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Eleven Days in Haiti: Part 9 – “LIVES SAVED, WHILE YOU WAIT”

This is part 9 of the “Eleven Days in Haiti” series that started here: https://fbcbridgeport.org/eleven-days-haiti-part-1-series-intro.  Be sure to get caught up if you missed a prior post!

DAY 7, PART 2- “LIVES SAVED, WHILE YOU WAIT”

My shift was not spent entirely in the friendly, tarp-walled, gravel-floored pharmacy. I did assist in oversight of the Oral Rehydration Tent, which is where those not sick enough to need IV treatment can sometimes recover by drinking a solution providing clean water, minerals and carbohydrates. Oral antibiotics are also given. At certain times, I was needed in the Triage Tent to help stabilize new patients and start their IVs. This was way out of my comfort zone but I am pleased to have been able to assist my cousin Dan, who being a career emergency medicine specialist, was in his element. He is a fearless, confident professional in whom I have the utmost trust. Dan has taught me a lot and I would do anything for him in spite of the frequent reminders of the Stan Laurel comment “Here’s another nice mess you’ve gotten me into.” In triage, I saw many patients delivered to the facility in a “tap-tap”, the local equivalent of a taxi. Most were carried in, limp and nearly lifeless on a piece of filthy canvas stretched between two boards. Unable to walk, or even stand, all patients are transferred to a “cholera cot”, a narrow piece of the familiar blue tarp stretched across a 2×4 frame with a large hole cut in the center. Placed beneath that hole is a plastic bucket. Another bucket is placed to one side of the cot, near the head of the patient. The debilitating weakness caused by the uncontrollable persistent nausea and diarrhea means that most victims cannot make it to one of the numerous portable toilets, which necessitates the design of the cholera cots. Aggressive rehydration is the key to treatment, so large gauge IV’s are started in each arm of the patient using Lactated Ringer’s solution to provide fluid and electrolytes. The familiar drip, drip, drip of IV’s that we see in our hospitals will never do. This treatment requires a wide open flow rate of fluids into the vein. As a result, even the sickest of persons shows dramatic improvement in the next 30-45 minutes. Most are then transferred to another of the nearly 200 cholera cots in the main part of the facility where they are monitored by physicians and nurses. Nearly all are released in 48-96 hours.

I still can’t say I enjoyed the 24 hour shift in a cholera hospital, but I’ll never forget it.

Volunteers are asked not to bring cameras due to the sensitive nature of the work there, but the images are etched in my memory. The smell I remember most is the bleach. The sounds I recall are the constant hum of the banks of generators that are the only source of consistent power. The Samaritan’s Purse organization, sole provider of the cholera hospital, is impressive, amazing and blessed. Nothing is impossible with God, as only He can assemble such a group of dedicated believers with the skills to pull this off. From the medical professionals to the support staff at all levels, there was an inexplicable sense of confidence and well-being among them. They knew what they were doing in a task that had never been done. Medical skills aside, these volunteers were bolstered by their desire to serve God by serving their fellow man, to be Jesus in the midst of voodoo and despair, and to provide a future of hope in presence of hopelessness.

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Eleven Days in Haiti: Part 8 – The Hospital: Armed Guards, Razor Wire, and an Evacuation Plan

This is part 8 of the “Eleven Days in Haiti” series that started here: https://fbcbridgeport.org/eleven-days-haiti-part-1-series-intro.  Be sure to get caught up if you missed a prior post!

DAY 7—SUNDAY 2AM-MONDAY 4AM—PART 1

THE HOSPITAL: ARMED GUARDS, RAZOR WIRE, AND AN EVACUATION PLAN

I just counted. I have eight pages of hand-written notes about one 24-hour shift in the cholera hospital. It was a unique, unforgettable experience that I must condense to something manageable. First of all, cholera is a devastating, quickly advancing illness. Persistent, uncontrollable vomiting and diarrhea leave the patient weak, malnourished and dehydrated. Untreated, it can kill within hours of contracting the disease. And yet, no one should die from cholera. Treatment is to re-hydrate and stabilize the patient. Once stable, patients are given single dose antibiotics. Those who die do so almost entirely from inadequate treatment. And so Samaritan’s Purse developed an adequate treatment facility.

