Friday, July 30, 2010
Joseph in May.

Joseph Stephen was a in-patient when I first came to Haiti on May 12th. He had been admitted in January following the quake and had a severe case of osteomylitis. If you've been here you probably met him. He almost NEVER smiled and if a nurse attempted to do anything to him at all he would scream bloody murder. He was given every toy and balloon available by many teams but still no smiles.

When I arrived two weeks ago he was an out-patient in the tents on campus waiting to have his cast taken off! (external fix to cast). He had it off last week. Now I can't walk outside without him yelling my name and covering me with hugs and smiles. His leg is severely scarred, but he has it!

We plan on discharging him "home" on Monday....just not sure where home will be. I've only ever seen his 12ish year old sister.

"i love the rain, but i hate it for them."

Tuesday, July 27, 2010
I just learned that the anesthesiologist is sleeping in a tent. I’ve been frustrated, borderline angry for a week and a half because we can’t manage to get more than three surgeries done a day, usually only two. Anesthesia only works from 11-4.

But she’s freaking living in a tent. She is a Medical Professional who has worked and studied in France, speaks at least three languages and actually has a paying job. If she can’t get out who can?

I think the first time I was really sad was yesterday. Poverty is always disheartening. But I think one reaches a point of understanding it and isn’t as grossly affected by it. I’ve thought of myself as there.

Yesterday I walked with my Creole teacher, a 16 year old whose parents have left him to fend for himself while working in Panama and the US. His tent is pitched next to what was once his house. It has a big red stamp on it marking it unsafe. It is.

He doesn’t see a future for himself. He thinks his country is dirty and poor and hot. But he says he won’t leave. He says he wants to get education in the US and come back to help. He wants to be a doctor. He is brilliant. He could do it. I hope that he does. Most Haitians who get out don’t come back. I’m not sure I would.

Brooke is officially leaving on August 31st. She needs about four nurses to do her job. I feel like I am successfully doing a small portion of it. I don’t think I can do it all.

I am really enjoying myself. Days are hot and hard and my feet hurt and I’m tired of sweating and annoyed that I have to walk to the ER to find an available translator every 33 minutes in order to get anything accomplished.

But we’re doing some good. I have helped nine patients receive surgery in the eleven days I’ve been here. Most of them were fractures and dislocations hanging out since the earthquake.

Brooke and I went for a walk today. It was perfect. So nice to be able to vent my “nursy” feelings to one who understands. Believe me, all six of the long-termers are wonderful. But there is a different level of responsibility when you’ve taken an oath. That’s something they don’t get. They can’t. When patients die on our watch when something could have been done to prevent it…YOU could have done something to prevent it...it affects you. Deeply. It's that way for nurses in the States, and it doesn't change across an ocean.

Paul Farmer said, “If I don’t work this hard someone will die that doesn’t have to.” I get his feelings. I know Brooke does. She’s been living it for 6 months.

There is so much garbage going on here below the surface, so much mess and corruption. But everyday I update the census and delete someone’s name off of it (because they had been discharged). I know there is good happening. Only by the grace of God.

beach day.

Sunday, July 25, 2010

Thank God for Sabbath. For those of you who haven't heard the hospital I am working at is Adventist, so they take their Sabbath on Saturdays. Very little, if anything, goes on at the hospital on this day and while it proves frustrating for patients and family members awaiting surgery, it is a blessing to be able to have a break.

Yesterday following the church service I went along with about six other volunteers to a beach about two hours from us. Two hours being Haitian time, and after our drive out of the way to the Project Hope compound and a flat tire change we were at the beach for about two and a half hours. It was well worth the wait. I've heard tales of muddy beaches and rocky shores in Haiti, but this place was amazing. It was clearly a resort for white people costing $15 US for entry.

The water was clear and beautiful and for the first time I felt as though I was in the Caribbean.

The went swimming, ate hamburgers and enjoyed getting to know each other, although sadly, most of those volunteers left this morning.

I am now beginning to realize Brooke's exhaustion with re-orienting a new doctor every week. Dr Pat and his Ortho team seemed to just have everything under control when their time came to an end. Dr Rich rounded with just me this morning (the crew dropped from about seven people to two in one day) and he seems flexible and ready to go.

