Stories of September

-Riding 5 hours on a motorcycle with 2 other people to cross the Dominican border to get my passport renewed. Beautiful, but returned with sore knees & a dirty face (literally). Corruption at borders is no joke...they warn you to not let people take your passport. But I figured once I was in the building by a desk that wouldn't happen. Someone professional asked for our passport and 50 USD (someone told me it was 40, so I figured the price just went up). Joe, a military guy, only gave him 40 to see what would happen & saw the guy pocket it. So Joe of course approached him while I translated...although the guy pretended not to understand me but with Joe there he gave up! The real worker only asked 10 USD, which could have been pocketed too who knows. Then, get our stamp into Haiti again, I was passed but then they tried to ask Joe for some money. So I came over & asked why Joe was getting charged but I wasn't. The guy gave me a look and stamped Joe's passport! Wow- pocket money for these people!
-We're basically trying to help this hospital run like a real hospital with policies & procedures because it's poorly run. Not an easy or fast task to change things that are already run, especially when you are met with resistance. Starting something new is probably easier.
-I'm glad I found someone in the choir to connect with, Jorene. I enjoy going to the choir, singing, & learning more Kreyol but I have a hard time connecting with them. The educated and better off Haitians are actually slightly harder to connect with than other Haitians. Although the tough part with the super poor is you feel like you don't have enough to give them all what they need.
-The hard part all in all is filtering who is just using you and who really needs the help. And just wanting to be friends sometimes.
-RAIN: something Haitians are afraid of. Twice now, they have said you better not go out it's going to rain. We smiled and thought, silly it's not a big deal. We left the grocery store no more than 10 mins after the rain started (deciding to leave instead of waiting inside like the rest of the Haitians) and we were taught a lesson. The road was completely flooded about 1 feet & flowing fast. We were going to risk crossing the basically sewer water, but decided against it. I guess we should have listened to the Haitians.
-We received another spinal patient, 33 year old male, that was struck by a car driven by his friend while he was playing dominoes on the sidewalk. He's almost a complete paraplegic, but still has some sensation. It's always hard and has to be repeated that he probably won't walk again. I get so connected to these patients and family. But out of all of this, his biggest concern was could he have sex again because he doesn't have kids yet (people aren't shy about this subject in Haiti...they shouldn't be. It is a medical question).
-I'm getting lots of practice with bowel & bladder regime, pin care, wound care, etc. Seeing what works best in this environment. I think I need a wound care class though! Unfortunately Haiti (no by choice, but because of neglect & unsafe care) becomes a "testing" ground for what happens you do this wrong or don't do it. Won't go into those stories though...I love the Haitian nurses, but the work ethic needs working on. Sometimes I have to choose safe patient care over being friends with nurses (some of them get offended & annoyed with me now)
-Calling patients on the phone is funny but frustrating. You have to repeat things multiple times and I even had his dad yell to his kid "how old are you?" when I asked him how old his child was.
-People do not wait in lines here. It's not considered rude to jump ahead...it's like survival of the fittest here!
-I've now seen 3 people die of pulmonary embolisms (blood clot in lung), and 3 people get small ones. And almost all of them were femoral neck or pelvic fractures! Ugh...the reason I don't like getting these fractures because they usually come in 1 week post injury and very high risk at that point for blood clots. Last guy ended up being a U.S. Citizen (the family conviently left that out until they wanted to take him to the states)
-Oh what a joy it will be when you tests can done properly, on time, & the lab doesn't run out of the supplies (not because it's not here...b/c the manager isn't keeping track & buying a stock before the other one runs out)....I guess it just building my work character to tackle these challenges.
-I'm sooo sad I had to miss my close cousin, Steph's wedding. Happy for her and Ray :)
-They finally did the spinal surgery on that guy. He's been slow to get moving for therapy. On Saturday night, I came down when ZJ & Emily had him sitting up. His sisters asked me to read Psalm 51 and then pray. I did that and instead of wanting to lie down, he asked us to slowly let go so he could sit by himself (he was putting all his weight on ZJ). And He did. Never underestimate the power of God through His word and prayer. I love seeing them go from depressed to slowly accepting what has come their way. In the states I was often too nervous or afraid of being judged or ridiculed by co-workers to pray with patients. I'm sorry that I missed out on opportunities. It's easier in this culture to pray because there's not much mocking even if they're not Christian. The world hated Jesus, so he warned us the world would hate us too. Help us not let that stop us from giving God the glory!
-After that instance, I've been praying & reading the bible with a couple patients in that room. One being a 20 year old girl with osteosacroma (bone cancer) in her hip with a bad fracture that can not be treated. She was admitted for pain control and now we're trying to figure out if amputating her life would make her live longer. The one time she was crying in pain while the nurse was getting the pain meds ready, but after we started reading the bible she stopped & took out her bible to read along. Another patient, Fanfon (a 50 year old police offer who had a cancerous malignant melanoma tumor removed from his foot) prays for us some nights. I liked the part where he prayed for God as their physician, the only one who can give or take away life, but also for the nurses and doctors that God has given the skills and medicine to assist.
-I appreciate the simplicity of their lives sometimes & how families care for each other basically because very few people can pay for nursing home or aids.
-I LOVE the countryside and mountainside in Haiti. I know country life isn't easy, but sometimes I wonderful if God intended more of a lifestyle like this. The silence, cooler & cleaner air, less tempting places, & just caring/tending to the earth we were placed in! It's hard to come to this simple & less money making lifestyle though. We drove through the Pine Forest. Amazing to see what Haiti would have looked like if it wasn't for the deforestation. The fruits & vegetables make the city food look sad/sick. The people spending time together at the end of the day (no TV, Internet, a million organizations to be involved in)...just talking (people more relationship oriented. I think we often distance ourselves b/c we think it's easier, but yet depression & loneliness is such a problem in America), playing games, and going to bed at a decent time. But it is hard work & have years that might not produce as well. I personally enjoyed the cool sleep, time to read, and hike a mountain! It started down pouring rain when we were on the mountain so we tried to hide under banana tree leaves. We still got drenched, but it was worth it and we continued on. I would have loved to have had time to talk to some of the people living on the mountains. Very different life & difficult. No water available...they have to hike up and down that big mountain for water and some foods.
-I probably don't talk about them enough...but Brittany, ZJ, Emily, & Jamo...awesome friends to share this experience & sometimes pretend we are not in Haiti experiences for a mental break hehe. Some of us exercise together, but we all make and enjoy wonderful meals almost everyday. Most the applaud goes to Brittany for being our amazing cook! I don't know how long I'd survive without their support and friendship.
-Wilshaw and I started doing 100 questions to ask before getting married! Super excited about this and of course the future marriage :) He does not get enough of my attention unfortunately.
-Sometimes I get frustrated in this culture because people don't seem to think you really want to learn Kreyol (I guess they don't see it as a useful language to learn)....but it is one of my joy's! I am sufficient and speak up to speed and understand up to speed. Don't know a fair amount of words...but most of the day to day words.
-I love how the one housekeeping worker, Ossee, took better care of my patient than the nurses (turning her to get her off of her sores & making gloves with water to elevate her heels).
-Exercises is good, no matter what form you get it in!
-Why was there no one in the only country hospital. Is it because people can't afford it or people are healthier? Good discussion question
- I always have to much on my to do list and rarely get enough sleep. I don't think I have more important things than those who go to bed at normal hours (especially because I don't have kids). What do I need to cut out?
- I can't believe I only have 3 months left...bitter sweet.
-It rains a lot during the rainy season!

