Rocks and Rolling

This morning I was standing outside our gate with one of the women who works at the house watching Thony and Jean, our two drivers, try to start a pickup truck in the field across the way. At one point, some children came up the road and stood by us, the littlest girl taking inventory of everything she could see. “Cow, cow, cow, white person, cow cow…”

After that I returned to the house and perched on my stool for my day of computer work. It seems relaxing after the last two months we’ve had here. The other group we used to live with (but no longer do) came last weekend to reclaim their internet, so I’m still trying to figure out this irritating little white thing we got. A few days ago I was reading my devotion book and saw the words “We lose interest…” and read it as “We lose internet…” and I thought to myself, “Oh my word! Oswald Chambers was prophetic! And he knows just how I feel!”

            Anyways, a few highlights from the last few weeks. When I returned after Christmas, my cousin came with me. I thought it might be weird to have my two worlds mixing, but it wasn’t. We had kind of a low-key week, aside from trying to break into my old house. I think it all would’ve worked out if I had been wearing chacos instead of flip-flops. Next time. The more she saw, the more I realized I wanted her to see…how do you show somebody your life in one week?

            On her last night here, we were planning to just hang out and stay up talking. But while I was in the shower, Becky came into my bedroom and started yelling to me about how there was cholera somewhere. Apparently Jon had seen something on the internet but hadn’t actually been in touch with anyone about it. So we spent the next 14 or so hours trying to find someone who was actually in Pestel and could give us a read on the situation.

            There was a fair amount of debate between the two of us about whether or not we should go. Pestel is 8-10 hours away, and the number of cholera cases reported seemed incredibly insignificant for that amount of travel (obviously I mean numbers-wise…I’m sure the puking people feel that it’s significant). But our caravan headed out of the city around 6pm that evening, right as the sun was setting.

            As I’d only slept for two hours the night before, I found it really difficult to stay awake on the ride out. Thony and I were in our pickup, stuffed to the gills with supplies which meant I couldn’t put my seat back. But I also felt bad that he would be awake by himself. Not bad enough, though, because I still tried sleeping. I assumed every uncomfortable position I could think of and didn’t manage to sleep much, though I was still in some sort of fog. For the last three hours or so the roads were incredibly bumpy and I felt like we were just driving around lost, heading for the edge of the world. Katrina, our long-term volunteer who was awake, was commenting on the roads and said she took comfort in the fact that she knew I was praying. But we finally arrived around 3am…I have no idea how…and I was curled up on a cot under my towel in the freezing cold supply depot (it also doubles as a church) by 4:15.

            The issues in Pestel stemmed from the fact that they are up in the hills and the nearest cholera treatment center (CTC) is a several hour walk. So the group we stayed with out there was setting up their own primitive CTCs to try and fill the gap. (We ended up in meetings with WHO/PAHO about this when we arrived back in Port-au-Prince.) The man we were working with, George, is absolutely wonderful but not medical, and he was trying to learn as much as he could. We visited the different sites each day, some by truck, one by foot, taking care of the patients and trying to do some teaching.

            On Saturday afternoon, the team (with the exception of Jon and I) headed back to Port-au-Prince. Some had to get to the airport, and some had to meet incoming volunteers. We worked late that night at a clinic where the staff seemed to be encouraging the patients to die. Luckily there were only three patients so it wasn’t a fiasco to get under control. To avoid the cold, I took to sleeping inside the truck.

            We continued visiting clinic sites and rounding on the patients the next day, giving instructions to the nurses. We were on our way to the last site when we saw a crowd gathered along the side of the road. There were 15-20 people carrying a woman on a bedframe. They said she was 3 months pregnant and had been bleeding for 23 hours, so they were carrying her to the hospital. It would have been another two hour walk to the hospital they were going to. As we’d been there the day before, we knew they didn’t have any of the equipment they would need to assess and treat this woman.

