The Chilled Haitian Donkey is enjoying the spring warmup in Michigan

Hello All:
I left a lot of loose ends unwrapped last time, still have not gathered them all but will give you an update on how things are going for the straggling Haitian Donkey. As promised, the blood cultures followed an elevated blood count, both lines had a low number but still positive cultures for Staph Aureus, not sensitive to any oral antibiotics except for Sulfa, which I am allergic to, unfortunately. So, started an IV antibiotic 10 days ago and have perked up considerably, to the point that we were able to do some yard work yesterday and make some progress on spring projects that yearn to be done after being frozen so long this lengthy winter. I will check another blood count tomorrow and see what it brings, as it affects future plans for work at Georgetown Med Center and Centre de Sante Lumiere. Tentatively, Dr. Lakhani has planned to skip cycle # 3 and just move it into cycle # 4, ie push everything back 3 weeks and step back into the routine. However, that presumes the line cultures come back negative, the infection goes away, and a number of other factors, some of which I likely don’t know about. I must admit that I feel better off the poison, less nausea in the mornings and more energy, but if that is the price to slow down the nasty cancer, I will put up with the grief if that is the Lord’s will.

The suitcases for Centre Lumiere arrived late Monday night, thankfully, so that is on the way to the destination of the handiwork of the ladies at the Center. Several people lately have asked me the difference between the titles, so will briefly try to clear them up. The hospital site we work at is called Centre de Sante Lumiere (Health Center of Light) and is located on a property owned by MEBSH (foreigners cannot own land in Haiti, if I understand it correctly) called Cite Lumiere (City of Light), where RMI and other mission agencies have their offices and a bunch of missionaries with various groups have their homes and bases of operations. Centre Lumiere (Center of Light) is the work that Caleb and Olga (and Luise Schurer in the past) do teaching ladies to do handwork, learning trades, etc, and where we have materials that we bring back to the US for sale to support the ministry. Finally, Hospital Lumiere is our sister hospital up in the hills, a 120 bed hospital run by the ACC group that utilizes a number of specialty groups from the US that come on a regular basis to do more complicated surgeries as possible. Many of those groups come through Lumiere Medical Ministries, a North Carolina group that organizes details of these groups going to Haiti to a number of different ministries to serve. I likely, in my usual fashion, only muddied the waters, but I promised I would try.

We still need prayer for another administrative decision in progress in Haiti, we are hoping that things will continue to smooth out there and we will continue to see progress in the overall situation at the hospital.  We also have received word that the fuel pump has come from Australia and that Ed Sanders and crew are planning on installing it, so hopefully the little Kia will be in operation soon. The Haitian climate is very hard on the vehicles, the fuel, the roads, the heat and the loads, so we are praying about another vehicle that possibly could come from the US, as we could get parts regularly and reasonably, impossible in Haiti. Who knows how many years the tires may have been in the hot warehouse before we buy it, they certainly don’t seem to last very long on the vehicle despite careful drivers.

So, we are setting up trips for the months to come, I have to organize the medical parts and my partners will handle the technical aspects, of course. I wish I could see into the future and how well my health will hold up under the treatments planned for me, but will prayerfully make plans for myself and my colleagues. Being of the Dutch persuasion, I hate to part with an extra $200 per ticket just to change tickets when the plans fall through. Continue to pray also for Drs William and Moise as well as Welser, the administrator, as they have pivotal roles in the future of the hospital and we try to work together to keep God’s Work in Haiti going for His Glory.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf and Crew

Update about Upcoming Events

Hi All:

This is a first time for a low tech donkey to try a more advanced technique (ie the flyer included in this update). I have three subjects to update you on. The first is that many of you know that the Haitian Donkey and his teammates carry suitcases full of supplies for the hospital down to Haiti, medical and sometimes some repair equipment/parts. Many of you may not know that the suitcases often come back with products by the Centre Lumiere, a place started by our dear friend Luise Schurer to help the ladies who otherwise would be destitute to have a source of income. She and her husband came from Germany like 40 some years ago, he taught in the Bible School and she developed this ministry from scratch, they make beautiful products from cards to place mats, hot pads, aprons, purses and handbags, etc. All is made from USA material and then we bring it back in our suitcases to distribute to churches and individuals to use to raise funds to continue the ministry. As Luise is a bit past retirement age, Olga and Caleb Thissen-Lapp now run the center, where they also teach the ladies about the Word of God and living for Him. So, it has been our privilege to contribute a bit to the ministry.