-Looking back at my time here, the people I've met, all the food memories, and times I wish I would have spent more time with a patient or friend. The times I was frustrated & impatient. I wish I could erase. Time flies, so I hope to care deeply for those set in my path. I don't want to miss opportunities with my patients & friends (and enemies).
-I have to have faith that God will provide in the next move/stage (marriage & move to Dallas) in my life because he certainty did for me to make it to Haiti.
-I got to see 3 of the 5 spinal patients I've taken care of at HAH when we took our new spinal patient to St. Boniface. It was a joy! I enjoyed St. Boniface and it sounds like a hospital I would enjoy worker at better. Surrounded by mountains, countryside & closure to the ocean. They said the biggest problem is gossip because it's a small town!
-I like taking care of spinal patients here, but not sure if I would like it in the states. Not actually sure what I want to do in the States, but God will provide something. I have dreams, but sometimes I don't know whats realistic. I want to accept wherever I'm placed and be effective there. The grass always looks greener on the other side. I'm also trying to prepare my heart for marriage because it's a big commitment and responsibility to be a godly wife.
- I enjoyed watching "Up." first move in awhile. Fun every once in awhile

-The things that just make Haiti, Haiti and my 2nd home:
-No safety regulations
-Beautiful countryside ride on the motorcycle (mountains on the one side and ocean on the other)
-Transportation goal is not meant to keep you comfortable but hopefully get you there in one piece
-People (anyone) block the only road between the north and PaP for anything...such as in protest of no water channel.
-Chauffeurs can answer the question to the passenger who said (on the boat) I'm getting all wet, with the response "well you know how it is" and points out a tarp if he wants it.
-Because of this, Haitians tend to bond (I believe) and are more relationship oriented
-The gas ran out in the middle of the country, so we walked until we found a neighbor whom gave Robenson a container to put gas in while I waited at their house. I'm pretty sure they were the musician stereotype, but nice family who kept me company and gave me some of their breakfast.
-Etc...It's funny how you get get accustomed to what most Americans would call uncomfortable and dangerous. But sometimes you do miss the things that you call home. (I have a hard time sleeping without a fan, a comfortable toilet, gum)
-I love getting to see Gamide (the compassion girl I sponsor) and Elisabeth (Pastor's wife who just had a baby).I guess the doctor told Elisabeth she has to stop giving the baby so much milk. She peed all over me today when I was holding her. Only problem with holding babies here because they don't -always have the funds for diapers.
-Visit with Gamide was much more relax because we knew each other. We played games, went to the market, made a meal, and went to the beach. I got to spend 2 days with her this visit before she started school. They have a cistern in their backyard for water so that is nice. We used that water to drink which I was surprised but hey I didn't get sick. I got into the beach fully clothed because they were more covered so I didn't want to be offensive! Kept away the blan yells though. We practiced floating because no one could swim except me. Micalerme's (our compassion guide) brought his 2 daughters. On the way back, there was this 3 year old boy that really want the opportunity to be near me so much that he was yelling & running to catch up. So I held his hand and talked a little before I told him he had to return home.
-Haitians have no issue sharing towels (learned that when I joined Gospel Kreyol and we went away for the night. I forgot my towel and so did another girl so all 3-4 of us shared the same towel).
-Robenson got delayed 3 hours picking me up, so that lead to some interesting conversations as people though it was an odd site to see a blan sitting by herself reading a book. Also, seeing me on a motorcycle humored a lot of Haitians today, especially when we got stuck in the mud.
-It's interesting when you get to see the 2nd side of Haiti. The small group of well off elite Haitians. Don't get me wrong, there are still more well off Americans and a lot of middle class live well. I guess it just strikes you more because of the devastation & extreme poverty Haitians live. The rich don't care about the poor in Haiti.
-I had fun getting dressed up & having a more fancy concert, but I'm glad most of our concerts are for the common people. We had a celebration of Gospel Kreyol concert at a fancy convention center. I could tell everyone was singing from their heart and praising so it turned out to be beautiful! I really enjoyed the dueling pianists. Everyone had fun taking pictures.
-We made equal fridge space & more rules for long term volunteers to help prevent issues & unfairness.

Well that's been my life in the last month :) Ups and downs as always, but still blessed and trying to serve Jesus here in Haiti.

Meet the team!

Here is a blog written beautifully by one of the other long termers introducing all of us foreigners here that I live and work with:

http://www.facebook.com/l.php?u=http%3A%2F%2Fadventurewagon.blogspot.com%2F2011%2F06%2Fmeet-team.html%3Fspref%3Dfb&h=CAQAAh4ph

Overseas Missionary Work in my Eyes

It's funny how we term missionary work as going overseas, but really it is the call of all Christians as we don't belong to this world so technically we are strangers everywhere. Therefore, every Chrisitan is called to be a missionary. Some stay in their home country, others are called oveseas for a short time, and others for a lifetime. For me, I'm not sure yet if I'm meant to be overseas for a lifetime. This year here has been a huge learning experience for me serving in Haiti for almost a year so far. It will be a year on September 7!

I volunteered 3 places, but most of the time has been spent at Hopital Adventiste d'Haiti as the orthopedic nurse coordinator (as my job formed itself that title). I have seen and done so many things as a nurse that in America I would never get to without 3 plus months training in some departments (like helping with 3 terrible head trauma patients...literally transporting the one guy in the back of his family's car with a trunk that didn't shut; having the security guard ask to me to assess a premature baby born 2 months early because there was no Peds doctor available; having to learn to work in recovery room & train other nurses when I've never worked in recovery room myself, etc etc). Trying to make things work as a nurse when I don't have all (actually many of) the resources I need. I have had to tackle less than desirable living conditions (like not so good hospital food- kind of just kidding) and work conditions, but still nothing compared to what a lot of people endure. I have learned a 2^nd language in order to communicate. I have endured some interesting car rides. I have met wonderful people, especially my children patients and actually made lots of connections to Americans. I have gotten to tour the beautiful island and enjoy the wonderful fruits it has to offer. I got to meet (and will get to meet again) the compassion girl I've been sponsporing for 4 years and nothing could beat speaking to her in her own language. I've also been soaking up wonderful aspects of their cultures- their endurance and making things work when it doesn't really appear there is anything you can do; just singing to praise God sporadically; the smiles & happiness on kids who live on dirt floors; joining a young adult Haitian choir; the joy Haitians give in giving you a gift (if you do something for them, they will repay you somehow); The greeting of a kiss on the cheek (going to have to remember not to do that in the U.S.); And living in a community of other Christians long term volunteers (like a college dorm again!)

