctor was on call. Lol, the doctors really have to know a little of everything around here. I had the OB doctor exam my pregnant friend because she contracted HPV. I ask for prayers for her and the baby; as well as her husband (I pray he's not being unfaithful).

I love the welcomes and farewells I receive at the hospital. I like the warm goodbyes. Hugs and kisses. I forgot a long sleeve and it's cold in the airport! I've never been in this part, because last February the airport was very different and when I left in December I went on a small airplane. For some reason, there are 3 places instead of 1 that they examine your bags.

20 February 2011 (0100)

I should have been in bed way before now! I do not enjoy staying up late anymore, but I've been enjoying my time with Klair. We went on a boat ride, ate lunch with her son Aaron, relaxed, and went to her Haitian friend Lucette's house, so it was fun being around Kreyol. She held a party for those who volunteered in Haiti, and most of them were Haitian. I could understand a good amount, but I felt intimated to speak it. It's funny because even though they were all well-educated and have well-off jobs, they all spoke Kreyol together, not french. That's why it's tough for me to put much effort into French. It would only help me at church. They definitely had aspects of the Haitian culture, but it was interesting to see how the American culture has influenced them, especially the women.

21 February 2011 (0615)

I didn't get too much sleep the last 2 nights, but it was fun being around Klair and her family. How time flies. We went to the swap shop yesterday. There were so many Haitians, I loved it!! It really gives me more motivation to get better at Kreyol.

22 February 2011 (0830)

As much as I love what I'm doing, there's just something so wonderful about coming home to see family and friends. I pray that this week I can balance being productive, but also spend quality time with my family. I am so excited about the possibility of my parents, Emmy, and Wilshaw visiting me in Haiti. I would love to show them all around.

25 February 2011 (2230)

I'm back to Haiti! I had a wonderful time with my family. I enjoyed meeting all the people at my Grandma's bible study; going out to eat with Gma, Mary, and Aunt Nancy; Mary's graduation went well. And just spending the evenings with my family. Time always goes too fast!

27 February 2011 (0920)

How wonderful and grateful I am for this day. It's a beautiful day outside. It's sunny, cool, and breezy. I'm ready to start the day. I'm so happy to see everyone. I love the welcome you get here. Everyone is genuinely happy to see you. Such a contrast from my last job. I'm glad for this week's study on jealousy. It's something that can easily creep in and can lead us to do things we never thought we'd say or do.

We went to an instrumental jazz concert today and it was really good!! They had a piano, bass, sax, flute, & drums. Let me tell you, I can't play like that flutist did. It was motivation to practice and improve. I miss singing in a choir and being part of a musical group. ZJ is joining a kreyol choir, so maybe I can see if they want another soprano singer. That would be fun to sing in Kreyol :)

28 February 2011 (2240)

While we should praise God in everything & trust that he works all things for His good, it has been a hard one today because Orphee was denied a visitors visa. I know there are a lot of problems with people staying illegally, but I don't it's fair that she waited 6 hours & paid lots of money and then all the consular did was quickly glance at her papers (including my letter) and then ask her if she was married or had kids. After she said no, he gave her no chance to explain or find out any other details. My problem with this it was very subjective and basked on his or her mood. 

I just felt bad because she spent what she makes in 1 month for this and was basically given no chance (I saw her papers with how much she makes between two jobs each month...let's say it's how much I made in 17 hours of work at my other job). I slept over at her house and went with her in hopes of going in and explaining, but they wouldn't let me because she's an adult. So I sat and spoke with the driver for 6 hours. Well, we probably slept and listened to music for most of it). Boy was it warm in the car. And eventually I had to use the restroom, so they found me a corner in an open field with people all around. Oh boy, I just went and didn't look to see if anyone was watching. I'm sure it was a sight, a blan in a dress and high heels. The driver was like, I'm sorry, this is Haiti.

I really enjoy Orphee's family. I want to spend time there every week. And it's good for improving my Kreyol. I felt like I could speak better after spending time with them. I notice when I'm only around Kreyol like last night and today, that I improve so much faster. I translated for the anesthesiologist and talked to another hospital in Kreyol about a transport of a paralyzed patient on my own on the phone. Not that I'm fluent at all, but able to do OK. There are a lot of words I don't know, but many times I can make my way around words I don't know. "this" (Sa) is a good word to know haha!

I attempted hand washing some laundry yesterday. It was a good experience, but boy did it take a long time. It would have been a little more enjoyable if I would have had a group of friends to chat while doing it. I forget what else I wanted to share. I just have to trust that there was a reason the visa didn't work out. But I lift it up in prayer, because we're thinking of applying again but finding out what needs to be done to help her get the visa.

6 March 2011 (1400)

So, it's been a busy work week as you can see by my lack of writing. I worked 12-14 hours Tuesday-Thursday and 8 hours Friday, so I was ready to be off. I love and have connected to my patients, but I was exhausted. And this week I felt a lot more comfortable with my Kreyol. A lot of times, I don't need a translator. I asked all the translators to speak only Kreyol with me and for the most part they have been doing that. It'll help me to learn it a lot faster. We have a lot of medically sick patients who have diabetic foots or pressure sores, so they have lots of things that need paid attention to. And we had a BKA surgery that lost between 700-900 cc of blood (that's 3-4 cups of blood) and his blood count started as a 9 but dropped to a 4.5 and 15. He was pretty symptomatic, but it took 3 days to find 2 units of blood. Praise God he made it through and looks much better. I was really worried about him. Then we were dealing with getting all of our pressure sores uninfected and putting wound vacs on them. The only problem with wound vacs is the nurses don't know how to use them, so I'm constantly hearing the beeps and having to go fix then. Sandra, the 28 year old lady with multiple washouts of her femur rod, is still here. It almost stopped draining now, but they don't want her to go home until it's completely stops. I love her and her Kreyol is very easy to understand. I told her to come visit me again after she's discharged.

