The Haitian Donkey Plods Home Again

Hi All:

We are back home (minus our luggage, but that is promised to arrive in a bit, as we were delayed getting in to Dallas last night for a tightly scheduled 45 minute layover (flights are becoming more expensive and much less available) and, despite then being delayed 1/2 hour once we were seating on the plane, our luggage never caught up with us. However, it is all suitcases full of stuff for the Women’s Center distribution, so not urgent. Jeff did bring home both Ultrasound units in his carry on to see if they are fixable, as new ones will cost between $7500 and $10,000 depending if we can get a charitable organization grant/discount from them. Obtaining and maintaining reasonable equipment is a daily struggle for our hospital on a limited budget, so appreciate prayer for wisdom in these endeavors.

The rest of my week went pretty well, I recovered well from the GI bug I brought with me INTO the country. The week before departure for Haiti was a bit hectic at best, though thankful that we were able to participate is almost all the activities surrounding Harold’s last days on earth and his great home going funeral (if that can be properly sequenced together?). Though of course, as Christians, we do sorrow over missing our brother greatly, we also thank the Lord that he no longer is suffering and has his glorified body and has been reunited with my parents (my mom died 31 yrs ago and dad 15 already) and his grandson, as well as the hosts in glory. I was greatly encouraged over the arrangements he had made for what was shared at the funeral, as he explained his trust in God and his desire that all of us examine ourselves and be sure that we are living as God would have us to and thus will be prepared to meet Him. There will be difficult days ahead for many of the family (my wife and my sister, Margie, are, as I write this, on their way to Brampton, Ontario, for the funeral tomorrow of the 7th of my dad’s 10 siblings, and another sister is essentially on her deathbed in the Netherlands, from what we hear), but we were greatly comforted and encouraged by the many cards and expressions of sympathy, prayers, etc extended to all of us. Although we are considerably less than perfect, I was thankful that my own 10 siblings and huge extended family, as well as many friends, pulled together incredibly to help out through the difficult days around Harold’s home going and will continue to do so in the days ahead. I think that I probably got my immune system’s resistance down a bit with all the extracurricular activities, was queasy on the trip out, but originally attributed it to the choppy way the planes seem to blaze through turbulent pathways now, instead of trying to avoid them. Not eating anything and only drinking gallons of Oral Rehydration Salts for a day does help the ministry of the interior to clean out, but takes a bit of your strength out of you also for a day and then some.

We finished the week in Haiti pretty well, with an extended required meeting with USAID quality control representatives (wow, can government projects exceed in paperwork and self sustaining expeditions propelling us rapidly in questionable directions), on Thursday. I may have salvaged something from the prolonged verbal completion of the many paged questionnaire (all in French, of course) in that I hit the Haitian coordinator up for consideration of a donation to the hospital of a packet of very expensive deep cycle batteries that we have been told fill an entire warehouse in Port and might be available through proper channels? At the end of the “quality control investigation” he asked me :if there was something they could do to help us in our care of the patients in our assigned region: and one doesn’t have to ask me twice.

Friday had 14 more cases scheduled, but not that many large ones (by design, I don’t like to do big cases when I leave at 2 the next morning, in case there might be a complication for me to take care of), plus an afternoon meeting with the guards and cleaning people, about 25 of them, ALL in very “villagy Creole,” bit tough on my comprehension, to be generous. We were cruising well in the OR when a huge host, about 50 people strong, including several well armed police, descended on the ER with 2 victims. It seems the two well developed men were “quarrelling” (is the literal translation), with another man when the fellow decided to bring the odds more into his favor by adding a machete to his tool box. Wow, can that do a ton of damage in a short time. His patellar tendon and it’s insertion into the leg bone were chopped off right through the bone, so that the entire knee joint was exposed. Similar damage was done to both men’s hands, ie all 4 of them, and then lots of significant chops on all the other extremities. Additionally, there were tons of dirt and grass well imbedded into all the lacerations, including into the exposed bone. It was useless to figure out how this could have happened, but it took all 3 of us physicians hours to debride/clean things up and sort out the pieces to the best of our ability and then try to make some semblance of restored order. I don’t know if they ever will be able to hold their own in future battles, should they be so foolish to engage in these activities.

