Tag Archives: Surgery

The Haitian Donkey And Friends Return To The Northland

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Hi All:

Since the last update had technical difficulties and I could not figure out how to send it out until I got home (will see if can get technical help in that department, no hope for the Donkey to learn such high tech skills), I will update you further on the rest of the week and specific prayer requests.  The week continued to be quite productive, though had another major struggle in that we had another ruptured tubal pregnancy come in that we were preparing for surgery when she passed and we could not bring her back.  She was the sister of one of our guards, Baoo, so that was doubly hard as part of our employee’s family.  Such a reminder of how fragile life is, how quickly, as James tells us, “for what is your life, it is even a vapor, that appears for a while and then vanisheth.”  We are thankful that, although there is NO functional Red Cross facility in either Cayes or Port (and thus all of south Haiti), that our lady with the huge tumors and considerable blood loss is doing well despite the hurdles thrown at her. 

The rest of the 40 some surgeries went well for the week, thankfully.  Saw a cleft lip, which I will do next time, and a cleft palate, which I will not do (as don’t have the obturator, like the top half of a denture, custom made for the little one, so that s/he will not tear up my repair with the tongue).  She seems to be growing well, but hope Smile Train or someone similar will come in the near future to do this.  The surgery itself is not all that hard, I have done it before, but was dismayed when the repair was destroyed when the child tries sucking (even if we dropper feed it).  I also saw the 90 (now) year old man Moise and I resected a huge cancer from his nose and face, I do have some positive margins, but no visible cancer, so discussed with him and his family that I would wait til some came back (not wait so long so it is huge again, though) and reresect if it does, as at 90, he might just live a happy life and pass away of other causes before it becomes a problem again.  He was quite happy with the overall situation.

Duane and Evert fixed a number of problems (though decided that we would not have the Haitian employee who considers himself an electrician after a week of classes in Port do any more electrical work, as he attempted a project with some quite negative results).  Bravery sometimes can have less than desirable endings, especially in the electrical realm.  Sometimes it is braver, and certainly wiser, to ask for help before attempting something we are ill prepared to undertake, whether in the medical/surgical realm or building repairs.  The battery backup system batteries, originally installed by USAID, have started to come to the end of their lives at about 7 years and we are exploring which of a number of expensive alternatives to give us power when we don’t run the generator (or the few hours a day the government may decide to give us some electricity)  This also requires considerable prayer for wisdom to maintain this vital system.  We are working at limiting electrical usage, it seems that turning off lights and fans, etc is an unknown concept in Haiti, one does not stop the water in the river from running, why stop the electricity when it wants to come out?  Or, for that matter, the water that wants to come out of the faucet?  Novel concepts. 

Unfortunately, despite being on both IV Vancomycin and oral Levaquin, I spiked a temp on Thursday evening and have been struggling since. I got repeat blood cultures and other labs done which showed no growth (good, but then why the temp)  but need prayer for wisdom as my Infectious Disease doctor is afraid that the only solution is to pull my last upper body line and then have to go to the groins, difficult to take showers, be active with a pipe sticking out there, not something I am looking forward to.  I also will see my cardiologist before work on Tuesday and see if my heart is functioning better.  So appreciate prayer for wisdom and favorable outcomes on these fronts.  At present, the oncologists state that they want to wait 3 months to see if I can remain infection free before considering further treatment, especially in the immunotherapy realm.  My blood results also showed that my anemia is slowly getting worse, I was reduced to begging to get one unit of blood transfused (all sorts of new rules based on numbers, but what about the poor patient?) 

Dr. WiIliam has gone to France for his 2 months of required training in laparoscopic surgery, I was finally able to make the proper arrangements, we could not purchase the tickets til we got the visa to go there and we couldn’t get that from the French Embassy til we had the letter of invitation from the hospital in France.  I can see that I still have considerable work on the transition front at Centre de Sante Lumiere, to get the situation ready for my possible absence, so would like to be as functional as I can be for a while longer, the Lord permitting.  Also have things to settle and organize on the home front, so Karen is not left with a bunch of problems. 

As always, thanks so much for your prayer and support of our service for our Risen Saviour at Centre de Sante Lumiere in Les Cayes, Haiti.

In His Service,

Bill, Duane, Evert, Linda, Robin, Ruth and Tabitha

The Haitian Donkey And Friends Enjoy Working In The Homeland

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Hi All:


It is hard to believe that it is Tuesday night already and we have passed the halfway mark in our work here again.  As requested in our brief update a week ago, we were somewhat concerned regarding the political upheavals here as well as my health concerns.  We are happy to thank you all for your prayer and support as we had a good trip down here, at least the Haitian Donkey and his friend, the Dutch Donkey, as we were joined in Atlanta by Duane and Ruth.  Tabitha, Linda and Robin came on American and were supposed to land in Port 2 hr before us, but had some weight trouble and had to return to the gate to off load some, so were there a bit before us.  We had a very slow trip to the hospital, about 6 hr, but partially because there were so many police stops in Port and we are thankful that that likely helps keep the rioting down somewhat.  So, everything comes with a price.

We arrived in Simon late on Saturday, the MEBSH folks had their annual convention at the 1500 seat church next door, where the whole courtyard was filled with benches and tarps and there was a huge screen attached to the church so that the thousands outside the courtyard could also profit from the singing and preaching.  We only got the tail end of the meetings, as the church is right next door to the hospital, but we enjoyed what we could understand of the services.  They were done on Sunday after the morning service but they really get into the fellowship and there reportedly were 10,000 people in attendance.  Apparently, they had people come inside in shifts so that it would be fair to all, all the cars that normally were in the courtyard were kept out so more people could attend, so we had people and vehicles everywhere (not that that many people have cars, maybe 50 or 60 were along the road.  People left in droves, a bunch went by on their way home in the back of a dump truck, singing away.  A good start to our week.