We got a 25-year old paralyzed male who fell out of a coconut tree. After they were almost here from 5 hours away, Dr. Terry told me the C-arm wasn't working. So, now he'll just be here for 2 weeks until they can get the parts & fix it. He can't do the surgery without the C-arm (it's an xray used in the OR). The patient is nice and I truly felt like him and his mom had nothing. Granted, I don't normally give people money because I can't give everyone money and I want it to be used right. I think God whispered to me to give him money though when he whispered to me that his mom hasn't eaten all day because they have no money. He came from Albert Switzer Hsopital. Which they told me was just stacked with patients. He came in impacted with stool, a terrible urinary tract infection, and a open infected wound on his forehead because it was never sutured. His accident was 14 January. I can see now why Dr. Simeon doesn't want this hospital stacked with patients, because the patients are not taken well of then. So we took care of all of that. I spent 1 ½ hours on Thursday and 45 minutes Friday disimpacting him. You tend to connect to these patients and families because you spend so much time with them. This is a hard country to be paralyzed, especially at the age of 25 with a child to feed.

I had 2 "Haitian female" experiences this week with 2 of the male translators (well all the translators are males) expecting me to make their easy mac and wipe their father since I was a female and most males don't do that if a female is around. I don't mind doing these things, but something about it is bothersome when it's expected and forced. I guess growing up in America, I have a hard time accepting that mindset. Women here don't know anything else. If I'm a stay at home mom, I'll do more, but if we're both working then we can share the work.

This weekend through Tuesday is the carnival so things are extra loud and it seems people don't want to work those days. CBM (our physical therapy group) said they had off, but I asked at least 1-2 to come in every day because I can't do their work and mine. I love to hear the sound of children playing or singing. I enjoy community living. And I enjoy being able to translate for myself. There were 2 nights this week we heard gunshots; it startled all the patients. I still get amazed at how people take care of each other without complaining (and they will help me with their family member or someone else's in the room if you ask). But, they can be very impatient. There also isn't much of a concept of organization and long term planning in this culture. So there are things I love about this culture, but also equally frustrating things.

Well, I just glad for these last 2 days to rest, study, fellowship, and relax. Cook for fun!

9 January- 5 February 2011

11 Jan 11 (0045)

 

What a day! I'm so ready to fall asleep after a long day. Except for maybe 2 hours scattered here and there, we were busy from 8am to 9:30pm with a transfer (a badly controlled diabetic patient with a gangrene foot & pressure sores) & 3 trauma's (bad motorcycle accident). I can say there is good teamwork among everyone. After showering & just going to bed, I got a call that one of our trauma patients blood pressure was dropping & heart rate increasing. Hemoglobin dropped from 13.9 to 8.8, but Dr. Terri said no blood unless less than 8.0 so we wrapped a new compression dressing and elevated the leg more. The nurse seems really attentive so I think he'll be watched well. And then, I helped Marc & Orphee with a 20-month old baby who died of anemia. Somehow Marc & I are functioning more like PA's or NP's.

15 Jan 11 (2115)

I went to the January 12^th services on Wednesday. There were hundreds of people at the memorial service our hospital put on, but no outward signs of morning. I worked 12-14 hours Monday and Tuesday so I was exhausted Wednesday so I didn't work much. I'm going to have to learn how to write dressing change orders in French to incorporate the nurses doing it because it gets to be a lot. We're doing lots of much needed surgery, but it can get crazy when we have lots of patients. I have to set my boundaries because I cannot work five 12-hour shifts. I start to become ineffective because I am so mentally and physically exhausted.

But I had a wonderful nights rest, went to service, and then came to visit Elisabeth and Servilus. Servilus bought his motorcycle so we rode that for over an hour all over PaP to reach their house. Let me tell you, the motorcycle was OK in the countryside but downright scary at times in the city because other people drive crazy swerving in and out. I wanted to close my eyes because of the dust, but I wanted to keep an eye on traffic so I forced them open.

Elisabeth is looking beautiful as usual, even in her pregnancy. She taught me how to cook rice, bean sauce, and fish. We cooked outside on the ground with a charcoal grill. I just love spending time with her. I wish she lived closer so I could come more often. We watched a theater production in Kreyol that was made in the U.S. With Elisabeth help, I got the main jist, but they spoke really fast so I couldn't understand everything. The mosquitoes are really bad at their house!! So after a bath, talk with Wilshaw, I'm ready for another goodnights rest.

Side note: I wrote a letter to Orphee to help her get approved for a visitors visa. I would love to show her around Lancaster, MD, Philly, Miami, & New York. I pray that if it's Your will, she would get approved and be able to visit me. She would come back & go around with me visiting friends. And I finally visited the little Haitian boy medical patient who had told the nurse earlier in the week that he liked me. I told him I would come back and visit, but I got busy all week. His name is Reme Leonidas. It's been fun seeing a lot of patients I know come back. Especially the kids, but I haven't seen Sondy or Denise. We haven't had any long term pediatric patients, which is probably a good thing, but I miss the kids!

The results got leaked- it's the lady and Micky who won 1^st and 2^nd place. Apparently there was a lot of ballot stuffing for Jude Celestin. I guess now it's up to the Haitian government to decide if to accept these results. There were some small riots thursday, but nothing today when we drove to Servilus's place. I like how I'm starting to recognize where I am at. I still couldn't get around on my own nor would I ever want to drive here.

Brian, Marc & I have been having fun with the P90X abd workout & cooking. I'm getting used to the rice & beans, cold showers, and mosquitoes. I feel like I'm home.

