Brief Update from the Chilled Haitian Donkey

Hi All:

I just wanted to send a brief update for prayer as we are still in the subzero temperatures and it will be a couple more weeks before we go again. However, there are a couple items of prayer that we would appreciate your attention to.

As we mentioned when we last left Haiti in January, we had a seemingly quite positive meeting with the officials at the Justinien Hospital in Cap Haitian, where we are hoping to set up a collaborative effort where we will help them with some of their dire equipment needs in exchange for them putting two of our doctors, who I have been teaching for 11 years now, through their program and making them official Haitian surgeons. I have emailed them but have received no response back yet, not necessarily a surprise, but we are hoping that Dr. William and his wife, Estelle, can go up this coming Friday via a reportedly flatter and less dangerous route through the mountains and see if their family can at least consider moving up there for his 4 years of training. This is a great request as I would dearly love to see the whole family stay together (they have 5 almost identical sons, ages 4 to 11 or so, my memory is not perfect, sorry) as this will be a stressful time for them in any situation, but being together will be important for their home and family life. Of course, that will be a big expenditure, but I am hoping this also will work out.

Dr. William will be bringing the first of the installments of some shared equipment, this in the way of some sutures, as they have NO sutures at all for the hospital, the size of which was hard to estimate (ie number of beds available), but I will see if he can get more specifics to share. We are hoping that this will encourage them to consider him and a second doctor from CSL as residents in their program soon. Pray for safety, that they will not get lost (we did once on our return, not a huge time loss, but roads are not marked well, if at all, in Haiti) and that they will be able to discern the Lord’s direction for their lives and ministry on this trip.

Also, keep praying for my sister Marge and her husband, Harold, in their most difficult battle with his pancreatic cancer. They are going through some trying days and need His help and strength each moment of the days.

Thank you very much for faithfully bringing us and God’s ministry in Haiti before His throne of grace.

In His Service,

Bill

The cold Haitian Donkey arrives back Home

Hi All:

Karen has graciously provided you all with a couple brief updates of our adjusted travel plans, as we were unable to do much about the blizzard that hit the northeast of the US and closed down the Philadelphia airport (and, of course much more), so that our flights were cancelled. I hit the ground running in the US as ended up working over 35 hours in the office in the 3 days I have been home so far, sort of like punishment for extending my stay in Haiti? So, most of you know we made it home via all different flights, but thank the Lord, it went well. As Karen hinted at in her notes, the chronically optimistic Haitian Donkey also feels that, by the grace of God, the meeting with the medical directors up at Hopital Justinien up in Cap Haitian seems to have gone very well also, certainly well beyond my wildest expectations, if it holds up. Will try to update you on a few of the highlights of the rest.

We had a bunch of surgeries to finish the week well, for which we are thankful. As usual, on my last day at the hospital, I try to get to bed a bit earlier than 11 pm, my normal nighttime goal in Haiti, as breakfast is at 6:30 and one can get some interruptions by the hospital, especially when my younger doctors are on call with me, something they try to arrange as they like having backup help “in house.” When possible, I try to attend devotions with the team from 8 to 9 pm and did so the last night. Afterwards, my friend Ido wanted to have me say “hi” to his wife, Henrietta, freezing in the Alberta snow, and he tried to get the internet working to do so. Somehow, while fussing with the electrical system, he got his head into the path of the ceiling fan and we ended up needing to stem the rivers of blood running down his face with a repair of his scalp. So, my sleep was a bit abbreviated and Butch and I ended up taking advantage of Duane’s putting a couple hospital mattresses in the back of the truck and slept while Jean Eddy drove Dr. William and us to Port the next morning at 2 am. We picked up Dr. Mario Florestal in Port (where his extended family and daughter live, his wife is a pediatrics resident at Cap Haitian) and headed up to Cap Haitian at 7 am. Jean Eddy drove us while the 3 physicians planned how to approach the authorities in the meeting the next morning. Mario was one of the few graduates of our medical school who was able to secure a residency spot in Haiti, not an easy thing to do as all slots normally are taken up by the public school graduates, who get first dibs at everything. Of course, many of them are children of the wealthy minority of Haiti, so this perpetuates the problem of the imbalance of medical care, most staying in Port au Prince where their families are and thus there is not much available to the poor folks who live out in the boondocks. Dr. Robert Belding, my longtime friend and a retired orthopedic surgeon from the Carolinas who has done a huge task of building up and running much of the orthopedics available at our sister hospital, Bonne Fin, has been behind Mario getting through school and influential in getting him into the residency. Mario is at present essentially the OB-Gyn department at Bonne Fin, in return for the help given him by Robert.

