Karen Fields Studios

To Die is Gain (Part II in a series)

2012-01-04T12:40:00.002-06:00

(Click on the images for a larger view)

Pet Portraits

2011-11-01T11:05:00.001-05:00

October had some beautiful days, so I grabbed my 50mm prime lens and headed into the backyard with my dogs, Maddux and Wrigley Fields. Maddux is a natural in front of the camera, while Wrigley is a bit more shy, but here are some of my favorite shots of them.

To Die is Gain

2011-10-28T15:36:00.003-05:00

(Click on the photos for the larger size:)

I took these photos a number of months ago, but hadn't done any processing until this week. While I loved the color shots, the B&W were more poignant. I title this series To Die is Gain, based on the writings of the Apostle Paul who wrote in Philippians 1:21 that "to live is Christ and to die is gain." These photographs are an attempt at depicting the beauty of being united with Christ through death (Romans 6) and the truth that to die is gain.

Published!

2011-09-06T09:47:00.001-05:00

This year, I've been published twice. Here is the first of two projects of which I've been a part: photography for a book cover as well as input on the design. Here is a sample mock-up that I worked on and the link to the final product. It was a lot of fun to be a part of the process and see my work published.

https://www.createspace.com/3589716

Find Me on Facebook!

2011-01-16T20:00:00.003-06:00

I haven't done much with my photography on my blog lately, but have decided to work on getting more photos up here. Please join me on Facebook and follow me there as well!

Orthopedic Ministries of the Caribbean: Over the Next Few Days

2011-01-11T08:46:00.001-06:00

Orthopedic Ministries of the Caribbean: Over the Next Few Days: written by Karen Fields

Over the next few days, you will be bombarded with images from the earthquake and destruction that changed the lives of millions of Haitian forever. Over the next few days, your eyes will see things that will make you want to look away. Over the next few days, you'll hear more news of destruction, of tent cities with people whose homes are not yet rebuilt.

It is easy to turn away from the TV and videos, to turn the page in the newspaper, to change the radio station, but over the next few days, I hope you'll let that tear roll down your cheek for the pain and suffering in Haiti. It rolled down mine today, 364 days after that treacherous day in January 2010.

It often feels hopeless, what can one person do? What can one dollar do? What can one prayer do? A lot. When I was in Haiti in April of 2010 just three short months after the quake, one dollar bought food for a family, one person comforted a crying child or brought a smile to his face, one prayer saved a life. Twenty dollars paid a week's salary for a man to provide for his family. Twenty people saved limbs, cleaned wounds, taught people to walk again, gave new limbs to amputees, served food to hundreds of people daily. Twenty prayers, we pray, saved souls.

I have no doubt that you are bombarded with organizations constantly asking for money, and in these financial times, every dollar counts for many, many people, in our own communities, in our own country. But please don't forget the people of Haiti, who are a grateful people, loving and caring, and looking for hope for tomorrow. When you think of Haiti, don't think of all the things that haven't been done yet to rebuild. Think of the things that are being done, and that bring that oasis of hope to the people there, an oasis of hope and healing to the tired and weary.

Here is just one of many stories of the good work being done at Hopital Adventiste d'Haiti. Yes, we need help funding care for indigent patients, and for building improvements, and we still need volunteers. As you watch, consider what one dollar, one person, one prayer can do in the life of one person. If you feel led, please Join Us.

Out of the Rubble from Loma Linda University on Vimeo.

It Is Good To Feel Hungry

2010-07-09T08:51:00.006-05:00

One of my college roommates and teammates leaves today for Haiti, for a city called Jacmel, about 25 miles south of Port au Prince. She is going with a team to rebuild some homes, visit children in an orphanage, and share the Gospel. As I think of Haiti and what she is about to witness, the work she is about to do, the love she can share, and the work she and her team can do, I am in tears. Not just a small tear trickling out of my eye, but many, many tears. There are things about Haiti I do not miss-- the heat and humidity and drenching my scrubs multiple times a day (after a week of oppressive heat and humidity in WI, how did I ever survive in Haiti?), the dirt and dust everywhere, the lack of fresh running water... but there are so many things I do miss and feel as though a part of me was left behind in Haiti and lives and breathes to hear how the people and patients are doing there. Yesterday I was in surgery all day, and we had a couple of long cases. I lost track of time and didn't realize it was as late as it was already, and on a break between cases, did not think to eat lunch. As I scrubbed my arms and hands and donned the gown and gloves, I came to the conclusion that it is good for me to feel hunger now and then and to not be able to immediately satisfy it with a sack lunch, a trip to my pantry (or even the luxurious refrigerator), or to a drivethru restaurant. I felt hunger, albeit minor hunger pangs. And as I was hungry, I thought of all those patients and hospital staff and translators who are lucky to get one meal a day. One meal. They work on empty, hungry stomachs daily. They go to sleep hungry and wake up hungry. They live hungry.

This picture was taken by a NY Times staff member reporting on orphans in PAP (Credit: Ruth Fremson/The New York Times). Yes, I cried for this baby, too, and her twin sister, all the ones like her who are malnourished and struggling to survive in Haiti and who have nothing. I cried for the husbands mourning the awful deaths of their wives, the mothers mourning their babies being crushed, the children suffering night terrors from PTSD after losing their parents and brothers and sisters. And yet, they go on. They struggle to find work to buy food and care for their remaning family. They work to rebuild their homes and lives, and to find medical care for their loved ones.

³⁷"Then the righteous will answer him, 'Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? ³⁸When did we see you a stranger and invite you in, or needing clothes and clothe you? ³⁹When did we see you sick or in prison and go to visit you?'

⁴⁰"The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.' Matthew 25: 37-40

So, go, Amanda. Go to Haiti and make a difference; build a house for even one family, clothe a woman, feed and play with a child, bring bandages and medical supplies, make a disciple. My thoughts, prayers, and heart are all with you as you go. Be changed and make a change, even if it's just one person-- it can be for eternity.

For more pictures and to read about the orphans in just one orphanage there, go to slideshow and article.

As Time Goes By

2010-05-26T15:51:00.020-05:00

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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.

2010-05-26T15:46:00.002-05:00

This a video filmed by a team that was in Haiti in mid-May. It is a minute and thirty seven seconds of video through the streets of Port Au Prince. It is the same sights I saw with my own eyes now almost a month after my return. It's worth the time to watch.

2010-05-24T10:41:00.003-05:00

Want to read more about the happenings in Haiti and at HAH? Check out the blog Haitibones.org This is a blog of the trips of an Orthopedic attending from LLU but he also posts blogs, trip updates, pictures, and videos from other organizations, groups, and news outlets on the relief effort in Haiti.

Hopefully I'll be posting some more stories about our trip later. If you want to subscribe to my blog, there is a new subscription feature at the top of the right column. Just enter your email address and click submit. You'll be sent an email to confirm your subscription.

How To Volunteer in Haiti

2010-05-18T19:35:00.004-05:00

I've had some readers inquire about opportunities to travel to Haiti, so tonight, I'm posting some information on the groups who are sending volunteers to Hopital Adventiste d'Haiti (HAH) in Carrefour, Haiti. I traveled with the Global Health Institute through Loma Linda University (LLU) in California. Also, groups of volunteers came through Cure International. Both groups coordinate transportation to and from the airport and housing arrangements. While the Orthopedic need is great, so are the needs for OB/Gyn with a very busy OB and NICU service, Emergency, General Surgery, Plastic surgery, Hospitalists, Infectious Disease and wound care, Pediatrics. PAs and NPs will definitely be put to good use. Even spouses with limited or no medical skills are welcome as there are huge needs for organization of central supply, pharmacy, meal distribution, and maintenance including plumbing and electrical amongst other things. While any single person cannot make a dent in the needs, together, great things are being accomplished and lives are being saved. The needs are great and will be ongoing for months and years to come, so consider giving a week of your time to the people of Haiti. It will impact you for life.

CURE International: Their main website is www.cureinternational.org However, if you have interest in volunteering at HAH in Haiti, contact Heather Hunter at hhunter@cureinternational.org

Since I personally did not travel with CURE, I do not have a lot of details about their arrangements. CURE arranged volunteer housing either in a nearby hotel or at the hospital and all transportation. LLU did provide volunteers with a travel insurance policy, housing at the hospital, transportation, and details for planning your travel and packing lists, vaccinations, etc.

LLU Global health institute:

http://www.lluglobal.com/site/c.msKRL6PNLrF/b.5767965/k.B2B8/Haiti.htm

AHI/LLU | Hopital Adventiste d'Haiti
Port-au-Prince, Haiti
Haiti Response

Loma Linda University (LLU) and our partners are working to support the Hopital Adventiste d'Haiti in Port-au-Prince. LLU is not alone in these efforts. Together we are pooling our resources and working closely with Park Ridge Adventist Hospital/AHS, Florida Hospital, CURE International, Life Enhancement Association for People (LEAP), and Adventist Development and Relief Agency (ADRA).