I always saw myself as fitting in better with non-American cultures, but after being here awhile I realize the aspects of this culture that are equally frustrating to what I deal with in the states. I'm in a spot that I love Haiti and the people, but their work ethic and other little things can be difficult to understand coming from an American perspective. In general, they move very slow and work becomes more like a social hour. They often neglect basic care and provide unsafe care at times. And work items get stolen or misplaced (if not carefully watched or monitored, usually by foreigners). Basically there appears to not be much accountability nor ownership of their jobs. I'm not sure the causes or reasons. Some of it is probably lack of education and unorganization (in general, life is unorganized here but somehow functions). And many times the foreigners are called to do many things, and you start to wonder what they do when we are not here. I never saw myself as saying Americans are better than other countries, and I still don't think we are but without a little support from outside help, a lot of hospitals don't function as well. Every country has its own problems, but every country also has its own beauty!

Once I overheard an American say they believe Haitians appear to have less stress (based on observing how they work calmly & the joy seen by people in clinic) and we Americans could learn from them how to decrease the stress in our lives. Being around Haitians, you might think that watching them because they don't complain or they don't show it as much as Americans in general (they do appear more joyful or enjoy joking). But in all reality, I believe they have a deeper stress than most Americans because they have basic stresses most Americans have never known. Like what am I going to eat later today because there is no such thing as food stamps if they hit a hard time not finding a job. Or unknown when the next civil unrest or natural disaster will spring up. Or can I afford to send my children to elementary school. Or where can I go to get medical care when I only have $3 USD? There is no other solution for many of them so they choose to be grateful, serving, and joyful people in general despite the great hardships they endure (and I've noticied that a lot of times people base Haiti off of PaP, but actually people in PaP are much more rough than in the country...as is the case in most countries...so can't base most things off of PaP).

And my job here requires me to be in the middle, to “coordinate”, between the 2 very different culture work styles, which has proved to be very challenging at times especially when the long term doctor does not see eye to eye with a lot of things the hospital administration has asked of our service. And of course working with short term medical teams makes me realize why a lot of hospitals in Haiti will not accept ST medical teams every week. It's just exhausting because every team comes in wanting to do as much as they can (understandly because as we said, most people who need surgeries can not afford it and thus wait for free surgeons). Even though I'm here long term, I have worked way over 40 hours a week most weeks trying to keep up with everything (and I never get 1 day off a week unless I leave). This is why you shouldn't work and live in the same place (at least not hospital type work). Which becomes difficult for me to keep with normal daily routine of life, maintain a long term relationship, as well as try to build relationships with the Haitians. Most hospitals in Haiti do not have beds and other resources to keep up with this fast pace (so they do not allow ST teams as often as this hospital has). You can tell the orthopedic service has put a strain on this private hospital itself because it's mostly free. But the times I do get down and connect with the patients or any Haitian has been one of the most blessed parts of my time here. I hit a burnt out wall a couple weeks ago, but with the Word of God I've been pushing through it. I think a lot of the long term volunteers have had a time they hit one too.

And I'm learning how to deal with the poor vs rich (grasp the concept of how God wants us to deal with this issue). Even in America, the poor have better access to basic things (example: like trauma's and children are always taken care of in a hospital regardless of what a family has; food stamps & a welfare system; etc). Here, there are a lot of NGO's....but more than not, people don't get treated because yes, there are places still providing free care, but not enough to cover all the people who make just enough money to eat everyday. In Haiti, if you don't have money, you don't get taken care of medically (you have to pay upfront at most places). I've been told multiple times people don't even bother going to hospitals if they don't have money, they just stay home and have a much higher chance of dying due to lack of basic medical care. And don't get me wrong, it gets tough on me because there are people who try to get what they can even when they are well off enough to pay (but that happens in every country, people try to work the system). So I struggle sometimes with not becoming too hardened in order to prevent being taken advantage of because I don't want to miss out on those who really need it. Unfortunatley, like anywhere people who have the means to have pay for services, will attempt use the free services which takes away from those who really need. And also is causing less business for Haitian health care providers.

It's tempting to feel like you have to overwork as a missionary because people are supporting you and you don't want to waste their money. But you can't burn yourself out because honestly after being here I'd say you need at least 5 years to really make a lasting change. You need to get to know the people and culture first before you can even be effective. Haitians are not like Americans; half of starting something new is building relationships with people, and then they will gladly accept and help you then. Things are very difficult to change in Haiti. It's very challenging and takes a long time. And once you do, you need to stay for awhile to keep it going or things will just go back to the way they were once you leave. You can't work crazy hours for 5 years. And you have to get away every once in awhile for a mental break...which proves be expensive sometimes. Haiti is not set up for tourism, so decent transportation is expensive.

I know leaving here I didn't improve the hospital that much (just kept things slightly more organized so that administration totally wouldn't want to kick the free orthopedic program out because of the stress & strain we put on their private paying hospital), but I grew as a person and I'm sure God used me to touch a life or two as I was touched by many lives here. It will be bitter sweet to leave. I know the time is coming closer for this job to end, and frankly I can't work like this much longer. But I think about all the wonderful people I've met and how I really feel like I connect to the patients (and nurses, etc) here, and I will miss that greatly. I didn't get that in the states. I will miss speaking and singing in Kreyol. I miss the beautiful island and fruits! But I am thankful God placed me here for this time and I know He will continue to provide for the people of Haiti. And maybe God will have plans for me (together with my future husband) to return to Haiti. Only time and allowing God to lead my life will tell me what work I can provide on this earth that will most further His kingdom.

And all in all, I'm slowly learning to put others first. I put too much time & thought on my stresses & problems instead of praying about it (then letting it go in God's hands) and praying for others. So my pray is for all of you that you can put your faith in God to guide every little aspect of your life.

April-June 2011

7^th April 2011 (0720)

How wonderful and awesome are God's ways and plans. I don't know why we give so much praise to mens plans that don't nearly match up. You always know the who-what-when-where-why. We don't always need to know. We had a good-bye party for Sharrie. She's called back to a job in the U.S. I know it will be hard for her and Randy to be apart for 8 months.

8^th April 2011 (0716)

How often I fail to just rely on God for my strength and courage. When things seem out of control, I need to stop to pray & let God's words come to mind. Everyday there is something frustrating about this job whether it's dealing with people not doing their job; having to remind admissions of the same thing over & over; the cleaning staff getting annoyed anytime I ask her to clean a bed (she'll clean all the beds we don't need before she'll clean the ones I ask for) or giving me a hard time about giving me sheets; administration deciding to implement a fee for our patients without telling us. Basically, our orthopedic service is stuck in an odd position because it's being run in a private hospital that has decided to up to this keep it free. But I do believe the workers know they are not paying, so they don't feel like they need to give them the same care. And then trying to balance the clashes between our doctor and administration. Sometimes I just feel overwhelmed and don't know how to handle these situations. After this, I'm not sure what is more frustrating. This or floor nursing. I think floor nursing was definitely crazier...but it was only 3 times a week. This I'm constantly here so I don't get a good break.