            I examined the patient to the best of my ability and started a line on her. Jon had gotten a hold of a doctor we knew, and I explained what I was finding over the phone. I had told Jon earlier that I wasn’t sure this woman was actually pregnant – it seemed like her uterus was too big for 3 months and not in quite the right place. He asked what I thought it was, and I responded by saying that my guess would be a fibroid tumor, though that wasn’t necessarily the most educated of guesses. I relayed all this to the doctor, and she assured me that a baby at 12 weeks would be about that size. She then suggested that we do a pelvic exam and told us how to do it over the phone. I volunteered Jon for that task, as the instructions “A healthy cervix should feel like the tip of your nose” just weren’t convincing me that I would do it correctly or find what I was supposed to be looking for. Regardless, she needed an ultrasound, and the closest hospital that could do that was 4 hours away in Les Cayes.

            Jon and I decided that we would take her back to the camp with us and monitor her overnight, then head home early in the morning, dropping the patient off at the hospital on the way. We were still waiting on a contact to confirm that they would take her. We went to sleep around 1am, with the intent of getting up at 3, having everything ready to go by 5.

            So around 7am, we were finally ready to go. The woman and her bedframe and mattress were strapped into our pickup (a shortbed, so we let the tailgate down and tie backboards, etc. in with rope). Her husband and I were sitting on the side of the truck bed with her, and I was holding her IV. It was a painful ride. It was also really cold – I’m not sure I’ve ever prayed for the sun to hurry up and warm me in Haiti, but I did that morning.

The roads were actually really scary, and I was glad that it had been dark on the way there. About an hour into this journey (which we were anticipating would take about 6 hours, as we had to drive slower with our patient who was in a lot of pain), we were following a big truck up this ridiculously steep hill of big rocks and dirt. The truck was kind of like a dump truck, stuffed full of people, animals, vegetables, and other random things. I suddenly had this thought that maybe we shouldn’t be following it so closely in case something happened or it started sliding back down the hill. About the time I thought that, Jon stopped driving. Within several seconds of that, the back fell off the truck, and a woman fell out on top of it, along with some bags. A goat, which was tied inside the truck, also fell out. For some reason, I didn’t care about the woman; all I could focus on was this goat, bouncing and twitching off the end of this truck while it was being hung. Meanwhile, the truck kept going up the hill a little further. (The woman did get up and start walking then. She was fine, I assume she was just very sore the next few days.) When we drove past the truck, the goat was inside and was shaking itself off. I guess it’s hard to hang an animal with a neck that strong.

            The rest of that portion of the trip was much less eventful, and we actually made it to the hospital in 3 hours. I’m not sure if I could’ve sat in that position holding an IV bag for any longer. We met our contact who got us in and got our patient taken care of, and she then took us back to her house so we could recharge all of our electronics. We stayed there for several hours, then as we were leaving discovered that the keys were locked in the truck. Thankfully, the replacement window in the back of the truck doesn’t always go up straight. So we managed to stick a piece of rebar in from the back right window and hit the unlock button on the driver’s side. We made it home about five hours later.

            We were greeted by the rest of our team, which again included the boss, as Adam was back from Afghanistan. After a bit, Jon and Adam went out to catch up. I showered for the first time in five days, talked to Becky for a bit, then got ready for bed. It was nearly 11pm, I was exhausted from the lack of sleep and the conditions we’d been in for the previous six days, and I was just about to crawl into bed when Becky came into my room saying we had a call. One of the security guys we know had called to let us know there was a bad accident on Delmas. Most of our equipment was still packed into the Nissan, which was out with Jon and Adam. Who weren’t answering their phones. The Defender was out of commission, and Thony had taken the other vehicle home. So there was nothing for us to do but wake Thony up and ask him to come get us. So much for a quick response time. But it did give us a few moments to gather up other supplies.

            We raced down the empty roads in the back of the car, hoping we didn’t have a lot of people to put into it. Our backboards would have to lay sideways to fit, and they were tilted upwards since they were laying on the folded down backseat. On our way, we called another paramedic we knew to see if he might meet us there and bring some equipment. We had no idea what the situation was. He said he’d think about it. Great, thanks. I’m a nurse and Becky’s a newly licensed EMT, so we were trying to figure out exactly how to operate when we got there, depending what we found. Someone with a bit more prehospital experience would have been fantastic, but nevermind, we’ll do it ourselves.

