Holding On

We recently enjoyed a short visit to Oriani by one of our board members, Keith Toews and his wife Candace. They flew into the Dominican Republic and I went to the border town of Malpasse to pick them up. They spent a few days here, visiting with many different ones and seeking counsel on the future of the clinic from our local clinic advisory committee, the national Mission Mennonite committee, and the local magistrate. We feel very good about the advice we received.

The situation in Haiti continues to be challenging. While we rejoice together with Christian Aid Ministries that all their hostages were able to escape safely and return to their families, the security situation here in Haiti remains volatile. There are many Haitians still being held hostage, and there is no sign that kidnappings are on the decline overall. For that reason, we are still avoiding traveling through the gang-controlled area of Croix-des-Bouquets. Our last trip into Port-au-Prince was October 12. There has been some question about the feasibility of us staying in Haiti, but the counsel we received while Keith’s were here has helped us to come to a more settled position on this. We feel that the Oriani area continues to be safe for the time being, and we are comfortable staying here, trusting our future into the hands of the almighty God and our local brethren and friends. We have faith that the locals will be honest with us and let us know if they feel our area is no longer safe.

We have found several workarounds to enable us to keep our clinic open and functioning, even if we are unable to travel into Port-au-Prince to buy supplies. We have several contacts from our area that make regular trips into Port with trucks and are able to bring items up for us. We also have resources in the Port area that are able to go from place to place on our behalf, purchasing items and bringing them to a drop-off point for the local trucks to pick up. We are very thankful these routes continue to stay open for us, and we are happy to see how the clinic is still able to function even in these uncertain times.

We continue to be quite busy here in the clinic, seeing anywhere from 50 to 80 patients per day. We seem to be seeing a lot of wound care lately. Several large, infected wounds have come in during the past several weeks, some of which have been treated previously with traditional methods, leading to them becoming very foul-smelling and challenging to deal with.

Our cleft palate baby, Jhonky, was able to go to the hospital last week for his initial assessment by the plastic surgeon that will do the operation. He continues to develop well, growing each time he comes in.

His consulation with the plastic surgeon at Hospital Bernard Mevs went well, and they scheduled a return visit for December 23 to go over lab results and hopefully put him on the schedule for operation. We are all ready to see his cleft palate repaired!

And so, the year draws to a close. We were unable to receive family or other company for Christmas due to the insecurity in the country, so we plan to spend a few days visiting friends in the Dominican Republic while the clinic is closed for the holidays. We hope to stock up on household supplies while we’re there also. We are looking at some staffing changes at the clinic in the new year, so we will need come back from Christmas ready to hit the ground running! It will be challenging to work through these changes while balancing the other needs of the clinic and household, but God will provide a way.

Continue to keep us in your prayers. We feel safe and secure here, and some of the anxiety and questions of the past few months are fading away as we trust the future into God’s hands. We feel like this is the place for us to be at the moment, but at the same time our hearts and minds are open to all possibilities, if the door should close for us to stay and we would need to return to the States. One day at a time!

As always, we thank each one of you who has donated money, supplies, and time to our clinic this past year. Our operation depends on people like you, and we are very grateful for each one. We are still needing to find a couple who would be willing to come serve as administrators of the clinic when our time here is finished later this year. We are looking for a married couple who is able to give several years to the cause, helping run the clinic and household. It would be very beneficial if either the husband or wife has medical training, but not absolutely necessary. Children are welcome. We have a safe and comfortable place to live, and all daily living is provided by the clinic. Oriani is home to a healthy church family, and there is plenty of spiritual food to be found every Sunday. There is not space enough here to list the blessings and benefits of your time here! If anyone is interested in this position, or know of someone who is, contact us via email at admin@confidencehealthcenter.com or via WhatsApp or Telegram at +509-3837-0605. Thanks!

Hunker Down

We’re into our fourth week now since the 17 Christian Aid Ministries missionaries were kidnapped in Croix-des-Bouquets, with no news yet of when or how they will be released. It has been hands-down the most uncertain and unsettling time since our family arrived in May 2019. We keep our ears tuned to any news, and sometimes it’s hard to prove what is true and what is rumor. It seems the country is holding its breath, waiting on a break and a return to some sort of normality. Besides the safety and kidnapping issue, the fuel shortage is ongoing in the entire country, making travel very difficult if not impossible. We had already been staying pretty close to home out of concern since the kidnapping, but I sat together with a group of local leaders this past Sunday, and they unanimously told me that under no circumstances was I to travel the road between Fond Parisien and Port-au-Prince. So that pretty much sealed the deal, meaning we are going to need to find a new normal that does not involve going to Port-au-Prince for the time being. This means no airport, no American grocery stores, no mail, and no medical supplies.

