The Haitian Donkey Update

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 brings Haitian weather back home, helping with aches and pains

Hi All:
We finished out the week well, doing all the cases that came our way and finished off a few more on early Friday morning. As we were finishing, a lady came in, with arrested labor with her baby in distress. We gave it a try as she had delivered 2 children already normally and we figured the space was adequate for the little one to pass on out. I left the nurses and Dr. Moise to do this while I finished packing my carry ons, cleaned up the room (I try to leave all spic and span to reduce the influx of cockroaches that make the place their home in our absence) and loaded the truck. We only had the kitchen to wipe down and we would be on our way when Dr. Moise came to suggest that the baby would not be able to find it’s way out and wanted to do a C section. We did it, very thankful that we made the decision as the uterus was paper thin and the baby in major distress.  We were able to finally get the little one breathing on it’s own, repair the lady and take off for Port.

You notice that I didn’t mention the gender of the little one. Everyone is amazed that I didn’t notice but all I ever care about is keeping the mom healthy and having a healthy baby, whether it is a boy or a girl seems like the last thing on my list (and I get a lot of ribbing over this). My priorities seem a bit different than others in that department, for which I get a goodly amount of grief. However, the little one was really wedged in the pelvis and we were covered with sweat trying to get him or her out of the belly alive. I woke up the next morning with a significant strain of my neck, bouncing back home on the plane and in the airports didn’t do a lot to make it better and it still gives me some grief. I have had a couple of physical therapy treatments by my good friend, Todd Wehrmeyer, and they have helped, but am ready to have those aches and pains go, especially as I get another immunotherapy treatment tomorrow and it tends to cause aches and pains all by itself, especially as they up the dose each time I visit them.  Ibuprofen does a lot more to help me feel better, but that little remnant of stomach I have left does not tolerate it and Tylenol is like sending a child to do an adult’s job, makes me feel better but the patient, not so much.

Dr. Bartlett’s PA, Heather, called me 3 days ago and said that they were happy that the cancer progress seems to be slowed down to maybe stable and want me to continue the treatment as long as possible/tolerable. So, will submit to it tomorrow and appreciate your prayers that it will continue to kill cancer cells instead of me and, Lord Willing, prolong my life and productivity. My partner has been on vacation, so the office has been a bit of a rat race, especially as my neck is still stiffer than it should be.

I had a nice visit with Dr. William on Friday night as he came to see us on our way out. I was encouraged as he seems to be more perky, likely because he can “see the light at the end of the tunnel” and the second 2 years are less punishing than the first two years, as the lower two years do all sorts of “grunt work” to keep patients happy until the older doctors can do the surgery. A bit different, maybe more than a bit, than what we do here in the US. We talked a bit about his plans for next year, they ship them off hither and yon to round out their training, in theory, a good idea, we will just leave it at that. Dan, Duane and the wonderful team of Haiti USA members loaded a 40 foot container with stuff for the hospital as well as Rod and Debbie Wray on the 30th, so that is underway, thankfully. Since Karen and I and our family members always did this the years we were in Africa, we greatly appreciate the number of folks who help out in this area.

So, as this has been written in a couple segments as I have time between patient duties, will send this off and update you a bit later on some of the information of what we have done at CSL Haiti in the last year, etc.  As always, thank you so very much for your help and encouragement.

In His Service,

Tom and Bill

The Haitian Donkey and his Haitian friends anticipate the arrival of Christmas

Hi All:
The weather has been most perfect for a small, stumbling Haitian Donkey, maybe a bit warmer than Sam and his Haitian coworkers might like, as they work in the container organizing the latest shipment of building materials into some semblance of order. Duane tries hard to put things in the container in a fashion that will facilitate unloading and putting things away in one step, NOT a Haitian priority. So, Sam and crew are getting things out needed for the next couple construction crews and putting spacers between the treated lumber pieces so they will not sweat too much and warp, etc. They have worked very hard at emptying the beds, furniture, etc from downstairs. There is an excitement among the employees as they have bugged me for a long time to put some tile on the floors and, thanks to friends in the US, it is becoming a reality. Seeing the new administrator, the newish head nurse, etc all pitching in with us in moving the stuff to the temporary storage spot also was encouraging, as their predecessors would not have dirtied their hands in manual labor. The whole spirit is encouraging.

