Marathon

Every now and then, Jon says that if we actually wrote down what happens each day and showed that list to someone, he or she would either think we were crazy or not believe it. But when you’re actually in the midst of such a life, it’s not a big deal. This is my lame attempt at excusing my lack of new blog posts.

            A few weeks ago, we got in a team of six nurses. They were fantastic and probably my favorite group of volunteers to date. First of all, these women were all very easy-going and flexible. That’s about all it takes to impress me now. Our house is quite nice. And I’ve noticed that volunteers are much more apt to complain than they were when we lived in the old house. Where we drew water out of a cistern to flush our toilets and bathe. Perhaps because our house is so nice they expect things to be less like Haiti? I won’t rant on. But more than once I’ve been tempted to say, “Yes, we know it’s hot. We were also born with sweat glands.” Maybe all these people were taken hostage and forced to buy plane tickets to the Caribbean in the middle of summer.

Anyways, back to the Minnesota women. I had scheduled them to cover the day and night shifts in the pediatric unit at Medishare. Those who weren’t working at the hospital went into Cite Soleil and did mobile clinics. But if I scheduled someone for the nightshift, I gave them the following day off to recover. This group did not want recovery time. At some point during the week, nearly all of these nurses worked 36 hours straight. They were so hardworking and eager to be involved. It was fantastic. One of the nurses spent the day doing mobile clinics (walking through the streets for hours in 90 degree weather), then went with us to an orphanage where she played soccer with a passel of energetic children, then she worked at the hospital all night, and then she went with us to put on a clinic for a women’s group.

            The clinic we did at the end of the week was for KOFAVIV, a group of women who run a safehouse for victims of rape. In addition to setting up a hotline and making sure that these women and girls get to medical care, they also provide counseling. DIRT is in the final stages of formalizing our partnership with this group to provide transport and treatment for any emergency calls they receive on the hotline. We are hoping that as our capabilities grow (with more funding, equipment, and volunteers), we will be able to expand this hotline to more of a 911 and take emergency calls of all kinds. The group that was able to work with the phone companies here to get a free number is called Digital Democracy (in case anyone likes to spend time researching organizations).

            During our initial meetings with KOFAVIV, we were asked if we also do clinics. As we are an emergency medical service, we don’t tend to stock routine drugs. But we had this volunteer group coming down, and the woman who was heading the team kept asking me what they could bring. I sent her a list of medications, and when they arrived, it was just like Christmas in our house. Not only did they bring medications, they also got us two pulse oximeters donated.

            This was the very first clinic like this that DIRT set up and ran. There were some typical Haiti hiccups in the plan, but overall it went very well and we were able to treat about 60 patients. Halfway through the day, an 18-year-old girl came into the consultation room. She was happy and smiling. Our female translator had been called away, so I sent Thony, our driver, into that room for a bit. When he entered the room, she turned away and became very quiet. This young woman had been gang raped two months prior, was still quite damaged, and our nurses had to inform her that she was pregnant. They sat and cried with her, and then brought her over to the pharmacy where she hugged us all fiercely. And then everyone who hadn’t been crying before started crying. We spoke with the KOFAVIV director, and she was more than willing to work with this young woman if she decided she wanted to be part of the program. It was definitely a tough but rewarding day for everyone.

            When I took nurses to the hospital for shift change, I would stick around for a bit to hear reports and make sure the volunteers felt comfortable before I left. For some reason, whenever I have a nurse on nightshift, I feel like I’m abandoning a child. It makes me a little nervous when I go to sleep at night and one of my volunteers isn’t in the house. (Dear Mom and Dad, I apologize for all those nights I stayed out way too late…) Anyways, while rounding on these little critters every twelve hours, I became drawn to one little guy in particular. His name is Gedeon, and he’s probably around a year old. He is an orphan and has quite a case of hydrocephalus. This hospital does a program for hydrocephalus babies – periodically surgeons will come for three or four days and put shunts in. Inevitably, after the surgeons leave, all the shunts become infected. Such was the case for Gedeon. His shunt was removed, but he still had a gaping hole in his head. The infection basically ate away at his skull and you could see to his brain when the bandage was removed.

            The hydrocephalus leaves Gedeon with very little brain function. He basically lays in his bed and periodically cries. His is malnourished which makes his extremities very puffy. He has pressure ulcers on his head from continually laying on it without moving, a feeding tube in his nose, a bad case of diaper rash, IVs in his scalp and arm, and he is so unused to physical contact that he sometimes cries when people come near him. And for some reason, I think he is the most beautiful baby. As the week wore on, rather than rounding with my nurse, I basically went to Gedeon’s crib and talked to him while rubbing his arms or legs.

            I worked in the ER one night while the team was there and would run over to peds periodically throughout the night. In the morning while I was waiting for the nurses to change shifts, I was telling Gedeon how I’d just like to take him home with me. And then I started to wonder if I could. Now, I am known for my “crazy plans” (and in my defense, I’d been awake for over 24 hours at that point), but I still don’t think this plan was that crazy. Essentially, Gedeon was made a DNR (all the fluid in his head is going to kill him in a relatively short amount of time), and they were waiting for him to stabilize before sending him back to the orphanage. I really wanted someone to be holding him when he died, so on the drive home that morning, I sent an email to Jon (who was in the States) asking what he thought. There’s a priest who runs the hospital down the road from us, and each week he does a service for the unclaimed bodies at various morgues and then takes the bodies out into the countryside to bury them. I asked Jon if he thought this priest would be willing to bury Gedeon as well, and he said yes.

            At some point during the week, I was trying to fish for more specific information regarding Gedeon’s prognosis from one of the nurses on the team. I don’t know anything about sick little people, only big people. The nurse I was asking eyed me a bit suspiciously, and I eventually told her what I was pondering. A few days later, she mentioned that the only thing that concerned her was that if the baby was with me, he would do much better than if he was in an orphanage and he may live for up to a month. Obviously, I can’t take care of a baby like him for a month. So the day the team left, I went to Medishare after dropping them at the airport, and I met with the social worker. She said it would not be a problem to have me visit him at the orphanage, especially if I went as a nurse to provide care for him. (I realize that I just said I don’t know about sick little people, but I had to ensure that they’d let me into the orphanage, and a stethoscope is a key that opens every door.)

            As of a week ago, Gedeon was still in the hospital. He had had surgery to close the hole in his head and they put a reservoir on the other side of his head so it can be tapped to pull fluid off. He was still kind of loopy from the surgery when I saw him. He’d also begun vomiting up all his feeds, but I’m hoping that had something to do with the anesthesia.

            In the meantime, DIRT continues teaching our trauma management classes to the security teams and drivers for NGOs in Port-au-Prince. I’m scheduled to teach CPR to this class in about three weeks and I am not looking forward to it at all. I’m not designed to be in front of groups of people so it should go well. Or it will at least be sufficiently awkward to provide everyone with good stories. 

"What Happens If You Love It?"

So it has taken me a month to post this, but I suppose the 13-month mark is significant as well…

Maybe it’s the OCD, but it really seemed necessary for me to have some sort of blog related to the fact that I’ve now been here a year. But nothing terribly unusual happened that day. I had plans to get a ride to the first street food place I ate in PAP. Naturally that didn’t work out, since it was planned, but I did get to ride home with the police after our truck left us sit at an orphanage. Other than that, nothing to write home about. Today, however, in the midst of a perhaps not-so-wise choice, I figured it might be appropriate to dedicate a post to a few of the multiple ways I’ve been protected this year.

            My very first terrifying experience occurred about 16 hours after I arrived in Saint-Marc. Apparently I have a food allergy. Granted, I overreacted to the way the death oranges made my lips and tongue go numb, but at the time, it was quite concerning. I didn’t like Haiti, really hated that I was here, and I was convinced something bad was going to happen to me. It only seemed logical to assume the worst.

            Obviously, I lived to get into more trouble. Sometime during my first week at the clinic, I think it may have even been my second day there, I still didn’t have my consistent hired moto driver. The nurses were waiting with me to make sure that I got home. At some point, a car stopped further up the road, and Anedzia and one of the other nurses went to talk to the driver. Next thing I know, I’m being instructed to get in the car with everyone because this man is going to take us home.  We drive off down the road, Yvena and I sitting on top of each other in the front seat, dropping people off as we go. At some point, the driver shook my hand and introduced himself to me. He then did the same with each of the nurses and I became mildly uncomfortable as I realized that not a single one of us knew who this man was.

            We drove past the road back to my house and up into some hills where we dropped another nurse off. A few moments later, the driver stopped in front of a gate and everyone looked at me. “Your house?” they asked me. Not even close. We sat there a few minutes trying to figure out where I lived. Eventually, I managed to describe the park (that we’d passed awhile before) and felt mildly confident that if we could get back to the park, I could get myself home from there. As we drove back down towards the center of town, we came upon a rukus in the street. Some sort of fight had broken out, stopping a Coke truck from moving any further. More and more people gathered until they were engulfing our car like an amoeba. Vehicle violence is fairly common here…not that I knew that at the time, I was just concerned because I’d only been in the country for a week. But just as quickly as they appeared, the crowd moved on and we continued down the road to the correct gate.

            And then I moved to Port-au-Prince, where I’ve encountered a whole host of vehicle-related incidents.

Our truck is a piece of junk. A clinking, clanking, clattering collection of caliginous junk. Since we bought the truck in February, we’ve replaced the tires (who else knew that tires have little copper thread things in them?! They make funny noises when they rub against the road), caliper seals (twice), calipers, ball joints, something to do with a crankshaft, the shocks and the radiator. Apparently the engine isn’t attached right or something so every time we stop quickly, it bangs into the radiator. Still to repair: brake lights and rear window, which got broken while I was in church. I’m going to pretend the fresh oil spots in the driveway are from someone else’s car.  Mark would always say: “The squeaking means its working.” Hopefully the other noises mean the same.

