Christmas in July

You ever had those times when you just had to sit back and smile in amazement because things worked out better than you ever expected? We’re doing that right now – just hardly able to believe how fortunate we are. It feels like Christmas came to Oriani early! Let me explain.

A long time ago, we had an ultrasound machine here at the clinic. She was gray and bulky and awkward and we called her Big Bertha. Bertha was a great machine, even though she was quite complicated and learning how to run her was kind of like flying the Space Shuttle. We learned the basics and made good use out of her. Then one day about a year ago, she died. Just quit. Wouldn’t turn on. We tried to contact some technicians in the States about repairing her but didn’t we weren’t able to get anywhere with that. We took her apart and examined her insides but we were unable to diagnose what her problem was. Eventually we had to admit that she was irreparably gone and we took her to the back and disposed of her. It was a sad day.

We continued on without Big Bertha, but often we would mention how nice it would be to have an ultrasound around here to be able to quick scan a patient. Maybe we had a pregnant woman and we were worried about baby positioning or placenta previa. Maybe a patient had a large abscess and we wanted to know if it had a drainable fluid collection. We made a few attempts to locate a replacement for Big Bertha, but new ones like her are far more expensive than our budget can handle. However, we started doing some research into an ultrasound machine called a Butterfly IQ+, and the more we read, the more we decided it would be perfect for our needs.

The Butterfly IQ+ is a small, handheld ultrasound probe that plugs right into a iPad or Android device. It is comparatively affordable and while it doesn’t have all the bells and whistles of Big Bertha, it is perfectly designed for quick, bedside exams like we do here. The pricing of the model we wanted, together with the iPad to run it, is somewhere in the neighborhood of $3,500. Together with our American board of directors, we started looking for someone or some group that would be willing to raise some funds to make this possible.

It is Summer Vacation Bible School season in North America, and we were very fortunate to find several Bible Schools that were interested in sending money from their fundraising to help us buy the Butterfly IQ+. We didn’t know how much to expect, but we were going to be happy with any amount towards the total. Imagine our surprise and amazement when we received $8,700 USD, plenty to buy the ultrasound and iPad and have some left over!

We just have to stand in awe at the response and we wish everyone that helped raise funds could come see what your money is doing for these people!

We purchased the Butterfly IQ+ and it arrived last Friday. We had lots of fun setting it up and learning the basics!

Butterfly IQ+ case.

The ultrasound probe and wireless charger in the case.

The new Butterfly IQ+ with the iPad and case.

The very first few days we were able to use our new ultrasound several times. We had a pregnant woman come to the house on Saturday with some vaginal bleeding, and we were concerned about placenta previa, a serious complication requiring immediate ambulance transfer to a hospital. However, in only a few minutes with the ultrasound, we were able to rule out placenta previa and direct her to go to a hospital on her own, as soon as it was convenient for her.

The second case we had was an older gentleman who had urinary retention due to prostate enlargement. After inserting a urinary catheter and draining his bladder, he was still in significant pain and we were concerned that the catheter was blocked and not draining properly. With the ultrasound, we were able to scan his bladder and confirm that there was no blockage and only a small amount of urine remained. Soon after, his pain resolved and he was able to go home.

The next day, we had a young lady in the clinic with a large area of swelling on her throat. With the ultrasound we were able to identify a cystic mass that definitely needs a biopsy to rule out thyroid cancer.

Scanning the thyroid mass.

Needless to say, we are very excited to have this new ultrasound available and we want to take this opportunity to say a huge thank you to each Bible School that helped us with this purchase:

• Lone Tree and Suncrest, Kansas

• Arcadia, Florida

• Faunsdale, Alabama

• Okolona, Mississippi

• Pinecrest, Georgia

May you be richly blessed!

