Hurricane No Mas

I have lived in the same house my entire life. My only moves were to college and to camp, so that made the last two months pretty interesting. A few weeks ago, Leah and I were returning to our house from YWAM when I got a phone call from one of the guys we were running the ambulance with. He was working with a group in Port-au-Prince and wanted our help since they were getting ready for the hurricane. A few days before, I had found out that the clinic I was working at was going to be permanently closing in the next few days. After obtaining permission from our various organizations, we agreed to go.

By the time the hurricane actually hit, it had downgraded to a tropical storm and changed course. We got lots of wind, rain, and a little bit of flooding, but nothing like what had been feared and predicted. Our team was riding around in two ambulances (or technically one ambulance and a bread truck) and we checked out the various tent cities around the capital to make sure everything was okay.

After the hurricane, it was back to being on the lookout for cholera. There are an incredible number of rumors and ridiculous reports going around and so we almost can't be very sure of whats going on. However, at the beginning of last week, we got a call that there was a nun in Cite Soleil who was running a cholera clinic and needed help. I believe it was the UN who referred to this area as the worst ghetto in the western hemisphere. So naturally we had to go check it out. Doctors Without Borders (MSF) was currently working there from 8-3 each day (I suppose if you have cholera you get better by 3pm?) but she had no night shift and MSF was planning to leave by Saturday. We went to see the nun Tuesday afternoon and we talked and told her we'd give her a call. We didn't just want to run in, due in large part to security issues. However, after returning home that day, we decided we would take over the night shift. After calling Sister back, about an hour after we left, we found out that MSF was pulling out completely, leaving only the Sister and another nun with the patients. Brenden and I spent the night working with one other doctor who happened to be in the area for a few days and one other nurse, with Leah to translate, and another marine serving as security. Four medical personnel for 60 patients. We worked 16 hours that night, losing only one patient shortly after we got there. And we've spent every night since then working at the clinic, though our team has now expanded as a team of four people arrived back with the executive director a few days later. I may actually be without some words for once, but with working 12-16 hours every night for the past week, I haven't had a lot of time to process. Oh, but before anyone worries, we feel completely safe. The nun has good standing in the community and that covers us since we're working with her. Leah and I, of course, realize that the Lord surrounds that place each night while we're there. But we don't even give a thought to the situation, so there's no need for anyone at home to be worried either. 

The house we're staying in doesn't have electricity or internet, hence the lack of updates. But this afternoon we stopped at a restaurant/hotel to get their wifi. And now its about time to get back and put on my bleach covered scrubs and head out to the ghetto. I love my job.

Semper Fi

For those of you who thought my newsletter was ridiculously long...

So about five minutes after I published my last post, I received a call from Leah. She was out in the ambulance with Duncan and Corina (a nurse on the DTS who volunteered to help us out) and wasn't going to make it back in time to meet this medical team who was coming to the base to see if there was anywhere they could help out. She quickly briefed me on what to say to them since she's really good at sounding professional and like she knows exactly what's she talking about even if she has no idea. That's not one of my skills, however. So I rehearsed everything she told me and felt fairly ready for these people to show up. And then they showed up. It wasn't actually a medical team, but two people from Grass Roots United. I was told that they'd heard we had a transportation issue. After I tried to explain what was going on with our ambulance and how we really just needed more people to help us run it, they seemed a little confused. It didn't appear that they'd be able to help us out, but they gave me some suggestions for protocol and left me with phone numbers, a stretcher, and some boxes of oral rehydration salts (ORS). A whole lot of information was thrown at me and I felt sort of like I'd been bulldozed. Before they left, Brenda started talking about marines. I must've missed some of the vital information in this particular part of the conversation, because then she was asking if I wanted them and saying they could sleep in the yard if they needed to. I was fairly confused about why I would need marines and didn't really want to be responsible for them showing up unannounced, even if they were "only a little foul-mouthed," so I told her I'd talk with Leah first.

The rest of the afternoon was a little crazy. There were YWAMers out in the 5th section (an area in the bush that no one else goes into) and Terry called the ambulance phone telling us he was bringing us sick people. When they finally got out to us (the ambulance couldn't go that far in), they weren't all that sick so we just gave them ORS. We did have some crowd control issues, and had to put up a fuss to make sure that no more than four people got into the ambulance. Its hard enough to move around in that vehicle on the bumpy dirt roads when its empty, so trying to dodge patients AND all their family members just wasn't going to work. 

We had a bit of a break around suppertime. Leah gave a very detailed explanation about how people needed to step into the kivets of Clorox before coming into the base (because apparently me saying, “You know, like when you go into a chicken house” wasn’t a good enough explanation) and also told people about washing clothes if they were in contaminated water (or vomit, in our case). So after supper, Duncan, Corina, and I set to boiling our clothes and it was hilarious. I won’t expound on the event, since it was probably a “you had to be there” kind of moment, but know that it involved us stirring our cholera clothes with a broom handle.

