I'm Back

Just wanted to let you all know that I'm now back home in California. I will be working on finishing my blog entries over the next couple weeks, but there will be a little delay as I try to catch up on life back home.

Thanks for stopping by!

SunMin

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)

Baby Jaundice, Gunshot Wound, Diabetic Ulcer, Suture Removal, and Laura's Birthday

Monday, July 14, 2008 - Part 2

We saw a 5-day old baby boy who came in to get his umbilical area cleaned. In Haiti, they use alcohol pads to wipe it, so it looked painful. The baby was quite jaundiced so we advised the mother to let the baby have more sunlight (my classmates should know exactly how that works). It was cool to see in real life something that I had learned in class.

I also got to see a man with a gunshot wound that went through his right thigh. The man works in the Bahamas, so he could speak some English. He explained that a thief had robbed him, hit him on the eye with the butt of the gun, and shot his leg. It was neat to see a gunshot wound for the first time, but only because it didn't seem too serious... Ok, it would be kind of neat even if it was serious, but I wouldn't be saying that.

There was an old woman who had been having chronic skin ulcers on her legs since 1998. They were at least 10 cm (4 in) in diameter. Since she had been coming to the clinic for such a long time, she had a really thick chart. I wanted to figure out why she was having these chronic infections, but the handwritings were illegible. So I talked with the patient to get her history while Amy changed her dressing. I was kind of surprised how well I could understand her, but that's probably because she talked slowly. Hopefully I might be actually getting better at understanding spoken Creole. Anyhow after a longwinded story of how everything happened, she told me that a white doctor who was at the clinic long ago told her that she had high blood sugar. Well, go figure.

Then we saw Ruth, one of our Haitian staff from the OMS office, who lacerated her right shin and got 6 stitches a few days ago. The wound was healing well, and it was time to take out the sutures. Evan showed me how to take one out, and I took out the rest. I guess taking out stitches aren't that big of a deal, but first times always feel kind of special.

For the rest of the day at the clinic, Laura and I took turns giving shots. IM injections are pretty simple, but it was good to get some practice because each patient is different. Sometimes the needle goes right through, sometimes you have to really push to break the skin, and other times you feel a lot of resistance as the needle goes in and it feels like you're tearing through the muscle. You may be giving the same glute shots, but you will always have different butt cheeks.

Today is Laura's birthday, so Amy, Evan, and I conspired to do something for her. Throughout the day we mentioned "secretive" stuff in front of Laura just to psych her out. But of course the real planning went on when she wasn't around. Now, before Evan came to Haiti, Laura's mother had sent him a package to give to Laura on her birthday. Evan brought it with him, but Laura had no idea. So we decided to send her on a treasure hunt leading to the package. We also decided to make a certificate of honor and merit, and if you've been following my blog, you know that those are a big deal around here.

After the clinic Evan and I went back to our place to work on the treasure hunt clues and the certificate. At one point Laura decided to come visit us, so we had to scramble and hide everything. Good thing I randomly looked out the door and saw her coming from a distance. Evan entertained her by playing ping pong with her while I pretended like nothing was going on. Laura randomly uttered that she was craving for some chewing gum, so Evan got the idea of putting chewing gum with each clue.

Wadner helped us by wrapping the clues along with some chewing gum, and planting them on corresponding destinations while Amy, Laura, Evan, and I ate dinner at the Holiday House. During dinner the three of us psyched Laura out by saying stuff like, "You might not want to be wearing nice clothes tonight, and you'd probably want to wear trousers under the skirt," or "When you pass the radio station you'll know you're almost there..." as if we were going to kidnap her and drop her off somewhere in the dark.

I had told the kitchen ladies that today is Laura's birthday (this time I told them during breakfast, so they had enough notice), so they made us an upside-down pineapple cake and lit candles on it. I brought out the cake singing happy birthday, but the fan was blowing so hard that the lights were going out as I carried them. I tried to light them up again with the candles that were still lit, and I was still holding the cake when the song ended, so we had to sing all over again. Amy tried to help me, but we just gave up and let Laura blow out whatever that was left of it.

When Gavin joined us at the end of dinner, Laura went hiding because she thought he was going to take her away. Anyhow, we gave her the first clue with the birthday card we had signed (along with some people from the clinic, such as Ms. Ketlye, Ms. Prudence, and Dr. Rodney). The clue said to go to the house with the number 11 written on it, which is where Evan and I are staying. So Laura left for the treasure hunt with Amy as a "bodyguard." Meanwhile the rest of us put the package and the certificate in the gift shop in the Holiday House.

Laura thought she was supposed to go to the place where Evan and I are staying, but Amy convinced her that Dr. Rodney's house was the one with number 11 on it. So they walked all the way there, which gave us three guys time to catch up with them. Anyhow, she got to house 11 and got her first pack of chewing gums with the second clue, which said to go to a building with "4VEH" written on the wall. Laura thought she had to walk all the way to the radio station, which is about 20 min walk down the street. We were just walking across the compound when she realized that the old radio station building is within the compound. The building was old and creepy in the dark, so the four of us stepped back while Laura walked towards the door by herself. Just as Laura got to the door, I couldn't help myself, so I shouted really loud, which made her jump.

She found another pack of gums with the third clue which said to go where you get your blood drawn. Obviously it was the clinic lab, but being a med student that she is, Laura overanalyzed and thought it was the Red Cross (where you donate blood), and cross meant church, which meant seminary, so we took a detour all the way to one of the seminary buildings.