            As we neared the end of Delmas 33, a crowd suddenly appeared. Thony parked the car a bit away, and we took off running. I was definitely not expecting what we found. Becky and I had come up with our plan (mostly), so as we neared what I thought was the main scene, I started giving instructions and making observations out loud. “Okay, moto vs. truck, that one’s dead, dead, move on and…whoa, Becky…what just happened here?” We stood there together, for the briefest of moments, confused. Hundreds and hundreds of Haitians were standing around watching, and there was big Caterpillar equipment in the street. We began running again and found some other responders, journalists, and UN police to explain what happened. A dump truck full of rubble was coming from the opposite side of the intersection and lost its brakes when it went to make the left turn. It took out a whole bunch of motos stationed at the corner, as well as street food vendors before it rolled onto its side and crushed three cars. Two of the cars were still underneath the truck, feet from where we stood. There were bodies everywhere. I’ve never seen anything like it.

            Becky and Thony and I stood together trying to figure out what to do next. The report was 56 injured, 27 dead. The survivors had been loaded up and taken to various hospitals, the last vehicle was just leaving as we arrived. (Many have since died.) So we needed to figure out if any of the trapped people we could see were still alive. One woman had had a pulse, but it was irregular, and then she lost it. My back was to the accident as we were talking. I can’t remember at this point what I said, but Thony responded to me by saying, “Adam is here!” “What?” “Adam, he is here, he is on the truck!” Of course he is. I turned around and there he stood on top of the wrecked dump truck. Which was also on the edge of a three foot wall. Becky and I ran over and found Jon. That was the best part of the evening – our team was separated and unable to communicate and we still ended up together at the accident scene.

            We remained there for about five hours. Adam was heading up the extrication and moving of the vehicles, as well as directing the equipment. They lifted the dump truck up a bit so we could pull out the black car, which no longer resembled a car at all. I’ve now told this story enough times that I can manage to censor it a bit. When we stepped in to pull out the car, the smell of blood was unbelievable. We removed four people from underneath the truck and in the vehicles. Bystanders and cops and UN were crowding around taking pictures. Becky and I were yelling at people, she more effectively since she speaks four languages, and she told a cop, “These people’s family members probably don’t want pictures taken of their dead bodies.” He shrugged and said, “They’re not my family.”

            This all took place outside a TV studio, where Haiti’s President happened to end up observing. Afterwards, he met Adam and Jon and said he was impressed with DIRT’s work. During that time, Becky and I were off on the other side of the road treating a man who had cut his leg somehow and then just laid down in the middle of the road. He was quite drunk.

            The next afternoon we were sitting down to lunch together to try and catch up and have a meeting. I got an email from our Les Cayes hospital contact: “Your pt. had her sonogram yesterday; she has ovarian cysts and a large fibroid tumor. She is discharged with Iron, vit, antibiotics and will return in 30 days for surgery. Our visiting surgeon will do the surgery
Thanks guys.” I had little time to celebrate the fact that my diagnosis was correct (in a surprised, “I can’t believe I was right” kind of fashion), because shortly after that, we received a call. The same guy who had called us the night before was letting us know about a bus accident that happened on the road to Jacmel – about three hours away. Reports said dozens dead. We discussed a bit whether it was practical for us to drive out there, if things would be cleaned up by the time we arrived, what contacts we had to get more information. Finally we decided we should just go.

            When we neared the place where the accident would be, we saw an ambulance coming around the corner, so we flagged them down. Inside were three patients. Jon and I ended up assessing them and riding along, as the “ambulances” here don’t actually have trained medical staff on them. They basically serve as taxis. One man had a broken arm, another was just banged up and sore, and another had a possible head injury and broken ribs. As I was checking him again on the way to the hospital, I told Jon that he might possibly have a pneumothorax, but I wasn’t positive. When we got to the hospital, we found that both patients in the back with us had pneumos. The three patients were construction workers, driving a dump truck that flipped. So we hadn’t even found the bus accident.