16 Jan 11 (2154)

It's an interesting experience learning to cook from the basics. The food is delicious. I feel that my Kreyol is slowly but surely improving. The one Haitian American volunteer asked me this week if my boyfriend is Haitian because he said I speak it well for not being Haitian. That's a great compliment for me :) I tend to pick up on whatever accent I'm around. Robenson had to fix the motorcycle so I'm staying overnight and leaving at 5am. I pray that my devotional thought tomorrow will reach or touch at least one person.

17 Jan 11 (2300)

How wonderful it is to be safe, well fed, have a shower, and warm bed. But God is more than just my provider. He's love, righteousness, Holy, merciful, omega & alpha. I like the quote Marc said, "Seek God's face, not just His hands." Today was busy, but not too stressful. And I got to fit in talking with co-workers, exercise, making dinner, and talking to Wilshaw. The one nurse was telling me about a patient, but I didn't know the word I wanted to say back, so I got Mac to translate and the nurse said, "Li pale Kreyol (she speaks kreyol)". I have had a couple nurses say that if I bring a translator. But I still do have a fair amount to learn. I feel it helps me connect better to the co-workers and patients.

18 Jan 11 (2340)

Today was a testing day on my patience- a drama queen patient that was refusing to do what we ask and then refusing to leave. I had to get security involved, and guess what? They didn't leave, but stayed overnight in a cot in the hallway. I told the nurse she wasn't a patient and didn't need any nursing care. And a lot of strong emotions today. Only God knows what is best and the outcome, so I have to put it all in His hands.

20 Jan 11 (2341)

As tired as I may be, I still need to be thankful for everyday. It was a calmer work day. Even though I may not be fulfilling a floor nurse positions, I'm learning a lot of other random skills to help me as a nurse and life in general. Like coordinating care, finding beds, teaching in another language, and learning what is normal. Like tonight, we had two big surgeries that can bleed a lot, especially if not elevated, so they weren't elevated. Back in the states, I would have worried more, but I know the normal now and just compress it and elevate it.

I lift up our meeting tomorrow with Dr. Terri & Dr. Simeon to set our goals, concerns, & protocols. All in all, we can't operate in earthquake mode anymore. I pray for respect to the hospital medical director's wishes now. We have 4 ortho surgeons coming next week so it'll be busy.

21 Jan 11 (2327)

You provided me a miracle and blessings already on this sabbath. I had the nurse change the C4-C5 Quadraplegic's catheter because he had the current one in for 1 month (one not made for long term use) and he was starting to have fevers. Well, I decided to check on it (I just had a gut feeling about it not being in right), and I came in 4 hours later & noticed there was no urine in it. So I got the supplies to put in another one. I deflated the current balloon & pulled the catheter out & it started bleeding profusely. I put pressure on it, but it wouldn't stop. (The balloon had apparently been blown up in his urethra instead of bladder so it broke the lining...and he has no sensation so he couldn't feel it). I was getting nervous because it was late at night & would be hard to get urology service. Thankfully Sophie (the ER MD from England) was walking so I had her come in and try to stop it. She placed a new 18-gauge catheter and the bleeding stopped! Praise God because if it didn't, he would have needed urology surgery. I have to appreciate families here, because instead of panicking they helped as we asked. And then they got the patient (their father), all cleaned up after the mess.

I saw Sondy today and I was so glad! He didn't act like his playful self though. I gave him the picture frame and colored pencils. It seems he will be back again for a couple more cast changes. He told me our little girl patient Denise is supposed to come back March 14^th. Besides her, I've seen all the patients I've printed pictures out for. I love seeing patients again! I realized I haven't been sharing patien stories recently. I've been working long days & my brain is tired by the end. But, I shall try to start doing that again.

It's been a brand new year & way of doing things. We're not taking large short term teams & it's been better just having 1-2 ortho MD & 1-2 anesthesiologist. I've been basically functioning as his PA, bed monitor, and coordinating things. I am trying to work with the Haitians nurses & nursing directors. I definitly feel my role now and it's sure busy. Apparently, Marc brought it up to Nathan to see if I can get a stipend. I am praying about it, but I could be more effective being here for 1 year.

25 Jan 11 (2300)

I have spent way too many days without quality time with God. Sunday became a challenging & busy day. I woke up feeling sick and when we rounded on a patient she looked very sick. I had a Haitian MD look at her & he said septic shock. So he ordered some things & then we had a meeting with Dr. Simeon. The meeting went OK- still have more to compromise & collaborate.

Then, I went to look at the patient again & she was no better. So we got Dr. Simeon involved. The patient ended up being in septic shock (Tempt was 106 degrees Fahrenheit, BP= 45/35, HR 130); she had dry blood in her mouth so the guess was she was bleeding in her GI tract because her H&H= 3.3, 10%; and she was in diabetic ketoacidosis (Glucose was somewhere between 500 and 1000). She had came in with a diabetic foot ulcer that went gangrene. I believe her husband took good care of her but had no money so he couldn't take her to see the doctor. A foreign run clinic was the one who found her and brought her to our clinic. They amputated that foot, but later also had to amputate the other leg because of another sore under the knee that went down to the hamstring. She also had multiple other sores from being bed-ridden on top of other medical problems that we probably didn't even know about. So she should have been followed medically & just consulted ortho, but the family couldn't afford to be followed medically. She didn't have too many signs of problems (or they nurse never told us when she started spiking temps) so it seemed to come on quickly. So needless to say, we were running around trying to save this woman's life. I was up most of the night watching her and then worked 9 hours the next day. Marc watched her Monday morning. Her hemoglobin came up to 5.5, BP up to 75/40, but she never woke up. Her family asked us to cease treatment so they could take her home to die, but she passed away before that happened. The husband said she has been suffering for so long and maybe this was God's way of ending her suffering. I'm glad he saw it that way, but it was hard on me because I felt like she shouldn't have gotten that far advanced in a hospital. She eventually would have died of sepsis or something else in the next month or two at home if she didn't come in, but the surgery exacerbated all her medical problems.