            One evening, Jon and I were traveling with a volunteer up into the hills in our rear-wheel drive truck. I’d been to the house we were going to once before (in March), so I felt confident that I had a vague idea of where it was. We turned onto the correct road, which is basically a switchback, but then missed the switchback into the gate. We drove up the gravel road a bit further until I was sure we’d gone too far. At this point the road split – to the left it went up and to the right it went down, these two roads parallel to each other. We went up to the left and started backing down to turn around. I was looking out the passenger window and began thinking to myself, “Hey, we’re going to fall off the side of this road here,” but didn’t manage to get those words out of my mouth before we started leaning, as my side of the truck was now on the road down and the other was on the road up. We tried backing up a little more, but didn’t succeed in moving in reverse, only in tipping more to the side.

            We sat there for a bit at a 45 degree angle, just hanging out and discussing things. At some point, Jon said, “Okay, we’re going to roll, so Sarah cover your head on the right side.” I actually felt okay with that at that particular time, because it seemed like it was all happening pretty slowly. I figured we’d just tip onto our side and then someone would pull me out the drivers’ side window.

            But at some point during these minutes where we were sitting there and the Haitians are trickling out of the bushes to spectate and offer advice (very common occurrence, but usually there are enough of them to help – this was too big of a pickle), I realized that we weren’t just going to roll onto our side. There was going to be far too much momentum and we were going to continue flipping right off the other side of the road. If you’ll recall, I mentioned that we were driving into the hills, so we had a good 40-foot fall onto the paved road below and no trees to stop us, thanks to the 98% deforestation. That’s when I began to be concerned. I was sitting half cross-legged with my foot against the door and in between thinking, “This is stupid, I really am going to die in Haiti,” I wondered if my whole foot was going to break or just my toes.

            Eventually, Jon said that I should get out of the truck. Hillari and I were concerned about opening my door because we didn’t want the weight of it to send us over the edge. Jon just kept saying, “It’ll be fine, just do it very slowly – you’re going to have to hang onto it because it’s going to fly open.” I wasn’t sure how I was going to open the door slowly and keep from falling right out onto the ground. I also remember thinking about whether or not I should take my shoes – my favorite flip flops (bought on the boardwalk in 2002). I couldn’t find them with my feet for a bit, the darkness combined with my shaking and the fact that somehow two pairs of Hillari’s shoes had ended up at my feet as well. Luckily, I was eventually successful in locating my shoes and then managed to wedge myself into the truck while opening the door.

            I emerged and rounded the truck. “So what’s going on?” Jon yelled out his window. What went on in my head was, “…I don’t really know what to say to that…our left rear tire is three feet off the ground and we’re beside a cliff?” None of that actually came out of my mouth, except maybe the part about the tire, I just kept looking at the truck and shrugging.

            More Haitians had appeared by that time, and Jon decided he would get out of the truck to assess the situation. Hillari remained inside. I stood there beside the truck holding Jon’s door open (or, rather, up in the air) because I didn’t know what his lack of weight in the truck and the shutting of the door would do. At this point, we called Sam, the person we were going to visit, to see if he could bring some people and help us. The Haitians had brought with them one ratchet strap and were attaching it to some part of our lift kit. They then decided to get Hillari out. Jon and two Haitians were standing on top of the running board and the suspended tire to keep weight on it while they pulled her out.

            At some point during all of this, while I stood there next to Hillari, our “atheist Jew,” I started praying out loud. I don’t remember what I said other than, “Dear Jesus…thanks, amen.”

            Jon handed me his camera eventually and said, “Grosh, get way down there and record all this.” So I trekked down the road a ways, watching for Sam to come driving up and hopefully rescue us. But it was another random car that drove up. It was a Haitian man in a suit, the car still decorated from a wedding. They pulled some of the bows off his car and attached our truck to it with the ratchet strap. The thoughts running through my mind at that point were, “I hope I can find my wallet with my drivers license, nursing license, credit card, and $300 of DIRT money in all the wreckage when we get to the bottom of the hill…or is it all going to burst into flames? What happens when the EMS people don’t have their vehicle?” But finally, with like 8 Haitians standing on the side of our truck, Jon turned it back on and backed it up…or the wedding car guy pulled…maybe some of both – I was intent on my filming after the “GROSH ARE YOU GETTING THIS?” and missed the details. Nevertheless, they got our truck upright again, it still runs, and nobody was hurt. Held up pretty well for a piece of junk.

            These are the things I pondered today on my walk. I had three female volunteers with me, as we had been doing education for a women’s group run by a non-medical organization. Afterwards, we had gone back to their house to wait for our ride. What was to be a one hour wait eventually turned into four. At that point, Jon texted me and said they would be there for us in another hour and a half. He suggested that we might want to borrow some money and take taptaps home. I don’t really like riding taptaps and didn’t feel like I knew well enough which ones to take. I also didn’t really want to risk getting really lost as a group of girls. I suggested to the volunteers that we could catch some motos. They were less than thrilled. So we were down to two options: wait for Jon or my new idea of walking home. I obtained permission from Jon to walk, he thought I was crazy, but agreed to it. After convincing the girls that I thought we could make it home in an hour, or at least before our vehicle did, they reluctantly agreed to it as well. And we set off on our three mile walk through Port-au-Prince.

            I thoroughly enjoyed myself. I can’t say the same for the other three. At one point, a street kid started yelling and chasing us. I initially ignored him because I naturally assumed he was going to greet me with “Hey you, sista, give me one dolla,” but then I realized that I knew him. It was a weird and kind of cool experience – personally knowing street kids is not something I’ve processed since.

            When we reached the busiest sections of town, I began wondering how dumb this actually was on a scale of 1-10. Then, coming from across the intersection, was one of the Haitian boys who lives at our house. He walked us the rest of the way home, and I went back to enjoying myself and the rainbow I happened to notice in the sky.

Third Time - Just As Charming

I am still a ninja. A body fluid ninja. I thought that I might’ve lost my skills after so much inactivity, but cholera outbreak #3 (occurring exactly 9 months after the original outbreak, for those of you that also find dates interesting) confirmed that I’ve still got it.

A week and a half ago, I was looking forward to sleeping in after a few days of mobile clinics. Jon and I were sitting at the table after everyone had left for the day when my phone rang. On the other end was a semi-frantic sounding Fabienne (medical director for MTI), talking a mile a minute. “Oh good. Does the new guy have Mark’s phone? I think he’s ignoring my calls. I’ve been trying to get you since 2am. Cholera has exploded in Port-de-Paix. Wednesday night they had 50 patients, by last night it was up to 100, and as of this morning they have 250 patients. They’ve overflowed the hospital rooms into the hallway and they’re spilling out into the yard and the walkways…” She continued to fill me in, said she was going up that afternoon with some logistics people from GRU, then said, “Can you come with me?”

            After some discussion with Jon about how the week would work (including how we were getting a 16-year-old paraplegic girl to Minnesota for surgery), he assured me he would be fine and said I should go. I called Fabienne back and was told to meet at MTI to leave at 2pm.

            It turned into a Haitian operation. I got to MTI at 2 and waited around for a while. At 3pm, I thought, “Oh, we’ll probably be in the air in an hour,” so I took my dramamine. For some reason, I was under the impression that we were flying up and working the nightshift, since Evangel (MTI’s long term head nurse) and Nick (their volunteer) were there alone. At 4pm, we left MTI and drove to GRU. Where we continued to wait around. When we left there at 5pm, got gas, and then had a brief prayer session, I realized that we were, in fact, driving the whole way to Port-de-Paix. A six hour drive. On second thought, yes, I will eat that bag of Fritos, thanks.

            The highlight of the trip was definitely reaching Saint Marc before sunset and being able to see my old house from the street. That wasn’t too long before I got really drowsy and we turned onto a dirt/gravel road. I kept thinking, “Okay, we’ll soon be off this road, then I can put my head against the window while I fall into a coma.” But the road never ended. Shortly before we reached MTI’s apartment around 11pm, I regained consciousness long enough to see the lights from the island of Tortuga.

            Luckily, I had assumed incorrectly once again, and we weren’t actually going to work the nightshift. So Saturday morning, bright and early, we headed down the street to Centre Medical Beraca. I stepped through the gate and was actually overwhelmed for around 6 seconds. I think I actually said “holy cow” out loud. By that morning, the number of patients had risen to 330, and they were laying absolutely everywhere. It all hit me at once, the sheer number of people (because every patient had family members with them), the smell, and that feeling that I can’t explain. What was different was the noise. It seemed so loud. Maybe it’s because I’ve always worked cholera at night. Whatever it was, after those first few seconds, I snapped out of it and went to work.

            We worked into the early afternoon, then it was decided that Evangel and I would go back to the apartment, sleep for a few hours, and return to work the nightshift. I was happy with that – I had actually volunteered myself and kept pushing to have some of us on nights because that’s when things were bound to get crazy. It felt weird doing cholera without any marines, and I was hoping the familiarity of the darkness would make it seem more normal.

            The only things I clearly remember from that first night are the absolute frustration Evangel and I felt with the Haitian staff, the stress of all the patients and family members (we peaked at 400) calling us and tapping us every three minutes all night long, and thinking I was going to be sick. At one point, I thought I was going to pass out and asked Evangel to take my blood pressure – 85/50. She’s like, “Why don’t you just sit here and drink your water?” For those of you who have lots of experience with passing out, you know that it makes you feel a little nauseous. Not something you want to feel while working cholera. All I could think of was how embarrassing it would be to get cholera, especially since I’ve said so many times that you have to try really hard to get it. As the week progressed, we discovered that I really only had strep throat…which then moved into my chest. The cough I still have is a souvenir from the week.