            It was around this time that we began meeting with the Secretary of State for Public Security. I honestly don’t know exactly how this came about, but he seemed to like us a lot, and we got food every time we had a meeting with him. We were also donated a “mobile command unit” – a gigantic bus that has an exam room, all kinds of cabinets and refrigerators for meds, and sinks for hand washing. The combination of these two happenings meant that we became involved in the medical response for Haiti’s Carnival (Mardi Gras). It was being held in Les Cayes this year, the first time Carnival would not be held in Port-au-Prince.

            I’ll spare the details and give an overview – Becky and Katrina (who wasn’t even technically our volunteer) and I ended up trying to pull this all together by ourselves because everyone else ended up having to be in the States for various reasons. Even now as I write this, all I feel about Carnival is irritated and slightly bitter, so you all are in luck and you’re getting the shortened condensed version! We took 40 people with us. Adam, Jon, and Thony were working at the dispatch center (we basically ended up taking over the event, because literally no other group there who was supposed to be organizing it had a plan), and Becky and I were manning the bus and organizing our volunteer teams. The bus was parked close to the parade route with all of our equipment, so we couldn’t leave it unattended. That meant that she and I got to babysit constantly. We were working 3pm-3am each day, so until we wrapped things up and got to bed (we both slept on the ob/gyn exam table) it was 4:30 or 5, and we would start getting calls from the team or needing to organize things by 7 or 8 the next morning. How we did not all lose our minds still amazes me. The people who got to leave the bus got to shower (we found some missionaries – they knew the people I knew in Saint-Marc). Becky and I walked around in our uniforms (thick long pants, socks, boots, 20lb tactical vests) every day for five days and did not shower.

            However, out of all these shenanigans came good things for DIRT. We worked with the ministry of health after being handed responsibility for all communications, we treated patients, and we ended up being the security vehicle for the President’s float during the last night of the parade. The next night when we were broken down along the side of the road, some people pulled up and offered to tow us. But only because they’d seen us at Carnival and on TV and knew who we were. Otherwise we were just another broken down vehicle of white people. So we’ll see where this takes us! I’m the only one currently in the country, and we just got down a surprise team of 7 EMTs. I can’t even begin to comment on the situation.

            Sidenote: Maeve is in the country right now, she came back and brought with her a team from Ireland to work for three weeks. It has been wonderful to catch up with her, and I’ve slept over at their air conditioned accommodations a few times. It was a little cold for my taste, but nice to be together again. Last Sunday we had Ralphie with us. The little bugger is walking now, still squeals periodically throughout the night, and picks up people’s cell phones to say hello. He’s got some sort of hair-do that makes him look like a little caterpillar. And at one point Maeve and I put someone’s headlamp on him and laughed a lot.

            That evening as we were winding down, talking with some of Maeve’s girls and getting ready for bed, someone came to get the two of us. There had been an accident up the road for the hotel. The report was that a truck hit a moto, the moto went airborne, and then the truck kept driving. Maeve and I arrived in our dresses (mine was still blue, so I think it should count as uniform), two white women in the middle of the street at 8pm. Both patients were still conscious but seriously injured. Someone was supposed to be bringing us gloves, but they were taking too long. So I dashed back across the street, stopping traffic as I went, to meet the security guards at the gate of the hotel. “Julie?!” I asked them. They told me in Creole that she was at the accident. So back across the street I went. But she only had gloves for Maeve. Someone else from the hotel joined us to try and assist and he had gloves. I kept requesting them but he was busy trying to be creative with a splint for the girl’s leg…wrong kind of splint, but details, details. So I started helping Maeve wrap this guy’s arm with no gloves. Surprisingly enough, I managed to walk away with his blood only on my hands and not my dress. Two points. Some of the worst breaks I’ve ever seen – this guy, who also had a head injury, had multiple compound fractures in his left arm, from his hand all the way up to his elbow. His hand was open. Maeve said she could feel his arm crunching while we wrapped it. The girl had multiple compound fractures in her left femur. After they were put in a vehicle and the crowd had cleared away, we walked back over to the hotel. The management was thanking us profusely but also looked us up and down and said, “Um…please don’t go into the restaurant.”

            This is where I give myself a pep talk! Unicef loves me, we’re going to give shots together, I love giving shots (my whole HOUSE IS GREAT, I can do anything good, yeah, yeah…) and my parents are coming next weekend!