(Sorry, this is very late as could not make the computer in Haiti do my address lists, you all know I am technologically challenged)
Once again, we are making progress but also trying to be sure we tie up loose ends, if possible. Surgery has continued to go well, yesterday was a very full day as we had 4 scheduled hysterectomies, then had two twisted ovarian cysts come in, both in a lot of pain, understandably, as the ovary is dying due to the twist cutting off the blood supply and it becoming very painful. They are fun to do as they usually are rather dramatic, they come in in a lot of pain and the next day, though the incision is painful, they are much relieved and bounce back quickly. We also did an interesting neck mass as well as the usual hernias, etc. Overall, a very satisfying day. We did have an 85 year old lady we had done a hernia on the day before have some bleeding when I saw her in the morning on the dressing, that seemed to stop all day long, then restart in the evening, so I took her to the OR to sew it and it stopped again. I had her get up and walk around, not a drop came out, so a puzzle, but then restarted this morning and we found the culprit and fixed it.
Speaking of culprits, when we arrived, the entire physical therapy department, which had been polished up last month by Margie and Marcia, was pouring raw sewage out under the door on our arrival. How long this had been going on was anybody’s guess, trying to get facts straight in Haiti is always a difficult situation. Patients will tell you the problem has been there for years, just to emphasize that they want you to take them seriously and fix the problem, often confusing the situation rather than clarifying it. However, it appeared that there was a blockage downstream and all the sewage from the hospital was finding this easy way out. Even in the OR, the rather unpleasant smell permeated most everything. After some research, Dan declared a state of emergency and kept all the American and US workers to dig in the driveway, trying to find the obstruction. As the driveway has a lot of traffic, the ground is very hard and they needed pick axes as well as shovels to find the plugged pipe. After many hours of hard labor, they were able to locate the river of foul water blockage and repair it. It was a bunch of “flushable wipes” that did not flush and plugged up the 4 inch pipe on the way to the septic tank. We are very thankful for the success of their labors, though it is a bit of a puzzle how this got there, as Haitians normally do not flush even toilet paper, rather put it in the wastebasket provided in the bathroom to prevent filling up of the outhouse sewage hole, which just lets the material seep out into the ground around it. This has put them considerably behind on the list of projects they have to attend to. Dan and the crew have had a number of other urgent repair projects, from the microscope in the lab and the chemical analyzer to fixing the fussy washing machines and helping me fix items in the OR, so, as usual, he is greatly appreciated. I am constantly amazed at the multiple talents God gives to those who are willing to accompany me to Haiti and work away at anything that presents itself.
Jose brought two delightful ladies who work in the surgical supply department at his hospital to help arrange the supply storage rooms. They have been working in a sweaty, dusty and dirty environment very diligently. There are numerous termite trails and they have made inroads into some of the supply, despite the monthly termite sprays that the maintenance crew is supposed to do. The termites destroy anything made of wood around here and we are slowly replacing shelves, etc with metal materials as we find these. We greatly appreciate their labors. Jose himself has been very helpful in keeping the OR running smoothly and allowing me some time to do administrative meetings, especially Tuesday as we had Dr. William with us for the day. He worked in the OR in the morning and we had a lengthy meeting about some plans for reintegration of him in 20 months or so back into CSL and more of planning for workable options should I be less able to return or not at all. I much prefer to work in the OR, but I suppose this is needful. Actually, I know it is, but not my forte. Jose also has added some dimensions to our activities with his opinions. Sunday morning, everyone went to Renault and then the camp except he and I. As we got home late from the airport Saturday night, after getting things put away, it was midnight and I slept in a bit in the morning, as the hospital chapel service for the patients is 10 am. I came out pre shower and his remark was that I should give some attention to my “Dutch hair.” He has nice, short, curly hair that likely takes little effort to look acceptable, though admittedly I don’t put a lot into my hair if possible. He also has dubbed himself the “Missouri Mule.” He seems never at a loss for some interesting comments, including those revolving around his area of expertise, some surprises he has found there, etc.
Will get to bed and get ready for our last day in Haiti again. Thank you so much for your prayer and other support of our ministry here for His glory at Centre de Sante Lumiere.