Obviously, the funds that were sent were more than needed to buy the Butterfly. However, we have an ongoing list of items and equipment that we need here at the clinic, and now with these new funds we will finally be able to purchase a few of these. Some items we have been shopping for include a new adult scale, new infant scales to weigh babies, fingertip oxygen meters for after-hours calls when we’re not in the clinic, and a supply of infant formula for babies needing extra nutrition. Some of these items, like scales, can be found cheaply online but they don’t last long and are soon needing to be replaced. High-quality, medical grade scales can be several hundred dollars each, but fortunately with the funds we have now, we should be able to buy the medical grade versions.

The Seca 334 infant scale we are looking into.

Adult scale we would like.

Again, a huge thanks and a shout-out to the children and Bible School leaders that made this possible! It’s people like you that keep this clinic running. May God bless you.

Moving On

The month of May was a time of changes for us here at Confidence Health Center. Our nurse Carmina got here in spring of 2020 and was a major asset to the clinic. She learned Creole quickly and was well accustomed to the culture of the clinic work here. All good things must come to an end and in May her commitment here was completed, so she said goodbye to Haiti and returned home to Canada. We wish her the best in her continuing career.

God continues to provide, and we were thankful to be able to find another American nurse to replace Carmina. Kay is a registered nurse from Mississippi who has several years’ experience working in Oriani in the past, as well as a medical mission stint spent in Kenya. She committed to spending another six weeks here this summer. Her former experience here means that she already has a concrete grasp on the language and culture and was able to jump in with both feet. We are very thankful that she was willing to come help us out, filling a short gap before a more long-term nurse is able to come.

Otherwise, the clinic has been functioning well and we are as busy as we want to be every day. We are deep into spring rainy season now, which means that everything is green and the gardens are doing well, but it also means that the hungry season is reaching a peak. The crops are not quite ready to harvest and the markets are very sparsely stocked. We are fortunate to be a recipient of rice from Feed My Starving Children, provided to us through a mission here in Haiti called Love a Child. They donate food boxes periodically and in times like these we are very glad to have a little nutrition we can give to patients at the clinic. It never seems to be enough, and it’s always a challenge to know exactly who could benefit from it the most.

Here are a few notes from our past month at Confidence Health Center:

-        A neighbor came to the house one Saturday with their son, a boy around 10 years old named Mondi. His complaint was that he wasn’t speaking. Indeed, when they brought him to us he was completely unconscious, eyes closed, unable to move or speak. We tried everything we could think of to get him to wake up or to show some reaction, but the result was minimal at best. He would flicker his eyelids and occasionally swallow, and when we pulled him to his feet he was able to stand, albeit unsteadily with his eyes closed. His vital signs were all normal and the family insisted that he had not drunk or eaten anything unusual, was completely normal throughout the day until he just suddenly “became like this.” He was breathing normally and there was really nothing medical we could do for him without further testing and scans. The family said they wanted to take him to their pastor for a prayer service. That sounded like a good idea to me, so I sent them away. The next day I walked past his house and he was running around, grinning and being just as naughty as ever. He claimed he had no memory of what had happened the day before. We still have no idea what the cause was. Was it something neurological? Had he ingested some poison that they weren’t aware of? Was he under the influence of some dark magic? Probably will never know.

-        One evening several people brought in an old man who was weak and not speaking normally. His vital signs were normal but he was very lethargic and minimally responsive. I started thinking down the lines of a stroke but when I bent closer I caught a whiff of alcohol on his breath. Ah ha! Maybe he’s just drunk? I asked the family and they immediately agreed, yes he likes to drink and he gets like this when he drinks too much. Well, well, not much we can do for this! He needs to stay away from the bottle! We sent them home and the next day he came into the clinic slightly improved but still not fully functional. Several liters of IV fluids perked him up and he left later in the afternoon walking with support.