We spent several hours winding back and forth on the switchbacks through the Massif du Nord Mountain range, the usual narrow roads with NO guardrails to protect us from the 80 plus foot cliff drop offs that were at the edge of the road, NOT my favorite adventure. Jean Eddy concentrated on his driving, a definitely appreciated endeavor, but Dr. William kept reminding him that we needed to blow the horn as we entered each blind curve, often 180 degrees, in case a large truck or bus was coming from the other side and to warn them of our approach, a common procedure. He kept telling Jean Eddy to “quank, quank” the horn, and we dubbed him the duck. His response was that he preferred to be a living duck than a “tomato catsup” splat on the bottom of the cliff. Needless to say, we all were relieved to arrive on the other side of the mountains and arrive at the seaside city of Cap Haitian 11 hours after departing the hospital. We had a tour of the hospital provided by Dr. Mario, a bit depressing as not much seems to work and the people were packed in everywhere on cots, beds and floors, reminding me that I am not eager to have socialized medicine installed in the USA. They had a huge library of books, almost ALL in English (I think I found one in French in a brief scan of the titles) and the majority likely donated many decades after publication. Not sure how many can read light English reading, let alone the dry, dusty English texts?

Much to my surprise and encouragement, we were met on time (a very relative thing in Haiti, from my previous encounters) at 9 am the next morning by Drs. Yvel V. Zephyr, the OBGyn physician who is the general director of the residency programs there and Dr. Jean Jean Coq, a General Surgeon and the Medical Director of the hospital. They seemed very open to developing a collaboration between us and them, as they promised to strongly consider placing Drs. William and Moise into their surgical residency program (4 years each) soon in exchange for CSL helping them obtain needed supplies and helping their limited educational resources. The items they wished the most were OR supplies, as they have no working cautery machine (they lost theirs in the unpredictable governmental electrical power surges, we know all about that, as Dan and Duane have installed a huge voltage stabilizer on our hospital to protect it after we had considerable damage from them), so would have to tie all blood vessels and they also have no suture available (sort of a no win situation, it seems). With the help of my network of gracious friends, I hope to find affordable resources to help them care for their patients while they help us make our two doctors (and maybe a 3rd, Dr. Adult after they are done) legal surgeons, so that we can provide 24/7 surgical coverage at CSL and make the hospital much more likely to be sustainable. My dear wife spends a lot of time encouraging me in my work, both in the US and Haiti, but she also at times has to temper her “eternally optimistic husband,” and I am still riding on the proverbial cloud nine in my dreams of the possibilities. Yes, she is right, this is Haiti and words are cheap, as are promises, but I hardly noticed the cliff drop-offs on the road back as Dr. William and I tried to get our heads around the visions of the future and how to, with the Lord’s help of course, make this into reality.

There is a great need for prayer as we embark on this future for the ministry there, as much needs to be done in a way that is God honoring and to His glory, but we got back to Port au Prince and rented a hotel close to the airport and let Jean Eddy and Dr. William return to the hospital (picking up the Bill of Lading for the IDA/Amsterdam 40 ft container on the way to deliver it to the customs people) and back to our “normal work.” Butch and I put on every scrap of clothing we had for the night, as no one in the hotel could figure out how to program the AC in the place beyond freezing, so that was a good preparation for our return to the US. We arrived at 7 am at the airport to find out that all our flights had been cancelled (as expected) as we were scheduled to go PAP to Ft. Lauderdale to Philly (in the blizzard zone) and GR. After a good hour of negotiations, we went PAP to Miami, then Chicago and then Kalamazoo (airport code is AZO as Haiti has no idea where Kalamazoo, MI is, I think that added to the puzzle for the agent) and Karen picked us up there. We are still praising the Lord for a great week of work at the hospital and such a seemingly positive reception by the hospital chiefs. Pray that we will be diligent and appropriate in our future collaborative efforts to further the ministry there.

As this goes out, I am hopeful that the other 16 team members are on the first leg of their flight from Haiti and that they had a safe and productive time after our departure. We have shared in the past our frustrations with the USAID dealings with our hospital, most specifically with the irregular paying methods employed by the Haitian administration they employ as contractors to do the on site work. However, Dan contacted me yesterday and his opinion is that the new contracts with Pathfinder are worse than our previous 9 years with MSH, and that they have not paid their 33 or so workers for at least 4 months. We have reached a crisis point in our dealings with them, as Haitian work regulations require that we pay the employees ourselves if they don’t and this will make the financial situation at the hospital even worse. Dan and I have wanted to totally eliminate the program ever since we got involved, as it is a constant, major headache, but we realize that doing so will cause an uproar as 33 people or so will lose their jobs, a real problem as there are precious few available and we neither need the extra workers nor have the funds to pay them. I am extremely thankful for his willingness to help me in this endeavor as I have neither the time or ability to sort that all out by myself. We have set numerous deadlines to straighten things out, only to have the Haitians find excuses to not enforce them, but I don’t think we can procrastinate much longer. Only God can enlighten us at to how to resolve this properly and we are praying for His guidance in this aspect of the ministry.

