Haiti Day 5: The Slums

Another 228 children seen today. Another image of poverty that took our breath away. The clinic itself was not that unusual. The road was bad enough that we had to park the bus several blocks away and walk, due to the ruts, the water and the poor condition. The 2 security police that were with us, called for back up support due to the area that we were in. Once you see the pictures you'll have a better idea of what I'm talking about. That aside, what we saw should never be. No one should have to live in the filth that we saw. No child should have to play in the garbage. But then again, who are we to judge. When I look back at the week, I saw some definite changes in the team. We realized how fortunate and yet vulnerable we are. We realized that life passes us too fast and if we don't slow down, we'll run out of time to experience all that is given to us. We believe we made a difference...for others, but also for ourselves. We're different becasue of what we did and who we've become. The hard taskmaster is to stay that way and not go back to who we were. As for where we go next, we'll see. For now I'm thiniking of today and wondering if I could ever live in a place like that. I'm not really sure. But then again, the children that we saw, had smiles on their faces, as they played barefoot in piles of garbage. Maybe they know something about life that I don't know. I'd sure like to find out. I'll let you know when it do.

In all things give thanks,
David

(see www.tenutophotoblog.com for great pictures)

Haiti Day 4: Oaunaminthe

About 350 children seen, one emergency, and a long ride back and forth. The day went well, with a lot of children seen. We had 3 Haitian pediatric residents with us and a local doctor as well.

Here's the story of the day: a woman comes to the clinic carrying a limp child, about 1 and a half years old, large head and with cerebral palsy. She says she found the child yesterday in the street in a pile of garbage. We take the child, rush him to the back room, start an IV, give fluids, antibiotics and he looks better. The local doctor takes off to find an orphanage that is willing to take the child. He and I both suspect something is not right. From the way she was holding the child, the way she looked at him, the way she got him to eat, said a lot. I get an interpreter to help understand the events of yesterday. Where did she find the child? Had she ever seen the child before? Did she have any idea who the mother could be? I did find out that she has 10 children and that she lives in the street. The local doctor returns and says that the orphanage is full and that the child with cerebral palsy would be too difficult to care for. We both talk about our suspicion and go talk to the mother. We tell her that "we will help her and her child." She says thank you. We all know now what the real story is. We gave her the opportunity to say what she couldn't say. We didn't shame her, nor humiliate her. We didn't judge. By telling her that we would help her and "her child" we told her we knew he was hers. She had tired to find a way to find care for him, beyond what she could provide herself. She was willing to give up her child, but could not bring it on herself to openly tell us that she was giving him up. The story was made up. We got the local pastor, got her tied in to the church, set up continuing medical care for her with the local doctor, got the child started on a nutrition program, gave the child needed medicines, and she left with the child as she had come. As a mother.

In a world such as ours, with poverty and hardship beyond description, people will do desperate things. We helped her without taking away her dignity. She had the best interest of her child at heart. She was not abandoning him. She was trying to find someone who could care for him and give him what he needed with his disabilities. We gave her a sense of dignity, and the child a chance to have a life. How good of one, is yet to be seen.

I ask the question over and over again: for what purpose are we here? And after today, it becomes clearer. To serve those who have nothing, who out of desperation will give up their own children to insure their children will have a better life. To realize our own short comings and our inadequacies. But above, all to give those who have not, a chance to have their dignity and to be recognized as persons, not forgotten, but embraced for who they are. It makes me wonder why it is sometimes so hard to do. It wasn't today. Let's hope it's not that hard tomorrow, or the day after, or the day after that...

In all things give thanks,
David

(see www.tenutophotoblog.com for more pictures)

Haiti Day 3: Limbe

(See www.tenutophotoblog.com for picturesd and Sandey's blog)

23 miles and a 1 hour and 45 minute drive to get to where we were going today. To say the road was less than perfect is an understatement. We saw a little over 300 patients today, in a very small building, little light, a generator that had a mind of its own, and people everywhere. We saw patients, played with the children, and did the "chicken dance".

