Wednesday, February 24, 2010

More Haiti Blogging

Today was a relatively slow day at the hospital because got 10 new nurses in from the Dominican Republic today. They have been taking over the tents, leaving some of the more interesting tasks to some of us who have been here for a while. Today, I got to do the procedure on my patient Joshua's arm. The anesthetist sedated him with some Fentanyl and Versed, and then I was able to flush and debrid the inside of his arm, pack and dress the wound. I felt like a doctor today! It was great! Later in the day, the ladies from Kenscoff (a midwife and a nurse) who are trying to build a clinic with a specialty in women's health in a small mountain town came by to meet me for some medications. I was able to pass on all of the supplies that were gathered by family and friends to them to start their clinic. With 2,200 doses of antibiotics, we were able to give them a pretty good start for their supply. I think I'll end up there during my time in Haiti to help them set things up and treat some of the incoming patients. As a matter of fact, as I write this in retrospect, we just found out that a man came in after being attacked with a machette on his head and the stitches we had donated were the ones that provided closure on his head laceration.

At the hospital today, things went pretty smooth. It's great to start seeing the patient's progress in their healing and therapy. We are lacking in physical therapists, but the ones that are here are doing the miracles. They are getting the people up and out of bed and giving them the confidence to walk with crutches and walkers. Our little boy Joshua is making great progress too. He is smiling and laughing. I continue to debride and pack his wound every other day. Between that and the rocephin he's getting, he's completly coming around.

After work today, Alex came and picked our team up for a little sight seeing. He drove us out past Carrefour to the epicenter of the quake in Leogone, which is 95% destroyed. It looks even worse than Port au Prince. On the drive there, passing through town, you'll spot plenty of roaming animals... dogs, goats, cows, horses, and giant pigs. One of the horses was just hanging out in the median. Other things you'll see on the ride between PAP and Leogone are the city buses that are filled to the brim with travelers. People travel however they can, holding on to the back, in a seat, or on the room. I just have seen about 50 people on the roof of the bus at one point.

On our way to Leogone, we stopped at a Rum Distillery. This factory is one of the two out of 60 factories still standing since the earthquake. We ate some fresh sugar cane straight from the fields and watched the process of taking the cane, processing it, taking the sugar and boiling it, letting it ferment, and then getting distilled into world-class Haitian rum. The rum here in Haiti is well-known to be some of the best in the world. After our little rum farm tour, we plucked some fresh mangos from the trees and chowed them down. We tore into them exposing the bright orange pulp on the inside. The juice was all over our arms and faces and none of us cared. It reminded me of when I was a kid and would crawl up under the tangerine tree with the neighborhood kids eating tangerines while they dripped down our chins after a long day of playing in the orange groves.

Anyhow, this trip to Leogone was short because we had already worked a days work and it was starting to get dark once we got there. The town was so interesting with rubble and destruction that we decided to head back in a couple of days. Driving back at night was interesting to see the candlelit sidewalks sihloutte the figures of wandering Haitians in a cloud of dust from the dry clay roads.

This morning we took Elizabeth and Victoria to the airport for their flights out. It was sad to see them leave because they've been here with us nearly since the beginning. It's interesting at the airport because there is a noticable decrease in US military. Instead, the Haitian police have started taking over parts of the airport. Perhaps that is because the commercial flights in and out of PAP resumed. The roads to get to the front are being rerouted and detoured. Police are out directing traffic and moving things along. However, it seems to be causing more confusion than good. It is nice to see that order returning to the country though. Even at the hospital, some order is beginning to return. We're using official medical administration records now instead of scribbling on the back of a piece of cardboard or something. With the rules and order comes greater responsibility for all.

I've been feeling pretty tired and sluggish throughout the day and been fighting a nagging headache. Overall, though, I still feel pretty good though- not like I'm getting sick, just worn out and probably a little bit dehydrated. After work tonight, the ladies from Kenscoff called wondering if Josh and I wanted to go down to the palace for a concert. I wreally wanted to just go home and get to bed early, but I figured that it would be good for me to get out and have a little fun and I also had a sneaking suspicious that there was something I was supposed to see or learn while I was there.

The concert was being held just by the palace. An organization has come together to help start rebuilding the moral of the Haitian people through music, spoken word, videos, cartoons, dancing, and more entertainment. There was a stage with 2 large projection screens. Our friend Justin from Kenscoff got up on stage and spun fire for a while. The crowd loved it. Folks got a chance to talk to their people into a microphone while their image was projected on the big screen. There must have been at least a couple thousand folks out enjoying the entertainment. It was a really special night because it was the first night of these hope spreading concerts. Instead of doom and gloom everywhere you go, there was music and smiling and people getting to speak their minds and feel heard.

At the end of the live music, they played the new music video for Haiti, "We Are The World". It was really beautifully put together by about 80 various music artists. Some of those artists include: Michael Jackson, Pink, Wyclef Jean, and more. As we were watching it and chatting, Josh and I looked up at the same time and then over at each other and said, "did you just see that? that looked like Joshua!" When they replayed the video again later we recorded the part where we thought he came up in the video and sure enough, there was the little boy we rescued from the side of the road. It was his wheelchair, his smile, and his eyes! It was our little boy! I started crying immediately, one of the first decent cries I've had since we got here. What are the odds of that, truly, that we would rescue the little boy in that video and then be there at the palace square that night to see it. That's God working! I feel like it's him saying, "you are exactly where you are supposed to be, doing exactly what I want you to be doing... keep it up." The rest of the song was so meaningful, standing in the palace square with thousands of raw Haitians singing along to we are the world, arms around one another, and for that instant feeling hopeful and not so alone.

I had my first real entire fun day off today since I've been here. Josh, Shane, Marissa and I went back to Leogone for a day of adventure and picture taking. It was fun driving through before, but it was almost painful for me because we'd see something completely amazing, but not be able to get out and get a shot.

Before departing, we were all meeting at the hospital. We really wanted to show Joshua and get his reaction to his appearance in the new "We Are the World" music video. We carried him into the office area, sat him down beside the computer and played the clip. When he saw himself in the wheelchair, his eyes lit up. He knew it was him and he was happy about it.

On our way out of town, we stopped by the Port. The ports have been pretty much destroyed. It's no exageration. The docks leading into the water have massive fissures running through the concrete and asphalt. I stood in one and it came up to my waist. Giant cargo containers are upturned like carelessly scattered legos. Some of the cargo containers are still laying toppled into the harbor and one sat anchored on a reef several yards off shore. We crawled over a few of the cargo containers off the side of a warped warehouse to get a better view. There's no activity, but plenty of boats anchored off shore. In fact, it looks like we're in the middle of a war or something. There are enormous naval ships like I have never seen before... one's where aircraft can land, one's with massive steel encasements like something you'd see only in pictures, and of course, the US Comfort hospital ship. Getting to shore to see these boats up close is nothing short of amazing. As we were leaving, the guards didn't want to let us out because we were apparently supposed to have a badge to have gotten in. They had just flagged us through when we arrived there, so we weren't sure why we were having problems leaving. It was a bit unnerving, but then they just said, 'okay, you can go'.

Continuing our drive Southwest to Leogone, we passed a number of tent cities that have popped up along the beach. This is where I would want to build my tent if I had to stay. The water is aqua blue, the breeze is refreshing, and your on a transportation route. We stopped off to see the tents and accomodations along the beach. The locals were selling a lot of local food delicacies including friend plantains and goat. Goat? Yes, goat! I ate me some goat! Surprisingly, it didn't taste like chicken, but more like beef instead. It wasn't too bad. I'd like to try goat jerky next. The kids were also selling little plastic cups with some sort of sea creature in them. We found out they were baby conch shells and when I looked over along the shoreline I realized it was littered with thousands of little bright orange conch shells about the size of my fist. There again is some beauty amid the chaos. We also stopped off along the way at the Rum farm so that Shane and Marissa could see the operations and try some of the best mangos in the world. It was a nice little pit stop along the way.

The closer you get to Leogone, the worse the roads got. Driving along, suddenly the road would just drop a couple of inches. Entire slabs of road have sunken, shifted, and massive fissures now like the asphalt. In one of the more hazardous crevices, locals have stuck palm fronds and plants to warn people. The plants were also accompanied by several signs that profoundly expressed the state of the community, "We are angry," said one. Another read, "People are dying". Still another one, in several pieces after getting run over by a vehicle pleaded "We need help!"

Continuing into the city, you see the police station destroyed, an 18th- century church collapsed, and a bank reduced to nearly dust. One thing I noticed that was pretty interesting as I looked through the rubble is the enormous amount of coral used in construction. Many of the key structural supports are formed using massive blocks of hardened coral. I would have never guessed that coral would form a strong enough material for construction. However, by the looks of things, it apparently wasn't strong enough.

We ventured over to the main graveyard in Leogone and had some real eye-openers. The cemetery is a mess! With the way the earth shook and warped beneath the burial plots, entire tombs and crypts have either crumbled, been knocked over, or completely unearthed. There are wild goats running through the cemetery as well, one I saw trapped inside one of the crypts. Gravediggers tirelessly work under the hot Haitian sun repairing and piecing the cemetery back together. Leaving behind an enormous death toll, the earthquake has created a problematic situation of where to place the dead. Space is limited. In one instance, we saw where a man's coffin had been removed from his tomb and replaced with a new body, resealed with freshly poured concrete, and inscribed with perhaps a stick or something in the cement the day Haiti changed forever 2-12-10. It was a very eerie sight. The efficted coffin that lay next to what should have been its final resting place, lay completely open, the skeleton inside exposed. You could tell it was a man, he was wearing a suit that was nearly disintegrated, a pair of rotting socks, and was holding a silk flower that had lasted longer than he had.

