There is a lot of exciting stuff going on at HAH. The Lord is blessing our feeble efforts in many ways. Jonathan and his men worked like a Formula 1 pit crew this month in order to move some major projects forward. Jonathan used my arrival from a 2 week trip to Loma Linda to motivate the team and they really impressed me. Many times after a trip arriving back can be a bit overwhelming but I have to say it was exciting to get back and see all the progress. In spite of my absence for two weeks surgical volume remained just below last month’s record high and exceeded all previous months. Here are a few November highlights.
THE WEEK IN PHOTOS:
Although our hospital continues to improve, the situation beyond our walls continues to deteriorate. The streets are a mess, protests and gangster control have locked down the country. Schools are closed until January, banks and businesses are only open intermittently and getting supplies is very difficult. Trips across town and airport transfers are made with trepidation. So far the ambulance has only suffered a few hits from rock throwers. All of this has significantly affected patient flow, but in spite of that, volume overall this year is up from previous and the hospital is surviving financially. We continue in our efforts to restore the hospital. On our campus people are working and getting paid for it. The work here provides jobs for people in need, teaches new skills, and gives a sense of accomplishment. We are all working with a sense of enthusiasm and loyalty for the mission of this institution. The result is a beautiful and peaceful environment where we can share God’s love, peace and healing power which is needed more than ever in this country.
Jonathan Euler and his crew are largely responsible for this. He and I watched a few youtube videos on how to make curbs before we launched the project. Normally curbs are not something that you probably have ever noticed but everyone is pretty excited about this as the job was quite a challenge
Hôpital Adventiste: Standing Strong Amidst Political Crisis
Monday I arrive at Port au Prince Aéroport Toussaint Louverture. Michel our hospital driver is running one hour late. Normally he is always on time but today he had to take a more circuitous route than normal to avoid the fiery barricades and mobs of people that have taken to the streets.
People are riled up because the president is trying to install a prime minister accused of a string of corrupt deals. Luckily I make it through customs OK with four heavy bags of equipment for the hospital. This was facilitated by an eager baggage handler who put my bags through an x-ray machine and quickly stacked them back on my cart while whispering something in my ear. I knew what it was about. As soon as we got around the corner he wanted $50USD. I smile and give him $10, which I justify as a tip for handling the bags rather than a bribe for customs. Before long Michel arrives, and we set out from the airport taking the back streets across town. Each time before making a turn Michel looks down the street to check for barricades. When we see smoke, flames, or mobs we take the alternate street, sometimes going in the desired direction. With minimal traffic on the road we arrive at the hospital a little faster than usual.
Jere Chrispens, our CEO is not able to fly to the US on Tuesday after a fire breaks out in the airport gift shop, coincidentally about the same time the president of Haiti is supposed to depart for the UN general assembly. Flights already in the sky out of JFK and FLL are diverted and all arrivals and departures are cancelled for 24h. This is great for me because I get an extra day to work with Jere on hospital administrative issues.
Wednesday arrives. The ortho clinic is almost empty except for all of the faithful moms who bring their babies each week to the clubfoot casting program. There is almost no public transportation, there are fuel shortages, and the economic situation only continues to deteriorate. But nothing can get in the way of a mom watching out for her baby. They might not have food or means for anything else in life but they still show up to the clubfoot clinic so their babies won’t grow up disabled, ridiculed and disregarded in an already challenging life. Thankfully most of our employees live close to the hospital and loyally show up for work, albeit in some cases having to bypass rock throwing and gunfire.
Thursday is unusually peaceful except for some trauma cases that arrive including a 6 year old girl with an elbow fracture. I specifically mention her for a few reasons. It’s not because the case is so rare or amazing, but I am excited that she showed up to our hospital only one day after suffering a type 3 supracondylar fracture (Type 3=bad). In the past our hospital has had a reputation of being elitist and inaccessible. When hospital finances were tight prices were raised and poor people were turned away. In addition to not taking care of the poor, hospital finances continued to struggle. It has not been easy to show how lowering prices and creating accessibility can actually improve hospital finances, not to mention our bigger reason for being here. But this is happening.
It is by a combination of factors, not the least of which are the blessings that come from generosity. We started something called “Pwogram Ijans Aksidan” which means something like program for urgent accidents. This is a package deal that gives a 75% discount to trauma cases that present less than one week from the time of injury. In the quest to give the best treatment to the most people with a set amount of resources it makes sense to take care of injuries soon after they occur. We have many cases that present months after injury with complications or neglect. Instead of coming to our hospital at the time of injury, they went elsewhere or nowhere at all because they could not afford our hospital. Now out of work for months having spent whatever they may have had elsewhere, they need help. So this little 6 year old girl shows up at our Salle d’Urgence (ER) with an acute injury and I am excited. Her dad was processed through our new financial counseling office, given an affordable price and she got a 20 minute operation that will avoid a lifetime of disability. Multiple factors have impeded this process from gaining traction, but finally we are seeing the fruits of our labor. We would love to give it all for free, but there are other implications to that… too complex for this discussion. In any case we now have a system to make treatment possible for all and to avoid turning people away. It still has glitches but these are getting less and less.
The political situation continues to escalate throughout the week with plans for the most massive destruction ever to take place on Friday. People are demanding that President Jovenal step down. He gives a small speech – at 2am on Friday, no one seems to pay attention. People are angry about double digit inflation, fuel shortages, no electricity and billions of dollars that are unaccounted for. They take to the streets. Banks are closed, schools are closed, all major businesses are closed and the city is locked down. I see a couple of major fires already burning downtown when I go for my 6am run. Fires, road blocks and destruction persist throughout the day.