            I decided I should try to write some things down during the week if I had a chance. From Sunday morning, after our first nightshift:

“One of the 3000 times I was frustrated with a patient and/or family member last night, I said, ‘Why can’t you just trust me?! I’m not going to let you die!’ When I’m not stepping over bodies or watching someone puke rice water on my boots, I feel a little bit of weight from that. Especially since I watched the woman I thought was dying while I held used tape over someone else’s pulled IV site…Should sleep. It’s a trade off – there aren’t dead bodies in the break room here, but I’ve gotta sleep on IV tubing instead of water bags.”

Tuesday

“Scratch that. Evangel and I found the best sleeping spot ever. Absolutely gigantic water bladders full of potable water. Didn’t I just say a month ago that I wanted a water bed? Right outside the gate by the new tents but close enough that we can still hear who’s puking (and a Haitian nurse come change the bag, conveniently enough).

Last night was by far the best (of this outbreak). The staff has gotten into a routine and they evaluate people a little better now instead of just jabbing every person that sits in front of them, so its relatively calm until like 4am. I’m not sure if everyone wakes up to discover they’ve got cholera, or if the nurses get sick of individualized treatment, or just feel like they haven’t gotten to practice their skills enough during the night, but we run a lot more lines in the morning/around change of shift. But Ev and I took over triage this morning. The Haitian nurse moved into the walkway to put a line in a kid Evangel asked for help with because we were both starting IVs in active pukers. So then people that didn’t like that I said they just needed to drink went to her and she stuck them! We’re like, ‘Mm, no no.’ We’re getting good at being mean. Or, Evangel and Nick are; I was already jaded. But she told people that if someone really sick comes in we won’t have fluid to give them and they’ll die because someone who didn’t need LR got it.

Moved mystery worm kid to Urgence. Really humbling when I was first evaluating him this morning – he’s still sunken and floppy but hasn’t been puking for a day and he drinks. Still has weird yellow diarrhea. I was leaving the room to see if there was a place in the tent, still talking to mom. Some woman laying on the table was saying, ‘Nis!’ repeatedly. Irritated by being interrupted yet again by someone who probably wanted me to know their IV was finished when they’d been told that now they could just drink, I sighed and was like, ‘Okay, tale [wait]!’ After I was done talking, the conversation went like this: ‘Okay, ki sa [what]?’ Blah blah, couldn’t hear her. ‘Sa ou bezwen [what do you need]?’ Then mom says, ‘Li renmen ou [She loves you]!’

Patient count yesterday afternoon was 328, so going down. 122 discharges, 104 admits. The second night was when I discovered I still hadn’t been in the actual hospital. Ha.

Officially have red bumps on my big tonsils and the back of my throat but I don’t feel like crap anymore. The perks of having a fever in Haiti are that you get cold enough to have goosebumps…”

My last night working was quite eventful. Evangel had gone into town to get supplies earlier in the day, so she planned to sleep for awhile and go in late. I wasn’t wild about walking to the hospital by myself in the dark in an area I wasn’t familiar with. But eventually I figured I had no choice. I went over thinking to myself, “Okay, situational awareness, situational awareness.” So knowing what was beside me caused me to miss what was in front of me. I tripped over some concrete, nearly falling into dogs that were circling a street fire.

            When I got there, I found the entrance and back hallways had been cleared out. The census was down to 240. I actually thought it was creepier with all the people gone.

            Ten minutes after I got there, I was rounding on the patients in the Urgent Tent and a nurse came running over for me because a kid in triage was seizing. There was not a thermometer in the whole place. He seized again 80 minutes later, for 45 seconds. I got the ambu bag for that one. Not sure what I intended to do with it. Evangel got there soon after with valium. The seizures weren’t cholera related, so my initial assessment had been correct, which was encouraging. He did fine throughout the rest of the night, and we had the doctor see him in the morning.

            Around 3am, we heard an ambulance pulling up. Confused, we went to investigate. There was a woman, she looked around my age, very pregnant and in labor. We took her into the actual hospital and stayed with her for about an hour and a half. She’d had two C-sections before and they decided to do another one for this baby. I was trying really hard not to laugh. I’d only been able to sleep for two hours that afternoon because people woke me up to ask questions and Jon had been calling me from Port-au-Prince. And then it was just too stinking hot. Anyways, the exhaustion made lots of inappropriate things funny. But the pregnant woman was also really cute. She’d go from screaming and singing during contractions to just having a very rapid conversation. In the middle she’d of a sentence (or, that’s what it seemed like, I couldn’t actually understand her), she’d pause and go, “Nis…” and look at Evangel like, “Please rub my back again.” Around 5am, we heard the generator go on for the surgery.

            Around change of shift, Evangel and I found a guy laying by himself on a bed out in the grass between the Urgent tent and the building. He was unresponsive. He had a line, but it was little and wasn’t running that well. I looked at his hands and said, “Heyyy, a molasses man.” Evangel gave me a really confused look, and I tried to explain while we were both sticking 18gauge needles in his arms. “This is how most people looked in Saint Marc. Because nobody knew what was going on, they were all super sick.” This particular guy was so dehydrated, his veins so fragile, Evangel and I both blew our lines. So we ended up putting a bp cuff around his current bag and inflating it as far as we could to run it in really fast.

After two bags he started perking up, getting a little confused. At one point we had to go catch him so he didn’t fall out of bed. Evangel was talking to two guys who wanted jobs as a translator and I was being the one-on-one for the climber, when a Haitian nurse comes up to me saying, “Problem!” I was like, “Uhh…okay. You stay with this guy, don’t let him fall. Where’s the problem?” In the Urgent tent. I had been there half an hour before, and everyone seemed to be doing well. We were actually taking out some lines and sending some people home. One old lady (the woman I thought I watched die the first night), had been sitting up eating when I was in there before, so she was about ready to go home.

            But when I walked into the tent, there she lay on the ground. The huge flies that had been attacking us every morning when the sun came up were buzzing all around her. I checked for heart sounds as a formality, then closed her eyes. Evangel came into the tent then and we both stood looking at her for a few moments. Just a few hours before, the two of us had been talking and she asked if there was something wrong with her because she didn’t necessarily have a lot of emotions regarding all the patients. I told her that there might be something wrong, but I felt the same way, so we were at least in the same place. But we both felt something while we stood with the patient’s husband.

            Before we went back to the apartment that morning, we checked in on our new mom. The baby was a girl. Mom was happy to see us. She was really smiling, but she was also shaking. We told the doctor that we thought she might have an infection and he went to examine her. We went to sleep. A few hours later, I was awakened by a phone call from Jon that started out, “Sarah…don’t freak out…” He’d been in a moto accident and ended up missing his flight to the States. He was also having a mild panic attack about getting the medevac patient onto the tarmac. I tried to be very calm. After I got off the phone, I sent my own panicky email to Mark. While I lay there unable to sleep, the doctor and some of the MTI staff came back to lunch. I overheard them talking about the C-section patient. She had died.

            Just a few hours earlier, I had been talking Nick through the death of the older lady. He kept talking about what he should’ve done differently – how he should’ve checked on her more or been more diligent with taking blood pressures. I tried to reassure him that he did all he could. This was, in fact, exactly what had happened to my first patient that died – the lady in the blue dress. She had recovered from the actual disease, the cholera wasn’t in her body anymore. But the stress on her heart from the electrolyte imbalance was just too much. That all makes sense enough that I could let it go. But my pregnant lady…that one actually woke me up the next night and I sent one of my friends a “what the heck?!” email.

            By Thursday, the census was down below 100, and I needed to get back home for an incoming volunteer. After we’d driven for about three hours, I decided I’d be audacious enough to ask if we could make a five minute stop in Saint Marc. The country director of MTI said he’d do me one better and we’d stop and have lunch there. We stopped at the Deli Mart, the last place I’d eaten out there (interestingly enough, it had been on Thursday October 28, nine months to the day – thanks overactive memory). I was too excited to sit still or eat anything.

            When I finally directed Ted down our street (a few minutes prior he’d said to me, “When you’re done being lost, let me know”), it looked like a ghost town. There were no kids on the basketball court. The market was gone. In its place was a fenced in concrete…area. There were still those few moto drivers by the fence harassing me, though, as I walked up to my gate. At the same time, Merites rode up on his bicycle. I called his name and ran up to hug him. “Ou sonje mwen [Do you remember me]?!” I asked. “Wi, Miss Sarah!” he hugged me again. I went through some formalities, then asked after the small child. “Is he here?” “No.” My face fell. But then he started talking again, and I caught enough of the words to realize he was asking if I wanted someone to find him. I said yes, and then he asked if I wanted to come in.

            I sat in the courtyard on a kid’s school chair that Merites cleaned off for me. There was a new painting on the wall and two more basketball hoops. (Interestingly enough they were positioned on different walls than before – does this have something to do with me popping the one soccer ball when I threw it over the hoop and into the barbed wire? We’ll call that part of my legacy…) After about ten minutes, I was starting to get anxious. I didn’t know when they were going to find Licson, and I felt bad for the people in the car who were gracious enough to make this “five minute” stop. Then his dad came running through the gate, followed by the small child with a huge smile on his face. I ran up to him and gave him a huge hug. I feel like he’s grown up since I left – he’s definitely taller. We talked for a few brief minutes. Then I said that I needed to go but that I would come back again – I don’t know when, but I will come back. I hugged everyone again and walked back to the truck. Even though I’d said goodbye to all of them in November, I feel like I got a little bit of closure from that visit. Definitely better than screaming goodbye to people across the street while I’m taken away in the back of a truck.

            And now here I sit in Port-au-Prince, on Wednesday the 3^rd, (the day of said kidnapping), awaiting a tropical storm. Like I know I’m weird about the date thing…but this is a little weird. Tomas on Thursday/Friday November 4/5. Now I just have furniture and I’m sweating more. I’ve been here too long…I’m really not terribly concerned about this storm. (Besides, the hurricane center says she’s “become disorganized”…how much damage can a disorganized storm do?) I’m considering strapping myself to one of the columns of the carpark. I’ll let you all know how it goes.

