Orphanage

Oh man. What a tough week. These days have tested my hearts ability to love and my ability to hold myself together in the face of sadness.

HODR has a couple of orphanages they go to during the week and Wednesday morning was "baby orphanage day." All of the kids are under 7 years old and live in the same two bedroom house. There's 30 kids and three staff members. I've been planning on going over for the last couple of weeks because the girl that leads the team keeps telling me how sick all the kids always are. Wednesday was my day to go. I got together with Amanda, a 3rd year med student, we packed a box full of meds and bandages and got ready to head over. As we jumped in the back of a "tap- tap" (basically a pickup truck with seats in the back) I started to think about where we were actually going. Orphanages in Haiti are filled with kids that have no parents at all or have parents that aren't able to financially support them, economic abandonment. '
We pull up and as we go through the gate, the kids start singing a welcoming song. It immediately took me back to my time in Uganda. Singing as you came and singing as you left... the way I think everyone should be loved on. I was almost in tears just from listening to the song of 30 children then I began to look at their faces. Almost all of them had conjunctivitis. Almost all of their eyes looked like someone had rubbed vaseline and green goop all up in their beautiful eyes. And then the way they looked at you, ugh break my heart. They had this way of looking at your with these super sad puppy dog eyes. They also tried holding you and being held by you if they saw that no other child had your attention. I was completely overwhelmed. To my left I saw about 6 smaller, younger babies in crib type things. One crying, a couple sleeping, one getting picked up by a volunteer, another with its face being smothered by the side of the crib... I fixed him. It was craziness.

Long story short... Amanda and I along with Margot (a lawyer thinking about trying out something in the medical field.... I've been taking people with me to the hospital who think they might want to "try out" nursing and haven't had enough exposure to know for sure. It's been super cool. ) set up shop in one of the two rooms of the house. We brought in some chairs and just started seeing and treating little ones. We would give them all a deworming pill and a children's vitamin and the treated each like it was gold. They took each one and sucked on it to make it last as long as possible. I tried one of the vitamins later on and it tasted awful. That didn't matter to them though. They just wanted to taste something.

As we tried our best to see the kids throughly, we were constantly distracted by them coming back in trying to get more vitamins or just wanting to be check out again. We had tons of conjunctivitis that we treated with Gentamicin drops, a bunch of scabies so we rubbed Permethrin cream on almost half of those kids and changed their clothes, and then a few with what sounded like Pneumonia so we gave them Amoxicillin. One girl had a wound on her head that was covered in gnats. Another little boy had a huge abscess over his right ear that we didn't have the equipment to drain. Another little girl probably has Hepatitis but we'll never know cause we don't really have those testing capabilities. One of the first ones we saw was terribly malnourished. Marie Carmel. She is 10 months old and only about 10 pounds. Her grandma had dropped her off two days before because she couldn't take care of her anymore. We took her back to the hospital with us cause we knew she needed treatment to be re-nourished. We have a small NGO that runs out of the hospital that does that so it was perfect.

Each kid I saw looked sadder and sicker than the last. Each looked absolutely miserable and sick. Like they each just needed a mommy to hold them and sing them a song. When you would pick up the little ones they would drop their head straight onto your shoulder and nuzzle into your chest like it was the most familiar place to them. Kids back in the states would never do that. They would scream and cry and loose it if you even tried to pick them up. These poor little tikes wanted nothing more than to just be held by you and cuddled. I almost lost it several different times as I listened to lungs or handed out vitamins or just sat and snuggled with them. It's a world very few of us know and to be part of it for just a day was so moving and heartbreaking. It's another reminder to me of how and why the important things are the important things for a reason.

I came back to base and the first person I saw asked me how my day had been. It was John, he' s a 65 year old grandpa type and I felt all too comfortable telling him how sad my soul was. I was in the courtyard eating lunch and pouring tears into it. It was much needed. Another couple of friends asked me later on and I was able to process with them as well. By the time I needed to go to bed, I felt fully processed and at peace.

I got sick after that day and have been spending time on base resting and drinking gatorade. This morning though, I knew I needed to go and check up on the kids. As I walked in, I saw no eyes that looked sad and greasy. I saw kids full of energy and not miserable and smiling and ahhhhhhh.... it was such a beautiful morning. They still seek out your hand and they still want to be held but at least they're healthy and a bit happier now.