Please pray that the Haitian anesthesiologists are open to working hard this week so that we can get some of the 16 surgeries on the list finished. We only got six accomplished last week.

As far as figuring out what my role is going to be here it seems to all be falling into place. I am working directly with the Surgeon volunteers making sure that their patients are ready in pre-op (labs, xrays, EKGs) and moving towards discharge in post-op. I am helping them schedule surgeries and will be working with the Haitian nurses and OR coordinator to make sure they get done. I also update the hospital census daily, right now we only have about 45 inpatients.

All in all life in Haiti has been going well. I am beginning to establish some routine and feel as though things are are being accomplished.

right this minute

Thursday, July 22, 2010
I'm sitting in the staff break room trying to decide what to write. Then it occurred to me that I just need to type what has happened to me the last hour.

Let's start with this minute. Jean Junior, a seven year old HIV+ patient is sitting on my lap. His father died in the middle of the night yesterday leaving him an orphan. We all love him so dearly that it's hard to want to find him somewhere to go...but we know that he must. He needs treatment. He needs adoption. Who adopts HIV positive children? Amy just pulled a suitcase full of donated clothes out of storage....Junior is going through them now.

He only has what's on his back.

About 30 minutes ago, Kristen, a third year pediatric resident from Loma Linda came up to me frustrated to death asking for new batteries for the pulse oximeter. She has a 3 month old in the ER right now struggling to breath. "I've done everything I can do, but he's wearing out and is going to die if I don't intubate him. I talked to Brooke and the only hospital with vents for baby's is full. This is so frustrating. I feel guilty....but I've done all that I can. Should I just intubate and bag him?? But we can't bag him for four days.....is this really all I can do!?"

A baby has died everyday that I've been here.

10 minutes later she returned, "Jessica!! God is so good. The Haitian MD in the ER knows of another facility and they will even come get the baby! If everything goes well he can be intubated there tonight!"

God is good.

About an hour ago Dr. Pat and the ortho team finished their second case of the day (another frustration as there are 5-7 patients on the schedule but the Haitian anesthesiologists won't show up till noon and try to leave by 4pm). The operation was on a lady whose ankle has been severely dislocated since the earthquake. She has been walking on the side of her foot.

Hopefully tomorrow she will walk close to normal for the first time in 6 months.

Ighor is sitting next to me waiting for me to finish so that I can have my Creole lesson. Pray that this comes easily. I cannot explain how much easier my day would be if I can master this language.

How amazing it is that our God understands them all.


Sunday, July 18, 2010
All my bags made it!

I found my driver with no trouble at the airport.

The patient I missed the most (Nadine) was sitting on the hospital steps when I arrived.

There is a very "America" grocery store about 3 blocks from here.

Amazing new friends in just 36 hours.

Headache meds have worked (two days in a row).

Sermon yesterday (Saturday=Sabbath) on total depravity...haha. Amazed at spot on theology.

Got to sing "Healing is in your Hands" offertory in church.

Preparations for Creole lessons underway.

It's cooler than when I was last here!

Ortho Surgeon arrived last night.

How Great is Our God.

contacting me in Haiti

Thursday, July 15, 2010
Hey everyone!

Looks like the best way to reach me is through text messages. I have my same cell phone number. It's free for me to receive and $.10 to reply, but I can reply for free from 706-623-2515. So that's me if you receive a text from that number.

My skype name is jezkascott and I also have a magicjack so making phone calls is no problem. If you need to talk to me just text and I'll call you back as soon as I can!

email is easy too jezkascott@gmail.com

I love and will miss you all!
Fly out tomorrow at 6:50am

Thanks for all the prayers, they mean more than you know!

~ Jess

"the only real nation is humanity"

Sunday, July 11, 2010

Yesterday I returned from a few days at the beach with some of my dearest friends. While there one of my goals was to start and finish one of the books my brother gave me for my birthday in June. I'm proud to say I did it. I had asked him to give me some books on Haiti, whether that meant politics, culture, religion, medicine or really anything...as long as they weren't too long or too boring. I'm not sure whether he did research or just has a nack for picking books (I suspect both) but the one I've completed was unbelievable.