After arriving at this facility around 1:30AM by way of an armed convoy of vans, our medical team received our orientation-a quick walk through and a demonstration of the emergency evacuation plan.

The armed guards and razor wire perimeter reminded us that Cite Soleil was one of Port-au-Prince’s most desperate neighborhoods.

The hospital consists of two main buildings, each able to hold about 90 patients each. And by “building”, I mean a state fair type pavilion with open rafters and walls made of the now familiar blue tarp. The tarp also provided separation barriers between the patient areas and the pharmacy, supply rooms, staff break rooms and changing rooms. Another connected facility provided areas for patient entry and discharge, triage and oral rehydration. Entrance and exit from the patient areas required a mandatory stop at a hand-washing station. There is no running water so an attendant opens a faucet on a water tank to assure there is no waste and no chance for recontamination. We also had to step through a carpeted box that had been saturated with bleach to decontaminate our shoes. These stations were strategically placed so that nobody could enter or exit a contaminated patient area without careful washing.

I was assigned to the pharmacy where I worked with a Haitian nurse and a translator. Many days, there are no pharmacists and the local staff must fill orders to the best of their ability with limited pharmacy training. Often, this lack of training and language barriers mean that a doctor or nurse is invited into the pharmacy to find what they need. If nothing else, I was able to streamline the pharmacy processes and teach the local staff a few procedures to ensure better safety, accuracy and accountability. With an actual pharmacist on hand, the nurse soon moved on to do actual nursing and I handled the pharmacy with 3 translators, each working an eight hour shift. The interaction with each of them was similar as we compared home, family, and working environments. The last one though was different. He somehow was studying English, French and organic chemistry with aspirations of a career in medicine. Yet for most of our time, he grilled me with questions about my faith, my church and if I had the chance to preach there. We got pretty deeply involved in comparisons of our churches and our Christian beliefs and practices.

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Eleven Days in Haiti: Part 7 – Roller Coasters, Purpose, and Providence

This is part 7 of the “Eleven Days in Haiti” series that started here: https://fbcbridgeport.org/eleven-days-haiti-part-1-series-intro.  Be sure to get caught up if you missed a prior post!

DAY 5—A ROLLER COASTER RIDE OF SORTS

Just when you think you might be sensing a routine in this desperate environment that is post-earthquake Haiti, things change once again. Jude, one of the local staff, is getting married sometime between 3:30 and 5:00 today. Evidently these things never start on time here. Most of the staff, drivers, and translators want to attend. Team 51 was invited as well. In order to honor this man and those wanting to attend the wedding, it was decided to combine the medical groups and “double-team” one of the mobile clinic sites. We saw 126 patients by noon. This enabled the locals and many of our team to attend a beautiful marriage ceremony for Jude and his bride. Dan and I chose to stay at the compound and work on a drug formulary and inventory for the medical teams.

At around 2:30 we learned that the unrest in Port-au-Prince has closed the airport until Monday.

With a backlog of passengers, our departure is not until Wednesday, December 15. This means we don’t get back to WV until Thursday, Dec. 16. We broke that news to the team upon their return and let it sink in for a while. After some prayer, reflection and some rare phone calls home, the joviality of the team returned. We seriously get a lot of work done, but we realized that the Haitians are now “getting” our sense of humor and are starting to crack jokes back at us. The pharmacy workers are good as gold. Most have very little formal medical education but their on-the-job training has been excellent. Mike and Tamare, both around 20 years of age, lit up when I said I would be proud to work with them in my pharmacy.

