Tuesday, January 29, 2013

Mob scene

My afternoon of entrance exams did not exactly go well. Instead of the 50 candidates I expected, close to 120 people showed up! And staying true to Haitian culture, they refused to wait in an orderly fashion. Several times, they rushed the door of my classroom, over 100 people, pushing and shoving, yelling and demanding that they be admitted to take the exam.
After multiple failed attempts at crowd control, I locked the classroom, told everyone to go home and rode away on my bike to angry yelling and ugly insults. Any doubts I'd had about my decision were erased right there; if you can't respect the teacher of a class enough to speak to her politely, you are probably not going to make a compliant student.
Where I would have posted the acceptance list, I instead posted a sign telling everyone that I wasn't taking any students because of the unruly behavior displayed at the entrance exams. Students who are still interested in taking the course can return in April to sign up for the fall session.

It was a very disappointing day. However, on the bright side, it is encouraging to see that so many people want to learn about medical care and that they would be willing to come into a notoriously bad neighborhood like Jubilee to participate. A few had come from as far as Gros Morne and Marchands, both over an hour away! And I discovered later that a dozen or so are already nurses, presumably there to benefit from the equipment that you earn during the course.

I am still mulling over what to do. I will probably put together a small class for this spring semester accepting students entirely on referral from our Haitian clinic and school staff. And then somehow, I will find a creative and safe way to filter the scores of people who are going to show up in April.

Sunday, January 27, 2013

A bloody mess

I was on my way to a meeting at Jubilee School when Julie suggested I pop into the clinic. "Rodolphe got himself cut open. There's a lot of blood."
No joke!
Rodolphe is a former teacher at our school and he'd apparently been messing around with someone's wife when the husband came home and got angry. At some point during the altercation, the woman smashed a rum bottle over Rodolphe's head, slicing him open deeply on the forehead, nose, ear, and just above the eye lid.
He'd made his way to Raboteau, the hospital that the Cubans run but was turned away. His friend, another teacher, took a moto to get Rodolphe and found him on the street in a pool of blood. They came to our clinic and our staff got an IV into him and tried to control the bleeding. They'd soaked through all our gauze, 2 t-shirts and a pillow. Despite that, there was still a puddle of blood under and around our patient.
Grace arrived on site about 45 minutes later and started slapping in stitches to close off the deepest wounds. When I got there, another 30 minutes later, the vital work had been done - most of the major bleeding had abated. There were still plenty of smaller wounds open though, so I settled in the pool of blood opposite Grace and started suturing too. Meanwhile, Oscar assisted us, mopping up blood and cutting threads, and Rusty held the light and kept asking Rodolphe silly questions, anything to keep him awake.
At 4:30pm, we closed clinic. The whole process, including a major cleaning of our clinic floor, had taken over 3 hours.
We joke that Grace is the trauma surgeon, there to save lives, and I'm the plastic surgeon, working with the miniscule needles and thread to make the scars look good...which is rather important because Rodolphe might be the most vain patient I've ever treated! Throughout the entire endeavour, the question he kept repeating was, "How do I look? Am I ugly?"
Don't believe me? Here he is the next morning, when we took his bandages off, checking out his reflection in a mirror.

I can be a plastic surgeon when necessary, but my best advice to you, Rodolphe, would be to avoid married women and rum bottles! Your face might be a little prettier that way.

Thursday, January 24, 2013

Can you help?

My best friend from Port-au-Prince, Sendhie, is getting married! She called me to share the good news and asked for help getting a wedding dress.
Can you help? Spread the word among your friends - we are looking for a wedding dress, size 17 or 18, chest 54 inches, waist 49 inches. Haitians like wedding dresses that are elaborate, so the longer the train, the puffier the sleeves, the more sequin-covered the bodice, the better!
If you have a dress that you'd be willing to donate, please email me, nursekezzie@gmail.com with a few photos.
Thank you so much!
If you want to read all about Sendhie, our friendship and her work with me, check out my blog post, Sendhie, from 2011.  

Tuesday, January 22, 2013

Back at it!

I'm starting continuing education with my nursing assistant students this week. They graduated in December, but they want to keep learning, so I've agreed to keep teaching them. We'll be honing skills I taught them in the fall such as vital signs and listening to breath sounds. We'll continue to do disaster training and my favorite exercise, "emergency scenarios" where I give them a patient and a set of symptoms and let them react accordingly.
We'll also start on new topics such as community health education and prenatal care. And since they've been begging for it, I will teach them how to give injections. I'm not sure why the thought of poking someone is so attractive, but they are jittery in their excitement about it. One of my students even requested to be the permanent victim - "I love getting shots, Miss Keziah!"

In addition, I will be picking my new batch of students for the basic course this week. Approximately 60 people will take my entrance exam and I will accept 20 of them. Pray for me! I need some high quality male students because we are still looking for someone to replace our nearly irreplacable Oscar when he leaves for medical school in the summer.

Friday, January 11, 2013


Sometimes our table is an operating table. Sometimes it is truly a kitchen table.

Orange, chadek (a cross between orange and grapefruit) and passion-fruit...with a little bumblebee to spice things up!

Thursday, January 10, 2013

Deja vu

The phone rings at 9pm. "Keziah, one of the guests just chopped off part of his finger in the door."

I answer with a laugh, "Haha, very funny. We already did the chopped-off finger thing. What actually happened?"

Pause. "No, really, Kez. He's missing a piece of finger."

Luckily, this particular finger chop wasn't as deep or as irregular as the first, so I turned our dining room into an OR and I sewed Garry's finger tip back on.
It took about 45 minutes, 19 stitches, 2 headlamps, one bike light and Grace's help holding the chunk of finger in place. The power went out once during surgery and I almost ran out of size 4 sutures before I finished.
Ironically, I happened to be wearing a t-shirt that a close friend had brought me from Texas. It's supposed to be a joke regarding Texans and guns, but it's very appropriate for me and Grace.
We don't dial 911. We are 911.

Wednesday, January 2, 2013

Happy New Year!

How did you celebrate New Year's?
I was making food for our party when I got a call, "Kez, I just smashed the gate guard's finger in the door."
"OK," I answer calmly. "It is bleeding?"
A pause. "Umm, there's a piece of finger on the floor." 
New Year's day in Haiti means that none of the local hospitals would be adequately staffed so we had to go all the way to Port-au-Prince. "Couldn't you take care of this yourself, Keziah?" you wonder, but the truth is that while I would care for this in a catastrophe situation like an earthquake, I have no qualms about using a more qualified caregiver when possible.
Our truck was already in Port, so we took two taptaps and eventually met the truck and drove the rest of the way, all the while carrying a ziploc bag full of ice and a piece of finger. Luckily, no one seemed to notice.
Almost 7 hours after the injury, a doctor started sewing the finger tip back on. I argued against it; since when is a severed limb still viable after 7 hours? I wanted a decent amputation but there was no orthopedist on hand, so an attachment was what we got instead.
We got home at 10:30pm. The whole endeavor had taken 10 hours, 8 of which were spent in transit. 
Amazingly, the finger looks relatively good today. There is a dime-sized section on the very top by the nail that looks dead, but the rest seems OK. It may be that the severed part will miraculously revive instead of infecting and falling off as I fear.
We'll see what it looks like tomorrow, but I am cautiously optimistic. And for those who were sad on my behalf about missing the New Year's party, don't worry. My friends postponed til the next day so that I could be there!