It's a hard thing here because if patient's can't afford it, they can't get treatment. Dr. Spendie said she will see them, even if they can no pay, but that's out of her pocket & I don't want to do that often. The CBM (physical therapy techs) explained that a lot of times in Haiti people don't come to the hospital or they come too late to save them because they don't have the money (or they try voo-doo first). It's hard to understand & swallow, but there is no insurance so this private hospital can only do so much free service without going bankrupt. It's just a different challenge I face here that I don't face at home.

The new team here, 4 ortho surgeons, seem nice & cooperative. They did a lot of surgeries, but made sure we had enough beds for everyone. I got really frustrated mid-morning because we got 2 more diabetic foot ulcer patients that couldn't afford to be followed medically. I didn't want anything to happen like had happened to that other lady who died. Now that I running into this problem more frequently, do we accept these patients without a medical doctor following them. We take a risk every time in doing so. They both need amputations too. So, Marc helped me realize there are no policies yet for this situation so I can't stress myself too much but help to try to make a policy. So that's something new I will never do back home as a floor nurse. Marc said I was the "hospital wife" lol well, I'm learning. Policies & procedures when not taken to extreme are a good thing.

We have a C4-C5 quadraplegic patient here for 1 week (the one I described above with the foley issue), but he's spiking high temps too, so we changed him over to be a medical service patient. We don't want to mess around with time with him because he's so vulnerable. I loved the one patient's daughter today. She was so amused that I speak some Kreyol and wanted to play with my hair. I got her a bible study in French because she wanted a book. I forgot to mention that a lot of patient pronouce my name, "Linz", but I don't mind because I can't pronouce all of their names either.

We went out to eat the Oberge, the local hotel restaurant, the last 2 nights. It just feels good to be somewhere else but the hospital.

27 Jan 11 (0021)

I thank You so much for a calmer work day today. And for the doctors willingness to help with anything. They really helped me with writing orders, dressing changes, and whatever else. So I'm learning how to handle the day, how things work around here, and what things I can work on changing for the better. With teamwork, this hospital really is going to function well. Hopefully it will provide as much spiritual care as physical care. As challenging as it will be to be away from Wilshaw for a year, this is a wonderful opportunity for me to spend 9 more months here. The hopefully be conversational in Kreyol; to understand the system and work with everyone to change things little by little; to have time to develop better friendships; and to hopefully grow closer to God. There are very exhausting, frustrating, and challenging days but those are times I need to remember that will help build my character to be more like Christ.

But, all in all, things I'm learning and doing, wouldn't happen in the U.S. as a one person role: Working more alongside the doctors; knowing all the staff including the medical director, working so closely together towards a change; learning how to make things work when you don't have everything you normally are used to using; learning how to deal with patient's who literally have nothing;  learning time management; bed placement; PA skills; having group exercises & meals; meetings lots of amazing people; etc! So I praise God for this opportunity. Granted we are living fairly decently here (running water & electricity). It wouldn't be safe for us to live somewhere random in PaP in tents. I wouldn't mind living in a tent, but not in PaP. It would probably be OK in the countryside.

It was interesting learning the water filter system & process to fill the water bottles. Too much clorox was put in the water, so Brian fixed it and taught us how to check the water to fill the bottles. Quite the process to get clean water- but nothing compared to what others in this world have to do to get water. The water here comes from the stream & some city water.

Our quad patient was told by me today that he wasn't going to need the surgery for the fracture to heal. I guess he thought he would have normal function again after a surgery, so I had to break the news to him. I've connected with his family and they are taking as best as care as they know. I know it will be a challenge though. He was having unknown high fevers, so they took him to the OR to debride the pressure sore. They said it was badly infected under the eschar and that if it wasn't debrided soon it would have killed him.

We have 2 new long term additions to our team. Brittany is a lab tech & Z.J. Is a social service year MD that is from America (parents are Carribean), but studied medical school in Mexico. So it's fun to have them :) I feel that we have the right combination of long term (1 year) foreign staff here and with the Haitian staff, we'll get this hospital working. We have Marc working on nurse education; Randy is an electrician & his wife is helping wherever is needed; Nathan is the assistant adminstrator & Amy is helping with whatever too (very needed!); Brian is the architect; Terry is the ortho MD & his wife Jeannie is functioning as an OR nurse; and Jamenson is working in prosthetika (where they make limbs for amputees). I don't think I missed anyone.

29 Jan 11 (1609)

It was a great week and wonderful team to work with, but I'm glad for the sabbath. The team took us out to eat. It was a good time to talk and laugh together. Today, we are heading to the beach. I was so happy for the 2 couples that never seem to get away, to get away. They all work long hours & don't have much time for themselves. We all need to work on balancing our time. Life is full of balances- work & rest; exercise & relaxing; time alone & time with others, etc. I pray that God can grant us the wisdom to know boundaries to set. The hard part is there are lots of people who need surgery (even surgeries from earthquake injuries that never resolved or the rods are malunion, etc) and not as many places that offer orthopedic service. So we're serving a large percentage population of the PaP area. Most MSF & other NGO that had orthopedic services are shutting down now.

Driving outside of PaP makes me really miss the countryside. Fresh air, less congestion & traffic, people are nicer & not so much in a rush. I think cities sometimes make people more rude, liable to sin, & puts them in over drive (constant stimulation). It would be nice to be more out of PaP/Carrefour area, but that is where God has me for now. I can live through most things for a year. We had to take an alternative route because there is some unrest & turmoil in Cite Soliel. So now we went the long way past Robenson's house, but I'll take over any disturbances.

