Tag Archives: Hospital Administration

The Haitian Donkey Update

Posted on by

Hi All:
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:

571        Surgeries

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

The Haitian Donkey and Friends are back home in Haitian style weather

Posted on by

Hi All:
Once again, we are thankful to be home and healthy and praising the Lord for His guidance in helping us navigate a difficult administrative issue to what we feel is a reasonable solution to a chronic problem. It definitely brought an encouraging end to 6 months of struggles in trying to resolve the situation. Again, I am immensely thankful to Pastor Johannes and Dan in their invaluable help (plus all your prayers and intercession to our Great Lord) in achieving this needful goal in a fashion acceptable to the Haitian Labor Guidelines, considerably different than US ones.

We had a good trip home except that Tom and I ended up stuck in the plane for a couple hours in Philadelphia, as we got the passengers on board but there was a thunderstorm in the vicinity, so we were unable to load baggage or fuel for several hours??? The storm hit us for maybe 15 minutes, but I suppose others had higher priorities to be serviced. However, even with the extra time, they couldn’t get our baggage into the plane, so all 4 bags came back late on Sunday, well scoured through and messed up.

While travelling the roads of Haiti, one always has to keep his eyes open for stray people, animals and trash. The roads are littered with junk, just tossed from the vehicles as well as dropped by pedestrians, as well as wandering people, critters etc, who don’t seem to look before they leap onto the road. We were driving back to Port and someone on the truck in front of us (there usually are at least a dozen people hanging on to the top of the baggage or the back bumper) tossed a plastic bottle off that I didn’t see. We hit it with a tire and a loud pop startled us all, it sounded like a mini explosion. I know there are laws in the US that can bug us, but certainly the anti-littering law keeps the environment looking decent and safer. Dan and Tom went to the Sunday School program at Renault, the road to the site runs along the river for a ways. They informed me that there is a trash pile 15 feet high x 100 ft long in the river, waiting for a healthy rain to fill the river and wash it all away to sea. This is the Haitian version of trash disposal, a river to ocean fill rather than a landfill. This way, they never have to look for new sites to dispose of their waste.

On a personal health note, my May CT scan seems stable so far, I ended up skipping a treatment for # 3 cycle (I am on 3 week cycles) due to the infection, but will get # 4/5 on Monday. I do have increased nausea, diarrhea and fatigue with it, but can adjust life to tolerate it. However, what I have found more troubling is that my hemoglobin continues to drift down, as well as my weight. I was a bit of Karen’s “chubby hubby” in December and clothing was tight as my meshed belly doesn’t tolerate stretching much, so backed down a bit on my TPN feedings. That has helped reduce the nasty side effects of the full speed TPN, but I have continued to drift down and have now lost 25 lbs despite doing my best to eat both donkey and human food whenever and however I can find it, considering the tolerances my short and rewired pipes will allow. I can up the TPN to 3/4 speed again, but am not excited about the undesirable and uncomfortable side effects. Enjoy stuffing my face whenever possible but wish I could gain weight without extra grief. Likely the new treatment has something to do with it, but would like to keep the guinea pig aspect of my mosaic composition going on the chance that it may slow down the growth of the cancer. Would appreciate your prayers for wisdom as to proceeding in this category, also for Duane, Ruth (and grand kids) plus Dave and Kurt as we hope to be in Haiti in 2 weeks again (a bit quicker turnaround, but trying to fit my Haiti schedule around my immunotherapy schedule and health needs). As always, your prayers and support is most thankfully appreciated.

In His Service,

Dan, Tom and Bill

The Haitian Donkey has highs and lows on the bumpy road

Posted on by

Hi All:

We are back at work, the load has been considerable to the point that I have not had a chance to write an update. So, my apologies for being behind on the production of information. We are happy to be busy, but it appears that we have to work on multitasking better as we have all sorts of projects going on simultaneously. We started out with a rather bumpy trip from Grand Rapids to Chicago, causing some delay in our arrival. We went as fast as our little legs could carry us to the Miami bound plane but our baggage couldn’t keep up with us. The next section was bumpy at the start, then settled down pretty well the further south we went. The outbound plane was late coming from Costa Rica and needed servicing, then had some additional maintenance problems and we were over an hour late departing for Haiti.