In His Sevice,

Bill and the rest of the team of 18 (17 Hebrew slaves with one Egyptian taskmaster)

A Delightful Team Effort for the Haitian Donkey and Friends

Hi All:

I never cease to be amazed and thank the Lord for the great people He sends to help here. Of course, I am enjoying my time with my little brother, Butch, as this is the 3rd year he has accompanied me and seems to find plenty to do. We are exhausted at night, but enjoy sharing the little time in the evenings together. Dan, Duane, Ruth, Theresa, Sam, Harris Rotman and Keith are long time regulars and have the ropes down very well and are, as usual, able to multitask and accomplish incredible amounts of work each day, of which the Haitians stand in awe, that people would just do this for others (without the usual expected return favors some day, I think that is the definition God uses for generosity, doing something for someone else that cannot possibly repay you, like Jesus has done for us on the cross, truly awesome, of course).

Doug Brink has been here before and now brought his son. The two, with help from Theresa and a Haitian coworker, have converted the termite eaten storage closets/cupboards into first class areas. I have worked together with Theresa for years at Georgetown Medical Center and she is an invaluable help at Sunset and is great at making sure I get plenty of food here, but maybe I am learning about a new side of her. She has been helping in the critter infested rooms in our place of work and residence and last night, Butch went to bed to see a note written on a paper on his pillow, wishing him a good night’s sleep and surrounded with cockroaches. He ascertained that it was feminine writing and, by process of elimination of the other 3 ladies, deduced she had left him the savory surprise. I assured him that she was too refined to do so, but when I asked her later today, she just smiled and said her brothers might differ with my opinion. Will check with Marge and Harold Punter when I get home to see if she is the likely culprit.

Tom VanderKodde brought his wife along to slave and sweat in the project and Dave Grifhorst, another returnee, brought his son, Paul along. Dan Boerman hauled his brother in law, Mike, instead of his wife, Kim, and each person seems to sync well with each other in doing their tasks and working with the Haitian crews we have hired to help move the 38 projects our taskmaster has assigned to the crew under him. Ido is new to the crew, though certainly not to Haiti, his home for a couple decades, but Shelby Rotman (a returnee who is responsible for keeping the web site up to date, a great help for those of us too old to handle that) can outwork many guys and doesn’t seem to let anything stop her, sort of like her grandfather, Harris, who has come for years also. So, all in all, a most greatly appreciated team and their work ethic is a testimony all by itself to the Haitians who notice everything. They had a nice dinner at the Wrays this evening, I had thoughts of going with them, but surgery just doesn’t seem to consider time management a high priority.
Speaking of surgery, I finally did, with some gentle prodding, get my surgeon in Pittsburgh, Dr. Bartlett, to give me his opinion of the questionable spots on my CT scan of December 17, 2014. He would like to repeat it in the normal 3 months (already scheduled on March 25) and then consider options. I feel great and am not eager to undergo another multi-shift surgical marathon any earlier than I need to, especially if we only get 8 months of clear CT scans out of it.
So far, have been able to do 29 surgeries, 10 of them hysterectomies, several exploratory laparotomies, unfortunately all for cancer and not curable, plus took out a huge rectal cancer today in an 84 year old gentleman, not curative, but he was obstructed and will buy him time, hopefully, and maybe by then he will be open to the colostomy option for egress of solid waste. I took off a golf ball-sized keloid on the earlobe of a 13 year old girl today, they do pierce ears here, but hygiene and the keloid scarring often take their toll on the results with somewhat less than beautiful looking results.
I ended up doing the Gutwein’s (a family who works with Loving Shepard Ministries) gardener at the end of the day. He worked for them Monday and Tuesday, then was hauled in to see me on Wednesday by his family. I asked him what his problem was, he just stated that he had back pain, normal for his work as a gardener, and he didn’t see what all the fuss was about. I asked the family why he was in the surgical clinic and they pulled his pants leg up to show a hole on his anterior leg about 12 inches by 6 inches and 2 inches deep with exposed bone and at least 50 maggots worming their way around the dead tissue. I asked him how long he had had this problem and he said for 4 days, really? The Haitians always tend to pretend that things are more acute than they are, to be sure we are properly shocked into action, but 4 days would be a stretch for this hole. We took him back to the OR to debride the lesion and drill holes into the exposed bone. I was definitely in the minority in my opinion that the maggots are just helping clean up the dead tissue, everyone else was grossed out to see these critters crawling on his open leg. Hopefully we can clean up the wound and get some granulation tissue to grow out of the drilled holes so that we can flip a skin graft over the open area.
Since the merchant’s lean-to stand across the street is up and running, Mondesir, Duane and I had a meeting with the merchants to inform them that they were no longer allowed to set up shop in or on the hospital grounds, that they were to keep the strip we made for them cleaned up, and assigned 3 of the ladies to be the committee to enforce the rules. As we finished with them, the motorcycle taxis who always park under the tree next to this place tried to convince Duane to build them a similar hanger/lean to for them to enjoy a respite from the sun and rain. Haitians are not at all bashful about asking for handouts, favors, money, etc. It sometimes can be a bit uncomfortable for us, but we have to understand the huge difference in our cultures.
So, we are winding up our week at the hospital, the other 16 team members will stay another week, though I will do surgery on Saturday, pack up and head north to Cap Haitian, anywhere from 9 to 15 hours (the last from Rod Wray, who is a faster driver than I, so I respectfully am considering the timing options) to encounter the physicians in charge of the residency program up there and seeing what alternatives we can negotiate to help secure the future of Centre de Sante Lumiere. We greatly appreciate your prayers for health, safety and God’s Great Wisdom in our dealings with the folks there, that His will will be done and we may make the right decisions.