* The need for additional medical teams continues, but as we move forward the composition of these teams will change to reflect current needs at the hospital. Keep in mind the needs change almost daily.
* As of April 20, 2010, the "Dream Team" includes:
o 1-2 Orthopaedic Surgeons
o 1 General Surgeon
o 1-2 Anesthesiologists (MDs and CRNAs)
o 1-2 ER Physicians
o 1-2 Pediatricians
o 4-8 RNs of whom 2-4 with OR and ER experience
o 1-2 Physical Therapists and/or Occupational Therapists
o 2 Pharmacists
o 2+ Central Supply Personnel
o 2 Utilities and Maintenance Personnel
* We also welcome applications from OB-GYNs, PAs,NPs and other health care professionals. We would like to keep the number of our teams to about 25-30 people on any given week.
* The teams will work at the Adventist Hospital.
* The current strategy is to send in teams for at least a 9 day cycle (Teams arrive on Friday and leave on Sunday.) A longer term of service is preferred.
* LLU will maintain and manage the schedule of the various teams and provide them with information about their trip and tips about what to bring, etc.

The Children of HAH

2010-05-17T15:59:00.044-05:00

Today, I thought I'd post some pictures of children. I actually had very little time to interact with the people and talk to them, which made me feel somewhat disconnected personally at times. We were so busy with clinic and operating (where patients are generally sleeping) that time to get to know some of the Haitian people was slim. One afternoon, though, I got a reprieve and got to go outside in the front of the hospital steps to the tent city on the hospital grounds. There was a large group of kids playing out front jumping rope and a lot of the adults had gathered around to watch. A group of volunteers who was waiting for their tap tap joined in to play as well. I got to talk to a couple kids that day, learn some names, give away some candy, and get lots of smiles, most of which I didn't capture in pixels. Here they are:

This is an 12 year old girl who had significant contractures of her knees. She underwent a procedure to lengthen the tendons so that she could eventually get her knees straight and be able to walk upright someday. She had casts on both her legs that we changed out one of the first few days I was there and she and her mom got to go home. These pictures were taken the morning she went home. She was a sweet girl and I loved the smiles and interaction between her and her mother.

One of the things you may notice is that children appear much younger than their stated age, often so much that we questioned if their recorded ages were correct! This girl was 12, but she really looked more like 8 or 9 by our US standard.

Here is one of the physical therapists working to help her walk with her walker so she could go home. Picture courtesy of Kaye Whitney, PT.

Kaye was pretty amazing. She rounded with the Ortho team every morning at 6 to keep all the day's therapists (who would arrive later in the morning) up to speed, she worked in the stock room sorting supplies, worked with a team to clean the kichen top to bottom one night after a full day of work, and also volunteered to pass out meals to the entire hospital during her last week, a job she said was so difficult to do because she just didn't have enough for everyone and had to turn away hungry family members.

Here is one of the new lives born during our time at HAH. She was born by emergency C-section and is a beautiful little girl. All the c-section babies I saw were girls. Average birth weights for the babies in Haiti are only about 5 or so pounds, a stark reminder of the malnutrition rampant in the country.

There are some of the kids outside the hospital living in tents on the grounds. This boy was playing with a little guy in a wheelchair and was pretty skeptical of having his picture taken, but sure liked popping the bubbles some of the volunteers were blowing at them.

Fun with bubbles

This little guy, Joseph, was one of our Ortho patients who had some infected wounds on his right leg. I didn't see him but once or twice, but our team took care of his wounds. He was a very sad boy and rarely smiled or interacted much, until the bubbles came out. Fred and Dianne who saw him regularly couldn't believe the smiles and joy he had playing that day.

This is Fred Liss, MD and his wife Dianne who brought bubbles with them to share with the kids. They were a hit! While we were playing, I saw a teenage boy sitting by himself just watching the interactions and the attention all the little kids were getting. You can barely see him sitting behind the lady in the wheelchair in the white dress. He looked pretty lonely to me.

I went over and talked to him through my interpreter friend, Jeanty, who had accompanied me outside. He told me that he had broken his leg when a wall fell on him during the earthquake. He had been showering when the quake hit and was with him mom in the house. He was able to get outside before his leg was injured. We talked a little bit more, and Jeanty told me Elizay asked for me the next day, but unfortunately, I didn't have a break again to go outside before I left HAH. I was very sad that I didn't get to see him again and talk to him one more time.

These are some of the girls jumping rope with some of the volunteers.

This young woman amazed me and demonstrated the resilience of the Haitian people after the quake. If you look carefully, you'll see she has an amputation of her left leg. You can just make out the ACE bandage around the end of her stump. Talk about amazing to see her jumping rope and having a good time with all the kids. I was flabbergasted and so moved by her. It still can bring tears to my eyes to see the pictures and remember her jumping rope.

This boy has an external fixator on his right leg and was outside watching all the activity from his wheelchair. He kept making signs at me, so I took his picture. He seemed upset by that until he got his sisters together with him and some artwork he had made and had me take a picture of them all together. Then he was happy!

She was one of the ones blowing bubbles and just looked so beautiful to me in her white lace dress, braided hair and smile. I dont' know her name.

This girl followed us around a lot. I forget her name right now, but she wrote it for me and I have the paper somewhere. She would join us for morning report on the steps and ask for our pens and notebooks to draw pictures and teach us words in Creole. She was the girl I met at the helipad our first Monday at HAH (see previous post and picture).

This young man was outside during report one morning. He is just one of the many patients living in a tent on the hospital grounds.

More kids at morning report hoping to make friends with volunteers. One day, they all wanted name tags like we wore, so someone took paper medical tape and made them all name tags. They were all really proud to wear them.

The boy closest to me (obscured some by the girl with the pink shirt) is Kervens. We were buddies my last week and would say hi and high five in the hospital halls. He remembered my name because I told him how close it sounded to his name, so we were buddies after that.

This boy has a condition called Arthrogyposis, a rare condition in which multiple joints suffer contractures. He came in for casting each Wednesday with him mother. He was a tough one to get to smile, but we got lucky a few times. He had very limited knee extension as well as clubfeet. With getting him help early in life, he has a chance to walk somewhat normally someday and may be spared the pain we saw in adults who never got the treatment they needed as babies and children. While Arthrogryposis is a rare condition, it is more common in Haiti and the DR as I have seen a number of children and adult patients with it in my few trips to the island.

This is Dayana. She was treated for a deformity of her right leg and had a Taylor Spatial Frame (TSF) on her tibia. A TSF is an amazing device, and Scott is probably one of the most experienced surgeon in the world in this technique. I had the privelege of assisting in a couple of TSF operations with him, which is more than most Orthopedic residents will see in their lifetime. Anyway, it's bascially an Ilazarov type external fixator "on steroids." It is used to correct deformities of long bones over a period of time. It has two rings that go around the leg, and then six adjustable struts that bridge between the two rings. The surgeon applies it very carefully to get the alignment of the rings right, and then takes some Xrays to make measurements on which the correction will be based. These measurements then get put into a computer program on a webpage, and it spits out a program of daily adjustments that the patient makes on their own at home over a number of subsequent weeks or months, depending on how severe the deformity is. This allows the adjustment to be made in very small increments and done slowly so there is less pain involved and the surgery is much less invasive than one where the the bones are cut to be realigned and then soft tissues have to be released and lengthened to correct the deformity.

Dayana was at the hospital almost the entire time we were there, going home on the Tuesday of our last week. Her surgery had been a couple weeks prior to our arrival, but she didn't have family who could help her with her adjustments to her TSF at home (see explanation below). Finally, our therapists were able to train an aunt how to do them so she could go home. Then, the family said they needed a tent, so our nurse coordinator went through the process to get her family a tent so they'd have some place to live. During her entire stay in the hospital, she had a cot in the hallway, never having a room to herself. During the days, I would see her in a wheelchair sitting at the end of the hall upstairs where there were some windows that overlooked the main hall below. From there she could watch the people come and go and have some way to pass the long days at the hospital by herself. I would often pass her sitting in her chair and slip her peppermints or butterscotch candies, and on the special days I had M&M packets in my bag, she was the glad recipient of some chocolate. She seemed pretty lonely, so I made a point to say Bonjour to her, to get her to smile and let her know she wasn't forgotten.

Wow, this little girl has a story!

Her story is told by Terry Dietrich (in quotations):

"She was brought from about 6 hours away by a neighbor. She has the most unbelievable case of bilateral Blount’s Disease I have ever seen.... "

Blount's disease is a condition affecting children where the tibia bows outwards at the knee. Here are her Xrays. Her right leg is pretty bad, but her left is much worse!

Basically, for those non-medical people, these xrays show horrible bowing of her tibia at her knee joint. Here's a normal knee to show the difference:
"....The neighbor speaks perfect English. He is married to a woman from Kansas. They live and work mainly in Kansas but come down periodically to their home here. When I told him that we could do an operation to straighten her legs he got tears in his eyes. The Taylor Spatial Frame will be perfect for her. I want to do her surgery with Scott."

It was amazing to see how all the pieces of her puzzle were put together to get her to HAH where she can have life changing surgery. She was neighbors with an American who cared for her and her family and had the means to get her to a center where the surgery could be performed. Because of the earthquake, Scott brought world class orthopedic care to Port Au Prince and will be able to operate on her legs with TSFs. Her surgeon is one of the most experienced TSF surgeons in the world. It's amazing to witness how God works all the pieces together to change this girl's life.

On a side note: I see Pierre and Stacey have found my blog now! It's great to have you guys in touch. Please say hi to Constantine, Gretchen, Mary, and Freeborn, too! I am not sure where my email addresses for you all are, so please drop me a line so we can exchange pictures and keep in touch.

More pictures: click on the pictures to enlarge

2010-05-13T11:10:00.015-05:00

One of our anesthesiologists, Constantine, performing a spinal.

