Category: Blog

Post Earthquake

Haiti-  March 2010

Having been to Haiti previously I was not quite sure what to expect post- earthquake. The first change I noticed was when I arrived in the Nashville, International Airport. There was an aid group checking in that had a “mountain” of totes that were on their way to Port-Au-Prince. The entire trip down I met people along the way that were bound for Haiti. It was encouraging to see other NGOs putting so much into the relief efforts. Once I arrived, it was interesting to see who was really getting the work done. Not to fault the efforts of large organizations, but many of them seem to have gotten hung up in “red tape”, and many of them were stuck in the immediate area around the capitol. Upon arriving at the PAP airport we were shuttled from the plane to a large new warehouse structure where we picked up our baggage and worked our way through customs.  Outside we found the driver that was to take us to Petit Goave, where we would be working on the Wesleyan Compound at our clinic. After fighting the traffic and the heat in Port-Au-Prince we spent the next several hours driving through the countryside. Along the way we saw evidence of the devastation. At one place there were the ruins of a four story building, now flattened like a stack of pancakes to a height of less than six feet. All along the way, the road was unexpectedly broken by cracks and fissures. The area of Petit Goave where our clinic was set up is nearby the ocean. That whole section of the town had shifted in the quake and dropped several feet. Every street going into the area had several places where they had to dump dirt to form a ramp to smooth out the drop off. The Wesleyan Compound was beautiful with its location by the ocean facilitating a cool breeze off the water. The building that we were using for our clinic was mainly being used for a pharmacy, with one end set up for OB and neonatal care. Surrounding the clinic building was an assortment of canopies, tarps and benches where we treated patients. We also had one wooden outbuilding that The U.S. Marines built us, which we were using as an ICU for patients that needed more than walk-in and walk-out care. After we dropped our luggage in the various tents where we were to sleep, we quickly got started helping with the patient load. The first several days passed with a flurry of activity. Emergencies and mothers coming in to deliver their babies continued 24 hours a day. The first evening there we devised a plan of primary and secondary OB and trauma teams to manage through the nights that would allow for those who were already there to get some much needed rest. Being an EMT-IV, I was assigned to Trauma team 1. The first night we spent most of the night taking care of various injuries that came in. Over the next several nights we had motor vehicle accident injuries, a gunshot wound (the result of a “cited” intervention by the police in a robbery???), a security guard who was assaulted with a machete, and various other trauma cases. Following the earthquake our clinic was providing the only medical care to the area. The Notre Dame hospital in Petit Goave had stopped operations for a number of weeks due to staffing problems and other issues. One of the goals for our time there was to gradually shift the medical care back over to the hospital without overwhelming them with a sudden transfer of all fields of patient care. One area of care that we were providing was OB and delivery. Several nights we had 2 or 3 mothers walking the compound between contractions, waiting for imminent delivery. There were so many deliveries that everyone got to assist in as many as they cared to and there were still plenty more to deliver. We had many patients for whom we provided the best care we had available and prayed for them, trusting the healing power of God. There were several cases in which it was very obvious that it was the healing hand of God that made them well. One of those cases was a young girl that presented with cerebral malaria. She came in already in the coma stage of the disease. At this point it is very critical to get IV treatment started immediately. We were able to get an IV started and started the medication. The problem was that we were not sure if she had been brought to us soon enough for the treatment to take effect before it was too late. We spent hours praying over her and finally she became responsive and definitely took a turn for the better. We cared for her through the night and the next morning she was well enough to go home. Even though we spent many nights with very little sleep, God gave us the strength to continue in our efforts and we were able to help many people. By the end of our time there we had accomplished a complete shift of all aspects of the local medical care except OB and some of the nighttime emergencies. These were to continue to be phased out over the next several weeks until the hospital was able to handle everything. We were blessed by many volunteers that worked alongside us in our efforts, and also with monetary support that was and still is a vital need to our continued ministry. Also as we were shifting the care back to the local hospital, we were preparing to move to a new location several kilometers away in the small town of La’Cule. We spent hours sorting through our supplies, packing them in boxes, and trucking them to the new location. Our work continues there as we provide medical care to that location and also use it as a base for our mobile clinic. We continue to make trips into the mountains, taking along our buckets filled with meds and hiking, sometimes several hours, to reach the remote villages. We treasure each of your prayers and other support in any way God lays it on your heart to help. We recognize that even our best efforts without the blessing of God and the support of His people would amount to very little. Please continue to pray for the work in Haiti, that God would continue to give us guidance in directing us to the areas where we are most needed. Also that God would continue to work in the hearts of the people as we share the good news of the Gospel, that souls would be saved and that the power of Satan would be vanquished across the country of Haiti.