We recently had a huge deluge of rain, again washing away a lot of people and possessions. Dr. William’s wife and family have been raising baby chicks and had 350 that they were preparing for market, including 110 that I planned to purchase so that the employees could have a special family meal at Christmas. Unfortunately, the sudden flash flooding included his yard and 295 of the chicks drowned. Even worse, several school children in the area left school to walk home and the flash flood washed them off their feet and they drowned as well as a motorcycle taxi driver. This morning we had a lady on a motorcycle totally crushed by a rogue bus coming over to her side of the road and she never had a chance. It again reminds us of the brevity of life especially here where it seems life is not valued as much as it should and the fact that the Christ of Christmas is our only hope for eternal life.

We also lost a 24 year old lady who tried to abort herself last week, then came in Sunday night as a transfer from another hospital, quite ill and anemic. We gave her mega doses of antibiotics and some blood but could never get her stable enough to take to the OR and do a hysterectomy and she passed yesterday despite our attempts to save her. When I proposed the possible surgery, she was very hesitant as she had no children yet, but in wanting to not have one now, she lost her life instead. Very difficult for us all. Sam told me he is squeamish about surgical procedures but we had a lady come in tonight with 2 washers and 3 rings on her left 4th and 5th fingers. I got my needle nose pliers and wire cutters and we put the lady to sleep as her fingers were necrotic due to infection and swelling. We worked at trying to cut through but the large washers (like those for a large bolt, fairly thick) would not budge. So I asked Sam for some more tools from the tool shed and he brought some and worked along with us as we sweat for quite a while before they gave way. Only then did his stomach rebel and he had to go out of the room, so I was proud of him concentrating on the job enough to see it through.

The town of Simon, where we are located, recently petitioned the government for a road through the village. They have been working on it a while and work started several months ago. Some of the cement has been poured but then a gang of robbers broke into the container they had full of the cement and stole it all. Then, a few days later, they sold it all to the residents of Simon at almost half price. One wonders about a population who is willing to be in cahoots with gangs just so they can get cheaper cement for themselves. The moral climate sometimes sinks too low and makes progress impossible around here.

So, the Haitian Donkey is most appreciative of the progress we have made here by the grace of God and for all of you who encourage and support us as we serve Him here for His glory.

In His Service,

Bill and Sam

A Warm Haitian Donkey has a few speed bumps to cross still

Hi All:
Once again, the wobbly Haitian Donkey is carrying his load around in Haiti and glad of it. The temperature is so much more agreeable though he still wears his MSU sweater hoodie at times (not out in the sun, but in the clinic and where it is a bit cooler). I have been struggling with a bit of a bug for the last 2 weeks, starting with a fever and body aches for a couple days, then seemingly better and just a bit more tired than usual. Also, no appetite, never a good sign for a Hungry Haitian (Donkey or otherwise). I have been juggling somewhat contradictory advice from my new oncologist (in Grand Rapids, my friend, who took excellent care of me for the last 5 years has retired) who is not fond of chemotherapy and Dr. Bartlett and the new surgical oncologist at University of Pittsburgh. The latter would like me to restart the chemotherapy, either one of the two I already have had a course of. I tolerated them, but at least the one has given me persistent neuropathy in my legs and feet (I can walk on my bare feet in the morning to start the truck to warm it as cannot feel anything there) and difficulty swallowing, not a fun thing for a Donkey who likes his food. Neither proved to be a lot of fun but we made it. So, praying about how to best follow the conflicting advice of the experts. I am leaning towards Dr. Bartlett as he has treated over 1000 of my rare cancer, but will see what settles out when I get back, repeat my blood and scan (and hopefully have been able to get rid of this infection).

