Several Haitian Donkey Updates

Hi All:

I normally do an update while in Haiti, but thought I would share a few things from the USA end. As noted in the last update, we made it home smoothly, though with a chilly reception around midnight in GR. The weather has been less than accommodating for a frigid Haitian Donkey, I was dragging a bit after being home a week, some of which I attributed to the nasty prep for my 36th CT scan on the 26th, as it was downtown and there are not a lot of way stations with bathrooms enroute, so was careful with my fluids for fear of accidents. But, it hung on and I had constant nausea and no appetite, a good sign an infection is brewing. However, my temp and white blood counts remained normal, so just kept working and waiting. Tuesday night, it spiked in the middle of the night, so went to the hospital outpatient lab the next morning, in the total whiteout we were experiencing. I drive the highway to work every morning, feel like I know every bump along the way, etc, but could not see the exit in the snowstorm and almost missed it as in the exit lane but couldn’t see far enough in front of me to catch the ramp. 

I started on antibiotics that night and have had considerable improvement. How to keep the nasties away is a more difficult decision and appreciate prayer for wisdom in how God would have us proceed.  Due to the infection, I again was removed from another study for the time being.  We are scheduled to return on the 9th of March again with a team of 12, so need to be up on my game by then. This group will measure and give eyeglasses to those that need it, a new service for our patients that I am sure will be greatly appreciated. One of the last patients I saw in Haiti had gone to a Christmas celebration/party, where alcohol was abundant. Apparently he got in an altercation and the other side took a chunk out of his nose with a bite. He had gone to the Eye, Ear, Nose and Throat Hospital in Cayes, a private Canadian hospital specializing in these disorders, nothing was done and by now it had healed well, just minus a section. I likely would have tried a small graft if it was fresh, but at this point, will see what he looks like down the road and consider revision? 

I also wanted to share our statistics for 2018 for those of you who support our work in prayer, financial support and otherwise, so you can see what medically, at least, has been accomplished for the glory of God at Centre de Sante Lumiere. 

We did 512 Surgeries

66,933 patients were seen in the outpatient clinic

913 was the average number of hospitalizations per month/some would include ER overnight observations for stabilization

33,090 Lab tests were done (and that includes some down time with the machine, which hopefully we have fixed (thanks, Dan))

We also did 274 deliveries

As we don’t try to turn away anyone who cannot pay for their care, we have a Poor Fund that many of you contribute to on a regular basis, and we ended up with a total of $116,610 that we were able use to care for those unable to afford even our low rates, for which we are thankful. This represents about 17% of our budget total and thus allows us to care for many patients with limited capacity, as there are very few patients who have some form of insurance in Haiti. 

In His Service,

Bill, Dan and Duane and the rest of the Haiti Team

The Haitian Donkey and friends receive a chilly reception

Hi All:

We are back in the US, after having had a good trip home, despite the freezing temperatures that greeted us here in Grand Rapids. I don’t think the Missouri crew did much better as far as the heat wave, or lack of same.  Friday was good to wrap up loose ends for some of us, I was able to arrange some connections with the president of the mission, Pastor Alneve, for future hospital plans as well as arrange for the next team, the Optometry team from Ferris State University with leaders from Zeeland, MI who will work with them as well as a gentleman who has come for years repairing things for Radio Lumiere, another project that seems to require constant maintenance to keep going. On the other hand, Dan, Paul and Dave started a project to repair the OR table in Room 1 AFTER we were finished with surgery Friday afternoon. This table was donated several years ago by a team who worked here for a couple weeks and it is electric, so the nurses have become spoiled using it. However, last week, it would only go up, not down, a bit of a struggle for us who are not giants by nature, and we had to wait til the surgeries were over to attack it as the sterile environment sort of goes downhill with tools, people and parts all over the floor. So, they started later in the afternoon, but by God’s grace, were able to rearrange the parts so that some non vital functions no longer work (such as tilting the table one way or another) but the parts have been wired into the up and down section. I so much appreciate the talents of my coworkers, as my skills in that realm are so little that they might be labeled as nonexistent. I will see what happened to the older table that was there, as those older, nonelectric ones are much more durable, especially in the heat and humidity they are exposed to. 