Lord willing, they will have a benefit sale at the church below as shown in the flyer, but I thought it would be good to get the news out early for those who would be interested in participating in some way. More specifics will be forthcoming as the time gets closer.

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Secondly, I have had another episode of sepsis (infection running rampant throughout my body) after aspirating my cholestyramine slurry. This is like drinking a glass of water with 3 tablespoons of dirt in it, the grittiness left behind is a joy to flush out afterwards. However, it is a life changer in that it has made it possible for me to function, reducing my visits to the little boy’s room from 25-30 times daily to maybe 8 or so and helping to increase the run time allowed to arrive clean and dry. Three weeks ago, I got a little down the wrong pipe, a byproduct of the chemotherapy, I have to be careful with eating and drinking as the mechanism leaves a bit to be desired, considerable nerve damage can be attributed to the medication, but, what is the alternative? I ran high fevers for several days, the 2nd antibiotic controlled the fever but not the symptoms and I have been wiped out, barely able to keep up with the patient workload and a few basic chores, so now catching up as have added an IV antibiotic that seems to be more potent in killing the offending organism.

The third problem is related to the second, as I need to be sure I will be healthy enough to go to Haiti again. If all goes as planned, Duane and I will accompany a team from Mike and Josh Langdon’s Bible Church in Lowell, MI, on the 9th of September. Mike was my medical school classmate and we spent hours studying medicine together, stimulating each other to learn more as we realized the grave responsibility a medical license confers on you. When he became a Christian not that long after our working together (we, us two and another classmate also named Mike) spent hours alone in the anatomy lab, arguing such things as evolution (I was outnumbered 2:1) and similar topics as we were the only students who wanted to dissect our own cadaver, so spent our free time working away with our friend, but when Mike became a Christian, all those subjects just changed instantly, Praise the Lord), we also began studying the Bible together with the same zeal we applied to our medical books.  So, it will be a joy to work with them both and the rest of the team in the medical aspect of the hospital and in evangelistic outreaches in the hospital and the surrounding village.

We also will have Ed Bos come with us to install new lab equipment, as the reagents for the old one will no longer be available. He needs a translator that has some medical knowledge as well as fluent English. There is only one person with those qualifications at the hospital at present, Dr. Moise. So, Mike and Josh will be pressed into service (Mike is an internist but had good hand skills when we were surgical students and Josh is a nurse) to help me do the smaller cases. We will do the hysterectomies in the evening when Ed is done with Dr. Moise, so will be long days for all of us. Pray for wisdom, grace and skill from God to do the work well and for His honor and glory. Pray for strength, endurance and discretion for myself that I can budget my time and energy to make things work properly for both the hospital and my health. We still have a lot of little bugs to work out, but plan on leaving in the wee hours of September 9 and getting to the hospital hopefully around midnight.

In His Service,

Aaron, Bill, Caleb, Duane, Ed, Jake, Josh, Mike, and Nick

Enjoying Warm Haiti

Hi All:

Once again, the week is slipping by and I need to get an update out for all of you who encourage and pray for us, a great blessing that we don’t take for granted. I spoke with Karen last night and she shared that, once again, I had picked a good week to absent myself from the ice, snow and cold, as she didn’t get out with the weather yesterday much and even the cats decided that exploring the great outdoors was not a wise course to embark on. So, very thankful that I get a week to literally sweat in my work while escaping a week of the chills and white stuff of Michigan. Karen and I had the opportunity of spending the Friday before my departure with Ido and Henrietta Kerpel, who now make their home in Alberta, Canada, also a place of chilly winters. We first met them on our initial trip to Haiti in early 2000, as they worked at Double Harvest, heading up the farm projects (teaching the Haitians to rotate crops and how best to get higher yields from their small plots of land, a great project that I liked to watch as I grew up on a farm and have always appreciated that type of work, plus we could have a steady supply of fresh vegetables to enjoy during our time there). Ido came to Haiti over 30 years ago, like so many Dutch individuals, including my own parents, for which I am very grateful, seeking to find a better life for themselves as the Netherlands is a great place, but cramped for space and thus opportunities for advancement at times are limited. Henrietta came from Canada and lived with MEBSH staff in the Cayes area for years and thus had many friends in the area before getting married to Ido and working in Port and later in Croix des Bouquets at Double Harvest with their 3 children. We became close friends when I started working in the medical/surgical department at Double Harvest and remained on great terms even when I transferred to Centre de Sante Lumiere in 2004 and I often would spend an evening with them in transit back to the US when time permitted. So, we had a delightful evening sharing what had happened in our respective lives since our times in Haiti, sharing a meal and exploring thoughts for the future, as Ido is an electrician who is at present working in Ontario on a large solar electrical project and has ideas of how this could possibly work in Cayes to help reduce our dependence on the very unreliable country electricity as well as our generators, which at present run well but fuel is often hard to get because of the protests, as they try to cripple the already tottering economy to voice their dissatisfaction with the lack of help they perceive the government owes them. We enjoyed our time until the late hours, the next day we went to the Vander Veen’s Dutch Store in Grand Rapids, where I think they could have spent longer than they did with lots of interesting things for us Dutch boys and girls to consider.

The same afternoon, I left for Haiti. My flights to Miami went well, thankfully, and I met up with Luke when he arrived there at 5:30 am for our flight together to Haiti. Unfortunately, he came in on the 3rd leg of a flight from Montana through Los Angeles, and his suitcase didn’t catch up with him. We left the ever gracious Jean Eddy behind with enough cash for the bribes needed to get the suitcase (even with the proper papers, often one still has to lubricate the wheels to get them to move at a snail’s pace), and he came later in the day behind us with the prized luggage in tow.

Our trip to the hospital went well and surgery clinic moved quickly with both Luke and I working with four of our Haitian doctors and the ever helpful Beth Newton. On my last Sunday in the US, Jim Heist, a friend from church, asked if I had had occasion to use the external fixation devices he had made for me on his lathe with the help of Dan Boerman preparing the metal so it won’t rust out so fast in the humid climate here, as we reuse our equipment. I told him I hadn’t had the opportunity yet but likely would in the near future. Luke and I were starting breakfast early Monday morning when the guard ran to the door and said there was an emergency case with “cartridges.” My Creole is limited and I hadn’t the sense to figure out that this meant he was shot several times, as it turns out, with a 44 at close range. He was a local bus driver who was robbed at gunpoint as he started his transport for the day’s work. This sort of violence is becoming more of a problem as disgruntled people are stirring up others with their perceived “rights/entitlements” as we near the proposed elections in the next few months. Thus, after Luke, Moise, William and I did the little cleft lip on a baby I had seen a few months before at 2 days of age, we used our most wonderful, impressive, made to order external fixation device to put together the chunks of shattered bone that used to be his tibia. It took a bit of adjustment, as I had to wing it in the OR and then take him to the xray department to check my alignment. We don’t have such luxuries as a C arm to take xrays on the spot, but he looks good and am praying that the bone fragments will heal in the months to come. We did 16 cases on Monday, a good start to the week, then will see how the rest of the week plays out. We have a bunch of cases lined up by our friends from Holy Redeemer Church in Missouri, headed by Joe Rudolph, M.D. and the church adminstrator, Harry Bahr. They ran a clinic last week about 45 minutes up the road and told these patients to come, which we appreciate. It is fun to coordinate our efforts and help each other care for those less fortunate than we. Tuesday and Wednesday have been quite busy with some more difficult cases, but we are thankful that they seem to be making good progress.