A few plots down from his, there was a huge pile of bones. The crypt keeper explained that you only get a lease of 5 years when you die here. Then, they can exume your body, pile up your bones and personal affects, clean out the grave, put your remains at the bottom, and pile a new person on top. That's what was being done here. Three skulls lay atop a pile of bones, resting on a tomb next to that was a pile of dentures and other small personal affects like a flask, a comb, and a little bottle of perfume. What an eerie thought to know that many of these graves are recycled over and over again.

As we were leaving the graveyard, we saw a much lighter sight. Some guys had just got back from fishing with 3 huge spearfish. Each one was about 4 or 5 feet long. The guys pulled the fish from the top of the tap tap (a sort of bus/taxi here) and put them on the back of a motorcycle already carrying two people. The motorcycle took off, the fish got bumped by the tap tap, and all the fish went flying. We were all laughing, it was such a random sight. You just never know what your going to see down here.

On our ride back into town, we stopped at an old tuberculosis sanitorium. It had suffered major damage in the quake. This is perhaps one of the eeriest places we've seen since being down here. Respiratory medications, nebulizers, and inhalers sat scattered throughout the rooms. Tuberculosis is still endemic to these parts of the world and it's still just as deadly and contagious as ever. As we walked through the various wards, we were amazed at the damage. Entire walls now laid on patient beds, a pile of diapers and pill bottles filled a back room, and sharps containers now had plants growing out of them. One thing that was rather hopeful though was that every room had a faded picture of Jesus on the wall. It was another little piece of hope among the rubble.

Continuing our journey back to town, we stopped off at a massive river bed where despite being filled with trash and rubble, children ran around as though no tragedy had ever happened. Several kids had made kites out of plastic bags, a tin can, and string. These are some of the shoddy kites I've ever seen, but boy could these kids fly them. Some of them floated so high you could barely even see them anymore. Down a ways, was a dozen or so kids buck naked swimming in the little water that still flowed through the river bed. I suddenly realized I was walking through a national geographic movie. It was entirely sureal. The kids were splashing, and running, and jumping, and laughing. It was really sweet to see them all so happy.

One last stop on our way into town, we stopped along one of the slums along the shore. We had to navigate our way back through the houses and rubble to get down to the shore. The view was amazing, as we could see the US Comfort up close and the many other boats that lined the harbor. However, the shore line was anything but pretty. It was cloudy, merky, and smelled. A few yards away, a girl popped up her head from a makeshift steel port-a-potty that hovered over the ocean. This is where they poop and pee, and suddenly I understood why the water was so murkey. A neighborhood of people stood back a few yards amid the damaged homes having a huge community bathing party. Everyone was scrubbing up from and cleaning themselves from what looked like a broken pipe. Can you imagine taking community showers with all your neighbors? Things are so different down here. While walking back to the car, we passed a few baby goats. I was able to pick one up and hold it... so sweet. Suddenly, I felt guilty that I had eaten goat several hours earlier.

Last highlight of the day, we pulled into downtown Port au Prince on our way back to the hospital and our driver went to do a U-turn in the road becasue there was a parade of some sort approaching from down the way. Just as he got perpendicular to the road, his car died. Of all places to have your car die, in the middle of the road for an approaching parade is one of the worst places for it to happen. I was laughing so hard as the parade approached and started going slower and slower, and then suddenly realized we weren't going anywhere and marching around us. It was pretty funny and eventually we got the car started after a few of us pushing it and popping the clutch, and our first real full day off was a wrap.

We were extremely short staffed today. In the ER sedation room, it was just me, another nurse, and an EMT to take care of all the dressing changes. It was very nerve-racking. We sedated them, removed staples, opened up some massive wounds down to the bone, debrided them, repacked them, and dressed them. It was intense, but at the end of the day we didn't kill anyone and everyone had fresh dressings.

After work tonight, it was about 8 o'clock and our ride never came to pick us up, so Josh and I had to walk a mile and a half up the hill to our place through the pitch dark. I was totally freaked out because I didn't have my mace on me and was carrying a bag with my laptop, ipod, and all my money in it. I picked up a big piece of rubble in my hand and I was ready to use it on somebody's skull it they tried to mess with me. Some parts of the town still don't have electricity and the parts of town we walk past that are just rubble certainly are dark... pitch dark. Fortunately, we made it home safe and sound, but I won't ever do that again- not unless I have no bags and a container of mace.

At about 4:35 in the morning, I was awoken from a deep sleep to my first earthquake I've ever felt. It was like someone was just gently shaking the floor. It took a couple seconds for me to compute what was going on, coming out of a dead sleep, but once I realized it was a tremor I jumped out from under my bug screen, grabbed my passport, and went running out the front door in about 2.5 seconds! It woke everybody else up too and they all came outside as well. Fortunately, it was just a little tremor at 4.7 so no damage here, but you always wonder if it was much bigger somewhere else for some other town. How scary that must have been for these people January 12th.

At work today, everybody was abuzz about the earthquake last night. Everyone was going around talking about how it had josteled them awake and how it was kinda scary. We had not heard of any injuries from it, but we did hear of a few houses that finally gave up and fell to the ground. Around 10 or 11 am, some additional tremors started happening around the hospital. They were very small, but enough to evacuate the operating room on the top floor and close it off for the day. Emergency repairs are being made on the hospital as we speak, repairs that should make it structurally safe at least enough for another big one. However, until those repairs are finished, the hospital is simply unsafe.

Guess who showed back up today? Joshua's mom. She and the grandma showed up wanting to take Joshua away. He still is getting heavy duty antibiotics and on an every other day dressing change under anesthesia. He's got a gaping hole in his arm that has the potential to cause major problems if he goes back to the lifestyle he came from. She explained to us all that she didn't care for him or like him, but that they needed him in order for the family to eat. She explained that they used him to get money from people so they could feed the family. I'm standing there taking to her through a translator and a few other nurses are standing around and we're so frustrated. This child is being neglected, if not abused as well, he's completely vulnerable right now fighting an infection and open wound, and we're supposed to just give him back to the mother?! That's like taking a goldfish and throwing it into a pond of sharks. The frustrating thing is that there are no systems in place here to protect children. If a child is being abused or neglected, then it's just too bad. There's no social services, HRS, or crisis hotline you can call. There's no one to report anything to. Even if there had been some sort of a system before the earthquake, it's not in place anymore. It seems so messed up to me that it's just as acceptable here to neglect and abuse a child as it is to abandon it in a dumpster as we have already seen. Where is the protective services? Where is the court system? Where are the advocates for those that can't advocate for themselves? I seriously contemplated the idea of just taking him to a good orphanage and heading back to the states, but realized that would be wrong as well. If there was anything I could do it would have to be through spreading awareness of the problem that exists, being part of solving the greater issue at hand, and perhaps before Joshua leaves us providing his mother with some education and training that will allow here to be more competent in her care of him. Other than that, it's a sobering reality of the problems that still exist in the world today and the gratitude we should have for the systems that we do have in place back home. I talked the mom into coming back to take Joshua on Thursday, but I know he won't be ready even then.

That afternoon, I went with Josh for a walk down to the palace to meet a couple his friends on their way to the Dominican Republic. We stood outside the palace gate chatting with them and the locals. Seeing such a great huge palace cracked and crumbled was so humbling. Many say the pride of the country went down with the palace when it fell. One man told us a very eerie story from the day of the big earthquake. He said that in Leogone, the epicenter, that in some places the ground actually opened up swallowed up houses and families whole, and then closed back up. He said people ran over to start to dig for the family, but not the people or the house could be found. Isn't that an unsettling though that the ground just swallowed structures whole? Who knows if it's actually true, could be the start of disaster laden urban legends, but either way, it scares the crap out of me.

Walking back up to the hospital, we passed the Plaza Hotel. We decided to go inside and check it out. This is like one of the nicest Americanized hotels in Port au Prince. It's also where all of the journalists are staying. Inside, you would have never known that an earthquake had happened. It felt tropical, had a huge swimming pool, a restaurant and bar that was opened, and a courtyard that was shaded and cool. It kinda caught me off guard because this one lady came over to me and said, 'hey there, I know you, aren't you that news anchor that quit her job to come down here?' She even knew my name! What a strange experience to be minding my own business in a third world country and be recognized by someone I've never met!

Back to the house tonight, again I started trying to type away journaling and found it difficult to keep my eyes open. I used to be somebody who could easily go to bed at 1 or 2 in the morning every night, now I'm out by 9:30 and up by 6.

Speaking of getting to bed and waking up early down here, this morning had a particularly early awakening. For the second day in a row, more earthquakes rattled the city. At 10:30pm I woke up to a quick tremor that got me up on my feet and just enough to get totally freaked out and not want to go back to bed. I laid back down anyhow, and again at about 1:30am, awoke to another quake. This one was another 4.7 like the night before, but it shook a lot harder. All of us went running outside the house, completely freaked out. We waited for a bit, then went inside and got all our bug screens, sleeping bags, and stuff quickly, counted off paces of the height of the house to the distance away the house could fall and tried to lay back down to sleep. Then, we started getting phone calls and text messages from locals. Josh found out someone in the Dominican Republic had felt this one, Alex up in the mountains had felt it too, and suddenly we started to really worry that a much larger quake had happened somewhere than we realized. We got a text message from someone at the hospital saying the 5 people had been dragged in with major crush injuries to their limbs. Apparently, several structures toppled in this one and caused some injuries to people inside or nearby. We decided we needed to get down the the hospital right away, as there would probably be more coming in. Alex's daughter dropped us off down there and it was rather quiet yet. The injured had left and gone to General Hospital because there was no one at the hospital to treat them when they had arrived. We stayed up through the night checking on other patients, treating a little girl with sickle cell anemia that was in pain, and waiting for the next trauma to walk to walk through the gate or for the ground to shake again. Finally, we all crashed on hospital stretchers for an hour or so and waited for the morning shift to come in. We had done our shift for the day and headed back to the house to get some rest.

