Twin Boys and a Mountain Road

As we reflect on the Easter season, a time of renewal, hope, and new life - we are grateful to share an update from the clinic. We are blessed by your support and want to report how your funds are helping lives and bringing hope every day. I wanted to send an update sooner, but an unexpected roof replacement required an immense amount of attention! I hope this season finds everyone well.

Ambulance trip Easter Sunday

On Easter Sunday, I was sitting in Oriani church when I was called to the clinic. Our nurse, Mis Vitani, was examining a laboring mom caring twins. She could tell the position was not good for a normal delivery and was recommending transferring to Fon Parisien for c-section. A quick look with our ultrasound confirmed the first baby was in breech position. Fon Parisien is 3 hours down the mountain on rough roads. This is always a difficult decision because many times that rough road has a way of delivering babies, ready or not! Do you try to get closer to a hospital that has more capabilities and risk delivering in the ambulance with fewer resources? Or do you wait and hope you can deliver a breech baby at the clinic without complications? Decisions we are forced to make here. Anyway, we decided Bodie would drive the ambulance and I would ride in the back in case we were forced to deliver on the road. So we loaded up and started bumping down the road. Less than 20 minutes down the road we heard yells to stop the ambulance. Sure enough a baby’s foot was visible and I was obligated to deliver in the back of the ambulance! Luckily, delivery went smoothly and the baby was doing fine. But now what?? The other twin is still really high and in breech position as well! Really requires an emergent c-section, but we are a long way from Fon Pariesien yet. Nothing else we can do but keep heading down. Hopefully, we can at least get the mom closer to help in case there’s a complication with her. A little ways out of Foret we stopped again. Now I can tell the baby has descended some…still breech position. At this point, if there’s any hope at all for this baby… I have to try and and get the baby delivered now. It wasn’t easy… because in addition to the high breech position and a very exhausted mama…the cord also happened to be wrapped around the baby’s foot. I was eventually able to free the cord and gently get the baby to descend. More of a miracle versus skill here! and of course many prayers were offered! Both babies seemed to be doing ok so we headed back to the clinic to meet Mis Vitani.

Twin Boys

Healthcare Challenges

Lately we have been seeing a number of patients that require a higher level of care. What do you do with a patient in heart failure, edemetous to the point of not being able to stand up, and wounds to both legs with gangrene setting in? Her son came to me and asking for help. She had been sick for a few years now and progressively worse. I suspect heart failure due to a heart attack in the past. She couldn’t make it to the clinic in her current state and was begging me to come see her. We walked up the steep path to her small house, barely more than a stones throw from the clinic. Just inside the front door seated on a bed in a dark room sat this dear lady. Grossly edematous and very labored respirations noted. She spoke in one word sentences but otherwise seemed happy to see me. Upon assessment, I found her hypertensive and an irregular heart rate 180-190 beats per minute! Also oxygen sat less than desirable. Her legs were dripping with fluid and the skin was tight and sluffing off in some places, revealing infected wounds I won’t describe here. The son told me they had been to multiple Dr’s and the last time they went for help they were refused. We cleaned and dressed her wounds the best we could. I also started her on a diuretic to remove fluid and medication to control her heart rate. A few days later she was feeling lots better and no longer in distress. We continued to dress her wounds but really the infection had been there so long she was risking losing her legs…or her life at this point. The real turning point occured when I realized the family was smearing tobacco and all sorts of other remedies on the wounds! The infection suddenly got much worse! People still tend to use their own remedies even when they are instructed not to. Maybe they feel like it’s worked in the past or they just don’t really know of anything else to do? It’s a hopeless feeling I’m sure! At this point the wounds need to be surgically cleaned or more likely below knee amputation. The family was encouraged because she was feeling much better with the medications and now they were desperate to find help for her infected legs. I messaged a few hospitals and determined University Hospital in Port would be the best option. Many hospitals have been destroyed by gangs and forced to close…which has really impacted health care in Haiti. We gave the patient and her son a ride down to Fon Parisien. From there they took public transportation through numerous gang territories before arriving at the hospital in the heart of Port Au Prince. We still aren’t travelling past Fon Parisien with our ambulance due to safety concerns. She doesn’t have the same opportunities we have in North America…but yet she has been given a chance and hope for healing.

