Just a picturesque view on a normal morning in Passe Catabois as the day starts.
Tuesday, April 27, 2010
Just Another Day in the Neighborhood
Just a picturesque view on a normal morning in Passe Catabois as the day starts.
Sunday, April 25, 2010
Thursday April 22, 2010
This is all a little surreal! I am officially sitting in Cange (central Haiti) right now and will spend the night here at Zanmi LaSante, the Partners in Health hospital started in part by Paul Farmer (aka my hero).
We brought Vigil, one of our TB patients who has already been in our care for treatment for two and a half months and still has a positive sputum test and is clinically getting worse. He started treatment for the first time last year but quit to go to the witch doctor for six months. We started retreatment in February but he's still fighting something fierce. We are suspecting a resistent TB that we definitely do not have the means to diagnose and treat in our neck of the woods. And so, after some phone consulting with Anne-Marie in the Netherlands, to Cange we go. The only place in the country (that I know of) that deals with resistence.
We left Passe Catabois at seven this morning and after seven hours of Haitian roads, sweltering heat, and a quick lunch in Gonaives, we arrived in Cange with some "heads that have been rearranged" (Sara's words for how bumpy that insane ride was) but pretty excited hearts. However, we soon found out there was no room for Vigil in the TB program at Cange, so he would have to be transferred to the hospital in a place called Hinche - another hour and a half away! This time just Vigil and his mother go by ambulance, provided by Cange. We all parted ways feeling sad and a little afraid with uncertainty. Vigil and his mother have no idea where they are going and now are going with complete strangers. Nacilia, Vigil's mom, left with tears in her eyes and enough money in her pocket to get back home to Port de Paix via bus. We could see the fear in her eyes and understandibly so. He son is sick and now off to a strange place. We don't know if she can stay with him so she will have to find her way back home by herself. Vigil's treatment will be long, a minimum of eight months. It's hard for us to say goodbye to Vigil but I cannot imagine how Nacilia is feeling right now. Sad, but so necessary. They will start Vigil on the regime for resistent TB the next day and send his sputum to Boston where is can be tested for specific resistence (all for free).
The other sad thing: I did not get to meet by best friend, Paul Farmer, today...but did use his internet some (don't tell anyone!).
We brought Vigil, one of our TB patients who has already been in our care for treatment for two and a half months and still has a positive sputum test and is clinically getting worse. He started treatment for the first time last year but quit to go to the witch doctor for six months. We started retreatment in February but he's still fighting something fierce. We are suspecting a resistent TB that we definitely do not have the means to diagnose and treat in our neck of the woods. And so, after some phone consulting with Anne-Marie in the Netherlands, to Cange we go. The only place in the country (that I know of) that deals with resistence.
We left Passe Catabois at seven this morning and after seven hours of Haitian roads, sweltering heat, and a quick lunch in Gonaives, we arrived in Cange with some "heads that have been rearranged" (Sara's words for how bumpy that insane ride was) but pretty excited hearts. However, we soon found out there was no room for Vigil in the TB program at Cange, so he would have to be transferred to the hospital in a place called Hinche - another hour and a half away! This time just Vigil and his mother go by ambulance, provided by Cange. We all parted ways feeling sad and a little afraid with uncertainty. Vigil and his mother have no idea where they are going and now are going with complete strangers. Nacilia, Vigil's mom, left with tears in her eyes and enough money in her pocket to get back home to Port de Paix via bus. We could see the fear in her eyes and understandibly so. He son is sick and now off to a strange place. We don't know if she can stay with him so she will have to find her way back home by herself. Vigil's treatment will be long, a minimum of eight months. It's hard for us to say goodbye to Vigil but I cannot imagine how Nacilia is feeling right now. Sad, but so necessary. They will start Vigil on the regime for resistent TB the next day and send his sputum to Boston where is can be tested for specific resistence (all for free).
The other sad thing: I did not get to meet by best friend, Paul Farmer, today...but did use his internet some (don't tell anyone!).
My Lament Today
Tuesday, April 13, 2009
My heart feels ragged and I'm not sure how I can pick up the pieces, bandage them together and go on. Lord, this is too much. It's one of the first times I'm seriously wondering how Haitians can go on with the misery they experience in this life because I've just gotten a taste of it and I don't feel like continuing on today.