It's getting more and more difficult to get rest around here because I keep getting more and more paranoid about the quakes. It was cool at first, but not I've been there, done that, and don't want to really do it again. I'm getting tired of being worried about falling asleep that I might not wake up. Every little noise now has me on edge. Speaking of noise, earthquakes do make a sound. They sound like distant thunder. There's a distinct sort of rumble that accompanies the shaking- it's very unsettling. As we were waiting around at the hospital this morning, a big piece of heavy machinery went driving past. It made the ground shake a bit and had a similar rumbling sound. It was interesting to watch the faces of the traumatized Haitian people. Even though we all knew it was a truck of some sort, their eyes got big and wide, they started to look around at each other, and it was as if a part of their minds were all re-living January 12th.

Saturday, February 20, 2010

More Healing in Haiti

Overnight, some more rain came and got our little boy we rescued yesterday's document's all wet. His name was washed away and nobody remembered what it was. We knew he was 12, but that was all. Since his mother had left, there was no way to find out either. Some of the other guys around the place suggested that I should be the one to name the kid since I had found him. I liked that idea. I put a lot of thought into it and decided to name him "Joshua Emmanual". Joshua means "God Rescues". I started planning his baptism, including a downloaded script and baptism certificate.

I was the charge nurse today and stayed very busy. I was busy coordinating the ER, OR, and tents. We only had 2 other nurses doing individual cares on like 70-some patients. We did get a new nurse today from Florida. She works as a prison nurse down there. When she showed up, she brought toothbrushes, toothpaste, shampoo and more stuff for us all! I was so excited not to have to brush my teeth with only half a toothbrush anymore and to have some conditioner finally!

In the ER today we had some highlights. One guy came in with a hole in his head that went entirely through his skull and to his brain. You could even see the gray matter! This man is a living miracle becasue he has been walking around with this hole in his head for the last 10 days and not gotten an infection. Another highlight of my day was passing by one of the tents only to see this young girl sitting on the edge of her bed, singing to herself and crying. She was alone and was coping with a rather fresh leg amputation. I can only imagine what was going through her head, what kind of loss she's experienced in the last month, and how she must envision her future to be. I sat down beside her quietly, put my arms around her and just rocked her. She continued to cry and sing softly. I cracked a little big here. Her pain chiseled away at the wall I'm having to reinforce around my heart to stay strong. I cried with her for a bit, we sat in quietness, and although we could not speak in another's language, the message of compassion and empathy were clear.

I noticed on our walk into the hospital today that my boots are finally broken in! This makes me very happy because I was worried about my feet getting wrecked in the process. When your in a place like this, you just can't afford to have your feet fail you.

The big highlight of today surrounded our favorite little "Joshua Emmanuel" who we had rescued from the streets last week. It was his baptism day! I went around to the different tents gathering families and visitors, we set Joseph up with a fresh new sterile gown, got out some baby oil, and clean water. We had one of the translators read a whole little thing about baptism in French to Joshua and the crowd. Then, we explained to Joshua that he was so very special and reminded him of how much God loves him. We went on to tell him his new name and why we chose it. He was smiling so big and was so excited. Everyone started singing together and clapping hands.

I've married couples before, but I've never baptised anyone before. I wasn't really sure how to do this, but I figured I didn't really have to know because it's about letting God show up and do his thing. I took the bowl of baby oil and made a cross on Joshua's head and told him that he was God's own. Then said a few words, took a scoop of fresh water and poured it over his little head, saying "I baptise you in the name of the father, the son, and the holy spirit." I cracked on that last line a bit becasue it was pretty intense! There were some others crying too. Then, everyone started to sing and clap again. Joshua was so happy about all the excitement and attention. There were angels in that tent! After the baptism, one of the women who had come to participate said she wanted to be his mom! Then, some of the other ladies were arguing about who would be his godparents, it was so sweet. This kid is so wonderful. He's got cerebral palsy,can't walk, can't talk, and looks like he's 4 when he's really 12, but when he smiles... he lights up the entire room. His face is filled with joy, innocence, and excitement for the moment. He's special alright, and he truly has touched my life.

Being here on a long-term mission is challenging in many ways, but one way that's particularly difficult are the continuous hellos and goodbyes. Just as soon as your getting to know someone really well, it's time you have to say goodbye. It's a sort of up and down roller coaster. Today, we had to say goodbye to three of the best guys we've had down here. Doc Bjorn and his medic staff Shannon and Adam are incredible. These are the kind of guys that if I'm every in a trauma incident, I want treating me! We had to send them off to the airport today, riding in the back of the truck, wind through our hair and laughing the whole way.At the airport, we were able to check on our options for flights out of the country when its time. We learned that the military has been "evacuating" any medical professionals on military planes for anyone wanting to return to the U.S. over the last few weeks. However, now that the commercial airlines are starting to reopen, they've been complaining that they aren't getting any business becasue the medical professionals keep taking the free flights out. Apparently, they ceased operations. Bummer. While leaving the airport, we saw dozens of soldiers escorting many orphans out of the country. It was quite a contrast seeing strong uniformed officers holding sweet, young and fragile children.

Back at the hospital, we got lots of new nurses today, about 6 of them. That was a real relief for us because we've been running ourselves ragged. I got everyone orientated and assigned to tents. For the rest of the day, I was in the ER with Doc Marty and Emergency Med Nurse Bob doing major dressing changes. We found some old speakers that hooked up to my Itouch and did our work to the sounds of Frank Sinatra and Michael Bouble in the background. We were dancin' and the patients were smiling. It was a productive day of work. During a lunch break, I went out to the back with the French Medical Team. I've had a few different types of MREs down here and can confidently say the French have the best taste when it comes to their rations. In one box there is a little stove, matches, water purifying tablets, coffee, tea, milk, hot chocolate, rehydration packets, Salmon entree, some sort of pate, sweet and salty crackers, fruit chew bar, nouggut bar, jelly, and chocolate pudding! It's really pretty neat! The French guys helped me get my little oven set up and then we had a little gourmet French ration picnic on a warm afternoon in Haiti.

Walking into the hospital today, we passed a church service that was going on in someone's front yard. It was packed, there were hundreds of Haitians pouring in to the crowd. I went over with a friend of ours, waited in line with everyone else and we went up to the priest and got some ashes on our forehead. It can't already be "Ash Wednesday" can it?

At the hospital today, everything was flowing pretty well. We were having trouble moving patients in and out of the ER where wounds are dressed and debrided under anesthesia. However, as always things end up working out in the end. On a positive note, Joshua, the little boy we rescued last week had his mother show back up. After she said those hurtful things about her son and left, we thought she had completely abandoned him. Turns out she has 2 other kids who she went back to and found out that a bunch of their stuff had been stolen. She says she had been trying to sort it all out, but her son nearly died and she disappeared for 5 days. I just can't fathom doing that! Either way, it's good that she came back because if she hadn't showed up by Friday, we were going to start making arrangements at one of the orphanages. However, it was a bittersweet day though because as Joshua's mom came back, two girls came in with a newborn baby found in a dumpster. The newborn had been abandoned by the mom.

Josh and I took off a little early today and went for a hike through town for some photography. We ended up getting way more than we could have hoped for. We went on quite an adventure! As we were walking, we started chatting with a Haitian guy with pretty good English. He was there with a couple of his relatives and gave us a few pointers on places to check out that were pretty intense. He ended up coming with us to translate and navigate. We went into the deepest of the slums. To get there we had to go through alleys, through some people's houses, and crawled over rubble. We finally got to the middle of the Haitian ghetto called what sounds like Sofu.

Just steps into the slum, we encountered a chilling sight. To our right was a small dead baby laying on the burnt-through coils of a mattress. Our translator explained that the house had exploded from a gas line. The corpse just laid there partially melted and deflating and everyone just kept walking by as though it was just another piece of rubble. I wasn't sure if we should do something with the body. Should be bury it? Take it somewhere? Cover it? What was the culturally appropriate thing to do here? If we did do something would if be offensive and be interpreted as pompous Americans who don't think the Haitian people know how to take care of their dead? We decided it was best to just leave the little body where we found it and keep moving. I said a quick little prayer for the baby's soul and we continued our journey.

We slinked our way through tiny passageways among a maze of makeshift homes constructed from sheets and salvageable remnants of the rubble. At about 3-feet wide, these parts of the slum only accomodate two-way foot traffic. In the broader areas, children can be seen bathing in the streets; goats, pigs and dogs eat left over garbage that litters the road or smolders in big piles creating a cloud of smoke. People piss and defecate in the middle of the streets and pathways, on buildings, and anywhere they can find becasue toilets are few and far between. The sanitation issues are paramount. With people living no more than an inch from one another in the middle of a sea of tents, the posibility for disease spread is inevitable. Here, some of the animals limp down the road as many of them too have lost limbs and mobility and now have ribs showing and are suffering from mange... many from rabies as well. Battered and worn, it just breaks your heart. I think about my little puppy back home and imagine him with no one to take care of him in such a mess and it makes me sad. Side note, it's only the dogs you really see here. I've only seen one cat and it was on a leash because cats are a delicacy here on the Haitian menu.

There is really nothing left in some of these slums. When one house would fall, it would take out 3 or 4 others. Those houses build on slopes and mountain would tumble down like dominos. Many of the bodies are still in the homes among the rubble, we saw various appendages and heard the stories of many of those affected by tragedy... entire families dead, 20 dead from a church collapse, 200 nursed killed in a nursing university, 50 kids dead in an elementary school, another dozen or so killed in the nursery. We walk among this rubble everywhere we go, knowing full well we are surrounded by death... the smell often permeates through the dust laden air.

