Wednesday, May 26, 2010

As Time Goes By

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I am back sitting on my couch in my living room watching a warm summer rain fall here in Wisconsin. It has been hot and humid this week, not unlike the weather in Haiti. Here, the rain will likely cool the air and decrease the humidity. In Haiti, it continues to be hot and humid, with more mosquitos. I took my last chloroquine tablet a few nights ago signaling that it is now just shy of four weeks since my return from Haiti. While I would say I have readjusted to life of luxury I truly have here in the US, I am forever changed and impacted by my first trip to Haiti. I look in my kitchen pantry and see more food stocked there than most people in Haiti could imagine, and is certainly needed by most people there. I have clean, potable water running through my pipes. I have air conditioning and electricity, and a solid roof over my head and walls around me. I sleep in a bed in my house, not on the ground in a tent. People have told me I'm inspirational and amazing for going and working there. I feel none of those things. I believe that God has given me the ability to learn and practice medicine and has provided abundantly for me to do so. This is simply a way I feel I can serve Him through serving the people of Haiti and of the island of Hispaniola. When I got the call from Terry and Jeannie on January 15th asking if I wanted to go to help, there was no other answer than "yes." There have been so many instances of seeing God's Grace to us and to Hopital Adventiste d'Haiti, and to the people there in the amazing circumstances that have occurred before and since the earthquake. For instance, our teams over the past two months have saved lives that would not have gotten the care they needed had the earthquake not occurred. I was part of a couple of teams caring for a man who suffered life threatening injuries from a car vs. pedestrian accident in early April (see my post entitled Joseph). When the earthquake happened, teams of medical personnel from around the world began mobilizing to provide months worth of relief to Haiti so that when Joseph was struck by a car, we were all there to care for him. Here's another amazing story from the blog of a team who was at HAH for two weeks in May:

"On the way home from the orphanage Dale, Leanna and I were dropped off at the General Public Hospital with Gregory our interpreter. It turned out that Charlie had gone there to round in the TB ward with our own ER Doc who is volunteering there. There was not enough room in the car for everyone, so Dale, Leanna, Lynn and Gregory stayed behind at the hospital to wait for the driver to come back for us. Now this hospital is huge, many buildings, some cracked, many tents of patients and it was dark. There is a gate, like at a military base and the guards only let certain people through, they are constantly arguing with people who want to get in and and are not allowed through.

We were dressed in our scrubs sitting on a wall and a guy comes up and asks me in English if I will come help his grandmother who is over there bleeding to death. I told him I would not go unless Gregory told me it was OK. So Gregory goes off for a few minutes and comes back and says, "Yes his grandmother is over there bleeding, there is a lot of blood and yes I think you can help her. There are a lot of people around her so we might get mobbed, we have to be careful. I say, "I do not want to get mobbed". He says, "No, it will be OK". So off we go with gallant Dale ready to protect. So we go down this dark corridor around this corner and sure enough there are lots of people standing in this tight walkway and an old woman is sitting on the wall with her foot up, blood running down the wall into a pool and all over the wall. I am putting on gloves and getting some towels out of my pack and then this commotion begins and we all have to stop what we are doing and back up against the wall it is so tight with people. Suddenly a man emerges from the throng carrying a writhing 2 year old boy who is naked and crying in pain. First thing you see is his gigantic scrotum the size of a large orange, tense as it can be sticking up above his body. This is an emergency. The father asks me if I can help him, can I fix it, is there anything I can do. They have been waiting to get into the hospital and they won't let them in. I tell him he has to get in, this kid needs to go to surgery right now. He says they will not let him in. So I tell him to go to the Hopital Adventiste, we have a surgeon on duty. Gregory explains and they take of running. I find out later they did not have a car. I finally get to the bleeding woman and show the grandson how to put pressure on the wound and hold it until she can be seen in the hospital. I knew that the bleeding had stopped and she would be fine. He was afraid and I told him to pray for the healing power of God to come through his hand, to have faith that she would be healed. He smiled and beamed at me and thanked me profusely for praying with him. We took off running as more people started pressing forward to get to me.

