Home again?

I am home again. That is to say, I am back in Sisters, Oregon where we make our home. There is snow on the ground and Christmas music in the air. A friend wants to bake cookies tomorrow and my mom is addressing Christmas cards. Usually this is my favorite time of year. And yes, celebrating the birth of our Savior takes on new meaning this year. But, I admit, I am not buying into the usual festivities. We are opting out on the tree this year and will go with evergreen garlands instead. We are exchanging only a few gifts and are just hanging out together.
Where are my thoughts? In Haiti. With my Haitian (and otherwise) colleagues who are fighting the good fight against the deadly disease called cholera, putting up a solid defense against the conditions which make the Haitians so vulnerable to its ravaging effects. I recall situations and patients who have impacted my life forever.
My thoughts are with the volunteers waiting for their flight itineraries to be confirmed so they will have a turn to serve. I think of the staffing decisions and the potential hires who will help the staff at Samaritan's Purse get through this epidemic.
I wonder how the election turmoil will be settled. Will there be a successful recount? Will there be a peaceful resolution? 
So, how do I reconcile the ache of Haiti with the excess of our land of plenty? I cry out to God for the dear Haitians. I long for Haiti to know the compassion of the Lord. After all, the fact that we are working against all odds to spare people the miserable death of cholera's devastating dehydration and organ failure is because God has not forgotten her.

O Haiti, return to the LORD your God,
   for he is gracious and compassionate,
slow to anger and abounding in love,
   and he relents from sending calamity. 

In that day the mountains will drip new wine,
   and the hills will flow with milk;
   all the ravines of Haiti will run with clean water.
A fountain will flow out of the LORD’s house
   and will water the valley of banana trees.   Joel 2:13 & 3:18, paraphrased                                                                    

Heroes

So many new friends. Doctors, nurses, paramedics and EMT’s from the US and Canada, UK, Sweden, Ecuador and Haiti. With rare exceptions, we have never met before. We are bound together by the desperate need confronting us and by the common call of our Lord Jesus. A little humor helps too.

Dr. Jeff and Mary Ann, husband and wife team, trauma surgeon and nurse from Alberta, Canada

Joany, a nurse from Ontario, Canada

Drs. Stephany, pediatrician from Indiana and Karen, ER doc from Tennessee

Dr. Trey, obstetrician from the States

Ben, paramedic from Indiana

Dr. Lance from North Carolina with Franz and Oliver, translators

Nurses Priscille, Natacha, Victoria and Micheline proud of  their new certificates

A Horrible Situation Redeemed

The last several days I have had the privilege of teaching Haitian nurses. These are the nurses at the front lines of this battle against cholera. Dr. Kara Gibson gave several us the task of brainstorming to develop simple lessons on hygiene and aseptic technique, rehydration and patient care documentation.

Our Haitian nurses come to us with four years of education and a variety of experience. For many, this is their very first job. Others have some experience in an outpatient setting, but not with IV’s. Then there are a few seasoned veterans among the ranks who can start an IV in the most elusive vein and who have the experience to help us tease out diagnoses which often coincide with cholera.

I love that Samaritan’s Purse is not only in the relief business, but also looks  toward development. The old “teach a man to fish and you feed him for a lifetime”. I also consider it a personal challenge and joy to work myself out of a job.

After all, long after we leave, these Haitian nurses will still be here fighting the good fight against poor health amongst their own people.

So, we begin with a diagram of a stick figure nurse teaching her patients and their families good hygiene, the importance of oral rehydration, and how cholera is spread and can be prevented. If each patient and family member returns to their community and teaches their household and neighbors, who then do the same, then the efforts will be multiplied and the results life-changing for an entire country. We plant the seed that one nurse can make a significant difference in Haiti.

We also point out the obvious: these nurses are becoming experts in the prevention and treatment of cholera. God is transforming this horrible situation into a gift of great value for these nurses. They will be forever enriched professionally by this clinically challenging experience.

We end each short session with the presentation of a simple certificate, complete with a stamp from the Samaritan’s Purse office. Each nurse will keep and use these treasured certificates when they seek future employment.

My favorite moments? When they become animated, jump at the chance to demonstrate removing an IV, or when they smile and laugh at my Kreyol. But the best moment was yesterday when they sang an impromptu song to thank me. No matter how much I give these dear people, I always come away more than blessed.

Sweetness.

Keeping Our Sanity

In the midst of so much suffering and overwhelming need, the tender and humorous moments help us get through the grueling hot days and long nights. They help us keep our sanity in an otherwise surreal world.

Seeing a recovering child sit up, eat crackers and laugh at a silly face drawn on a balloon.

Catching a glimpse of a chaplain stroking the cheek of a child frightened by an IV insertion.

Holding a limp child who needs some TLC while her mama nurses her younger sibling.

Watching a father tenderly care for his small children while their mother lies ill on the adjoining cot.

Wondering which patient has the strange cough only to realize it is the cow just outside the tent.

And then there are the definitions unique to this setting:

Positive TapTap Sign:  patient arrives at Triage in a TapTap with horn blaring, lights flashing; have the IV ready to go

Pest Control: Mama hen leading her chicks around the camp to devour the hundreds of gnarly grasshoppers

Multi-tasking Generator: powers floodlights, dries freshly cleaned cots, dries hands, warms IV fluids and offers heat to patients chilled by the night air and cold IV fluids

Gourmet Survival: MRE’s, Meals Ready to Eat. Shelf life 12 years. Mmmmm.

Decon: process of cleaning every possible contaminated surface with diluted Clorox; including shoes, scrub clothes, pens, stethoscopes and bodies.

BRAT diet Haitian style: ripe banana, white bread, bouillon with plantain or bread, white rice

Rehydration Cocktail: Oral Rehydration Solution (ORS), straight up (no ice)

Baby Food: crushed crackers mixed with ORS and perhaps ripe banana

These are the moments which make the scope of this disaster less terrifying.

How much more?

I often wonder how much more can a people take. Haiti has suffered floods, hurricanes, a devastating earthquake and now, the killer known as cholera. And that is just in the last several years.

It is also known for its extreme poverty, political corruption and devastated environment.

How do the Haitians persevere in the face of such overwhelming odds?

The Haitians I work with and love put their trust in someone bigger than Haiti’s problems. They put their trust in the almighty God, ruler of heaven and earth. In Jesus Christ, the Alpha and Omega, who will right every wrong and wipe every tear.

I think of Franz. He calls me sister, I call him brother. He is married with three small children. He accompanies us to the CTC (Cholera Treatment Center) in Bercy four nights out of each week. His job is that of interpreter. But that does not begin to describe what he does every night. He helps recognize the sickest, he carries the frail, the helpless, and he assists the nurses as we start life-saving IV’s. He even comforts us when we feel overwhelmed by the size of the task at hand.

He recently went home to visit his family in the south of Haiti over election weekend. We shared a meal the evening of his return to base. We just sat silently next to each other, comforted by each other’s presence, each knowing the other understood what we could not speak. I asked Frantz if he had tried to tell his wife what he had experienced. He said “M pat kapab”….I couldn’t. Those of us who have seen what we have seen, who have had to do what we have done are forever bound by our shared experiences. Not unlike war veterans, for whom I now have a deeper respect.

We cling to one another, but more so, we cling to God. He is our righteousness.

The salvation of the righteous comes from the Lord; he is their stronghold in time of trouble. The Lord helps them and delivers them; he delivers them from the wicked and saves them, because they take refuge in him. Psalm 37:40