-        A very sad case came in one morning, a 14-year-old boy brought in by a female relative. The first thing we noticed was his extremely labored, heavy breathing. He was also very weak and unable to walk without assistance, but instead moved unsteadily and jerkily like a patient with Parkinson’s. He was awake and oriented but his speech was extremely slurred, he was restless, and could hardly breathe. He denied any medical history. Nothing seemed to add up to a clear diagnosis. Even his story didn’t make sense – he said he had lived in the Dominican Republic with his mother since he was a baby but had just come back to his birth home in Haiti the day before, alone, on motorcycle. He couldn’t really give us a reason for leaving his mother and said he had only become sick like this during the trip back to Haiti. I noticed that his tongue and mucous membranes were ashy gray and checked his hemoglobin – 1.8. Normal for his age would have been in the 12 – 15 range. We immediately realized that he was far too sick for our abilities here and began to discuss going to a hospital. Unfortunately, before we were able to finish making arrangements, he started foaming at the mouth and within a few minutes he had passed away. It’s so frustrating to us as American medical personnel to watch a case end up like that without clear answers. We would love to see an autopsy report, or lab work, or CT scans – something to give us an idea of what was wrong. He had obviously been sick for a while and we are just too far from definitive emergency care up here in the mountains. There was nothing more we could have done here, but the whole situation just leaves us sad and wondering.

-        This past weekend we were kept busy off and on checking up on a woman in labor. She was from the Oriani area and came in several different times within a few days, progressing very slowly. Finally by Monday morning her cervix was fully dilated but the baby was still very high and not advancing anymore, so we decided it was time to move her to higher care. Fortunately we had no trouble finding a hospital to accept her and she made the trip down to Fond Parisien in our ambulance. The doctors there confirmed she had cephalo-pelvic disproportion, a condition where the baby is simply too big and cannot be born naturally. They did a C-section and last we heard mom and baby were both doing fine. We were very thankful we had been able to help her and her outcome was positive. A case like that without medical care would have ended up with the death of the baby and likely the mother as well.

So, life moves on here in Southeast Haiti! For months, the COVID-19 pandemic was hardly mentioned in the country and life went on as normal, but in the past several weeks we have started to see in increase in cases again, mostly in the Port-au-Prince area. So there is once again a curfew and a mask mandate in the capital city, although up here in the mountains we have not seen any confirmed cases and are continuing to operate cautiously. The political instability and gang activity in Port-au-Prince seems to be on the rise again, and we monitor news carefully whenever we have to go to the city for supplies. There are a few areas to avoid, but usually business can be conducted safely and up here in Oriani we do not see any violence.

Keep the work in Haiti in your prayers! We need them.

A Call for Supplies

Our operations here at Confidence Health Center are funded 100% by donations. We charge a minimal fee for patient consultations, around $1.20 US per patient, but the amount brought in is barely a drop in the bucket of our regular expenses. Each of our American staff here on a fully volunteer basis and receive no salary. We are immensely thankful for each donor that makes keeping this clinic open possible, from the individual who donates one time to the foundations and groups that are committed long-term. Every one of you is appreciated. It amazes us many times to see how God has continued to provide for us to be open these past 10 years, even in times when we didn’t see a clear way forward.

Today we would like to highlight one group that gives generously to our clinic: Christian Aid Ministries. CAM is a non-profit international aid group based in Berlin, Ohio. We have been privileged to be on their list of recipients for several years now, and our clinic operations would be much more difficult and expensive without their assistance. Their operations in Haiti were on hold for several months in 2020 due to the instability in the country, and we felt their absence keenly. We are very thankful they were able to return to full capacity a few months ago.

CAM has a base in Titanyen, Haiti, and periodically they send us a shipment of donated supplies. These range from over-the-counter medications like Tylenol and cough syrup, to face masks, IV supplies, newborn layette bundles, soap, and much more. Getting a shipment from CAM is like Christmas and we eagerly open the boxes and watch our stockroom shelves fill up! Thank you, Christian Aid Ministries, for your continued support of Confidence Health Center. May you be blessed for your work here in Haiti and around the world.