CRNAs Mary and Freeborn

Constantine at work

I&D of an infected wound and application of wound vac on Quito (From L-R Jan, Sharon, and Terry)

VAC placement around a Taylor Spatial Frame, thanks to Jan, our wound care RN specialist who helped us learn some advanced VAC techniques and wound care.

Rebuilding in town

Tough guy-- all the kids want to pose like tough guys and show hand signs. I saw this in the DR as well. It took a bit to get them to smile but showing them their picture on the camera screen usually helps get some smiles from kids and parents a like.

A view of the mountainside from our veranda sleeping quarters

A view of the back grounds of the hospital and laundry facilities. You can see the blue towels from surgery hanging out to dry in the lower right corner.

This was a sweet boy we met in clinic who was ready to learn to walk without his crutches.

One of our physical therapists during week one, Kaye, who worked some miracles.

This was the sterile processing room before reorganization. You can just make out the steel sink along the wall on the right that was used for cleaning the dirty instruments. So, the dirty, pussy, bloody instruments would be brought in and set down to be cleaned right next to the clean instruments waiting to be wrapped for sterilization. This sink was moved to it's own dirty processing room and new shelving set up for better organization.

Supplies to sort

Liz and Sylvia from LLU spending long hours sorting instruments and supplies.

Terry seeing a patient in clinic on our first morning. She had fallen and broken her wrist just that morning and we were able to reduce the fracture and splint her in our "after church" clinic.

Just some pictures today

2010-05-12T14:21:00.022-05:00

Since I'm slowly recovering from my Haitian Parasite crash diet (effective though not recommended), I am up for posting some photos today and will probably edit my post with more detailed descriptions tomorrow. Most of the scenes are taken from the bus on the way to the hospital. Clicking on the photo will enlarge it.

Here is the exit from baggage claim at the airport. All the men in gray uniforms are porters ready to help with your bags and will require a tip even for just touching your bag. Cure Intl and HAH arranged all our transportation arranged and took care of our bags and tipping. We just had to keep saying, "No, no!"

Here is the gate to which you exit from the airport. Once beyond the gate, it's "every man for himself" so we were cautioned to remain inside the gates until we met our transportation. Thankfully, he was there waiting for us with the bus.

Packing all the stuff in the bus. Thankfully, no one had to ride on top (just kidding!).

Oncoming traffic on the narrow crowded streets.

Some common sites along the way-- note the spray painted cries for help and good bye messages to loved ones.

The following photos were taken by Hasan Syed, MD of LLU who came down during our time at HAH. He got some better shots from the van he was transported in than I could from the overflowing bus.

Joseph

2010-05-10T18:36:00.008-05:00

This is a picture of the man to whom I left my powerbars to upon departure. I got word yesterday that he is turning the corner in his recovery. I was sent this picture by one of the physicians still in Haiti who has been continuing to work with Joseph and his multiple injuries. He was the victim of a car vs. pedestrian accident in early April and underwent less than optimal care by the local hospital there. He was transferred to HAH for more definitive Orthopedic care and, honestly, needed to be in an ICU. We battled a raging infection in his lower left leg and had to consider amputation as a viable option in order to save his life. However, with a lot of hard work on the part of many people, including Joseph and his wife, he is sitting up in a wheelchair and his wounds and fractures are healing. He looks to have lost weight, but he looks healthy and is smiling.

This was our team on morning rounds one on Tuesday the 27th discussing with him and his wife the possibility of having to amputate. We were able to pray over him together for his healing that morning which brought tears to my eyes. His wounds and complications from his injuries were starting to get complicated and we weren't sure we could continue to work to save his leg with the resources we had available for his care. Here is a picture of his leg and the massive tissue deficits from all the debridements we had to do to control the infection.

He lost most of the musculature and tendons of his anterior compartment, which will make ambulating difficult as he won't be able to pick up his foot normally, but he may very well keep his leg and just need a brace to support his foot.

In addition, he began developing multiple pressure sores from being bed bound. We were able to get him into a hospital bed from the cot he'd been on for a couple weeks and our therapists started to work with him and his wife on repositioning to help, but things were progressing from bad to worse. We had to do daily washouts and debridements of his leg to battle the infection and necrotic tissue, and we were battling his hemoglobin which kept falling despite our attempts to get blood for him. If the hospital had had the equipment to process blood, I'm sure a number of us would have donated as my blood type was a match for the major antigens at least. Obtaining blood was another hurdle as was getting accurate hemoglobin counts. He had been hovering in the 6.2-6.4 range for a few days. At one point, Joseph's reported hemoglobin was down to 4.5. Since he was hemodynamically stable, we had to wonder how accurate the result really was, but nonetheless, he was losing blood and we could not get enough packed red blood cells to transfuse him up to a stable number.

I was educated on the process for getting blood. First, a nurse or lab tech will draw a tube of blood for a "type and cross" so his blood can be matched to donated blood. Next, the family takes the tube of blood and the prescription for blood to the Red Cross down town. For every unit of blood, two family members must donate a unit of whole blood. Therefore, if we wanted two units, Joseph's family needed to take four people to donate blood. Then, they would be given a unit of type specific blood and the family's donation would go into the general bank to be matched to someone else. Also, blood can only be obtained during the day, so there was no way to get blood after dusk. Even with the prescription indicating the low blood count and need for more than one unit of RBCs, Joseph's wife returned with one unit of blood and the promise that if she returned again the next day, she'd be given another unit of blood then.

It is just another example of the uphill battle these people face in getting healthcare. Howeve,r had it not been for the earthquake in January, there would not have been any resources to save this man's life. Instead, because of the relief effort, surgeons and skilled medical personnel, the Red Cross, the orthopedic and wound care equipment were all nearby when Joseph suffered a life threatening accident. Thankfully, it appears he is starting to improve and while his life will be forever different because of his injuries, he will live, and it looks like he'll also keep his leg.

This was going to be a quick post of a picture, but I guess the story was waiting for me to tell it. I have actually been fairly sick since my return from Haiti, and so have not been feeling well enough to post pictures and write more, but I am starting to turn the corner myself and get back to processing my pictures and my trip. Look for more posts this week as I have energy.

Aftershocks

2010-05-02T14:12:00.001-05:00

There were no aftershocks felt while we were in Haiti, but I will be feeling the aftershocks of this trip for sometime. In my dreams, I see children with amputations selling goods from baskets on their heads, babies with clubfeet needing casting, cases in the HAH ORs and doing battle with the flies to prevent them from landing on our patients' open wounds. When I'm awake, I still hear the cries of the people experiencing PTSD (post traumatic stress disorder) including our little 11 year old girl, Mirlanda, who lost her entire family in the quake; I hear the cries of a mother, Denise, who awoke from anesthesia suffering flashbacks of losing her baby. How do you even begin to comfort someone who has lost so much? I see Joseph battling to keep his leg and prevent an amputation, and Kettely, sick from necrotizing fasciitis, struggling to save what remains of her leg after an infection of the stump of her above knee amputation. There are countless men, women, and children struggling to rebuild their lives and families, with stories of homes destroyed, businesses ruined, lives lost. Last Friday, I lost a friend to cancer. In my grief, I collapsed in gut wrenching tears. Yet at the same time, I thought of the images of people running through the streets in the days after the quake inconsolable from the loss of their children, parents, their entire family. I felt deep pain and anguish from one friend passing and could not even begin to imagine what these people have lived through. Yet there is still a spirit in them of determination and to push ahead and continue. I was amazed when we drove through town and the couple short walks we took beyond the hospital gates to see all the road side stands people had set up trying to sell their wares to passersby. Families have large steel bowls, probably close to 2 feet in diameter, that they place over open flames to cook their meals with the smells of delicious foods wafting through the open car windows. Each morning during our morning report and worship, we saw children in neatly pressed uniforms being led hand in hand by parents taking them to school for the day. We saw bright eyes and big smiles and loving and tender moments between family members caring for their loved ones in the hospital. Kettely's daughter wiping her mother's forehead with a damp cloth to quell the heat from her fever, a mother rushing to put clean sheets on her son's cot after he returned from surgery, families bringing in meals for their loved ones, mothers emptying bedpans for their children. The list goes on.

