Haitian Donkey Happenings

Hi All:
This should be a brief update on a couple issues of praise and prayer.  First of all, I don’t have Dr. Bartlett’s reading on my first postoperative CT scan yet  (I am supposed to have one each 3 months for a year or so, so this is # 1) but the reading thus far is negative for any residual disease.  Admittedly, it took a year for some to show up last year, though we did have chemotherapy for the 7 months after surgery, but this is still a cause for thankfulness and praise to God for his help this far.  Dr. Bartlett, being the surgeon who did/supervised the work, would be the most critical examiner of the CT scan, and so await his opinion, but thankful for the good report thus far.  By the grace of God, I have pretty much regained the majority of the weight that I should gain, I may put on a few more pounds just for good measure, as an insurance policy, should I need/be able to tolerate a third marathon procedure, but will basically stabilize my weight and keep my strength up.

The prayer items include prayer for my brother in law, Harold Punter, who is still undergoing rather difficult chemotherapy and struggling to keep up some strength and ability to work, at least to a limited degree, and keep his life going. We have always been close in so many ways, sharing our cancer trials has brought us even closer, but it is difficult to watch my brother in law and friend struggle with what the Lord has allowed in his life.  My sister Margie and Harold have been an encouragement to me to keep my head up and going in our battles against our cancers and appreciate your prayers for them also.

The other major item of prayer is for our struggles to figure out a reasonable solution to our leaking septic system at the hospital.  For some reason, whether the shakes caused by the quakes, the buildup of pressure from the solids in the huge tank (knowing what interesting items have been flushed down the toilets in the hospital, including mango pits and other things even the most durable of systems are not made to take), we have developed a leak in the system.  Poor Duane Ver Kaik is commissioned with the nonenviable task of trying to make this work.  One of my concerns is that, IF we even can get a “honey wagon” truck or two to help empty it, we figure it will be at least 10 loads and, with all the fears of diseases, where will it be dumped.  Those who have had the privilege of going to Haiti know that convenience often rules over logic and trash is deposited all over the scenes, on the road, all over the hospital terrain, etc.  So, we need some wisdom as to where to dispose of this so that those who already fear Ebola coming from Africa, have survived the rigors of cholera allegedly due to the UN not properly disposing of their waste products, etc, will not suspect that anyone becoming ill in the area where this waste is deposited caught it from the “fertilizer” we contributed to the land.  I have made inquiries into the procedure that will be followed, but changing time established routines may not be so easy.

The Lord willing, Duane will start this procedure in 2 weeks, so that by the time I arrive with the other 5 team members and we crank up the hospital to a much fuller occupancy (and thus increased water and waste usage), as well as the laundry running full tilt with the soiled laundry/OR drapes, etc, the system will not be in the down and out mode but in the up and running one.  Thanks for your prayers for wisdom and strength for all the various aspects of this smelly affair.

In His Service,

Bill for the Haiti Team

A Warm Reception for the Straggling Haitian Donkey

Hi All:

For some of you who know me better than others, this may surprise you, but Dan and I have been sweating since our arrival in Haiti. Now, I am not complaining, won’t quite say the same for my good friend, but he isn’t quite built like the donkey and doesn’t enjoy sweating as much as I do. But, it is hot for even myself and, once again, I am very thankful for the regular double bed that I have to sleep in, so can roll over from the sweat spot on one side to the dry side and then exchange sides after a while. I am even covered with sweat in the air conditioned OR, as it is a bit warm for even heat seekers such as I. Dan, who loves the cold, is really suffering, especially as he struggles to get the industrial washing machines in the laundry working, as well as the water pumps for the hospital water supply. He states that he had a bit of a shock a couple times while working on the machines and touching a live wire, and the Haitian laundry ladies howled with laughter. Not sure they understand the cultural difference of laughing over another’s difficulty nor likely the more serious nature of getting electrocuted, although the pastor husband of one lady, Madame Petit RoRo, died when he engaged in a very common practice here: The majority of Haitians think nothing of just dropping your house electrical line onto the EDH (government power) line and enjoying free electricity compliments of the minority/paying customers. My friend Ed Amos, who works as a PA in Port, says that in some areas there are thousands of such lines going to the poor shacks where he helps take care of people, it is just expected that one may do this, like getting a few buckets of water out of the stream that runs by your house?