As noted, the trip back home went quite well and we are thankful to settle in to our families and “other job.” While we were in Haiti, a good segment of the “Haiti team,” in the US gathered supplies, sorted and packaged them and on Friday, the 24th, loaded another 40 foot container for the hospital and the Wray’s ministry on a mega crammed schedule. A group from South Carolina who have a number of orphanages in the area of the hospital have been trying to coordinate the medical aspect of their services with the government hospital, including sending down like $400,000 US of equipment, like an new anesthesia machine, other OR equipment, but the customs agents told them they would have to pay $50,000 US in fees to get the supplies they would donate to the government hospital and let them use it in exchange for doing some cases on the local population for free! In frustration with the system, they got hooked up with us and we will send it down and put some of it at least into use at our hospital in exchange for them helping us with just the shipping, as we have a duty exempt status situation, something the government run hospital doesn’t? Due to the misunderstandings, this needed to go out under a big time crunch, so I/we have, once again, greatly appreciated the EXTRA effort put out by Duane, Dan, Theresa and MANY others who do so much to make the work at Centre de Sante Lumiere possible. The work just could not be done without them and they are a great blessing to us.

In His Service,

Bill, Jeff and Linda (sorry, will spell it right someday)

A Good Running Start for the Haitian Donkey, Maybe Not So Much for Jeff?

Hi All:

As mentioned in my last update, it seems that this week has been considerably different than last month, when Travis and I had a pretty much nonstop running week. We have been very busy, but having the extra staff, (ie having both Dr. William and Dr. Sony here) makes a world of difference in the patient load, etc. So, we are thankful that the medical part seems to be running well. We have seen close to 100 patients in surgical clinic so far, of course not all need to have surgery, a few are too late to fix, etc, but that has gone well.  We have been able to do 22 cases so far this week and they all seem to be going well.  We have a couple diabetics with foot gangrene that need amputations and I think that we are getting close to convincing them that they need surgery, it is difficult to lose your leg anywhere, but a special struggle in a non handicapped accessible society. Walkers don’t work well on the rough ground and wheelchairs do even less well on the uneven surfaces, so one literally is one leg behind the rest of the world.

Jeff is always very concerned about preventative maintenance, an unheard of concept in Haiti. So, he came with a long list of projects he needed to work on to KEEP things running. Unfortunately, thus far, he has just been plugging holes in systems that are NOT working, including a literal hole in one of the plastic water tanks on the roof. It has been leaking for a few weeks now, he obtained the tank in Cayes today and hopes to get it up on the roof and working first thing Thursday morning. When he arrived, there was no water available to the room on top of community health, where Dan, Duane and Jeff and their families stay, a broken water line had developed, so they just shut off the water to the area and you learn to do without. He tried to fix the ultrasound, which has not been working for a couple weeks and is greatly missed, but it appears we will be carting it back home in our suitcases to see if it is repairable. He also has to fix the washing machine this week and it appears that the battery backup for the OR is nonfunctional, as I was stuck in the dark after only 3 minutes when the government power disappeared in the middle of a case.  Fortunately, as opposed to our last trip, where we counted the amount of time the government gave us electricity in minutes/day, we can count it in hours each day so far, a special blessing as we have a good number of patients who have respiratory difficulties and running the 6 or 7 oxygen concentrators is much cheaper than using tanks of oxygen, which is quite expensive and difficult to obtain here. We cannot afford to run the generator just to keep the concentrators going and they draw enough electrical juice that the battery backups cannot tolerate them for long. The explanation for more electrical availability is that there are some important events going on in Cayes and the government needs to make a good impression. Beth tells me that we always have extra power when the World Cup is on and similar special events. Whatever the reason, we will be thankful for the provision.

We have had a bunch of rain and the crops are starting nicely, plus it keeps the dust down around the hospital and elsewhere. It also has been quite warm, something again I enjoy, Jeff maybe not so much. Of course, he does a bunch of physical labor in the hot sun while I am in the OR a fair amount of the time, so suffer less than he does. Jo Marturano and her colleague, Bobbi, from the Carolinas were here last week already and will go home with us (we try to economize rides, especially now that Capital Coach, a nice bus ride for a bit more money than the regular Haitian buses, have been taken out of service as they were run by the Dominican Republic and with the present animosity between the countries, several buses have been stopped, emptied and then burned, always a wise choice in a country already strapped for service). Jo is a psychiatrist and her friend is also in psychology and they have found plenty of work as they have tried to help folks in that domain. I think this is the 6th or 7th trip for Jo and that aspect of the medical work has grown steadily. They set up shop in the chapel so that gives the patients a bit more privacy, peace and quietness compared to our crazy clinic population. Several of her patients also profited from being here to see me and get something surgical fixed, sort of a one stop shopping trip.