I brought with me a small water filtration system that is amazing. Using a 5 gallon bucket, I hand drill a hole in to the side, attach a pipe connector, attach a small filter and let the dirty water (and I mean dirty: drain wter with dirt from the ground mixed in) drain through the filter by gravity. (I'll post pictures when I get back). The water came out crystal clear, and with a crowd around me, I drank it. Quite the experience. With a $45 filter kit, we now have pure drinking water for a village.

We had a local doctor meet us there today as well, and he saw patients with us. I'm hoping that he will continue to care for the children when we are gone. I'll be taking 3 Haitian pediatric residents with us tomorrow from the pediatric hospital.

We saw the usual types of patients. A lot of rashes, stomach aches, abscesses, generalized malaise, and parasitic disease. One of our doctor's saw an 80 year old woman (after all the MoM children are seen, we see adults) who had had a stroke a year ago, and had one side of her body paralyzed as a result. One side of her face was also paralyzed. When asked what we could do for her, she said "can you help me smile again." No much more I can say to that.

Haiti is a torn country, devasted by war, revolts, corruption and poverty. It is said that "your lucky to be alive in Haiti." The poorest country in the western hemisphere. But the smiles on the children that we saw today, as they danced and played with the team seemed to make up for that. The smile of a child is richer than all of the gold in world. We smiled all the back to the hotel tonight and I'll fall asleep with a smile on my face knowing that we made this day, one that they may never forget.

In all things give thanks,
David

Haiti Day 2: Trou de Nord

(Please got to www.tenutophotoblog.com for pics)

Early start, late arrival, bad roads, pot holes, people, animals, narrow streets, garbage everywhere, and hot and humid. Hello Haiti. We get to the site where we are going to have the clinic, and start to set up. A few glitches, rearranging, reassigning, and we're off. We saw 110 patients in the morning and 110 in the afternoon. 220 total patients seen in about 6 hours. A slow start but thorough and complete. We didn't see anything out of the ordianary: rashes, pneumonia, urinary tract infections, etc. 2 semi emergencies: 1 woman with heat exhaustion and a lethargic child. Both did fine after we cared for them.

The pastor of the church where we were, gave a very touching speech of thanks at the end, which gave all of us a mirror to look at: what we do, and what we are can be seen by others, and yes, by ourselves, as noble and humanitarian...for the week that we are here. The pastor's work is everyday, without rest, without question: caring for the forgotten children. Noble and humanitarian. It made me at least look in the mirror and see who I am, not what I am. A servant to those who came to us, the ill, the suffering, the hungry and the poor, their hands out stretched. I wonder if I will still see that "who" in the mirror when I get home. I can only hope.

In all things give thanks,
David

Haiti: Day 1

(Pictures at a later date)
Up early, and off to Haiti by bus, trailer, and van. A 3 hour drive to the border. The scenery changes, the atmosphere changes, and our mood changes. A little more somber, a little more worried. We are to cross the border with over 600 pounds of medicine, go into some hostile territory, and there you have it.
We arrive at the DR side, and the bridge is waiting for us. Across that bridge is a desolate and barren land, strikingly isolated from the rest of the world. Haiti: the poorest country in the western hemisphere. The bridge spans a river named for the genocide and atrocities that occurred during the political upheaval years ago. "Massacre River". Thousands upon thousands were butchered and violated. We cross with that in mind and wonder what it was like, and more importantly why it had to happen.
At the end of the bridge is the Haiti customs and passport control. The test of our paper work and contacts works. We get through. Nothing is confiscated, no fees, but a few bribes. We pick up our 2 plain clothes armed police men who will be with us for the week, one in the bus with us, the other in the van with the rest of the meds. Within 30 minutes they earn they keep. We are stopped by a "customs" officer, later to be found out to be renegade and wanting a bribe, and then the national police at a road block. Without our escort we would have been in some serious trouble. No fault of our own. It's just the way it is here if you don't have someone who knows the ropes and has some fire power so to speak. We make it to Cap Haitian after another 2 hours. The city is difficult to described. Picture a city pummeled by poverty, garbage, isolation, war, corruption and dry. That's where we are.
We get to our hotel, and it is a welcome site, nice and clean and a little out of the area of filth. We spend the rest of the afternoon and early evening packaging meds for tomorrow. We're tired, yet excited. Anxious, yet patient. Tomorrow brings our first day of patients. We'll have double the team that we have now, with interpreters and support staff. And our 2 security officers. Practicing medicine with armed protection. Maybe a little too cautious. But then again, who knows what's behind the throngs of people we may see tomorrow. Perhaps just love and acceptance. And that will be just fine with me.