It Takes A Village

This is why people have nine months to prepare for children. Maeve and I were acting as foster parents this past week, and I contemplated going to bed at 8pm tonight. Baby Ralph (who’s real name is Markensson) is a 6-10 month old Maeve has been dealing with since I went home in May. He was brought into the clinic with a chest infection and was treated in the hospital. He ended up staying there for about a week because of social issues. He is not being raised by his parents, and there are many different stories circulating about where his parents are/if they are still alive. The hospital wanted to put him in an orphanage. Maeve was trying to avoid that, but eventually did find one the hospital worked with that she felt was acceptable.

Baby Ralph was finally discharged into the care of his “aunt” (who always works during the day, so it’s really an 11-year-old girl that takes care of him) on the condition that they bring him back to the clinic each day so Maeve could give him his antibiotics. Last Tuesday I got a phone call from her asking if we could take him in for a few days. Somehow he got an infection in his arm, and he had two draining wounds. We think they were in a sinus or something, because they were also draining into the area outside his lungs and giving him a horrible cough. But the hospital wouldn’t take him back because of the social issues. So I was sitting at the kitchen table when she walked in holding the little bugger, shrugged her shoulders, and gave me a look that said, “I didn’t know what to do.”

Night One: We put the baby to bed around 8:30 (in our bed…did I mention that Ralph also had scabies?), and Maeve went to bed shortly after. I, of course, stayed up for awhile longer. I think I finally went to bed a little before 11. I’d been asleep for about half an hour when he started crying. The whole night is running together in my memory now, but I know that he was up again at 12:30, 1:45, and at 2:30, Maeve and I just stayed up talking until about 4. We’re pretty sure he got spoiled at the hospital being held all the time, and they had said that he slept all day and stayed up all night (thanks for that, daytime nurses), and he was teething on top of that. We wanted to just let him cry, but unfortunately, the landlord’s wife is in during the month of July, and she had actually wanted to kick us out. But for some reason, she graciously allowed us to stay in the bottom floor while she’s here. So we didn’t want our crying baby to wake her up.

Ralph woke us up yet again at 5, and Maeve asked if I would take him for a little bit since she had to get up soon to go to the clinic. Now, Ralph isn’t content to just have you awake. He doesn’t want you to get in a comfortable position. So even though I was holding him, it wasn’t enough for me to sit up in my bed. I had to be standing. So we went outside and walked around the house for an hour and a half. I tried sitting down in some of our broken bag chairs from the old house, but again, comfort does not equal happiness for the Ralphster.

He started doing this little thing where he’d yawn and then sigh. Like he was just exhausted from working really hard or something. It was irritating because it was so stinking cute. Keep me up all night and then sigh about it.

A little before 7 we went back in to wake up Maeve, and then we were going to feed him. Maybe it’s because he usually just has flour and water, but for some reason he was just not into beef and vegetable baby food. I was holding him, and Maeve had spooned over half a jar of food into him. Then he decided that was enough. Hot orange puke. All over both of us and the bed. Mornings are not my favorite. Maeve almost fell over from laughing so hard, but then she did also clean the puke off my arm and legs because I just continued to sit there.

We got Ralph a pacifier that day, and that helped a bit. Looking back, he really did sleep a little better, but we also got exponentially more tired throughout the week, so every time we woke up it was just 12 times worse (I know, all you actual parents are laughing at us). At one point, maybe during night four, I woke up to hear Maeve telling Ralph that she was going to put him outside the window. (I think that was also the night he peed on her.) We also considered putting him in the tent with Uncle Mark, but thought that might turn out worse for us in the end. (That may have also been the morning when we tried to murder the chickens with a lacrosse stick, but the loudest one got up into a tree. When the baby is actually sleeping, I don’t want to be awake due to some bothered rooster.)

At the end of the week, we had to return Ralph to the “aunt” (but really the 11-year-old), so that Maeve wasn’t accused of kidnapping him. He is not able to go to the orphanage now because we don’t know that at least one of his parents is dead. Different stories continue to circulate regarding their existence/whereabouts. But the little girl brings him back to the clinic each day, and we may end up getting him back again.

I think it’s amazing how quickly you can feel parental. The third night he was here, Ralph was in our room with the door shut. I was sitting at the kitchen table talking with people from another group who were taking their meals here. The Haitian staff had the TV blaring at a ridiculous volume (as usual), plus the radios on, plus the generator was running. And then I jumped up and went to my room because I knew he was crying.

And now the section where I brag about my foster baby. While he was here, Ralph learned to hold his own bottle. He still doesn’t hold it up in the air, but he can hang onto it. The way he sits is absolutely hilarious. I’m not sure what’s not quite right about it, but he looks a little bit like a little frog (he also reminds me a little bit of my cousins Eric and Lindsay’s dog). And he’ll sit there and then just suddenly do a face plant. But it’s kind of like he intends to do that, because then he’ll just stay here and cuddle up to whoever he just fell on. Something he loves that actually makes him sleepy is when someone rubs his nose. So basically, he’s just like Bud. (Because Baby Ralph is also beautiful.) And he has the cutest little smile. Which he whips out at inappropriate times, because usually you’re trying to be mad at him. And I can’t wait to have his little ‘fro cuddled up under my chin and kiss his little face again.      

Change of Address

Note to self: always pack shampoo in your carry-on. We left for the airport at 4:30am Monday morning. And can I just say that I’d been packed for 12 hours at that point? I actually went to sleep the night before. Anyways, my flight was at 8:40, and at 9:00 we were still on the ground. Then they announce that there’s a mechanical issue with the plane. Something with rivets. But that flight was not going to be taking off until at least 12pm. Flights to Port are quite limited (because really, who goes to Haiti?), and I figured that mine (which was supposed to depart around 2) was the last of the day. I waited in a line for over two hours to have the ticket woman ask me if I’d rather spend the night in DC or Miami. I picked Miami.

So I browsed through the bookstore, bought a book my mom already ordered, and paced around for awhile. At one point, I sat down and some boy came and sat next to me. I truly hope he could hear the Campus Chorale songs blaring from my ipod.

My flight to Miami was half an hour late, not that it mattered. What I was thinking of as a fun adventure was rapidly growing less fun. I tried to check my email in Miami, but they wanted to charge me for wifi. So I walked to my gate and found a suitable spot to curl up in a ball on the floor. But I only managed to sleep in sporadic 20 minute increments throughout the night because it was so flipping cold. I was wrapped up in my sweatshirt with the hood up. I pulled the tshirts out of my backpack and wrapped those around my legs. What a fine and pleasant misery.

My 6:45am flight to Port-au-Prince was delayed by an hour and a half due to issues with the intercom. Personally I thought they should all learn Morse code. Mostly because I felt bad for Mark, who had to get up in time to be at the airport at 7:40, and had no idea I was going to be late.

I arrived safely in the hot sun, sleepy and with dirty hair. I may have a mild obsession with washing my bangs. My roommate made fun of me fairly frequently during college because I was too lazy to take a shower, but always washed the front of my head in the sink. So I was a bit distressed when I discovered that we couldn’t go home right away. Well, not “home,” but to the house they moved into while I was gone. We had to take Maeve, Clare (the ESL teacher for We Advance’s literacy program), and two volunteers to the clinic first. But since the cab was full, Maeve and I sat in the truck bed, thus collecting massive amounts of dust/soot/smog. It all stuck incredibly well to my greasy hair, which made it look clean. And that’s enough information about my hair. Moving on…

Eventually Mark brought me back to the new house, which we are renting from another organization who sends teams down probably four times a year. We were told that when there isn’t a team here (so pretty much all the time) we can have the whole house. But I think the staff just end up sleeping inside when that happens. It’s confusing and I haven’t made much of an effort to figure it out. I know the lady who brings the food; the rest I’m still working on. Anyways, this new house…it’s nice. And big. Like, to the point where I’m embarrassed that I live here. I know it was a move DIRT needed to make, but personally I don’t like it. To be fair, I don’t like change (you’re all shocked, I know), and I hate leaving my memories in the old house. But the night I got back, one of my friends came over to visit and she looked around and said, “Well…just try to think of it as a blessing…” And this was after one of the volunteers said that the house seemed a bit inappropriate. There’s just no pleasing everyone I guess. We’ve either got a resident rat or a house that’s so fancy that I have yet to be bitten by a mosquito. So for my own peace of mind, can I just remind people that for eight months in Haiti I took bucket baths with water I drew out of cisterns? And I cooked outside on the ground with a propane stove and/or a single burner kerosene stove that only had half its wicks. And I electrocuted myself switching on the generator when the city power went out. I feel better now thinking of those things…as I lay here on a real bed, under a fan, looking at a dresser. And there’s a fountain outside my bedroom door. Ai yi yi. I miss my balcony. Anyways.

Yet another change we’re anticipating in a few weeks is a new country director. Mark is heading out, and Jon, who was with us for a little bit during January, is going to be taking over.

But even amidst all this change, there’s still those typical Haiti days. Thursday I went to the clinic to help out for a little bit. It was the maternity clinic day, and someone was coming to do ultrasounds. We hurried to get there in the morning (women were waddling in from every which way), only to find that we couldn’t turn the generator on because the plug had caught on fire. So a security guard ran around for an hour or so looking for a place to buy a new plug they could attach. I spent a good portion of the morning with the doctor and one of the volunteers, attempting to measure bellies and listening to heartbeats.

Mark picked me up partway through the day so we could go grocery shopping. He’s trying to teach me all the roads so we’re not completely lost when he leaves. We get out to the main road and he says, “Alright Magellan, take us to Megamart.” I told him, “Okay, just get me to Delmas.” Pause. Sigh. “Sarah…we’re on Delmas.”

