Saturday, January 31, 2009

Happy endings

Vanesse, my little burn victim who I was treating daily in November, finally came back from the countryside looking great! Her scars are healing nicely and she actually permitted me to hug and kiss her.

Likewise, the finger that I thought we would lose has been saved, along with the whole hand and possibly the man's life. He was beaming when he came out of his little shack in the Ravine to show me his almost completely healed finger.

Getting over your fears

I spent this week directing medical clinics for a team from Virginia that was visiting Sherrie Fausey’s place in the Ravine. There was a nurse and nurse practitioner, but neither of them spoke Creole, so I recruited students from Quisqueya Christian School to be their translators. Each day, I brought 3 tenth, eleventh or twelfth graders with us and watched them step out of their comfort zones.

In general, the girls did better than the boys. Sarah fell in love with a newborn. Lorena made friends with a 9 and 10 year old, and let them play with her hair, touch her skin, and kiss her good-bye on the cheek. Katherine, Abir, Rachel, and Celine all did a great job translating despite the heat and the abundance of patients.

A sophomore named Stephanie had 2 fears: handling babies and falling into the river in the Ravine. However, when I asked her to hold Mackenson while we vaccinated him, she did not hesitate. And when we arrived on the muddy banks on the river, she was the first of my 3 students that day to dare to step onto the rocks. She made it across perfectly (with a little help from Chris).

The first time I taught Chris Zuraik, I got a clear picture of the eleventh grader: a boy with lots of attitude who is just too cool for school. Turns out I was very wrong. Chris was one of my favorite assistants this week. He did everything we asked him to do, from translating to being our official medical records keeper, from counting pills to administering polio vaccines, he did it all cheerfully and willingly. He even asked if I would take him in the Ravine every week as the book-keeper.

Laurent, a senior, had several bad experiences with police officers as a child, so wouldn’t you know, it was just his luck that when I sent him across the street to buy some sodas, a policeman saw him and started questioning him about what we were doing. Laurent explained about our clinic, but the officer insisted on coming inside to see it. I saw them come walking in together and to be totally honest, I was scared. Police in Haiti are notoriously corrupt and I wouldn’t have been surprised to have him demand an exorbitant bribe to allow us to continue treating patients. Instead, the officer asked if I would give him cough medicine! I gave him the medicine and he left, only to return 3 minutes later to ask for my phone number. When he was finally gone, I turned to Laurent. The boy was anxious and furious. “Miss Furth, it just makes me so mad that we had to let him pass in front of all these other people who have been waiting patiently! But if we didn’t, who knows what he would have done to us.”

Fares, my senior who plans to be a radical and change this country, was visiting the Gonaives orphans with me one day after clinic. He called me over to see something strange on a little boy’s back. “That’s ringworm, Fares.” He instinctively recoiled from the orphan. So when I brought a cream to put on the spot, I asked Fares if he was willing to apply it. For a moment, the 18 year old looked at me like I was crazy, but then he pulled himself together and took the cream from me. Little steps towards a big future.

Douglas, a typical tough guy basketball player, helped us by holding babies while we gave vaccines to all of Dorothy’s kids after clinic one afternoon. Most of the time, he looked like this: overwhelmed and terrified that he would inadvertently hurt an infant.

But occasionally, he relaxed. One of the team members told me later that she saw him holding a baby when he thought no one was looking – he was actually cuddling with the little one!

In 5 days, we treated nearly 300 people, vaccinated 45 children, introduced 4 Americans to the medical challenges of Haiti, and helped 12 Quisqueya students conquer their fears. It was an exhausting, but very successful week. To Kim, Sandra, Penny, Dina, and my 12 students: THANK YOU from the children of Haiti.

Monday, January 26, 2009

Happy Birthday, Emmanuel!

When you're a senile 23 year old and you think that your unofficial son's birthday is January 26th but it's actually January 25th, it's a good thing you have cool kids like Argusto and Alex and Degraff to call and remind you.

