Efforts Underway To Keep CDTI Hospital From Closing

Tuesday
I walked to the hospital this morning with George. I could have rode the bus with Operation Rainbow and the Dominicans from Esperanza, but I wanted to walk with George for old time's sake. At the hospital, we had some more discussions about the hospital's fate. It truly may have to close this Saturday or by the end of the month at the latest. There is no money to pay the hospital's employees and without the support staff, the administrators say the hospital can't stay open. The employment laws here make it so that after 60 days, workers must be released with severence pay. The only way to do that will be by selling the hospital's capital, including equipment and property. Additionally, we don't know if we'll have any diesel fuel to keep the lights on and the power up. We go a day at a time on our fuel predictability. Relying on outside funding is this hospital's last hope!

Before heading to General Hospital this morning, I worked for a while in triage. I collected vitals, gathered a history, and gave a brief physical exam and assessment. One of my patients we believe may have been bit by a rabid dog last night. He approached the dog, it was foaming at the mouth and attacked him. He's been febrile, aching, legs cramping up, and having strange symptoms since. We started him out with a simple tetanus shot and will follow up on his progress to see if we should start him on a rabies series.

At General Hospital today, it was a tough group. Inside the tents it was so hot, so everyone was a bit distracted. This group in particular has some challenging dynamics because of a few things- there is more of a consistent turnover which leaves makes it difficult for the group to get much past the forming stage, with about 15 kids the group is just too large, the acuity of the patients is more severe limiting many kids to their beds and leaving us with a wide open space instead of a tight safe-feeling circle, many of the parents choose to participate in the group which adds a strange age incongruity, and the nurses continue patient care while the group is in session. It makes for a very distracting environment. Today we focused on the emotion of sadness and depression, the kids did some coloring activity, and we did a discussion. Here, I was able to pass out more cards made by 1st graders from my childhood elementary school "St. Joseph's Catholic School" in Winter Haven. The patients were so appreciative of their cards and after they read them, we hung the cards over their beds. As the group energy was finally starting to build today, we decided it was time for the music. We got out the instruments and started to play. Hivelt, my translator, brought his guitar today so we got a real treat. He played, we added the rhythm. Then, I played for the group for a bit to the tune of this sone Hivelt and I made up. Finally, we started seeing the smiles come out.

After group, I swung by the IMC, International Medical Corp, organization's central command at the hospital. I spoke with them about my Grief Therapy Program and about how they are organizing their psychological care at this point. I gained some good insight and left with some new contacts and a new possibility for implementation. Just a couple buildings down from their headquarters is the hospital morgue. You may have seen images of this morgue featured on an episode of 60 minutes. Behind the morgue there were literally thousands of bodies stacked up, bloated, and covered in blood and gore. They were using dump trucks and bulldozers to transport the bodies by the hundreds to mass burial sites. Certainly, all of those bodies are now gone, but the air is heavy with the stench of leftover remnants of bodies Truly, the smell is overwhelming. You have to breathe shallow to avoid puking. As we approached the building, a new body was rolled into the building and another body was carried away in a hurse. People are still dying here in relatively high numbers... unable to keep fighting against what the quake did to their bodies. Walking through the morgue was a reminder... stacks of steel coffins piled atop oen another, a tower of stretchers piled up to the ceiling covered in dried blood and flesh, an autopsy room filled with the intense sense of doom. We had to leave. It was too much.

Leaving General Hospital, I had two more stops to make for the day. First, we stopped by the Ecole Nationale des Infirmieres (National School of Nursing) in Port-au-Prince. This was one of three official nursing schools in the country that was entirely destroyed. This quake hugely damaged the country's medical population as thousands of healthcare workers were killed. At this particular school 150 nurses were buried in the rubble. Robbed of their dream to administer to the sick and ill, they now had become the injured and dead. Reports I have read indicate that 150 second-year nursing students and two professors were killed when the school collapsed. Actually, we just happen to currently have one of the surviving nurses at our hospital at CDTI. Anyhow, I was able to go on the grounds of what's left of the campus. The multistory building that collapsed has all been cleared. There is a row of empty lockers separating the tent where surviving students are now conducting their classes and the empty plot that once was the foundation for their classrooms that housed their friends and trusted teachers. I sat with the nursing students and had my translator explain to them that on behalf of myself and the College of Saint Scholastica, where I am currently attending Grad school in Minnesota... that we send our deepest condolences. Something about this just really choked me up and fighting behind tears, I told these women how important their role will now be in a country where the demand for caring professional nurses is at an all time high coupled with the enormous toll taken upon the nursing population as a result of the quake and the many nurses killed. I told them to be strong, stay focused on their studies in less than optimal conditions and that whatever they end up doing to be great at it. The girls seemed to really appreciate that I had stopped by to share a message with them, and I felt so proud to represent my College.