We’d been home from our shopping trip for about five minutes when Mark’s phone rang. It was Les from MTI asking us to call ahead to St. Luc’s hospital to let them know he was bringing in a patient. The patient was in an ambulance and Les was following, but the ambulance had no medical people in it, or even equipment like a backboard or a cervical collar. Apparently it was a 25-year old male who’d been hit by a Minustah (some sort of UN thing) vehicle. Then a UN tank came by and they’re actually the ones who called the police…who called the ambulance. So, a hit and run by the UN…

A little bit later, Mark came into the house telling me we needed to go. Les called from the hospital and wanted our help. For some reason, I was surprised by this. After all, the guy was already in the hospital, so why did they need another nurse and EMT? Mark’s response to my question: “This is Haiti, so subtract all logic…”

This hospital is literally a mile down the road, and it took us 25 minutes to get there. Traffic is usually horrendous, but that day was especially bad because there was a book fair. At the sugar cane factory. (You can’t make this stuff up.) We got to St. Luc’s and eventually found the room with the CT scanner where the patient was. Within 30 seconds of entering the room, it became apparent why we were there. There was a crowd of staff around the patient, and the only people doing anything were the doctor (who was still giving orders) and Les. I was putting lead on and asking for gloves (in both languages about 6 times), when the doctor asked for someone to check a pulse. The patient had been responsive when they brought him in; they’d actually given him a mild sedative. But Les and I were both checking for femoral pulses when the doctor said, “I’m waiting for someone to tell me they have a pulse.” I told him that no one was going to tell him that because the patient didn’t have one. So we started CPR. After many unsuccessful attempts in both English and Creole (complete with hand motions) to get an AED, Les threw his lead on the floor and went to find one. He was successful, but when we turned it on, we discovered that it was in Spanish. We continued CPR for another 20 minutes, but never got a shockable rhythm. Time of death: 1724.

Yesterday morning we were sitting in the clinic waiting for the Haitian nurses to finish their education session and send the patients inside. I was sitting in a wheelchair, but my feet were on the floor. For a second, I thought I felt the floor shake. But no one else commented on it. Then it started again, and I knew I wasn’t imaging it. Maeve and I looked at each other, both thinking, “Is that…?” and “What should we do?” And then it stopped. Finally, one of the volunteers said, “Did you feel that?” Then the doctor ran into the room and goes, “Did you feel the earthquake?!” We found out later last night that it was a 3.5 with the epicenter in Leogane, and it lasted 45 seconds. So only a 3.5 – that’s only mildly disconcerting.    

Roots & Wings

I don’t think it’s surprising that after having the madre that I do, I currently feel like I’m living in a vacuum cleaner. For the last few weeks I feel like my mind is constantly going in at least 17 different directions. Which is why nothing in this blog post will be cohesive. But I figured it was time for another one nonetheless.

I worked at Medishare pretty much the entire month of April. I really really loved it, but it was exhausting at times. It was pretty apparent I needed a break the night I started laughing at a dead man. (Who had, in fact, died while I was putting an IV in him and drawing blood). One afternoon when I was working in the ER, they brought in a boy who’d been in a moto accident. His left leg had been partially amputated. When I think back on it now, the whole process really took a long time. Something that would’ve taken minutes in the States took hours in Haiti’s trauma 1 hospital. The tourniquet on his leg wasn’t terribly effective and he probably lost two units of blood just while laying on our table. So I was scrounging around looking for ace wraps or anything to put pressure on his leg. I’m not sure how long it actually took to get blood to do surgery. Mark and I had gone for blood the week before, and even though we told them it was an emergency, it took two hours (three if you include travel time). While we were waiting, I was talking to one of the doctors. He mentioned that he’d come to Haiti before to work in a different area through his church. I’ve gotten really good at condensing the last eight months, but I like to start out with, “Well, I initially came down through Eastern Mennonite Missions…” The exchange made me think of early Christians drawing half a fish in the sand – his brief comment to say, “I’m a Christian,” and my EMM comment to say, “Hey, I’m a Christian, too!”

The boy went to surgery not long after that, and he did make it through. But he’d lost too much blood and he died early the next morning.

One evening we were getting ready to leave when the doctor in triage asked if we could do a transport. Mark and I groaned a little bit inwardly but agreed. I think I may have groaned out loud when I found out it was a cholera patient. The last thing I felt like doing that night was boiling clothes. We were getting ready to head out, had the family in the back of the truck, and the doctor (who I affectionately called Hurricane Barbara) was giving me her report/commentary like a squirrel on speed. As she was about to hand me the baby, I caught a glimpse of her eyes. “She doesn’t have cholera.” Yep, the 9-month-old RN (or 7 months if you count the time I’ve actually practiced) blatantly told the doctor her diagnosis was incorrect. It took her about four seconds to regroup, then she started questioning me. “Well do you think it could be malaria? Typhoid? She had a fever of 104. Let’s ask the family again, they said she was having diarrhea and vomiting…” I don’t know, I can’t really give you a whole lot of pathophysiological answers, I just know she doesn’t smell like cholera and that it doesn’t manifest with fevers. Is that an acceptable answer after I contradict you? She really was quite understanding and told me that she’s never seen cholera before. Unfortunately she then also said, “It’s your call. You just tell me what you would do.” I’d been pretty sure of myself until I was the one with the final say. I decided she should stay and get fluids and be monitored. The whole way home I second guessed myself. Luckily, the next day Barbara shouted to me from across the compound as she was whizzing by that I’d been right.

That was one of the least disconcerting things (for others) that she shouted at me during her trip. One week I had been filling in for five days until some EMTs came to work in the ER. It was a father/son pair, the son newly certified (they don’t get much newer than that kid). The dad walked up and introduced himself to me, then immediately said, “Don’t you have to be 18 to work here?” I’ve grown quite accustomed to the comments about how young I look, so I responded with, “Well usually, but I’ll be 18 next month so they made an exception.” I mostly found it ironic that he chose to pick on me when his son looked 14. Barbara was rounding on a patient the next morning and asked me to check on something because “those EMTs, they’re fresh, they don’t know anything. And what is that kid, 12?” I proceeded to tell her the introduction story. She looked at me a little confused and then walked away. She returned a few minutes later with another nurse who was laughing. She had believed my sarcastic comment and pulled someone aside to say that even if I had a license, she felt a little uncomfortable having someone who was only 18 taking care of patients. Heather just asked her if she was crazy. A few days later, I was in the ER with a new batch of Medishare volunteers when Barbara yelled from the unit next door, “Sarah! I talked to your mom last night and I’ll be at your high school graduation!” She winked at me then was off, while everyone else just stared at me.

One afternoon, Mark came into the ER to say we might have to leave to transport a patient. There was a 7-year-old boy up north who’d fallen three stories and they were going to fly him down. It must’ve taken a little too long to try to find someone to pay for the flight and organize the transport, because eventually Mark came back and said that if the transport happened, it wasn’t going to be until the next day. Luckily, the little boy made it through the night. Less fortunate was Mark coming to me the next day and saying we had to fly up to get him. It was a little missionary Cessna, not medically equipped. So we ran around collecting everything we thought we could possibly need. My pockets were full of different syringes of medications.

The flight up was uneventful. When we found the little boy, there were no medical professionals with him. Just his family members. Who were holding a bag of IV fluid. Not good. I thought that one of the cardinal rules of head injuries (especially when you can’t measure the intracranial pressure) was that you don’t want to load someone with fluid and increase the pressure in their head. Ai yi yi.

I wasn’t happy with what I was finding while assessing him. He wasn’t following my commands (I gave him a bit of grace in that since my Creole probably left a bit to be desired), he wasn’t talking, and he didn’t withdraw when I poked his feet with a needle. I gave Mark one of my syringes and some brief instructions on where to hit his leg with the med if the boy started seizing.

About five minutes into the flight, I was reassessing and was trying to get him to open his eyes. He wasn’t responding to me, and I started freaking out. It was only a few moments, maybe 30 seconds, until I agitated him enough that he opened his eyes. But the things that went through my mind and the conclusion I drew that really there wasn’t much I could do while in the air with an ambu bag and some blood pressure meds made it seem much longer.

Thankfully, that was the scariest moment of the flight. Unfortunately, it was also one of the best. We had to fly pretty low because of the head injury/pressure situation, and low = bumpy. I just do not do well in small aircrafts. Shortly after my heart attack, I started feeling funny. Really hot and sweaty and like I was going to pass out. I remember thinking to myself, “This feels familiar…kind of like that time in the helicopter in Hawaii…” And I proceeded to throw up the rest of the way back to Port-au-Prince. I’m sure that was quite comforting for the patient’s mother. Once we were on the ground and on our way for a CT scan, I discovered that while vomiting, I had been able to squirt the medications in my pocket all over my scrubs. Who’s wearing the Labetalol? Yeah, that was me.

Nothing has compared with the stress of this past week, however. This is day 27 without power. The neighbors had been using their generators as well, and when we asked they told us they didn’t have city power either. But since then, we found out that the power to our house has been turned off because we haven’t paid the bill. I don’t think we’ve paid an electric bill the whole time I’ve been here. And the rent for the next year comes due at the end of this month. After talking through some options, we were a little hopeful that the landlord might let us pay month to month rather than the whole year. But we can’t even do that right now. One night earlier this week I was talking to a friend about this and he reminded me about Jesus telling one of his disciples to pull tax money out of a fishes mouth. It was really difficult for me to try and stop worrying, but after telling Jesus that we need $3000, there was really nothing else to do.