30 Jan 11 (2350)

I am so grateful to come before You this evening. It's been a fast day! I was teaching some nursing students how to dilute the morphine 10 mg/mL into 1 mg/mL and how to give it. It took awhile to explain, but I think she understood mostly. The next day she & all the nursing students wanted a picture with me so I guess they were OK with me. Their white uniforms & hats make me giggle. So glad I never had to wear that!

31 Jan 11 (2220)

Lord, life is so short & our lives can be taken away at any moment. This past week has taught me that. We had another patient die today. He was the 55 year old quadriplegic patient I explained earlier. He was in a motorcycle accident on December 25^th. He was seen by a hospital, but sent home. They brought him here January 19^th in hopes of doing surgery on his neck. They decided he didn't need surgically stabilized; that it would just heal by a brace. In the meantime, he came in with a huge pressure sore (bed sore) on his coccyx (it was all covered with eschar). We were just doing a wet-to-dry dressing, but then he started spiking temps that they couldn't find infection anywhere else & it started draining foul smelling green drainage. So they debrided it 2 times in the OR and it was fine. Today, around noon, we changed the wound vac at the bedside and the wound looked good (no signs of infection. It was deep stage IV down to the bone). But his vital signs were good that morning and for the last 3 days. I reemphasized that the patient will never walk again because his nerve had been damaged and that can't be fixed. I told him & his family no matter how the bone is fixed (by surgery or by brace), that won't make him walk again. Because they were thinking of taking him to another country to get the bone surgery, so I think this was the first time they actually understood why he could never walk again. No more than 30 minutes later, his family found me downstairs to tell me he's not breathing. I got the doctor up there & gave him an ampu bag while I ran to look for other supplies. I ran around for 10 minutes (because nothing is organized here) but the minute I got back up, the anesthesiologist pronounced him dead. They had all the intubation supplies there but it was too late. Everything just happened so fast, I didn't know what to think. I had never seen anything like that. Someone who was stable, just stop breathing. They think he either died of a pulmonary embolism (a blood clot stuck in his lung) or his neck got turned the wrong way & the nerve that controls the diaphragm was injured. I think it hit me so hard because I had just interacted with him and changed his dressing.

Some of the translators were saying that this patient had told them he couldn't live like this anymore. It was a lesson to me, when I give really bad news, that I should offer to pray with the patient after wards. We can't wait because we don't know, they could die anytime after. It was a hard lesson for me and we did pray with the family after he passed, but we never can bring back the chance to do it beforehand. When I was taking out his foley & wound vac, I had the son help me turn the body, but his son asked to leave because he didn't want to see the wound again. All I could do was give his sons a hug because I had spent time with his family & gotten to know them. After the family left with his body (it's the families responsibility in Haiti to take the body in whatever transportation they can find, including the tap-taps), I found a letter under the head of his bed. I asked Orphee to tell me what it said. She said it was a prayer, but not to God. She made me throw it away right away because I think it was some type of voo-doo saying. The patient's pastor did come & pray with them, but I've heard a lot of people practice Voo-doo while claiming to follow Christ. So, all I can do is lift up with family in prayer to God, our rock & redeemer. 

 

3 February 2011 (0630)

Yesterday, the medical team had a shorter day (in that, I mean a normal 8 hour day lol) so we cooked for them. It's nice to have a group here 2 weeks because they adjust to how we do things and it makes it easier for me. At first, we were worried because it was a big group and we weren't sure if they would try to cooperate with how we do things now. But they have been very respectful and helpful. And I've learned many things from them.

I stayed up later because a dislocated shoulder came in while I was downstairs trying to finish the census. So I got Terri & I assisted him put the shoulder back in place. The electricity went out when we were trying to insert the IV. That always makes me giggle. I also had to be the translator. I can get by if I need to. Well, time to start the day!

4 February 2011 (2200)

Starting the sabbath off right has been a blessing- finishing cooking by sunset; a vespers bible study gathering; and enjoying our meal together. I'm glad for this group of young believers! It's college roommates, only an added bonus of spiritual accountability and growing together. There is something so peaceful about spending a quiet evening with God. Tonight, I was thinking about how powerful words are. How, 30 minutes after I explained to the paralyzed man and his family that he would never walk again, he died. While he probably died of a PE, I think he also gave up on life. I told the guy I was sorry after I told him the bad news, but the better would have been to pray. I need to be in more constant talk with God throughout the day- no matter how emotionally, mentally, & physically exhausted I am. Help me to be patient even when I'm tired and frustrated. God, open my eyes to others need and not just to focus on the busy work. Help me & all of us to reach people in the truth.

2 Jan- 8 Jan 2011

2/1/11 (1524)

Awesome redeemer, healer, creator, and our perfect Father. How glad I am to come before You today. What a bitter sweet day- saying goodbye to Wilshaw for another couple months, but excited to continue my time in Haiti. I thank You for safe travel and just another day to be alive. 84 degrees in Haiti- going to feel hot again now that I've been in weather below 65 degrees the whole time. Not really looking forward to the craziness at the PaP airport, but it will soon be over and i'll be back "home" again for a little. I was nervous about my Kreyol being really rusty, but I actually could still understand a fair amount on the airplane, so I know it will come back to me.

Wilshaw & I enjoyed our last evening together. I had one last S'more we had by the fireplace. Five am came around early, but after one last warm shower and baked oatmeal I was awake. Well, the flight is descending so I'm going to look at the beautiful islands and mountains!

4/1/11 (0650)

Blessed Savior, how wonderful are Thee. You allow me to sleep and then wake up again, even if I am tired. If I choose to stay up late then I have to sacrifice my sleep and not sacrifice spending time with You. I can't get away from that because I want to grow closer and closer to You. I thank You so much for a wonderful day yesterday working and seeing everyone again! As well as a couple new people. Marc, Brian, & I stayed up until midnight catching up and talking. I am glad for a group that we can talk about personal things and not be judged, but instead we can encourage each other in the word of God & speak truth in love. I pray for us all to stay close and grow with You everyday. I pray for our individual and group ministries here. May we pour out blessings unto others.