Last stop for the day... Ministere De La Sante's Centre De Psychiatrie Mars & Kline. This psyhological facility is really one of the only standing mental hospitals in Port au Prince. {For a good article regarding this place read, http://www.nytimes.com/2010/03/20/world/americas/20haiti.html } I sat down with one of the directors and talked about my Grief Therapy Program. I inquired about the current needs of the hospital and how I could best be of assistance to them during this time. The doctor explained that they are seeing high numbers of PTSD, extreme psychosis, and schitzophrenia. He welcomed me to do return and do some grief counseling with some of the patients. I agreed. He gave me a tour of the facility and while parts of the main building have been abandoned for safety issues, a large courtyard remains occupied by about 20 male "criminally insane" and inpatients in lock down. The men are walking around looking dazed, some of them naked, others hidden in the shadows. It looked like a very lonely and empty place to live. I'm sure my experience here should prove very interesting.

Finally, back at CDTI, I tried getting some work done finding out details regarding the potential closure of the hospital. We're currently working on a press release to get the attention of the American people. Perhaps somebody could find a way to step up, become the hero, and help restore a hospital and a staff. It will break many of our hearts to see the hospital we have worked so hard at over the last couple months have to lock its doors. What will be even more painful is having to watch the patients we have come to love be discharged back to the streets without a full recovery.

Unfortunately, just as I was setting up for the kids therapy group at CDTI today, I found out the Operation Rainbow bus was leaving. I really didn't want them to leave without me becasue that would have meant having to hike back through the pitch-black streets at night. I did that once and vowed to never do it again. I had to explain to the kids that I wouldn't be able to do their group today, but would make it up to them tomorrow. Just as we were leaving, an older woman was wheeled into the hospital, she was placed upon the guerney and we suddenly realized that she was dead. Myself and a couple of the docs searched for any trace of a pulse, or breath, but they were both absent. The woman's eyes were fixed, her skin was cold, and her body was lifeless. The doctor called it and told the woman's family she was deceased. They cried. We moved the woman into a quite area where we covered her and the morgue was called. The Operation Rainbow team then did a quick little tour around town so their folks could get a feel for the damage, and we headed back to the house.

Right now I'm laying in my tent catching up on my journaling and experiencing some real caregiver fatigue. I've been fighting a headache that nothing will ease for about the last 5 hours. Honestly, this is very draining work to sit and talk with kids about their dead parents and constant fear their world will fall apart again. It breaks your heart and you do all that you can to be strong for them. The most draining part is what I call, "carrying the light." It takes a lot of energy to keep the group focused, attentive, and enthusiastic about participating... especially with the patients at General. Communicating through a language barrier adds and additional challenge. I'm walking about 4 miles a day, which doesn't help with the dehydration issues, but I can't drink enough water fast enough it seems. Please, oh please, headache go away!

Wednesday
We had to say goodbye to George, the cop from New Jersey, today. It was so nice having him back, but was time for him to leave. At the hospital today, we had a new visitor. Out in the courtyard sitting on the curb was Sean Penn! This Hollywood actor that starred in films such as Milk, Dead Man Walking, and I Am Sam, is now featuring his skills as an incredible relief worker both financially and physically. He has been down here in Haiti for a while now. He's getting dirty right alongside the rest of us, doing what he can. He's our last hope for saving the hospital. He stopped by to the hospital today to get a tour, and I was able to shake his hand and meet him. I wanted for him to see how happy the kids could be here and how much they glow when they are playing their music. I got all the kids together and setup our music, but we were too late. He had already left. That was okay, we just flipped our group slot to doing the CDTI kids earlier instead of later today.

At General Hospital, our group went much better than yesterday. We had a couple of the "Debbie Downers" that had left the hosptital and created a group more willing to listen and share. I also moved everyone closer today and tried to create more of a circle in the limited space we had. These factors led to a much richer group expereince and a much deeper level of sharing. At the end, we did our usual music therapy group, then prayed together.

Leaving General, I headed to my next destination for the day at the Ministere De La Sante's Centre De Psychiatrie Mars & Kline. This is basically, the only inpatient lockdown psychological center in the area. I met with one of the main psyhologists who then motioned for a few security guards to come over. Before I knew what was going on, these three security guards were unlocking the secured courtyard at the hospital and motioning us to move through. We do, and I hear a big clunk of the lock behind me. There I am standing in the middle of a locked nut house, surrounded by about 20 men... half behind bars, and the other half buck naked just walking looking to the sky aimlessly. Some of these men are here because they committed crimes and are deemed criminally insand. This was certainly out of my comfort zone and not what I had in mind when it came to grief therapy counseling, but I knew it was where I was supposed to be. I was able to get some of these guys to sit down and color with me, to talk about how they are coping with their life and feelings. In the end, the guys wanted to pray with me. I was a little apprehensive to put my hands behind some of the bars, but I did and we just praised Jesus for the amazing work he is doing here and asked him to continue to provide everyone with the strength and needs to get through this rough time.

On our way back to the hospital we swung by the completely collapsed and already cleared Louis Pasteur Institute of Nursing. This was sad to know many nurses died here as well. Back at the hospital, I tried to get some stuff finished on the Internet, met with the kids for a bit, Kira came and picked Victoria and I up at the hospital, we went home, showered, got fixed up and went to the Pizza Garden for dinner.