But regardless of these frustrations, I do love Haiti and the Haitian people. I love speaking Kreyol and I'm glad to help with whatever is needed.

11^th April 2011 (0830)

How often we work and try to plan out every detail or our lives. How we try to please men to win their approval. Lord, how fruitless is all of this. Help me to show faith in, character like, and trust in You. I can trust that God will work out the problems in the hospital; He will help me to learn and memorize the songs for Gospel Kreyol; You will show me the right time to marry. So I don't need to worry or do things on my own. I pray for the hospital for to being seeking Your help when making decisions. I pray for collaboration and teamwork. I pray for the upcoming vacation to give us the rest & rejuvenation we need.

Lord, how often we take things for granted, even here in this hospital. The generators are going bad (and Haiti power is not reliable) so we are losing electricity a couple hours a day (which means no running water). Can you imagine a hospital that didn't have electricity 24/7 on a regular in the states? It is what it is here. We make do with what we have. (As I'm writing right now...28^th April....the generators are going crazy....it's flashy in & out...and only some parts of the hospital have electricity).

12^th April 2011 (1805)

I am a people person (well, maybe not as much as I used to be) but I love talking to people and sharing frustrations & joys. But, sometimes God (well all the time) I need to come before God first. Because other wards I am only getting mere man's opinion & judgment. At times, You will speak to us through others, but I really have to work on coming to You first before man. This is difficult for me!! Not saying I can't go to friends at all, just need to start with God. I am still need of refining from God.

Many people from back home ask me what it's like on a regular basis to work here. Of course there are many comforts I've given up- 24 hour reliable electricity; a variety in food, easy (and comfortable) transportation; all the supplies needed to do my job; family & friends; a well-paying job; etc. But truly, I don't have it bad at all. I'm getting a stipend to pay my bills & pay for all that I need; free room & board (even if it is dry rice & beans everyday); and a job. There are joys & frustrations like every job- such as a I love speaking Kreyol with the patients & nurses. I'm learning a lot of random skills & ways to make do and character building. It's the usual as a nurse job- super busy in the morning & have to deal with the same issues of people not doing their job. We start with rounds- then I'm balancing admitting patients & discharging patients; writing orders for the doctors; dressing changes & other patient issues (I act more like a Physicians Assistant than a nurse, but do some floor nursing work too). As of now, I don't have a translator. Most of the time I can get my point across by myself. Trying to keep things smooth between the ortho team and administration. I guess they've deemed my title as orthopedic coordinator. Some weeks I'm so busy I don't think I can handle it and others are a normal pace. ZJ (the social service year doctor) is working on improving policy & procedure to get things running smoother.

Work hours vary, but tend to be 40-60 hours a week. Occasionally, I get woken up in the middle of the night. In the evenings, we try to exercise & cook. I try to fit in talking to Wilshaw (not enough, I'll admit). Now, that I'm in Gospel Kreyol Choir, I also try to practice my songs every night (I have to memorize about 30 songs in French & Kreyol). Wednesday we are trying to make bible study. And then, at night now I'm trying to read a couple verses in the Kreyol Bible and look things up in the dictionary. Practice praying in Kreyol (because I want to be able to pray with people and talk about my faith).

On Sabbaths, after service, we usually eat together. Then rest or reading. Now I have choir practice or programs at 3pm. Sunday is a light work day, chore day, or visiting friends. Friday afternoon is my food shopping day. There are days I go to bed to late and days I don't want to get up for work. But I do love my co-workers so that helps.

So, do I think I'm a "better person" for working in Haiti? NOT AT ALL!! Lol, it's just a passion God gave me. Living in Haiti actually feels like home now. We all have our own callings & places to live & work. For now, mine just happens to be here. I'm not scared walking down the street & I go shopping by myself (well always with another person...but they don't have to be Haitian b/c I can purchase things on my own). I think I might at times be a little hardened to all the suffering and hardship. I will admit, in a lot of places in America, we are sheltered to extreme poverty. Here, it's in your face more and sometimes you just want to take a break from it. But of course, these people never take a break...they have to learn to make the best of it. The hard part is the people who have enough but lie to try to get more. It makes you hardened a little at times, because sometimes it's hard to tell who is faking it and who is really in need.

There are many things you see here (in terms of medical), that you rarely see in the states. We had a 28-year old motorcycle accident from 2 months ago come in. He was in another hospital (being seen by an American doctor) in Cap Haitien. He had a femur, hip & tibia fx. He had ex-fixs to hold the broken bones in place, but the tibia fx was still an open wound for the last 2 months. I went to take down the dressing over the tibia fx (didn't know it was an open wound), and saw his tibia bone broken in half still sticking out of his skin. I don't know what the plan was at the other hospital, but it wasn't working so I guess that's why they sent him here. And unfortunately I've seen lots of complications that I never saw in the states (or not often)- compartment syndrome 2 times, 2 people die from pulmonary embolism, and a probable death from anesthesia.We ran out of all our meds for DVT/PE prophylaxis currently (which really isn't the best for big fx).

When I sing with the choir, it feels like the choir back home except a different language and less personal space (the car rides are always nice & personal, lol). So, anyway, that's the normal as of now. We're off to get some donated supplies now!

15^th April 2011 (0830)

I am so glad for this week of vacation. You know our needs God, however I do pray for those who do not get paid vacation either by choice or necessity. I'm glad to be here, but I will miss speaking Kreyol for a week. Yesterday we went to pick up supplies at J/P HRO, and while we were waiting for Richard to reutrn I was surrounded by a group of young Haitian men. I called my friend, Yonie, who speaks no english, and after one of them told the group "She speaks Kreyol", I guess as a warning to not say anything that don't want me to hear. I love that!

I think Beatrice, our 14 year old patient who had surgery to correct her blouts disease on March 13^th (but developed compartment syndrome), was sad to see me leave. I spent 29 minutes listening to gospel kreyol music with her last night. I reminded her to call on Jesus in prayer for anything. 14 is still an age where they look up to people my age. I hope she chooses God as first in her life.

16^th April 2011 (1950)

As the sun sets and another Sabbath day end, I have nothing but thanksgiving and praise to You, O God. As I read in Your word, it is so mighty and worthy of life. It refreshes and restores me. It helps me confess and repent to move towards doing what is better. I'm reading a fiction book about 5 women in the bible (well it is based off their stories, but expands it in a historical context) and a book about marriage. Marriage is hard, and I want to be as prepared as I can (I know it's a life long learning experience). Marriages are falling apart and it really affects the family so I want to be serious about it. I want my marriage to bring us closer and others to know Christ.

I am so thankful for wonderful friends that week after Your way and word. We can pray, study, laugh, implement God's word, and have fun together. I am thankful for quietness and peace as well as not all the dust and dirt in the air. The ease of transportation. A warm, comfy bed and no mosquitoes overnight. A warm shower. A break from living and working in the same spot.