When I got my biweekly blood draw last Monday, it was evident that I had my fourth blood infection in a bit over a year, despite my being very careful with my line. This is a bit discouraging. Theresa, my nurse, sent me the results but the internet is not working (doing this off line and will send/correct when the internet comes back up, hopefully) so know I have a Staph Epidermitis infection that is sensitive to the IV antibiotics we started on the night before we left for Haiti. So, please pray for wisdom for both of the above. I am glad to be basking in the warmth with my buddy, Sam Baughman, who has come 9 times and has his work cut out for him this week with the number and complexity of projects Boss Duane has assigned him.

When we decided to go with the IV antibiotics, the cold storage space in our carry ons was at a premium, as had to take 18 bags of antibiotics in addition to the 8 bags of TPN (my lunch). I called American Airlines and asked if I could pay for a 3rd carry on, no promises there. There was no room to spare, but we made it. We had a great flight down and our luggage made it, though the suitcase with the batteries for the DeWalt power tools was totally destroyed due to the weight, etc. Three of the 4 were 1/2 pound below limit. For the first time in 14 years, I experienced the joy of using the toilet at the halfway point as the need was there, though the desire to sit on it was not so much. Real donkeys have it so much easier. There was an inch of water on the floor, the seat was not attached and needed vigorous cleaning before any hope of use and I had to keep all the equipment off the ground to have any hope of cleanliness. However, the last 2 hours to the 11 pm arrival at the hospital was a lot more relaxing. Maybe I will take along a little step stool to keep the TP, Wipes and my clothing from touching the floor.

We have had a good surgical clinic and saw a number of patients we hope to operate on in the next week. My tiny cleft lip is growing nicely and will do it next month as mom has been worried since she brought it at 4 days for repair. Our first patient was a 13 yr old with a widely dislocated left elbow, we had him stop all oral intake and did him at the end in the OR so could put him to sleep. It certainly took a bit of pulling and manipulating by Dr. Moise and myself (with just the right timing by Miss Lisberthe who pitched in at the end and it popped gently back into place). One of Sam’s many jobs is to take everything out of the downstairs, beds, dressers, desks, etc so it will be ready for the construction crews coming in January to revise the 70 year old structure to make it more useful again and also allow the tile laying to begin in February unhindered. Pray for safety for the crews as they work together towards that end. Sam also has to sort through a container worth of supplies that were tossed into storage from 6 feet away, I know it was heavy but a bit of organization on their part would make a lot less double work today (but I suppose that accounts for job security).

Will send the update if it flies and correct the infectious information whenever I can access it. Thanks for your prayers and support of our service here for our Lord.

In His Service,

Bill and Sam

The Haitian Donkey and friends are working despite having a good time

Hi All:
Once again, the week is almost over and we are scrambling to wrap up projects and other loose ends. Surgery has gone well, except for one lady that had a cervical cancer I thought I could remove on my pelvic exam, but when I opened her up, the cancer had spread too widely to even give it a try. Again, I get frustrated as the family adamantly refuses to let me talk to the patient about it, I am kind in the way I present it, but I feel I owe it to my patient to tell them that things don’t look so good. So, I try to give them hints when possible without truly breaking the rules. We seem to have had another rash of cervical cancers again, some resectable, many not, and have had the pastors/chaplains busy helping me encourage and counsel the poor ladies. We also had the male counterpart of the widespread virus that likely contributes to this all and had to give him a rather radical surgery.