On Sunday, the 25th, I stuck post-it notes on my door, my mirror and my computer saying, "CALL EMMANUEL" so that I would remember to call him on the next day, his birthday. That night, I was tired from taking care of tetanus baby, so I was already in bed when my phone rang with the secret code that meant it must be the HFC boys. I called them back and heard Argusto yell something. Instantly, a raccous chorus of "Happy Birthday to you" came bellowing into the phone.


The song ended. Argusto laughed into the phone, "You hadn't called to tell Manno happy birthday yet, so I figured I'd better call and remind you."

I love that. I love the fact that even though those boys are upset that I am not living with them anymore, even though they are suspicious that I have other kids that I love more than them, they refused to let me miss Emmanuel's birthday. I love the fact that they know me well enough to know I wouldn't want to miss it for anything and that they care enough about him to assure that he got to talk with me on his special day. They're great kids.

Miracle Moses

Last Tuesday morning, Dr Ed called me from clinic. "Kez, I have a baby who is septic. I can tell you what meds to put him on, but he's probably going to die today. Can you take him?"

I said "Yes," and that's how I met Moise (Moses), my little tetanus baby. He came to me dehydrated, 10 months but weighing only 10 pounds, with a raging fever and a series of inflammed abscesses around his left shoulder. His entire body was writhing in pain, his back was arched, and his jaw was clenched shut. He didn't cry; he just lay there in constant muscle spasms and moaned.

I put an IV into Moise's arm and started him on IV fluids and antibiotics. After consulting with a doctor friend in the States, I also started giving him doses of ativan to relax his clenched muscles and give him some rest. Nothing seemed to work. I was up with him all night, giving him tylenol and ativan, monitoring his IV, and praying. Finally, Moise fell asleep at 7:30am and slept for the next 24 hours.

The beautiful part of Moise's heart-wrenching story is his family. One month ago, a 23 year old named Jackendia found Moise in a trash heap in one of the ravines near Delmas 31. He was covered in scabies and nearly dead from starvation. Jackendia took him home and with her mother, Jacqueline's help, has been raising him as her own ever since. Each day, Jackendia would sit with Moise, holding him, feeding him when he could take a bottle, and praying for him. She would leave at night and her mother would stay all night, frequently not sleeping at all while Moise suffered.

I asked Jacqueline about their decision to adopt Moise. "I have a business selling pate (fried food) in the evenings, but ever since we took in the baby, no one will buy from me. We talked about it - without my pate business, it will be very hard to provide for our family. But if I got rid of Moise just so I could keep selling pate, it would be like saying that I love my business more than I love that baby. I can't do that." She smiled confidently at me. "God will make it back up to me somehow. He'll take care of us."

Moise was supposed to die on Tuesday. He didn't. He didn't die on Wednesday either, or Thursday, Friday, Saturday, Sunday or today. For 5 days, I cared for him here at our house, watching him improve and then spike another fever, sleep calmly for a few hours and then wake up writhing in agony again. I eventually was able to get him admitted to the best children's hospital in Port-au-Prince because my other commitments were making it hard to provide him with the amount of care that he needs. I didn't want to let him go, but it was better for him.

Jacqueline calls me every day to tell me how Moise is doing. He is still in a lot of pain and still running fevers, but he is still alive. The worldwide survival rate for tetanus is only 50%, and for one as tiny and malnourished as Moise, it seems impossible that he would beat the infection. But he has lived this far, and even if he dies tonight, he is a miracle baby. My miracle Moses.

Friday, January 16, 2009

3 years are finally over!

Peterson and Mathurin are finally going home!! It has been over 3 years since the process started for them, but on Friday morning next week, they will at last be with their American family in Boston. God is good!

Wednesday, January 14, 2009

The babies

My "office", also known as the floor and napping location for Johnny J.

Our newest baby is named Bethsaika, nicknamed Betty or TiBet. She is from the Ravine and she is 9 months old, but she cannot sit by herself and she only weighed 9 lbs when we brought her here. Today, 10 days later, she is 10 lbs and 3 oz. Progress, slow but steady!

JJ had a small seizure last week. It only lasted 3 minutes and it did not need any medications to stop it, but we have no idea what caused it. He was running a fever, but it was too low to have caused a febrile seizure. He has been fine since, showing no sign of damage and having no more seizures. But it still makes us a little nervous!