I was just thinking about Spendie telling us when she was on the tap-tap about an illegal prescription drug seller selling lisinopril (a blood pressure medicine) as a vitamin. Oh my...lol, that's a disaster!! He didn't know what it was, but as a doctor she knew what it was. Oh, I do love Haiti...even the quirks. I've been told most Haitians would prefer to live in Haiti, but come to America because of better jobs in order to support family in Haiti. I do miss things in America. I guess you're naturally going to miss things you grew up around.

20^th April 2011 (0835)

We got to go to Animal Kingdom for free. That was fun! I enjoyed Disney when I went at age 14. It's expensive, so I am very thankful for my dad spending his hard earned money to provide us a memorable trip together as a family.

I've been enjoying the hot tub and talking to Wilshaw on the phone and being able to understand everything clearly. And I've been getting lots of practice on our songs.

25^th April 2011 (2219)

We have arrived back to what I call home sweet home. Thank You, Jesus, for providing a week away to get some sleep, an opportunity to read, visit Orlando, shop for things we can't get in Haiti, water park, enjoy the Sabbaths in a new environment, and talk to lot sof friends and family. But mostly, it was a time to not have to stress about the daily routine of work and be away from living in the hospital.

At first, I was cringing about going back to the stresses again, but when you get back here and greeted with excitement, it feels good to be back. The one nurse told me she could sense that my presence was not there. How sweet- never had anyone say that at my other job. Beatrice discovered I arrived back today and called me to come visit.

I pray for Elisabath as it appears she is going into labor.

27^th April 2011 (0703)

How glad and joyous I am be up today. I have many joys & praises- they decided orthopedic surgeries would still be free; a fan to keep me cool overnight; a mind to choose (free will); filling food; ability to sing, work, do my laundry by hand; a beautiful view of your nature in the middle of the city to study Your word; Elisabeth giving birth to a healthy daughter!

I'm getting back to the swing of things here. Enjoying speaking Kreyol again- it comes back easily and my goal is 5 new words each day. And now I'm working with Amy to organize the outside storage supply room. It's got so many random boxes everywhere. But if we can go at it, a couple times a week for 2-3 hours, it will get there. I mean there is an overabundance of some things we rarely use, but the things we use often are running out. We got about a garage full of hydrogen peroxide!! The hospital is starting to buy IV fluids and medicine.

29^th April 2011 (0722)

The faith of others inspires me. My one patient that I was trying to get an IV in (unsuccessfully) would just tell me to try this spot after I missed one. And then he said "God is blessing You." Haha- how many people would say that when you've just stuck them 2 or 3 times and missed, lol! And the other evening (after sunset), the electricity went out for a couple moments (but you never know how long it will be off), and it was pitch black trying to provide nursing care. I was holding a flashlight for the nurse when the light came back on and she said "Thank You Jesus." Such pure and simple faith.

1^st May 2011 (0751)

I am thankful for genuine for fellow sisters & brothers in Christ. I appreciate the gentle way Ossee & Coran approached me about my earring yesterday. They weren't judgmental but just respectfully asked me to remove it because in Haiti, they said people in the Adventist Church make it a big deal and they will talk about you (and then hence talk about the choir). Ossee said he's been in the states so he knows it's not a big deal and he has no problem with it. Coran asked about how it was seen in the states (tried to understand instead of judge). I appreciated their approach. And I'm very willing to respect cultural things.

I took my 2 female patients to divine service yesterday. I love girls around the age 11-14. There is a 18-month old girl that is slowly getting used to me. She used to always cry and hide in her mom's lap when I entered the room. Everyone else said she likes you, she's just afraid. She's adorable! Slowly, she's letting me come closer (especially singing songs with Beatrice, she's getting used to me). And then there's Maxi, the 28 year old guy I described before with all the leg fractures that were never properly dealt with and sent to us 2 months later. His bone is still sticking out, but the wound is shrinking in size! It hurt him a lot to change the wound, so I helped just to keep him calm. The whole time he was yelling my name (even though I wasn't changing it) so I told him to call on the name of Jesus. He had told me earlier I was patient and never got mad (well I guess I don't show it when I do). I told him I try because that's what God asks of us. That was a powerful example to how our attitude and interactions really will be noticed by others and can be used as witness tool. I truly pray for my attitude, interactions, and reactions to be refined to be like Jesus (no matter what comes on my plate). The best way to do that is staying in God's word and praying.

I was so happy I knew the songs at Gospel Kreyol practice. Although I had a cough and running nose, so it made it difficult to sing at times. I am so thankful for some friends I've made in the choir. I pray for each individual walk with You so that we are truly glorifying You and preaching to lost souls.

I'm happy my family gave my mom a special birthday yesterday! I pray that we continue to serve one another, be kind, and have patience. Let love (God's type) guide our interactions!

3th May 2011 (0712)

How sweet it is to get a good nights rest and then have lots of time for devotional in the morning. I rested very well last night, I need to cut out what is not necessary every night so I can go to bed earlie

I got to see Elisabeth's baby girl Donna. How precious is life! It could never have happened by chance or continue happening without an active involved God. I enjoyed being around Elisabeth's mom as well. I slept in the room with all 3 though, so I didn't sleep well that night. But I was glad to share the day with them. I am going to try to visit them more often. I want to cook for her. It was fun watching Elisabeth's mom teach her things of motherhood and it made giggle when they disagreed on the cloth diapers.

6^th May 2011 (0716)

How lovely is God's name in all the earth. No matter what is going on here, that doesn't change the fact that You are an amazing and never changing God. How beautiful it is to sing songs of praise to You with my patients. I'm thankful for the choir to learn words of faith and then share singing with my patients because that is a huge part of their culture. And even the 18-month old baby allowed me to give her a kiss on the cheek! We have come a far way from when she used to cry everytime I entered the room.

I thank you for providing safety on the road! Amy went out to St. Marc today and ran into 2 issues on the road. They ran into a demonstration that was monitored by armed U.N. Soliders...they found a back road around it. Then, later, they were driving through Cite Soliel (the most dangerous part in Haiti), which we've driven through many times, but this time the car in front of them got robbed at gunpoint. It was a nice looking car apparently (filled with Haitians)- they don't particarly target Americans here...just people showing off their wealth. It's better to be in a ratty car.

Lord, life is uncertain here, so let us be prepared at anytime to die or that You may come back. And this applies to everyone- no matter if you live in the "safest" area of have lots of money. No one is immune to death. But we all have been the wonderful gift of salvation and eternal life (a place void of evil) through Jesus Christ.

8^th May 2011 (0925)

I'm having a "uh-huh" moment for what marriage is about. While yes they are meant to be our lover and friend, ultimately marriage is supposed to be a metaphor of our relationship with Jesus Christ as to the church. Love and respect and honoring who has authority. So whether our spouse is doing the right things or not, we are asked to not to change, get even, or get them to try to treat us better but to please God in our reactions. So whether you choose a believer or not, we need to, as professing believers, obey God. I am glad for this time to prepare my heart for marriage. You know we needed more time to prepare us to be husband and wife. In the meantime, we have callings that have called us apart for awhile.