Tasha pounded on our door at 5am. Acdonel, one of our TB patients, is vomiting profuse amounts of blood. I hear in my half awake ears people throwing around the word "mouri" and I shoot out of bed along with Sara. We hurry down to the hospital. I'm praying the whole time for God to give us strength for whatever we are about to see. We enter the hospital and approach the door of their room. Tasha, his sister, sees what's inside and falls the ground, rolling, wailing; he's covered with the sheet; he's died already. I can't explain the shock that jolted through my heart right then. I don't understand. He was fine the evening before. More than fine. We even joked around a bit about how I insanely love mangoes. It was just a normal day. He's stayed with us for more than a month now and he was getting better everyday.
This one is hitting me harder than most. Acdonel is the one we look forward to see the most at rounds (don't tell anyone else). He was gaining strength enough to walk again. He would lay on his mat right by the open door, greeting and joking with everyone who passed by. The other day we found him with Orisnel, our little malnourished boy with Down's syndrome, and they were giggling up a storm as he teased and poked him. Oh...his voice. Everyday you would hear "mesi Missla" after his daily shot. His precious sister who shared food with everyone in the hospital. He was only 32, he has 3 kids, and he died from TB - how stupid is that?
I sat in the hospital for an hour and a half this morning, stunned. I felt for the first time myself, the raw emotion in the wailing that happens after someone dies here. It came in waves. Silence as everyone sits trying to comprehend what just happened. Then Tasha starts with another bout of wails that let out the depth of her misery, pain, and cries to God. It fills the whole hospital. "Bondieu! Bondieu! Jezi! Jezi - oh! Anmwe (help me)! Anmwe! Li te mouri nan men mwen (he died in my hands)!" Over and over with real live fresh tears. They had called the family to come get the body. When they arrived I lost it again, hard. When you see a grown man fall to the ground and cry, it breaks you. This man was loved.
I don't know how much I can take Lord, or you will have to shovel my flattened heart off this Haitian soil. I watched John Love, aka. the baby with worms, die in front of me yesterday after he had vomited and diarrheaed everything out of his body. There were signs that the worms had most likely attacked his brain, so it was more or less a relief to see him pass. And the pregnant lady finally delivered her stillborn baby today, the one we figured had already died inside since we couldn't find the heartbeat and there had been no movement for several days.
But why Acdonel? Why did you take him now? I don't understand. He mustered up enough strength to go to church last Sunday despite the fact that he did not have church shoes - something no Haitian has ever done that I have seen. I think he really loved you... like really; sort of a rarity here. He was loved immensely in this hospital, he was making everyone laugh; he was getting better. But the TB took him so fast, so unexpected and left us all gasping for air as we stood there stunned. This hurts.
It's too much for a heart to handle today. The only comfort I have now Lord, is the fact that you know this misery well; you know this heartbreak well. You feel the effects of how messed up this world is and your heart is breaking more than mine is. That alone gives me strength today.
My heart feels ragged and I'm not sure how I can pick up the pieces, bandage them together and go on. Lord, this is too much. It's one of the first times I'm seriously wondering how Haitians can go on with the misery they experience in this life because I've just gotten a taste of it and I don't feel like continuing on today.
Tasha pounded on our door at 5am. Acdonel, one of our TB patients, is vomiting profuse amounts of blood. I hear in my half awake ears people throwing around the word "mouri" and I shoot out of bed along with Sara. We hurry down to the hospital. I'm praying the whole time for God to give us strength for whatever we are about to see. We enter the hospital and approach the door of their room. Tasha, his sister, sees what's inside and falls the ground, rolling, wailing; he's covered with the sheet; he's died already. I can't explain the shock that jolted through my heart right then. I don't understand. He was fine the evening before. More than fine. We even joked around a bit about how I insanely love mangoes. It was just a normal day. He's stayed with us for more than a month now and he was getting better everyday.
This one is hitting me harder than most. Acdonel is the one we look forward to see the most at rounds (don't tell anyone else). He was gaining strength enough to walk again. He would lay on his mat right by the open door, greeting and joking with everyone who passed by. The other day we found him with Orisnel, our little malnourished boy with Down's syndrome, and they were giggling up a storm as he teased and poked him. Oh...his voice. Everyday you would hear "mesi Missla" after his daily shot. His precious sister who shared food with everyone in the hospital. He was only 32, he has 3 kids, and he died from TB - how stupid is that?
I sat in the hospital for an hour and a half this morning, stunned. I felt for the first time myself, the raw emotion in the wailing that happens after someone dies here. It came in waves. Silence as everyone sits trying to comprehend what just happened. Then Tasha starts with another bout of wails that let out the depth of her misery, pain, and cries to God. It fills the whole hospital. "Bondieu! Bondieu! Jezi! Jezi - oh! Anmwe (help me)! Anmwe! Li te mouri nan men mwen (he died in my hands)!" Over and over with real live fresh tears. They had called the family to come get the body. When they arrived I lost it again, hard. When you see a grown man fall to the ground and cry, it breaks you. This man was loved.