We met this guy Ali Deschamps who is the sort of chief of this particular slum. He was very kind and his English was good. He took us around with our interpreter and introduced us to many of the locals. He showed us his house collapsed where 2 of his children were killed. Later he introduced us to a man who's family started to run out of the house to escape the shaking, but as soon as the shaking began the entire family couldn't get out of the house fast enough before it collapsed killing them all. Ali then took us to another home where we had to actually crawl into the pit of rubble beneath a collapsed house (I know, I know, very stupid decision and one I won't make again... heaven forbid we would have another aftershock, ya know). Inside, we found the body of another crushed child. You could still see the hair on its little head. It was very disturbing because it was very close and Ali even cleared some 200 pound pieces of cement to get to it. It was one of a whole family that had died in the now pulverized rubble and foundation surrounding us. Right then, I asked Josh and the other 3 or 4 Haitians with us if they would like to say a prayer for the family lost in tragedy. We all held hands and prayed to give their spirits peace and blessings into the afterlife. We prayed to just bless this particular slum and for God to heal the hearts of the people who survived. Strange, holding hands praying to Jesus beneath the earthquake rubble surrounded by the mangled dead. After our little prayer, we quickly hopped out of the rubble and moved on. Only a few hundred yards away, we found a group of men digging a hole. They were digging a grave for the body of a women who was killed in the quake. We didn't see her until we noticed the sheet tied like a bag... she was inside.

What amazes me is the magnitude of how these people have been stripped of everything they've worked so hard to acquire. If you lose everything in the U.S., there are systems, programs, insurance, and organizations available to help you rebuild. Your house burns down, Red Cross gets there while the house is still smoldering with food, water, shelter, and assistance. Insurance companies write checks to replace loss, should anyone be injured medical care is easily accesible, and should someone die... they receive a proper funeral. The more you talk to these people, the more you realize how bare they really are. Everywhere you go, children lift out their hands for money, point to their stomach and beg for food, and in order to not create a mob scene and protect yourself you have to just shake your head and keep walking. It breaks your heart. The sad part too is that Ali explained that there has been no aid in these slum areas becasue many are too afraid to go in. In asking Ali what his people really are in need of, he explalined to me the importance of tarps, or as he referred to them as umbrellas. Everyone knows the rain is slowly coming in and they are terrified.

The last thing I'll leave you with on this impressive day were some of Ali's final words. He said that before the earthquake, not too many Haitians believed in God. After the disaster, people are now walking around and can't talk enough about Jesus because they know he is real. Instead of dwelling on disaster, those who survived the quake are now being floated by faith.

Wednesday, February 17, 2010

It Looks Like the Apocolypse

I woke up this morning with one thing on my mind... go exploring! I had been so sheltered and focused in the hospital that it wasn't until our drive through downtown that I realized the world that awaited me. Josh and I decided to work a half day and then go exploring. Let me tell you about Josh Weirich. It's crazy because he's from Hayward, Wisconsin- about a 2 hour drive from my house. He's an EMT for the county ambulance and runs a snow shoveling and grass cutting business "Josh's Clean Cut" on the side. Before he left, one of his EMT buddies told him, "Hey, did you hear Julie Pearce from the news is going to be down there, I wonder if you'll run into her." Josh doesn't even own a tv, so he had no idea who I was, but we ended up crossing paths anyhow. He is here for a flexible length of time as well and has very flexible plans. We look out for each other. When it comes time to part from CDTI, we might travel together to another location where we become needed. It's nice because I've made a friend down here with more in common than just the northland- the two of us are always shooting off like a couple hundred pictuers a day, love adventure, and have strong faith.

We put in only about 6 hours at the clinic today. The owner and administrator's moms organized a mass in the middle of the compound for the patients. The priest spoke into a bullhorn in French for the whole thing. When they had communion, I had the priest come into my tent so that a few of my immobile patients could receive one. After we could get away from the clinic for a while, we paid a translator and cab driver to drive us around downtown for a couple of hours. We wanted to get amid the rubble and get out and walk with the people and snap lots of pictures along the way. It worked perfectly, we'd drive until we saw something we wanted a picture of, the driver would stop, we'd get out snap a few or keep walking and then get picked up at the end of a few block strip. I cannot even hardly describe what it is like to walk amid the rubble and what little remains of downtown Port au Prince. It's one thing to see pictures, it's another thing to drive through it, but it's entirely more profound when your feet hit the ground. There are fires burning in the middle of the roads, the only way they can dispose of the mounting piles of trash. Thousands of Haitians walk around aimlessly and leave you wondering where everyone appears to be going. The insides of buildings are exposed, power lines dangle over the street and curl themselves along sidewalks. 4 story buildings are completely collapsed with each layer of flooring now touching the other. You wonder how many bodies have yet to be counted. Throughout the air, a thick dust remains suspended as the rubble continues to settle. The smell reminds you there are still many left. When you look closely, deteriorating bodies could be seen. In one building, we found a man crushed amid the rubble at a sort of nursing home. With his disabilities, he probably didn't even have a fighting chance of getting free. Another upsetting sight was a school where a man nearly was free, but was smashed between two floors of the building and flattened to only a couple inches thick. His leg dangled over the side. Seeing these things is very upsetting. I've seen death before, but it's always been very reverent, very peaceful... not so twisted and traumatic as this. These people probably died filled with fear and pain. Its hard to see. Walking through the slum areas, we saw people living in some of the most horrific conditions. They were selling things like live chickens, charcoal, ice that's insulated by sawdust, and even pig's tails.

Finally, our translator had to get back to the hospital and our cab driver wanted more money, so Josh and I felt safe enough just walking by ourselves. It was a bit intimidating now because we no longer had a translator and we had a long walk back. We were certainly the minority too. In the whole day of walking through downtown and the slums, we were the only two white people around. We stuck out like a sore thumb. Once we got inside General Hospital, it was like a cultural melting pot. Medical staff from around the globe lined the tents and compound.

General Hospital is like the main public hospital downtown. The building was structurally damaged, so everything is functioning outside under several big tents. Josh and I wanted to explore the empty building, so we went on a little adventure. I've been inside many abandoned hospitals before, but this one topped them all. There was the most upsetting and unsettling feeling of being inside. It smelt like complete death. There was a room filled with gourneys and stretchers that were still covered in layers of decomposing blood and tissue. Afterall, thousands must have died here in the hospital that day. It was the closest facility to the worst of the damage. I've never smelt death like this- it is very distinct. Among this room, a patient had found refuge and was nearly dead. Dozen of flies feasted on his open wounds, a plate of food was flipped over, he was lying in his own vomit and feces, and yet so peacefully oblivious, sleeping probably his last few days away.

Throughout the rest of the hospital, it's obviuos everyone left in a big rush. Equipment is strewn about the rooms, there are big cracks in the walls, IVs that were probably ripped out in the chaos that still hang with the medicine attached on IV poles, medications sitting on countertops still waiting to be administered, and patient records scattered across the floors as entire filing cabinets and shelves tipped right over from the shaking. We went through the children's ward, the operating room, several other adult wards, the delivery room, and more. We found this one room that smelled like death times ten and found a refrigerator filled with unused units of blood dark and looking slightly cooagulated as they probably sat without power inside there for several days. Finally, we made it to another building where they were doing all of the operating. It was all open flow air, probably patient wards previous to the quake. There were a few bays they had set up where surgery was taking place. I believe this is the place I saw on the Nightly News where they were cutting limbs with actual rusty hack saws.

As we made it back out to the streets, I continued my trash collecting. I'm going to make a really neat art project when I return home, so I'm picking up interesting pieces of papers and documents for it. We were over at one of the fallen government buildings where identification cards, passports, and debt slips were weaved through the rubble. I had collected a few id cards and cool looking documents before getting a tap on the shoulder from the UN police asking what I was going to do with this trash. I told them I was going to make an art project and they said no. I quickly emptied the bag and apologized and they quit hassling us. I've collected several other neat things throughout the day though.

Josh and I were both wearing our scrubs, so we weren't really bothered by anyone unless it was a medical concern of some kind. Over by the Palace, we had a mother pull us over to check out her two small twins. I bent down and listend to their lungs and heart which sounded fine, only to look up and see a whole crowd of Haitians gathered around wondering what "the doctors were doing with the babies". Throughout the day, we'd randomly have people stop us and ask us to listen to their heart and lungs, even a crew from the Haitian Police Department and some guys with big rifles. I'll tell you, if a guy with a gun wants me to listen to his heart, I'll listen to his heart! As we continued our walking journey that took us past the fallen cathedral where the bishop died, past the big banks now destroyed, and past the tent city, we came upon a mom who saw my stethascope and asked me for help with her child. She didn't speak any English, but pulled me over to the sidewalk where there was this big blanket on the ground covering something. I pulled back the blanket and found this 44 pound little boy covered in sweat, frothing at the mouth, and covered in tears from crying his eyes out. He was burning up too and I knew we needed to get him some help immediately. We didn't have any supplies on us, so we decided to bring him back to CDTI. I hoisted him up into a wheelchair and we started pushing. The mom was lagging behind unthusiastic about the whole thing. Then we were able to stop this big SUV driving by and asked for help getting this little boy to the hospital. The man was very kind and spoke some English. Turns out we had just been picked up by the Palace architect! What are the odds of that? He drove all of us right to CDTI and I carried him into the compound and laid his little body on the closest stretcher.

He had a fever of 102+, a hand and wrist that were swollen like a balloon and was crying in pain. We had no idea the background on the boy at this point because we had no translators. When our hospital translator showed up, we discovered the 44 pound boy was actually 12 years old. He had suspected Cerebral Palsy, was born with clubbed feat, and his mom explained that he had been trampled by a crowd on the day of the earthquake because he could not get away fast enough. Immediately, we started a line in him, started running fluids, got him some Tylenol, and splinted his wrist until the morning for an xray. That night, the mom told our translator that he was nothing to her, that he does nothing, and that he's like a dog. Then, she left... leaving the child behind. She hasn't snown back up yet. Heartbreaking...