The good thing about being late was that it did give our luggage a chance to catch up with us. It obviously was the last loaded in Miami as it was the first off the plane in Port au Prince and we skipped out of the airport, almost. Unfortunately, the customs chief overrode the agent’s decision to let us go out and searched 4 of our 6 bags (the other two were out the door before they noticed, these were on the baggage cart). Every piece was removed and inspected, we had nothing that troubled them except some inhalers, which I was able to convince them were for personal use. However, they took the entire large cold pack with laboratory reagents and I was unable to convince them to give it back to me. It essentially means that our lab will not be very functional for months to come as these were the last of the reagents for our machines, which need replacement soon.

Dr. William stopped by to get some supplies as he came home for Sunday only to see his family and us. He was on call on Saturday and Monday, so rode the bus each way so he could sleep en route both ways. He shared that he will not likely get the results of his big exam for a couple weeks, it was hand written by the surgeon examining them and he shared that, sometimes he had no idea of what the question was, let alone knowing how to answer it. He stated that the surgeon’s writing left a bit to be desired.  Dan, of course, could not pass up the opportunity to opine that this was a bit of poetic justice, as Dr. William rivals me in his writing skills. William also shared that the government hospitals still do not have water, so one cannot scrub before surgery nor are the patients beds washed before the new patient takes over, a good way to spread infections which go like wildfire. He shared that the attending doctors, who do NOT really come and teach as they are supposed to, just having the older residents teaching the younger ones, scary, have no motivation to improve the system, as they hope that some of the poor patients will scrape up enough funds to pay for their care, rather than the socialized medicine system the government has installed. When I saw the prices for the private hospitals, it was a major eye opener, as some of the prices are higher than USA surgeon prices. A very discouraging situation.

The trip to the hospital was decent and we were able to settle in, a bit discouraged with the loss of valuable equipment. After surgical clinic, Miss Lisberthe took Dr. Moise and I down to show us her masterpiece, the organization of the OR storage rooms. I was duly impressed, as was Dan later when we had to show him her hard work. There is hope yet for some organizational skills for some Haitians. Definitely a major up bump. She has been most diligent in keeping us going, so far, we are averaging over 10 cases a day and working our staff to the max. There is no empty bed in the hospital at this point and we have tried to squeeze a few patients in nooks and crannies.

Dan, Mark and Andrew are very busy as well, having had a bunch of new projects to try to complete. They are experimenting with making some prefab Windows and doors to help finish the employee’s houses that we are trying to get habitable. We originally had only planned to do repairs on the walls (some at interesting angles) and replacing the roofs, but due to the incredible inflation especially in our area due to the hurricane and loss of crops and livestock, we revised our plans and are putting doors and windows in so they can safely get back in their homes. However, there again is a line of hopefuls who bring us requests to help build small houses for their families, often the whole family lives in a few hundred square foot house. It is hard to know how the Lord would have us show Christ’s love to the host of destitute folks around us here.

We did stop at the mango stand about an hour out of Port au Prince and I have risked pushing the limits of my fruit ingestion. I have done well, but Mark lost a day of vomiting and diarrhea, he did recover quite well with the IVs we inserted into him to help him keep hydrated. Andrew struggled some today, has not let it slow him down much. We all have made “absolutely must be done” lists as well as “hopeful” lists to get done in the few hours that remain. We are thankful for all that we have been able to do and the measure of health we all have been able to enjoy. The speed bumps have been significant, but, by God’s grace, He has helped us go over them with minimal disruption of our lives and work schedules. Additionally, the new administrative situation seems to have radically improved the morale of our workers as well as our spiritual outreach.  That is a huge encouragement and answer to many prayers.

