
Join us in praying for these dear ones..
This is quite interesting I think.....
If you want to know where we will be you can go to 2 Chronicles 11 - the village where we will be was once called “Adoraim”. Adoriam was one of the cities fortified by Rehoboam, son of Solomon, to protect Jerusalem over 1,500 years ago. This is a time when the nation was divided and many were worshipping false gods. There were also many who set their hearts on seeking the Lord and serving Him turned away from the worship of false Gods. Please pray that the people of this city will turn away from false religion of Islam to worship Jesus and this city will become fortified with the love and presence of the Living God.
Thoughts on Haiti
Having just returned from a medical relief effort, I cannot get my mind off of Haiti. The experience continues to haunt me, brings tears to my eyes and overwhelms me with emotion. At the same time I feel anger for the unnecessary suffering and misery that this country has dealt its people. The common man in Haiti, has a life expectancy of 50 yrs, and an average daily wage of $2, when he can find a job. Although he has nothing, he still manages to walk with pride and exude friendliness and kindness. (This is true in the countryside and smaller cities, as I was not in a large urban area.)The children are beautiful, friendly and innocent. The women work hard trying to scratch out a subsistence living. The people are clean, although they are ridden with malnutrition, congenital and acquired health issues. It is not money for which they occasionally hold out their hands, but for food. And when you hand them a sandwich, a small snack, or a bag of trail mix, the smile of gratitude, makes you wish you had more in your back pack to give.
The economy seems to be one based on bartering. Charcoal, the primary cooking fuel and the manufacture of which may have contributed to the devastating deforestation of the county, is traded for rice. Sugar cane is traded for beans and a chicken or pig or goat for something else, and on, and on. The ubiquitous burning of charcoal leaves a haze of irritating smoke over the populated areas, that is largely responsible for the chronic complaints of cough, asthma and burning eyes.
Anger? Yes, for it is hard for an American to comprehend a country without any sense of organization or infrastructure. Chaos and inefficiency rule. There is no running water, unless you count the river, which is full of people bathing, doing their laundry, digging sand, dumping garbage, etc. Even the hospital has no water! Can you imagine a hospital without the basics of water? There is no electricity, unless you have a solar panel, or diesel and a generator. Even with these, the power is turned off around 5 PM. This includes public facilities such as the airport and hospital. Voluntary surgeons are ready to work through the night to save lives and limbs, but are told to leave at 5 PM, and the power shut down.
There is no organization and the country smacks you with total chaos. Nothing runs as expected or according to any sense of planning. There seems to be no interest in public welfare or the suffering that is universal, rather than occasional. I presume there are some people who have better living conditions than average. But these “well-to-do” do not seem to have any interest in helping the masses of needy around them. Indeed, in my shallow experience, they seemed to be clearly more interested in themselves than their countryman.
Imagine a hospital filled with people suffering with fractured limbs as well as mind boggling medical issues, covered with flies, and lying in darkened, warm, humid rooms without ventilation. They are tended primarily by their family, who are responsible for feeding them, cleaning them, emptying the bucket under their bed and chasing the flies from them. When you walk by, they look at you with hope and expectancy for any sense of relief. Your training tells you what to do, but your efforts are impeded by locked supplies, resistant nursing staff and hospital administration.
Although there are many foreigners trying to deliver aide to this population, their efforts are met with incomprehensible delays and hurdles from those in charge, who do not seem to mind the suffering around them. Oh, the massive relief effort has provided food and masses of medical supplies. However these supplies are not available to the medial teams, and relief efforts. These desperately needed supplies are warehoused and locked away, by customs or hospital officials. To access them, you need to run from one authority to another wasting precious time and energy at the expense of suffering and death. The UN and the US military try to assist, but remember they are there to help in a sovereign country and have very limited authority to act. Many religious organizations have made significant strides in their attempts to serve the people, and move them into the 21st century. But their efforts are not enough by themselves, and require country leadership.
It has been hard to have experienced this without developing a mixture of love, sadness, frustration and anger. Haiti is a “country” without any semblance of structure. Perhaps this devastating earthquake is a moment, not to start rebuilding, but to build a country from scratch, with a new economy, educational efforts, public health, and perhaps a whole new social culture. This will require a totally unselfish political and engineering leadership, which hopefully can arise from the ashes that now cover this country.
Some more thoughts – Friday, January 29, 2010.
I don’t think I wrote much about my first impression upon entry into the Hinche hospital last Sunday. It was really beyond belief for us – even after visiting the hospital in Peru. The large room full of beds, a ward, was full of patients, many of whom had legs attached to a rope and plastic bottle full of sand acting as their traction device. In the US, we have 5 lb weights. They are attached by a plaster cast to the foot here, and this tends to irritate the skin.
In the US this traction is usually overnight, with surgery scheduled the following AM. Here most will be in traction for 6+ wks, until their fracture stabilizes. They did not have the rods necessary for fracture stabilization, nor the sterile conditions to make such repair feasible. Unfortunately this also exposes the patients to a very high rate of pulmonary embolization. One patient actually did suffer such an occurrence with threat to his life later that night. Fortunately, he received emergent Rx from the Americans and has survived.
The rooms are dark. During the day, they are poorly lit. And at night, there is usually only one small fluorescent bulb lighting the whole ward.