12^th May 2011 (1300)

I'm so glad for another year of life. While God has prepared a better life ahead for us, there are still many joys and blessings in this life. 25 years, that's a pretty good age. It's funny how make every new stage of your life into the best. How time flies! This is my first birthday ever away from home. I miss spending it with my close family and friends, as well as my mom's TLC (Tender Loving Care). I had to make my own breakfast.

No, but a couple people knew it was birthday and have been telling others so lots of people gave me a birthday wish and kiss. It was also nurses day, so after the program today they sang happy birthday to me. So I did some work, but relaxing and reading in the cool now. Napping, practicing some Kreyol.

This week has been busy with surgeries, but thankfully a lot have been same day surgery. Only 1 generator works right now....just need to have a bucket of water for the morning in case. Electricity is supposed to go off early morning (5-7:30 am) so then surgeries can happen all day.

I've been trying to fight off the feelings of depression. I think it hit me in all my business, that I've made lots of amazing friends but haven't made a close girlfriend. I struggle without that, but I want to find my refuge in God's wings. I can make it and take it with Jesus. My life is in God's hands. Sometimes I get frustrated that I'm not better at Kreyol than I am, but I just have to keep it keep at it and keeping a learning a couple new words every day.

Yesterday it was nice to finish at a decent time (5:30pm) so I could sit on the roof to watch the sunset and practice my songs. It's so peaceful. If it wasn't so hot, I would sit up there now.

It's such a reality check when you hear of others stories- it gets your mind out of your own bubble. It's hard not to be hardened to things here sometimes because there are times when people truly have nothing, but other times people can afford it but think they can get things out of you. It's hard because all in all, I know that a lot of people I interact with have significantly less than me (even if they have enough to make it by each day). I guess this is called getting out of your "comfort" zone. It's going to be uncomfortable...but I guess it's better to be deal with uncomfort than live a whole life of comfort but never reached anyone else's need. Sometimes it's hard to be compassionate when you're tired and you have to deal with lots of people who can't pay for things in the hospital. I've never had to get involved with those aspects as a nurse in the U.S., but here I do.

Surgeries and beds are still free, but clinic, labs, & meds are costing now. So a lot of times, people can actually pay for those things. I have had to buy some things though. We put 2 of our patients in a building outside because they need daily rehab only. Apparently it was built for that reason (long term rehab needed for those who live too far to come everyday) by Project Hope, but now they're not sure if they want it for that. But Jamo decided it's just sitting there so we put our 2 pre-teen girls in there. It's always fun seeing post-op patient's back in clinic. Although they all think I can get them in sooner to be seen by the doctor. Everyone gets a number and has to wait in line (up to 8 hours...it's a full day even to go to the doctors in Haiti).

17^th May 2011 (0720)

How sweet and wonderful it is to sit in a quiet spot overlooking the mountains and ocean, hear the birds and silence, and get away from the business of life. What a beautiful spot to do devotions in the morning. Saturday morning, the recognized all the nurses of the hospital for nurses week. I have to appreciate the measures the medical director and doctors went to to make the nurses feel appreciated. Because apparently the nurses were getting tired of getting told all they are doing wrong and not getting appreciation every once in awhile. They mentioned good nursing attributes about all the nurses. They even included me. They said I work a lot and I can speak with the patients. Then, they prepared a wonderful meal.

Saturday evening, we sang at a program in one of the biggest churches I've seen so far. It was across from the palace. There were hundreds of people inside, and about another 100 outside because there was no room inside. Just standing there there to hear. Never seen people do that in the states. If there's not a comfy seat, forget it!

Sunday, the medical director paid for us all (about 15 people) to go to a beach resort. I think the tickets were about 40 USD. That's extreme generosity and wanting to show that she cares and appreciates the nurses. It was a nice time to relax, play, and speak Kreyol. I realized I think I learn the most Kreyol with Beatrice and her family. When a returned, a 41-year old male with a 2-week old pelvis fracture threw a suspected pulmonary embolism (clot in the lung) after they finished manipulating his hip to put in traction. His oxygen sats were ranging 70-85%. They started him on a heparin drip and the sats came up. But, since the Haitian nurses don't know how heparin drips work (or maybe they do, but I couldn't guarantee he would get watched well enough overnight) and we weren't sure how stable he was, ZJ & I split the night staying up watching him. He is still doing fine, and with all that heparin his PTT Level is normal. Which mean he normally probably clotted very fast (heparin was given before the PTT was checked) which means he was probably very high risk for clots. Especially not being on DVT prophylaxis for 2 weeks after a pelvis fracture. Unfortunately, the PTT solution ran out, so I have to figure out what to do because it's really important to check it every 6 hours until therapeutic and then every day to prevent it being too high or too low. We still do have to do the actual internal surgery to fix the fracture. Now, as Amy said, we need to make sure he knows Jesus.

20^th of May 2011 (0715)

So glad it is Friday! This week has been somewhat mentally exhausting. I've been busy, but half of the time I'm not sure what I was doing. But, I'm here to serve no matter what it is. I can truly say I enjoy serving my patients here. The hard part comes when you don't have everything you need. For example, this guy with the pulmonary embolism has never been therapeutic on heparin after the first day.We haven't been able to get him therapeutic again.  Now ZJ and Terry are gone, so I'm left here trying to figure out what to do. I'll just have to ask Dr. Spendie, but I always feel bad because she works for free all the time for our patients. And I know this patient can't afford it.

And having professionals do their job poorly because they wanted to leave (and I don't think it's because they didn't know, but that they didn't care). Hanging ice cold blood after 30 minutes when it's not an emergency. I found him with elevated blood pressure and shivering. I got him warmed up and apparently he doesn't have any major heart problems. That was basically a stress test on the heart. He is fine, but I didn't appreciate the unprofessionalism from the Haitian anesthesiologist.

But, I really enjoy hanging out with Beatrice and any other long term patient with her at the time. They brought me new fruits last night, but I worked too late so I didn't see them. I'm exhausted from waking up in the middle of the night and working long hours. I guess it's hard when you feel responsible for the patient's overall care. In the states, I have to stress about it when their, but then I go home and rest assured someone else is taking care of them.

22 May 2011 (1135)

Medishare CMO (chief medical officer) got my telephone number and has starting calling about transfers almost every week now. I'm accepting the fact that I truly never get one day off that I don't have to do something medical. That's why they give us vacation every 3 months, and let me tell you I need it. I worked 2 years with only 2 weeks of vacation a year, but I don't think I could survive 6 months without a vacation here.

To me, my biggest ministry is connecting to the patients. Especially kids between the ages of 11-16. Divegline (a 13-year old girl with a femur fracture) said she didn't want to come to church again, but she decided to come. The message was given from a genuine follower of Christ and the speaker spoke to both my girls afterwards. The one guy even helped me bring them back down to the long term house and spoke to the girls. Then, Brittany and I went back later to sing with them and read a bible passage. They both believe in God, but they're at an age when it can be tempting to see what the world has to offer.