NEW SOLAR POWER INSTALL

Bodie has been busy with various maintenance projects at the clinic. We did get the new solar power system installed and it’s working great! We have considerably more power and have enough reserve to make it through some cloudy days and easily run the oxygen concentrator all night. The entire system has been upgraded. We started by installing twelve 700watt panels (8.4kw). The panels are mounted on a separate roof. Keeping the panels off the clinic roof will help prevent future problems with the structure. The solar wires are ran in conduit and feed a Sol Ark 12kw inverter and 4 lithium batteries giving us 20 kilo watt hours of reserve. The lithium batteries are maintenance free and should last for 10 years or more. With the old system, one cloudy morning and we needed to run the generator! It’s nice to know that anytime (day or night) we will have plenty of power for medical emergencies. Awhile back, the oxygen concentrator ran all night and in the morning we still had 80% battery life!

Structure For Solar Panels

New Solar Panels

New Inverter and Lithium Batteries

Attending to the Injured

Confidence Health Center continues to be a bright spot in the community. Many times just treating basic problems like high blood pressure or providing medications for “grip” (common cold). Each week, our vaccine nurse is administering pediatric vaccines. In this low resource setting, preventing illness is one of the best things we can do! Our nurses are available 24/7 for any emergencies and their dedication to this work is amazing! I’m happy to assist with after hour calls, but some times I don’t hear until the next day about some of the cases they were treating.

Malnourished Baby

A Leaky Roof

In my last update, I mentioned the clinic roof is urgently needing repair. We have been getting some rain off and on and there are many places where water is entering. Most concerning is where water is dripping in the pharmacy and medication storage area. There’s also quite a bit of condensation inside the clinic that’s causing the purlins to rust. It became evident that trying to patch the old roof wouldn’t be very successful, and the clinic would really benefit with a new roof system that includes a moisture barrier. After some research, we were able to source some suitable roofing materials in the DR. The metal sheets were considerably thicker than what could be found in Haiti. I was also able to find synthetic roofing underlayment and 3/4” plywood. We hired 4 local boys to help Bodie and I with the project. One of the biggest challenges with the project was working around the rain that came nearly every afternoon! We removed the roof in sections and started some mornings at 4am. By early afternoon we needed to have everything covered again. The clinic remained open the entire time and the nurses moved to different rooms to continue consulting patients. Our local roofers did a great job following orders and the finished product looks great! The new roof is a significant improvement and many people commented on how much warmer and drier the clinic feels.

I wanted to thank everyone that donated to Regi’s eye injury. Regi is a youth boy that lost sight in one eye from a soccer ball injury. He was able to have surgery on the injured eye to remove the cataract. He reports his vision is improving. In order for him to get help, a friend had to take him on motorcycle to Jacmel. The trip was about 12hrs one way and they traveled on some of the roughest mountain roads in Haiti…with parts of the journey at night and in the rain. He will need to follow up again soon and possibly require another operation. Without your donation this would not have been possible.

Well I guess that wraps things up for now. My family and I are safely home after a 3 month stay and grateful for the time we were able to spend in Oriani. Although we are back home, the work at the clinic continues every day. May you remember the Haitian people and the challenges they face. Thanks again to everyone who supports this mission through prayers, encouragement, and generosity.

Haiti Revisited

view overlooking Oriani

It’s really hard to believe it’s been over 7 years since we left the clinic in Oriani! A part of us never left… it seems. Our hearts were knitted together with these dear people as we briefly walked their mountain trails, admiring their strength and resilence. Now 7 years later, we are back again with our family. Bodie is now 19, Alyssa 18, and Dawson 14. We are happy it worked out for all of us to come. Since Jonathan’s left last May, the clinic has been operating without North American staff onsite. We are thankful for all the systems Jonathan has put in place and it’s working well. Fre Eldar has been performing some administrative tasks for us and the board is in contact with clinic staff almost daily. We are still actively seeking someone to fill the admin position! In the meantime, my family and I will be spending a little time here in Haiti, supporting the clinic however we can.