Leah was in contact with Brenda more throughout the day, and at some point she informed Duncan and me that we were receiving these marines. The part of the conversation I must’ve missed was when she said they were field medics, and that’s why they were relevant to our situation. We had no idea what exactly we were going to do with them since we didn’t really know what we were doing ourselves, but decided I’d take the 6am-noon shift and we’d see if they wanted to split up.

They finally arrived around 11pm, and I was looking quite professional, draped across three chairs in the cafeteria. We fed them and talked briefly; they’d been working at the hospital since the early morning hours, and we’d been awake as well so we were headed to bed. I think I’d been in my bed five minutes when Leah’s phone rang and she said we had a call. Thankfully, Audrey had let us use her dryer for our clothes. We ran outside and I was trying to figure out if Ronald (our driver for the night) had woken up both marines (I missed their names during our introductions and Leah is so bad at remembering names she doesn’t even try). I figured it was silly for them both to come when they’d already been awake 24 hours. One of them might as well sleep since I was going out.

Thankfully, that message never got relayed. Our call was to a clinic in Bocozel, out in the 5^th section. We don’t really know who called us, or why they called when they were already at a clinic. Upon arrival, we loaded two ambulatory ladies into our ambulance and gave them some ORS. There was also a little boy who looked quite unwell. Sometime during all of this, Leah came back out and told Riaan and Brenden that they might want to check out the inside of the clinic. I stayed with the patients, with Ronald guarding the ambulance. The next series of events was kind of ridiculous and is a little bit of a blur (and I’m working on leaving out details), but at some point, the ambulance doors flung open and I was told to kick out the two women. They were replaced by a nonambulatory guy with his hospital gown on backwards. The guys were officially on a mission, muttering things about a peeing guy, and Leah quickly told me that this place was a huge dark room absolutely filled with people just laying everywhere. I worked on fixing backwards gown man’s IV line after Brenden pushed the clot through and they went back inside. They triaged this place in a matter of minutes. The next time the ambulance doors opened, I heard Riaan asking for someone to help him carry this man into the ambulance. All the Haitian spectators literally backed away, saying “He’s dead, he’s dead,” even though he wasn’t. So Riaan picked this man up and he simultaneously began to have diarrhea and pee all over the place. I was trying to move backwards gown man so they could put that patient on the other end of the stretcher. Within two minutes of putting him in the ambulance, Brenden was checking for a carotid pulse. He was gone. That patient was taken out and immediately replaced with a tiny woman who began seizing as soon as they laid her inside. The rest of our team quickly got in the ambulance, and the guys set to work as we took off. They were absolutely phenomenal. By the time we arrived at the hospital, all patients were stable and had working IVs. Then we went back to Bocozel for Round 2.

Riaan and Brenden already had some people in mind when we got back to the clinic, and I decided I was not waiting in the ambulance this time so I checked out the one woman they pointed out. Her family members kept shutting off her IV because they said the medicine was making her sick. This happened three times. We opened it and returned and found it closed. At some point, we happened to notice that her normal saline IV bag had “KCl” written on it. Bad. We took her with us, along with another woman. Little potassium woman was having some minor tremors on the way to the hospital. We passed on the information to the MSF staff at the hospital, wondering if that may have been why our lady from the first transport was seizing. Throughout the week, we continued to make trips to Bocozel. We took more people who were given potassium and gave them different fluids en route to the hospital. One morning we found an unresponsive child, and when the doctor told us “No, he’s just sleeping,” while I was doing a sternal rub and Riaan was flicking his foot, we snatched him up as well. We broke out the pediatric ambu bag for that ride, but thankfully didn’t need it.

Our team continued on as the sun came up on our first night. We picked up a critically ill man who was lying along the road on a mattress, along with a little girl. When we got back to the base shortly after 6am, Riaan commented, “Well, we had a nice run there of critical, critical, urgent, critical…”

One morning, Riaan, Duncan, and I were out. We had a call, which somehow didn’t turn up, I’m not sure exactly what happened, but we started walking down a different road while the ambulance was turning around. We found a little girl lying along the road who was pretty sick. Duncan and I worked on starting an IV while Leah and Riaan kept walking down the road to check out what looked like another clinic. We took the little girl to the hospital then returned because we were pretty wary of any clinics that just appeared. When we walked in, we were immediately greeted by someone from Samaritan’s Purse. We explained about having the ambulance and numbers were exchanged as they were in need of transportation in case some of their patients were in more serious conditions. He (Justin) asked if we could help out for a minute by starting IVs in one of the treatment rooms. They were using an old school building as a rehydration clinic. The room we entered had about 16 camp beds in it and we went to work. The staff kept thanking us and saying that we were sent at just the right time. After a little bit, Riaan and Leah went out on a call while Duncan and I stayed to help.