In His Service,
Bill, Dan, Dave, Jenna, Jordan, Jose, Joshua, Kelly, Mary, Patti, Paul, Stephanie
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
|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
We are thankful that, at least some of us, have arrived back home safely with only a few minimal speed bumps. Tabitha, Zella and I had a good flight to Miami, arriving early but needing to wait for the jammed arrival bays to empty a slot for us, so lost the 30 minutes we had gained by sitting out on the tarmac. We then pulled up to the bay and they brought out the jet bridge but were unable to open the door that would funnel us upstairs to the passport control to prevent us from entering illegally? They had to wait another 30 minutes or so to have the Miami Dade police arrive and open the door for us to empty out. I always leave a minimum of 2 hrs in Miami for unplanned extras but the poor lady in front of us had only left 90 minutes and undoubtedly missed her connection. Fortunately, Tabitha and Zella had over 2 hrs also as we got jammed up in TSA and again were routed to the outside to try to get us through it faster (that has been the last 2 times, I have not been impressed with the speed saved). Actually, Tabitha and Zella did progress pretty well, my line was a rookie (hopefully) who sent everything through repeatedly and took forever so I think we processed only 10 people in more than 30 minutes. A couple times I think I saw her coworkers roll their eyes at her requests, but progress remained at a donkey’s pace. The rest of the trip went fine for us, but we somehow had a miscommunication with Jean Eddy about him staying in Port after dropping us off at 6:30 am to take 2 men from Jamestown Baptist Church who were to work with Duane and Ruth next week. We had made a bunch of sandwiches for them to last the day, I did have them get 2 fuel filters for the Kia supposedly while they were waiting, but I know that Jean Eddy was a bit worried as his father in law is failing fast, confused and disruptive at his home (he stays with them) plus his wife is struggling with her diabetes and I know he had a lot on his mind. I have given him some medication to sedate him some and make him more manageable, but he insists on taking off the diapers we give him and doing things here, there and everywhere.
Long story short, they went back to the hospital with the fuel filters but no passengers! That is totally out of character for Jean Eddy, who is very meticulous in his work. Once again, we had to call upon our faithful friend, Dr. William, who is still working in the burn center at Doctors without Borders (he said they treat over 1,000 burns yearly, what a painful situation) who was able to get free and arrange their transport to Cayes. He put them on a taxi from the airport to the hospital with an estimated arrival time of 11 pm but we got a text today that the taxi had an accident en route, so they had quite a traumatic trip overall. Mob rule takes over when, especially a foreigner in a vehicle hits someone else (even if they are not driving) and they pound the vehicle trying to punish the people “responsible”. I have always offered the drivers $50 US, about 3 days pay for a good driver, if they will go slowly, they have never taken me up on it. So they ended up paying $500 US to obtain their “get out of jail card.” Again, not their fault, but in Haiti, guilty until proven innocent is the law. Hopefully they have recovered today and can have a productive week after all.
We wrapped up surgery well, Dr. Moise had caught a cold and was struggling to keep the pace going but we were able to double team the ORs as much as possible and thus get him home sooner to rest and bounce back. He remains very dedicated to the work and is appreciated by myself and others. The other doctors don’t seem to share his and William’s dedication and this is frustrating to us all. For them, this is more a job rather than a ministry, to a degree, similar to some of what I perceive as struggles in medical care in the US, so many people involved that the patient gets caught in dropped passes, etc. Moise and William (both local boys, living a few hundred yards from the hospital) always saw every one of their patients every day and developed relationships with them in a good sense and the patients appreciated it. Moise has been trying, without much success yet, to get more accountability in the care system. Pray for wisdom, encouragement and cooperation for him in this regard. We finished with a couple more interesting patients, including the one from the prison system where they have rather bizarre activities?