The construction team, which spent the first part of the week doing projects at the local police department, finally got to build some of the pre-fabricated shelters provided by Samaritan’s Purse for those displaced by the earthquake. The one they finished today, the typical 12 x 12 foot blue tarp, tin roof, wood frame structure will house a family of eight persons. For all the dis-organized mess that is Haiti right now, there are rules to follow for shelter placement. Those who receive a shelter must be able to prove ownership of the property or be a valid renter as proved by the owner or surrounding neighbors.

DAY 6- PURPOSE AND PROVIDENCE

God revealed to us today the purpose for keeping us here for a few unscheduled days. Samaritan’s Purse operates a cholera hospital in Cite Soleil. Cholera is easily transmitted in this environment and the epidemic was spreading death and panic throughout the area. The hospital has a medical team completing their deployment and leaving tomorrow and the next team can’t get in until a charter flight arrives late Sunday. This leaves the hospital extremely short-staffed. Teams work 24 hour shifts starting at 2am since it is safer to get through the city at that time. Without a solution, the Samaritan’s Purse staff was praying for God to provide 5 medically trained persons to staff the hospital. That’s at the very least a bold request considering this is 2010 post-earthquake Haiti. As they prayed, Dr. Steve Daub was walking up to the Samaritan’s Purse facility to see if there was anything we could do since we had some free time this weekend. He told them we had 3 doctors, 2 nurses and a pharmacist if we could assist in any way.

Perfect timing? God’s timing.

In an obvious plan orchestrated by God, we rejoiced and responded.

After giving thanks to God for his provision, the SP staff came to meet and instruct us. As a part of this conversation, they mentioned they had run out of a certain IV administration set, vital to the cholera treatment and had been praying for God’s provision. Our clinics had no use for this item, but someone in the states had given us a suitcase full of this exact item to bring, so we did. Now we know why. OK Father, we get it. “Ask and it will be given to you; seek and you will find; knock and the door will be opened to you.” Matthew 7:7

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Eleven Days in Haiti: Part 6 – “Please Sir, I Need Soap!”

This is part 6 of the “Eleven Days in Haiti” series that started here: https://fbcbridgeport.org/eleven-days-haiti-part-1-series-intro.  Be sure to get caught up if you missed a prior post!

DAY 4- “PLEASE SIR, I NEED SOAP!”

Each day in Haiti is a little different that the last. This morning, we got one translator and one driver back even though many of the streets were blocked and there was some violence downtown. As we circled up to pray, Scott pointed to George, one of drivers and asked him to pray. George became uneasy and said “No English.” Scott said “It’s OK. Just pray.” Even though most of us knew no Creole, we were able to join in lifting praise and petitions to God the Father through George’s passion alone. What a beautiful blessing.

By evening, Scott had talked to Mike, my translator and assistant on Monday and Tuesday, who felt that things had calmed down and the streets were getting cleaned up. This was confirmed by a call to another staff member in another section of town. Word is that the airport will be open Saturday for our scheduled return flight to the US.

The clinic was busy today, mostly with kids and routine stuff, but we did see 162 of them. Sort of like yesterday, a teenage boy was so weak and sick that he had to be helped in. Our docs started IV’s, did a malaria test which was positive, gave the appropriate drugs and the young man walked out with his mom about 4 hours later.

malaria post-treatment_resize

Just as memorable was a boy about 14 years old who was standing with a line of kids that were constantly peering in watching us work through the open sides of the building. He was proud of the fact that he spoke English. His grandparents were sending him to an academy to learn the language. Some people understand that speaking English may very well provide a job and steady income. Most kids’ English vocabulary consists of “Hey you! Give me a dollar”, but not this boy. We talked of loving Jesus and about our churches, families and hometowns. And he literally begged me for soap. Not a dollar, not candy or water, but soap. And he said “please.”

“Please sir, I need soap.”

 

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Counter Culture

Counter Culture from Fellowship Bible Church on Vimeo.

Sunday, June 12, 2016
Counter Culture
Matthew 5-7
Sam Schwenk

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Eleven Days in Haiti: Part 5 – Fewer Patients, More Serious Illness

This is part 5 of the “Eleven Days in Haiti” series that started here: https://fbcbridgeport.org/eleven-days-haiti-part-1-series-intro.  Be sure to get caught up if you missed a prior post!