I left Haiti Thursday morning, a day before scheduled so that I could be at the memorial service on Friday afternoon for my friend, Gail. I returned home to WI Thursday night and got to my house about 10:30, having left the hospital at 6 that morning. It was a long day of travel and full of emotions-- emotions for leaving behind Haiti and the people there, emotions for knowing that Gail is gone and the pain of burying a friend, a mother, a wife, a sister. Our plane from Port Au Prince was full of various relief workers-- I sat next to Carlos, a biomedical technician from Cape Coral volunteering at the Medishare field hospital, and Stan from US AID working to build infrastructure in the country. I knew that most everyone on that plane had seen things like I had and had been there caring for the Haitian people and for the country. Once in Miami, though, we all went our separate ways, and my next flights were back to a random mix of US citizens and visitors returning from vacations or business trips. TVs in the airports showed preview coverage of the Kentucky Derby. Flying into Miami showed subdivision after subdivision with red roofs and blue sparkling pools, well groomed golf courses, green lawns and flourishing trees. Streets in repair and free of free flowing water. When we flew out of Port Au Prince, I saw blue tarps over tent cities and homes and buildings destroyed. From the plane as we were waiting to leave Miami, the tears flowed despite my feeble attempts to keep them at bay so as to not draw attention to myself from those next to me in my row. I had, just that morning, said good-bye to a new friend who sleeps a few hours a night in a tent on the campus of HAH. Last week, a departing aid worker gave him a sleeping bag so now he has a bit of cushion between him and the ground. I gave him some money and some of my remaining snacks so he might eat more than once a day. I left all my meal replacement bars to Joseph, our patient fighting for life and limb as he suffers from malnutrition amongst other battles. I could not keep in the tears of seeing our wealth and comparing it to the world I had just left. I got to leave. I do not know if I will ever see those people again. Yet how can I not return? As hard as the trip was, coming back to the US might be even harder. In Chicago, I had a longer layover, and got to sit down with a large twist cone of TCBY frozen yogurt. After the long hot days and sweaty nights, I missed having cold drinks and ice cream in the evening, and when I saw the TCBY stand in O'Hare, I had to stop. As I sat with my cone in the sunlight, enjoying the warm rays through the window of the terminal, I saw a woman eating a "to-go" meal of out a styrofoam container. I immediately flashed back to the lunchtime meal distributions at HAH which were served in those same divided styrofoam containers, with a large portion of rice and beans, a small serving of a vegetable or salad, and some sort of protein. I think in my two weeks there, I ate those meals twice. A woman from Loma Linda with whom I worked a lot during the two weeks would save me a meal somedays when there were enough for the "Americans" to get meals. Often I wouldn't get to the breakroom anywhere near the time of food delivery. One night, she had left a meal for me with my name on it, but instead of eating it, I heated it back up in the microwave and took it down to Joseph who had not had a meal in two days. He was often "Pa mange, pa bwe" (Creole for no food, no drink or NPO for the medical people amongst my readers) during the mid-day meal distributions while awaiting surgery, so he would not get a meal. His family had little to bring him and he would go days without eating. So we started trying to make sure Joseph got to eat at least one good meal a day. He was the recipient of much of our left over food upon departure. I left my sheets, blanket, and Green Bay Packers towel in the care of Jeannie to have washed and given to a patient or interpreter in need.

As I walked through the terminals of the airports, I saw all the luxury shops in which one could buy expensive soaps, jewelry, sunglasses, etc. I thought of my friend Jeanty, the volunteer interpreter from Cap Haitien who had come to HAH to help when he heard and felt the quake. He told me Thursday morning that he wanted to come to the US someday. What shock he would have had to see the extravagances in the airport! I said good bye to him Thursday morning not far from the tent he sleeps in. He showers in the hospital and gets one meal a day from the hospital cooks. He is very thin and is hoping to make some money to send home to his mom and 5 brothers and sisters to help feed them up in Cap Haitien. The PAP airport is a sharp contrast. There is one entrance and one metal detector and xray machine through which everyone passes. Then, one line to get to the desk to check in and check baggage. While waiting to get through the first metal detector, the line extends outside under a canvas awning where locals come up and down the line saying, "Missus" or "Mister, buy my painting?" "Like my painting?" "want a bracelet?" "jewelry?" One even knew the word "Souvenir" I bought a wooden jar and hoped that it would help his family eat this week. Inside the airport, once we got through emigration, we went through another xray machine and metal detector and then proceeded to the gate. Along the way there was one tiny shop with a few books and Haitian artwork on display with carved wooden boxes, metalwork, jewelry. Before the stairs, there was one stand selling coffee beans. That was it-- two small stands inside and street vendors outside. The control tower was a box of windows high on a truck lift. The baggage claim was a makeshift conveyor belt that sometimes worked in an old airplane hangar with fans and makeshift gates for immigration and customs. It is apparent that the quake has damaged the airport and they are making do.

This weekend, I have not felt well, struggling with a bit of a GI bug and exhaustion. I have spent my weekend on the couch in my living room watching the wind blow through the trees and listening to the birds. I am hardly interested in TV though I did watch the last inning of the Cubs game yesterday. I was glad to see a win, but would I have really cared if they had lost? My friend, Sylvia, from LLU wrote to me Friday night telling me in her email of her travel which summed up my experiences on Thursday as well. She writes,

"When I arrived at customs [in Miami] the officer asked me if I had accomplished my goals in Haiti. I told him "Oh no, I never could have." Then the second officer who checked my passport said, "Welcome Home." and I choked up and couldn't even reply. It just seemed so surreal."

Yes, it just seems so surreal.

Parting is such sweet sorrow...

2010-04-28T21:01:00.002-05:00

Today marks the final day here at HAH. I decided Monday to come home a day early so that I could get home in time for my friend's memorial service on Friday. Since it was just a difference of a day and we had some good teams come in this week who can help with the work load, it was workable so I could leave and get home by Friday. If all flights go well, I'll be able to make it home late tomorrow night.

Leaving will be a mixed bag of emotions. In once sense I am very relieved to be heading home as we have worked day in and day out since arrival, with our easiest days being the first two we were here. We have continued to work 12 hour days or more with little time for breaks in the days. We did get to the hotel again last night for a short dip in the pool and some dinner-- I had the Italian spaghetti in honor of our departing friends, the Italian plastic surgery team. I decided to forgo the ominous dish of hotdog spaghetti. Yikes! It was a nice night to swim and enjoy being outside but not dripping in sweat.

We continue to work hard to save limbs and even a few lives from infection and blood loss. Things here are difficult for even easy tasks and so after two weeks, I am definitely in need of a break and just some time to not have to think about the long list of things we have to do to keep people alive and well. I usually don't sleep well on airplanes, but tomorrow might not be a problem.

Well, I am really exhausted and words are not coming to mind, so I am going to sign off for tonight. I actually plan to continue to write and post pictures over the weekend and possibly into the next weeks as I recall our experiences here. It will be really hard to say goodbye to the people, to our team, to our patients and to the hospital, though the respite is much needed. I'll let you know when I'm home....

Monday, Monday.... Part Deux

2010-04-26T22:22:00.002-05:00

Warning.... this is entirely unedited as it's way past my bedtime! I hope it makes even a little sense.

Today was our second Monday of our trip. It came after a very busy weekend with very little rest. As my exhaustion increases, my brainpower for blogging decreases, and I have found myself at the point of having to choose sleep versus updates. Sleep has won out almost every time! I actually took out my camera again to day and took some pictures again, but posting them will have to wait a while. I'll probably not go through them until I'm home.

Things here are continuing to be busy. Saturday we worked till, well, now I can't remember Saturday. I'm sure we worked later than we wanted to. Wow, I really can't remember Saturday now much at all. Sunday we started rounds at 6 and then started cases soon there after. We had on three easier cases and then a bigger case, but because of "island time" it still took us till 5:30 to get done. Things just don't' move with efficiency around here so a potential light day of a few easy cases still took all day, causing us to have a few hours of rest for the entire weekend rather than any substantial amount of time. It took our toll on us, working 9 days straight as today, our 10th day, we were really dragging at times. Things that should be easy, here they take more effort and more time, and just aren't that easy to get done. We can't just write an order in a patient chart for medication. We have to write the order, then find a translator, then find the nurse, then explain the order until she understands, and then check back later to make sure it got done. One of the major jobs this week has been overhauling most of the OR including the supply rooms. Well, that means that where things were on shelves yesterday are not where they are today and not labeled the same, so today I found myself running around looking to where things were moved. While the OR needs the overhaul, it just adds more time and stress to find things when we're in a hurry to grab something needed in a surgery. Yesterday, we were delayed for an hour for maintenance on the generator as we had numerous power outages yesterday. It's great fun to be operating at night and have the power go out. We all have headlights we try to keep around with us so that if the power goes out, we have some light. Of course, the ORs may or may not have functioning lights (one OR just has wiring in the ceiling, but no light) so the only light we ever have is from the fluorescents or our headlamps. I should remember to take a picture of the ceiling in there!

I have actually not been scrubbing in on many cases lately. One of the things I have really been able to help with is getting the supplies and getting the room ready for the surgery. It is certainly not as exciting as performing the surgeries, but we all find ourselves in an environment like this "dividing and conquering" the work to get through things most efficiently, and it's turned out that if I can set up a room to get Terry started on the surgery, I then can get another room ready for another surgeon and try to maximize our efficiency. We now have four Ortho surgeons here, including one resident who is in his 5th year and will graduated in June, so there are a lot of hands to get cases done, but not necessarily enough rooms to keep going at a good pace. And of course, there is only one gurney in the hospital, so we are also limited by the availability of the gurney to transport patients to and from the OR. We do break out the stretcher at times for the smaller patients if we're desperate to get going.

Last night, for our evening of rest, we went over to the hotel again for dinner and a swim in the pool. We got done early enough to catch the 6:15 taptap ride over to the hotel. It is not a far ride at all to get there so takes only about 5 minutes or so. We piled high into the tap tap with the Italian plastics team and enjoyed the ride over until we got up to the top of the hill to enter the hotel driveway and the police truck was coming out. Imagine a "road" up hill only one car width wide and literally you could reach out and touch the US Aid tents lining the street. The road has water draining down the sides and through the ruts in the dirt, and there is a fair amount of garbage lining the street. If someone comes the other direction, it's basically a standoff to see who backs down first. So, we get to the entrance to the hotel drive which is also one lane when the police come driving out. and want to go down the hill, right where we were coming up the hill. They weren't budging, and our tap tap driver wasn't budging! After about 30 seconds of no one moving, the yelling started between the drivers at which point we started ducking for cover and got out of the tap tap and walked around the "traffic jam" into the hotel and got out of the stand off! The police eventually backed up and let the tap tap into the driveway past them. The previous night, (now I am remembering Saturday a little), we also went over to the hotel but we took Scott's landrover and Terry drove us over for the evening. We had a bit of an adventure finding the right street and ended up with quite a tour of the streets around the hotel. We have really not had time to get out of the hospital much and see the area much, so these short forays into the neighborhood were very memorable. LEt's just say it was as close to off roading as I've been in an SUV and certainly would be considered off roading in the US. There is constant water flowing down the hills mixed with garbage and likely sewage. The tents line the streets and people have open fires burning for light and cooking. We ended up having to back down one street when we realized we had gone the wrong way because there was no way to turn around on the narrow road. We ended up on the right street and did get to the hotel safely and home again to the hospital without incident.