Yesterday morning I was laying on my bed in such distress about how I was letting DIRT fail that I couldn’t move, when Mark started hollering from the big room. One of his good friends unexpectedly got a ton of money, and he was willing to loan us $8000. Thank you, Jesus, for being an overachiever. (But I think I’m done learning patience now…)

In other news, the rat is dead. Last week Mark managed to sneak up on him and trap him under this plastic thing that keeps the flies off our food. He didn’t want to kill the rat until our volunteers had left for the clinic, so he set a nursing book and a saw on top of it. The next thing I knew, he was freaking out. The kitchen lady was walking out of the house holding the plastic thing. She claims she didn’t see the rat. A few days later, however, a curious smell was pervading the downstairs. After a little searching, we found the dead rat. Unfortunately, some maggots had found him first. We let Mark take care of it.

In exactly a week (or 167 hours and 44 minutes) I will be home for a few weeks. I’m a little bit excited. (Just a little). Today I was laying on the hammock thinking of all the things I’m going to do, like drink myself into a caffeinated craze at Starbucks with my cousins, take random road trips because I’ll be allowed to drive again, finally be able to go to family night, and get one of my best friends married off. Mark interrupted my daydreaming to ask about an ambulance policy. Ambulance reminds me of fast cars, which reminds me that I get to watch the Coke 600. Must focus. (167 hours, 35 mintes…)   

A Stitch In Time

I don’t like mornings. And I don’t like the phone. So when I get a phone call at 7:30am, and while I’m on the phone, another phone gets a text, and yet another phone starts ringing, I’m not terribly amused. Adam is still out of the country since earthquakes are becoming pretty popular, and Mark went back to the States for a week last Monday, so I have both of their phones in addition to my own. I’ll go ahead and admit to the panic attack I had that morning before we took him to the airport. We were getting three volunteers in that afternoon, and as of 6 hours before their arrival, I had yet to get confirmation on any of the things I was trying to set up for them. I told one of my friends that I was really hoping this was one of those things where God was trying to teach me patience and to trust his timing, and thankfully I was right.

After dropping off Mark at the airport, we picked up Isabella, an Italian photographer staying with a friend’s organization, and we took her to Sister Marcella’s for a few hours. The place looks really different – it’s painted and there are babies and toys and equipment – all signs of life. I know I say this every time I write about going back there, but it’s just so strange. I was telling Stephen (a friend of Adam’s from previous Haiti and Pakistan work who was here for a few weeks) how every time I walk in that building I see all of our patients. An 11-year-old girl who just wouldn’t get better, a guy with pink crocs who also had worms, and a little old lady with orange hair who we all affectionately called “Grandma” who got 26 bags of fluid.

After taking Isabella back to Brenda’s house, Stephen and I headed to the airport to pick up our volunteers. Mike and Justin had worked cholera with us at Sister Marcella’s in November, and Justin was also bringing his girlfriend along. Even though I’d only been with them for a week back then, there are only eight other people who can understand that experience, and it was so good to have two of them back. I’ve definitely enjoyed the other volunteers we’ve had since, but I loved when, for example, we’d drive past something and one of them would say, “Hey, isn’t this where Brenden fell out of the truck?” For once, I had people that remembered all the stories I told. And they were also quite impressed by the fact that we now have a refrigerator and running water.

The downside, however, of having people come back who worked with us in a crisis, is that there’s no longer a crisis. We had something to do each day, but it wasn’t nearly as stimulating for them as keeping people alive. Saturday morning we picked up a baby from the Germans and took her to Medishare, so it was nice that they got to have the experience of hanging out on the tarmac and checking out all the broken down/wrecked planes and helicopters that take up most of the space. But after returning to the house, we didn’t have any other work plans. So we decided we’d hang out for a little just in case we needed to do another transport and then head up to Ibolele to get some food and watch basketball. About 45 minutes after coming up with that plan, I got a call from the head nurse at Medishare asking us to come back and work. So Justin and Mike went to triage and I worked in Med/Surg. Some combination of us continued working there for the rest of their trip. Katie came with us on Sunday because they needed help feeding and holding babies in Pediatrics. At one point I went over to check on her and she had a baby in each arm. So cute. I spent the rest of the week there, which I absolutely loved. The only thing that I was kind of bummed out about was that Monday and Tuesday we had set up a couple locations for Katie to do cholera education at and I was looking forward to it because that’s something we haven’t done before.

So many random patients came into the hospital this week. We had some births, we had some deaths, we had mystery diagnoses, and pressure ulcers. I’ll save the detailed stories, because when one of the Medishare nurses (they volunteer for a week) asked me some questions about cholera, she told me I should see a counselor after she heard my responses. No, I did not get to deliver the baby. But we’ve now had four in a matter of three days, so I’m figuring if there’s another one and I happen to be there, the doctor just might let me help out. I did, however, finally get to suture someone! I’ve only been practicing for this day since October 31. I was filling in in triage on Friday morning, and in the midst of seizing babies, a woman with an abscess on her bum, and a patient with an infected leg, a woman came in with a sliced hand. Becca, another nurse who had done sutures for the first time earlier that morning, asked if I wanted to take care of her. Then we asked the doctor if he was okay with that, and after saying yes, he left. So Becca and I decided that to do sutures you either need one doctor or two nurses. At one point while I was getting stuff together, a translator asked me if this was my first time. “Yes it is. Don’t tell the patient.” And Becca agreed, “Yeah, we never tell the patient that.” After I’d finished, the ER doctor was passing by and stopped to see what we were up to. Apparently the silk we used was a bit too big, but hey, stitch and learn. I thought it was pretty. My very first stitch was a little tight, so she’ll have a bit of a bigger scar there. But now that I’ve had someone that legit needs stitches, I’m ready to take volunteers. Adam once said he’d let me practice on him, and now I’d be okay with that. Maybe that’s why he’s staying in Japan…

Another interesting aspect to the week was that I had nursing students! How very strange. At one point during one of the days, I was sitting on the counter charting (that took some getting used to – paper charting…all during clinicals I just scanned things, clicked things, and checked boxes) when one of the students starting asking me questions about drugs. Then she started writing down what I was saying. That’s when I was like, “Shoot, I need to find a drug book.” Before I knew it, I had 8 girls in white uniforms around me listening to me talk about medications. One day, my student was giving me a report on my patients vitals (they just did baths and vital signs) and she told me that the patient’s temperature was 91.6 F. I’m not quite sure what my translator told her, but what I said was, “Mmm no, I don’t think so.” Upon further investigation, I discovered that she had no idea what normal was. After telling her, I asked what she thought we might want to do if we had a temperature of 91.6. She didn’t know. So I suggested taking it again. While we waited the five and a half minutes it takes for the thermometer, I tried to explain to her what our patient might look like if that was an accurate temp. But the fact that she was sitting up and complaining of pain indicated that we should probably double check for accuracy. I’m not sure how effective my teaching was. After that is when I started semi-joking about starting a nursing school here. The next day one of the nurses I’d been working with asked if I was serious because she’d be willing to come down and teach… 

'Almost' Doesn't Count

So close, and yet so far. Today I was working with a friend’s organization doing a mobile clinic, and the doctor asked me to bandage up a kid’s leg. Lo and behold, this child had sliced open his leg quite nicely and needed stitches. I told the doctor what I thought and she asked if I was going to do the suturing. Silly question. I’ve taken to carrying around Brenden’s suture kit with me wherever we go. So I had the translator tell the little guy that I needed to give him some shots with medicine to take the pain away and that it was going to burn a little bit at first. I had a teeny tiny little needle, and it was pretty tough to get that into his skin to give him the lidocaine. But after four shots of that, he was all numbed up (and probably hating me). Let me just say, this little Haitian boy did not have skin at all like the banana and mango peels that I practiced on. In fact, his skin was so tough that I couldn’t get my needle through. I tried two different sizes and types of silk and got nothing. I asked the doctor if she wanted to try and she said, “Well if you can’t get it, I won’t be able to either.” So at least she had confidence in my skills. But I had to just bandage him up and hope he went to the hospital like we told him.

About three weeks ago, I got to accompany a patient on a med-evac flight to Philadelphia. It was a 13-year-old boy who was injured in November when he was climbing a tree and someone threw a rock at him. It hit him in the head and he fell out of the tree, landing on his face/stomach and breaking his back. That left him paralyzed from the waist down. He needed surgery to stabilize his spine, and they don’t have the capability of doing that anywhere in Haiti. He lives with his Grandma, and Grandma was going on the flights as well. The patient did very well and the flights were uneventful from a medical perspective. During the first flight (5 hours on a missionary plane built in 1943), Grandma leaned over and told me she needed to go to the bathroom. So I was walking her back because I didn’t want her to fall. There was an area behind the seats where the luggage was before the bathroom, and when we reached that area, she started to squat. I managed to say “NO!” enough times that she didn’t pee there and I got her to the bathroom. Unfortunately, before I could show her the toilet and put the lid up, she started peeing on the floor. Not just the floor, but the door, the shelf, and her foot as well. Thankfully, there was a roll of paper towels and lots of Lysol in the bathroom.

Once in Miami, Grandma and I went to do paperwork in customs while they transferred the patient to the air ambulance. It went really smoothly considering they didn’t have passports and I was trying to read Creole on their birth certificates. We were in the air before I realized that I should’ve had Grandma use the bathroom. All I could think was, “Dear Jesus, please don’t let her pee on this airplane…especially not while she’s practically sitting on top of me.” Well, the Lord was gracious. Grandma waited until we landed in Philly and then just peed right on the tarmac while the flight nurses freaked out behind me. “You can’t leave the hospital until you explain to her that she needs to use a bathroom!” “I know, I will. But you have to understand that she’s probably never seen a bathroom before.” “Well, she’ll get arrested for doing that here!” Luckily, the EMT driving the ambulance happened to have a step-grandfather who is Haitian and she called him and had him explain to Grandma how to use the bathroom.