It's called Mountains Beyond Mountains which is a Haitian proverb basically meaning that there are always going to be more hurdles even when you've overcome what is in front of you. The book is a biography about Dr. Paul Farmer (DP) by Tracey Kidder (TK). Dr Farmer is an infectious disease physican who graduated from Duke, then Harvard and spend the majority of his time (even while enrolled in classes) taking care of Tuberculosis and HIV patients in Haiti. He left for Haiti at age 23 and almost singlehandedly started the organization Partners in Health (along with an 18 year old British girl) which is now serving in Boston, Haiti, Peru, Rwanda, Russia, Malawi, Burundi, Mexico and Guatemala.

Crazy thing too is that I applied for a job with Partners in Health a couple months ago (that I was completely unqualified for) knowing very little about them, except their renown work in ID. Now I think I could easily work for them forever if the job ever presented itself.

I can't really recommend the book to non-medical personnel as there were pages filled with treatments for multi-drug-resistent-tuberculosis and analysis on HIV medications (which I found intriguing). But if you think you can skim through those pages then I'm sure you'd find the book a phenomenal read.

I'd like to share some of my favorite quotes...

The world is full of miserable places. One way of living comfortably is not to think about them or, when you do, to send money. ~ DP

...wild screams erupted from the child. "She's crying, 'It hurts, I'm hungry.' Can you believe it? Only in Haiti would a child cry out that she's hungry during a spinal tap." ~TK

Giving people medicine for TB and not giving them food is like washing your hands and drying them in the dirt. ~Haitian public health worker

Just when you thought you had the hang of [DP's] worldview he'd surprise you. He had problems with groups that on the surface would have seemed like allies, that were allies in fact, with for example what he called "WL's" or white liberals, some of whose most influential spokespeople were black and prosperous. 'I love WL's, love 'em to death. They're on our side,' he had told me. 'But WL's think all the world's problems can be fixed without any cost to themselves. We don't believe that. There's a lot to be said for sacrifice, remorse, even pity. It's what separates us from roaches.' ~TK

You want to see where Christ crucified abides today? Go to where the poor are suffering and fighting back, and that's where He is. ~DP

The fact that any sort of religious faith was so disdained at Harvard and so important to the poor- not just in Haiti but elsewhere, too- made me even more convinced that faith must be something good. ~DP

spoken to DP's associate...why do you call your patients poor people? They don't call themselves poor people!? "Ok, how about soon-dead people?"

The goofiness of radicals thinking they have to dress in Guatemalam peasant clothes. The poor don't want you to look like them. They want you to dress in a suit and go get them food and water. ~DP

I remember signing the oath to assist the patient and do him no harm. I don't really remember signing that I would do it in a cost-effective way. ~ DP (DP's team spent $18,000 flying an eleven year old boy from a village in Haiti to Boston for treatment. The patient was untreatable even in Boston. Farmer had no regrets).

The problem is, if I don't work this hard. Someone will die who doesn't have to. ~DP

....he murmured something about how much could be done in Haiti if only he could get his hands on the money that the first world spent on pet grooming.~TK

All the great religious traditions of the world say, Love thy neighbor as thyself. My answer is, I'm sorry, I can't, but I'm gonna keep on trying. ~DP

All too often international aid organizations weaken the societies they are supposed to help. Often they rely almost entirely on professionals from the world's wealthiest countries, and they fail to make their projects indigenous. This all but guarentees that their projects will neither grow nor last. PIH is different. The organization now has on the order of 6,500 employees. The overwhelming majority come from the impoverished countries where PIH is working. Fewer than one hundred of the employees come from the United States. ~TK

There is all the difference in the world between witnessing misery and witnessing people at work trying to relieve misery. ~TK

I wish I could explain all the ways this book has inspired, challenged, moved and given me hope. I'm not sure I can. But the fear that was inside to me, the freak out moments that I've had the last three weeks when all the sudden I'll stop while pumping gas or walking in Walmart and all I think is, WHAT THE H-E-double-hockey sticks am I doing?!?!?! are gone.

I'm no Paul Farmer but I can give a lot of time towards relieving someone's misery.