DAY 3—FEWER PATIENTS, MORE SERIOUS ILLNESS

Exhilaration describes the mood throughout much of the medical team as we headed back from the mountain village of Topya. We had held back a new soccer ball until all the patients were seen, then gave it to a dozen or so kids that were hanging around. They briefly clowned around for our cameras, then disappeared to enjoy some play time. To see the thrill on the faces of these energetic young people brought a pleasant end to an otherwise stressful day. We had driven several miles up a dirt road constructed by recent well-digging teams to this clinic site which was set up in a double version of the blue traditional Samaritan’s Purse tarp shelter. We had packed everything we could into a single van because two drivers and two interpreters were unable to make it to work today. Reportedly, the roads out of Port-au-Prince were blocked and closed due to protests surrounding the elections. The taxis or “tap-taps” were not running anyway as their operators were discouraged from working. None of this should make any difference to us as we headed away from the trouble and into the mountains, but it was obvious that the locals were uneasy. The apprehension soon spread to the rest of the team as we saw the seriousness of the day’s first patients.

Patient #1 was a teen-aged boy whom it was surmised had severe malaria, although typhoid or tetanus was considered as well.

He had been completely unresponsive to his parents since the night before and had to be carried into the clinic. His vitals were fairly normal, blood sugar was good, but he was incredibly weak. He could not open his mouth to take even liquids, so Dr. Dan wanted to start an IV, which he claims not to have done since he was a paramedic, perhaps 25 years ago. So since I thought this was to be a safer environment for Jenna to work, guess who Dan called on to help start the IV? She calmly did whatever was needed, from securing the patient so he did not flinch from the needle, to actually injecting medications into the port in the IV. Jenna, now “highly qualified” in IV procedures, also assisted in starting at least two other IV’s in equally ill patients. I might have assisted in these procedures but my services involved preparation of the IV medications that were required. We were short on certain drugs in liquid form, so I taught our local Haitian pharmacy techs to crush solid forms of the drug and mix with Pedialyte or Tylenol liquid to make sure the patient got the needed medication. I feel like this was one of my biggest contributions-to be able to provide some optional “work-arounds” in less-than-optimal situations and to suggest alternatives when preferred treatments were unavailable. The day did become less intense as the afternoon neared conclusion and the patient count was somewhat lower than yesterday, but the illnesses were much more serious in the mountains this day.

The ride back down the mountain was beautiful as the late afternoon sun reflected off the bay. The air was clear and calm and we could see many miles to the opposite shore near Port-au-Prince where many small fires were burning, some due to the political protests, others attributed to daily cooking or trash-burning. Dr. Vlad stopped the van at a nice overlook for photos. We photographed the bay, the mountains and each other. Vlad stopped a man walking home to take a group photo for us. He had to take one with each person’s camera and this worked well considering it was the first time the man had held a camera.

Scott and Janet got an email from the American embassy today warning of the unrest in Port-au-Prince and that the airport was closed. American Airlines suspended flights into and out of Haiti. Not sure what this means to us.

DAY 3 ADDENDUM   As we left the mountain clinic, patient #1 was still mainly incoherent, but was able to take some liquids. We did what we could, but were not entirely confident that he would even survive. When the next team returned to this site the following week, his parents had walked several miles to the clinic just to say that their son had fully recovered.

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Eleven Days in Haiti: Part 4 – Permanent Disaster?

his is part 4 of the “Eleven Days in Haiti” series that started here: https://fbcbridgeport.org/eleven-days-haiti-part-1-series-intro.  Be sure to get caught up if you missed the prior post!

DAY 2-PERMANENT DISASTER?