I did make at least one error in the last update, you likely figured out that the Donkey miswrote it. I mentioned that Dan declared the state of emergency over the sewage situation, very appropriately, and asked that all workers, USA and Haitian (not American) work on this til it was resolved, which thankfully it was. On Tuesday, we also ran into another problem with no simple solution. The container from Amsterdam arrived in Port on the 30th of December, late, as the non profit was moving and I doubt they have a moving company do so as on a limited budget. So, we really wanted to get at the contents, but the Bill of Lading was sent DHL from Amsterdam on Dec 13, 2018 and an Edward H, 1312 (nothing in Haiti seems so organized that our employees have numbers) signed for the package, but no one knows who that person is. So, the clearing agent was warning us that he needed a copy of the original Bill of Lading from the shipping company. This required a release of responsibility from myself/CSL, so that if Edward H and we showed up to claim the container, they would not be held liable. None of us could figure out how to fill out this form online (and there were a number of younger, more computer savvy individuals trying to help us complete this form). English is clearly not the primary language of the agent at IDA in Amsterdam I was dealing with and, though I speak Dutch, my skills in the technical realm are limited. Everyone scurried around trying to get someone to budge or get the form filled out (NO progress on any front), when the papers suddenly appeared at Pastor Alneve’s church in Cayes on Friday, the package had been opened and rifled through. No one knows what really happened, maybe Edward H. was disappointed that there were only papers and no money in the package, maybe he had a strike of guilt of his conscience and returned it, but we are VERY thankful to the Lord that this was returned one way or another and we can proceed with clearing the container and much needed supplies. When they gave me the package Friday morning, I grabbed Jean Eddy to deliver it and the team said they saw him streak out of the hospital at high speed. He delivered it and then accompanied us to Port the next morning in the bus as he always is such a responsible person, making sure the team is well taken care of, much appreciated. 

The ladies left a very shipshape storage space and I do think that the employees will continue to keep things well organized. Likely not quite as good as at present, but much was packaged in plastic tubs so the critters no longer can sharpen their teeth on the supplies. Jose, as you know, a colorectal surgeon, had a number of his specialty cases to wrap up the week. When I was in training, we were always told that colorectal problems were limited to developed countries, as our diets are low in fiber, etc, so they don’t exist in 3rd world countries. I fear that this is one of the blissful theories that is propagated by those living in “ivory towers” and not really in touch with the real world, as I certainly have seen an incredible number of patients in both Africa and Haiti with difficulties in this area, with not a lot of simple solutions, as their diets are low in fiber and the options are limited. 

On a personal note, today marks the 6 year anniversary of being told I have this nasty cancer and the start of a long, tumultuous journey of three 15 hour surgeries, 2 rounds of chemotherapy and now, last Friday, I appear to be signed up for my 3rd round of immunotherapy. Will get eye and lung evaluations, it appears these treatments can take their toll on these organs, a bit scary, as a blind surgeon who cannot breathe is likely not all that useful either here or in Haiti. But, I try to proceed down the paths that the Lord opens up for me, these treatments may not help, may hurt or do nothing to slow down the cancer, but they do try to keep me going. As it is supposed to get UP to a negative 1 degree Farenheit on Wednesday, that troubling element does not do a lot of perk up my spirits, but every day I drive in my pickup to work or church, I thank the Lord that I don’t have to take a horse and buggy in the ice and snow. I know the Lord gives grace for what He puts before us, but I think my faith stumbles a bit at the difficult situations our forefathers had to endure. So, appreciate continued prayer for wisdom and strength to go through this round of treatment, make difficult plans for the future possibly without me, and that we will, as Heb 12 tells us, “fixing our eyes Jesus, who for the joy before Him endured the cross.”  Nothing I will have to endure comes close to that price He paid for my salvation. 

In His Service, 

Bill, Karen, Rachel, James and Jenn

The Haitian Donkey and friends enjoy Haitian sunshine

Hi All:
Once again, we are very thankful to the Lord that He has seen fit to allow us to return to Haiti and serve Him here with our brothers and sisters. As most of you know, I was quite ill after the return from the last trip in December. As I was in Haiti for the first 3 days of my line infection, by the time I got home, it had entrenched itself very well before I got home, got blood cultures and was able to start IV antibiotics. With all the fluid retention that is part of the body’s response to stresses such as surgery or infections, I was up 16lbs from my normal and struggling with excess fluid in my lungs, a bit scary at times. I know many of your were praying for me and I greatly appreciate it, as God was gracious again and has kept me going for the time being. So, the twelve of us, 9 from Grand Rapids and 3 from Missouri, met in Miami and flew in to Port au Prince Saturday afternoon. Thankfully, everything there went well and we were on the road soon. I had operated on the driver last year, so he was more kindly inclined to go carefully and we had a good trip back to the hospital.

Surgical clinic was interesting, both Jose and I worked with Moise and it rolled well. We had a good variety of cases and, if they all show up, surgery will go well. The rest of the crew went to the Sunday School at Renault and then to the camp and had an enjoyable day. The weather has been perfect to a bit cool for the Haitian Donkey, so tolerable for the rest of the team. One group is building the morgue and a couple bathrooms for the patients in the downstairs of the hospital, another is putting some roofs on houses in the village and there have been a number of repair projects that need attention. Dan has been trying to repair the chemistry machine for the lab with some success thus far, also trying to repair the washing machine in the laundry. We also are organizing the storage rooms further and making progress in that regard.