Basically.... I still love being here and can't imagine being anywhere else right now. I can't imagine letting those little ones go one more day without proper medical attention and how miserable they would have been. So another beautiful day through my epic journey of life. I can't believe this is my life. I'm so lucky. Thank you for your love and support!!

ugh day...#1

I just saw someone die.

53 years old. He had a stroke 3 days ago and they didn't have enough money to bring him to a hospital because they lived too far away. I'm not sure how they found the money to bring him today but he showed up panting in a cold sweat, mouth open eyes blank. We put him on a stretcher and got some vials. Blood pressure 198/148 Pulse 60 Temp 94 O2 saturation at 46% Respirations 28 in a Kussmaul pattern turning into Cheyne Stokes. He was going and we all knew it.

We gave him some Labetelol to bring his blood pressure down a bit. Then we couldn't find a blood pressure so we gave him Atropine. His pulse was weak peripherally and his heart was barely audible over the apex of the heart. He was sweating profusely and was super cold and clammy. Then he stopped breathing. He would still look at you but you could tell he was gone.

As he was dying, one of our docs went to find another doc to get a second opinion. I was alone with this man in the ER watching him suffer and die. I brought his wife over to ask if she wanted to be with him or hold his hand because there was nothing else we could do for him. She was stoic. No response. No emotion. Meanwhile, I'm trying to hold it together... and doing a very poor job at it. She went to get her daughter. Her daughter started making the phone calls to take care of his body after he died. They looked at him, but barely and very emotionless.

Then he went. He took his last little gasps and that was it.

I can't help but think about the trauma so many Hatians have been through and will continue to go through as they keep on living in such awful conditions.

We had a 50 year old man come in earlier in the day who had cut his hand with a machete. He hadn't eaten for days. When I asked him why, he said it was because he had no wife to cook for him, no money to buy food, and no job to get money. I had nothing else to say. I could have asked him about his wife's death but I was too scared to find out. I would love to tell him to get a job but there's no job to be had. We don't have enough money to give out food along with medical supplies. We barely have enough money to continue to run the hospital.

I'm so so so thankful for this hospital. I have to give an update every night at our meeting and I always joke about how we save lives. Its true though. So many more people would have died if it were not for this hospital. For example, Jean Claude works outside in our clinic. He's our crowd control. He brought in his daughter last week cause she was vomiting and had some awful fevers at night. The doc on at the time thought she might have had worms so gave her a quick pill and sent her off. She said she didn't want to test for malaria cause she didn't have a fever. I should have spoken up but ... I didn't. I know malaria causes your fever to spike at night and I should have said something but I didn't. Jean Claude came in the next two days saying how his daughter still wasn't better. I kept telling him to bring her back and I'll test her. He finally did and as I was doing the test, he was telling me how his wife died 8 years ago because of Malaria. Who knows if that's true but regardless, she died... and she didn't have a hospital to go to. That's when I'm so thankful. So thankful for this hospital and the opportunity to be a part of the healing that happens here on a daily basis.

I sometimes question if I can emotionally handle what this country brings to me. I forget where I am because it's so familiar now. I walk by houses that are pancakes on a daily basis and it's normal. I greet people in their shanty makeshift tent shelters and smile as I walk by. I have 2 year olds chanting Christina running at me with open arms no pants and a t shirt on. (Donaldson is one of my favorites who does this.) It feels so right to be here and so essential to keep on doing what I'm doing so I'll continue to heal and hug and kiss and smile but my heart is broken. Broken beyond what I'm able to fix and I'm not sure I'd want to.

Okay, that's the end of it. Basically, it's been a tough day. Thank you for reading my rant. I love you guys. Please remember how to live simply with compassion and remember. Remember Haiti. Remember Katrina victims. Remember what love and life are truly about. Remember to kiss and hug your family. Remember what matters.

christina

Being a doctor in Haiti.

Cayla's arm pre-stitches.

Stitching Cayla's arm.

Sweet final product!

Oh what a month!!

One month down and four more to go. It's crazy to think about but somehow this last month has held so many different emotions and so many special moments and has been quite long and terribly short all at once.
HODR is such a beautiful place to live and get to know people but they leave just as quickly as they enter. Here one day, gone the next. This last week, about 7 "really good" friends (as good of friends as you could have in a month) left to go home and start their lives back up. It's a tough transition but so beautiful to know that new different people will come and hopefully bring a different kind of richness with them.

