Haitian Courier #6: Pieces of My Memoirs

[This is a copy of the latest issue of my newsletter Haitian Courier, which was sent on July 26. To subscribe to the newsletter, please visit http://groups.google.com/group/haitian-courier]

Bonjou Mezanmi!

My last newsletter was a brief update just to let you know that I'm alive and well. This time I wanted to give you snippets of what I've been doing in Haiti for the past 6 weeks. Throughout this newsletter, you'll see words with web links, which will take you to corresponding entries on my blog.

First of all, I wanted to let you know that my return flight has changed from August 9 to July 31. The reason is that my older brother Sundo is getting married on August 2. So now I only have a few more days before I go home! Seems like my plans always change on the fly (last year I decided to stay an extra month in P-au-P). I can't believe my time here is almost over!

Secondly, I wanted to put a word out that the clinic here needs an X-ray machine to replace a broken one. Please let me know if you know anyone who needs to get rid of an old machine to replace it with a new digital one or for whatever reason. The one we have here has been broken for a while, and it would help so many people if we had a working X-ray machine.

Anyway, here are some of the things that I've seen and done so far. During the first week at the clinic, I learned how to do a breast exam, observed a vaginal exam, saw a patient with trigger finger and a very sick and hyperventilating baby. The fist weekend I went to the beach in Labadee with a bunch of people from different mission teams.

Second week, I saw several HIV patients including an old lady with an acute onset of dementia, practiced drawing blood, saw a fetus using an ultrasound, gave babies vaccine shots, and heard all sorts of lung sounds at the tuberculosis clinic. That weekend we went on a mobile clinic up in the mountains, where I got to draw lots of blood, and we brought down a girl with a machete wound to take care at the clinic.

Third week, I did some manual labor at the new seminary construction site, helped reduce a fever on a baby, saw tendons on a torn hand from a car accident, pulled a birthday prank on Vicki (another short-term missionary), and took lots of blood pressures for the hypertension/diabetes clinic. That weekend we went to Labadee again, and I went kayaking and snorkeling (for the first time). On Sunday, we saw a girl who had sickle cell crisis.

Fourth week started with the most emotionally draining day, where I saw a 6-year old boy with respiratory emergency, who turned out to have diphtheria, and two little orphaned girls who were tested positive for HIV. The boy ended up dying at a hospital, so I lost my first patient. We had saved the boy's life by bringing him to the hospital and having him intubated and put on antitoxin, but next day during the night he woke up and took out the tube on his own, and died. It was such a tragedy. Also that week, I dealt with many impatient (and non-patient) parents at the well baby clinic, got to eat a cheeseburger, and took a tour of downtown Cap-Haitien.

During the fifth week I saw a Haitian nurse open a closed hymen on a 7-month old girl, helped treat a delirious patient with fever caused by tuberculosis, learned how to take out stitches, sent Laura (another short-term missionary) on a birthday treasure hunt, rode a motorcycle, tried to resuscitate a 6-month old boy who ended up dying, learned how to start an IV, and learned how to properly clean wounds and change dressings from a Canadian nurse. On Saturday I went to see the Citadel, which was quite amazing.

This past week, I learned how to do vaginal smears, saw a lesion on a cervix through a speculum, helped take a boy with a broken femur to a hospital, distributed some food for tuberculosis patients, and attended a funeral of one of the Haitian doctor's mother-in-law. On Wednesday, there was a violent and insane woman, so we had to drag her out of the clinic.

I haven't written about the last couple weeks yet, but you can see some pictures on my web album. I will continue to write about my experiences after I come back home to the States.

Since all the other short-term medical missionaries have left as of last Saturday, it's been pretty quiet (and a bit lonely especially during breakfast and lunch), but I'm still enjoying my time here. Of all the mission trips that I've been on, I've seen and learned the most through my trip to Haiti this summer. I want to thank all the short-term and long-term missionaries that I've met here for making this such an enjoyable experience, all my friends and family for sponsoring me and for praying for me, and God for allowing all this to happen and for making this undoubtedly the best journey and the best summer ever.

Thanks for reading and for all the responses and comments on the blog!