Evert (the Dutch Donkey, he also named himself) is a HVAC person from Lowell, MI, and has been invaluable at fixing stuff here.  Duane has been working with some of the Haitian team on storage shelving as well as getting the supplies we sent in a container from Bluffton a while back, including 2 new radiators for the generators, other needed supplies.  Evert has a couple Haitians working with him, they have repaired the truck in several needed places, including the AC and the broken off door handle, they replaced the well pump again and have a host of other projects lined up.  Duane is building some tables for the physical therapy department, as Mme Shaller has brought a physical therapy assistant and will work with her people to get the department back up and running, a great blessing for all concerned and a relief for me.  Both men will keep busy til they leave, as usual, as they have a rather long list of projects to complete.

Ruth, Linda and Robin have been organizing the pharmacy and taking inventory and putting it on the computer as we hope to work more efficiently in ordering and using our supplies, though admittedly, at times it seems impossible to get the Haitian doctors and pharmacy people to think outside the box.  Often it is like the patients back home who are convinced that Advil or Motrin works better than Ibuprofen, despite much higher cost for the same stuff.  They also are working on other organizational projects.

Surgery has been busy, we are very glad that Tabitha is here to help us in the OR.  We had 3 fairly difficult hysterectomies yesterday, 2 difficult hernias (and a couple easier ones) and a ruptured tubal pregnancy that was a bit of a struggle.  We also had an incarcerated hernia come in that had a very low blood pressure and, while we were stabilizing him for surgery, he passed away, a very sad surprise for us all.  Also had a lady in severe congestive heart failure, surely would like to have some of the medicines we use so freely in the US.  Today, we had an easy hysterectomy, a thyroid mass and some hernias that weren’t bad, but then had an add on exploration of the abdomen in a 65 yr old lady who looked well over 9 months pregnant and had had previous surgery, so lots of scar tissue and we had a sweat bath trying to sort it all out as she had huge masses all over her abdomen that were troublesome and stuck to everything, colon, small bowel, side walls of the abdomen and we struggled for hours to sort things out.  I am watching her carefully all night, trying to get some blood for transfusion, a difficult chore here in Haiti on a good day.  So, appreciate prayer for wisdom and healing for her.  Tomorrow has 11 cases scheduled, so if all show up, will be a run day.  Am thankful that my health is holding up but did not feel I could leave the patient tonight for a wonderful meal at Johannes and Luise’s house (Tabitha was late, I would be late also), but still have a lot to do and want to keep a close eye on her, her fluid balance, etc.

So, we thank you all for your prayers and support for the ministry, the trip over (and back) and our work output during our time here, that all we do may bring glory to our Savior, whose indescribable gift we will celebrate this coming weekend and the reason we all are here at Centre de Sante Lumiere.  Also, pray for Duane’s dad, he has been in and out of the hospital all last week and this one, now in Brookcrest with severe infections (we used to keep them in the hospital to stabilize them, now they get sent back out as soon as possible and end up coming back?)

In His Service,
Bill, Duane, Evert, Linda, Robin, Ruth, and Tabitha

A couple Brief Prayer Requests

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Hi All:

I had planned on an update after we returned from Haiti, but life has been hectic for a number of reasons. The busy week ended well, we did 49 cases, few little ones as Dr. Moise does little things while I am gone, not sure if totally legal but he certainly is capable. Friday night, the 3 of us were wrapping things up, packing and just sharing thoughts. The main one I appreciated was that all 3 of us spontaneously agreed that the Lord had given each of us the very best spouse we could ever have and we thanked Him for that. That was a special thought. The trip home went well, though Michigan persisted in giving us a chilly reception. We hope it is the last for a while, at least til the late fall.

Sunday evening after church, we picked up our dear friend, Pastor Etienne Degbey, from a church in Indiana where he had spoken in the evening. He was our OR tech during our 10 years in Africa, as well as the leader in our largest church plant and now a national missionary there, working on his 3rd church, come briefly to stay with us during his reporting to his 4 supporting churches (and some individuals, including Karen and I). He speaks fluent French and Eve (the tribal language, tonal) but the mission here would like him to learn English better so he can be the area director for them there, but how to do it when no one speaks English to teach you and to practice with. He continues to be an inspiration to me, the fact that he and his family give their lives to their own people rather than going to the U.S. for a better life, at least financially, as many of his family have done. It had been 7 years since we last saw him, though the marvels of modern technology let us communicate regularly.

My health has given me some fits, have had almost constant nausea (common since my first cancer surgery and the following chemotherapy, but also often gets worse as an early warning sign of a developing infection). However, I never could find a fever, my blood counts were normal without signs of an infection, so kept watching, working and waiting. Finally, Thursday, things got worse with a fever spike, etc. I have cultures cooking and have started IV Vancomycin again and ask your prayers for wisdom in finding out why these bugs come back so often of late. We are super careful with line changes (the tubing part), just changed the line going into my chest/vena cava a month ago over a wire, so why can we not stay ahead of it. Planning on going to Haiti next weekend but pray that the riots will not wreck things for us and the Haitian people, a real possibility, but we want to go if at all possible. This infection will knock me back out of the Immunotherapy trials for a while, pray that the cancer and infection will be prevented from raising its evil head.

In His Service,

Bill, Duane, Evert,,Linda,  Robin,,Ruth and Tabitha

The Haitian Donkey and friends receive a chilly reception

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Hi All:

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

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

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

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

In His Service, 

Bill, Karen, Rachel, James and Jenn

The Haitian Donkey and friends make progress

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(Sorry, this is very late as could not make the computer in Haiti do my address lists, you all know I am technologically challenged)

 

Hi All:

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