Cross Cultural Haitian Medicine

Cross Cultural Medicine

 

I’m gradually, creepingly learning some rules about being a good health care provider in Haiti.
Here are a few of the things I’ve learned:

1) If you want to awe your patients with your insight into their health problem simply observe which part of the body has a rolled-up piece of fabric tied around it. A cord tied tightly around the waist? Backache or in pregnant ladies round ligament pain. A handkerchief tied headband style around the head? Headache. Around the knees? You guessed it—knee pain.
2) Even if a scratch seems minor, never simply wash it and smear a little antibiotic ointment on it. Always cover it. This will prevent wind from entering into it. If wind would enter into it it could cause the patient to have gas; all kinds of pain in various parts of the body. Wind entering into a wound is what causes it to swell. It is also what causes umbilical hernias (protruding belly buttons) and inguinal hernias. Unfortunately I still haven’t figured out an impressive way to take wind out of a wound.
3) Always reassure a patient they may bathe the area in which they’ve received an injection whether this is for the purpose of injecting medicine or for withdrawing blood. I regularly forget this and was surprised the other day when a week after his first dose of benzathine penicillin as treatment for syphilis, an elderly gent returned for his second dose with the bandaid from his first injection still intact.
4) Here, as everywhere, a listening ear can soothe a multitude of problems.
5) Never underestimate the power of a stethoscope. I first realized the great importance attached to being really, thoroughly “stethoscoped” upon hearing an elderly woman relate with great gusto her experience of having a doctor “stethoscope” her upper arm. Now as far as I know there is absolutely no reason (other than checking blood pressure of course) to “stethoscope” a person’s arm, but just out of curiosity I have tried it a few times in patients complaining of arm pain. They are inevitably delighted. “Yes, ahhhhh, yes, right there!!!” If nothing else it makes the patient feel as though you are taking their complaints seriously. People seem to attach almost mystical power to a stethoscope, seeming to think it can somehow magically whisper a person’s diagnosis into your ear. There are plenty of times I wish it would.
6) There are (at least) three types of fever. Fever that makes your body hot, fever in the blood and fever in the bones (aching, as far as I can decipher). Therefore when a person complains of fever it is wise to find out which type of fever.
7) And then there are the ways of describing problems that keep a westerner such as myself somewhat mystified. “Anba kè-m vid” (Under my heart is empty). That’s a very common complaint, but I think I’ve come to finally understand it—that gnawing, nauseous feeling that accompanies low blood sugar. “M-gen yon van nan zorey’m” (I have a wind in my ears). My best guess is that this is what we would call fluid in the ears. The list goes on . . .
All newborns must come to the clinic for medicine for gas.
9) A baby’s back should not be broken (bent) until it is a month or two old and when you do “break” it you can expect the baby to have diarrhea or a fever similar to teething. Therefore the mothers lay their newborn infants across their laps and bend down to nurse them.
10) Twins are easily jealous of each other and may bring curses to other family members. Therefore if they are brought to the clinic care should be taken to give each twin similar medications otherwise the family may chose to give each twin the other’s medication just to keep things even.
11) Congratulate patients for gaining weight and commiserate with them if they’ve lost.
12) Vitamins have tremendous power (especially in liquid form) and are believed to be appetite stimulants. If someone is saying that don’t have an appetite and are becoming smaller, reassure them that you will prescribe vitamins for them.
13) My idea of what is causing an illness and my patient’s idea of what is causing an illness are often worlds apart. Recently a woman brought her infant son to the clinic. He appears to have an abdominal tumor. Treatment is not an option. Upon discussing her son’s condition with her I assured her there was nothing she could have done to prevent it. I don’t know if she believed me. Her neighbors had other theories. Her sister-in-law died from complications of AIDS earlier this year. Afterwards she took in her orphaned 18-month-old niece who, although testing negative for HIV, died several months later. Her neighbors say it was because of that baby’s spirit that her son was becoming sick. They had warned her not to take in her orphaned niece. They knew it would make her own baby ill. Others shook their heads and said it was because of her set of twins—they were a bad omen who had cursed this baby. I cannot convince them of my point of view; but I can present it as another option and I better be aware of what perspective they’re coming from.
14) Almost every death can be blamed on a curse—even if the person was aged and ill for a long time often someone is accused of cursing the person and thus causing the death.
15) IV fluids have supreme power and are to be desired above all else for giving strength.
16) If a baby is born at 7 months it has a chance of surviving, but if a baby is born at 8 months it is sure to die.
17) Although this has changed, long ago the placenta of a baby was buried in the dirt floor of the house, underneath the bed. A fire was then built over the place it was buried using wood from three different types of trees.
18) If a person has a seizure you should take the clothes the person was wearing when he/she had the seizure, burn them, then take some of the ashes and have the person who had the seizure drink them to prevent them from having more.
19) If a nursing lady experiences a great shock or surprise (ie witnessing an accident; experiencing a sudden death in the family, etc) she should be given special teas as a treatment ASAP. Otherwise her milk will go to her head causing all sorts of problems in the future such as mental illness. The infant should not be given its mother’s milk for a little while following the shocking event either.