This week has been particularly tough at the hospital because we've had such a shortage of volunteers. We had one PA and one 4th year med student both as our providers and then just 4 nurses. We had to cancel our outside clinic and just run the hospital. This would had been fine if I didn't have an awful run in with the PA. Most of the people down here are incredible. Most. This woman, from day one, was pushy and rude and very disrespectful. Being that I also have a fairly strong personality and I don't back down very easily, we clashed. She told me I walked around acting like I knew everything and really I was just in the way basically. So I gave her a little piece of my mind as well. It was all done respectfully but I guess I just couldn't believe how awful she was being to me and for no good reason. So I left the hospital to cool down a bit. I went to see Williamson to see if his presence would cheer me up. I walked up to his tent and he was outside eating plain white rice for breakfast. The first this he said was "CHRISTINA!" the second " Manje!" as he holds his bowl of rice out to me. He wanted to share his rice with me. He has nothing yet whatever is given to him is usually quickly redistributed to anyone around him. He's just so good. His soul and generosity are ridiculous. Such a healing moment right after such a damaging encounter with this grown woman. I cried a bit in front of his tent with him. He just kinda looked at me sorta funny.

As I returned to the hospital to grab my stuff a couple of good friends had shown up injured. One girl needed stitches and as we walked in the hospital, she said she'd really love a gnarly looking scar so she wouldn't mind if I did her stitched. so.... of course I did. She said I did too good of a job though. I'm totally okay with that and kinda proud of myself. Another reminder that this woman is kinda crazy and a big jerk face.

We've worked together the rest of the week and she's been civil and slightly nicer so it's been good.

Also, because we were so short on providers at the beginning of the week, we still ran the clinic and me and another nurse acted like doctors. We saw patients, asked questions, assessed, and prescribed medication. It was weird. I mean, I know a lot of the complaints were the same and fairly simple but it was super awesome knowing how much we were helping these patients. We would always consult a doctor if we were unsure and the nurse was far more experienced than I was... either way, it was incredible and terribly humbling to know these patients trusted us with their treatment and health. Basically, in Haiti, I'm half a doctor. Oh and the jerk PA woman missed a very obvious diagnosis the other day. I had the dad bring his sick daughter back in the hospital and tested her for malaria (which she had, which I knew she had, and which the PA missed cause she was being dumb about her symptoms) and she had it. It was so classic and I felt so good that that little girl is gonna finally sleep through the night without throwing up anymore. As I was talking to her dad, he had told me that his wife died 8 years ago because she wasn't treated for malaria and she had gotten so sick she died. Can you imagine? Your wife dies of malaria and your only daughter is sick for four days and gets sent home with a tums? I'm so glad he brought her back to get tested and treated. Poor little thing.

So this is long enough. Many more amazing things have happened but I'll leave those for another day.
Love you kids. miss you too. Besitos.

week two. done.

So another week completed in Haiti. My goodness this week was tough.

The new team at the hospital was fantastic and I met some really wonderful people. One of the women, Barbara, has led the life I aspire to lead one day. I guess I'm already starting to, but her stories are incredible and I love talking to her about her year in Indonesia and working for the Air Force and the clinic she goes to in Central America. It's always reassuring and quite exciting to meet new people who have been where I want to go and still love doing what they're doing.

The hospital itself was a little frustrating however. A little boy came into the ER having a ton of general pain and he was moaning in bed. We tested him for malaria and found it to be negative. After about an hour of asking for more symptoms and getting a more complete history, we found out that his mom has Sickle Cell Anemia. Sickle Cell is passed on genetically so we concluded that he probably has Sickle Cell and was having a Sickle Cell Crisis. Basically the treatment is supportive. A crisis can bring on severe generalized pain so you give the patient pain meds, oxygen and hydration and usually treat for infection (which can precipitate a crisis). We started treatment in the ER and sent him over to the inpatient unit. We don't have a ton of nurses this week so we had the Haitian nurses taking care of our admitted patients. Well the next day, the boy isn't doing well. Turns out the Haitian nurses didn't give the kid any of his meds throughout the day. He ended up dying later that night after the team intubated him and bagged him for several hours. He was 8. I wasn't there to experience all of craziness that happened through the night, but I do work closely with the nurses that failed to look after his care and it's been hard to know how to best approach the lack of quality care in our hospital and best be an agent of change in that place without being insensitive and crazy bossy.