As it turns out, the boy's swollen arm had x-rays come back clear, and his CBC came back with a WBC count of 46,000!!! His arm was swollen because he had a significant infection. There was a little abrasion that was starting to fester and the suspected point of entry. This boy was septic. The doctor had told me earlier today that if we had not gotten him to the hospital, that the kid would have died for sure. I realized what a huge deal that was at that moment. I said to him, "So, does that mean we really saved a life?" He said, you've saved at the very least one life today. That hit me as so profound at that moment because I realized how if we hadn't been at the right place, at the right time, wearingthe right attire, we would have never passed the boy, the mother would have never flagged us down, and he would have never been rescued. This is truly a wonderful path that God is waking me down. I wake up, throw my feet on the ground, and he does the rest. I'm just so glad I get to be a part of his plans. Right before we had passed the boy, we had passed by the cathedral where we took pictures at the foot of the cross of another standing cross despite a devastated Church.

Monday, February 15, 2010

Friday- Out of the Cage

Today marks the 1-month anniversary of the earthquake that devastated parts of Haiti and claimed the lives of at least 225,000 people. We were awakened at 5am to the sound of singing. The Haitians wasted no time getting an early start to remembering the dead and celebrating the living. They are in the middle of their carnival weekend too. Everywhere we have been today there have been services, parades, and ceremonies honoring the day. Later in the day we actually ended up driving right through the middle of one of the parades of people. It was called a Thanksgiving March where they were offering praise for their blessings and asking for salvation. Some were singing, some were dancing, and nearly everyone was waving their hands through the air. They have these vehicles here that are like announcement trucks. They creep me out because they remind me of something in an armagedom movie or war scene or futuristic disaster film. The trucks have massive speakers on them and drive around with this loud creepy voice emiting from them saying important messages and sometimes playing music. They are loud too. One of these little trucks creeped its way along with the herd of people in the parade.

We got to see this whole little parade on our ride to find a package that was shipped here for me. A friend of mine got me 2200 doses of antibiotics that were coming in on a charter flight today. I had the tail number and the ETA, but not more information than that. We had been walking down towards the hospital from the house when Alex the hospital administrator drove by in the bus. We waved him down and he told us to get on the bus and he'd help us get the package and show us downtown. First, we had to go to the airport to pick up some new medical staff coming in. While we were there waiting for them to arrive, Nancy Pelosi's plane came flying in for her visit. They kinda secured the airport for her arrival. Meanwhile, a bunch of us were able to head over to the University of Miami's medical tents. This is quite a setup. They have massive air-conditioned tents filled with hundreds of patients. The cots line every piece of space in the building and cards, posters, and drawings are hung around to cheer things up. It's really quite a sight.

Finally, Alex came back with the new med staff, and he starts talking about this package that he has to pick up. He says he doesn't know when its coming in or what the tail number is, but he said that he might just have to go pick up his package at the Ruuska Village later. I nearly jumped out of my seat... the package I had coming in with those 2200 antibiotics were also coming in on the plane bringing crew and cargo to the Ruuska Village. It turns out that randomly, both Alex and I had our packages coming in on the same plane with the same pilot at the same time. Indeed, we did head out to the Ruuska Village where there was a package waiting for me and him. This was definitely a God thing... way too crazy for it to be purely coincidence. God wants those antibiotics to get to the people.

Another crazy coincidence happened today too. The group that was leaving us on their flight were picked up at the house by a driver and the pilot through Samaritan Air. My roomate's husband was piloting some of their flights as well. We got to talking and once them mentioned Samaritan Air, I thought why is that so familiar? Then, it dawned on me. It was one of my backup plans to get here to Haiti. I ran to get my list of contact information and sure enough, there was Samaritan Air, the name of the pilot Brian was listed as my contact who was now standing in front of me, and name of the church on my contact list was the one both of these guys go to. Later on at the airport amid all of the chaos, we ran into them again! What are the odds. Now, I might be doing little 1 or 2 day outreach missions with these guys around the region cruising around by helicopter! This little strange happenings are tiny reminders that I'm on the path I'm supposed to be. If anyone has ever read the Celestine Prophecy (I think tha's the title), you'll understand what is going on in my life right now. I keep having these moments that are way too strange to be coincidence and realize that in following what is laid out of front of you brings great joy. As Jill in my small group described in prayer before I left, was that I would find many "happy accidents".

On our way to get this package Alex drove us through downtown PAP, the area that received the most damage. It was unbelievable. In parts it was like an absolute ghost town, empty streets, trash burning in the middle of the road, rubble lining the sides, complete buildings collapsed... it was haunting. It looked like the armegeddon. We even passed a bus that said Apocolypse painted across the side in big letters. We learned that the energy exerted in this quake was the equivalent of 4 megatons... Hiroshima was only 1. That puts things into perspective! We passed by the palace and saw it in ruins. You can only appreciate what a big deal this is when you see it in person and realize how big the building is. It's like the 10 of the white houses collapsing! All the other government buildings are collapsed too; the house of justice, the ministry of finance, the ministry of etc. The important tax documents, passports, identification, court records, strewn about the street and piled atop the rubble.

Finally, we had to return to the house so some of our friends could get packed for their departing flight. We settled in at the house and Kim gave me an ice cold orange Juicy Juice. I might go so far to say it was the best thing I've consumed since I've been here. Again, we had to say goodbye to our newly made friends and it was a quite night in the house with only Josh, Elizabeth and myself.

Saturday, February 13, 2010

More Long Days in Haiti

It rained again last night, another sign of what is to come.I had to go and clean up our old friend known by most around the hospital as "Papa Poo Poo". He came in on my first day there, passed out in a wheelchair. Everyone thought he was drunk and put him to the side. Turns out he may have suffered a stroke or something and was definitely dehydrated and malnourished. He's at the back of the compound and not really assigned to any one nurse, but we all go visit him and take care of him throughout the day. Papa Poo Poo was covered in feces and flies. I went over to him with some soap, water, a fresh diaper and gown. I bathed him, got him some fluids, and fed him some rice. As I was leaving, this young guy came over to me and was saying something in French. I asked the translator what he was saying and found out he was saying, "You are so gracious... I love you." I nearly started to cry. I think about people like Papa Poo Poo and the elderly lady who sits beside him in the corner. They have no family. Where will they go when they leave the hospital? They have no home to return to, there are no homeless shelters, board n lodges here. There is no medicare, medicaid and no such thing as public nursing homes. If you can't pay to go into a nursing home and don't have any family, then you are destined to die on the streets alone. While there are plenty of orphanages here, the elderly seem to have been forgotten about. Aren't their lives just as valuable as the young ones being saved? This leads me to the other issue of discharging patients in general. It's a very difficult thing to do here under the circumstances. There are patients with amputations and external fixators who are just a few days post-op, but well enough to leave at the cost of freeing up another valuable bed for the next person who's post-op that would have to go without. These people don't want to leave. At the hospital they are being cared for, fed, given water, medication, shelter, safety, and plenty of love. The only thing they have to look forward to once they leave the compound is a makeshift tent, the rainy season, and trying to now provide food and water for themselves while healing. It's really heartbreaking to have to tell a patient, "I'm sorry but you have to leave now." Many of them don't even have the transportation to get picked up. It's hard to balance where the patient care shifts into patient housing, and at what price one bed should be abandoned to make room for another. Because the severity of cases is diminishing, that urgency is changing as well.

The day was a pretty uneventful one until it came time to leave. Just as we were walking out and passing the ER, a baby wrapped in a sheet being hung like a hammock passed by. It was a 3 year old that had come in earlier for failure to thrive. He was malnurished, had that protein deficiency condition where the belly swells, and was dehydrated. His little body just gave up and died on the table. We followed the body out. I laid my hand on his little chest and said a little prayer, wishing him peace on his journey to heaven. It's just so sad to see first hand, children who are flat out dying because they don't have the resources to keep their bodies running. After the baby died, there was a different mood around the hospital. Everyone was rather somber. It was like a kick to the gut.

On our walk in today we passed kids who had made kites out of plastic trash bags and string. They actually flew in the air and looked like kites. Really sweet to see how they can make something out of nothing. On our way in, we stopped at the Church to do our little prayer and ended up having this Haitian woman and her child come and join us. We all prayed together and it was very sweet.

The clouds were rolling in again today by about 4pm. Fortunately, the rains never came though... but that's going to change very soon. This was a great day, it started with a good laugh as I looked over and noticed my roommate Kim's sheet had two holes in the middle of it. We figured out the two holes were placed perfectly in line with your eyes. We laughed because we realized the creativity and resourcefulness of the Haitian people to make a Halloween costume out of a sheet. It was a ghost! On our way out today, we had to say goodbye to some of our new friends New Jersey cop George, California nurse Debbie, and Haitian native Margaret. It's hard to see you're new friends leave, especially in such a lonely place.