Our driver showed up soon and we went back to the hospital. Sure enough our boy arrived at the same time. By this time he was vomiting, screaming and his scrotum was bigger. I took him to the ER and there was no doctor to be found. I ran upstairs and woke up Mohammad. He came down and said immediately it was an incarcerated hernia. The surgery team fell into place and the boy was healed!!! They saved him, his bowel was saved and he is resting downstairs." (read more at traumaqueen1.blogspot.com)

Another instance is in Scott Nelson, MD. Scott is a pretty amazing man, and would deny it vehemently, but what he has been able to do at HAH is amazing. A number of years ago, Scott was coming out his residency and was wanting to serve in Nepal. However, when that opportunity didn't pan out, he happened to hear Terry (the surgeon with whom I work in the US and traveled to Haiti) speaking at their alma mater on the work Terry has done in the Domincan Republic. To make a long story short, Scott accompanied Terry on some of his surgical mission trips to the DR and ended up taking a position in the DR in Santo Domingo for 5 years. Fast forward 5 years to January 2010. Scott had planned to leave the DR that December, but stayed on to transition the CURE hospital to the new medical director. Then comes January 12, the day of the quake. Two days after the quake, Scott has assembled a team of four from his Santo Domingo hospital and has a friend with a small plane who agrees to fly them and some supplied to PAP. When they left Santo Domingo, they didn't even have clearance to land at the airport in PAP which at that point was being operated by US troops with radios standing on the ground as their control tower was destroyed. As they are circling the airstrip, their pilot radios down that he has a surgeon and medical team in his plane and wants to land. They are cleared for a three minute window in which to land, unload, and get the plane off the ground again. It happens. Scott and team are able to get transport to some facilities and to start the process of looking at where they can set up a tent OR and start treating the wounded. For the first six days, they worked around the clock doing amputations without anesthesia and watching people die from sepsis and multi-organ failure from crush syndrome. Scott writes, "Emotions were high and fatigue was intense. I worked day and night for 6 days until I felt like I was starting to loose my focus and was able to escape the hospital and get a full 6 hours of sleep." After a couple weeks into the relief effort, the team had set up some sleeping areas inside one of the hospitals. They arose in the mornings at 6am to start work. One morning, an aftershock hit at 6:15, crumbling the wall at the head of their sleeping bags. Had they slept in just 15 minutes, they would have all been dead.

See more of Scott's first few weeks in PAP including pictures here

After the initial Scott ended up setting up at HAH, a hospital that had never had an orthopedic service before. He began in a tent operating room (OR) and has now been able to run three functioning ORs. The largest company/maker of orthopedic trauma equipement and implants (plates, screws, nails, external fixators, etc) sent a charted jet to PAP with an estimated 10 million dollars of equipment, of which Scott estimates he has gotten about half and it is being used at HAH. Donations have come in the form of a used but excellent condition C-Arm fluroscopy unit and portable digital xray machine, items unheard of on the island in most hospitals and more than likely, the first C-Arm and portable digital xray machine to ever be used in Haiti. Because of Scott's work in the DR and connections through his training with world experts, he has brought world class orthopedic care to HAH, to Port Au Prince, and to the people of Haiti. His gifts of forward vision, abilities to organize and mobilize, knowledge and skill in medicine and orthopedics has saved lives, limbs, families, businesses, and hopefully souls as well.

Here is Scott and me operating on a limb deformity with the C-Arm unit in front of us (the black hefty garbage bag was sterilized and covered the top of the C-arm) and the monitor is seen in the far background.

Here is the same case with Terry, right, Scott, middle, and me, left.
Okay, last story for today. HAH is the closest hospital to the epicenter, a mere one mile. People have asked me why HAH was left undamaged by the quake. The simple answer is God's grace. Yesterday, Terry and I were talking in the OR here in the US about this amazing occurance. HAH (Hopital Adventiste d'Haiti) is an Adventist hospital, part of the international Adventist health system. When the hospital was being built, the lead administrator on the project was a man from southern California. With knowledge of PAP overlying one of the most active fault lines in the western hemisphere, the building must have been built with higher standards and codes than surrounding areas, leaving it less susceptible to quake damage and available for use when one of the worst humanitarian crises hit PAP. Amazing provisions by an amazing God.

As I flew out of PAP on April 29th, the hymn I chose to listen to on my iPod was This is My Father's World. I'll leave you with the words:

 This is my Father's world,
and to my listening ears
all nature sings, and round me rings
the music of the spheres.
This is my Father's world:
I rest me in the thought
of rocks and trees, of skies and seas;
his hand the wonders wrought.

This is my Father's world,
the birds their carols raise,
the morning light, the lily white,
declare their maker's praise.
This is my Father's world:
he shines in all that's fair;
in the rustling grass I hear him pass;
he speaks to me everywhere.

This is my Father's world.
O let me ne'er forget
that though the wrong seems oft so strong,
God is the ruler yet.
This is my Father's world:
the battle is not done-
Jesus who died shall be satisfied
and earth and heaven be one.

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