Patients receive their primary nursing care from their family, who attend to them at the bedside constantly. They feed them, clean them, clothe them. The family brings in their food. There are buckets at the bedside for toileting, and the family empties them. I’m afraid to inquire where, but saw one just dumping the contents in the hospital courtyard!
There are only a few windows, and of course no screens. Therefore, the patients are covered with flies! Their wounds are so covered as well. The family, when attentive, brushes the flies away.
I couldn’t comfortably take any photos in there. As a physician the patients look at me hopefully, and the last thing I could do would be to take out a camera and memorialize their misery. Some of them had compound fractures, with the bone tearing through their skin. These do require surgery, and it should be done urgently. As I have said earlier, their surgery is unnecessarily delayed. In one instance this resulted in the patient become septic. She went to emergency surgery by our team and had her left leg amputated, and her right one sliced open for drainage. She did survive and our team was able to further debride her wounds before their departure.
In one corner of the pediatric ward, there was a child with 40 burns. He was crying and he had a crowd of people around him. At first I thought they were chanting, then realized they were praying and signing. This occurred frequently around patients in the hospital.
Another child was in traction – he had broken both hips. He lost his family with the exception of his grandmother in Hinche. Before they left, our team was able to place him in a spica cast. There was another child, with broken hip, who are required and received a spica cast from our team.
One poor fellow was crushed in the quake, and had his spine severed around T10. He is a quadriplegic. I heard today, the one of the hospital ships had offered to take him. But the hospital administrator denied this request. I don’t know what they will do with him.
The country is going to be in great need for prosthetics, crutches, walkers and wheelchairs. I have previously told you, the only survivors among those injured, were with limb fractures. Anything more serious resulted in a quick death.
Amongst the trauma victims are a large patient component of incredibly bad disease which usually populate the hospital. It seems that many patients are anemic with Hemoglobins in the range of 8. Normal is greater than 12. One woman’s was 3.7. She was given two units of blood, but the one was wasted by poor nursing attention.
The patients often had IV’s as at home, but often they are empty, not running, and/or infiltrated. Their urinary catheter bags are usually lying on the bedside. The correct location is hanging from the bedrail below the patient.
The three operating rooms or course also have flies. They and well and the rest of the hospital communicate with the outside. And they have outside window, although they were closed. With the exception of the OR, the hospital has old wooden floors, which of course are hard to keep clean, and perhaps impossible to sterilize.
As I walked through these wards day to day, the patients would watch and look at you hopefully and expectantly. I felt bad that I was not necessarily going to their bed, and especially bad that I couldn’t talk to them.
I will be interested to see what the world press is reporting about this catastrophe. Certainly I now have an appreciation regarding the difficulty and lack of efficiency in the world response.
John
Friday, January 29, 2010
Last night before sunset, and with the rising full moon, we drove to the back of our grounds. Just behind an enterprising Haitian bought some land, dug two large ditches and damned them. They fill in the rainy season, and stay full throughout the winter. From them he raises Tilapia, for food and fertilizer, and around them he has a large field of food, which is watered from these lakes. This is the type of activity that is needed in this county for revival.
After lunch the clinic here got very busy, and we worked it until 5 PM.
As you might expect there are many minor and major health conditions besides the recent trauma. Some of the trauma patients are returning for wound checks and dressing changes. I saw a woman with a very advanced breast CA, another with a breast lump. I have seen end stage congestive heart failure in young people. The average life expectancy is around 45. HTN is very common, and usually untreated. Malnutrition, fungal skin conditions, scabies, HIV, Malaria, Typhoid and many unknowns round out the selection. Sadly there are many congenital and developmental abnormalities. Before he left Dr. Combs showed me a 12 yr old girl with hydrocephalus. I have never seen anything like it. Somehow she has done well mentally.
Many are just hungry! This may be a growing problem due to disruptions in food supplies through Port au Prince. You may actually know more of this than me, as I have looked at no news. The Haitian Endowment Fund is driving to the Dominical Republic tomorrow to try to get a large truckload of rice and beans through to resume their feeding program.
The population continues to drift up in this direction as well as north and away from Port au Prince.
I’m tired after today. This evening is again cool, with a full moon. There was chanting over the walls this AM. It is an interesting mixture of sites and sounds and smells.
John
From Christine: I am wondering if it is better that they are not listening to the horrible news we hear or not..jury is out on that. I am thinking how difficult it will be though to make it from the Dominican Republic with the food, given the mobs...They are not aware of that I fear..
Imagine a beautiful, full moon shining on such sadness, devastation and yes, hope! The chanting he is hearing is from the poor people caught up in Voodoo! Pray that they will be delivered from the bondage of these practices, and the sounds of our team singing worship songs to the only true God will drown out the chanting and bring the chanters to their knees before Him, where he lovingly waits..
Thank you for all of you reading this, praying for them, thinking how you can help, just being there for everyone involved.
"And they shall rebuild the old ruins, They shall raise up the former desolations, and they shall repair the ruined cities, the desolations of many generations..... Instead of your shame you shall have a double honor, and instead of confusion they shall rejoice in their portion. Therefore in their land they shall possess double; Everlasting joy shall be theirs." Isaiah 61:4 & 7
"Be still and know that I am God: I will be exalted among the nations, I will be exalted in the Earth."God has His eye on every detail.