Monday when I was just about to grab my bag to leave the hospital, I heard an ambulance pull up outside. We've only had a handful of "ambulances" pull up to our hospital in my time there and it's not always been an emergency. This time it was a brown land cruiser with a siren (good enough to be a Haitian ambulance) that came to us with victims of a car accident. I've not really been around a lot of trauma so what I saw next was a huge test for me. The woman who got out first was kinda moan-cry-yelling and was completely covered in blood and dirt. Her jaw was huge and her mouth was full of possibly broken teeth and blood. She was shocking. I was the first one to get to her and I almost kinda froze. Two big men helped walk her to a bed so we could start cleaning her up. The next guy was my guy. He was walking fine but had huge abrasions all over his face. We got him to a bed and started cleaning him up too. At this point in the ER was have a Pediatric Neurologist, a resident an ER nurse (Barbara) and myself. Was I kinda freaking out? Yes. Just for a sec though. I wasn't sure if we were going to have a ton of head injuries that we wouldn't really be able to treat and honestly, I didn't know if I really knew what I was doing. After maybe 10 minutes, a bunch of other nurses and doctors came to help out with the 4 other patients that came in from the same accident. My guy ended up needing some stitches in his arm cause a huge chunk had come out and some staples in the head. I ended up helping staple his head shut so... that was kinda cool. I'm also kinda awful at injecting lidocaine into a skull. Practice makes perfect though right?

I've also been really helpful here on base. I've been ceaning up wounds, squeezing out some cellulitis puss, handing out Cipro for some intense diarrhea, consulting people regarding their different wounds and what to do. I love it. It's been so good this week to feel really helpful at the hospital as well as on base.

I went rubbling with a group earlier this week also. We started working on a two story house that collapsed during the earthquake. I was lucky enough to also help finish the project and see how much of a difference it's going to make for her. She lives with her 6 month old daughter, sister + her kid and their mom. The house wasn't super big to begin with but apparently they make do. It's amazing what you can do with a bunch of shovels, pick axes, sledgehammers and wheebarrows. I mean, seriously. To see that house pre and post was incredible.


Now we're dealing with some management issues within the non profit that hopefully will resolve themselves soon and bring about a more unified place to work.

I love you guys. I feel at home here though. I feel loved and helpful and encouraged everyday to continue to do what I've been doing. It's glorious.

week one over.

My first work week is now over. I've had my ups and downs like I thought but at the end of the day, I'm still pretty excited to be here right now.

I worked in the hospital for two days helping out in the ER. They had discharged all the inpatients so we were fairly quiet this week. The ER was slow, the clinic was as it always is, busy on Monday, quiet by Thursdayish.

Thursday through Saturday I worked with HODR. First planting some cherry trees then rubbling. They just started a new rubble site where I was able to see all the destruction on the very first day. It's amazing how devestating the earthquake was to certain buildings. The house we were working on was a two story building with a shop out in front. The roof had been taken off by a different NGO I think but the remainders of the house were left to be manually destroyed and carried off the foundation of the house. Crazy if you ask me. You seriously look at a 4 bedroom, 2 story house and it's in pieces. The floor is still sometimes intact... which means you have to sledge it to small pieces. And you have to do this all strategically so that you don't sledge the floor out from under you. Oh right... it's also like 100 degrees and you're in the blazing hot sun. You know when you sweat so much it's running off your face? Literally dripping, continuously down your face. Maybe you do cardio. Maybe that's when it happens. For my yogis you know how I sweat in our yoga classes... well imagine that kind of sweat but for 7 hours a day! Also imagine that your shirt doesn't ever dry and your eyes kinda sting from the sweat that's gotten in your eyes. It's glorious. Really, glorious. It's a beautiful way to be helpful and encourage others near you and I've even been known to do some small nursing stuff on site. Minor injuries but still good stuff.

I also got to meet the co founder of the hospital this week. Josh White. Really great guy, fabulous doctor and new friend. We got to talking about the hospital recently and the future of what's going to be happening to it. I've heard rumors that it may be closing down due to funding and now after talking with Josh it sounds more political than financial. I'm sure I'll find out more and while I started freaking out right after we talked about "what am I gonna do if the hospital shuts down?" Instead of freaking out I have decided to just be present here...now. Just be.The hospital is still open. People are still sick and hurt. Everyday still makes a difference. We also just got a huge donation of supplies which is always so amazing. I will continue to split my time working at both places until something happens that makes me have to look elsewhere.

Love to you all. Sorry for the infrequent updates. Once a week might be all I can swing.

xoxo