Last night, though, we did get to the hotel in time to swim before the pool closed and enjoyed a raucous game in the pool with the Italians and a beach ball. After an attempt to play waterpolo and losing the first ball down the side of the hill when someone scored a goal through the iron fence, we got out a bigger beach ball and tried to keep the ball in the air and count how many hits we could make before it hit the water. Some of the Italians speak some English, but mostly they speak Italian, making it quite entertaining at times. They are quite a rambunctious group making time around them quite entertaining and humorous. So, we enjoyed letting off some steam and playing around a bit until the stern woman at the hotel came and took our ball away. We had accidentally batted it out of the pool just as she walked up to our raucous game, and refused to give the ball back! I guess we were too noisy, but we stayed in the pool anyway and enjoyed a nice swim under the moon and stars. Sometimes when I'm far away from home I look up at the sky and marvel at the same moon and stars that I can see from my own backyard.

Today was another busy day. The added emotions of having lost a friend back at home have compounded the emotions of the trip here. It's been a challenge to stay on task at times and we are constantly pulled in many directions. Tonight, we moved patients around in rooms to create a room of patients without infections and room of those with infections. We don't need our non-infected patients literally in a cot two feet away from someone with a draining wound. So we spent an hour moving people around on their cots being interrupted by people stopping us in the hall and asking us to take care of their family member because we are in scrubs and don't understand that we cannot help every problem that people may have but have to turn them away to get help from the ER or someplace else. It is hard to not be able to help everyone who asks, but it is impossible. We have had some interesting questions asked to us in our Ortho clinic involving body parts we do not deal with and have had to refer them to Urology and General surgery for their.....ummm..... problems. Jeannie today had to keep some man from dropping his drawers right there in the hall to examine what I can only imagine is a testicular hydroceole. Terry got asked about leisure activities after hernia surgery, and I had a man come up to me to inquire about having a hernia examined. When I explained I cannot help with that and he'd have to come back to see the general surgeon, he nodded but then went on to ask me about another problem he had. So I listened and tried not to blush too much when he asked about his erectile dysfunction in layman's terms. I gently deferred the question to the general surgery clinic as well. So, we have had some laughs at times about some of the silly things, at the Italians all singing together silly songs in the OR, and some of our own jokes and occurrences (like the availability of breast implants that were donated by some hospital). Since we had a plastic surgery team, it seemed like an opportune time to joke about the crazy things donated.

Well, I can hardly see straight and rounds start in less than 8 hours. This was a longer post than anticipated. I expect I will actually blog more when I'm home and can post pictures more easily and have time to tell more stories and reflect more on what we've done and seen and experienced. I am thankful for the teams we have here this week and the help they have brought but also the laughter and fun we've had together, even with the language barriers. I have learned that I am not a piece of fig from the Italians. And I can say "piece of fig" in Italian as well! More on that another time....

Just a minute this morning

2010-04-25T06:01:00.000-05:00

quick note

We continue to be very busy each day this week, though thankfully, the nights have not been as late. We were done by 7 on Thursday, 10 Friday, and about 7 last night, too. A group went to the hotel restaurant Thursday night, but I decided to stay back and get to bed early, and I was able to sleep almost 8 hours with only some tossing and turning. I felt pretty good Friday morning and could tell I had some energy back for a few hours that morning. Friday morning, though, I got word that a good friend had lost her battle with cancer and had passed away that morning about 7:30. So, the past 48 hours have been extremely difficult on top of the pain and suffering we are seeing around us here. The few moments I've had for down time have been spent just catching my breath.

We have gotten a new team in this weekend, and along with the surgeons came a couple of Physical Therapists, a wound care nurse, and some other people who can help with our patient load. That is a huge answer to prayer. OR experienced people continue to be in short supply, though. We have settled in to many things here and have gotten familiar with a few translators who are eager to help us and seem like they want to learn. IF we can teach them some skills, it will really help this place run in the future when the "Americans" are not coming so regularly.

Friday, the Italian Plastic Surgery team arrived and they have started to work in the OR as well. Now we have 5 languages being spoken and another language barrier, but we enjoy listening to them speak and picking up phrases in all languages. We also have a psychologist from Switzerland and a number of new Americans, some from the Chicago area.

Well, rounds are about a minute away, so I should post and get ready to go. I haven't seen the rest of the team assembling yet, so I hope I didn't get up at 5:30 for naught. I hope to ahve more time today even to write more and catch up with much needed rest. We are at t-minus five days, 7 hours till departure. The first week has gone fast and slow at the same time and it feels like we've been here much longer than just a week.

92 degrees.

2010-04-22T20:59:00.002-05:00

Someone hung a thermometer on the clothes line today and tonight at 7:30pm it read 92 degrees. Although right now, I'm actually quite comfortable after a long cold shower and a fan blowing around our section. The heat and humidty though cause us all to feel hot and sticky and sweaty all the time. The ORs have air conditioning, but only in the rooms themselves, not in the hall, so with all the people in and out, we not only have a fly nad mosquito problem, the rooms get a bit warm. Wear a lead apron and a cheap surgical gown, and one easily soaks through scrubs and drips with sweat the entire case.

The last three days have been absolutely crazy. I have lost track of days and of time. Morning runs into afternoon which runs into night and night runs into la madrugada (spanish for the wee hours of the morning). We have been operating past midnight the past two nights, Wednesday morning it was 1:30 and today was 12:30 or so. We get up for rounds which start at 6 and the day just continues from there at a relatively nonstop pace. We have morning report at 7:30 on the front steps which is a time for a short devotion and prayer, then a chance for the head of each division to make announcements. It's a chance to stop and smell the roses so to speak, and today, it wast just wonderful to sit down for 17 minutes. I was sad to see the brief reprieve come to an end and to be back on my feet. I have been very foggy in the head today and have had a hard time concentrating and moving. My feet are so sore they hurt even when I'm lying in bed. While I have a great pair of shoes, no shoes can make your feet not hurt after being on them for roughly 51/60 hours. I have had a chance to take a brief nap yesterday and today, so that has helped. I would have slept longer yesterday if I'd known how late we'd be up last night. Tonight, Terry and Jeannie went out for dinner with some of the other volunteers. I finally had to say that I just didn't feel up to it and needed to get to bed so I could function tomorrow. Terry has been very appreciative of my work this week and long hours and has also been gracious to let me rest. I just always feel pretty guilty about resting when he's working so it's hard to rest when I know they are operating and have little help if I'm not there.

I am certainly not thinking straight and cannot even think to recap the past two days. We continue to washout a lot of pus in wounds and have now done a few ORIFs of limbs that have healed from their infections. (ORIF is open reduction and internal fixation where we make an incision, realign the bone, and hold it in place with plates and screws). Actually, we have done three IM nails to be more precise which means we've fixed a tibia (shin bone) and femur (thigh bone) with a long rod that goes down the medullary canal of the bone and is held in place by a few locking screws. to keep it from rotating in the bone. We have also continued to work at saving limbs or stumps that have horrible infections and need continued surgeries help clear infections. I can't even count the people we have on our service (inpatients). We have a very busy service and the hospital is beyond full. We have patients in the halls because there is no room in the units. The units are hardly much larger than a standard double hospital room but house 6-7 patients on cots rather than two. In many developing countries, family members act as the primary caregivers in the hospitals,. The patients bring their own sheets, the families bring the patients food each day, they do the bathing, run blood and surgical specimens to the lab, and keep watch over their family member. There is often one nurse for 10 patients or more. They take vitals, give medications, and start IVs, but much of the other care falls to the family. The family members do not get beds to sleep on. Some will bring sleeping pads but some sleep on the floor next to the patient''s cot on cardboard. Even when I feel like I'm "roughing it," there are people all around me with much less. I have access to a shower, running water (though sometimes the water is turned off and we always have to drink filtered water not out of the tap), a cot, nutrition from the food we brought along. These people have a cardboard box they have cut open, a bedpan, a bucket for bathing. The patients are to get one meal from the hospital a day but the family brings the rest and has to bring their own food to feed themselves. There are a few people who volunteer every day to take the lunches around to the patients and have to turn away from hungry people who are not on the list to receive meals. There are still hundreds of people living in tents on the hospital property. I have not had a chance to get a tour of the tent city here at HAH, but some of our team was taken out by their interpreter to see his tent and see the grounds. He apparently lives in the tent with 10 family members and was very excited to be promised a flashlight and sleeping bag when our nurse departs tomorrow. We are personally not making a dent in the tremendous illness and poverty here, but maybe collectively, with all the people who have come already and are yet to come, maybe we can make a difference for the people of Haiti. The long term goals are huge and seem insurmountable at times, but in one perspective, there was great need in Haiti for years prior to the earthquake, and maybe the quake was a means to get people interested in coming to help who would have never otherwise considered it.