William and I spent a while tonight piecing together the face of one and the foot another motorcyclist who had accidents and rather severe cases of road burn embedded with gravel on their exposed areas. Helmets would help cases like this face injury, as the patient had torn his lip loose from the lower aspect of his nose, as well as making mush of his left lower eyelid and eyebrow/forehead. I may need to do some revisions in the future, depending on how it heals. So, will head for my bed (Luke sleeps in a hammock on the back porch, it apparently is like a sealed outfit so he does not become mosquito fodder). I prefer my mosquito net in the house, but we are getting along quite well from my standpoint. Will let him give his own opinion.

Thanks for praying for us and supporting us.

In His Service, Bill and Luke

Centre de Sante Lumiere Annual Report and Christmas Requests

Hi All:
As most of you know, I will be returning to Haiti this week, this time to meet and work with my colleague, Dr. Luke Channer, who has reported that he is making good progress on healing his broken foot and will split duties with me, as he shouldn’t stand on his foot too long yet. This will free me up for some administrative duties, NOT my favorite job, nor something I am particularly good at, so will need prayer for wisdom as we seem to have a lot to attend to. Probably the biggest is to work on finances, as the economy in Haiti has steadily gone in the negative direction and much of the positive input from work teams, etc that came in large numbers after the 2010 quake has dwindled down, understandably. However, this has left Haiti more destitute than ever and we find ever increasing patients who come to be seen but don’t have even part of the funds needed for their care.

Additionally, our number of diabetics have increased, partly because no one else has ever wanted to care for them, as they have spent all their cash (what little they may have had) before they come to seek help from our hospital and many of the government hospitals seem to actively discourage their seeking care there. As you may know, medical care is technically free in the socialized medicine system here. However, when you see the surgeon, you are told what you have to purchase in order to have your “free surgery,” such as so many IV bottles of fluids, these medications, so many pairs of a certain size surgical gloves, etc, all of which you can purchase right at their pharmacy for a goodly fee. So, the end result is that most cannot afford the care they need and we end up caring for them. Also, Dr. Sid Fortney and Beth Newton have spearheaded a diabetic program for insulin dependent diabetics, to help prevent the long term complications, a great effort underway, but that also ends up with more diabetics coming our way, etc.

So, we have found that we spent all of our poor fund monies ($42,069 USD) in this fiscal year (October to October) and we are searching for funds for next year, a matter of prayer. Additionally, thanks to Dan Boerman’s help and expertise, we are trying to sort out our financial situation in a more transparent fashion (a MAJOR prayer request, not a Haitian characteristic, we tend to keep things close to the vest, I think the statement is?, so we are gently trying to change this way of doing things). For many reasons, including my absence, as I will only make it 8 times in 2014 due to my surgeries, the hospital revenue gathered in Haiti is down. One of the problems is that we only did 230 surgeries in the last year and surgery is one of the few departments where the hospital can gain some income, as at least the elective cases can be scheduled when patients get the funds, if possible, from family in the US, etc. We don’t charge much by US standards, a child’s hernia total cost is $140 at present, but still need to recover some of the costs to make the hospital work sustainable as much as possible/reasonable. We did 53,939 clinic consultations, 2,641 hospital admissions, 131 deliveries and 4,234 lab examinations. Many of these patients pay part of their costs and we try to supplement as needed to assure they have access to adequate care.

At present, one of the difficult tasks I will have to do as the Medical Director this month is to give our “State of the Hospital” address and field questions from the employees (we have about 103 or so including Community Health, Guards, Groundskeepers, Cleaning Personnel, etc) as to why they will not be able to have salary increases, etc. I dread this time about as much as anything I have ever been asked to do, partially as much of the disgruntled muttering and questions are in Creole and my understanding is incredibly limited. So, pray for wisdom from God to do this in the most acceptable manner to all concerned, especially our Heavenly Father, who is the focus of our care anyway.