It is fascinating to learn more about the health beliefs and practices of the area. It is also challenging and sometimes makes me wonder how surprised both me and my patients would be if we could get inside each other’s heads and see the rationales each one of us is operating under.

Pray that I can care for my patients in a way that makes them feel valued while also pointing them to the One who can provide freedom from fears of curses and has power to overthrow sickness and death.

Thanks!
Bethanie

A Real Blessing

By Virginia Rudolph

This trip was a real blessing to me.  It had been almost a year since I was there, and I was so happy to be back.  I was on a team of nine Americans and six or more Haitians, and we held clinics in three places.  In Fond Doux, we participated in evening evangelistic services.  Once again it was a joy to work along side of others, providing medical care

 

and sharing the love of Christ.  Since it was my fourth trip, I was a lot more comfortable with knowing what needed to be done and how to do it.  My job is the pharmacy, and this was the best supply of medicine we’ve ever had.  Also, our method of transporting the supplies has changed from cardboard boxes that squash and tear and disintegrate in the rain, to round and square plastic buckets.  They are wonderful!  Everything stays dry, clean, and where it belongs.  They also make carrying thing over the mountains much easier.

In two of the facilities, we had ample room to spread out, and that made my job much easier.  I’ll give you an idea of what I do.  First, I have to unpack and arrange the supplies (with help of course).