Bondye beni w,

SunMin Kim

Blog: http://zanmihaiti.blogspot.com

Photos: http://picasaweb.google.com/doxadeo/Haiti2008

PS. Thanks to Laura, I now have a number you can call or send text messages to: +509-3727-7275 (but it's only good until July 31)

Tragedy, Repentance, Baby Hymen, and Paranoid Fever

Monday, July 14, 2008 - Part 1

This morning I found out from Gavin how the boy with diphtheria really died. On Tuesday night, he woke up when he was still intubated, and while no one was watching, he took out the tube himself, which caused his airway to shut completely. By the time someone came, it was too late. What a tragedy, and such a waste after all our efforts to save his life. How sad that the boy unwittingly killed himself, and that he died without his family around. It's one thing if he had died of the toxin, but he still had a very good chance of survival. If only he had been monitored or sedated...

We also heard a good news today. Ms. Prudence told us that the man who injured Madelene with a machete had come out from hiding, apologized to everyone at the church, and became a Christian! While he was hiding, Ms. Prudence's husband, who is the pastor of a church up in Souffrier, told him that Madelene is healing well, and that he should repent. It was really cool to hear that something good came out of what seemed to be an unfortunate event.

Most of our regular patients come on Mondays, Wednesdays, and Fridays, so we got to see many of them today. And by regular patients, I mean Madelene (machete wound), Augusma (torn hand and broken elbow), Kettelie (pubic sore), and Acephise (facial abscess). The more I work at the treatment room, the more I become familiar with these patients. It was great to see how each patient was getting better, except Acephise's abscess still seemed pretty bad. She had lots of green discharge which smelled awful as usual. Because the abscess is right on her cheek, she could hardly talk. We're still not sure if she's taking the antibiotics. I think she'll be coming to the clinic everyday now.

We also had couple of interesting cases today. Ms. Prudence brought into the treatment room a 7-month old girl whose hymen was completely closed. She wanted to show Amy how to open it. Basically she gently rubbed a tip of a cotton swab against the hymen until it opened up. It was hard to watch the little baby girl helplessly cry with her weak little voice. Ms. Prudence put some draining strip into the newly formed orifice so that it won't close up again. It looked like such a traumatic event for the little girl, but I suppose the earlier it's done the better. At least she won't remember that she had to get her hymen open. Still, it looked really painful.

Another interesting case today was an 18-year old boy named Eddie with a really high fever (105ºF) who was carried into the clinic by his relatives because he was so delirious and paranoid about everything. Whenever he saw gloves he'd say we're going to operate on him and kill him. He was scared of the thermometer and would try to dodge it. We tied him down on a bed so he wouldn't run away. We had to get three or four guys to hold him down while Gavin gave him shots of lorazepam (my class should know what this is and how it works) to calm his anxiety and sedate him.

We figured that Eddie might not be cooperative enough to take pills, so I ran to the pharmacy (within the clinic) to get some acetaminophen (Tylenol) in syrup form (which comes out to be quite a lot to match his dose). He wouldn't drink it claiming that it's poisonous. So we gave some to his cousin who had brought him in. Even after she took a sip, he wouldn't drink it saying that she didn't sip it. Then after a while of trying to convince him he finally took it and put the whole thing in his mouth. We all stepped back thinking that he's going to spit it out, but he gulped it all down. We had to repeat the exact same thing when we gave him chloroquine syrup (except the syrup was twice as much as the Tylenol) because we thought he might have malaria.

We had to get his fever down quick, so we used cold wet towels to wipe down his whole body. We kept telling Eddie to lie down and rest, but he refused saying that he would die if he lay down. We left him with his cousin while we went to lunch, and when we came back he was much calmer and was even laying down. Eventually his fever went down, so we let him go with an instruction to get sputum samples to test for tuberculosis.

TB Clinic, World Food Program, and Football

Friday, June 27, 2008

Once a month on Fridays we have tuberculosis clinic. We have all the TB patients come in with their empty plastic containers to make sure they've taken all the meds. After they've gone through 8 months of treatment, and if their sputum test comes out negative, we do a little graduation ceremony and give them a certificate. It seems like certificates mean a lot in Haiti. So the first thing we did was the graduation ceremony, and all the patients graduating from TB were given a chance to make a quick speech. I didn't catch what they said, but in the past, patients have said things like, they used to rely on witch doctors and never got better, but the medicine they got from the clinic really cured them. We hope that other patients will be inspired to comply with the treatment plan so that they can be cured, and so that they don't develop multiple drug resistant strains.