We went to Shriner’s Hospital and I stayed for a little while waiting for my dad to pick me up. At one point (this was around midnight), the charge nurse told me I had a phone call. I was confused about why my dad didn’t just call my cell phone. But what I found on the other end of the line was a woman crying because she was so happy that the patient was finally in the States. Apparently she works for Sky Hope, an NGO in the States that does these flights, and she had been the one working to set up this flight for the past few months. So I had a 20 minute conversation with her about how it went and things like that. It was strange. Not that she called, just the fact that I was having a conversation with someone that I’ve never met and will probably never meet. It was one of those “surreal…but nice” moments. And then, since I was already in Philly, I got to spend a long weekend at home. The flight conveniently coincided with butchering weekend, which was wonderful. There are few things more beautiful than sitting down for lunch and seeing my entire family around me. And gut buckets. Just kidding. (Mostly). I told my Grandma that I wish I could be in two places at once. But I haven’t figured that out yet, so I’m back in Haiti, where I am hopefully succeeding in implementing the tips my family gave me for making my blog posts shorter…

Yesterday morning in between teaching our groundskeeper how to properly clean the bathrooms, I was sitting in my house in my mostly broken camping chair talking to my friend on chat. She’s been telling me for days that I need to blog, but I haven’t had anything to write about. The previous day involved me picking up barrels to burn our trash, getting a water truck to come to the house, singing obnoxiously loudly while I thought I was home alone and then the kitchen lady walked in, and then using our new staple gun to put screen over the faux transom on my balcony door. Not blogworthy at all, but I was trying to figure out how to make it so when Mark’s phone rang. He was nowhere to be found, so I answered it. It was the CNO from Medishare, and she said she had an American aid worker who came in the night before with malaria and dengue fever and needed to be med-evac’ed out, but he didn’t have med-evac insurance, so could we help figure that out? I told her I’d talk to Mark and call her back. Usually I get off those calls feeling really frustrated because I always have to say, “I don’t know, let me talk to Adam,” and I really need to be able to do this myself in a short amount of time. So Mark and I conferenced really quick and he started calling people to see if they knew of anyone and we were coming up short. Then I remembered crying Sky Hope lady. After a series of emails, she pulled through for me and was checking into flights. Mark and I decided we’d head over to Medishare and check the patient out ourselves.

The report I got from the doctor when we got there was ferocious (nurses, nursing students – ask me about it because it’s incredible and I’ve saved all my notes – making this guy better is my ICU dream job). After we were there for a little bit, the director for the patient’s organization discovered that he did have insurance after all, which was fantastic. That meant we could get an air ambulance to come right to PAP for him. And miraculously, they were going to be able to do it the same day, when usually no one can fly out of Port after dark. So all we ended up having to do was work out how to get us and our truck through security so we could take him right onto the tarmac and out to the jet. He was stable enough when we transported, considering he’d spent the past two days with nausea, vomiting, diarrhea, and had low blood pressure, a cough, fluid building up in his one lung, and very low red blood cell, white blood cell, and platelet counts, among other things. They gave me a bag full of injections to take with us just in case, but thankfully he didn’t need any of them.

This evening we got an email from the patient’s director. He said the night went relatively well, considering, but the patient has gone downhill today. He had to be intubated this morning and his platelet counts continue to be very low. Acute respiratory distress syndrome was something the doctor briefly mentioned to me that she was concerned about, among other very serious complications. So please pray for this man, specifically for his lungs and his blood cells/platelets counts.

Occasionally I still struggle with my decision to leave EMM, especially considering my original return date is 13 days from now, and wonder about how the support shifts when someone goes from “missionary” to “humanitarian aid worker.” Sometimes I just think it’s interesting that the support shifts at all. But this past weekend I got encouragement from one of our volunteers. The rest of the group was going out for the evening, and I was staying home hoping to have the house to myself. Unfortunately, one particular volunteer decided he wanted a quiet evening as well. Eventually we got into the two standard questions: “So how do your parents feel about you being down here?” and “What are the Mennonites?” Somewhere amongst my ramblings of trying to distinguish Mennonites and Amish (it’s more difficult than you’d think to try and explain something that is so ordinary to you), he brought up evangelism. And then someone who will only say that he “tries to go to church sometimes” told me that he thinks I’m exactly where I need to be to share my faith with people. 

Advocacy vs. Animosity

If I had a dime for every time one of my clinical instructors wrote that I was quiet or needed to be more assertive, I would be a very rich woman. Or at least a lot less in debt. In fact, I got so annoyed with seeing that on my papers, that one time I wrote an evaluation stating that I might not be a social butterfly but that doesn't imply in any way that I won't advocate for my patients. (I'd just like to add that the response I got was, "Fair enough, this is true. See you guys? Sarah doesn't talk much but when she does it's good. And she gets you extra points on quizzes." Thanks, thanks very much). I wish my instructors (especially the L&D one who told me I'd get eaten alive as a nurse) had seen me yesterday. Not necessarily because I'm proud of what I did, but because sometimes I just like proving people wrong.
Yesterday morning, Ashley, Adam, and I went to the airport and put Leah on a plane for home. I arrived in this country exactly five months ago, and I've never been here without her. It's weird to still be in the same place but have entered into a new season of life. After that, we dropped Adam off to go flying with some people, and then Ashley and I came back to the house. Mark got a call about mid-morning from the MTI clinic that there was a woman in active labor. There were two random things that I prayed for before coming to Haiti in September: that there would be a piano in my house and that I would get to deliver a baby. I can only expect that since I had a keyboard in Saint-Marc, that there is some midwifery in my future as well. So when I heard the words "active labor," all volunteer rotations went out the window. After I was already in scrubs ready to go I asked Ashley if maybe I was a bit overzealous and I should stay back. She said no, and that was all the affirmation I needed.
During our trip out to the clinic (which was longer than necessary because our driver didn't know where we were going even though we've been there like five times and the translator told me he knew where we were going and he didn't), I got about three calls asking how soon we'd be there and if we were comfortable with delivering a baby. I was afraid they were going to try to find someone else to take her if we didn't get there soon. But when we finally got to the clinic, the woman was up walking around with contractions about 15 minutes apart. The person who kept calling me wasn't even at the clinic. Oh Haiti.
Needless to say, we did not get to deliver a baby en route. But her contractions were getting a lot closer together. I wanted to let the volunteers handle it, so they walked her to the gate. Then some sort of commotion ensued. One of the EMTs asked me to come over and see what they were saying (not that I could really tell), so I pushed my way to the front of the crowd. By now, our patient is hunched over trying to breathe and the security guard was yelling at people. Our translator said they weren't going to let her in because they didn't want her husband and sister to come with. I started telling the security guard (for no apparent reason because he didn't understand me), "Okay, well this woman needs to come in right now!" He continued yelling and closed the gate. I start muttering about how I'm just going to do it myself. So I flung open the gate. Security guard freaks out and is trying to close it against me trying to keep it open. Then I start yelling in an attempt to convey to this man that my patient is going to have a baby on the sidewalk. Somehow we end up pushing through, though the security guard shoved the patient's sister out of the way. Then our translator came behind and the security guard tried to stop him. In turn, our translator smacked the security guards arm and there was nearly a fight. This was when I was like, "Shoot...just keep walking, just keep walking..." We always joke around our house about things causing international incidents. As I listened to all the yelling going on behind me while we calmly walked our patient inside, I was afraid that I may have actually been the cause of one.
Later yesterday afternoon, true to form, I began analyzing the situation. I had definitely stood up for my patient and made sure she got the care she really needed, but I probably could've done it in a different way. Was it really necessary for me to start yelling just because everyone else was or try to force my way inside? I can't decide. Either way, I felt  like I needed to apologize to the rest of the volunteers for my temper. It was one of those times where I realize how far I have to go before I'm a calm, wise medical professional instead of a spitfire young gun.
Sidenote, since I've been asked by quite a few people. Yes! I did get to watch the Super Bowl! And it was absolutely glorious. We went back to La Reserve (sadly, no former dictators were sighted this time) and ate really good food. I was harassed because I was not jumping out of my seat or yelling or clapping, but the people sitting around me will attest to the fact that I was squealing and twitching quite a bit. I'm sure I looked special. Such a good game. It brings so much happiness, love, joy, and other fuzzy feelings to my heart that I can't even make any mean comments about the Eagles. At age eight I remember sitting in church drawing pictures of the Packers for my grandpa (as all good little Mennonite girls do), but I don't actually remember watching that Super Bowl. The next year I spent an obscene amount of time arguing with a boy in my class about whether the Pack or the Broncos would win. I finally feel vindicated over that loss. It's a beautiful day.    

Balancing Act

A few hours ago, us girls were sitting on the floor (because we don’t have enough chairs to all sit at the table) and I asked what time it was to see if it would be absolutely ridiculous if I just went to bed. When we found out it was 9pm, we were all kind of excited about sleeping. Then the power came back on and we were suddenly rejuvenated.

Adam likes to say he’s an “extreme humanitarian.” I think the ‘extreme’ part comes from the fact that we live a life of extremes. Extreme action or extreme boredom. This past week was the first that I feel like I had such a good balance of the two. Sunday morning we had the opportunity to go to church. This was the first time that happened because we don’t have any transportation on the weekends. We’ve gotten to know some of the staff at MTI (a faith-based organization) on a more personal level and when we asked about churches in the area, they offered to come pick us up. So Leah, Ashley, and I walked to the end of our road to catch our ride. Thank goodness I threw a skirt into my suitcase at the last minute. Sometime before the amazing music started, Alex (our ride) asked if anyone was going to be watching the football games that afternoon. Luckily for me, I was sitting down when that happened. Luckily for everyone else, church was about to start. I had literally been praying for days that I would end up at Hotel Ibolele to watch the championship games. I pretty much didn’t think that would possibly happen, and I’m pretty sure the people that kept hearing me pray about it didn’t think it could happen either. But after Alex asked and Leah and Ashley had to respond because I couldn’t speak, we arranged for him to pick us up later in the afternoon to go watch the games. At Ibolele.