Surgery is doing well. The number of cases has been a bit limited, to be expected during the early part of the year, as no one has a lot of money left, with the holidays, school fees for the new year, etc. So, have been able to work on a number of projects, not finishing any, but trying to make some progress as time allows. We are possibly interviewing a physical therapy assistant to work with Isaac this week. There appears to not be many of these individuals in the country, so a lot of negotiating is needed to sort things out, including salary, etc. Pray for wisdom, as years of struggling with the previous individual make us want to start this department back up on a good foot (no pun intended).

Thanks for praying for us and your support in so many ways. It is appreciated.

Bill, Dan, Dave, Jenna, Jordan, Jose, Joshua, Kelly, Mary, Patti, Paul,  Stephanie

The struggling, straggling Haitian Donkey again asks for prayer for wisdom

Hi All:In the world in general, I suppose that donkeys are not well known for having rather high Intelligence Quotients. Those in Haiti, and the one braying to you in particular, are likewise not overly endowed with wisdom and thus we come again, asking for prayer for divine wisdom in knowing how to treat the struggling Haitian Donkey and plan for future trips to the homeland, etc. I am well aware that the Lord has allowed medical care to advance to the level it is at now in the USA, even amazing the Donkey in his 40 years of practice. Because of this wonderful care He has permitted, I have been privileged to benefit and be able to live fairly well for the last 6 years despite my aggressive cancer and the consequences of the extensive surgeries I have undergone. Also, the progression of the TPN (Total Parenteral Nutrition) again in my lifetime has allowed me to keep living and working despite not having enough intestines to live (I only have 180 cm of the minimum 200 cm).  But, the Donkey is also acutely aware that it is especially by the prayers of so many faithful friends and supporters, some of whom I will never likely meet this side of heaven as we don’t live on the same continent, that He has ordained that I am allowed to live despite the severe restrictions and conditions imposed on me by the nasty cancer and the consequences of the treatment of same. I am constantly humbled, amazed and encouraged by you all and your kindness and willingness to sacrifice your time and energy on my behalf. To God be the glory.

So, I come again, asking for prayer for God to guide my thoughts as well as those working on and with me for the near future as well as a bit longer, should He allow me to continue to live and work for Him. As I mentioned, my strength was a bit down in Haiti last week. I had a sinus infection a few days before departure and felt a bit dragged down, but treated it and, although it is still there, is tolerable. However, Wednesday night and each night thereafter, I had fever and chills, tolerating the warm nights only with my sweatshirt on to keep things on an even keel. The trip home went well, though very thankful for my heated jacket (like the hunters wear, with batteries to keep me going) and the team took care of the 11 suitcases of stuff while Karen took me directly to the ER from the airport. I had a temp of over 103, a white count over twice normal at 21.500 and they wanted to keep me in the hospital. However, they always take my bundled clothing away and I shake like a leaf. I know they want the temperature down, but I don’t do so well with chilly temperatures. They did start me on the ever faithful Vancomycin and I have continued it to this day as it seems to be the only antibiotic that will work. However, we checked levels on Wednesday morning and the usual dose was not sufficient this time, so have bumped it up and yesterday the levels were acceptable. Thus, am hoping this critter will surrender his territory and go away soon.

Part of the body’s way of dealing with sepsis, the severe infections that I get from either my hole in my intestines or the lunch line in my chest, where we dump in 35% Glucose with other nutrients that the bugs like to share with me when possible, is to third space fluids, causing swelling in the legs and a bit in the lungs.  This normally has been a bit of a struggle for the Donkey, but this time, I seem to be hanging on to considerably more fluid, about 15lbs. worth, and it is causing some congestive heart failure for me. Thus, a flight of stairs makes me so short of breath that I have to rest before going back the other way with whatever I have come to get, etc. Additionally, in my first 15 hour surgical marathon, they spent a fair amount of time picking cancer globules off my cardiac area (as well as the rest of the abdomen, etc) and since that time my heart has done more than it’s share of flips and flops and other fun things that the Haitian Donkey does not enjoy, so have been taking a beta blocker with help. As I have been struggling, I did see a cardiologist on Thursday, who did what all medicine men do, shuffle your pills, trade a green one for a red one and a yellow one for 2 white ones, etc, as well as do an echocardiogram that shows I have some heart damage from the infections. So, am slowly getting back on my scrawny (though puffy with water) donkey legs and hope the healing process will continue. My blood tests done yesterday showed some improvement, the white count down to 13 but still having low potassium due to the water pills, etc. We are making progress, I have lost 10lbs so far, but not out of the woods yet and appreciate prayer for wisdom.