I got to work with Ms. Prudence for the TB clinic today. Ms. Prudence has been working at the clinic for over 20 years, and she is the head nurse. We'll be doing the mobile clinic at her husband's church this weekend. Since we had many patients as we usually do for TB clinics, we had to work fast. We asked each patients if they've been taking their medicine, check their lungs, and get their sputum sample. Ms. Prudence put me in charge of checking their lungs, and I got to hear wheezing, crackles, and rales, the lung sounds that I had learned about in class but had never actually heard before. They sounded just like I was told, but it's hard to imagine what it sounds like without actually hearing it. I could hear the abnormal sounds in patients who had just started treatment, but those who were well into to the program sounded much better.

To encourage the patients to come every month because it's very important that they come every month for 8 months, we give out some food through the World Food Program. So all the TB patients got some beans, oil, rice, and flour. I had always heard about WFP, so it was cool to see it in action.

While the food distribution was taking place, Vicki, Laura, Evan, and I sorted out some medical supplies in the depot. There were hundreds of birthing kits, which we packed tightly into boxes. Because of the power-line incident yesterday, the power had been going on and off today. Usually the depot is the coolest place at the clinic because of air-conditioning, but we were all quite sweaty at the depot because we didn't have power most of the time.

Afterwards we played football with some local kids. I hadn't played soccer in forever. I usually don't like sports much, but it was a lot of fun. Emily, Vicki, Wilfried, and I were a team, and we called ourselves Team Mango.

Amy and Julie got their power back, so we watched Enchanted at their house. The power went out (after 10pm), so we couldn't finish it.

We're going to mobile clinic at Souffrier tomorrow. I'm excited!

Pregnant HIV, Ultrasound, TB, and French Braids

Wednesday, June 25, 2008

In the morning Laura and I shadowed Ms. Betsy and Lourd, both Haitian nurses, with the pre-consultation for HIV patients. We saw a few HIV patients and a few patients who came to get HIV tests. Before the test they have to fill out a questionnaire about STD and HIV. Today was prenatal clinic day, so we didn't have many HIV patients, but we had one 5-month pregnant woman who was just tested positive. I don't know if they understand what it's like to have HIV or AIDS, but there wasn't much of a reaction from her. She seemed very apathetic or ignorant of the whole situation. If I were pregnant and found out that I was HIV positive, I would cry for a very long time. But people here don't seem to react much to the news that they are HIV positive.

At one point the patient flow at the HIV clinic stopped, so I wondered around the clinic for a bit. I walked into Dr. Rodney's office when he was doing an ultrasound on a 8-month pregnant lady. He stomach was really big, so he wanted to see if there were twins. Dr. Rodney stepped out to find Gavin, so I played with the ultrasound for a bit. I think I saw a hand and a head briefly, but most of the time I couldn't tell what I was looking at. Gavin came and looked at the ultrasound, and said there's probably just one baby.

A 60-year-old woman had been coughing for a long time, and her TB skin test was positive, but her sputum test was negative. I saw her after Gavin had taken her to the X-ray clinic, and the results showed that her left pleural cavity (space around the lung) was filled with fluid at the bottom. Using the percussion technique I learned in ICM (Intro to Clinical Medicine), I could tell that the left bottom part of her lung sounded dull. At first when I auscultated (listened w/ stethoscope), I wasn't careful enough to listen at the bottom of her lung, so I had missed it, but Gavin pointed it out to me later. I realized how important it is to do physical exams thoroughly. I also realized how important the X-ray was in diagnosing that she actually has TB. i really hope we can get a new X-ray machine soon.

Gavin told us that 2 patients came to Christ today. Our clinic staff are very active with sharing the Gospel, and time to time patients pray to accept Jesus as Lord and Savior. I'm honored to be working with the staff here.

I keep forgetting that dinners are at 5:30PM on Wednesdays, not 6:00PM like other nights. This is the second time I came to dinner late because I thought it was at 6:00PM.

We played Dutch Blitz again, and some how Laura and Jen won by a huge margin... again! I'm thinking the game might be rigged because they used the same deck of cards as last night. Whatever, it's still a fun game.

Beth taught me how to French braid. We used Nadine's hair to practice. This is what happens when I'm surrounded by so many girls 24/7. They told me it will be good for my surgery skills... sure...