I have also been in constant communication with our board of directors in North America. At this point, we do not feel an immediate need to leave the country. The area we live in is extremely remote and far removed from the worst of the kidnapping and violence, which is mostly centered in and near Port-au-Prince. We have been fortunate to build up a relationship with the local leadership and community here in Oriani, and we feel like they have our backs and we can trust them to keep us informed if we are in increased danger. Our route to the border with the Dominican Republic does not involve driving through Port, and as long as the border stays open we can count on leaving that way if things deteriorate further. As far as our household supplies go, we are able to find most major staples in local markets. We might need to change our style of cooking for a while, but that won’t hurt us.

For now we are continuing in faith, keeping the clinic open and pursuing alternate ways of restocking medicines and other critical supplies. We currently have a reasonable inventory and will be able to operate at almost normal capacity for several weeks yet. At some point soon we will likely have to start limiting the services we provide at the clinic, but that is out of our control. Even if the clinic were to close completely, there are other ways we can encourage and be an asset to this community in general.

We aren’t discouraged, but rather going forward cautiously and trying to remain flexible. For now the door seems open to stay, but we have no promise of it remaining that way. We realize these are very uncertain times and we have no idea what the next days will bring. We feel loved and supported by our church family here in Oriani, and they are concerned about our well-being and wish the best for us. Thanks for your continued prayers and support. We need them more now than ever!

Progress in a Troubled Country

Haiti has been in the news again lately, and not in a good way. By now many of you reading this are already well aware of the kidnapping of the 17 North American missionaries from Christian Aid Ministries, and don’t need more details on the story from us. However, since you are concerned and interested in the clinic and our lives enough to read this blog, I thought I’d update you on how this situation affects us and our work here.

First and most importantly, we’re at a safe place up here in Oriani and do not feel like we are in any immediate danger. Our clinic is still open normal hours and we have a full house of patients every day. However, the area where the 400 Mawozo gang operates, and where the CAM missionaries were taken, is right along the main route that we take into Port-au-Prince to buy most of our clinic and household supplies. Even though these kidnappings have been happening to Haitians for a long time already, the fact that Americans were taken brings things a bit closer to home. For now, we are staying put here “on the mountain” and avoiding travel down to Port until we know now the CAM situation shakes out. We are hoping and praying with the rest of you that all 17 hostages can be released safely and without ransom money being paid, and that the country can become a safer place for Haitians and foreigners alike.

While we wait for news of the kidnappings, we also have a very concerned eye on the fuel situation in Haiti. For quite a while already fuel has been hard to find, because the country's petroleum distribution port in Martissant is in a heavily gang-controlled area and trucks are not able to come and go freely. However, in the last week or so things have gotten even tighter, with little or no gas coming out of the port and most fuel stations empty. For several days now there has been absolutely no gasoline or diesel available at any pumps near us. Fuel is available sparingly in street markets at the exorbitant price of at least $10 or sometimes $15 USD per gallon.

Needless to say, a world without fuel is a very small one indeed. Beyond not being able to travel by vehicle, we also have spotty cell phone service because most of the cell towers are powered by diesel generators and therefore not able to function normally. We use solar power at the clinic but occasionally on cloudy days we need to run a small gasoline generator. These days we are holding on to our last few gallons of gas in case of emergency. Our lawns grow high and weedy because we aren’t running the mower anymore. Many trucks sit idle in market, unable to haul produce to the city. Motorcycle taxis are still available but the cost is rising with the price of black market gasoline. Market today in Forè, usually a packed chaotic affair with thousands of people, was subdued with very little truck traffic in and out.

There is no telling where this fuel situation is going. Will it be tomorrow or next week or next month before gas becomes available? Nobody knows. For now, we’re adjusting our routines as necessary and just waiting to see where the next days take us.

Ok, enough negative news. The good news is that the clinic continues to operate normally and we are able to treat between 40 and 70 patients daily. If you remember our cleft palate baby, Jhonky, I am happy to bring you up to date on his progress. He came several weeks ago, continuing to gain weight and develop normally. His next follow-up was yesterday, and again he showed remarkable weight gain. His birth weight on August 10 was 3.2kg, and yesterday he weighed 5.2 kg (11.4 lb) at 10 weeks old.

As you can see, he is alert and healthy, developing well. We will monitor him for another month or so before arranging his operation at Hospital Bernard Mevs.