I had an interesting conversation with Dan last night at bedtime. I thought about Day 1’s work and wondered, based on that, if we would be seeing the same people and treating the same illnesses had January’s earthquake never happened. We had seen very little that would be considered medical disaster relief. Oh yeah, the quake worsened many existing problems, such as lack of sanitation, poor diet and lack of infrastructure and services. But these problems were here before. The lack of progress and recovery leads to the tough questions. When does this mission end? If “disaster relief” ends, and the relief organizations pull out for the next disaster, how does Haiti care for its ailing population and provide basic services and infrastructure? By continuing to care for Haiti’s poor, are we creating a dependency problem? How far away from this is any nation?

2:30 PM

I don’t know what the temperature is today, but the word ’perfect’ comes to mind. I’m sitting on my bunk on the screened porch where the men sleep overlooking the bay that swallows up the sun every evening by 6:00pm. The cool breeze that ruffles the surrounding palm trees is also—well—perfect.

Last night we were just too tired to pack meds into the “units-of-use” and thought we could just package as we go, but we were lucky it was a light day. Pre-packaging saves time so we’ll be counting pills tonight. Who knows what tomorrow brings.

I rode to clinic today with Dr. Vlad. Just the two of us in the front of the truck. He is an amazing man. He went to med school in Haiti, but did a residency in Indiana, then returned to Haiti. He is now a US citizen, so every six months, he must return to the US. He was due to return in January 2010 when the earthquake struck and he just couldn’t leave. It was logistically impossible, but the needs of his people were just too great for him not to stay and render aid. During the week of the quake, some of his friends from Indiana were visiting Haiti. They were staying in a seriously stricken area, just southeast of Port-au-Prince. The house they were in started to shake, so they ran outside while the house crumbled around them. Two Haitians stayed inside and perished. Vlad, of course, knew where his friends were supposed to be, but they were forced to live on the streets for the 4 days it took Vlad to find them. I don’t know Vlad well, but from the change in his tone and facial expression, I know it was emotionally difficult for him to tell that story. Vlad finally felt compelled to return to the states in September, 2010, fully eight months past his required return. His apprehension was likely evident as he approached the immigration agent in Miami. When asked how long he had been in Haiti, I’m sure Vlad’s calm demeanor was challenged, but I can hear him quietly relating his story of service to his people in a time of great catastrophe. The agent didn’t hesitate, but handed Vlad his passport, said “Thank you for what you did” and motioned him past.

Vlad lives in one of the one of the Samaritan’s Purse tarp shelters just outside the Global Outreach compound. And his medical director’s position with NCBM pays him $75 per week.

He is a hero, but it is doubtful anyone will know his story.

Drs. Vlad and Merline_resize
He is so willing to share history, customs and his experiences of Haiti. He shared today that every January 1, all Haitians, wherever they are in the world celebrate the independence of their nation by eating pumpkin soup. This common food was denied to the Haitians under harsh French rule, so they commemorate their freedom by re-instating this custom.

Today was market day, which is best described as a flea market in US terms, although it serves a much higher purpose of supplying certain vital food items to local residents.
Vendors set up in tents or booths along the road selling food, personal items, electronics and many sundry items. This all sounds quaint, but in truth it is noisy and filthy. I’ve never heard anyone say “It’s garbage night” but I did see trucks in the city with crews picking up bagged trash along the streets. They are way behind in this task as garbage, bagged and otherwise, is piled everywhere. [I discovered later that the garbage on our compound is collected and burned daily.]

I enjoyed my first Coke this afternoon since last week, but what I miss here is milk. There is some powdered milk available but it didn’t taste good to me.

It has been interesting watching Dan work without all the technology and staff he is accustomed to at home. The term “practical compassion” comes to mind if that makes sense.

We took Jenna with the medical team today, as we thought this would be a good opportunity for her to observe the way medicine and pharmacy are practiced in Haiti. We also felt this was a safer environment for her since the construction team would be working at the local police station. There is a possibility of some unrest, especially in Port-au-Prince due to the release of national election results.

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Shipwreck!

Shipwreck! from Fellowship Bible Church on Vimeo.

Sunday, June 5, 2016
Shipwreck!
Acts 27-28
Sam Schwenk

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