Speaking of heat and water, we have had several lightning storms, one at 4 am yesterday made Dan sure that rain was coming, but it just gave us false hope as everything is very dry and we need water badly, sort of like it was the last few weeks back home in our part of Michigan, although Karen told me last night that there was a good gully washer yesterday afternoon that soaked the inside of her car after leaving the windows cracked open. Thus, it is very humid as the moisture is in the air but doesn’t arrive at the desired locations yet. I continue to be very thankful for my friends on the building teams who have improved my sleeping (and eating) quarters so much that I can have a fan going all night on the battery fueled inverter that keeps it cool enough to sleep under the mosquito net. Those extra repairs and additions have been the proverbial icing on the cake to living here and it is greatly appreciated.

The cases have been going well. I saw a 2 day old with a huge cleft lip that I thought I would let grow a bit until Luke came, as he was planning on coming with me in November and we could undertake that together, plus let the little one grow a bit as his mom seemed to be able to feed him with a syringe. However, Luke decided he might make things a bit more of a challenge by breaking his foot last Friday and now needs to have surgery and possible bone grafting, so timing will be questionable about him joining me after all. We are all praying that he will heal well and be able to come back soon. I also have had a bunch of hysterectomies that had had previous surgeries, thus lots of adhesions.So far, we have been able to do them all safely except for one whose cancer had extended into her bladder and colon and I decided that it probably would be too difficult to undertake out here without undue risk. Also, while doing my last laparotomy (which is exploration, which works well here when you don’t have much of a clue what is going on inside, something we do run into quite often with our less sophisticated equipment) yesterday, I found what was almost an exact replica of what was found in my abdomen March 13, 2013. We really tried to reduce her cancer load as much as we could safely do under our limited circumstances, but it brought us all a lot of sadness. She seems to have a fairly solid faith in Jesus Christ as her Saviour, for which I thank the Lord, and we are trying to help her cope with the future as best we can. Since Dr. Jim Webb was here a couple weeks ago, the pressure of surgeries is a bit less and I have had the opportunity to do more administrative work, UGH. However, it must be done.

It appears that the (Haitian) mission administrative team persists in having Pastor Joel running the USAID program, so Dr. William and I are having nothing to do with it, as his track record is dismal at best. But, they are functioning to a degree and seeing and treating patients with preventative care, a good thought, though not backed up with a lot of practicality at times under our circumstances. Things like telling them they have to boil their water to make it safe to drink brings a quizzical look, as there is precious little wood to spare, but the efforts continue. Several nurses have asked me if the Ebola epidemic will spread to Haiti, an unknown entity, of course, but something that strikes fear into the hearts of those who already live in perpetual fear of the scary unknown. Dr. Barb Okamoto, who was here a year ago filling in for me for 6 weeks, is presently in Niger and asked our prayers for their safety as Ebola is a more realistic threat to them.

We had, among other tasty treats, a new food, compliments of Beth and her two German housemates, both named Suzanne, consisting of grated coconut palm hearts (the center of the tree) a really neat replacement for cole slaw in a country where such vegetables are quite hard to grow and find. I think Dan and I are doing a good job of plugging up our arteries with the tons of eggs he makes each morning for my continual meal grazing. I still continue the habit of getting up in the night to do what all older men have to do and instead of keeping a book nearby to read while otherwise occupied, as most normal people do, I feed myself with whatever food I have set in very close proximity, so as not to wake up too much to find it. This has kept the nutrition intake reasonable, though both Dan and I are struggling with keeping hydrated, despite drinking every chance we get. We have see that the water intake breaks far outnumber the water output ones.

Thus, we are over half way through our week with enough projects to last several more weeks, but time flies out here also and will do what we can to finish up in some semblance of style. Thank you very much for upholding us and our efforts to serve Him in Haiti in prayer.