Thanks again for all your prayers and support,

Andrew, Bill, Dan and Mark

The Haitian Donkey enjoys a warm and wet return

Posted on by

 

 

Hi All:

One would have thought that it was a first time trip for Dan Boerman and myself as we left Grand Rapids. We arrived at the airport at 4:45 or so for the 6:51 flight with our baggage. I took the two passports and checked myself in with my two bags of medical supplies. The agent then asked me for Dan’s passport and I told him it was there on the counter. He smiled and said it was a lady on the passport. Dan lives about 45 minutes north of the airport and it was about 90 minutes before departure. He and Kim took off and their son met them halfway and we thanked God that that would work out. As they left with their baggage (in case they didn’t make it back) we noted that Dan had loaded a carry on at the last moment with lots of heavy plumbing parts that were needed, so we had an extra carry on, as I always need to use my trip mate’s carry on to fit all my TPN in, as it has to remain cold. I won’t ask how quickly we traveled, but he made it back in good time.

While he was gone, I tried to send the carry on as an extra piece, paying the extra charge, as my two bags were gone and I couldn’t easily put it in his suitcases (plus he had them with him). Apparently, there is a new rule that you cannot purchase a 3rd bag at any cost. Fortunately, the Grifhorsts who were going with us and were already at the gate had only two carry-ons for three people and we escaped that scrape. When we took off, I prepared to switch from my TPN to the regular fluids but started thinking that, as we checked our TPN carryons, I hadn’t noted the spare pump and charger. On arrival in Charlotte, I confirmed with Karen that the pump was plugged into the charger at home! She and our transportation specialist daughter in law, Jenn, spent the next hours trying to find some way to get these to Haiti in the next couple days as FedEx, etc, for all practical purposes, doesn’t exist in Haiti. (Nor does the mail system- a Women’s Missionary Group from the Kalamazoo, MI area wrote me several years ago and mailed it to the hospital; it took 18 months to get here and I am sure they didn’t believe my response as I never heard back from her and presumed I was stretching the truth). Karen also emailed people in Haiti and called Olga, our friend who runs the center for women, and Olga and her husband Caleb sent an emergency email to everyone they could think of. Karen was about to leave for American Airlines with a tiny package to send for a not tiny price when she got a phone call from Val Gutwein, saying that her husband, Jan, was leaving at 4 a.m. on Monday for Haiti. So Karen and Kathy Sytsma, our friend who is always seemingly game to help out, took off with the parts to Indiana and I am praying they will catch up with me tonight and I can return to my normal schedule of IV food and fluids. Last I heard, Kim had to undergo some “retail therapy” at the stores to restore her emotional status. I think we both taxed our wives’ levels of patience and frustration without intending to. We are both blessed with special friends as spouses and we thank God daily for them.

The flights in were good and we arrived in Port at Prince pretty much on time at 5:40 pm. We had heard that there has been considerable flooding in Haiti, especially in Cayes. Travel to the hospital was challenging as the roads were flooded and one has no idea where the huge potholes and speed bumps are under the mud and water.  Forward progress thus was quite slow, plus we had rather vigorous winds that soaked Dan and Dudu in the back of the truck as well as much of the luggage, despite tarps wrapped around them and the baggage. We arrived after midnight and slept like logs.  Evert is a talented HVAC and other skills man who was “recruited”  by the Lord during our last trip to Haiti as he sat next to me on the way down to Haiti and sat next to Tom Failing on the way back; Tom had a totally different itinerary from me! During our time there last time, Evert was up north with a water purification project but was interested in helping us with our broken down OR air conditioning and the equipment for that arrived in a container while we were in Haiti. The Lord engineered that one perfectly and Evert seems to fit in well. He is my age and came from the Netherlands at 25, so we talked about our love for Indonesian food among many other topics as we slogged home in the pelting rain at a snail’s pace.

Today was Labor Day for a good segment of the world, which I had forgotten, thus we ran the clinic and hospital, as well as the OR, on a skeleton crew. We only did 8 surgeries as Dr. Moise and I took off from the OR for several hours to work the clinic and help them see the number of patients who took advantage of the holiday to get checked out. Tomorrow, we should be back to full staff again. Evert and Dan have been working on one of the generators (we carried 2 alternators in our suitcases for the brand new generator that had a defective one), repairing the leak in the water line to the hostels and the dental clinic, trying to fix some more roof leakage, though how much is due to the high winds and deluges of water remains to be seen. They are also going to work on a couple other houses of employees that need some more adjusting, so, as usual, they will not be sitting around looking for work.