In all things give thanks,
David

Haiti: and so it begins...

13 left Phoenix, picked up 2 more in Dallas, and 3 in Miami for a total of 18. 2 already in Dominican Republic. Grand total: 20 US team members. There are 5 DR members here, and we expect about 15-20 interpretors when we get to Haiti. Total team of about 40-50, perhaps more.

We made it to the DR with over 600 pounds of medicines, and had a short glitch at customs, but paper work helped, and after discussion, negotiation and persistence, we made it through. The team is ready, and we leave early in the am for Haiti. Thru customs again, and then into the country with hopefully all of our meds.

It interesting to see who we are on the 1st day, and who we will become by the last day. The changes are dramatic, in our emotions, our expectations, our outloook, and our understanding of life. We come with an attitude of "giving" and leave with a gratitude of "receiving". We always leave with more than we came with...I think you know what I mean. Our expectations are somewhat skewed until we realize that it is not about what, but about who. The greatest too we bring to the people we'll see in Haiti is ourselves. I'm excited to see how we'll use it. Tomorrow comes early and soon...and so it begins.

In all things give thanks,
David.

Haiti: Getting ready…

We leave this Friday, October 30th, 2009 for Haiti. 22 US team members and 25-35 local team members. Big team for a big medical mission trip. We expect to see over 2500 patients and will be traveling to some pretty remote places in Haiti. We have over 600 lbs of medicines that we are taking in addition to our equipment. We have a photo journalist and a video journalist who will be with us, 4 doctors, 6 nurses, a pharmacist and 1 pastor and 10 lay people. We’ll have 2 security guards with us  at all times, a police escort from the border from the Dominican Republic into Haiti, and police to watch over us. Sounds dramatic, but it’s really only precautionary.

We’ll be seeing the 1000 children that MoM sponsor, their siblings and families. 10 projects, 100 children each. Clinics will be run every day, from 8am until we’re done. We finally got our clearance in writing from the Minister of Health in Haiti to bring the team and medicines in. We’re ready…now all we have to do is make the flight. More to come…

In all things give thanks,

David

Health Care Worker Course: Kenya and Ethiopia

I returned a few weeks ago from Kenya and Ethiopia where I taught the global health care worker course. There were 22 students in Kenya and 23 students in Ethiopia. All of the students were either teachers or staff at the Mission of Mercy projects and were committed to the intense one-week course that was given to them so that they could become a health care worker in their projects being responsible for the health care of the children to whom they serve.

The healthcare worker course entails five days of intense learning with an overview of anatomy, physiology, pharmacy, first aid, CPR, common illnesses, management of emergency situations, and algorithm based treatment. Physical examination skills were taught and each student received a medical Fanny pack that included a stethoscope, a blood pressure cuff, trauma scissors, pen light, peak flow meters, a thermometer and an assortment of accessories that they would need to do a full physical examination on a child. They practiced on each other and learned to listen to the heart and lungs, to examine an abdomen, and to do a neurologic examination. There were skill stations where the , students learned  CPR, how to stabilize and move a trauma patient, and do basic first aid. They also had time to spend with anatomical models of the heart and the brain and to present to the class the anatomy and physiology of different organ systems. Actual patient cases were discussed and the students were given an opportunity to share their own cases. In five days the students went from never holding a stethoscope to being able to tell the difference between regular heart sounds and a heart murmur, clear breath sounds and wheezes, and were able to ask the right questions to get a history and were able to do a full physical examination on a patient.