We sang at a tiny little tin-roof church on the top of a mountain yesterday evening. So beautiful, but hot until sunset. I ended up in front of the microphone again, but instead of making me move Roseandy and Tammi pulled me in closer. I did fine. I made one noticable word mistake, but got right back on track. It's so wonderful the experiences I have. I wish I could share the experiences I have better in words and pictures, but I can't. Some of the best experiences have no pictures attached. I'm not a very good writer, but I try to share the best I can.

I'm going to cook with Beatrice's mom today. She's so generous. She wanted me to know more fruits, so she bought me a couple fruits.

I started to get frustrated a little this week over little things. We have 2 IV pumps for the entire hospital. We used the one for the heparin drip, but realized it wasn't calibrated so it wasn't giving the dose put in the machine. So we had to figure out the difference based on what it gave and what it should have gave, and then titer the dosage to that. And then without Brittany here, the labs needed every 6 hours wouldn't have happened or they would have been wrong (because the first time they did it, it was very wrong). Overnight, even though it's a 24/7 hospital, the hospital really doesn't function. Most of the workers sleep. There are so many items, skills, and people not readily available working as a nurse here (and it's not as bad here as most of the hospitals in Haiti), that you really do have to be flexible. But there are lawyers here, so it's hard too because you do what you can for what you have here, but at times you know it's not all can compared to the states.

But there are many pluses as a nurse in terms of rewarding work. Connecting better to patients. Most patients are nicer, more grateful, and patient. Learning to communicate in another language. Interacting and working alongside the Haitians. Learning very random skills. Put in position where you are the one of the nurses with the most experience to take care of critical patients, but yet I've never had ICU or ER experience. I'm very thankful for Marc and ZJ to help me learn. ETC!

Well, I think that's all for now. Time for laundry. We made pizza last night, which is just a wonderful change from rice and beans. The hospital food has the same flavor, dry. I hate to admit it, but I probably would have been one of the people complaining about having to eat the manna for 40 years. I like variety in food, but I guess it really is a luxury and comfort.

24^th May 2011 (0720)

I have been feeling joyful, content in the Lord, no matter the circumstances recently. And for God never allowing me to get pushed past what I can handle. I'm thankful for the people placed in my life, family in Christ to study The Word, and for keeping me even though I don't get enough sleep. I've been trying to quiet myself to hear God speaking to me. I noticied a couple times this week, that in a frustrating situation or when I'm busy, a bible verse came to mind and helped me handle the situation better than I was about to handle it on my own.

31st May 2011 (0410)

Any time of the morning before starting on our day is a good morning. The nurse woke me up to ask what pain medications she could give, so I showed her morphine was on the chart and showed her the vial (even explained how to give it). I decided to check down 30 minutes later, and it turned out she never gave the patient the medicine but went to sleep. The child was screaming. So I gave the medication and stayed up to monitor them. So I'd thought I'd take the quiet time for bible study. Everyone's sleeping, including the workers! The roosters and mosquitoes are up!

The group of 18 people arrived that we were prepping for. But, we all met together with them on Sunday and got most things set straight. Terry actually brought up most issues. I think he is handling issues better and being more understanding. Makes my job much easier and not so stressful. Especially last night when Medishare sent a young male pelvis fracture that they said was hemodynmically stable. He arrived in the E.R., so we put him in a bed. The nurse checked his vital signs, and came to get me because his SBP was 60. Needless to say he was not hemodynimically stable, he was in shock. I got Terry and the anesthesiologist and we got him out of shock but something was terribly wrong. By the grace of God, there happened to be a general surgeon on call who doesn't normally works here. He suspected abd internal bleeding (because the guy was struck in the abd by a car). His abd was getting bigger and harder and his blood count was dropping. He took xrays and discovered it was that, but the pelvis fracture was stable. After much reluctance from the American run hospital who sent him unstable, we took him back because they have a general surgeon and ICU. He didn't have much more time before he would internally bleed to death (probably 3 hours). It was 2 am in the morning. I don't think the patient realized how serious he was. Even his family didn't want to come search for blood. I had to break it down to them that he doesn't have until the morning. We got to bed at 3:30 am, and had to get up Monday morning to start a full day's work. And of course, I'm woken up again in the middle of the night. It's going to be a long, tiring week. Ugh, this is why I have to get away on my days off.

But, the group has been good to work with in terms of rules, working with the Haitian staff, and flexibility so I can't complain. There are a couple Haitian Americans with the group, and they'll speak some Kreyol with me. A lot of them think I'm learning Kreyol fast, but I don't think I'm learning that fast. One of my favorite parts of the day is visiting Beatrice and her mom. We laugh, talk and they love teaching me new words. I hope to visit them in July. Maxi is leaving tomorrow morning and Divegline left already. As well as another good part of my week, is speaking with Gospel Kreyol. Sometimes it's hard in the large group to understand because it's fast and lots of people are speaking loudly at once. So I tend to be quieter, but I enjoy listening. I do better with one one one conversations. I'm running into this problem, that there are too many people who speak English or want to learn English with me. Number one, I don't have time to teach English. Number 2, if I spoke English with everyone who wanted to speak English, I wouldn't advance as fast in Kreyol. I'm torn what is the right thing to do. If someone came to the U.S., I'd have no problem speaking English with them. But since I'm here, I want to speak the native language and advance. It's hard because I don't think they realize I speak too much English already because I'm around lots of Americans.

6^th of June 2011 (0715)

Last week was so busy and long days, so I am really glad to get a slower week. Jeff and Francel are 2 calm and nice pediatric specialty orthopedic doctors to work alongside. We got 2 calls from Medishare for a pelvis and hip fracture, as well as Louison (previous spinal cord injury surgery we did) who fell and it loosened the previous plates & screws we put in. But they will all have to wait until Terry returns.

We actually only ended up with 3 inpatient and 2 outpatient by the end of this week, which isn't bad considering they did about 28 surgeries this week. It was a self-sufficient, cooperative, and pleasant group. They pre-oped all the patients (everyone got a H&P), handled the scheduling, and had nurses to work the recovery room. They set up the PACU nicely and brought lots of useful items. We had a dinner at the oberge. The main doctor, Dr. Jon Hezenberg is Jewish, so no arguments about no surgeries on Saturday. Plus the group wanted to get out. Dr. John was really nice and taught me a fair amount about TSF's on Saturday.

Sunday was a catch-up on sleep (well afternoon nap), laundry, and that was about it. We went to the delimart. On our way out, we tried to ask the guard a question but he told us to hurry up and get out. When we returned to enter the hospital gates, we found out why. Police showed up as we did. Apparently a visitor punched the chief security guard when he told them visiting hours were over. The guy called these police who arrived at the gates, but Francois (the security guard) left to get trusted police. So he told the guys at the gates not to let any police in. And the police did not appreciate being told they could not come in. Then people starting jumping through the hole in the fence. Of course, they couldn't let us in because then everyone would want to come in. So we found a back way through forests and a hole through the barbed wire fence. We made it back in safely, but dirty. It finally resolved, and they arrested the troublemaker. Nathan say it really only escalated to that point because security wasn't doing their job well. He said first thing today, that will change.