I don't know how much I can take Lord, or you will have to shovel my flattened heart off this Haitian soil. I watched John Love, aka. the baby with worms, die in front of me yesterday after he had vomited and diarrheaed everything out of his body. There were signs that the worms had most likely attacked his brain, so it was more or less a relief to see him pass. And the pregnant lady finally delivered her stillborn baby today, the one we figured had already died inside since we couldn't find the heartbeat and there had been no movement for several days.
But why Acdonel? Why did you take him now? I don't understand. He mustered up enough strength to go to church last Sunday despite the fact that he did not have church shoes - something no Haitian has ever done that I have seen. I think he really loved you... like really; sort of a rarity here. He was loved immensely in this hospital, he was making everyone laugh; he was getting better. But the TB took him so fast, so unexpected and left us all gasping for air as we stood there stunned. This hurts.
It's too much for a heart to handle today. The only comfort I have now Lord, is the fact that you know this misery well; you know this heartbreak well. You feel the effects of how messed up this world is and your heart is breaking more than mine is. That alone gives me strength today.
Thursday April 8, 2010
Success today. Just had a pretty awesome day. We departed this morning in Rob's car to Port de Paix with a long checklist of things to be done in hand. We were transporting a patient we've had in the hospital for the past month back home. He was shot in the low spine and is now paralyzed from the waist down. It's been a tough road with him, but he's going home with a wheelchair and supplies he needs for home care today.
Next, it's my turn. Rob drops me off at the big hospital because I need to get some HIV meds for one of our TB patients. This goal is a little far fetched. We had sent our guy with TB (and his wife) two times last week for the test and to get the meds, but after some very frustrating and body breaking rides to and from Port de Paix they only came back with pokes in their arms and no appointment with the doctor. The wife had gone back another time, since now her husband was too weak to even get out of bed, but they wouldn't give her medicine for him because he wasn't there in the flesh. So...we decided we had to try one more time before we send him home to die, since he is so bad now. And so back at the hospital in Port de Paix, I find the SIDA (HIV) program, talk to the nurse, show her my "official" letter from Dr. Michael and she gives me the meds! Check one...
Next I had time to moto it to the grocery store to find some heavenly goodies you can only find in the city for Esther and Sara. I found what we needed and yes maybe some Snickers bars, check two... Then I moto'd it back to the airport to meet up with everyone. As soon as I walk through the door, I meet Lynn...part of our team who was coming in today, who had just stepped off the airplane! We talked for a while until Rob returned and told us Dr. Michael had found and bought the motorcycle they wanted! Check three. Then Esther returned and said she found the medicine we had been looking for in LaPointe. Check four. After that, the whole Seattle team walked through the gate. Everyone accounted for, check five...
A lot of small victories today that came at a good time in the midst of this week.
Next, it's my turn. Rob drops me off at the big hospital because I need to get some HIV meds for one of our TB patients. This goal is a little far fetched. We had sent our guy with TB (and his wife) two times last week for the test and to get the meds, but after some very frustrating and body breaking rides to and from Port de Paix they only came back with pokes in their arms and no appointment with the doctor. The wife had gone back another time, since now her husband was too weak to even get out of bed, but they wouldn't give her medicine for him because he wasn't there in the flesh. So...we decided we had to try one more time before we send him home to die, since he is so bad now. And so back at the hospital in Port de Paix, I find the SIDA (HIV) program, talk to the nurse, show her my "official" letter from Dr. Michael and she gives me the meds! Check one...
Next I had time to moto it to the grocery store to find some heavenly goodies you can only find in the city for Esther and Sara. I found what we needed and yes maybe some Snickers bars, check two... Then I moto'd it back to the airport to meet up with everyone. As soon as I walk through the door, I meet Lynn...part of our team who was coming in today, who had just stepped off the airplane! We talked for a while until Rob returned and told us Dr. Michael had found and bought the motorcycle they wanted! Check three. Then Esther returned and said she found the medicine we had been looking for in LaPointe. Check four. After that, the whole Seattle team walked through the gate. Everyone accounted for, check five...
A lot of small victories today that came at a good time in the midst of this week.