The purpose of the healthcare worker course is to have one or two people who are in the projects every day where Mission of Mercy children are, in order to evaluate, treat, and referrer as necessary, children who are presenting with any signs of illnesses. The children will now have the opportunity to reach their potential for physical and spiritual growth.     

In all things give thanks,

David

Haiti: poor is what poor is....

Haiti. The poorest country in the western hemisphere. And from what I saw, there is no doubt the statement is true. I came back recently from doing a health needs assessment of the children there, in preparation for our medical team trip the end of October. I’ve been to some poor countries, but this one seems to stand out a little bit more. The reason is simple: isolation. Due to the political turmoil, the bad publicity, the violence, the uprisings, and the attitudes, there is a sense of isolationism, somewhat self imposed, that prevents many from the outside of entering. Mission of Mercy has taken on 1000 children in 10 projects, all but 2 are isolated, wilderness confined, and poor beyond poor. And that’s where we’re going. The children for the most part have the usual maladies, degrees of malnutrition, and a sense of longing. Their faces where either bright and happy, or empty and drawn. Nothing in between.

I visited the Justinian Hospital where there is a pediatric residency program and saw this baby who was dying in front of our eyes. I gave them a quick bedside lecture on resuscitation and within a few hours, he had some life in him. We’ll be using the hospital as a referral hospital for the sickest children we see.

Dirt is dirt. Pollution is pollution. Filth is filth. All of that is in Haiti. We’ll need to pick through all of it to find the clean hearts of those who know to whom they belong. The children, all 1000 of them that we’ll be seeing, are reaching out. I can’t wait to hear their hearts sing.

Day 5 Lotubae and Elelea, Kenya

Emma died. She stopped breathing yesterday afternoon. We were not able to go see her yesterday and today we just ran out of time. The health center's director came to pay us a visit at Pastor Parks's house and informed us. Her picture taken less than 24 hours ago showed that maybe she might make it.

We went further into the bush today, crossing rivers and using 4 wheel drive the whole way. The Land Cruiser was packed high. We saw about 200 children. One of the last children we saw had severe conjunctivitis and a high fever. Oral antibiotics, paracetamol, and oral fluids was all that we had to offer. In the US she would have been admitted to the hospital for IV therapy.

There is much to be said and little to say. When you look at the pictures, what do they say? We can only begin to understand the meaning of all of this when we look at ourselves and ask whose are we, and to whom do we serve. We reach out our hands, and touch those who are reaching out to us. We gentle take hold, and hope that what we do will remain with them and us for a very long time. Because if it doesn't, we have lost the meaning of grace. This has been an incredible experience, one that will remain with me for a very long time. The faces, the places, the people, all of it, are now part of my heart and soul. It just keeps on getting better and better, and I can't imagine doing anything else. Let it keep growing. You've all heard it before: there is so much to do yet, and so little time.

In all things give thanks,

David

Day 4 Lokori, Kenya

This day is the day of reckoning. We have been around the bush, seen a lot of things that only we can see in our minds, and we are beginning to realize that we have been given a rare opportunity to witness life at a different level. What we do with that is what we are struggling with. Will it change our perspectives, our goals, our vlaues, our lives? We ask the questions of ourselves, waiting for the answers to appear. We know that we are here for a very short period of time. We have made a difference. we hope. We realize we have been changed, like it or not. The team members, Leah, Kelly, Sue, Bill, Candice, Yvonne, Hapi, Nicholas, Pastor Park, his wife Sungi, and Sam (a close friend of the Parks who joined us in Lokori) are bonded in faith, committment, and love. Here they are.

In all things give thanks,

David

Day 3/4 Lokwii, Kenya

A 15 kilometer ride into the bush and we get to Lokwii. A small isolated village in the middle of nowhere and we set up our medical clinic in a church that Pastor Park has built. 8 hours later we see the last of 300 children. We walked throught the village at lunch and saw how they lived.

We got a goat and a rooster as a gift. Not sure what to do with them, we give them to Pastor Park, hoping that these 2 will not be on the dinner menu very soon. This brings a whole new meaning to "medical insurance and co-pays".