Towards the door sat a lady in a blue dress. They had discontinued her IV and she was waiting for her dose of antibiotics and the teaching they were giving before discharge. She was trying to talk to me, I think telling me she didn’t feel well. She said she needed to go to the bathroom and I told her that was fine. Patients had been walking themselves to and from all morning. She got up and left. A few minutes later I looked outside the door and saw her sitting on the ground. I started heading for her as a staffer approached her. He asked if I’d take her to the bathroom. A tiny, gruff Haitian nurse was helping me as well. Walking her there was a bit tricky, as we had to go up steep steps to actually get into the bathroom. When we were walking back to the room, she sat down on the ground again. I gave her a moment, and then the Haitian nurse pulled her up and we kept going. After a few steps, she collapsed, though she didn’t lose consciousness. I started yelling for Duncan. The great thing about yelling in the medical profession is that you always get more people than you asked for. We carried the lady back into the room to the bed and tried starting another line on her. It took a little while, even though she’d already been given two liters of fluid. After her third bag was up and running, she rolled over onto her side with her arm and head hanging off the side of the bed. Haitians get into the weirdest positions to be comfortable. This actually causes a lot of problems when you’re in an ambulance. Nevertheless, she was happy in that position, so we left her and continued frantically working. I glanced at her periodically, but between the girl who was quite possibly possessed and the other patients who kept calling me, I didn’t go over and check on her. Then I heard MaryAnn (SP nurse) say, “I think I need some help over here!” She asked me to help her move the lady in the blue dress onto her back. I don’t remember what happened next, but then we were listening for heart sounds and MaryAnn was saying to the patient, “I’m sorry love, I’m so sorry.” I closed her eyes and walked away.

We had a ridiculous number of divine appointments with our ambulance throughout the week. Some other stories were in my newsletter (talk to my mama if you didn’t see it and want to). During the middle of the week, we were preparing a report about our protocols, patients, and other such things. To that point, we had transported 50 patients, losing only one en route, and having two pass between the time we were called and when we arrived. Wednesday we went out into the 5^th section to do reconnaissance and take any patients who couldn’t get out. The whole team went out, thus throwing off our shifts a bit. I included this story in my newsletter, but some people I was talking to were unaware of our current situation so I’ll briefly repeat it. We got back to the base later in the evening, and I volunteered to stay on call for Corina, who ran the noon-midnight shift, because she wanted to rest. I would’ve slept in the ambulance and gone on every call if they had let me. Apparently I’m an adrenaline junky? Anyways, Leah, Brenden, and I were in the kitchen around 930 when a call came in. Corina still wasn’t down, and I wasn’t going to make too big of a question about it or I’d have to stay home so I just immediately ran and got dressed. We were walking out to the ambulance when she appeared. Shoot. I was still going to ride along with them just because, but at the last minute decided I should stop making a big deal about it and just wait until my shift at midnight.

A little while later, I was sitting in the office talking with a friend when another staffer knocked on the window. He and Bryan had a quick conversation, then Bryan grabbed my arm and told me we were going out because the ambulance had been in an accident. We ran out to the cafeteria where the same message was being given to Riaan. About that time, Kevin (Audrey’s husband) drove around in his truck and we all jumped in. Long story short, everyone inside the ambulance was fine other than a few bruises. In fact, we think we’ve been hurt worse just riding in it on a normal run. Corina said that while she was rolling around, she felt like she just kept landing on soft things. The ambulance did not, in fact, flip like we originally thought. When it was pulled out the next day, they found that it went up an embankment and then slammed back down into the ditch, which is why they felt like they were rolling. However, not a single light was broken on the ambulance. Nearly everything was still on the shelves behind the doors, which we’d taped shut earlier in the week because they refuse to stay closed, and that was fairly useless due to the bumps. All of this and the fact that everyone walked away was “highly improbable,” as Riaan said. The only question in my mind is whether whatever soft things Corina was rolling around on were angels or the hands of the Lord.

Our team was all pretty bummed out about the loss of our ambulance. Bummed out is an understatement, actually. I worked with critically ill cholera patients all week but didn’t cry until I saw our wrecked ambulance. We took Thursday to rest and then continued to do some teaching out in the 5^th section on Friday. We’re still waiting on the possibility of another ambulance. The director or president or someone at JPHRO was going to Port to talk to the Haitian president about getting us one, but we haven’t heard anything yet. It’s definitely hard to sit around and wait. When we found the ambulance phone on Thursday, we had 21 missed calls, and that was really tough.

In the meantime, we’re trying to find other ways to entertain ourselves. Brenden spent Sunday afternoon helping me practice my suturing on a banana. We also got these fun things from some organization we’ve been in contact with to start lines on people in their sternum if they’re really dehydrated and we can’t get a regular line in. Brenden offered to let me use one on him, and I initially said no because it’s essentially 10 stabilizing needles and then a barb that goes in your chest. But then I changed my mind. Unfortunately, so did he.

That was the week of cholera in a nutshell (yes, that was the nutshell version). I am thankful that I haven’t had to boil clothes in 5 days. Now we wait. Wait for an ambulance, wait for direction, wait for the possibility of a hurricane. Blessed be the name of the Lord.