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.