In His Service,

Bill and Dan

The Haitian Donkey Prepares To Head South

Hi All:

Will give you all an update before the next trip down south. I am very glad that the recovery from the repeat hernia repair/clean out of the mess in the groin, etc went very well, thanks to Dr. Dan De Cook, the Lord (of course) and all your prayers and I feel back to my normal skinny self. However, the weight has been returning much easier after the hernia/cleanout and I am now at 11 pounds, so cleared for takeoff by Karen’s flight regulations. I have been eating 1/2 of a sandwich, or whatever edible things I can find/Karen makes for me, at least 3 times during the night, this has supplemented the body corpulence quite nicely. So, for all you who have contributed, either by prayer, encouragement and many who have brought “tasty snacks” to me one way or another, THANKS very much. I would like to gain a few more pounds to have a bit of a buffer zone to live with, but am very appreciative that the strength is really back to normal and am able to do most anything (that I could do before, of course, still cannot climb a ladder more than a few rungs without my knees shaking, still don’t love flying, or more precisely, riding in fast moving bodies that wobble, etc) now again.

I am in the process of checking my labs to see if the anemia has resolved, or at least improved, as am planning on doing my first post hospitalization CT scan when I get back from Haiti, on the 27th of August and need the chemistries checked before they give me the “contrast smoothie” to drink. I think it should be fine, although Dr. Bartlett decided that I would not need chemotherapy for the time being and will see if we do ok without it. I am not eager to add that, but will do as told, I suppose, if the order comes down from Pittsburgh. My brother in law, Harold, is undergoing it, has had a change from the Gemzar, which I think is more aggressive (and much newer), to the 5FU that I had last year, a cousin chemotherapy of a similar class and hopefully better tolerated. He really seems to try his best to remain as active as possible, which I am sure helps keep his body in shape to try to fight the cancer and I am always encouraged to see my friend and brother keep going with a disease that has a prognosis as dismal as mine, but, by God’s grace, we are both doing fairly well. I also have been taking some chloroquine again to be sure that malaria doesn’t rear it’s ugly head as it did after my second surgery in Pittsburgh in May. I have done it with some apprehension as I developed severe hives with the treatment, using a cousin of chloroquine, called hydroxychloroquine, used for treating rheumatoid arthritis, as there was no malaria treatment to be found in the hospital otherwise. We used chloroquine for all our years overseas without reactions on my part, but had stopped as my cumulative dose would be too high if I continued it while in Haiti. But, restarting as really don’t want malaria again at this point (or ever?).

Dr. James Webb just returned from Haiti last weekend from his second trip there since my surgery and it went well, both in the number of cases done and how they went and in his travels back and forth, as he always tries to go standby and there are a lot of unknowns involved. We are thankful also that Dr. William was able to pick him up and bring him back to the airport, it is an extra burden for him and I appreciate him trying to make things as smooth for the surgeons who fill in the gap for me. Dan Boerman and I will leave next Saturday, the 16th of August, Lord Willing, and I have a number of extra projects that I would like to try to sort out as well as I can. The biggest for us at present is to continue to sort out the financial situation of the hospital, as well as the USAID continuing saga. I don’t understand still what is all going on there, not sure I will this side of heaven, but will keep working on it with Dan and other’s help. There are so many “fuzzy finances” involved that the smoke screen never really lifts the fog off the books.

I also am still making attempts to contact others re the possibility of a surgical residency for the men, not sure I am making much progress yet. I have sent out letters to several physicians and the head of University Lumiere, not sure how much this works in the Haitian culture, so will try to contact them personally also. There seem to be so many roadblocks in the path that at times I don’t know if this is God’s way of telling me that I am not to go down that path or just testing if I am persistent enough to walk in faith for His glory, as Jesus encourages us to do in Luke 18:7, in the parable of the unjust judge who delivered the widow due to her persistence, and He says God will answer those who cry day and night to Him also. So, continue to pray for divine wisdom and balance in the many tasks in front of us in the next few months. I do have a set of requirements for making a hospital in Haiti considered a university hospital, the first step in having a residency program, plus have gathered a bunch of data from our sister hospital, who would join us in this venture, but there seem to be a bunch of things that still lie before us that no one really seems to know for sure in my questionings.