At the hospital today, I met a nice lady at the hospital today who was so sweet and took my pile of dirty sweaty clothes and did a load of laundry for me. It is so nice to have clean clothes! The day was one of the best ones yet. I'm really getting to know and care for my patients. I look forward to seeing them and taking care of them. One of my girls was turning 23 today. It was her birthday and I was determined to make it special for her. I rounded up nurses and docs from around the hospital to find little trinkets that we could give her for her b-day. We ended up with a box of kleenex, hand lotion, deoderant, body wash, and crocheted little teddy bear that was handmade by our nurse Susie. She made it on her flight here and has been waiting for the right person to give it to. I found some sterile drapes that we wrapped the presents in with medical tape. We got a protein bar for a cake, took a cutip, dipped it in alcohol, and lit it for the candle. Also, we made a card for her that an interpreter helped us write in French, "Happy Birthday, Feel Better Soon, We Love You." Lots of us signed the card, huddled up, and then started walking to her tent singing "Happy Birthday" in French. She looked up and got the biggest smile from ear to ear. She and her family and everyone else in that tent was so excited. This patient had her left leg amputated a few days ago and still might lose her right leg before it's all said and done. Just for a moment, she forgot about her legs and was counting her blessings. We all watched her open her presents which she was so grateful for. When she got to the teddy bear she held it up and hugged it and pulled it close to her. She was so happy! It was the highlight of the day for all of us and such a reminder that joy can still be found in the midst of tragedy and loss. Later in the day we got another happy moment. A group of about a dozen Haitian Boy Scouts showed up to pay their friend a birthday visit. The leader of the troop was waiting for me to be the one to crack open her bottle of Champaign for the "party". They even brought cups and ice. I wasn't strong enough to pop the cork out and we were all laughing and smiling. Finally, the troop leader helped me out and champaign went flying through the air. Everyone cheered and was poured a little portion into a cup. I then joined the scouts as they circled around their friend and started to sing for her and pray for her. It was really beautiful.

On a break today, we walked back down to the Church to go inside what was left. It was hauntingly beautiful. All the pews were covered in dust, the Nativity scene and Christmas decorations scattered amid the rubble, the heads of wise men and angels separated from their plaster forms, and broken stained glass. I tried doing some search and rescue for the little baby Jesus, but had no luck. We even found pairs of shoes in the pew aisles, as though people shook right out of their shoes. The whole thing was amazing! On our way back, we passed the woman who had prayed with us earlier. She was holding her baby who didn't look very healthy and was very weak. Another woman came up to us then with her baby who was as limp as a wet noodle. The baby was totally unresponsive. She was breathing shallow and had an irregular pulse. We told the woman we needed to take the child to the hospital right away. They whole crew of us walked back to the hospital with the baby and tried to assess what was going on. Suddenly the baby was responsive and looking around, appearing fine. We brought him into the urgencies room and kept for monitoring for a couple of hours while we fed her pedialyte out of a syringe. After getting some nourishment and hydration, the baby was appearing much more responsive and content.

A couple of other exciting things today... I got a Haitian cell phone. I added some minutes to it and have about 50 minutes of local calling for making connections, etc. It's already been very useful. Other interesting stuff is that the Mexicans finally joined the team today. Their crew came in and started at the hospital today. They are super friendly and much easier to communicate with because I know a little Spanish. Although, it will be a bit more confusing to now have Spanish, French, and English in the already messy writing in the charts. Lastly, I got to call home to both sets of parents tonight. It was nice to update them on what has been going on and get some nice encouragement to keep moving.

Wednesday, February 10, 2010

Medical Relief for Haiti Earthquake Victims

This has just been one of the longest and most mentally exhausting days of my life. I don't even know where to begin... I got up this morning (Thursday) at 4AM in order to make it to the airport for my flight. Upon arriving at the dark hanger out of Melbourne Airport, several of us from our team and others came together to meet for the first time and match faces to names from many long phone calls. Cherie was so wonderful. She had McDonald's breakfast waiting for us. I quickly discovered I was flying all the way to Haiti on a Cirrus plane! Those from Duluth will appreciate the irony of this knowing that cirrus planes are made in Duluth. Those familiar with Cirrus planes will recognize amazement that a plane that compact can easily fly that far away. There were only 3 of us in the cirrus and 5 in the other plane . We all joined together before taking off and prayed for a safe trip, for safety, good judgement, relief, compassion, and praised God for leading us on this adventure of a lifetime. I took the co-pilot's seat, next to our trusty pilot Troy and Robin in the back. After about 3.5 hours and a getting to watch a beautiful sunrise along the horizon line, we landed in the Turks, a country not far off the coast of Haiti, to get refuelled and wait for our landing slot. The community here has mobilized and created a depository of additional supplies that we were able to stuff the rest of the plane with... mostly things for kids, diapers, formula, food, etc. They also had supplies for the aid workers. They had several handmade sandwiches to choose from, chips, and drinks. There was a big comfy couch, air conditioning, and a chance to meet with others coming through and just start to prepare ourselves for what lie ahead. By the way, the Turks are beautiful! There's blue water like I've never even seen before there and even more beautiful people.

Finally, we reboarded and took our flight into Port Au Prince. We had to sit on a holding pattern for a while until we could finally get onto the strip. Of course, Murphy's Law, just as we're coming in to Port au Prince with this amazing overhead view, my video camera died, and has not been working since. Oh, well. I'm really bummed, but know it's probably for a reason. I do still have my regular camera and am just hoping that the low quality video on there will be adequate for memory sake... perhaps the video camera will just start working one day again too.

As we passed overhead PAP, you could see the massive destruction. What looks like whole sides of the mountain are just landslides of cement. Many of the other houses are hard to tell they are collapsed from the air because everything so compact and smashed together. As we were coming in for our landing, watching the Marines, the herd of rescue boats and everything else, I listened on my headphones to the background of airport landing personell, the song from U2 "If God Will Send His Angels." There were many angels descending upon the city both from the ground, water, and air.

Once landing, there was a massive effort of relief and military installations to provide security and distribute rations. Although, it must be noted that the majority of the supplies and rations just simply sat on the tarmac not moving at all. That was rather disturbing. It was neat to be amid a swarm of military from around the world, all decked out in their uniforms and AK47s, big planes, helicopters. I looked over at the small Cirrus plane that we flew in on and realized we looked like a little mosquito amongst a flock of birds. I suddenly was amazed that we had traveled so far in such a reliable plane. It made me proud to know these planes are made in Duluth.

After much shuffling around, we got our passports stamped, got through customs, and our pilot was told that if he didn't pay about 200 dollars that he would be jailed. They called it some sort of airport fee (no one else had to pay this) and we're pretty sure the money went right into the airport authority's pockets. Once we were secured on the ground, our pilot went to meet the 6 orphans that will be taking our empty seats back. They will finally get reunited with their parents who adopted them several years ago, but who have been waiting to have adoptions finalized.

At this point, things had come together and I had officially joined the CDTI Hospital Team because the director of the hospital was on one of our charter's fleet where we had all left together in the morning and asked if I would like to join them. It's amazing. I'm now joining forces with Dr. Rod an internist from FL, Nurse Linda Kubiak from FL, and Dr. Michelle Henderson an orthopedic surgeon from FL as well. We were picked up at the airport by the owner of the hospital, went to the UN Promess medical supply ware house, and were taken to his relative's house where there were mattresses and pillows waiting for us. There is a 12 foot security wall and guard that protects all the medical staff inside. The house is not entirely structurally safe, but it's adequate... and certainly nice for now until I move on to the village and am in a tent. There are huge cracks going up the walls and ceilings. We keep jump bags by our sleeping bags in case another earthquake comes and we have to run out. Although, it's kinda disconcerting because the windows around me all have bars on them, so kinda scary. Everyone here has been expecting the aftershocks to continue and just recently, the locals were being told an 8.0 might be expected. A seismologist who had given a conference here last year warning people of the quake's imminence was telling me that the plates were backed up by about 250-some centimeters, and even after the earthquake, there's still about 140-centimeters to go. Those movements could come a little at a time, or all at once. I think it's past that happening, but taking safety precautions is certainly important. That includes being aware of the nearest exit wherever you are, always keeping your passport and water bottle on you, and not going into dangerous locations. Not to freak anybody out or anything, but I'm so happy with my life right now and where my path has led that if it would be my time, then I could be okay with that. I would have gone doing what I love and taking care of the people he loves. I'm not afraid to die... but I'd rather not and get to continue my work into the future.

So, as far as the drive to the house, things around the airport didn't look too bad. I didn't see people rioting, fighting, and few buildings looked very damaged. I was thinking that maybe it wasn't that bad here after all. As we got closer to downtown PAP and into the neighborhoods, it was a complete change. Suddenly, it looked like a warzone. Entire cafes, grocery stores, banks, hotels, homes, and businesses reduced to nothing by rubble. The nursing school lost 200 nurses in the collapse. Even a 7-floor hospital collapsed to a pile of dust. Can you imagine that... you get severely injured and are able to get to a hospital only to find it gone... including all the people inside who you know would be your only chance of survival. Some people even arrived at hospitals already fresh amputees from the chainsaws they had to used to cut pinned limbs from the rubble. Sorry for the gory details, but it is the reality for these people here and the reality of the type of psychological trauma that hasn't really even been addressed. We talk about a nation of amputees, but how about a nation suffering from severe PTSD and depression. It's another area that needs to be addressed. If you think reading about these things are hard, imagine having lived through them!

It's sad to know that there are many bodies still under the debris as well. The locals are saying 225,000 confirmed dead and another 150,000 expected dead beneath the rubble. Then, there are the tent cities. You'll turn a corner and see blocks upon blocks of homemade tents. People are using sticks, branches, poles, sheets, and tarps to provide themselves with shelter. It makes me smile knowing I will leave behind a tent that will become someone's home... especially with the rainy season around the corner. There are pigs, goats, and dogs running in the road. We even saw a big cow on the sidewalk the other day. I'm actually surprised they haven't turned to bacon yet! Surprisingly, the smell is not too bad. It comes and goes. In some areas, things smell just completely normal and in other areas the smell of trash and feces. There's a haze around the city still, just walking down the road, it's hard to not get the dust in your eyes. It permeates the air. The sounds are not as I imagined them either. It's loud, but there's not really people crying and shouting... unless it's throughout the day at the hospital where some are moaning and wailing.

Everyone is just sleeping on the streets and in these massive "tent cities". These cities consist of about an inch of space between one tent to the next. The people have constructed homes using sticks, branches, and sheets. It looks like a massive quilt from above. Once it rains, the sheets will be pointless. Right now, the sheets just help diminish the hot Haitian sun. There's one tent set up that has 200 orphans living in it. They have no food, no water, and are just trying to stay alive, and figure out what next... like everyone else. There's a real need for huge humanitarian efforts here to provide safe and dry housing for these people. It frustrates me when I think about the hurricane Katrina response. When FEMA brought large trailors to live in and some decided to complain that they were not good enough... well, there's no FEMA here, no clean water here, no food rations here, and most of these people aren't complaining.

