Tag Archives: Surgical Certification

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

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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

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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

Trial Voyage for Technically Challenged Haitian Donkey

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Hi All:
This is an attempt by the technologically challenged Haitian Donkey to revise, update and get the lists on the new Haiti computer. After 14 years of travel back and forth in my backpack, as well as doing some work here in the US, my laptop expired in the process of trying to revise it and everything was lost, including my Medical Committee Notes, etc, though much had been printed off, but frustrating. The biggest loss was all 6,000 of the cases I had logged for governmental documentation, we have the hard copy in the OR log book, but sometimes a bit hard to decipher (I am NOT allowed to write it in, so don’t laugh too hard).

Dan Boerman obtained a new one and I think, with help, of course, that I have installed the update list on the computer and this brief note is to see if what I think happened really did. Then, Lord willing, I can send updates directly from Haiti instead of sending them to the US and Karen having to send them. A down side for you is that she often edits and corrects them, so you have more the unvarnished copy, so apologies. My skills in the grammar department lack some.

The other reason is to update you on my dear friend and colleague, Dr. William. As I mentioned, only 2 of the 6 surgical residents in his year passed the test, who knows what the lack of legibility in the writing of the test contributed to the situation. However, one wonders about the quality of the system when less than half the students pass a test? This was a blow to him, understandably, as we operated together last week and spent a lot of time being able to share struggles for him. He misses his family, though as he goes to the higher levels, he will be able to come home more often on weekends and some of our supporters have been gracious enough to donate funds specifically for this project, a real answer to prayer that I had not even thought about. His car is a bit cobbled up, so pray that that will continue to function, though he does often take the bus back and forth and he can sleep in it on the way (he, like me, can sleep standing up or anywhere the opportunity arises). But, the government still has not given mattresses for the beds for the patients nor any sort of regular water supply to enable the cleaning personnel to clean the hospital and beds, etc on any sort of reasonable basis, and they are threatening to strike again, which would only slow him down further. Pray for a realistic solution to this problem that will allow him and his classmates to progress correctly. He has to retake the exam in a bit, I don’t think that has been determined yet, but just pray for God to sustain and encourage him in the days and months ahead.

Thanks so much for your intervention for him before His throne,

Bill for the Haiti Team

(PS: Let me know if you have another contact that needs to be added and will accommodate)

The Haitian Donkey is back in warm and very wet Haiti with friends

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Hi All:
I didn’t get a chance to send you an update last time after we got back to let you know how the end of the week went. The last few days were a flurry of activities as we tried to wrap up projects and plan for further ones as well as what the Haitian part of our construction crew would do during our absence. The trip home went well, for which we are very grateful, and we settled back into the USA part of our lives smoothly. Had a good week getting to know Mark Snyder better and meeting and working with his son, Andrew, great additions to our Haiti team as they are innovative and can help bring dreams into reality, especially considering our limitations in non first world countries.

The three weeks in the US were hectic, trying to get things organized in that part of our lives, especially since we had the storm added to disrupt things, as well as trying to run Georgetown Medical Center for the better part of 4 days without the telephone or computer functioning. It certainly reminds us of the positive and negative effects of technology when it works and, more so, when it doesn’t. My partner, Dr. Lugthart, took a week vacation right before I left for Haiti, so that made that last week even more interesting. I am thankful for my supportive wife (and family) as well as my great coworkers who put up with the demands added to our lives as we try to serve God here in Haiti as well as the US. It is hectic and crazy at times, but so much better with such fantastic people to share the burdens that come with the territory.

We packed our 9 suitcases the week before and were ready and at the airport on time at 4:30 am on Saturday. We had a quick (40 minutes) layover in Chicago and were on our way to Miami on time. However, that was the end of the smoothness. On arrival in Miami, we were told our plane would be 4 hours late to Haiti. The rationale was that they had no crew available to fly the plane til then??? About 1 hour before departure, they announced that we would be another 1/2 hour late and brought out sandwiches, snacks and drinks to smooth out the restless customers. They asked everyone to take one of each, something not comprehensible to a Haitian mindset. The grinning little old ladies walked off with 4 of each item, typical for what happens each time one has a dinner for our people. We got on board and had a good trip, used a new thought process to get through customs smoothly and out the door at 8:45 pm in the dark. As we left, a major deluge dropped from the heavens and we were soaked just in the short trip to our vehicle. The roads in Port were more like a river, in places several feet deep and major chaos ensued. On good days, Haitians are not known to stay on their side of the road if there is a slow up of traffic up ahead, now there were often stalled vehicles drowning in the muddy water, so the traffic would form another line next to it, in places the other direction was 4 cars wide and we had only half a shoulder to go on. A governmental car with his red and blue flashers tried to squeeze past us, riding on our side of the barrier and bumped into our cow catcher front bumper, doing some damage to his side. The angry official screamed that he had the right of way, as was the government and pulled a gun on Jean Eddy, placing the barrel on his chest to intimidate him, which he was succeeding in doing. He demanded that I give him $400 USD for the damage to his car and we finally were able to continue our soggy trip. I fear this country runs by intimidation and will only get worse as the fairly ineffectual UN pulls out in October.

Tom Failing was trying to pass a kidney stone, plus has about as nasty a case of motion sickness as John Harlett and I do, so we made a straggly bunch as we finally came out of the water and continued on our way, arriving at the hospital at 3:20 am, wet, droopy and bewildered. We all were soon in our various beds, not caring much about the niceties of preparation for that and slept til the morning light arrived to start our week of work here. Tom, John and Kurt went to Renault and then assessed the situation with the new developments, including some we had no idea existed, like USAID putting solar panels up on the treehouse that the men crews sleep in (right where they hoped to put a second roof of our steel to allow some space for the heat to escape before pounding on their heads). I saw a goodly number of patients and we all had a nice visit by Dr. William and his lovely family. He has vacation this week and will be operating with Moise and me, something I am looking forward to enjoying. He did say that he was not one of the 2 (of 6) residents that could read enough of the scribbles and come up with the answers to pass the test, so he will have to try again in a couple months. Pray for wisdom and strength for him as he continues to work towards this lofty goal of ours. He said that there are rumors that another strike may take place, that is a definite prayer request, as that already has cost him a year of work/time.

We are all dried out, have settled into the routine laid out for us for the week and thankful that the trip was not any more painful than it was. Thanks for praying for us and supporting our efforts for His glory here at Centre de Sante Lumiere in Les Cayes, Haiti.

In His Service,

Bill, John, Kurt and Tom

The Haitian Donkey has highs and lows on the bumpy road

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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