I also hope to join our sister hospital in making combined IDA orders from the Netherlands, so that we can save money and get meds and supplies more frequently (so keep fresher stock in the pharmacy, etc) in 40 foot sea containers, we hope to go maybe for 3 or 4 times a year. However, this takes more time on my part to do the ordering, as it has to be done online and coordinated. We hope to also accomplish the first order in the next few weeks. In addition to the medical work, Dan, Duane and Jeff have been brainstorming on how to fix a sewer leak from the septic tank that handles most of the waste of the hospital and is located next to the “condominiums” as the hostels have been dubbed, so that looking out your back door may lead you to decide that the odor is not worth the lush greenery that grows in the immediate area. A storage space was inadvertently built right on top of the tank, limiting access to a considerable degree. Things in Haiti never seem to have easy solutions and I am eternally grateful for my dear friends who help so much in keeping the physical grounds clean, functional and constantly improved.

So, will stop with the update and write again when we are in Haiti. We certainly appreciate your prayers, encouragement and help as we continue to serve Him in Haiti at Centre de Sante Lumiere.

In His Service,

Bill, Karen, Rachel, James and Jenn (and Dan)

Donkey Trots

Hi All:
Not even sure if a donkey, let alone a scrawny Haitian donkey, can trot, as his more elegant relative, the horse does, but if he can, we feel like that is happening, for which we praise the Lord. As we mentioned the last time, I am under a strict regulations from Karen that I have to get 10 pounds on my skinny frame before I can return to Haiti and we applied the proverbial feedbag with the addition of three nighttime feedings to help with the number of daily meals, as trying to increase the size of them only produces our not so happy “dumping syndrome.” We had a couple episodes of this over the Fourth of July holiday, as Jenn and Karen combined to make some “smoothies” which went over big with most of the family and I decided to try one in the evening, when could recuperate in my chair if the tasty treat proved a bit much for the system. It reinforced the idea that such calorie boosters like Ensure and Boost will remain off the diet for the rest of my life, as more than 1 ounce of them bring immediate cramps, sweats and a definite ill feeling. As it was the holiday spirit season, I even tried a small “moose tracks” ice cream dose, as it has been over a year since I tasted ice cream, but I knew beforehand that would not fly. It tasted good enough to make the grief which followed worthwhile, though won’t do that too often.

However, the weight has been slowly creeping up. I have to have the pounds on board for 5 days in a row before it goes on the official record book towards the return to Haiti, but I am up to 5 pounds for sure, working on the 6th at present. The best part of the news is that Dr. Dan De Cook, my friend and surgical colleague, agreed to do my repeat hernia surgery July 1 and that has really made a big difference in what I can eat, how much pain meds I have to take (have cut to half the preop dose already) and how active I can be, though I have to remain obedient to not lifting and straining as much, as certainly do not want a three peat surgery, two is enough and I have mesh in there. The surgery at Holland Hospital went well, though he found a fair amount of not so great looking tissue to remove, but repaired it the same way we used to do in the US (and what I still do in Haiti), then threw a mesh over it all for good measure and sent me back home. Almost immediately, my nausea has diminished greatly, the pain from the new incision is there but the “ball and chain effect” of the dead tissue is gone and this is much more bearable, knowing the healing process has begun in earnest.
As my partner, Dr. Lugthart, had vacation planned starting the 7th of July, I was able to work full time that week and put in almost 60 hours in the office and Sunset Manor, so thankful for the good recovery.

As many of you know, the sad news of last week was that our “partner” in the building industry, Lamar Construction of Zeeland, MI, went out of business. Thanks to our contacts there through Duane Ver Kaik, they have helped us tremendously with supplies for the hospital building and repairs of surrounding structures, etc. We have been very blessed by their help over the last many years, including sending a team out to build the hospital chapel last year (2013) and the gym for the camp the Wrays have up the road in 2014. As we have made many friends there, it was doubly sad to think of all them (among the 280 or so employees who lost their jobs) now having to find new ways to support themselves and their families in our less than robust economy.