This is not a horror movie, it's real life
Wednesday April 7, 2010
This week, I'm trying to grasp what's been going on. It feels a little dark and I'm not sure why. Monday night I had the most haunting experience I've ever had here. It was 11pm and I went to the hospital to give our dehydrated baby with diarrhea/vomiting fluids via the NG we had placed the Friday before. He was still not taking fluids orally. I get there and see the baby is laying on his side with a spot of red blood he had just vomited. He was still gagging some, his mouth and nostrils still coated with blood. I start to escalate inside and run to the other room to get some gloves. He hadn't been vomiting blood before. I get back to the room and then I spot some stuff in his mouth. I ask the mom, what did you give him?!! I try to scoop whatever it is in his mouth out with my fingers - he's still obviously in distress. Then I see it... in the back pockets of his mouth sit a pile of an uncountable amount of white small worms wiggling their little bodies away - coated in the blood that was still in his mouth.
I didn't know what to do. I was at a loss. I tried to scoop them out but they were wedged and too far back. I tried for a while until I realized I needed help and some bravery from someone else considering it was almost midnight and my headlight was almost dead and I was in a dark room with a five month old baby who has worms coming out his mouth.
I sprinted back to the house and got Sara. We did what we could for another hour or so with a bulb syringe, tweezers, and every worm medicine we could think of, but could only do so much. It's awful, a nightmare of the worst kind, except that it was real life. I don't understand this and I am having trouble shaking this one. I almost vomited on our way back home and was oscillating between laughing with hysteria, shock, and crying some. I had to shower again to calm my mind that I hadn't taken any worms home with me. Yes. a nightmare. Worms are something that eat the dead, not a five month old baby. I can't help but think that physically, we are fighting against a game that is already lost. Yes, my pessimism is coming through tonight. I don't know what kind of game is going on here.
Just these past two days it's been worms and wounds galore. Dr. Michael is becoming the king of stitching machete wounds; maybe four or five in the past week we've had. And the one yesterday was a 16 year old boy who chopped through his entire bone while "weeding" his garden. And we got a lady in the hospital with a massive deep wound covering her whole upper thigh, which we had to debreed. She had been here a few weeks ago and the wound was not so bad. It's mind boggling how a wound could get so bad in such a short time until we decided to do an HIV test...positive. We are fighting a bigger battle here...HIV, TB, abscesses, burns, machete wounds, worms....the fight against physical illness and degredation is overwelming this week.
This week, I'm trying to grasp what's been going on. It feels a little dark and I'm not sure why. Monday night I had the most haunting experience I've ever had here. It was 11pm and I went to the hospital to give our dehydrated baby with diarrhea/vomiting fluids via the NG we had placed the Friday before. He was still not taking fluids orally. I get there and see the baby is laying on his side with a spot of red blood he had just vomited. He was still gagging some, his mouth and nostrils still coated with blood. I start to escalate inside and run to the other room to get some gloves. He hadn't been vomiting blood before. I get back to the room and then I spot some stuff in his mouth. I ask the mom, what did you give him?!! I try to scoop whatever it is in his mouth out with my fingers - he's still obviously in distress. Then I see it... in the back pockets of his mouth sit a pile of an uncountable amount of white small worms wiggling their little bodies away - coated in the blood that was still in his mouth.
I didn't know what to do. I was at a loss. I tried to scoop them out but they were wedged and too far back. I tried for a while until I realized I needed help and some bravery from someone else considering it was almost midnight and my headlight was almost dead and I was in a dark room with a five month old baby who has worms coming out his mouth.
I sprinted back to the house and got Sara. We did what we could for another hour or so with a bulb syringe, tweezers, and every worm medicine we could think of, but could only do so much. It's awful, a nightmare of the worst kind, except that it was real life. I don't understand this and I am having trouble shaking this one. I almost vomited on our way back home and was oscillating between laughing with hysteria, shock, and crying some. I had to shower again to calm my mind that I hadn't taken any worms home with me. Yes. a nightmare. Worms are something that eat the dead, not a five month old baby. I can't help but think that physically, we are fighting against a game that is already lost. Yes, my pessimism is coming through tonight. I don't know what kind of game is going on here.
Just these past two days it's been worms and wounds galore. Dr. Michael is becoming the king of stitching machete wounds; maybe four or five in the past week we've had. And the one yesterday was a 16 year old boy who chopped through his entire bone while "weeding" his garden. And we got a lady in the hospital with a massive deep wound covering her whole upper thigh, which we had to debreed. She had been here a few weeks ago and the wound was not so bad. It's mind boggling how a wound could get so bad in such a short time until we decided to do an HIV test...positive. We are fighting a bigger battle here...HIV, TB, abscesses, burns, machete wounds, worms....the fight against physical illness and degredation is overwelming this week.
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