At the hospital things are eerily calm but we are safe. We do surgery and then I have time to tend to my many other responsibilities. Finally Friday night arrives and I have enough time to enjoy dinner before getting called to the salle d’urgence.
On Sabbath afternoon I take a walk down by the bay with Patrick to visit some of our patients. The conditions down there would be shocking to even the hardiest of missionaries. We see Jervens who previously had a colostomy after getting clogged up on cement that he ate, we see Michena who had burn contractures on her foot, and Jackson who had a life threatening infection, all of whom were treated at our hospital. I hear repeatedly “Bonswa blan” (good afternoon white) “Mesi mwen blan” (thank you my white). Then they bring me to see a 3 day old baby. The parents again thank me profusely for saving the mother’s life and for their baby. At first I don’t know what they are talking about, I am an orthopedic surgeon. But then I realize they had come to the hospital with mom in distress a few days before. They had no money. So I directed them to our new financial counseling office and they got treated. The system is working!!
Boot Camp Blast!
I wake up on Sabbath morning to enjoy a few peaceful moments under the mango tree, reflect on the events of the week and read a chapter in my French Bible. Sabbath is the only morning that we don’t have to hear the recently donated gas leaf blower start up at 620am. I also slept in a bit later than usual due to the absence of at least one outspoken rooster who routinely wakes up at 3:45am…
I contemplate the busy week of boot camp activities, wondering if the medical students have been as inspired by the experience as I have. We kicked off most days with a morning run, either a 5am run at the track or a 6am sunrise jaunt up the rugged dirt road hills returning through the chaos and pollution of Port au Prince rush hour traffic. Hospital worship starts at 730am sharp – a hymn, prayer, hymn, Psalms, devotional, special music, benediction, announcements and the salutation. It is good chance to practice French comprehension and greet the staff.
We then gathered around the table under the tree with our boot camp family to hear Sarah tell a story about working in a bush hospital – always with a spiritual pearl. The work strategy of the day was briefly discussed. Teams A, B and C – 3 students each take turns on different activities. The surgical service includes going to clinic, doing rounds, observing surgery, washing instruments, and organizing the OR. Sarah’s team roams the hospital looking for patients and projects that need attention. Their activities include caring for patients in the ER, transporting them to the OR, facilitating x-rays and labs, reorganizing the pharmacy, cast room, multiple storage rooms, working with nurses, repairing gurneys and wheelchairs. We also had a maintenance and grounds team which spent most of the two weeks putting a fresh coat of paint on our 300 foot wall. Lots of graffiti was eliminated, but more came in the night almost as quickly as the paint dried. Luckily there was time to repaint those parts of the wall and we now have two days of no graffiti in front of our hospital. Probably a new record.
Projects stopped at 4pm for the afternoon Kreyol class. Harrison is the professor and he did an excellent job. Everyone also got a chance to experience the hardships of life in Haiti by doing some home visits. Dr. Lamberton, chairman of the DMA program, came from Loma Linda to join us during the last several days. His sense of adventure found him on the back of a motorcycle taxi going on a home visit with some of the students. After dinner each night testimonies and experiences were shared and the answers to some difficult questions were discussed. Everyone went to bed tired.
Click the video above to see Dr. Dan Smith mellifluously insert an intramedullary nail.
James and Scott at work on a TSF
Dr. Dan Smith and Dr. James were able to do a much awaited for operation on a young boy who lives in squalor with a colostomy. He ate some cement a few years ago and plugged up his colon which resulted in 6 operations and a colostomy. The operation this week will once again allow him to have normal bowel function. This is a whole story of its own. No time now. But it is one of the many miraculous and providential events happening at HAH.
After finishing his surgery on Wednesday afternoon James and the students decided to chase the rooster down and chop his head off with a machete. The med students who just finished their anatomy class plucked him and used their knowledge to remove the liver, heart, gizzard and other innards. The rooster was then prepared with some spices from the bunkhouse and served as an hors d’oeuvre. Even the vegetarians and animal rights activists joined the occasion.
All of these events run through my head as I sit under the mango tree. Birds chirp, a gentle breeze blows, and the sun rises. After enjoying a few moments of peace I come back into the house to get away from the mosquitos, when suddenly I hear a loud boom and shattering glass. I run back outside to see James coming out of the duplex across the yard in a stupor. I find Sarah sitting inside on the floor relatively unharmed by the oven that just exploded. She is in a daze but still has a smile on her face and is chuckling about the event while holding her head. A thick smoky haze fills the house and oven parts are strewn about the kitchen. The oven was 18 inches out from the wall and the top looks like the open hood on a taptap. The blast blew out the kitchen window, shattered glass all over the porch, but the screen intact. Sarah only suffered a minor head injury from some unknown projectile. The flame had gone out while baking banana bread. Thinking the tank had probably run out of propane she tried to relight the oven. These Haitian ovens can be finicky and we learned that it is not good to relight them after the flame has gone out. Evidently the learning lesson was not clearly communicated to the students who were later cooking dinner and noticed their flame had gone out in the bunkhouse oven. Later in the day when Greg and Brianna try to relight the oven BOOM! Another blast, albeit slightly less forceful than the first. Hairs were singed, no windows blown out. Unlike the first oven this one might be repairable, or we will consider replacing with something of higher quality.
We wanted boot camp to be an authentic experience – not one that would just be called fun or enjoyable. Nonetheless it seems that everyone had a blast and thankfully it all ended well.
Good times with Greg