Port au Prince

Port au Prince
"He drew me up from the pit of destruction, out of the miry bog, and set my feet upon a rock, making my steps secure." Psalm 40:2

Wednesday, August 18, 2010

The terrain

Everyday, we pass by the rubble and garbage and people living in the tents. I confess, there are times when I find myself shutting it all out and trying to desensitize myself so I don’t need to think about it. There are times when I don’t want to and try not to get into the mindset of the people and what their lives may be like. There are times when I let myself fall into this apathetic state of what could I possibly do? There is so much poverty, so much devastation, what actions could I do that could have any type of sustainable or even short-lived impact?

As I sit through our air-conditioned van, bumping along, in some ways, it's hard to see all of the poverty and on top of all of that, all the destruction that has happened. We look out the window and see row after row of dirty tents - not a nice one that you may take on camping trip - but kinds that are strewn up with blue tarps and scrap materials. If you peek into one of the tents, the conditions inside are the same as the outside: completely gravel and dirt filled with hardly any space to move around in; occasionally, I see a pot. There is no privacy, people resort to bathing in the streets with what seems to be questionable water in the first place.

When I really let it all sink in...my only hope is Jesus...for all of us and Haitians. The only thing that makes me not despair and have hope is that we have a loving God who heals, a loving God who sees all of this. I realized that we need to hang onto that hope and pray more and help in the ways that we can. There's a reason why we are able to empathize with our fellow people - don't shut that down.

Monday was the first day of clinic. We walked in with no set game plan and Grace suggested I start by triaging the 50-60 patients who had been waiting for us. I went in, sat in the middle of the room with all of the patients waiting around me and with a "deer in headlights" look as I'm told, I desperately tried to take vitals, chief complaints, and patient histories. I was shaky and nervous with everyone surrounding me and trying hard to put to use all of the EMT knowledge that I had so recently learned (kicked myself for not have taken more blood pressures of people for practice!), but by God's grace - I managed. There were a couple of uproars, (over how slowly I was working I'm sure), but my dear translator decided to spare me. Malia came to my aid about ~30 min in and we made a superb tag team throughout the rest of the day. Our team worked fabulously with one another: MaryAnn and Jennifer set up a Physical Therapy room, Stephen and Ashley making Kings Hospital history with organizing the first ever medical records of the hospital and our physicians Joyce & Grace treating our patients! It was so special to debrief about all the patients that we each played some small role in helping. In addition, it was great building relationships with Haitians, the Haitian hospital staff and each other. Praise God!!

After that initial brief jolt of acclimating to the demands and volume of waiting patients, I really enjoyed it! It was so wonderful to interact with the Haitian patients and to hear what was bothering them and potentially being able to help them. I was so excited after I heard my first abnormal squeaking lung sound on a 3 year-old boy (probably a little too much so, actually).

There were some cases that really touched my heart - and made me want to break down...

Throughout, you could see how the earthquake served as a thread in their histories. "After the earthquake...I've been having pains here / lack of appetite"... "I was trapped under the rubble but wasn't seen by a physician"...."I lost two of my sons in the earthquake"...

As Joyce said in a previous post, many of the patients were dressed in their Sunday best despite how miserable they were feeling. There were some, however, who were not...

One patient in particular, did not have clean clothes on, and had an odor similar to what someone in Boston who was homeless would smell like - I thought nothing of it and tried to give the same gentle care as all the other patients that we saw that day. When I asked him what he was here for today, he lifted his left pant leg to reveal a large open wound, the smell magnifying as he showed us. He had a large ulcer with flesh missing with green, yellow pus and black necrotic tissue that was down to the bone- it was the source of the smell and had numerous flies swarming around it. I asked him how long he had this and he replied, since the earthquake, after something fell on it (which, time check, was 7 months ago...) The amazing Haitian physician in charge of the hospital gently told the man the course of action and that amputation was a possibility if the infection had spread through the bone. We could assume that he lived in a tent - how could he possibly keep it clean there? How could he possibly take care of his wound in a dirty tent with poor sanitation and limited clean water? Is he even able to pay for the x-ray to see if the infection has spread (our hospital is not yet equipped with it)? What would happen to the livelihood of this already not well to do man if his leg had to be amputated? How would he even be able traverse through all of the rubble filled "streets" that were uneven with large rocks, and in some cases, precipitous slopes and muddy, deep puddles when it rained?

Although he had a long ways to walk to the hospital from wherever he lived, we saw him again in the clinic today, to clean more of the wound. There is hope. There are many others of these patients, and many, many people living in tents. Please pray. We have a loving God who heals, a loving God who sees all of this. Please pray.

I know this is already a very long post, but I also wanted to give a bit of background on the hospital that we helping at. The construction of the hospital has been largely supported through donations - both abroad and within Haiti. Initially it was to serve the OB/GYN needs of the Haitian community but after the earthquake, it opened early to serve more immediate needs. The services are far cheaper than other medical facilities in the area (60 cents a visit). But it also plays an encouraging role in sustainably helping the Haitian community by employing Haitians themselves. As counter intuitive as it is, well meaning NGO’s who provide free medical care can make it impossible for Haitian medical professionals to compete. Haitians are driven out of business and it is often the case that NGO’s cannot stay forever to provide free care thus leaving Haiti with limited medical care and the Haitian physicians to either leave or unable to set up business again.

Please pray for Haiti.

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