Life here is a lot how we remembered it. Though the little boys that used to play in our yard and do odd jobs for us, have turned into strong young men! And yet there is another generation of little boys to take their place! It’s a joy to see the children walking to school in the morning. Cheerfully talking and laughing.

Boys walking to school

In light of the current insecurity here in Haiti, life here on the mountain is a lot the same. I’m under the impression they aren’t suffering here as much as other areas around the Capital. Here they still have a secure place to live and food in their gardens. The markets are thriving with beautiful produce. Some may still experience periods of hunger during dry season, but that’s not a change due to the unrest. Marketing their produce to Port has been more difficult and costly, but they have further developed markets in other southern towns. January has brought some earlier rain than usual and people are eagerily planting gardens. We have still been getting frequent showers and the gardens are beautiful!

Oriani Market

The clinic continues to operate well and I’m very pleased how well our staff work together. Each morning begins with devotions out on the porch, led by Pastor Willi, who also serves as our receptionist. It’s a time when the patients and staff can connect with God and acknowlege that He has the power to heal us both physically and spirtually. There are two other church brethren employees that will help with leading a song and praying too. It’s the part of the day you don’t want to miss! Our three Haitian nurses provide patient care with skill and compassion. Mis (Nurse) Yolette and Mis Vitanie both handle the daily consults with patients. Mis Vitanie also specializes in obstetrics and handles deliveries. Mis Rachelle is our vaccine nurse and also supports the pharmacy as well as working with the other nurses too. We have additional support staff filling various roles, and of course a driver on standby… ready at moments notice to transport a patient by ambulance!

This time, it’s feels odd tho because the clinic operates like it’s on auto pilot! Last time we were here, I was frequently awakened at night for clinic emergencies. Now these after hour calls are handled while I sleep. When there is an emergency, people will find the nurses and they are ready to help. The other evening was an exception, though! It was Saturday and market day in Foret, which can bring extra activities and more limited availibility for the nurses. For whatever reason, I heard the familiar honk of a moto and then a knock on our gate. Arriving at the gate, I found only a moto driver letting me know there was a woman in labor by the clinic gate. Hmm not my favorite kind of clinic emergency! I tried to call a couple of the nurses but no luck reaching any of them! Ok… I’ll just have to attend to this situation myself and hopefully a nurse will arrive soon to help me out. It has been JUST a few years since I worked in this speciality! Jumping on a moto I soon arrived at the clinic gate. There was the usual crowd of people and one woman crouching down in the dirt. Opening the gate, I tried to narrow the group down to those that were actually connected to this laboring woman. Probably about 6 people stormed through which was certainly better than 50! We marched back to L&D room and I got her settled on the delivery table. I then turned to the doorway…only to face yet another group of people with another laboring patient! How did I miss that detail! Anyway, what choice did I have but to get the 2nd patient settled on our gurney just outside the L&D room. My hunch is the 2nd patient is about to deliver! I scrambled around trying to locate the needed supplies…and then Mis Vitanie appears! I am so grateful! We take some vitals on the patients and very soon after Mis Vitanie delivers the first baby girl…the patient on the gurney. Everything went well and I was able to just assist instead of being in charge of this multi-patient-laboring situation. As it turned out, things timed well and we were able to discharge the the first mother and baby before delivering the 2nd girl. Both babies delivered without complications and we were so happy for that. Mis Vitanie is so kind and compassionate with her patients and she really has a soft way of educating and acknowleging God too. It’s amazing that most times… within a hour or less these mommas are getting on motos and heading home!