10^th June 2011 (0648)

How grateful I am for a sunny day and life. We had lots of rain the last week, and a dozen or two people died in mudslides. This week has been wonderful working with Dr. Jeff Young and Dr. Francel Alexis. They're both calm, nice, and flexible. But, yesterday, we had someone go bad coming out of surgery. They're not sure what happened (clot, stroke, abd bleed, aspiration, etc) but he was fine throughout the surgery. Completely cleared for surgery, blood sugar & HTN controlled. He had a spinal, but started losing conscience when they when closing him up. We checked his blood sugar which was fine, but his blood pressure & sats started dropping. He ended up going into cardiac arrest. We tried to revive him for 1.5 hours but he didn't make it. It's hard to say why he died, but he was 5 days post a hip fracture, and was not on any DVT prophylaxis before coming to us. And unfortunately the Haitian anesthesiologist was not the best. She wasn't able to intubate him and didn't help with the code. But, we had enough qualified other medical staff to run the code.

I'm learning codes. I never had anyone code in the states here, but this is the 6^th I've seen. And I don't even help with the NICU baby codes. It's just crazy, and I need to sit in some practice codes to get more efficient.

12^th June 2011 (1252)

What a wonderful opportunity to get away from the hospital. It's just a needed day away for all of us long term volunteers to enjoy nature and relax. Haiti is actually beautiful once you get outside of PaP. We had to get up early, but it was worth it. My stomach was been upset the last 2 days, but I think it's mostly stress. I just worry about our patients sometimes. After having 2 unstable people in 2 weeks, I constantly feel uneasy about some patient going bad. So Nathan, the head boss, decided we all needed to get away because we have no group here this week.

I realized my ministery is children between the ages of 12-15. Sondy and Beatrice and both staying in the long term house. It's a joy to me to have both of them there at the same time. I went last night to talk, read the bible, pray, and sing. I want to do that every night this week because this opportunity won't come that often. Time just goes so fast! I never get to do all that I want to do. I haven't even seen Elisabeth and baby Donna in like 6 weeks.

I visited Roseandy's apartment on Saturday evening, for a small 1 bedroom and sharing a kitchen and bathroom, she pays 3,000 HD per year ($375 USD per year)...which isn't a lot compared to what we pay. But, imagine lots of Haitians only make 125 USD or less a month. It was a study house overlooking a corn field. It was back from the main road, so a little more peaceful. There is a mountain across the street and she said it's cheaper to rent there (about 1,000 HD per year...125 USD per year), but everything is crammed together and you have to trek up the mountain. But she said those living on the mountains, did not feel the earthquake on January 12^th. Although mudslides are probably a danger.

I'm excited for this week to be calmer because we only have Dr. Francel (the Haitian orthopedist who will be doing 6 months of fellowship here). I can get more Kreyol practice, especially in rounds because we don't have to translate to any American doctors. He tends to revert to English with me because he worked with mostly Americans in the Dominican, so he's used to speaking English to his co-workers. But lunch on Wednesday, I ate Mac and him so that was good Kreyol practice.

We took off the cast on Beatrice foot because she said it smelt bad and hurt. It ended up having a infection, so today we had to clean it out in the O.R. I feel like a clutz in the O.R. I need to spend a couple days so I can help with Jeannie is not there.

I really enjoy just having choir practice on Saturdays instead of a program sometimes because we do devotionals and then just sing. Then we end the Sabbath together.

21^st June 2011 (0717)

I feel like a lot of Haitians go to bed early and rise early, so I need to adopt that practice. I guess if I had no electricity or internet that would help. I just have been feeling exhausted all the time. I was going to be done at a normal time yesterday, but then I had to write a medical report on a 19-year old male patient who has a bone tumor growing on his shoulder and down to his bones. They started arranging care with another hospital, which was fine with me. Apparently this place might be able to get him to the states, which would be better. Apparently it's a massive surgery they have to do to remove his arm, part of his shoulder, etc. There are lots of big vessels there and nerves. They have everything easily accessible in the states (including an ICU), so I'd prefer them to do it their if they can.

So, I try to fit everything in. Talking to Wilshaw, exercise, and Kreyol practice. Excited it's less than 4 weeks until Wilshaw comes down. Robenson bailed on us because he's not setting up the ride, but it might actually be nicer that way. I'm still going to try to find my way to the orphanage without him

Terry's back, and we have 2 doctors, as well as 1 resident & medical student staying for 5 weeks. And we have an anesthesiologist, praise the Lord! We got 1 of 4 of the hip surgeries done. There was a MSF hospital shutting down that sent us 4 hip fracture ladies between the ages of 66 and 87.

26^th June 2011 (0900)

I always love mornings to wake up slowly and not have to rush into anything. I'm thankful for the opportunity to visit other church homes as a choir to worship God with them. I'm thankful for the group to laugh with, even though I'm always squished in the car and can't understand all of it. I somehow ended up sitting in between the 2 joksters of the group, so they would go back and forth standing up & sitting down telling jokes. I am slowly starting to get more of the jokes. Haitians love jokes, story telling, and singing. Glad I can join that part of the culture. Then, I spent about 2 hours with Beatrice and Chademere last night. It's time well spent. Chadmere is a 14 year old girl with bad rickets, they placed a device on her leg to make it straight. She's staying longer term for therapy. There's many people I want to spent time with, so sometimes I need God's guidance on how to spend my time the best.

This week was pretty busy- they did surgery all 5 days, but a lot of them went home. I worked in the recovery room. I'm learning because I have not had formal Pediatrics or recovery room training or experience. They have a thing called an oral airway, just to keep the tongue down so it doesn't obstruct the throat. Well, the guy starting gagging on it, so I thought it was time to take it out. Then his sats dropped to the 80's. I ran and got the anesthesiologist who put oxygen on him and taught me a technique to keep the airway open. He did fine, and we got him up and coughing. But it sure did give me a fright. I"m not used to taking care of patients with things in their mouths yet. I'm learning, and thankfully there are people to teach me- Marc, Summer, and Tim.

Other than that, slowly trying to get better at Kreyol everyday. I'm trying to make my night devotions reading the bible in Kreyol. That is really helping my Kreyol. I wish I could learn faster, but I'm getting there little by little. Mostly for work, I don't use a translator. I actually translate now for the doctors. I praise God we successfully performed all 4 of the hip surgeries. They're all doing well. 2 left, and 2 more will leave tomorrow. I still pray for them because the mortality rate is 50% a year after surgery. Mostly, for their souls to know You.

I feel so joyful in my soul. I am thankful for God to give me this joy and peace. I'm thankful for God refining my character (and I guess the trials & tribulations to do that). Even though it can be hard on the sleep habitat, I'm thankful for this opportunity to live with a body of believers to help me learn what it means to live as God calls us to live.

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.