As Dr. Luke is coming in 2 weeks, I have tried to send some of the workload to him, but clinic has been very busy with patients and emergencies have completed the schedules. We had a lady with an ovarian cyst that twisted itself 360 plus degrees, she was in a ton of pain, but I sent her home today after she finally smiled at me. I needed to encourage her each day that life was improving and she finally seemed to believe it. We also have had the motorcycles supply their share of trauma, a badly dislocated elbow, a number of cracked ribs, several patients with lacerated faces, hands and legs. There also was a 40 year old gentleman who fell off his motorcycle and has a compression fracture of his back. Thus far, he does not have any paralysis, but have him on strict restrictions (as much as that means in this difficult culture). We had a young lady come in yesterday that likely had a stroke as she was pretty much unresponsive and our efforts to revive her were too little, too late. We also have had a number of infected feet, we ended up doing several rather malodorous debridements of dead tissue there as well as an amputation of her second leg on a diabetic 83 yr old lady, very sad but there really was no alternative. So far, she has turned out rather feisty in the 24 hours post-op, hope she remains that way. Today, we finally were allowed to operate on a teenager who had been treated elsewhere for 5 days and now came to see us with a painful, distended belly. It was not clear what he had, but we are so thankful for the ultrasound machine, as we were able to see some fluid outside the bowels and we removed over 2500 cc of pus from his little belly from a typhoid perforation that had been there a while. I pray that he makes it as the next few days will be rough, at the very least. We also are thankful that Evert has replaced the AC in the large OR room and added a vent fan for the less pleasant to our noses cases. Ed has repaired and replaced most of the equipment in the lab and Zella keeps finding new messes to straighten up. Miss Catherine, the head nurse, has asked if she can come back regularly to help organize things, Wow.

Anyone who has come to the hospital over the years knows Madame DoDo, the little lady who “brooms” the yard all day to remove fallen leaves, trash and other debris. She has next to nothing, her family are what we could gently classify as noncontributing members of society and she was the breadwinner in the family. We had just built her a small, 2 room house so she could have a place to call her own as she was well past retirement age but adamantly refused to retire, nor could she afford to do so with such a lack of family support. Despite having essentially nothing according to the world’s standards, this lady always was cheerful, always was praising the Lord and I always gave her a hug several times during my week here as she praised Him while brooming (they don’t have rakes, if we gave them some, not sure they would use it, plus they use the broom the opposite way we do, an interesting concept), during the chapel services and pretty much 24/7. She always had a smile on her face but a week before I arrived, she was found unresponsive, hypertensive and never woke up despite a week in the hospital and we will bury her November 1. She is rejoicing in her Savior’s presence but we will all miss that 80 pound dripping wet bundle of sunshine.

We have a few minutes to spend with William in Port while loading the truck, as he is busy in his residency. One of his colleagues spent the week with us and seems to be a very nice young doctor. It is hard to gauge them by William, he is so advanced, but then, even a slow teacher should impart some training in 13 years together, as we often did as many surgeries in my week there per month as many general surgeons do in a month, so they had a lot of practice. His wife made us delicious fried banana chips, which we traded some apples for with the 4 of her 5 boys she sent up last night with them. Zella also gave them books and crayons, so we had a delightful time together.

So, it is now time for us to pack up our bags (actually, Olga already did pack 6 of our suitcases, as she has 3 sales in the US in the next few weeks, including one in the Grand Rapids area November 3 and 4 at Bella Vista Church in Rockford, so there is a lot of stuff we are bringing to that sale and the one near Bluffton, IN, where Zella lives and will take 2 suitcases). The little 4 cylinder diesel Kia will labor up the hills with it’s load again, I feel sorry for it, but I suppose it is just like the little engine that could, and does. We thank the Lord for all that everyone has done, from the delicious meals Tabitha and Zella made, to the repairs that Ed and Evert did (I am constantly amazed how Dudu and he get work done with the huge language barrier) to the help that Tabitha and Philipp were in the OR and on the wards. It makes the workload so much easier with everyone trying to help the others. As usual, we had a delicious meal and a good time with Caleb and Olga and good fellowship with them as well as our Haitian staff. To God be the glory for the things He hath done for and through us this week. We will leave at 1 am again and are praying we will get to the airport before the disgruntled folks have a chance to make trouble and set up roadblocks.

In His Service,

Bill, Ed, Evert, Philipp, Tabitha and Zella