It was such a wonderful greeting from all of the Haitian staff. Hugs & kisses and genuine gladness to see us. I don't think all of them knew who was coming back. I pray for guidance in my position to be led by You and to truly blend myself with the local staff. I pray all these things in Jesus Christ name!

8/1/11 (2343)

I guess I haven't written in my journal for a couple days! I haven't worked in almost 4 weeks so it took some readjusting to get back in the swing of things & fit everything in as well as working. We had a orthopedic MD and anesthesiologist for 1 week and they have been wonderful to work with this week. They adjusted to how we do things now, showed us a new exercise machine, and lead a bible study. For some reason we had a lot of no-shows on surgeries this week, but we could provide a couple much needed surgeries and adjust to being back here. We had a spinal cord injury patient come in Monday. He fell out of a tree on December 26^th and had some deficits since the fall. They wanted to surgically stabilize him and minimize long term deficits.

Good thing we weren't as busy this week because I spent a whole day getting 2 units of blood for his surgery. And we tried lots of different things to get him to have a BM. Nothing had been done at the other hospital, so he came in to our hospital very impacted. So now, we'll have to figure out a regime for him so he doesn't get that way again. So for the blood, the family had gone the last 2 days and there was none at the main Red Cross. So I called around for about 2.5 hours until I found a place remotely close. Then Richard drove us over (about an hour drive) and we waited 2.5 hours to get the blood, but praise God they had 2 units! I took Mac with me because we had to ride the tap-taps back (public transportation). We took 3 different tap-taps. Boy I would have never known what I was doing because we were all over the place! We payed a total of 75 gourdes for all 3 rides (about $2 US). It was an eye-opener and learning experience for me. The things people here have to go through to get the basic necessities, or what we can easily get in America. In Haiti, it's usually the family that gets the blood and brings it back in a cooler. The only reason I went was because we had to do the surgery by Saturday (because the OR nurse and anesthesiologist were leaving Sunday) & the family had tried the last 2 days but they had none at the other places. We didn't want to risk not getting it that Friday, so I went instead. It was a new experience for me having to do it. 

But, all in all, the surgery was able to get done! They didn't need the blood, but it obviously was better to have it than not have it in emergency (because you can see how long it took me to get blood.). So now we have 2 more units of non-expired blood. We only had 5 out of about 50 units (bags) of blood that was not expired in the hospital fridge (none that was the patient's blood type). It took me about 30 minutes to go through all the blood to look for some not expired, so Lucia helped me to properly discard of the expired blood because it wasn't worth keeping all that expired blood in the fridge. Hopefully we can put a system in place for blood- and try to give it to other places if it's about to expire if we don't need it.

This afternoon (after my 3 hour nap), we hiked up the mountains (Sophie, David, Gerry, & I...Sophie is the ER MD here for a couple months; David is the anthesiologist here for this week; and Gerry is the ortho MD here for this week). It was so beautiful! We met a guy Amos who guided us back to the right road to get down. I got to speak to Wilshaw for awhile then.

I'm readjusting to the cold showers and mosquitoes! My fan went "walking away" while I was gone, so I need to buy one because it's certainty muggy tonight! Kim (a physical therapist) said something that I didn't think was really noticed that I was trying to do, but she said "You're really working alongside and together with the Haitian doctors and nurses, which this hospital hasn't really had in one year." so I pray that You would be my guide as nurse "coordinator" (as Marc put my job title) and to keep Your will for this hospital. 

Another thing that Mac (one of the Haitian translators) noted when we were sitting in an actually very nice medical facility in Delmas 33 waiting floor the blood was that there was a leak coming from the ceiling over the door. So with everyone's dusty shoes, it made the floor muddy. So the cleaning guy would sweep it up every once in awhile. I saw some of the Haitians sitting there point out the leak to him. Mac said "You see that's a problem in Haiti. Instead of actually fixing the problem, they just clean up the mess." Interesting way to look at that, and I pray that will change. Well, it's midnight! Time for bed!

My break in America Dec 7-Jan 1

12/12/10 (1037)

    Even though I'm a little saddened that I won't be going back to Haiti for awhile, I know all things work out for God's good. I printed out pictures to give to some of the patients and I'm not sure if I'll see them again because I don't know when I'll be returning yet. As well as to say goodbye to some volunteers not coming back. But, I can still praise God for the warm (and cold) weather, safety in Haiti, for rest and for work. I do not want to be idle during this time, so show me ways that I can serve You. I am enjoying my time with Wilshaw, but the days seem lonely by myself because I'm always used to being around people all the time except for my bible study time. It's good to have time just to yourself, but I love community living and the supportive Christians in walking distance.

     I can tell it is going to take much longer to make close friends when I return because of not living in a community (like you do in college) so you don't get to get to know each other as quickly. That's why the transition after college was hard. I enjoy community living! We don't have to live in the same house, but same neighborhood to easily meet up to share food, exercise, discuss the word of God, etc. I have been growing close to God and learning so much about His word this last couple months. I pray that you open that opportunity up for Wilshaw here in Dallas and for when I return.

     I lift up Haiti now. Lord, only You know what is going to happen in these elections and in general. I pray hard against the use of violence to prove their points and get their way. I pray for all the innocent people who have to suffer because of a couple people causing violence. I understand the frustration (as much as I can for it not being my country) because the people have been lead by very corrupt presidents in the past that have not attempted to help them. And the situation since the earthquake has not really improved- now they also tackle cholera. It's sad that violence seems to be the only way they know how to show their anger and frustration over it. All the roads, shops, and airports are shut down. So now most people cannot work and therefore won't have necessary money for food and clean water. And aid organizations will start pulling out if the violence gets bad so then there won't be much needed medical care, especially for the cholera outbreak.