In my personal devotions, I have just finished rereading Nehemiah, where he sets such an incredible example of how to do God’s work in His way for His glory and it keeps me asking Him how to proceed with the surgical options for our hospital and doctors in our attempts to negotiate through the maze of political posturing that exists in attempting to accomplish something of a legal nature in Haiti. Nehemiah’s finishing the wall of Jerusalem in 52 days despite opposition from the neighbors and other government officials makes me jealous. At present, it appears that one first must become a university hospital to be eligible to train residents and then one can apply to have a residency program, ie there is no such thing as community residency programs like we have in the US. So, trying to see if maybe our sister hospital, Bonne Fin, can become one and we then can combine forces to complete the eligibility process. Needless to say, I need a lot of God directed wisdom and patience to navigate this process without making mistakes as this is a new procedure in a country that is able to produce more red tape than I can wiggle through without supernatural help.

My second partner is negotiating trying to get his kidney stone dislodged, then blasted in the hopes of getting this nagging pain out of his system in the next few weeks, so I have pretty much resigned myself to not being able to go to Haiti in July (as we are only 3 in the practice and only one can leave at a time, understandably), plus my lack of spare tissue growth has prevented that possibility. I am again very thankful that Dr. Jim Webb has graciously agreed again to fill in the gap in surgical coverage for the month of July and will leave the 26th of the month for a week of work with the crew down there. Dan Boerman and I are aiming for the 16th through the 23rd of August and then I plan to go the 27th of September through October 4 with Duane Ver Kaik (and Ruth, I think), as well as my medical school classmate/partner, Mike Langdon and his nurse son, Josh, a physical therapist, Jenn Wichterman and her parents, who will work with Duane and Ruth on repair projects, etc while the rest of us (four medical and four repairers of the gaps)concentrate on medical and financial issues. Those plans are not yet written in stone, though starting to sort out fairly well if the Lord continues to give us all green lights in the way of health, time off work, finances, etc. Part of my goals for both weeks include making some headway on the political process involved with the possible surgical residency program.

So, once again, you get a bit of a rough draft form update, but wanted to let you all know what has transpired and hopefully will in the near future as we greatly appreciate your prayers for wisdom in our efforts to serve Him in Haiti.

In His Service,

Bill, Karen, Rachel, James and Jenn

Who can refuse them water?

Hi Friends and Family:
We are thankful to have had camp several weeks already this summer. Our most recent camp was a volleyball camp. We are grateful to the visiting team who helped and for the way they shared their testimonies each evening in front of the children. Many children are turning to the Lord.

The gymnasium has been a great asset to the camp. We have been able to have most of the activities in it and are thankful to be out of the sun and wind. With three courts, we are able to have a couple hundred children in it at the same time, no problem.

The latest addition to the camp are the sewing machines all set up and ready for use. The young ladies really enjoyed making a bag or a skirt with their newly learned skills. We are thankful to each person who has kindly sent these machines to Haiti via sea containers.

Yesterday morning we woke up to the front fence fallen over from the storm in the night. We had high winds and it seemed to be just enough to push over the galvanized fencing along the ocean that was put up just a couple years ago. The fence was covered in salt and rust which happens quickly living just a few feet from the ocean. Thankfully, we had received a container two weeks ago with some fencing for future use. The Lord’s timing is amazing and we are thankful for His provision. Rod and Tim quickly got to work with some young friends and had the new fencing up by the end of the day.

It was a privilege to have the water slide pool of water used for a place of baptism for 9 people yesterday. The river beds are dry and the ocean is rough, so it was a good alternative. This church group drove from about 1 hour away to come to the water of Camp Mahanaim to be baptized.

Thank you for your continued support and prayers. We are thankful for each one who prays, gives, sends and comes to help with the various ministries.
God Bless, Rod, Deb, Tim and Katie