The container arrived already today and was unloaded without difficulty, from what I have heard via email. We are thankful for that answer to prayer and all the many folks who helped gather materials, sort, categorize and then load it on the 22nd of October. I have a second container of about $78,000 of medications and supplies for both our hospital and Hopital Bonne Fin being loaded and shipped from Amsterdam (IDA Foundation) and we should get the USA container sorted and put away before the second arrives, so are thankful for the timing of these two jobs.

Also, as we look at the finances and the upcoming holiday seasons, we are very thankful for the Thanksgiving season and our Lord for providing the health and strength needed for all of us to put in another year of service for Him in Haiti. My family and I are especially thankful and grateful to be able to be together and healthy, from all physical and CT standpoints, and give God the glory for that extra blessing each morning when I wake up and can face another day of work and health. If any of you would be interested, since the finances in the hospital are not so great, I would like to again provide a sack of rice for each employee and, if I can raise enough funds (some people have already contributed funds and for that we are grateful), I would like again to give a goat to all employees who make less than $100 a month (last year there were 23 of them, likely about the same or maybe a couple more of them this year). If you are so led, would you send it to:
Centre de Sante Lumiere
c/o Dan Boerman
2886 Clydon Ave, S.W.
Wyoming, MI 49519
and designate it “Rice and Goats for Christmas”

Thanks for all you all do to pray for and support this ministry for Him in Haiti at CSL

Bill, Dan, Duane, Jeff and the Haiti Teams both in the US and at CSL

A Cool Michigan Reception

Hi All:

We had a pretty uneventful trip back home after a great, eventful week in Haiti. We got up at 1:30 and left a bit after 2 am, despite Dr. William thinking we could go at 3 as our plane left at 10:21 for Miami and it would usually take 4 hours at that time of the day, as there are few crazy drivers/people other than ourselves, so he figured a 7 or so arrival would be decent. However, I am notoriously a slow driver in somewhat less than perfect conditions, and potholes, uneven pavement and a large number of vehicles without tail lights, a significant number without headlights travelling in the dark adds to the challenges of navigating a vehicle in Haiti with innumerable obstacles to safety. Using signals is purely an optional suggestion, assuming, of course that they even exist or work. Add to that the couple hundred speed bumps (the raised bumps added to slow down the crazy drivers) and the tens of “dos d’ane”s that are strategically placed to wipe out unsuspecting vehicles with a dip in the road placed to further inhibit speed, one has no need of speed traps for myself. These dips, called after my relative, the Haitian Donkey’s back, the dip that the poor creatures have due to the chronically large burdens they carry, are often at an angle to the road direction, so one wheel drops and, while it is coming out of the planned dip, the other front wheel drops and one can really lose control of whatever already careens down the road at an angle due to being piled high with goods (and a person or so braving the trees while riding way on top). We saw a bus that lost control and ran off the road last week, killing all 45 people inside as well as the people in the house it blew through, a grisly sight.

Duane, who would leave at midnight if he could further avoid the traffic on the road, and I decided 2 am would be less likely to cause us ulcers in fearing a late arrival at the airport, and we were thankful we did. Even at that time of the morning, there were an unusually large number of private vehicles, plus quite a few fuel tankers and other heavy trucks out, presumably as they had been blocked by the riots/demonstrations all week and wanted to take advantage of getting somewhere before others had similar ideas and would try to stop them. Even the market in Port au Prince was already quite active, including the wheelbarrows hauling 3 or 4 skinned pigs to the sales, where they would be chopped with a machete into however many grams of meat you would desire, including the bone chips produced during the cutting process in the price, of course. So, we were very happy to arrive at the airport at 6:45 am and just check in almost the first in line. We had 4 suitcases of materials for the women’s center, as this Haitian Donkey doubles as a hauler of the embroidered materials and other handiwork back to the States for churches to spread out for donations back to keep the center financially solvent. Duane had put the power washer part in his carry on and was rejected by security, but otherwise we had a great trip back home, even switching out the part in Miami and putting it in one of our suitcases (which had already been checked when he was sent back from the Haitian version of TSA, so he checked his carry on to Miami and we corrected things after immigration in Miami, as Duane and Ruth stayed in Florida a few days to visit grandchildren). As our flights went through Philadelphia, we avoided the still troublesome Chicago area in our travels and were thankful to the Lord that He had caused me to use a new flight course (not an option in the past with American, but it is a hub for US Airways). The old route was too short a layover for a group to risk in Miami, so I opted to choose getting home at midnight instead of the alternatives. Everyone but myself welcomed the air conditioned American Airlines lounge temperatures on our arrival in Port, most everyone joined my opinion when we received a cool welcome at 45 degrees in Grand Rapids.