Well, my stream of consciousness post is coming to an end. I need to wind down and try to fall asleep here soon. Most of the people in my section are leaving in the morning, some very early, so there will be no sleeping till the last moment before rounds tomorrow. I have to walk down the hall and hope to reconnect to the internet there so I can get my email and hopefully get this posted. Evening time connections are hard because everyone is trying to connect and the little wifi server is overloaded. 1:30 AM i can connect from my cot without a problem, though!

I hope tomorrow also ends at a reasonable time and that my rest tonight will help me focus and have more energy for cases, clinic, and managing patients. Most of our team leaves tomorrow and we more volunteers this weekend. We can hope and pray that we get some good hands who can help with our busy Ortho service. We'll see what God provides. I am seeing that I cannot make it through each day on my own strength and need His help to get through. Looking through the halls, though, makes us realize that each day of health and of having four working limbs and food to fill my belly are all gifts and much to be thankful for.

32%

2010-04-21T08:49:00.002-05:00

My computer battery is currently at 32%. I think my personal battery is much lower. Yesterday was a long, tiring, busy day. The disaster relief effort is past the battlefield medicine of the initial weeks after the quake, but we are in the midst of our own battle at HAH. Everyday, the clinic lines are long, the operating room schedule is beyond capacity, and people are transferred and flown in from field hospitals and local hospitals needed "definitive" orthopedic care. Definitive meaning more than just a temporary solution until the patient can get to someplace more sophisticated. We are that more sophisticated place. We have the honor of having the best Orthopedic care in the country and being a tertiary referral center for the county. We are the end point. If we can't take care of them, no one can. We don't turn people away and we do all we can for them.

Yesterday started out with the news of an emergency C-section for a baby who did not survive. Sometime mid-day, there was a C-section done for a beautiful baby girl who was crying and moving and giving "the eye" all of us oolgers with cameras. I marveled at life and death and the spectrum we see. The day yesterday was full of Ortho cases. We did at least 11 surgeries, and a Plastic surgery team who came to HAH for the day did 4 cases that were on our schedule as well. About 7 last night, as we were plowing through our last 5 cases, we got a call that an American relief worker had had an injury to her left arm with a possible severed artery. They were 20 minutes away and wanted to come into the OR we were in. Scrub technicians (the people who really know the instruments and are responsible for handing instruments, setting up and taking down cases, well, we really don't have any. We have a two nurses who used to scrub cases years ago, and well, that's about it. So, I was acting as scrub tech and 1st assist for our Ortho case last night when this woman came in. The general surgeon asked who he had to tech and I said, well, I'm an Ortho PA with no vascular tech experience, but I can try. When he asked who we had just had as our tech, I said, "Me!" I was very thankfully that one of our nurses/previous scrub nurse was able to step in and take over and I was relegated to running and finding supplies for them. THankfully, the artery was not damaged but it was a large vein that bled badly. The people in the field had put on a tourniquet so tightly there was no pulse in the wrist and her hand was blue. It ended up being a simple procedure and over quickly, and she was on her way. The remarkable thing was seeing everyone come together for an emergency, make the most of the situation and the supplies we have, and get something accomplished. The whole night was like that, though less emergent. We worked till past 1 am this morning. I got to bed about 1:30 after a much overdue albeit quick shower and slept soundly till 6 when rounds started. It was even cool enough to need to pull on the sheet last night.

We did wash out a TON of pus yesterday, and will have more today, and more tomorrow, and more the next day. The major things we are dealing with post earthquake are all the infections. Imagine having your family killed in the quake, living in a tent in a field with no clean water, and having a wound from surgery. Even some of the "clean wounds" have been infected. Also, initial treatments for some open fractures (bones that protrude through skin) was to fix the break with metal hardware. One principle of Ortho is to NEVER implant metal in an open fracture. It 99.9% of the time gets infected, but people here don't know that. So, we are still cleaning out wounds of people with horrible infections. Last night, at midnight, we were debriding the stump of a 40 year old woman whose stump form her above knee amputation was infected. She was sent from another hospital because they didn't feel they could care for her. We did extensive debridements for necrotizing fasciitis, or flesh eating bacteria. It was ugly with lots of dead tissue. She could potentially die from this infection if we don't keep it under control. She could certainly lose the rest of her leg which is highly likely. We will take her back to the OR today for another cleanout surgery.

Well, I know there is more to tell, but no time or brainpower to tell it right now. I'm going to check my email with my feet up for a few more minutes and then get down to clinic. Terry was gracious and suggested I take a break while he gets things rolling downstairs. He thrives on this kind of medicine and schedule and can operate, literally and figuratively, on 4 hours of sleep night after night. I do not. Also, our medical student leaves this Friday morning, and Jeannie and I will be trying to take the job of three people. Also, our wound care nurses will leave on Friday as well, taking most of our team. You can pray that some people come who could join our team and really help shoulder the load. We do have some nice size teams coming from CURE this week, so we can hope and pray for some more hands. Also, our amazing Scott leaves this weekend for some much needed respite time in the US with his family, leaving Terry as the head of Ortho. We will be getting another Ortho surgeon as well, so we'll have his help, too. Terry has a wealth of knowledge and experience in this kind of medicine, but we are still figuring out the logistics around the hospital and with teams coming and going constantly, Scott does a lot to coordinate the entire effort. We will need to all work hard at communication and working as teams to care for these people. We are all tired and all working on little sleep, and what we do get is restless from heat and humidity and from having 40 people stuffed into one area and another 20 down the hall. It is noisy and cramped and crowded, but we are making a difference for people one at a time.

2010-04-20T05:50:00.010-05:00

The view from the veranda

The view from my cot

A boy in town selling bags of water, looks like what the relief teams handed out a few months ago. He kept asking me "Hey you.... got money?"

Waiting for the chopper to come in:

A young girl at the "helipad"

Walk thru the streets

The hospital from the main drive

The electric fly swatter

15 minutes before rounds

2010-04-20T05:42:00.002-05:00

Not much time today before rounds start. I might have a few minutes if rounds go quickly to hammer out some more on yesterday. Quick summation: it was a very busy clinic day. Scott (the chief physician for the Americans/volunteers and head of Ortho) said it was the worst clinic day yet. If that was the worst, we can handle it. While it was busy and chaotic, it was not frustrating or enfuriating in any way, just very very busy. So, I am thankful for that. Of course, things can always go South here quickly.

We did three cases yesterday on top of seeing 39 clinic patients. Our day was from 6 AM rounds to after 6 PM. Terry's wife Jeannie has been a huge blessing to our work here and yesterday her strengths in organizing Terry's schedule and coordinating were very apparent. Her birthday is Thursday so we may go out to the hotel for dinner that night. I'm saving my shower for after surgery today. Yesterday, I was filthy and literally soaked my scrubs in sweat, pants and shirt, before 10 am. The facilities guys were working on plumbing yesterday, so there was limited running water. It might have been a blessing because with limited water, limited internet, I was in bed about 8 and asleep shortly there after. I slept fairly well till 5 this am. I am not "rearin' to go" but at least not a complete zombie.

I was going to try to post pictures, but I fear my internet service just went down again, so I'll post what I can when I can. Thanks for prayers and emails. They do help me feel closer to home. I've only been here four days, but already feels like it's been much longer.

Monday, Monday....

2010-04-20T05:37:00.001-05:00

This post was written Monday morning, 4/19, but due to spotty internet access, I haven't been able to post till this morning.
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Last night was an extremely hot and humid night on the third floor veranda. Ithink sleeping in a tent in the roof would be nicer as long as it's not raining. It hasn't rained since we've been here and the air feels like it's about 150% humidity. Actually, outside feels better than inside. We have morning report and worship in a half hour then startsthe craziness for today. I only slept about 5 hours last night I think so today will be tough. Thankfully someone has some starbucks instant coffee packs that are helping me out. It will be a challenge to stay interested and keep the right mindset towards everyone when I'm so tired.

There is a lot of pain here, phsyical, emotional, spiritual. The people come to us with physical wounds from the earthquake that were not appropriately treated initially by the healthcare system and are now infected and full of pus. The 11 year old girl screams and night and seems to have nightmares. I'm sure it's related to the quake and the trauma. When half asleep we just want herto stop screaming, but the truth is that the wounds in her heart are much greater than her physical wounds and are hard to even imagine. Another woman had to have both her legs amputated at the hips and has wound healing problems. She has no family to care for her and cannot get into her wheelchair by herself. I don't know where she could even go.

Over 200,000 people died here. Bodies are still buried in rubble in places. There is no where to put the rubble so it sits in the streets alon withte garbage and the tents that house people. People try to carve out a living with roadside stands and eat over open fires. Raw sewage empties into an open area next to the hospital. There is more pain here than I can help, but maybe we can help a few and by saving their limbs help them be functional and live with less phsyical pain. The spiritual pain we can only pray for and try to show Gods love for us through Christ by being here and caring for each person we come in contatc with.

I'm writing at 7:15. Morning report starts soon. Not sure when I'll get this posted.

First "Kill"

2010-04-18T21:15:00.003-05:00

I've heard from soldiers that you always remember your first kill. Today, mine came in the form of a Haitian housefly with the electric flyswatter. See picture below. We operated today, and a window was left open in the operating breakroom without a screen, so with all the doors that are left open and even when closed, don't seal tightly, we had FLIES and MOSQUITOS GALORE in the ORs today! We are all quickly becoming proficient with the electric fly swatter which resembles a tennis raquet. We all have double duty as health professionals and fly killers. The zap of the bug killer is music to our ears!