Also, as we are working on organizing work teams for Haiti for the future months and my health status being a bit unknown complicates things. I am deeply grateful to Drs. Jim, Jose and Luke for their invaluable help, especially as Jim and I both struggle with significant health issues and he never states no when I ask him to help, often on short notice. However, we need God’s wisdom and help/direction as we work through other topics that need addressing at the hospital that they are not able to help with, due to language, cultural, etc barriers. We have been working on getting the rather gentle new administrator, who similar to myself, needs an infusion of backbone stiffening, better organized in setting up rules and guidelines for the hospital. He is so much easier to work with than the last one I have endured for 12 years, an autocratic ruler that all hid from when he came around and who now seems to have made his way with his family to Canada??? However, we are trying to set things up in the administrative realm for years to come with the help of Dan and Duane when they are available. We also are working on getting the reintegration process going for Dr. William, who hopes to be done in 20 months more with his Haitian Surgical Residency. How this picture will work out is taking lots of time, prayer and wisdom that the Haitian Donkey lacks but asks you to pray for divine intervention in this regard. So, planning on future trips, the composition of them as I never am able to go alone just for the TPN that needs a second person to help haul, etc is a bit difficult as he struggles with health questions and concerns.

The Haitian Donkey, true to form, has rambled on a bit, but appreciates all your prayers for wisdom, encouragement and strength from on high.

In His Service,

Bill, Karen, Rachel, James and Jenn Ten Haaf

ReplyForward

The Haitian Donkey sends thanks and a couple requests at Thanksgiving time

Hi All:
I have been sorting out all the information and was waiting to make more sense out of it before sending out an update, but also need to ask for prayer for wisdom this week as we are watching the situation in the Haitian Donkey’s homeland daily to decide on how to proceed with the next trip.

First of all, the Donkey is doing well, at least partially because no chemo or immunotherapy for a month now. As mentioned, I was disqualified from the study in immunotherapy due to progression of the cancer despite the treatment. Thus, 9 days ago, I went and saw the original oncologist, who wanted to start chemotherapy the day before Thanksgiving. As our daughter, Rachel, was undergoing a gallbladder surgery and would be recuperating at our house, I wanted to wait a week to prevent the ill doctor helping the ill patient (plus Karen twisted her knee outside, so we would make very questionable helpers to her). He agreed, though I usually feel the worst for a couple days starting about 2 days after the Wednesday administration, which would mean the Haitian Donkey dragging himself to Haiti struggling with the negative effects of the chemo. Since it would be every 2 weeks, obviously it would always be administered right before the Haiti trip.

I still had to finish the follow up monthly meetings for the study medication, to see how my body adjusted to the infusions, for a while. When I saw the study oncologist (a partner of the original one), he was excited as he had found another study he wanted to try on me, hoping that this chemical, again experimental, admittedly, could work together with Dr. Bartlett’s original study and the latest one to slow down the cancer growth. So, this Wednesday, instead of starting the chemotherapy, we will meet to consider this possible experiment.

So, that brings me to the greatest need for prayer for wisdom. If this all goes as planned, we have tickets for 6 of us to go to Haiti on the 1st of December for some projects and me to do my usual surgery work with Dr. Moise. However, as some of you know, there has been extensive, violent unrest for weeks now, blocking traffic totally, crippling the already struggling economy. It appears that, over many years, there have been pilfering of the money intended to pay for the fuel purchased from Venezuela and there have been riots over the situation with no simple solution for the resolution. Duane and Ruth, then 2 days later, Dr. Luke, left via plane from Cayes to Port and caught ongoing flights back to the US a bit over a week ago. We were hoping things would calm down, but so far, not so much.

We have been in contact with Rod and Debbie Wray, as well as Dr. Moise and Dr. William, as we keep praying about the situation and what would be prudent to do to proceed. We certainly would appreciate your prayers for wisdom in continuing to monitor the situation and making adjustments. Also for our hospital staff, for their safety as schools have been closed, for fuel for the hospital generators as there will be none available and certainly the government electricity will not increase from the few hours they supply each day at most, so medications that have to be kept cold, etc, and will be in jeopardy. We have looked into Missionary Aviation Flights availability and costs as an option, but, at this point, just need prayer for wisdom to make correct plans and decisions, both for safety and to be good stewards of the resources entrusted to us.

Once again, thanks so much for your support, prayer and encouragement of our service for Him at Centre de Sante Lumiere in Les Cayes, Haiti.

In His Service,

Bill, Butch, Gord, Kathy, Margie, and Sam