So, as usual, the week flies by with more projects waiting each day for attention. We are praying about further contact with the surgical residency program, as my doctors seem to not want to count the proverbial chickens before they are hatched, understandably, as nothing seems to go the way one would expect things to go and so we put logic aside and pray for a good result despite the obstacles. The last time I was here, Dr. Moise and I were operating together and I had a bit of difficulty in a case and I apologized to him, stating that I was a bit clumsy in getting a clamp off smoothly. He looked at me quizzically and I had to explain what clumsy meant. The rest of the week, he kept using the word clumsy whenever he could. I don’t think I quite got it through to him that someone else might take offense at being called clumsy, especially repeatedly. Yesterday, I made a comment about “making something worth someone’s while.” That took a lot more explanation to get the idea across and it joins a long list of Franglais expressions that we try to educate each other on. William always uses the phrase, “the patient might get die,” if we are considering a risky operation that he worries might have negative repercussions if we do it. It still makes me smile to hear him say it.

I had a young man come in yesterday that tried to commit suicide by swallowing acid. He then thought better of it and came to see me but I fear that he may have done a better job than he had intended. Since I do not have electricity 24/7 and do not have a ventilator, the chest is pretty much off limits except for collapsed lungs, aspirating off fluid, etc, which we do a lot of. However, the family didn’t want to go elsewhere and were very disappointed when I told them this was out of my realm of expertise, especially in Haiti. Not sure any other hospital has the capacity to do this, but referred them to the University of Miami coordinated group in Port in the hopes that they might be able to help this poor young man.

Will get this off and wrap things up for the night again as the week seems to fly by each time and we try to tie up loose ends before we fly off to the US again. I think we will again carry our suitcases full of the handiwork done by the indigent ladies courtesy of the German outreach, specifically Louisa Schuer and Olga Thissen/Lapp, whose surgical friend from Germany will work with me on my next trip, when I come the 31st of May. The ladies make impressive embroidered and other handcrafted items and I haul them home for people to distribute around the US and thus support this fine ministry.

Thanks for praying for us and supporting/encouraging the work here in Haiti at CSL.

In His Service,

Bill, Jeff and Lyn

Happenings in Haiti

Dear family and friends;

It was a pleasure to have Dr. Bill (left) and Dr. Jon Roberts (right) here.

Dr. Bill is doing very well and thank you for your faithful, continued prayers for him. His recovery since the operation has been miraculous, and his continued ministry here in Haiti is extraordinary. Dr. Jon has been a huge encouragement to us all.

Deb fitting and prescribing eye glasses at a medical clinic

We are in the process of building apartment / suites for longer term visitors here at Camp Mahanaim. The project is progressing well, and we should have two apartments for couples and two for singles when finished. Deb helps set the levels for the cement roof.

We continue to have camp for children / youth even while the construction is happening.    The camp in March had 160 campers aged 12 to 18 and several of them accepted the Lord as their savior while they were here.

We are also working on construction of the bathroom building for the gymnasium. It is nearing completion and should be in use by the end of April, Lord willing.

It was great to have our son Tim come visit us for the past two weeks. He was able to join the Athletes in Action men’s volleyball team as they played against the Haiti National volleyball teams.

This past weekend, while Tim was here, I took the opportunity to return home for a few days. Although it was a very short trip, it was a great blessing as I hadn’t been to Canada since 2012. It was special to meet our first Grand daughter (Ellyanna) and spend a lot of time with my parents. My mom is down to 90 lbs now as ALS continues to attack her body. It was great to see her peaceful contentment as her faith and hope is truly in God.