It is Sunday, and supposed to be a light day as most locals are in church. Since we celebrated Sabbath yesterday, the traditional Jewish and Adventist day of rest, we worked today. Our teams got some GREAT stuff done in the OR suites. The sterile processing room was doubling as a dirty instrument processing room. Not a good idea to have clean and dirty instruments in the same room for obvious reasons. So, a group of nurses and staff cleaned out a huge scrub sink of instruments and sorted them, then the facilities men moved the sink into another room that was emptied and cleaned top to bottom, and now they are working on moving all the supplies back. HUGE project. Having done a major organization project in the DR last May, I understand the overwhelming feeling when getting started, and its amazing to see such a big job accomplished. It will make a huge difference for instrument processing and huge leap forward for cleanliness and disease transmission.

From the Ortho standpoint, we did three cases today. Our first case was an 18 year old woman with an open tibia fracture who now has an external fixator on her tibia. Her bone is infected and we needed to clean out the bone, cut the bone ends off to get down to clean healthy bone, and reduce the bone back into alignment and tighten up the fixator. After that case, we cleaned out a few other open wounds with infection and pus. In between, we helped to sort screws and instruments. It seems like any trip Jeannie and I are on, we end up sorting screws together! It's just one of those jobs....

We did enjoy dinner out last night. We went to the hotel down the road a ways via Tap-Tap hired by the hospital. The service is notoriously slow, so we enjoyed a night out in a nice atmosphere and just visiting together. The hotel had a nice 2nd floor open veranda with large fans running, so there was a nice cool breeze. It took about 2 hours to get our two cheese pizzas (probably had to age the mozzarella first) but it was pretty good and certainly edible. I was so tired by the end of the night, I was seeing double almost. The hospital sent an ambulance to pick us up and take us back to the grounds. It was a good night out.

Before our first case today, I tagged along as Terry and Scott walked through town up to the "heliport" to greet an incoming helicopter from Santo Domingo with a friend of his on board coming to help and deliver some supplies. It was great to walk a bit through the streets, see some people, meet some children and catch a few pictures. The children are friendly and often want to have their picture taken and see their picture on the screen on camera. One boy, probably 10 or 12 years old kept saying, "Hey you, hey you" so we would try to exchange a few phrases. One of the first things he asked was if I had any money. I was carrying a shoulder bag that had some supplies from the hospital in it and he kept wanting some of what was in the bag, even after I explained it was hospital supplies. Even patients' family members may ask for money after greeting and smiling at them. It is hard to say no, but there is more need here than we can ever meet. There was some rebuilding going on of a wall along the road with new ditches and supports going up. There are many street-side stands selling all sorts of goods from clothes to toiletries and everything in between. One has to remember that pedestrians do not have the right away in this country and to get out of the way of the motorbikes, tap taps, and other vehicles driving through the streets.

Today, we did get some hot lunch. I'm not really sure what it was, I think some tofu (though Terry now clarifies that he thinks it was gluten) in some sort of sauce, a vegetable, and some rice with some sort of cheesy tasting potatoes (I think they were potatoes). The rice and cheesy potatoes were very tasty and so was the gluten. It was certainly food and filled my belly which was good. Dinner tonight will be more power bars and trail mix, which is good too.

Tomorrow will be an extremely busy day. Manic Monday, so i'm told, and the guards will have to hold the crowd back at the gate. We will have a full day of clinic and some surgery. At this time, it's a lot of washing of infected wounds and while we could do some "clean" cases of non infected extremities, we are just trying to help a lot of infections so they can hopefully heal. It's hard to see the pain and suffering these people are and have endured with their injuries, but the alternative would be that they would all have amputations and live a very crippled life. There is some amazing work being done here and helping so many people. There are still great needs for the people here, one of which is training for the local hospital staff-- things as simple it seems sometimes as keeping doors shut to keep the flies out of the ORs.

Another interesting occurrence for me today: a large group of volunteers came last night as part of the Cure International group. Today, there was a physician in one of the ORs whose name was familiar to me. I was trying to place him when I realized who he was. I asked him where he was from and he confirmed my suspicion that he was in fact from Philadelphia and was one of the Emergency Medicine physicians who lectured to my PA class back in January of 2001. We chatted for a few minutes and when he saw me operating the electric fly swatter, he was very proud of his teaching back in the day. Apparently he still lectures at my alma mater in Philly.

Tomorrow will be another test for us all as the local staff comes back in full force and as we learn to work together more and struggle with the language barrier. Scott brought one of his scrub techs with him to help for a few weeks from the DR, so we have been speaking Spanish, a few words in French, and also of course English. My french lessons have come in handy a little bit so far and I have actually taught a few words to people throughout the days. I need to refresh even more with some phrases and vocabulary. I have also asked the translators a few words as well. I do find myself thinking in Spanish more since that is my foreign language of familiarity. The language barrier is hard and frustrates us all at times. There is a translator staff to help-- locals who started as volunteers and then were hired on by the hospital a few weeks after the quake when they said they needed to get to productive work and making money. Their English knowledge varies but they are a great asset to medical care for these people.

Well, I am going to get some pictures posted here hopefully (when the internet is back working again) and hopefully get some rest tonight. I for one am hoping for a quieter night tonight than it was last night so I can get some better sleep before 11. Pictures to follow another time:

2010-04-17T17:43:00.012-05:00

Our luggage arrived today and we are grateful! We got a call from the airline saying it had made it and it was brought to the hospital about 3 when the next group of volunteers came. So, I spent an hour sorting supplies, food, and my extra personal things like my headlamp and extra bug spray.

I don't think there will be time to write about all we've done and seen throughout the next two weeks but I'll do the best I can. We arrived in PAP (Port Au Prince) yesterday about 3. After waiting for our luggage which didn't arrive and collecting the entire group of volunteers on our flight (there were also 7 volunteers through Cure International and 2 other women through Loma Linda University) we finally got in the bus to take a group to the hotel and the rest of us to the hospital. It was about 7 or so by the time we got to the hospital and then proceeded to unload and try to settle in a bit with cots and mosquito nets. The drive through town was a brief tour of the destruction in the area and a brief view of some of the tent cities. We drove past the Presidential Palace which was just completely toppled as well as many other buildings and piles of rubble, garbage, water backing up in streets. By the time we got to the hotel and then hospital, it was dark (we are on eastern standard time, so it's the same time as central daylight savings, but we're much further east of Miami, so it gets dark early and the sunrise is early). We saw families living in the tents with their little grills cooking dinner over open fires. Some people were in buildings. Some had electricity. Some tents were set up on the islands in the streets between the two directions of traffic. Apparently they set up far away from any walls as they are terrified of walls falling on them. WE passed by tent cities of tents stretched as far as we could see. There is rubble EVERYWHERE, and garbage all mixed in. Someone said they heard a statistic that all the rubble from the 60,000 destroyed buildings would fill the Houston Astrodome 23 times. Where do you even begin? In someways, it si cleaner here than before the earthquake as there have been groups employing locals to help clear streets. The buildings sit very close to the street and people are living outside of the buildings in tents, so the narrow streets are even more narrow and dangerous. They are a generous single lane, but lanes don't matter and it's pretty common to see large trucks coming straight towards you in the bus. It's a lot like the DR in some ways

We had a brief meeting to do introductions and get a tour of the hospital. I got to bed about 10 last night and fell asleep soon after only to wake up at 11 to the cries of a girl in pain (my bed is up a few steps and just behind a wall from the 2nd floor ward). She settled down soon and I slept till about 5:15 when people started moving around. We started rounds about 6am and then had a worship service at 7:30. We had patients lined up for Ortho clinic afterwards already, so saw a few patients before heading into surgery to do a partial hip replacement for a broken hip and then washout an infected wound/fracture on the 11 year old girl crying last night. In clinic, we also saw two people who had broken their arms today and we were able to do closed reductions on them and put them in splints. So, we are still cleaning up injuries from the earthquake as well as problems and injuries that are everyday type occurrences. There are still babies being born, C-sections, and traumas. A girl in the ER had been hit by a car but thankfully had no significant injuries. A baby came in to the ER early this morning and was hemorrhaging (from what I don't know) and did not survive. I was not involved in taking car of her, but it is hard to hear about regardless.

Apparently there was some lunch served today, but we were operating and there wasn't any left by the time we got done. So, we ate some more bars and snacks. I have thus far avoided the Humanitarian Daily Ration (HDR) and we'll see how long I hold out. I weighed in on the scale in one of the bathrooms and will compare it to my weight when we leave in two weeks. We'll see. I just have to remember to drink enough water.

Here are some pictures from the past 24 hours so far. They are all completely unedited and will be till I get home, but wanted to share some right away. I am being inundated with the singing of How Great Thou Art in Creole. It's lovely to hear it echoing through the veranda. We're off to dinner soon. Have to catch the tap-tap soon! Have a good night!

My cot and mosquito net. I have a wall behind me, so i can put stuff on it.

Section 1 of the veranda

Stairs to the veranda in the volunteer area

A boy outside this morning by the front door. They love seeing their pictures on the camera screen.

Worship this morning. Great singing.