Next, the process of rebuilding and recovery. I've been speaking with a few structural engineers and controlled demolition teams that are working with the buildings affected. The Israeli's apparently have some sort of rubble-eating machine that they will use to break down the rubble, re-mix it into a cement, and use it to rebuild with. Talk about rising from the ashes! One day they should rename this country Phoenix.

There is already some hope, markets are starting to open. In fact, there are lots of street vendors returning to business. Some sell egg sandwiches; others are selling things like luggage, belts, and cell phone chargers. I have no idea where they got all this stuff from, but it's nice to see the economy returning.

What has struck me as disturbing is the number of people I see throughout the drives and walk of people who literally are walking around with a zombie-like look on their faces. Many of these people have lost everything... their homes, their families, their livelihood, their friends, and their hope. It's just a look of complete despair, aloneness, and trauma. I'm reminded by some in the movie 28 Days Later, where the deadly rabies plague wipes through Europe. I actually listened to the unnerving 28 Days Later theme song on my walk into the hospital today, I felt like I was in a movie. Another fitting movie for where we are is "I Am Legend". Very depressing. It's also kind of scary because many of these people are in the anger stage of the grieving process. They've gone through the denial, the depression, and the negotiating, but the anger phase is stewing. Many feel they have been forgotten, that the world doesn't care. They're getting testy and desperate. We hear gunshots every night, there have been 2 reported kidnappings that we know of, and the looting is still going on.

The military presence here is enormous. The U.S. appears to have complete control of the airport in PAP. Everywhere you go, there are humvees, tanker-looking vehicles, and soldiers in uniforms armed with large guns. It's interesting because we are seeing soldiers from around the world. This truly is a global effort, whether that be from the medical front, the supply front, or the security standpoint.

Back to the story, we stopped by at the location we will be staying. It is the house of a relative of the hospital owner. There are about 30 us living in it right now. We sleep on the floor. It's a shell of a house, no furniture or anything, but it is dry and safe. The mosquitoes fly through and get pretty bad because none of the windows have any screens. I’ve actually got my tent set up inside the room without the fly to keep the bugs off. The room I'm in looks like a cell block, surrounded in metal bars. The house has an armed security guard that watches a 12-foot wall that surrounds the property. Just over the wall, people are living on the street in makeshift tents. Electricity and water come on and off sporadically. There's a toilet to use, but we sometimes have to add the water in order for it to flush. There's a shower that trickles down, but a broken pipe off the side of the house that works pretty good. All of this is still pretty rugged conditions and certainly not the way I'd choose to live, but I've never felt so blessed! When I found out there was a sheet for me to use, it was like winning the lottery. I like this simple gratitude swelling inside of myself. It feels good.

After dropping off our stuff at the house, we went to visit the hospital. Upon arriving, we were greeted by a nurse standing outside emphatically smoking a cigarette and crying, saying, "The French have left and there are no nurses or doctors here. They didn't leave any orders. We can't do all this alone! There's nobody here." I went over and gave her a big hug and just said, "I'm Jitterbug, I'm a registered nurse, and you’re not alone anymore. We're here to help, what do you need." That woman has become of my favorite people here since. She's a real hoot and an incredibly strong individual. I've been holding it together really well since I've been here actually and been staying pretty emotionally strong. However, when we finally got to the patients at the hospital, the reason I'm here, it hit me. I've never seen such collaborative pain. I started walking into the tents and holding patient's hands and praying for them. The tears started to flow, and I realized at that moment that this was going to be more of a challenge than I had anticipated. But, I do know I'm ready and prepared for it. My whole life has been preparing me for this moment here right now.

The CDTI hospital is huge. It's 4 stories tall and has everything from CT scans, to Ultrasound, to patient suites, to an OR, ER, and pharmacy. However, it is very much lacking at the moment, including structurally. One half of the hospital, the wing with all the patient rooms has been deemed structurally insuffient. That's where we store all of the supplies and stuff now. The patients are all being placed in the open area surrounding the hospital and living in tents provided by the French. They have also been lending their medical staff which is relieving a large burden of the work. However, it's very confusing because you'll go to read a patient's "chart" (which we call their dociae and consists only a scrap piece of paper or cardboard) and it will half be in French and half in English. This is also a problem with the supplies and the medicines coming in. Supplies are coming in from around the world... I've unpacked boxes from Morocco, Israel, France, and more. Many of the drugs have different names that we are not familiar with here. Many of the supplies are incompatible with one another. It's frustrating. As far as the global effort of medical professionals, I'm working with docs and nurses from Israel, Russia, France, Haiti, the U.S., India, Philippines, Canada, and Holland. As a matter of fact, the Israeli docs say in all of their wars, they've never seen anything this bad.

The hospital has received little support from the Haitian government. In fact, the government is more often an obstacle. For instance, when the hospital opened the ER department, all the equipment sat at the airport on palates for 3 months before being released. Now that part of the hospital is at risk for collapsing should another shake come, the government is certainly not helping to keep it standing. It will cost about more than $75,000 alone just to solidify the main support pillars so that the space can be used safely. The rest of the repairs will be upwards of a half-million dollars. Insurance doesn't cover things like this because it's exempt through disaster status or something. Some people are saying the hospital should just shut down so the owners can cut their losses and stop hemmhoraging With no income coming in, daily operating expenses exceeding $8,000 a day, the funding will certainly end up running dry. However, what will happen to the people still needing care? The earthquake left an estimated 400,000 people injured. Every day we're seeing 3-400 patients alone... and those aren’t all runny nose, diarrhea cases. Many of the cases are severe wounds and infection.

While I've got your attention on the hospital, let me explain some of its great need. For the most part, we are doing great on supplies. We've got tons of medications, wound care, and protective equipment. But, there are still some orthopedic needs. The director of the hospital and U.S. orthopedic surgeon Dr. Michelle Henderson says on her wish list of hospital supplies most needed would be SYNTHS, large and small frag sets, femoral and tibial rods, external fixators, other orthopedic supplies, and anesthesia drugs including Propophal and Ketamine.

Regarding staffing, the hospital is in need of Orthopaedic surgeons with experience in non-union, mal-union, and osteomyelitis. They would need to bring hardware for surgical fixation of fractures with insertion devices and instruments as well as a cast saw with blades. They need plastic surgeons to perform split thickness skin grafs and local notational flaps. That department is in need of dermatome, dermatome blades, and mesher. Other doctors needed include internal medicine, family practice, and pediatric doctors who can also bring medications that would be used in clinic. If you are a surgeon, come as a team with anesthesia and an RN. IF your an emergency medicine doc, bring and RN or a paramedic. If you’re a Family Practice, Internal Medicine, or Pediatric medicine, CDTI suggests you bring your own RN or MA as well.

Lastly, the infectious disease department is in major need of vaccines. The drug companies could not get any vaccines here quick enough. I spoke with hospital administrators today and discussed public health concerns of the upcoming rainy season. Port au Prince without the earthquake sometimes gets 2 feet of water downtown. Now that the drainage systems are clogged, people are living within inches of one another, and thousands of dead bodies lay beneath the rubble, the rain will cause big problems. The medical disposal containing blood products and bodily fluids will mix with the water, rains will filter through the rubble and drain the decay from the dead bodies into the streets, the mountainside that's composed mostly of sand will likely have mudslides, and if any disease breaks out, it will spread like a wildfire. Just regular old influenza could cause enough of a problem, but then add the posibility of Cholera, Typhoid, H1N1, Dysentery, Tuberculosis and we have another disaster zone on the way... yet it is one we can predict and prepare for. I'd like to see the WHO stepping up to produce mass quantities of vaccines and health care workers just going into tent city, tent to tent to adminsiter them. There's basically another disaster on the way and unlike the earthquake, this is one we can anticipate and prepare for.

On our ride home that night, as we passed the candlelit sidewalk filled with Haitians with no home and nowhere to go, I was filled with gratitude to be here and blessed to know I was being provided for.

It was our first full day at the hospital today. Throughout the night we got our first exposure to the gun shot sounding around the neighborhood. We wake up at about 6:30am, get dressed and then hike about a mile and a half to the hospital. On our walk we spotted the collapsed church and saw an amazing sight. While the building was collapsed, the cross was still standing. I don't think there was even a scratch on it. It speaks volumes; the body of the church is not in the building, it's in what it's all based on. In the midst of all this chaos and rubble, to see a sturdy reminder of the importance of faith was profound. My friend Linda and I always try to start and end the day with prayer. This has become our new place we pray in the morning. Now, we've got others joining with us as well. In the mornings, we stop at the cross, hold hands and just lift up our hands, feet, decision making, and guidance to the heavens. It's beautiful! It's also the only reason I don't think I've lost my sanity yet. Apparently, there are 3 other churches around PAP that had the same thing happen. The church collapsed, but the cross is still standing. People are all freaked out. Even many of the voodoo doctors around here are flipping out. When the earthquake happened, many saw them should out "Jesus." Now, when people come to them, some of them are saying, "I cannot help you anymore, but Jesus can." Let me get kinda sappy here... what I like about this whole thing with the cross is this... when you come to the cross, you come exactly how you are. You might be man or woman, rich or poor, desperate or hopeful, diseased or healthy, ragged or clothed, but God meets you exactly where you're at. When everything around you is falling apart, he can be the one thing that will always be there to look up to, and the one thing that can gently take you by the hands and lift you off your knees. That is hopeful.