In His Service,

Bill and the rest of the 18 laborers

The Haitian Donkey Loves Seeing No Snow In Haiti

Hi All:

Not that we have looked very hard for it, but the absence of snow is pleasant for the cold Haitian Donkey. The team had a smooth trip to Haiti Friday, as did Butch and I the next day. The plane was only 1/4th full, and was an hour late taking off as we had mechanical problems, but despite the fairly empty plane, Butch was assigned a seat next to a couple who are in the administration of a Wesleyan mission hospital on the island of La Gonave, where they have a 40 bed hospital which has had some struggles similar to ours, functioning in a somewhat less than cooperative government medical system. We found out that they have the entire hospital on a solar powered system, using the generator only for surgery, i.e. when they need to have more kilowatts. They were excited about sharing information with us and possibly with Ido, our electrician friend who is looking into those possibilities for us and is part of the team this January. Obviously, that made it a very interesting trip for all of us. Butch and I were VERY thankful that we weren’t assigned to sit next to the lady who sat in front of me. She was a youngish Haitian lady who must have been at least 400 lbs and she took up all of 2 seats, including removing the hand rest into the aisle so she could have more space. It was a seat designed for larger people, but  that wasn’t enough for her. It was painful to see her try to walk, get out of the plane, etc, very sad.

We had one of the busiest surgical clinics I have had in a long while. It has produced a busy surgery schedule, complicated with generator problems. Dan, Duane and Ido are still sorting things out, but it appears that our USAID folks may have unbalanced our electrical distribution, so that one of the electrical legs has way too much of the load on it. I will not go further into detail, as I am way out of my comfort zone and into the dangerous area, but it has meant that the big generator has browned out and shut down several times while we were running 2 ORs and once was while Dr. William and I were doing a very difficult hysterectomy. After an hour or so of no AC, I had sweat pouring out all over my body and that certainly takes a lot of energy out of you. I can work in the heat and sweat, but in the OR with the old style multilayered OR gowns, the energy goes down quickly with the rivers of water coming out of us. On Tuesday, we begged EDH, the government power company located less than a mile from us, to make an exception for that day so we could do surgery. They agreed to give us power from 9 am to 2 pm and shut it down exactly at 2:01 pm, the buggers. The newly constructed government hospital next to the power plant with it’s helipad and 2 ambulances sitting there has power 24/7, which is fine of course, but we would love to share some electricity at least a few of those hours. I have yet to see a patient in the couple times I purposely drove past it, but there must be some as they have referred patients to me. So, praying that the crew can figure that out this problem in addition to all the other projects they are rolling along on, seemingly quite well.