Another interesting case we saw recently was a young man with his 4th and 5th fingers on the left hand injured in a knife accident. We took him to the clinic to clean and assess the wound. The 5th finger was fully amputated at the base of the nail, but the 4th was only partially amputated and we felt there was hope of him retaining it if we could get him to definitive care. The family was very hesitant about going to Port, but I was able to get them to agree to at least call around and check hospitals. Unfortunately, the three best options I tried did not have surgeons available, so the family told us to just do what we could. We worked for several hours and were able to trim back both fingers into stumps that were able to be closed with sutures.

He tolerated the procedure very well and came back the next day for wound care. The surgical sites looked good and we scheduled him for daily dressing changes, but unfortunately he quit coming and dropped off our radar completely. This is all too common here and we’re not sure of all the reasons. We can only hope that the incisions continued to heal well and he is doing fine.

One last story. A lady in labor presented to our house after hours, and as we sometimes do, we let her labor here on the porch. Everything progressed normally and some time later a beautiful healthy baby girl was born. She took a breath and cried, but unfortunately soon after her airways became blocked with thick secretions and she went into severe respiratory distress. We vigorously stimulated her but were able to get only a very weak response. We quickly realized we needed to get her to the clinic asap, so Ang wrapped her up and jumped on the moto that had brought the lady. The driver took off thru market and I followed shortly on our moto, with the new mom sitting side-saddle behind me. By the time we got to the clinic, Ang was inside with the baby and thank God, she was breathing normally and had a strong healthy cry.

We monitored her for a while and did some deep suctioning, removing a lot of secretions from her airway. She continued to stabilize and we were eventually able to send her home with the family. Just another reminder of the dangers of childbirth and another reason to be thankful we just happened to be in the right place at the right time. Had the baby been born at home, who knows what the outcome would have been.

If you’ve made it to the end of this very long post, congrats. That’s all for today. Keep us, and this country, and in particular the 17 CAM missionaries, in your prayers. We know there will be a way!

Small Miracles

It was a Friday afternoon, one week ago. The clinic had closed around noon and we were home getting ready to leave for the prayer service at Frè Dieuna’s house, which was a long walk away. Sure enough, as it usually happens, there was a knock on the gate at about exactly the time we needed to leave. It was a woman in labor. We ushered her onto the porch to do our initial assessment, and she told us she was only 34 weeks along and had been having pain for several hours already. Our assessment confirmed that she was in labor, which made us quite concerned due to her early gestational age. We felt like she should deliver in the clinic where we have better capabilities to take care of an early baby, so we arranged that the other nurses would go to the service and I would take the patient to the clinic and monitor her.

I scanned the mom with our Butterfly IQ+ ultrasound and according to measurements she was around 31 weeks along. We didn’t have much hope that the baby would make it, but there are very few affordable hospitals within driving distance that would be able to care for a baby born that early and besides, it was already too late to transfer her. Fast forward several hours, and she was progressing very slowly. The other nurses came to the clinic when the service was finished and we started swapping out, some staying to monitor the mom while the rest went home for supper.

While we were keeping an eye on the first mom, a second lady came to the clinic in labor. This was a younger girl who was pregnant for the first time, and unfortunately she had drank ginger tea, which is a folk remedy commonly given here to “heat up” labor pains but which usually ends up causing a myriad of problems, including nonstop abdominal pain even between contractions. Thus this girl was in a lot of discomfort even though she was quite early on in her labor. We assessed her and sent her home to continue laboring on her own.

Finally around 9pm we started oxytocin on the first lady to speed things up a bit, and at 10:00 she finally delivered. Her baby was born “en caul”, meaning she was still wrapped entirely in the amniotic sac. In addition, the placenta was delivered at the exact same time as the baby, something I had never seen before. Imagine our surprise when the baby let out a nice loud cry immediately and began breathing on her own with no problems! She weighed only 1.57 kg (3.45 lb.), but was otherwise in good shape. Our biggest concern was her hesitancy to breastfeed and some grunting she was doing while breathing. We did what education we could and gave her an appointment to come back the following Friday. We sent her home not knowing if we would see her again or not.

The baby on Day 1.

Friday morning came and we scanned over the patients gathered at the clinic, but there was no baby to be seen. Our hearts sank as the morning went by without them showing up. We assumed the worst, that the baby had obviously not made the week. We were finished with consults around noon, so the nurses and I went home for lunch except for Ang, who stayed to work a bit in the pharmacy. It took her a while to get home, and when she walked in, she announced, “Guess who showed up to the clinic right after you left?” Yep, you guessed it. The baby!

Apparently the little girl is a little fighter and is doing well! She weighed 1.49 kg (3.28 lb) so had lost a few ounces, but that is to be expected for the first week. But she is breastfeeding and developing normally. Praise God for small miracles! Like Ang said, “It was worth staying late over lunch for that!” We will continue to monitor the little girl and hope that she continues to grow and develop.

After one week.