Thanks for your prayers and care,

bye for now,

Love Rod, Debbie and Katie

Home with Friends (again)

Hi All:

This is an update from a whirlwind driven Haitian donkey who is back home. Remember that donkeys don’t like to go at something other than their own pace and can dig in their heels if pushed otherwise. But, by the grace of God, we were able to fly along at the predetermined pace of the workload there, something that seems to have a mind and life of it’s own, and get done what seems to have needed to get done (needless to say, some things didn’t get done that might have needed attention, just ran out of daylight and evening hours to do the work) and literally were able to fly back home without much of a hitch. Unfortunately, one of us seems to have brought along some friends in the GI tract, hopefully they will pass off the scene soon. Just for the record, that person did not indulge much, if at all, in Haitian food, as the rest of us did, so that does not seem to be the cause of grief.

As mentioned in my delayed update, we ended up with late nights, despite all hands on deck doing their best to keep things going. Thus, I didn’t get an update finished til Thursday, as kept having snags with trying to whip off something in the late night hours (probably not the wisest thing to do in the first place, but donkeys are not always accused of great amounts of wisdom) and then having the computer eat, or otherwise hide from my abilities to recover it, what I had tried to recover and complete what had been started the evening before. Maybe the computer, who has made likely the majority of my 150 trips back and forth to Haiti in my backpack, is starting to show signs of wear and tear, but not sure my aged and non technological brain could comprehend learning new tricks, for it is hard for an old Haitian donkey to learn new tricks, of course. In any case, I apologize for delayed updates. As Dr. William was gone during the day with the Missouri team at Rod and Debbie Wray’s camp (actually out at their mobile medical mission sites) a supportive ministry in many ways for our outreaches, as we do the surgeries they find out there and help us by paying for them, a great big help for us, we were a planned doctor short for the week, something we can deal with. However, USAID had unexpectedly pulled Dr. Sony to Port for meetings on treating AIDS patients for several weeks, etc, seminars they organize to teach the Haitian physicians under their training, on a regular basis, something I wasn’t aware of, nor do we usually get much advanced notice, the usual Haitian way of doing things, it seems. Communication and consideration are apparently not high priority items. So, we were 2 doctors short for the majority of the week in one of the busiest weeks I have had in a while.

Travis is only a 3rd year premed student, who does work in a nursing home while in college and has shadowed some doctors in the US, so had a small amount of medical exposure, but wanted to come out and see what missionary medicine was realistically about. What I had planned for him wasn’t quite what he got, but he seems to have risen to the occasion quite well, and we all are thankful. We ended up doing 64 cases, many of them fairly complex and causing the two of us to have rivers of sweat pouring down our bodies for a good share of the time, despite mostly having air conditioning in the OR. The Haitian doctors wear their scrubs OVER their regular clothing a lot, even I sweat thinking about that, despite my liking the temperature on the warm side myself. I had him scrub on as many cases as possible as wanted to have him get his feet wet, but he seems to have a considerable aptitude for the work and also a good pair of hands and a good work ethic (likely from his family as I understand Dad is a hard driven builder and uncle a lawn maintenance specialist and he has spent a lot of time and sweat on those endeavors). As he fit in well and quickly, we moved him from second assistant (ie holding retractors and passing instruments to the two people (Dr. Moise and I most often) doing the majority of the surgery) to first assistant to Dr. Moise later in the day on Monday on hernias and other smaller procedures, ie less demanding cases, so I could go to surgery clinic in the afternoon and see the patients that had been seen that day in the regular clinic and needed me to see and sort them out. He responded well to the challenge and we then began running the second room later each day to keep the pace going when possible for all but the really major cases when I could have Dr. William or Dr. Adult come in in the evenings after their respective obligations in the clinics were completed to make us a group of 4, after doing the larger cases, hysterectomies, C sections and the like during the day with Dr. Moise and Travis helping me (or more likely, us two helping Moise, as he has progressed quite nicely over the 11 years of training).