Last update, I bragged a bit about how hard Miss Lisberthe (Nurse Beth is her English name) works to keep the OR going and clean, single handedly responsible for our very low infection rate. I would expect it is lower than the US, partially because our people don’t have much in the way of resistant organisms, etc but much credit goes to her hard work also. Her skill in choosing husbands is maybe not as good, both ended up in adultery and she divorced them promptly and will now remain single. She has one 24 yr old daughter by the first fellow but has a large heart for helping others. Last month, an uncle brought a boy with some congenital deformities for surgery. We fixed some of it, will see what progresses with the rest, but the uncle never came back to pick up the orphan (we found it out from the young man, who looks like he is 6 but is allegedly 12, that he has not had parents for years and has been bounced from place to place, not ever being wanted). So, the boy just hung around the hospital, eating what he could find. Now, Miss Lisberthe has brought him food and will see if she can raise him as her own. How this all fits in the legal system is not clear, but she is going to enroll him in school tomorrow, got him some clothes (from the donated stuff I bring down) and will take him in. He already calls her his “Mama” with a broad smile. He is called John, but then likely 80% of Haitian men are called John, so will wait to see what more distinctive name he inherits from her? Those are the things that greatly encourage us, when the Christian brothers and sisters take care of their own without our help (though Tabitha and I have promised to help with the school expenses as she has limited funds and is still building a couple rooms for herself on her dad’s cement roof).
So, will get this delayed update off and, once again, thank you all for your support, prayers and encouragement of our ministry for Him in Centre de Sante Lumiere in Cayes, Haiti. Thanks also for the donations we have received so far for the “Rice and Goats Fund” which will encourage our employees so much at the season that we remember the great Gift God gave us in sending His Son for us.
In His Service,
Bill, Duane, Ruth, Tabitha and Zella
I am sitting in the oncology department getting my infusion of goods and thought I would bring things up to date on a couple fronts. I finished my IV antibiotic course 2 days ago, so they could give the next treatment now, as it is experimental and they don’t want any complicating issues, ie extra meds on board, etc. This is treatment # 9, they raise the dose each time until # 10, not sure what, if anything, happens after that. I will get a repeat CT scan again on October 8 and will see if the cancer is progressing or not and I guess that will impact what happens next.
I had my line changed over a wire (so that I won’t lose the last remaining site in my upper body, not as desirable as just pulling it, leaving it out for 2 days and replacing it, but didn’t want to take the chance it would not be able to be put back in) and have finished the antibiotic course after that to cover the critter growing on the line. I am hoping that I can eat a bit more now as still seem to have nausea pretty regularly, not sure who is the culprit but the weight slowly dwindles with it. Am continuously thankful for space heaters, a heated jacket (battery powered, what a “cool” thing) and other aids to staying warm when not in my Haitian homeland. I think the strength is returning some, have been able to continue working pretty much normally in the interim, as hate sitting home feeling poorly, at least seeing and caring for patients takes one’s mind off his own situation. So, hoping to get back into the rotation for Haiti next month, as will have a bit of a backlog of patients to take care of.
I thought I would just comment on a couple other issues that are of interest to me and hopefully to you also. First, our statistics for last year included:
62,924 Outpatient consultations
2,028 Hospitalized Patients
19,844 Laboratory evaluations done
276 Deliveries done
Plus a few hundred xrays and about that many ultrasound evaluations each month, mostly on our own patients but we also have patients being sent from elsewhere for testing.
However, I am also very thankful that we have been able to have our evangelization department functioning, to accomplish our goal that each patient, and often their caretakers or family members, receive a clear presentation of the Gospel of Christ Jesus as their only hope for eternal security. We show the Jesus film and other evangelistic films, I make it a point to speak to each surgical patient each day and give them a different tract and encourage them to consider not only their physical/medical health but also their more important spiritual health. We are happy that our two chaplains, Pastor Zidor and Pastor Juste, faithfully follow up on our patients, sharing more in depth teaching and encouragement to consider the claims of Christ on their lives and help them follow up with Bible based churches in their home area, contacting pastors to introduce them, giving them a letter of introduction to the church/pastor and also calling them, if possible, to see how they are progressing and if they would like further information. They have kept track of the numbers of people they have counseled and tracts they have distributed and it is encouraging to see their hard work for His glory.
So, as we bounce back from this major health speed bump and anticipate going in mid October again with Duane, Ruth, Tabitha and Zella, I wanted to take this opportunity to thank you all for your prayers, support and encouragement for our efforts to serve our Lord at Centre de Sante Lumiere. Continue to pray for especially Dr. William as he now has a year where he will be shipped here and there to “complete areas where the resident needs training.” He is presently at the burn center at Doctors Without Borders for September and October. We don’t know the rest of the plans yet, but need wisdom and encouragement for him as he sort of has to go where he is assigned.
In His Service,
Bill, Karen, Rachel, James and Jenn Ten Haaf