We checked on little Emma and saw that she was a little better, but we still couldn't find any formula. She is weak. We are getting tired, and feeling very vulnerable. Can we do anything that will make a difference for her? Just how far should we go? The ethics of third world medicine are hitting home; do what you can with what you have, the best way you know how. No more, no less. We all sense that Emma will die.

In all things give thanks,

David

Day 3 Lokori, Kenya

300 lbs overweight and something had to stay back. Weighing all the medicne and the passengers for the MAF flight put us over the 1073 kg limit for the Cessna Caravan that we were going to use to get to Lokori. We went over the almost 2500 lbs. That's a lot of medicine and a moderate amount of people. Nicholas (he and Hapi are the country liasons for Kenya) is there with me as we sort out what is going to stay and what is going. We took 2 empty seats out of the plane and that gave us another 50lbs. We loaded up and made the 1:30 minute flight to Lokori through a little weather. Pastor Park, who is a Korean missionary, was waiting for us when we got there. We unloaded, claimed our individual tents which would be our place of refuge for the next 4 days, and off we went to our first clinic. 150 children later and a sick 3 month old we were done.

Let me tell you about Lokori. It is a very small village south of Lake Turkana, isolated and very remote. It serves as the base for Pastor Park and his wife who run a ministry to MoM children in 6 villages that extend out in a 32 kilometer circle around Lokori. We are to go to most of them over the next 4 days. There is nothing in Lokori. Nothing. A dirt strip is used for MAF to land, the nearest town, civilized town, is about a 10 hour drive, there is no electricity, water, nothing. And we are there. It is in an area that is potentially dangerous with bandits around, who prey on those who are vulnerable, and for that reason we had 2 armed guards with us the whole time we were in the region.

A 3 month old little girl, Emma, was brought to us

by her mother. The mother had no breast milk, the baby weighed less than 5 pounds. She was minimally reaponsive, extremely dehydrated and grunting with respiratory difficulty. I cut some IV tubing and place it down her nose as an NG tube and we gave her ORS down it as she could not suck. We took her to a local clinic where we did an old fashioned blood smear looking for malaria. There were none. The nurse James who ran the clinic found some old IV catheters and I placed one in her hand and we found some IV antibiotics which we gave her. The baby is staying the night there to get more NG feedings. We'll see how she is doing tomorrow. All in all, a very difficult day.

In all things give thanks,

David

Day 2 Emarti, Kenya

Two and a half hours south of Nairobi, we're in the bush. Everything is packed up on a Land Cruiser, our off road, bush running, hard core 4 wheeler, and off we go.Emarti is one of the MoM projects with 250 children, isolated in the bush, but surrounded by many who love them.

We picked up along the way, Julius, a nurse who runs a clinic in Kajiado, and Mary a community health worker. I had met them in May 2008 and wrote about the hidden haven for phyically disabled children that Julius runs. Julius is also physically disabled, having had polio at a very young age.

When we arrived we were greeted by a large throng of singing children

and Masai women who wore traditional beaded jewlery and dress. To see the contrast from us and them is beyond description, but one thing was clear - human dignitiy, personhood, and acceptance as one who is valued, is never to be taken for granted. We are those who ahve. They are those who have not. With little time to spare, we set up our exam stations outside and we started. And I mean outside. We had about 6 hours of day light to see a bunch of children, and get out of the bush before dark. Each of us had a small table from which we worked from, the children coming to us one by one, getting examined then off to pharmacy for meds.Hours later we were done. We had seen all 250 of the children and then some. Several children stood out: one boy with HIV/AIDS and 2 children who were mentally handicapped. Even with those limitations, and in an isolated environment, they were as much of the family of forgotten children as the rest. Well cared for, loved, and counted as persons.

As we wrapped things up we were gifted with song and dance, jewelry, and love. And on the way home we saw giraffe, gazelle, and zebras.

There is no better way to spend a day with God than to be doing what we did today. Giving, receiving, and living in grace.

In all things give thanks,

David