 

When the patients come from the doctor or nurse, I take their chart and gather up all the medicine the doctor ordered.  I explain to the translator how the patient is to take the medicine and when, then the translator tells them in Kreyol.  The patient is then free to go, and I move on to the next person.  Thankfully, I had an awesome person to work with in the pharmacy, Jess Lear.  She was such a great help and without her I never would have kept up.  We got behind sometimes as it was, so my dad would come and help us out.  Since I’m kept pretty busy, I don’t get to spend much time with any one person.  It is a blessing though to look a tired old lady in the eyes and say

“God bless you” or “Have a good day” and see a big smile in return.  Or to have a small child with big dark eyes break into a grin when I talk to her.  It’s the little things that make it worthwhile; it’s the love of Christ that makes it of eternal value.  Sometimes, all the medicine in the world is useless, but we

can always share the love of Christ.  On the second day of clinic, a little girl was brought in, very badly burned.  Her clothes had caught fire that morning, and her parents brought her to see if we could help them.  We did what we could, but her lungs were damaged and within a few hours, she died.  We could not save her life, but hopefully we eased her pain.  It was so sad to see the mother try to wake her up, and then hold her baby close while she wept.  I only hope the parents saw the compassion of Christ through us.

Why would you spend your life on something that may be ok, when you can spend that same time sharing the love and gospel of Christ with a people who are physically and spiritually destitute?

I can truly say it is a privilege to be able to hike into the mountains and hold a clinic.  We have been received with warm hospitality and a generosity that is a lesson to me.  They have so little and give us so much; it is definitely a pride deflator.  I know that through these trips, I have grown spiritually.  If nothing else, going to Haiti will increase your faith as things rarely go as planned.  When we got down there this time, we found out we could not go to the village of Patmos where we are treating the people with goiters.  A person in the church was causing problems and it was impossible to go where we’d planned.  We decided we would still go to that area and hold a clinic somewhere.  We have to hike the last part of the way into the mountains, and when we parked the truck at the end of the road, we still didn’t know where we were going.  The people who met us to carry in the supplies, discussed for two hours where we would go.

 

By then it was dark.  For all I knew, we still had two to three hours of hiking ahead of us!  They finally decided we would go to a school/chapel about thirty minutes away.  It was close enough to Patmos that people with goiters could come anyway.  So that worked out, but the problems weren’t over yet.  As we were packing up after the last day of clinic, it started to rain.  When it rains, the trails get slick and the river rises, and we have to drive out through the river.  We weren’t planning to leave till morning, so we went to bed praying for the rain to stop.  It didn’t.

The rain came down all night long, and towards morning, it started pouring and getting windy!  It was like a mini hurricane!  All morning long it rained and rained and rained.  A couple Haitians went out to buy some rice because we were out of food.  What do you do in a situation like that?  We waited and prayed.  Finally, around noon, the rain slowed to a drizzle and some of the Haitian men started carrying the buckets out to the truck.  They would not let us help, so we sat there and waited some more.  In about an hour, the rain stopped and we set off, praying the river wouldn’t be too high.  An hour or two later we were ready to leave.  When we got to the river bed, three of our guys joined hands and walked in front of the truck through each river crossing, rolling hidden rocks out of

the way and pointing out boulders and deep places.  God brought us safely through the river, and we reached our next destination without any other delays.  The next two days we drove to the top of a mountain and held clinic in a little bamboo and palm leaf school.  If it had rained, we would have gotten very wet!  Thankfully it didn’t rain.

God is good, and has blessed us abundantly each time we have gone.  Through Him we have had the strength to work through every trial and difficulty that has come our way.

In closing, I pray that God will give me many more opportunities to serve in Haiti, and that through me, His name will be glorified.

Long Awaited

 

I know we’re not very good about showing pictures of our Haiti trips, and if we do, it’s forever after we get back. Here is my effort to do better. The trip went wonderful with only a few glitches. The crew consisted of Papa Rudolph, Gin, Micheal, Caleb, Anna, Jacob, ET, and myself. We met up with Jeriah, Lamar, and our Haitian friends and headed out to Patmos, the village we are treating for the iodine deficiency. We did three days of clinic including a day that Jacob, Papa, and I hiked to nearby schools to collect urine samples and dose the children with the iodine. We finished up with a 2 day clinic in Karfou a town outside of Port Au Prince. At times during the trip things can become mentally, emotionally, and physically grueling; however, the Lord always reveals Himself and His will encouraging us as we press on joyously serving the One and Only God.
Packing the truck that will carry all the meds, our luggage, and 13 people.
I loved going to the school. It was so much fun trying to get the kids to swallow pills then pee in a cup. They were very disciplined and did a wonderful job! Patients come from far away and wait for a long time to receive treatment. Elliott did a great job capturing the beauty of the people.
ET working hard on a little girl.
Anna and the pharmacy
All the kids get wormer. They don’t like it, but if they eat it they get candy!