One way the unrest in Port is severely affecting us is the lack of hospitals when we need a higher level of care. There is a small hospital and a couple of clinics in Fon Parisien, which is 2.5hrs drive down the mountain. Sometimes it’s possible to get a C-section or a minor surgery done at this hospital, but it’s never certain and not a reliable solution. The clinics down there can also do some basic lab work, but again they are difficult to rely on for challenging cases and have their limits too. Most of the hospitals in Port we frequently transported to in the past, have either been destroyed by gangs or forced to close because of violence. Currently, for safety, our ambulance will not travel past Fon Parisien. This is one of the most difficult and saddest things we are facing. It forces us to treat illnesses and trauma the best we can locally, even though a higher level of care is what’s actually needed. Just the other day, an elderly gentleman came to the clinic from a very poor area. He had the largest inguinal hernia I have ever seen. He has been suffering for a number of years with it and has no means or way to get help for it. The clinic has provided some small financial aid and has consulted the hospital in Fon Parisien. There is a surgeon that seems willing to operate…so pray this surgery will be possible one day. The clinic is very much apreciated here, and I’m so thankful for the services we do provide with the help of all our donors.

We have some projects we are working on while we are here. Bodie has been working on maintenance with the clinic vehicles and motos. Seems like there was also a backlog of computer and technology issues at the clinic…so he is also learning how to troubleshoot and re-install operating systems. Another thing we will be doing is installing a new solar power system at the clinic. Having enough reliable power is key when operating oxygen concentrators ect. We were able to bring a new inverter with us and have sourced the rest of the items here in country. Surprisingly, with the right connections, you can purchase and have items delivered from Port! So stay tuned for updates on this project. Other needs I see…the clinic roof is in poor shape with multiple leaks. It’s been repaired a number of times and it seems that replacing it might be the best option. It takes some strategy by staff to keep medications and supplies away from all of the leaks! We are assessing funds and looking for ways we can realistically make this happen. We thank you all for your continued support and may you all continue to pray for the clinic and of course the people here in Haiti.

Year-End Comments

We thank you for your continued support for the ongoing work of the clinic. Jonathan and Julie and family were admins but their allotted time was up so they went back to NY state in summer. We thank them so much for the time they spent in Haiti!

Jon helped set things in motion for the continuation of the clinic operations while we wait for God to provide us with a new admin family. 

When people ask me how its going down there, I just tell them that I am enthused that the nurses and employees are working, patients are being seen, the sick are being healed, and the poor have the gospel  brought to them. (Sorta like Matt 11:3.)

As I look back over the year, I see how God has protected and led many aspects of the work of the clinic. He continues to make ways for us to get all the medical supplies and medications we need. With all the challenges Haiti has come through it is really amazing that we have never lacked much of anything! Our old ambulance is still holding together as we continue to raise funds and hunt for another. Our nurses and staff are working well as one united group and local trust level in their capabilities and our medicines is very high. We don't drive into Port au Prince, but our vehicles are able to travel all the southeastern mountain roads, from Fond Parisian to Oriani, down to Thiotte, out to Bel Anse, and even Jacmel. There have been no danger or safety issues. God is good! 

We as a committee have been in touch with our clinic workers every few days and have been able to go visit them as needed. (We come in through the DR.) 

Thank God for email and WhatsApp! 

I can also report that the Oriani community is doing quite well, considering the country's problems. The farmers have sometimes struggled to get yields to their satisfaction, but there is enough to help keep the community going.  Everytime I go back, I'm amazed how much construction is happening and how many more houses are built. 

One Haitian friend said to me,  "Yes, those who have a little money will keep getting a little. Those that have a lot of money continue to make more, and the poor... they can hardly find a way to advance."

We can't help all the country's issues but we feel happy to fill the role God gave us to fill... helping show the gospel and love to the poor and healing them from their diseases ("dis" "eases") while pointing them to the Great Physician! 

Thank you for your prayers and monetary support this past year, and please keep on helping with this exciting endeavor! 

Some are again asking how to help. Here is a link that gives info.

