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