It is a fairly hot January compared to what we have had in the past, plus it poured buckets just as I got out of surgery tonight. Maybe that will cool things down a bit for the crew. They have the roof on the bathrooms in the clinic as well as over the merchant’s stand across the road. Butch has the floor done in both places, is working on the wall, so in the sun it is horribly hot and he is struggling to keep hydrated. All the termite-infested cabinets in the administration building where I live and have meetings and where Beth has her office are all torn out and in the process of replacement. They will then continue with the administration offices, as we all live under the same critter shared space. Butch said that Duane had sent Shelby Rotman up into the attic of the building to caulk the holes in the roof and she came down looking like she had been playing in the dirt. Thus our place of living/working is shaping up nicely. Dan has been doing quite well with the brace on his leg. He has two braces so one can get cleaned and dried while he uses the other. It doesn’t seem to have slowed him down much as he hobbles around on his banged up body and fractured knee cap. Dave Grifhorst landed on some ribs 3 weeks before coming here, I placed him on pain meds in my USA office and he seems to be doing just fine. I am hopeful that all the injuries will have happened BEFORE we got here and no more will happen on my watch. I did repair a lady preacher visiting a missionary in the area who had a dog decide to munch on the back of her knee this evening. We have no tetanus or rabies vaccines to give her, so hope things will continue in the right direction despite our limitations.

I seem to be seeing more than my normal load of advanced cancer patients this time again, including a malignant melanoma referred to me by Dr. Sid Fortney, who saw him last week. However, he has a huge groin lymph node, so his request that I just take off the large mass jutting out from his foot is a recipe for a non healing wound on the bottom of his foot and there isn’t much I can do for him. I also had a lady who had a goiter taken off at the EENT Canadian hospital just up the road and came to see if I could help her with an esophageal stricture and fistula (hole) as well as the massive swelling of her feet and legs, all due to the resultant malnutrition, as the gastrostomy tube they placed after the complication is difficult to keep going well enough to keep her alive. I backed out of a huge abdominal tumor today as it involved her colon, stomach, omentum and retroperitoneum.  Oh for a CT scan to give a roadmap before I explore them, it does keep one on his toes. I also had a lady who had a stroke 2 years ago and is paralyzed from the waist down (not sure how that goes, but am not a neurologist: her arms are fine, but both legs totally nonfunctional. I will try to figure that out if someone doesn’t enlighten me first). She has a huge decubitus that I cleaned up last night but have little hope of getting it to heal under our limited resources. So, doing a lot of praying for wisdom in caring for a bunch of seriously ill patients.

Will send this on for Karen to send out, as I don’t have the capacity to send directly from Haiti at this point. Thanks for praying for us as we serve God in Haiti.

Bill for all 18 of us

A Request

Dear family and friends;

We really appreciated Dan and Christie coming  to Haiti this Christmas again and we had a great time together. We were able to do several Christmas distributions again  this year to Haitians who live in very poor conditions.


Thanks to some gifts of children’s clothes, we were also able to do a Christmas give away at the Renault Sunday school program.

After a year of working with us here in Haiti, our son Tim has decided to move back to British Columbia to work and continue his education. We will miss him. He left on December 26th.

On Dec 27th our first team of the season arrived and together we hosted a special camp for youth, which went very well.


Last week we headed out to the Island of Isle a Vache with our second team. They did  a great job of helping many couples get married. This week we have a medical team here, who are ministering to Haitians in a community at the base of the mountains.

Our request is to ask you to please continue to pray for us. We often share with you about the exciting and positive things that are happening in our lives and here at Camp Mahanaim, but as we reflect on the year 2014,  we admit that there have been many extreme and demanding challenges that we have faced. One of our volleyball girls being beaten by a local young man using a large rock. An older neighbor man who has been a leader in the church for years, molested a 4 year old little girl right outside our gate and nobody in the community would call the police for fear of his relatives. One of our dearest, long term co workers was beaten by her jealous boyfriend and we gave her
sanctuary in our yard, and in turn had to face the wrath of this evil young man.
These are just a few examples of the many difficult situations that we have encountered this past year. In every case we have helped the victims and spoken out and taken action against the wrong, including calling the police to come and arrest the child molester. This has made us unpopular with some who live in our village as they would prefer that the deeds of darkness remain hidden.

A few days after Christmas we visited the slums of Cayes where Daphnie lives. She is a young girl who has come to our Renault Sunday school for many years. We don’t know exactly how old she is, but she is definitely less than 15 and this Christmas she had a baby boy.

In these and many other situations, we don’t know how to respond or what to do, but as you continue to pray and we continue to trust the Lord, we pray that He will give us the grace and strength and wisdom to do the right thing.

Thanks ,

bye for now ,

Love Rod, Debbie and Katie