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

Put on the Full Armor of God

This battle against cholera is a spiritual battle.

I think of the mom who sang to the Lord while she labored to deliver her stillborn infant; she recovered and went home later that same day.

I consider the woman who was slowly deteriorating before our eyes. We released her to her family for transfer to another hospital better equipped to diagnose her problems She needed medical help which was beyond the scope of our CTC (Cholera Treatment Center). Instead, they took her to a Voodoo doctor. She died later that same day.

I remember the young man asleep at the foot of his ailing mother’s bed, waking from a heinous nightmare and fleeing the camp, knocking over IV stands and startling patients and their families as he ran by. The Haitians all said it was a result of Voodoo influences.

That same night, we heard Voodoo chanting off in the distance.

Yes, we come with lots of IV solution fluids, some clinical expertise and servant’s hearts. But the work we do is the work of the Lord. It is only He who saves. We press into His presence, waiting for a word from the Lord, a reminder that when we are weak then we are strong, Perhaps He will whisper that He loves us and approves of us. Sometimes we just need to be still and soak in His grace. Then we can put on the armor of God.

For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms. Ephesians 6:12

mattpowellphoto.com Used with permission of Samaritan's Purse

Though He slay me, yet will I hope in Him

Photo: www.mattpowellphoto.com Used with permission of Samaritan's Purse

She was 25 years old and nine months pregnant, happily anticipating the birth of her fourth child. Then, cholera struck like lightening. She was admitted early Wednesday morning with severe dehydration.
She wasn’t surprised by my news; she hadn’t felt the baby move since the day before. Losing a baby is part of life here, something to accept and move on from. In fact, she was able to sing to the Lord between contractions, still finding something for which to be thankful.
She progressed rapidly and gave birth to a beautiful, perfectly formed but lifeless baby girl. She had a chance to see and hold her, but also needed to collect herself to recover from this deadly disease so she could return home and care for her three other children.
While I observed her over the next several hours, I cleaned up, put unused supplies away, prepped the infant’s body for burial and made rounds to make sure that the rest of the staff were handling their responsibilities alright.
She was stable, and I could find plenty of other things to do, but God prompted me not to forget her. I went in to check on her about 2:30 in the morning. I can’t tell you how thankful I am that God had me check on her. She was tossing and turning, agitated and cramping everywhere like many of the other cholera patients I have seen when they are on the verge of cardiovascular collapse. Her pulse and respiratory rates were dangerously high. What was puzzling was instead having of a weak and thready pulse, hers was bounding. We confirmed a dangerously high blood pressure accompanied by hyper reflexes, suggesting pre-eclampsia, a serious complication of pregnancy. 
Was she about to start seizing from severe pre-cclampsia? Or was she about to go into shock? What to do?
Lacking more diagnostic tools, we had no choice but to rely on the Lord to guide us. With His guidance, we started a second IV line and ran in a liter of fluid as fast as possible. She began to respond as we had hoped. Praise the Lord!
By the grace of God, the next afternoon she was able to go home to her children.
How thankful I am that God watched over our little OB ward that night. I consider it a miracle that in the midst of a cholera treatment center, in the middle of the night, we were equipped to help her. He is a personal and loving God who knit her infant daughter together in her womb and knew the days He had for her. He smiled on that mama as she sang songs of praise between labor pains. It would have been very disheartening to lose both infant and mama. He was gracious to us.

I know that the Lord secures justice for the poor and upholds the cause of the needy. Surely the righteous will praise your name and the upright will live before you. —Psalm 140:12 & 13

Though He slay me yet will I hope in Him. —Job 13:15

Responding to Cholera

Haiti Cholera Appeal.mov