We had a nice mix of cases, from removing a goodly number of growths from various body parts, both inside and outside the belly/abdomen, including a huge, over 2 gallon, ovarian cyst from a lady the Missouri team sent us from the Renault Sunday School site. She had delivered a child 5 months ago, but her belly rapidly regained it’s pregnant form and she could not longer eat or feed her baby, so two lives were at stake. Thanks to the ultrasound unit provided from our friends via Vi Anderson and Dr. Sid Fortney, we were able to diagnose the gallons being enclosed an ovarian cyst rather than freely floating in her abdomen (as it was in my case, in those cases, usually much more serious and likely a cancer versus being benign, as it was in her case) and we were able to remove it and send her back home a revitalized young lady. We also did a repeat C section on Friday from government hospital which had a bunch of dense adhesions and we ended up having to resect some small bowel to put the pieces back in some semblance of proper order. She has AIDs, so really tried our best to minimize the stress on her already struggling system and am praying that she will do well. We were able to put a split thickness skin graft on the gardener who was growing his own garden of maggots in his tibia the last time I was there, we had shown them the door and needed to get the exposed bone covered with a nice bed of living tissue to receive the graft during the month I was back in the US to hopefully get this delightful 79 year old gardener back at his job on the compound soon. My patient with gigantism and neurofibromatosis, who I have resected softball sized tumors from different body areas now four times over the years when they outstrip their blood supply and the central tissue dies and rots, came back to have me do it again on his right leg. He is one huge fellow (his hands, feet and toes are almost twice mine in thickness and largeness) and we give each other hugs each time we cross paths before doing the nasty job of cleaning up and trying to cover the holes left behind when the dead tissue is removed.

The multitalented Dan Boerman came this time to help me try to sort out the financial situation of the hospital better, as well as to inform my colleagues there that the USAID aspect of our work, the community health sector, is creating financial havoc for the acute care aspect of the hospital outreach. Over the last year, he has diligently waded through the confusing array of facts and figures and estimates that the hospital is supporting the preventative and AIDS/TB curative aspect of the hospital work to the point that it is risking a financial collapse for our entire system. He presented his conclusions, not sure we were able to convince the rest of the leadership team that we need to make major changes to the situation to correct the course of the ship of state to prevent it sinking. I think there is a lot of fuzzy math involved on their part, nothing dishonest, just not clear to those who really do not understand finances properly (and that would include this Haitian donkey, if it were not for my friend helping to enlighten me, of course). So, pray for God’s intervention and direction for us all so that we do not make a financial mistake that would put a huge hole in our testimony as a God honoring institution caring for patients in a compassionate but also fiscally responsible manner. Does that make sense? Only the Lord can make us all see what He would have us to do to rectify this properly.

Besides struggling to help us in the financial sector, he was invaluable in helping keep things afloat in the mechanical sector, as we needed to get a second cautery unit up and running to run both OR rooms simultaneously and the AC in the main room blew a switch designed to carry current to a light bulb, not a large, 220 volt window AC unit. Just fixing those problems would have been something none of the rest of us could diagnose in a month of Sundays, as the saying goes? He took a few minutes and corrected it, as well as a drip coming from it that would sprinkle you as you entered the room, and a host of other projects that we thanked the Lord daily for his willingness to repair for us. He also helped with some questionable wiring situations for the skin graft equipment on Friday afternoon, so we could finish all the tasks we needed to before departure the next morning in the wee hours. We, Travis, Dan and I, reflected on our shared observations of our week on the way home and will share one of them with you in closing. As we picked our way through the darkness, peering for signs of vehicles without running lights at all (and a few without headlights either, both motorcycles and huge trucks), we wondered at the logic behind a government who required all vehicles to add a second license plate (likely to gather funds for the upcoming elections hopefully scheduled for later this year and stimulating lots of protests that make about as much sense and do about as much good as those in other countries recently) and now gives tickets for not wearing the seat belt, but does not punish the scores (certainly more than the majority of vehicles) of trucks without more than hopefully one of the two headlights as the only source of illumination for them and nothing for the rest of us to distinguish where they are going at rather high rates of speed, nor restricting the hundreds of trucks of various sizes that have just a bench lining the back of the truck and pack customers in the back without a tailgate and have people hanging off the back to get from point A to point B at rather rapid speeds. I am thankful that I have my trips in and out of country scheduled on the weekends because of my work needs in our clinic in the US, as that avoids the daily riots aimed at bringing the government to it’s knees but is mostly restricted to the week days to stop and destroy buses and trucks bringing people and goods to their desired destinations. Pray that, in the midst of the chaos, we can be instrumental in bringing the light of the Gospel of Jesus Christ to those who need it as much as the rest of us in more structured situations.

In His Service,

Bill, Dan and Kim Boerman and Travis Blok