Movie time with the toddlers and Kevs

Kevs and Miltha - she adores that boy and he adores her back. She will smile and giggle at anything he does and he just dotes on her. He also adminsters her TB meds to her some mornings because she takes it so much better for him. When it's me or one of the nannies, she throws a fit and spits it all out. For him, she throws a fit, but she keeps the meds down.

Doing the pillow dance!

Everyone else has gained weight since we last weighed them in October, but Johnny J has lost 2 pounds. He continues to have chronic ear infections, frequent fevers and diarrhea, and he's always raspy. We are still trying to get him started on AIDS medications.

Gerty is officially our tallest kid. She is 1 meter tall!

Despite being sick, Poutchino has managed to gain a pound since our last weigh-in. He's 28 pounds and 99 centimeters.

Miltha continues to gain weight and cough less and less now that she is on her third month of TB treatment. Her little legs are actually looking pudgy!

Mackenson has hepatitis A. There is no treatment for the disease, so we are just taking care of him as usual, though we are trying a new milk combination with oil and brown sugar in hopes that he might gain a little weight. The poor thing is quite miserable.

Monday, January 12, 2009

Gonaives clinics

We drove to Gonaives for 6 hours on Thursday morning, arriving around 1:00pm. We ate some lunch and then went to one of Pastor Genada's feeding programs in the ghetto. In 2 hours, we treated approximately 75 kids for head fungus, scabie, diarrhea, malaria, colds, infected cuts, worms, and athlete's foot.

The next morning, we went to Pastor's church and set up clinic there. I did consultation while Mary and her daughter Janice ran pharmacy. My friend Maggie, who is a nursing student, visiting from the States, took care of the bandages and the head fungus. We saw patients from exactly 8:15 until 12:15 and then loaded back into the car for the drive back to Port-au-Prince. We were supposed to see 75 patients to assure that we would leave on time to make the journey before dark, but we ended up seeing closer to 130. I try to remind myself that they are desperate for medical care, but it is easy to get frustrated when they use dishonest means to get into the clinic or when the doormen allow extra people in under the same ticket.

It cracks me up when a mother walks into the clinic, hands me a fat healthy baby and says, "My baby will not eat." Clearly, one of us does not understand what it means to not eat. This particular kid was born the day before the flood, and by some miracle is completely healthy and beautiful.

I am nurse. This means that I was never officially taught how to diagnose and treat illnesses. Most of the time, I can figure it out or I can remember how Dr Ed or Lori at the clinic in Cazale treated someone, but occasionally, I am met with a case that totally stumps me. For example, this young woman has had these wart-like bumps all over her face for about 9 years. They don't itch, they don't burst, they don't hurt. What are they?

In a place like Gonaives where there is so much destruction and need, it is easy to overlook the beauty. But in the ghetto where we treated the children at the feeding program, we were 30 feet from the bay. This is the Caribbean after all.

Gonaives - before and after

Nearly 3 months have passed since my first trip to Gonaives in October, and though the city is still full of mud and destruction, there are clear signs of improvement, especially near Pastor Genada's church and former home.

Before: on the road just outside Gonaives

After: there is still a lake, but it is much shallower

Before: the garage at a home directly behind the hotel


Before: outside Pastor Genada's church

After: the church minus 3 feet of mud

Before: the driveway behind the hotel, buried under 12 feet of mud

After: a fully clean drive where we parked our car

Before: the abandoned bicycle in an unfinished house

After: the house is still full of mud but someone wanted that bike back!

Before: the river ford

After: the river is still there and it's deeper. People cross on a makeshift bridge about 50 yards downriver.

Before: the street adjacent to the hotel, full of wet mud

After: still full of mud, but now it has hardened so you can walk on any part without sinking in.

Before: a truck buried in the field beside Pastor's orphanage

After: the truck is out but the hole is still there.

The mud flats have hardened now and are perfect soccer pitches. There are streams and greenery everywhere, and much less mud. Look at my feet compared to how they looked on my last trip!