Once we got to the hospital for our first day, we found out there had already been at least 3 cases of tuberculosis, 2 cases of tetanus, and a case of rabies. We heard a story about a 2 month old baby that was found in a pile of trash in the woods. Someone heard a baby crying, found the baby, and brought them to the hospital. The Haitian nurse who found him and has been unable to conceive a child for 12 years now wants to adopt him. He was baptized and named Noah. Another story about a patient I have here is this young boy named Joseph. Both of his parents were killed in the quake and he has nowhere to go. He's got a fractured leg and lays on his bed crying in French, "Why? Why? It's just not right!" Once he can ambulate with crutches, we'll have to hook him up with an orphanage somewhere.

The layout of the hospital is shared with the French medical teams here. They have one area and we have another, but yet they are mixed. You just don't touch their patients or else they will get upset. People come in through the front secured door and get triaged. Some go to the French, some come to us. Those with more serious conditions are housed in the tents we have set up. These tents are not very big, but they can house about 8-10 cots. There are 9 tents up in the front, and then there are more post-op tents with patients in the back. If patient's need x-rays, ultrasound, emergency care, or surgery, those things are available inside as well. Sometimes the lights flicker and sometimes the OR has no lights leaving the docs to operate with headlamps, but it is working for now.

I discovered the rooftop today. You can climb on the roof and get a broad 360 degree view of the city. You can see the dozens of boats in the PAP harbor providing supplies and care, you can see the damaged mountainside, and you can look below at the hospital tent city and see the healing being done. It's now where I like to go and decompress. You can catch a beautiful sunset over the mountains from there and the breeze feels good.

Just as we were about to finish a 12 hour day, we quickly realized we weren't going anywhere. We had a guy get brought in with a gunshot wound to the chest. He had been an innocent bystander when a looter decided to steal something. As people were scrambling, the innocent guy went running. The looter thought he was coming after him and popped him in the chest. This was intense! I was one of the nurses in on the case. The guy was laying on the gurney coughing up blood, getting the death gurgle, and his eyes weren't responding to light or accommodation. I was suctioning his airway and holding his IV bag above his head all at once while we're trying to wheel him into radiology. He needed surgery right away, but all of the surgeons had already left. We ended up having to get him to another hospital with surgeons, but had no way to get him there. We're all standing in the street with this dying man and no one would pull over and stop. People just kept driving past. Then, once someone with a truck did stop, no one would help lift him into the back of the pickup. My New Jersey cop friend was screaming for people to help. I threw some gloves out of my pocket towards some guys and finally we were all able to drag him into the back. It was the most pathetic transfer I've ever seen, especially considering the fragility of his condition, but it was the best we could do. No one would step up to the plate. We all just stood there quietly on the street after they zoomed off, covered in bloody gloves and looking at each other blankly saying, "What just happened?" It was surreal! Then, a girl came in with a fractured leg and another man is dragged in amid a grand-mal seizure. We put him in the ER, got a line in and tried to suppress the seizures with some valium. It wasn't until 25g IV that he finally started to calm. That was my first full day at CDTI and it was exhausting. But, I must say.... I love this stuff!

Today was just another day of work. We put in another 12 hours in the sun and treated anywhere from 300-400 patients. About midday, I heard a couple singing in one of the tents. I went over there to find a Haitian nurse leading the patients in this song. I joined in and started building the energy. Before I knew what happened, we had a full blown hospital tent revival! The patients were smiling; the nurses and I were dancing with some of them and their families. People were clapping their hands, singing praise, "Amen, Amen, Amen, Alleluia!" It was so inspiring because for the short bit that song lasted, those patients forgot they were victims of an earthquake. For a short while, they forgot about their loss and embraced the moment. I was very touched to be a part of the whole scene.

On another note, I was in on an interesting case today with a patient getting their leg amputated. The tools used look like something out of a medieval movie- lock cutter looking pliers, a chisel, mallet, and hacksaw. This poor patient had been fighting the recommendation to amputate for 2 weeks now, but the infection was going to kill her if she didn't. To watch someone's leg get cut off and then placed in a bag is pretty gruesome, I must admit. I just wonder how the doctors who had to do 20-30 a day in the beginning are feeling now. That takes a toll on your emotional bank account.

On our walk to the hospital today, we passed a religious ceremony going on. Hundreds of people were gathered either because it was Sunday or perhaps as a funeral service for those thousands lost. We worked along tediously throughout the day and got off a little early. We drove to an opened place called the Pizza Garden. We got to have pizza and watch the Superbowl. It was so American and fun. There was lots of laughing and some of us even got up and danced after it was done.

As we retired at night, it started to rain. That was the first time this area has seen rain since the devastating earthquake. I do think it was God's welled up tears. It's also an uncomfortable reminder of the rainy season that lies ahead. Perhaps it is making its arrival sooner than we had planned.

I finally connected with Anne-Kary of the duluth-based Kako Foundation. The program is a music school created in memory of a boy named Kako who was kidnapped and murdered 2 years ago in Haiti. His family wanted to create a music program in his honor and that's exactly what they did. The children there were so sweet. Two of the students had died in the earthquake, many fled town with their families, and the rest were still in the area. This was their first day of classes back. Anne-Kary picked us myself, New Jersey cop George, and Dr. Rod the internist from the hospital. We rode to the Kako Foundation and met the children. We were able to give all of them and some of the parents complete physicals. Everyone checked out and appeared to be pretty healthy too! During the physicals, the kids were taking part in a therapeutic support group that the program will continue. Anne-Kary talks to the kids about what happened the day of the earthquake, how the kids were affected, and how they are dealing with it now. It's such a crucial part of the healing that needs to happen in this community and I applaud the Kako Foundation for not wasting time getting there. Once done with physicals and therapy, the kids got to pull out their instruments for the first time since the quake. They happened to be in the building that did not collapse and were intact. It was the neatest thing to witness... children managing the "after-shocks" of extreme stress and trauma pull out their instruments and start to make music. The trumpets were going, the saxophones were humming, a flute delicately added to the mixture, and a set of drums kept the rhythm. The music provided a sort of invisible barrier from the outside world. It was a distraction from knowing that within a 1-block radius there are probably still bodies buried and buildings demolished. George, Rod and I just stood there feeling some peace. Amid all the doom and gloom this place was actually happy. I remember doing a news story on the Kako Foundation a couple years ago, and never did I think I'd actually be in Haiti standing in the Foundation! After the music, the kids got a snack and I was able to give them some balloons from the CSS Cultural Anthropologist and some cards and pictures from a 1st Grade Class in Duluth.

After work at the hospital today, we got to go somewhere very exciting... a grocery store! We had to drive a little ways to get there, but once we arrived, I was in heaven. I love going to the grocery store to begin with, but it's so much better when all you're eating is rice, beans, and granola bars. I was so excited to get peanut butter (that was one thing I left behind in order to pack more medical supplies), jelly, dried cereal, tang, and bread. The imported brands there cost an arm and a leg. A container of Gatorade costs $20 american!! Usually, you can find a locally produced equivalent though.

Following our little grocery field trip, I returned to the compound, changed out of my scrubs, and went with Alex (the brother- in law of the hospital owner) on his motorcycle up the mountain. I have never been on a ride quite like that. It's dangerous enough driving in a car through Haiti, but a motorcycle is even crazier! There are practically no rules. He was flying about 90kph through town and then weaving through the windy road up the mountain. I was holding on for dear life, but those who know me, know I loved the adventure. The only ride crazier than that was when I was on the Snowmobiles driving across the lake in Moose Lake. But, there you didn't have to worry about rubble in the middle of the road, pedestrians, night lighting, or other cars. We went to one of Alex's friends houses and had dinner along with a structural engineer, a controlled demolition expert, and a couple guys from India doing work in the orphanages. It was a nice time and the nightime view above PAP was wonderful.

I got in late last night from my motorcycle ride. I woke up and had to say goodbye to my original crew. Michelle, Linda, and Rod had to leave today to fly back. It was so sad to see them go because I've really grown to care for them. When you're out here working together, seeing the kinds of things you see together, it is a very bonding experience. Plus, most of us are cut from the same thread because it takes a different sort of person to just pack up, leave, and find a way down here. Everyone I've met here has become a friend and what's even better is that I'm starting to build my medical relief team that had been established prior to leaving. The word is spreading through camp that it's something I'm doing and I'm having doctors, nurses, and transport people come and ask me if they can be a part of it. I tell them all, 'Of course, yes you can be!' It's exciting to watch it building.

It's about time for a day off for me. Today, I decided to stay home. Alex was supposed to come and pick me up on his motorcycle this morning at 9am, so I got dressed quick, sat out on the porch waiting for him, and he never showed. We were supposed to ride out to Leogone, a city that was like 85-95% destroyed. I waited for about an hour and a half until he called and said he was still coming and he'd be here in an hour... waiting on the hot porch alone, sad that my friends left this morning, and now pissed off because I just got stood up! I tried taking a nap later in the afternoon, laid around and watched "I Am Legend" on my iTouch. The thing is that perhaps there was a reason I wasn't at the hospital or on the motorcycle today. Perhaps I would have got poked by a needle, or perhaps the motorcycle would have crashed. Again, it's one of those things that didn't go my way (like the videocamera breaking) that I have to just continue to trust in God's higher purpose and plan. In the end, I think he wanted me to just rest, relax, get my mind off of the tragedies I'm experiencing and just simply be. Perhaps he does have plans for me to stay here for a month or two and is just trying to keep me safe, relaxed, and well rested. Either way, I can't be too upset about the situation anymore because as it turned out he had been in some sort of an accident, something happened to his bike, and some friends of his that were an SAR team at the Market trying to recover dead bodies. The whole thing then collapsed and now there may be some rescue workers either dead or injured. Now, I'm not so upset that Alex never arrived. Instead, I got to just relax. The Mexican medical team is coming in tomorrow and the French are slowly fazing out; things are going to be changing with this new group. I'm headed to sleep.