Our Friday was busy but profitable. I ended up doing a complication from our sister hospital, a patient I had seen and treated a couple years ago, then had further surgery there a couple weeks ago and now decided to visit me again to correct the abdominal hematoma from the latest surgery. I drained the large blood collection, washed it out and left most of the wound wide open and pray that she will do well postop. The young man with the possible poison that Mike and I admitted on Thursday with presumed renal shutdown (a favorite method of getting the voodoo doctor to put a curse on those who oppose your life choices in Haiti), seemed very much alive when we last checked him Friday evening and we pray this will continue. We shared tracts with him to read as he recovers, or even to consider if he doesn’t, as eternity seemed (and still is) a very near and distinct possibility for him, as dialysis is not an option. He was weak and troubled but definitely alert and communicative, so hoping that our desperate treatment will have long lasting results.

My attempts to make a site visit to Cap Haitian to look at residency options available there, both for ourselves or possibly having one of our doctors go up there for a 4 year training stint, has run into a dead end street for the time being, as Dr. Mario Florestal, the OB Gyn physician who graduated from our medical school and managed to get a residency slot there a bit over 4 years ago and now works for our sister hospital, Bonne Fin, works 3 weeks straight and then has the 4th week off starting in November, but I am reluctant to spend either Thanksgiving or Christmas away from home as my own future is not all that definitive and would like to maximize family times when possible.  So, hoping to go in January, 2015 while our team is working on roofs, remodeling termite eaten cupboards and shelves, putting up the toilets behind the clinic on that new septic system and a host of other projects that seem to sprout up and demand attention. The power washer broke down while Duane had the guys blasting the layers of grease, dirt and other questionable items deposited on the areas around where the merchants cook and peddle their wares in front of the hospital gate. We plan to move them across the road to see if we can keep things cleaner around the hospital itself, then use this site to let our patient’s families cook for themselves and the patient, as well as doing their own laundry there and sleeping in the hostels, instead of all over the hospital floor, making movement and patient care a risky business, especially by the dim lights when we only use a few batteries to light the wards.

We spent a fair amount of time as the leadership of the hospital, trying to figure out how to reduce costs with the government mandated minimum wage increases, especially with our increased number of diabetic patients who come with nonhealing leg ulcers/gangrene and we end up trying to keep debriding the wounds for months before getting to the almost inevitable amputation under life conditions in Haiti, thus causing a bill that, even by our charitable institution’s lower rates than most anywhere else, is too much for the already impoverished individual to settle. Almost all other Haitian hospitals just refuse to care for the patient, so we end up with considerably more than our share of these indigents. I never mind caring for them, but it is a struggle to try to keep the hospital solvent and also sustainable in the future while showing Christlike compassion to these seriously ill individuals with such chronic, incurable conditions. Pray that we will have His guidance, attitudes and wisdom in doing His Work His Way at Centre de Sante Lumiere.

In His Service,

Bill x 2, Sue, Jen, Duane, Ruth, Mike, Joshua (and we sent Dr. Mary Preston home to Virginia on her own today, haven’t heard if she made it yet)