Farewell to Haiti

Well, time goes on and the responsibilities of life beckon. One can’t spend their whole life as a volunteer. The first of June finds us back in New York. We are setting up life in another house and I’m preparing to go back to work in the Emergency Department at Upstate in Syracuse. It was 2 years and 3 months ago we were preparing to go to Haiti, not sure what we would find there and how God would use us. We knew the stories of the difficulties and dangers in Haiti. We knew the clinic was closed. I had no idea what it would take to reopen. But, when God gives a conviction to do something, we can follow in confidence He will open the doors. Keith and then Matt came to help with hiring staff and finding sources for medications and supplies. Looking back over the last 2 years, I want to thank those who have contributed to the success of the clinic.

One of the most amazing things to me is that in the first week we made contact with the 2 men who would be essential to supplying medications. Riky, a Haitian from Fond Parisien, living in the DR. Gabriel from Croix de Bouquets. Riky has his license to buy medications in the DR and import them into Haiti. This meant we only had to go to Fond Parisien to get medications from him. He took care of the hassle of bringing them across the border for us. Gabriel organized purchasing medications from Port au Prince and arranging transport to Oriani for us. He told me he could get us anything we needed and as long as the road was open, he always came through. He said he just had to wait for the shooting to stop before going out, but when it was quiet he could travel into Port to find things for us.

Quentin and Krystel were living in the administrator compound when we got there. He did a lot to help me learn where to find things, how the clinic systems worked, and how he was able to buy parts for the vehicles. Krystel helped us learn to buy in the market. Rosemard and Carmina. Carmina as a former nurse at the clinic helped me learn how to care for patients in Haiti and to communicate with them. She spent a lot of time working with our Haitian staff and training them in the clinic. She also helped me review and rewrite the clinic protocols. Rosemard was always willing to go with me when I needed an interpreter or someone to take the ambulance to Fond Parisien. Our 2 Haitian nurses, Mis (nurse) Yollette and Mis Vitanie. They both fit in well with the local staff and are happy to help with emergencies after hours. Mis Vitanie especially deserves a shout out for her calm demeanor and expertise with delivering babies. Mis Rachelle, who came to us from MSPP and continues to do an excellent job with vaccines. Fre Willy who opens the clinic with devotions every morning, does registration, and helped me work with families and patients and understand their needs. The 3 nurse aids, Se Papi, Se Berlin, and Se Emanualla, who work together to help the nurses and in the pharmacy. Fre Roosevelt who manages the pharmacy and arranges medication orders. Fre Dieu Met who opens the clinic gate every morning and hands out numbers to patients as they arrive so they can be seen in order. Se Jean Claude who keeps the clinic clean and the laundry done. And now Fre Eldar who is learning to oversee everything for us and provide us with reports and serve as eyes on the ground for the board. Finally, Jenel, who worked many long hours in our yard to keep our vehicles running. These all work together well to keep the clinic operating, and in exchange the clinic gives them a stable income.

There are many other people who helped us in many ways. Carlos, the Dominican who is always available to help bring things to the border, give us rides to the airport, and assist with anything we need in the DR. The Haitian advisory committee who were often willing to drop what they were doing and help me if I needed it. The clinic board does a fine job of coordinating money and supplies from here in North America and does a lot of work behind the scenes with fundraising. And the donors, without whom none of this would be possible.

I often felt like the least of these. Nothing we did was extraordinary. The most extraordinary thing was how God opened doors and enabled the clinic. Without Him it would not be possible. We got to visit and learn to know a small corner of Haiti and some of the people there. The resiliency of the Haitians is as amazing as the beauty of their country. The memories we made will be special to us the rest of our lives. I am happy we had the opportunity for this experience and to help in some small way. One thing I often thought about was that we weren’t so much helping Haitians, as helping Haitians help Haitians. There are many talented people there who simply lack the resources to work. Enabling them and watching them work was very rewarding. We found a Haitian, Fre Eldar, who can serve as administrator and keep things running, but it would be best for another North American to come fill this role. The house is ready, the pieces are there. All that is needed is for someone to say, “Here am I. Send me”. - Jonathan Kurtz