We had a wonderful time (or I did, at least) watching the Packers thoroughly trounce the Bears. (Let’s take a moment to relish the victory…I know all you Eagles fans will begrudgingly join me.) Then Alex suggested we go to another place to watch the second game. I forget what it was called, but he told us as we pulled into the parking lot that it’s the place where most foreigners get kidnapped. Awesome, thanks for sharing. Apparently we were safe because we didn’t bring a security brigade to announce our arrival. At that point I didn’t care as long as they had food.

Sometime during the second half of the game when we’d finally eaten and I was again able to be happy and speak to people, Alex got a phone call. Apparently one of the volunteers at GRU had been in an accident with a moto and broken his femur. (Forget cholera, we now have an outbreak of femur fractures.) Then Leah got on the phone with Corinne, the medical director at GRU (who is ironically not medical) to get the details and see how we could help. After a few discussions with her and a call to Adam (still in the States), we arranged to pick the volunteer up the next morning and take him to the airport to be flown to Miami, with the possibility of me going along on the flight. Leah and I returned to the rest of the group and she was catching them up on details. “Blah blah blah … IS THAT BABY DOC?!” Sure enough, there he sat a few yards away. So for anyone who read that he’s been arrested or that he’s hiding in the mountains, disregard that. He’s eating shrimp with former US Congressmen.

Monday morning we set out early to make sure we would be on time for his 1pm flight out. It’s good we did, because we sat in traffic on the road up to Petionville for nearly 2 hours. That road is kind of like 95. Every 5-10 minutes you get stuck in a traffic jam for no apparent reason. While we were sitting there, we discussed how it would probably be ridiculous and pretty painful to bring him back down that way to the airport. Mark, who used to work at JPHRO, mentioned that they have a landing zone. So Leah called someone else we know who used to work there to see if that was a possibility and then called the Germans. The Germans were actually there already for some other reason and they agreed to wait for us.

When we finally got to the hospital, it was kind of like playing a video game to get into his room. We talked to the receptionist, who called someone and then let us go up a flight of stairs. Then we talked to the receptionist at the top of those stairs, who called someone else. Then the doctor appeared and we talked to him, and then we were shown where his room was. Aaron, a GRU staff was with him at the time of the accident, and he walked out of the room to meet us. He looked exhausted, the first time I’d ever seen him that way. Then Mark and I went in to assess the volunteer. The whole situation was even weirder because we’d just seen this guy a few days before when we gave him a ride from the airport back to GRU. I was checking him out and when I got to comparing his legs I found that the calf and foot on his broken leg were much cooler than the other leg. That’s when he told me that he was feeling “pins and needles” in his foot. I conferenced with Leah and Mark in the hallway. Compartment syndrome…pain, pallor, pulselessness, paresthesia… I had no idea what to do, because they teach that the treatment for that is a fasciotomy, so I’d have to cut this guy’s leg open. I offhandedly mentioned that I wished I could just call Brenden and be like, “Please help me!” Next thing I know, Leah is handing me the phone. “It’s Doc.” He made some more practical suggestions. “I know, I know,” I told him, “I know just enough to kill somebody.” When Brenden was here he’d frequently shake his head and comment on how new nurses know just enough to kill someone. That may have had something to do with the fact that I automatically assume something is a tumor or an aneurysm…

Anyways, we thought we’d try loosening the straps on his external fixation device. So Mark held traction on his leg while I opened the straps, and thankfully that seemed to help.

While Mark and some other strong people were loading him into the truck, I asked Aaron about what exactly happened. Apparently, the two of them were standing on the side of the street talking to the driver of a Mack truck. A moto drove between the truck and them, and must’ve accidentally jerked his wrist or something. Aaron said he couldn’t remember. But the moto hit the volunteer at a high speed and threw him into a pole, breaking his femur in three places. We got him to JP with no trouble. The only issue was that the Germans had their logistician with them, who was taking up a seat in the helicopter. I realize that it was literally a three minute flight from JP to the airport, but it was going to take our truck 30 minutes at absolute best to get there, and if there wasn’t a nurse to go along to the States, he’d be up a creek. But Leah somehow weaseled me in, and then managed to get herself in, too.

The plane taking him to Miami arrived shortly after we did. I talked briefly with someone who told me there was no nurse with them. I didn’t really feel like flying to the States and having to try to figure out how to get back, but the patient needed someone medical with him. So I was talking with the pilot and came to discover that she really didn’t want to take me along. She told me that there were people waiting in Miami to take him right to the hospital. “Okay…so…what about if something happens between Haiti and Miami?” I asked. She responded to this by telling me that she had a physical therapist with her. Good, how very helpful. I had a miniature conference and minor freak out with Leah because I couldn’t decide what to do. In theory, he was stable, having minimal pain, and would be fine on the flight. But I can’t really bank on “in theory.” The pilot kept saying, “Well, it’s your call, but I’d rather not…” So I eventually decided I’d stay and give report to the PT. He was very gracious and listened to everything I said. At one point he said to me, “I’ve read about compartment syndrome…is that a concern?” I’m pretty sure I laughed at him. So I gave the patient another dose of pain medication, gave the x-rays, hospital chart, and my own ghetto charting on a scrap piece of paper to the PT, and sent them off. In retrospect, I still have no idea if I made the right decision. Should I have pushed more and not cared about offending the pilot? Who knows? We got word from the PT later that the patient did just fine on the flight and was awaiting surgery. Later that night, Leah and I were talking about why that particular transfer felt so much more exhausting than the rest. He was, essentially, one of us. None of us know this guy very well at all, but we’ve worked with him and his team, and we know what they do on a daily basis.

The next day we were up early for another transfer. We were going to Medishare to pick up the femur patient from the previous week and take him to meet German Air 2 so they could take him home. After a slight miscommunication at the hospital where an EMT thought she lost the patient, he walked out to us on crutches. He was obviously still in quite a bit of pain, and they really went to town putting the staples in his leg, but we were amazed that he was walking. It was pretty sweet to actually be able to help send a well patient home for once, especially one we’d taken to the hospital when he was broken.

We were pretty excited about Wednesday. We had appointments scheduled, and Leah and I were finally getting to meet with the directors at We Advance to iron out some details. We’ve been trying to pin them down for weeks and we’d finally been successful. So the plan was to walk down the street to change the bandage on our neighbor boy’s head at 8:30, get to a warehouse to pick up supplies at 9:00, have the supplies, Mark, and our new volunteer Irene out to We Advance by 10:15, meet with Aleda and Alison before their own meetings began, then head over to the airport to pick up Adam. At 7:15, Leah’s phone rang. It only woke me up, but it was G and I can’t talk to him. So I had to wake Leah up (not an easy task) and get her to call him back. I was trying to ignore it, but then I heard her say that she was going to talk to me and call him back. Apparently, G had run out of gas and had to push his truck home the night before, so he couldn’t come get us. I’m not sure why he didn’t think of calling us the previous night, but whatever. So we called him back and told him he needed to get here somehow, take our gas can, go buy gas, then get it in his truck and come back. A little while later, Ashley walked into our room and said, “Guys? G just pulled up on a moto…” There was nothing else to do but laugh.

So after successfully missing all our scheduled appointment times, we headed over to the warehouse. We were picking up cots and two exam tables. The Haitians put the exam table into the back of our truck on its wheels instead of upside down, which just made the ride all the more interesting. But now I can add to my resume that I can successfully balance an exam table in the back of a truck in traffic while drinking a bag of water.

Thursday and Friday were more filled with running errands. We went to another warehouse and did some supply drops. We also had the chance to just hang out and walk around the neighborhood, buy sodas, and buy street food, hang out with our street food lady. Friday we also got another volunteer, a Canadian paramedic. Adam didn’t want her to be sitting around the house bored all weekend (since we have no transportation), and Irene is only here for a week, so we wanted to get her involved in as much as possible. So Leah tried calling some other people we know to see if we could borrow their truck for Saturday so that some of the team could go out to Cite Soleil to work on setting up the We Advance clinic. She couldn’t get through.

Saturday morning we got a call from the head nurse at Medishare. She had a patient who needed blood and wasn’t able to find any, so she called us. Then Leah had me call the nurse back to get the report on the patient. Apparently, there was a woman in her 30s who was septic and had a hemoglobin of 4 (it should be 12). She was on oxygen and not doing well at all. The Red Cross was closed. The woman had the blood type AB+, which is the universal recipient, so she could get any type of blood. First of all, we had no access to blood. Second of all, even if we decided that DIRT was going to donate blood, we had no vehicle. I asked the nurse, “So, she’s AB+?” “Right.” “Okay, so then anyone at Medishare should be able to give her blood, yes?” She responded, “Well, today’s our turnover day, so the staff has to go to orientation.” I’ll leave the story at that, because I have no further productive words on the subject.

Soon after that, Leah got a call back from the people with the vehicle. They were willing to let us borrow it for the day, and after Leah gave their driver directions, he headed over. Mark, Irene, and Kyle (our newest Marine – we’ll soon have all of Bravo company down here) were about to leave when Leah got another phone call from Fabienne at the MTI clinic. She passed it over to me. A young woman came in and they suspected she was having a miscarriage and she had a fever and needed transport. So we jumped into the truck instead and headed over.

When we were getting close to the airport, Adam got a call from the Germans. So we pulled in there first and picked up a 16 year old with a tumor that was pushing his eye out. And I mean, literally pushing it out. It was covered with a cup, but one of the medics showed us a picture, and it was sticking out from his head a good 2.5 inches. I can’t even describe it. So we took him to Medishare, then headed to the MTI clinic. When we got there, they told us they had another woman who was 7 months pregnant and possibly had cholera. So we loaded them both up.

And thus ends another week in Haiti, complete with candlelight dinner because our inverter still doesn’t work…