     So I pray that God's truth and gospel be heard among the turmoil. Without a change of heart and change of masters (God over sin), then not much will really change in Haiti. I lift up the true followers of Christ in Haiti as they suffer because of their fellow man's corrupt ways and as they preserve in the truth. May they find refuge and peace in Your promises. They will one day suffer no more, but live in eternity with You. I have met so many wonderful Haitians- to numerous to name them all.

     Lord, You know my heart and my desires, but I will trust that things will go according to Your will in terms of when I will go back to Haiti and a future job back in America when I return. I will be excited to come back to America, but right now I feel slightly unsettled here because I feel that God is not finished with me yet in Haiti. But I should gladly receive the blessing of time here that God has given to me. I should rejoice and be glad in it, for each day is a gift.

13/12/10 (1721)

     How grateful I am for this day. Through the temptations and the joys. I thank You for the Holy Spirit's guidance and Your word to study. It's so great to study history. And to see the examples of men who claimed to be Your children in godly and ungodly moments. We are also called to be the light & salt to this generation. I pray that I serve God in my words, actions, thoughts, & behaviors. Guide me to make my talk about Haiti this Sunday to reflect Your work through me in Haiti. May I take none of the glory.

     I've been picking up things for our kitchen in Haiti, gifts for Gamide, and pictures for some patients & friends in Haiti. I'm so excited to give the little gifts out. People carry a few pictures, but it's hard to come by pictures in Haiti so I'm so excited to give out these pictures! But whew- it's different being back in the consumerism culture and driving! It's scary getting on these highways in Dallas because people drive super fast and expect you to force yourself on instead of making it clear that they're letting you on.

     Well, it's time to practice my Kreyol and make lasagna.


14/12/10 (1212)

     How excellent is God's name and truth. How we might fill our lives with temporary things that make us feel "good" or happy, but how short-lived they are compared to eternity with God in Heaven. Where there is true joy, peace, and love; and no more mourning, pain, or death. The reason You gave us the prophecy in the bible is to foretell us of what is yet to come so we can prepare ourselves. The devil knows Christ's return is coming, so he's fighting hard until his doom to bring as many souls into misery and final death with Him. It aches me to know so many people who don't believe or accept the truth. I hope to be a good friend to them in sharing the gospel, not just in words, but in action.

     Lord, that is why no matter how many things are on my "to do list," I cannot compromise my time with You. I can cut out other unnecessary things. In bible study today, I read about Absalom's revolt. The theme taken from it was often things are not what they seem. For example, a smile covers an aching heart. As God's light & salt on this earth, I need to be open & sensitive in order to look beyond appearances in order to see people and situations for what they really are. This can be difficult because it takes time & effort to be a good friend as well as emotional energy in bearing in others burdens. Sacrificing ourselves to help (people other than family & friends) is against our fleshly nature a lot of times so it can be tough! But even with family it can be hard at times.

15/12/10 (1143)

     Wow! The more I study God's word, the more I love God and have a better understanding of this world & my life. There are so many ways people try to disprove the gospel, but the truth will be made known one day in visible view to everyone. Help me to guard what I watch and read. Grant me understanding of what people believe so that I can relate to them and know the best way to share the gospel.

     Thank You for placing Jenny in my life. A Christian nurse who works at Children's hospital in Dallas as a clinical nurse educator. She volunteered at HAH for 1 week in November. She gave me a tour and then explained how best to apply to the ICU's or floors. Apparently to work in the ICU, it would best for me to have peds or ICU experience before. So the options are to go through an internship program (with classes & longer training) to prepare me for the ICU (it's for post-grads or people like me who did adult nursing & want to switch to peds) or to start on a Peds floor first. It would start in June if they discover a need for more ICU nurses. Jenny said she loves working there. So I'm not going to worry about it, I know God will provide something for me where I will be the most effective as a Christian nurse.

16/12/10 (1153)

     Gracious Father, I am so thankful & glad for this chance to visit my family. Allow me to be a blessing to them, and not use this week selfishly. I'm the one getting a 3-4 week break here so I should be serving them in anyway. I was glad for the 75 degree weather we had yesterday. Wilshaw and I got to eat outside and sit in the hot tub. Boy, did that feel good on the muscles. I've been having a great trip home- got some sleep on the first plane and did bible study on the second plane ride. I am almost finished with my photo album for Sondy, Gamide, Grace Orphanage, and Robenson's wedding. Excited to give them out!


17/12/10 (1021)

     It's so nice to see my family! And even though it's really cold, the snow is beautiful. But boy am I glad for a warm house. I get to spend the day with my Grandma and my Aunts.


18/12/10 (1006)

     I am grateful for this day of rest, service, & worship (well I should say week and a half of rest). Today, I will be helping my sister out with her school project. May I use today to serve my family with love and to honor my parents as God has asked us to do. It's been fun going on walks with my parents and Roxie. I stopped by to see Chris, Maria, & Greg. I love catching up with friends & family.

20/12/10 (1123)

     I am so glad that I go to see my loving church family yesterday and to share what I've been doing. I was so happy that my whole family came too. We all worked together on Mary's projects afterwards and had a wonderful meal. Grant Mary & I the nursing knowledge needed for these care plans (brings back my college days) and projects. But, Lord, I lift up a request to fend the devil off because he is really trying to distract me right now. And I like how Pastor Steve said, we, as Christians, can't say "I can't help myself" because we have the power of Jesus Christ and the Holy Spirit to fight it off. I want to think of what is holy, pure, & righteous.