Beth Newton is packing up some of her stuff and will return with us, plus we will carry a couple suitcases of stuff home for her, as well as some for Olga’s Women’s Ministry. Jo Marturano, the psychiatrist who comes for a couple of weeks twice yearly, will fly in as we leave on Saturday, as we try to economize on trips to and from Port and we are trying to set up some supplies for her work. Dan and I hope to work on some administrative issues to help set that on proper footing with the changes that have taken place. Please pray for wisdom for all of us, that we may make decisions that are just and God honoring for the work and testimony we want to maintain for Him here in Haiti.

In His Service,

Bill, Dan, Evert, Kelly and Paul

A Happy Haitian Donkey heads home

Posted on by

Hi All:
The week is winding towards an end and the craziness with it. I had a couple more encounters with the MEBSH administration today (Friday), one to get the accountant, Welser, on the bank encounter capacity for the hospital (for some reason, we have accounts in 3 of the Haitian banks and one of them has both Haitian money and US money accounts). We then were requested to make some other adjustments to help reduce the stress of an employee, but, after we tried various avenues to accomplish that, to no avail, we discussed it directly with the employee and she felt she could handle the situation just fine. So, another long rabbit trail in trying to get along with our Haitian expectations. We have greatly appreciated the wisdom and help Johannes and Luise Schuerer have given us in this situation, veteran missionaries and his work in the Bible School was so valuable in dealing with the pastors involved in the decisions.

We had a decent surgical schedule, not as busy as some of my other weeks have been, but it did allow me to do a few other necessary things. Wednesday night, we heard that the container with replacement 2 x 4s, 2 x whatevers and a lot of roofing steel was coming here. It arrived at 10 pm and we started unloading it at 7 am on Thursday. It had a large amount of wolmanized lumber in it, as we have an abundance of termites and other critters here, so many boxes got soaked and sweat was dripping off the ceiling of the container itself. It was a lot of hard work for the crew, but it got done while Duane was here to organize it, thankfully. Things are back where they need to be, i.e. we have repaid our loans of wood, roofing, etc from other missionaries, and we can go home relaxed.

The weather has been pretty nice for me, not sure Duane and Tom are liking the warmth as much, but not a lot of rain, so we could make progress on the cement work that needed to be done. This morning, they found a significant leak in the line going to the dental clinic, but all the lines are under cement, so we did not start the project at this late date. Also, they put a shower in the doctors’ call room, an addition greatly appreciated by them. There did a variety of other jobs, as it seems there is never an end to breakdowns in the heat and the fact that the original building was put up in 1946, but there are a number of other things left for the next team (and many after that, I fear).

[I Am finishing this after we got home.] All went well on the return trip, other than little sleep, only 2 hrs plus cat naps in the plane. (I think Duane slept better in the back of the truck but the others in the cab couldn’t sleep much except Elizabeth). I do not sleep as my job is assistant navigator. We need 4 eyes to look for the many cars and trucks that have no running lights and drive like crazy all over the road, as well as the ones without even headlights who also fly along at reckless speeds with abandon. Jean Eddy does most of the driving now, but doesn’t speak English, so I have to keep watch on the road and keep us both awake with chatter, etc. We arrived home late last night with our 4 suitcases of sewn materials from the Women’s Ministry that Caleb and Olga Lapp run now (Luise Schuerer started it years ago to help the ladies who had no other means to support themselves), and are happy to see our families again. I greatly appreciated having Duane stay another 5 days to provide support for the meetings and then change all the locks that needed to be changed with a new administrator, as well as the other 3 team members who were most encouraging in sharing the work load, meals and other duties. I thank the Lord for the people He has given us to make the load lighter and help us accomplish more for His glory.

Dr. Luke and Jeff Berkompas will leave on the 15th of April, then Dan Boerman and I will go on the 29th of April to do both surgery and continue to sort out and organize the hospital authority structure in a way that we believe will be more efficient, God honoring and encouraging to our staff, who have been in need of relief for years now. We want to be sure that we replace the old system with an improved one, so pray for wisdom and direction for us as we do this. Dr. Moise and the accountant/interim administrator, Welser, will have to continue until we return, I do have confidence that they will do their best.

In His Service, again with MUCH Thanksgiving,

Bill, Duane, Tabitha, Elizabeth and Tom