We would also like to get the word out that we are very open to receiving recently expired medical supplies from clinics and hospitals in North America. Often items like intravenous catheters, bandages, sutures, and instruments have expiration dates but are still fully functional and safe to use after that date. North American healthcare standards require hospitals to junk all supplies and medications that are expired, but operations like our clinic are happy to receive them and put them to good use, providing they are still in the original sealed packaging and do not involve medications that are unsafe after the expiration date. If any of you work at a hospital or other medical facility, or know of someone who does, you can contact your management and let them know that there is a place they can donate their expired supplies rather than seeing all those resources thrown in an incinerator! We have a normal USPS mailing address in Florida, and a company called Missionary Flights carries cargo from there to Port-au-Prince twice weekly, making shipping items down here as simple as dropping off a box at your local post office.

If you have any questions regarding sending expired supplies, reach out to us on Telegram or WhatsApp at +509-38-37-0605 or email at chc.oriani@gmail.com. We will be happy to talk with you and decide if what you have would be appropriate to send. Thanks for your consideration and may you be blessed for your efforts.

A New Roof

It is the afternoon of April 19, and the clinic is finally quiet after a busy day. Monday is market day in Oriani, so a lot of people from outside the community pass through the area and many of them time their clinic visit to coincide with their market trip. So Mondays are long, full days here at Confidence Health Center! Today we saw, among many other cases, a three year old girl with partial-thickness (2nd degree) burns to her left arm and neck as a result of hot water spilling on her; an unfortunate young man with a badly deformed right arm due to an accident he suffered back in January and was never able to find a hospital to reset his broken bones; and a very tiny baby that was born 6 days ago weighing only 1.45 kg or 3.2 pounds. She is doing amazingly well, even though her mouth is too small to breastfeed so the mother has to get creative to get milk into her. She is almost too small to believe but otherwise appears healthy. Time alone will tell how resilient she is and what her outcome will be.

March was a busy month for us. We saw a total of 1,744 patients, which included 1,223 adults and 521 children age 14 and under. We delivered 2 babies and performed 388 prenatal consults on pregnant women. Otherwise the patient census was mostly more of our usual: hypertension, diabetes, wound care, cough/cold, and skin infections. We also vaccinated 22 children.

In other news, we are very happy with our new and improved clinic roof! Back in February we were blessed to have a group of volunteers fly into Haiti from the States and help us fix our roof. The original metal was in bad shape, with lots of rust spots and holes here and there. The old skylight material was brittle and broken in places, and patching it was ok in the short-term but was not a long-term fix. Every heavy rain brought rivers of water pouring into the clinic. Our board member Dave inspected the roof during a visit last year and arranged for a crew to come repair it by applying an acrylic coating over the existing metal to seal the leaks and extend the lifespan of the roof. We went with a brand called Duro-Shield, which was shipped in a while ago, along with new heavy-duty skylight material.  

The crew arrived on Saturday, February 20 and we started work the following Monday morning. The first item on the agenda was pressure washing the old tin and treating the rusty spots with a wire brush and a rust inhibitor called Ospho.

Treating the rust spots with a wire brush and Ospho.

After that we removed the old skylight material and replaced it with the new. There was an immediate difference in the amount of lighting inside the clinic; I compare it to old fluorescent lighting versus new LED. It was an incredible improvement!

New skylight material.

While the skylights were being replaced, we sealed up the larger rust holes with a caulk material called Vulkem. The final step was applying the new acrylic coating, which is a thick white paint-like substance and went on with a brush and roller.

The old weathered tin versus the new white acrylic.

We were finished up by Wednesday evening and spent Thursday cleaning up and taking care of a few other odd jobs around the clinic. We were also lucky enough to have time to take the crew to the beach and let them experience the beauty of the Caribbean on Friday! Saturday afternoon they flew home. It was a busy week but worth every bit of effort.

The finished product!

We have tested the new roof this rainy season and are very pleased with the vast improvement over the old. There are a couple of tiny spots we need to touch up, but we do not deal with water pouring in multiple places in a heavy rain anymore. We give a huge shout-out to the crew: Dave, AT, Andy, Ryan, Shandon, David, and Joni! Your time and efforts are much appreciated! It is people like you that make running and maintaining this clinic possible.