22/12/10 (0847)

     How great and magnificent is God. You make the sunrise and set everyday, as well as our heartbeats & breaths. So no matter what is happening, I can still praise You and seek You. I thank You for yesterday to spend chatting with my Grandma, organizing my finances, and spending the evening with church friends. It was fun to see Joe and Alison; I haven't seen them in years! I exercised with Mr. Dixon in the morning. Last night my parents & I went to the Dixons for a game night and chatting. I love it when my family sits down together for meals or games.

     Well, time to begin this day. Lead me, O gentle Savior, so that in all that I have to do, I am still representing You and serving You. Not just doing busy work with a stressed attitude. There is no point to a "to do" list if I'm not glorifying You with it. Which reminds me I need to call my Grandma Fleur again because I felt like I was busy with other things when talking to her yesterday and didn't represent Christ in that instance.


23/12/10 (2331)

     I am so thankful for these 5 days to spend with Mike and Wilshaw. And for our family Christmas celebration last night with dinner and playing games around the fire. It is such a joy when I can just enjoy time with my family. As we get older and our schedules are different, you learn to cherish those special moments. Like doing errands with my dad in the morning and eating lunch with my mom at her work. Lord, continue to give me wise choices with my finances. Relying on donations gives me extra accountability and I pray that I use it wisely.

     Mike and I had fun traveling to Dallas. We explored the Chicago O'hara airport. It's like a museum in there! And they have one terminal that has a light show on the roof and relaxing music. I could have sat there for awhile and enjoyed that. Then we enjoyed a game of spit after dinner. I just love hanging out with Mike- the simplicity of having fun and chatting. Well, the flight is descending. I just realized I've probably ridden as many flights this past year than I have my whole life. Don't think I'd want a job where I had to fly all the time though.


24/12/10 (1146)

     Savior, as we look forward to celebrating Your birth, I pray that we truly reflect on ourselves and think of others above ourselves. I can see my spiritual growth as well as things I still need to change to grow.I don't want to be a lukewarm Christian. In revelation 3: 15-16, Jesus says "I know your deeds, that you are neither cold nor hot. I wish you either one or the other! So because you are lukewarm- neither hot nor cold- I am about to spit you out of my mouth." I want to follow Christ no matter what the cost. I lift up the Christians in Iraq in other parts of the world that are being persecuted, even killed, for claiming faith in Jesus. May You give them hope and peace so that they will see the future life for believers. It gets me thinking, would I really openly claim to follow Christ if I could be beaten or killed for it? I hope I would.

25/12/10 (1600)

     Rejoice, Rejoice~ Emmanuel was born. We celebrate the miraculous birth of God's only son, Jesus today. It can be easily drowned out by the business of planning, cooking, services, shopping, decorating, etc. But to truly sit and contemplate on the miracle with each other and what the birth brought to us. Emmanuel, Savior, Redeemer, and Friend. There are so many wonderful ways to describe Jesus.

     For me, having a year away from decorating and shopping/making gifts has been a good way to change it up. Don't get me wrong- I still enjoy those things & will be excited for them next year. Other traditions, such as having peanut butter kiss cookies on Christmas Eve, were a little different this year too. The 3 of us had dinner by candlelight and fire. We then sat by the fire and enjoyed its warmth. We had a little bible study and made s'mores. It felt nice to go to bed early. I thought we'd be up by 6am, but we slept until 8am.

     We had some delicious baked oatmeal before out way to service. I enjoyed hearing Your story and promises. You are not distant, uncaring, fickle, or angry God (using that term as a God who just seeks to destroy us. Yes, you will judge us according to our works, but You desire us all to accept Christ's sacrifice in order that his blood will cover our sins and we can be saved). We went on a walking trail through downtown afterwards. We saw a couple people, but for the most part it was empty. It will be another wonderful evening to relax and enjoy each other's company.

     Lord, I am still a sinner in need of your grace. My thoughts are still sinful at times. And I think the devil knows what tactics to use to try to get me to sin. And I think he tries harder when you are growing closer to God. But I know he's been defeated, so I pray for You to guard my mouth, mind, and soul. Help me not to make any haste decisions in sin. Help me remember I representing You every moment. I think of the girl at LCOG who wants to be a missionary when she's an adult so she looks up to what I am doing. And having the financial accountability really makes me have to not take my decisions, thoughts, & behaviors lightly. People know I call myself a Christian and they are watching. It's good though because accountability helps keeps us on tract (and get back on tract if you veer off the path) and can help you stay focused knowing others are watching. If I keep my thoughts on You and take the necessary precautions to avoid things that lead me to temptation, I can stay on the righteous path and Honor You. Thank You for Your Son, Jesus, to take away my sins when I don't do that.


28/12/10 (1130)

     I am having such a fabulous time with Mike and Wilshaw- cooking together, building fires, rock climbing, seeing the Chronicles of Narnia movie, making cookies, chatting, sitting in the hot tub, and going on walks. All 3 of us getting together won't happen as often as I'd like, so I like to cherish these moments.

29/12/10 (1548)

     Even though I've had a great time visiting friends & family, I am ready to go back to Haiti on Sunday. I've gotten more than enough time to rest, spend time with friends & family (well I can always have more of that), & shop for some food to take back. I've gained back the 10-12 pounds I've lost, which I wanted too. But it's just funny how 1 month in America will do that to ya again. And I'm not exercising any different here- so it's definitely the diet! Now, I just need to prep myself for the cold showers, mosquitoes, and rice & beans!! But the team coming back has had lots of time to refresh & rejuvenate. Because of the presidential elections still up in the air, they are not taking any short term volunteers at the Adventist Hospital. So it will be the Lindsay's, the Dietrich's, Marc, Brian, Sarah, & I. We have had good teamwork in the past, so I pray that we will continue to work together as a team to serve our God. Give us the strength, courage, & wisdom to do Your will at Hopital Adventiste d' Haiti in this new year, 2011.