These 5 month twins girls waited while their mama was treated for diptheria. The mom was so sick the husband went to buy a coffin from town. Praise God for His divine timing. Now the babies will have a mama to raise them.
Proof our treatment is working! Her goiter is getting smaller. The ladies from LBC provided a polaroid camera and film so we could take pictures of families. They absolutely loved it and some even cried when I handed them the photo. In the mornings, I would help the ladies shell the pwa congo (beans). They mixed them with rice for lunch. ET conquered the mountain once again. And I leave you with a sweet video of the school kids singing to us to thank us for the treatment.

 

 

On a Medical Mission

On a Medical Mission

Daily News Journal – Murfreesboro, TN

Feb 17th, 2009

Though they’re still studying, Elliott Tenpenny and Caleb Trent, both Murfreesboro natives, have already begun making their mark in the world in the field of medicine.

Tenpenny is now a medical student in Memphis, and Trent is an intern in St. Louis. The men have been involved with an ongoing medical mission project that has identified and started treatment of people in a remote part of Haiti with severe iodine deficiency.

This deficiency can cause large thyroid swelling and mental retardation.

“A friend of mine took a trip down in the mountains of Haiti and noticed people with giant goiters on their necks,” Tenpenny explained. “These goiters are caused by iodine deficiency.”

“Iodine deficiency is the number one cause of preventable mental retardation world wide,” Tenpenny said, “And it’s easily reversible — it costs just pennies per person.” Children can be treated for 2 to 5 cents each, he said.

According to UNICEF statistics, 38 million newborns worldwide are at risk for developing the lifelong consequences of brain damage associated with iodine deficiency.

One million children in Haiti are at risk, Tenpenny said.

The men and their team have traveled to Haiti several times to administer treatment to people suffering from the condition and to monitor their progress. They just returned from their most recent trip at the end of last month and Tenpenny said they have seen a few of these massive goiters disappear due to the treatment they were able to provide.

“The people have been very receptive,” Tenpenny said. “Each time we go, more and more people show up, so word is spreading throughout the mountains.” He said that by the time the team is ready to start its day, there could be between 60 and 100 people lined up and waiting for treatment.

“We’re working with community leaders and the mayor of the principality, and have gotten permission from the government.”

“Our goal there was to have a general medicine clinic. We would see anything from severe skin conditions, kids whose bellies were swollen from worms, to people who were really sick with wound infections,” he said.

Though both plan to specialize in emergency medicine, they had the opportunity to present their findings at a conference in a thyroid meeting in September.

“If you don’t have enough iodine in your diet, your thyroid gland gets big,” explained Trent, who is now an intern in St. Louis.

The two Murfreesboro natives are in the process of establishing their nonprofit organization, Aid for Haiti, where they hope to coordinate trips where medical students can be involved in helping people in need of care.

He said that while there are hospitals in Haiti, some of the people who live in the more remote areas can’t easily access them or afford to access them.

“We have big dreams,” Trent said.

“We don’t know what it will involve or what it look like,” he said, referring to whether they will be able to establish a full-time clinic in the area.

Trent said his involvement in the process has made him grateful.

“We have been given so much and we generally have so much, that we sometimes take it for granted. Here, if worse comes to worse, we go to the emergency room. There, if worse comes to worse, they go get the coffin.”

“It’s one of the more important things I felt I’ve been able to do,” Tenpenny said. “To make a difference and to be able to see the difference, and to prevent mental retardation in children, has been an amazing adventure, really.”