Collapsed buildings along the drive to the hospital

The Presidential Palace

Large piles of rubble in the streets

Tent Cities
A Tap-tap (a sort of cab)

D-Day

2010-04-16T21:39:00.002-05:00

Today is our D-Day. We have arrived in Haiti, in Port Au Prince, and now am at the hospital. Our travel today was largely uneventful other than our bags have not arrived. Thankfully, we were aware that this could happen and packed our necessities in carry ons.

This will be a quick post as it is 9:40 and the roosters start crowing at 3, the sun rises at 5, and rounds start at 6. Tomorrow is Sabbath, a day of rest, so we will have a church service in the morning (in English, I'm told), then do a few cases and then some rest. Sunday starts up full schedule again.

Food here is short. We're told the some of US volunteers are not eating a lot of the one daily provided hot meal to allow the patients to have more food. As some of you heard, the chefs left last Sunday and things have been a bit different. I think they were from China somewhere, possibly with the group Chefs WIthout Borders.

We got a tour tonight from the nurses who arrived this morning. This is true "see one, do one, teach one" apparently! There is plenty of fresh water. I am thirsty and pretty sweaty already. The volunteer breakroom has wireless internet and an A/C unit, so it's somewhat cool and I put on some dry scrubs, so I'm fairly comfortable right now. I hung my mosquito netting around an empty cot and we'll see how sleep goes tonight. This is definitely still disaster relief medicine, but still some luxuries like a room with A/C and clean water in a 5 gallon bottle dispenser. We do have some flush toilets, and some cold showers. We'll see when I decide to brave the cold water, thought it'll probably feel good after working in the heat.

Pray that our bags with all the supplies do arrive tomorrow, and that we get some sleep, stay healthy, and that God provides our strength. I for one know that He is the only way I will get through these next two weeks.

Have a good night. Hopefully there will be some time tomorrow to post some pictures and write more about what we've seen and done so far including the drive through the city and the destruction but also the smiles we can bring to the children just by waving and smiling at them.

Oh, we are on central daylight time for anyone that wants to know what time it is here. At least I think that's what time it is. I think technically they are on Eastern Standard and don't change clocks ahead for the summer like we do in the US.

Thanks for prayers already.

A Video from Hospital Adventise d'Haiti

2010-04-15T08:23:00.004-05:00

Just a quick post this morning to share a video by the group working at the hospital we'll be at tomorrow. It's less than 5 minutes and will bring some tears to your eyes. At least it does mine.

http://www.youtube.com/watch?v=_n8sgreJ15M

I am heading back out to the store to get some last minute items that Scott, the surgeon in Haiti requested. Right now, I have a small suitcase to carryon half full of scrubs, half full of food, and a large suitcase to check that is full of supplies. This is the smallest clothes to days traveling ratio I think I have ever packed with the exception of our La Vida backpacking trip in high school.

We leave this afternoon. Until then, last minute packing and a run with the Maddog. I miss my family dearly already and have been for 3 months since we first started planning to go.

For more detailed information of the situation at the hospital, visit:
http://www.haitibones.org

2010-04-12T16:50:00.008-05:00

I have taken a very long hiatus from this blog over the winter, and really have picked up my camera very little lately. Over the next few weeks, I plan to blog more and hopefully post some photos of my upcoming trip to Haiti to work at Hospital Adventiste d'Haiti. I took my first Chloroquine tablet last Friday night (anti-malarial medication that is started one week before arrival in the country), and the countdown is currently at 3 days and 40 minutes till push back at the airport for the first leg of our trip. It will take us about 24 hours of travel to get down there with layovers. We are scheduled to arrive Friday afternoon if all goes as planned.

I am working today on packing and making sure I have my own personal pharmacy ready-- antibiotics for diarrhea, chloroquine, bug spray, and mosquito nets for malaria prevention, iodine tablets to treat the water just in case, sunscreen, nutrition bars and snacks to supplement the food the hospital can provide, gatorade packets for electrolyte replacement. The list goes on. The temperatures are about 90+ in the daytime and 80+ at night. The rainy season has begun officially as well, making life for the people living in tents even more difficult. The hospital there continues to be very busy, but is doing amazing work. For more on the happenings there, visit http://www.curecaribe.blogspot.com/

Since I do not yet have pictures from Haiiti to share, I wanted to share a few portraits from the Domincan Republic, which borders Haiti and shares the Island of Hispanola. These are some of the people I met last year while on trips to the DR. Thank you for all your prayers that have been prayed for us in advance and for those while we are there and for the teams there already.

Photography Exhibition Dec 2nd Appleton WI

2009-11-20T15:47:00.001-06:00

Photography by Karen Fields
Wednesday, December 2nd, 2009
8am to 4pm
Appleton YMCA
218 E. Lawrence St Appleton WI 54911
PUBLIC WELCOME! (No Y membership required to view the show)

2009-11-11T11:01:00.000-06:00

Sundrops

2009-11-06T12:11:00.002-06:00

This is a new photograph from October still working with the idea of abstracting every day sights.

2009-11-03T16:57:00.002-06:00

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2009-10-28T09:03:00.000-05:00

2009-10-26T13:50:00.001-05:00

2009-10-22T11:11:00.001-05:00

2009-10-21T11:17:00.000-05:00

2009-10-19T16:02:00.001-05:00

Three for One Deal today only!

2009-10-16T08:35:00.005-05:00

This is a short series of multiple exposure photographs I did. They create interesting effects and toy with the idea of the surreal, almost transcending the actual objects and become something entirely different. These are all part of the impressionistic and abstract photography series as well.

2009-10-13T16:08:00.000-05:00

2009-10-12T13:15:00.002-05:00

This photograph begins a series of pieces that explore a more impressionistic and abstract style of photography. They are an attempt to see common sights through a fresh viewpoint and stretch the boundaries of how we see common objects. Some photographs are intentionally ambiguous and hardly represent the objects they actually are.

2009-10-03T19:36:00.002-05:00

This will be the last of my flower pictures for now. For a few more pictures, visit www.karenfieldsstudios.com Another theme will start on Monday.

2009-10-01T15:18:00.000-05:00

2009-09-30T14:38:00.002-05:00

This is a piece I did today in honor of a physician assistant who recently passed away.

FAREWELL KEN

By John Padgett PA-C, Ph.D.

It was one of those beautiful fall days when we gathered to say goodbye to Ken Gartzke. The mountains surrounding Arvada, Colorado were still green in their early fall foliage, with traces of snow far above. The sun was warm, the day weighing lightly.

Ken was in his casket at the front of the room, flower tributes stating sympathy and farewell. He was dressed in his Army mess dress uniform, his medals appropriate, and a Veteran's Caucus pin on his right breast. He looked peaceful. To his left and right were photographs of Ken at various times in his life, from infancy to shortly before his passing. I particularly liked the one of him as a young child aboard a rearing horse, smiling broadly. The photo of the Usual Suspects of the Veteran's Caucus in Orlando from a few years ago was also on display.

As Vicki and I were in the vestibule awaiting the start of the service, we heard it: the sound of rolling thunder. Up the main street came a formation of dozens of Harley-Davidson motorcycles, their riders and passengers all in colors, the engines emitting their unmistakable rumble. The formation turned into the mortuary parking lot and the riders dismounted and filed respectfully into the chapel to pay their last respects to "Doc" Gartzke.

As Ken was a man of many interests, so were those represented at his funeral. There were family and friends, fellow members of the health care team, veterans, bowling buddies, the motorcycle club, the Elks, and the Caucus. Ken's life touched many people, and it showed.

After the remarks, the mourners filed by Ken's casket. Some of them left little mementos: a motorcycle pin, a patch, a flower, a subdued Army warrant officer pin.

After the service Ken was escorted to the Ft. Logan National Cemetery by a police motorcycle escort, as well as his club's motorcycle escort and the traditional limos and an assortment of pickups and cars.

He was interred on that beautiful early fall day, the mournful sounds of the trumpet carried off by the gentle breeze to the surrounding mountains.

Donations may be made to the Veterans Caucus for the Ken Gartzke Scholarship Fund. (P O Box 362, Danville, PA 17821)

2009-09-28T21:44:00.000-05:00

2009-09-25T13:17:00.001-05:00

For a few days, I'll be posting pictures of flowers I've done in the past year or so. I hope you enjoy God's beauty.

2009-09-24T16:05:00.001-05:00

Wedding Invitation

2009-09-23T16:08:00.007-05:00

This is a wedding invitation I was asked to do last fall (names have been changed to protect the privacy of the families). The couple are both members of the US Marine Corps and I took a number of photos of the couple in their dress blues. The bride loved the way the sun reflected off their uniforms in this picture.

Thank You for Serving

2009-09-22T13:58:00.006-05:00

Today I decided to send a Thank You out to our service men and women deployed around the globe, sacrificing many comforts of home, including life and limb in service to our country.

The above photo montage is a collaborative effort with my "cousin/little sis" who took the photograph of her brother's ship the USS Cleveland. Together, we made the montage with him saluting at his US Naval Academy commissioning ceremony, a photograph I took of the Blue Angels doing the flyover at the opening of the commissioning ceremony, and some words of the Navy Hymn, Eternal Father Strong to Save.

Clouds

2009-09-21T16:46:00.010-05:00

I thought I'd start this blog with some of my favorite photographs of clouds that I've taken. Alfred Steiglitz photographed clouds to express his thoughts and emotions. While not all the following are taken specifically for that purpose, some photographs were, and at the least, show the beauty of the sky from below and above.