The fourth clue (found at the lab) lead her to the "Crazy Canadian's house" (isn't it obvious that Evan wrote the clues?), so we went to Amy's house, where she found a clue that said to go back to where we started, and to look "among many gifts." So we went to the Holiday House dining hall, but Laura didn't find anything, so she just stood around for a minute until she realized that there is a gift shop. So she finally got the certificate that we made and the package from her mom, which almost made her cry when she saw the handwriting on the label.

As a finale, Gavin decided to give Laura a motorcycle lesson. It took a while to get started, but soon enough she was going around in circles on Gavin's motorcycle. Then Gavin asked if I wanted to give it a try, so I got to ride a motorcycle for the first time ever.

When it started going, I panicked for a second and twisted the throttle, which made it go even faster, but I quickly regained control, and was able to make couple laps around the little loop. It was fun, but I don't think I'd ever use motorcycle as a mode of transportation... unless maybe if I'm a missionary doctor in a rural area where motorcycle is the best way to get around. But otherwise it's too dangerous. You know what the doctors call motorcycle riders who don't wear helmets?... Organ donors (That's from Chaos Theory).

Afterwards, we hung out at Amy's as usual, and watched episode 403 of Grey's Anatomy.

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.

Maranatha, Turtles, and Homemade Ice Cream

Sunday, July 13, 2008

Today we went to Maranatha Church, which is a few minute walk down the street from the compound. This is the church that Scott has been going to. Scott is a long-term missionary who's been working at the radio station for many years, and he's going back to Alabama for good on Tuesday. Since this was his last Sunday at the church, he spoke to the congregation and bade them farewell.

Afterwards, Amy, Laura, Evan, and I went to Christoph, took a quick dip in the pool, and ate lunch at the poolside. They have a few turtles at the hotel, so we paid them a visit. Nothing too exciting, and their water needed to be changed, but it was cool to see turtles in Haiti.

Amy joined us again for dinner. The kitchen ladies had prepared sloppy joe and ice cream for us (they don't work on Sundays, so they made them yesterday). Ice cream was a bit too sweet for me, but it was still ice cream, so it was good. Later we hung out at Amy's as usual, and the three of them (Amy, Laura, and Evan) watched another episode of Grey's Anatomy while I chatted with friends online. I love Grey's, but I'm not big on re-watching shows unless they're hilarious.

It was another relaxing weekend.

Cap-Haitien Tour, Bargaining, and the Twelfth

Saturday, July 12, 2008

Today we went on a tour of downtown Cap-Hatien. Amy, Wadner, Laura, Evan, and I drove over to Enoch's house and walked around the city from there. Enoch is a Haitian ergonomist who deals with agriculture and works with an organization called Hope Seed. He plays piano at the English Bible Fellowship on Sundays. He was our tour guide for the day.

First we went to the city square (see it on Google Maps), which is between the Notre Dame Cathedral and the city hall. We went inside the cathedral and looked around for a bit. Then we visited a few private catholic schools. I guess it's no surprise that schools and buildings funded by the richest church in the world are the prettiest attractions in this city.

We also visited the Justinian Hospital (Google Maps), which is the biggest hospital in Cap-Haitien and the one we usually send patients to in case of emergencies. At hospitals in Haiti, patients have to pay for every single equipment that is used for them, even gloves. With the food crisis, less and less people can afford healthcare, and more and more people are becoming sicker. Just when you thought the US healthcare system was bad...

After that, we walked through the Iron Market, which is probably the biggest market in Cap-Haitien. If you look up Cap-Haitien on Google Earth (or Google Maps), you will see a big brown square the size of 4 blocks put together. It was so crowded, smelly, and dirty that we were busy just trying to get through, so we couldn't see much of it when we were inside. Watch out for pickpockets!

Then we went to the Boat Market (Google Maps), where you will find a number of tourists. There is one long row of shops that sell paintings, sculptures, jewelries, dresses, and all sorts of souvenir items. I wanted to buy some paintings, so I went scouting down the entire row, then went back to the shops that had ones that I liked.

As usual, I had to bargain like no other. The first seller offered me three paintings for 3000 gourds ($80), but I bargained it down to 1100grds ($30). I probably could have got them for less, but at least it was quick. The second seller offered three paintings for $300US(!), claiming that one of the pieces was done by a famous painter, which is total bull crap, but I didn't want to offend him by calling him a liar (not good for bargaining) After a long negotiation he offered them for 2000gds ($53), but I only had 1600gds ($42), so he just took that. I probably could have paid less if I had been carrying less money... Bargaining takes so much energy out of you.

Then we walked over to La Kay restaurant (where we ate yesterday) and had lunch. I got chicken spaghetti this time, but it was very salty... I still ate it though. I should have gotten cheeseburger again.

In the afternoon, Amy, Evan, Laura, and I went over to Gavin's house to celebrate the Twelfth of July (an Irish tradition). We tossed around a rugby ball for a while, then ate food prepared by Gavin. For dessert we had caramel ice cream, which was probably the best ice cream I've ever had in Haiti.

Chapel, Blisters, Lightheadedness, and Cheeseburgers

Friday, July 11, 2008

This morning, instead of having a devotion at the clinic, we met at the seminary chapel with people from other OMS ministries. Dr. Rodney lead the devotion, all the different ministries shared their praise and prayer requests, and we all prayed together. We have these meetings once a quarter or so.

In the morning we saw some of our regular patients including Madelene (girl with machete wound) and Augusma (fractured elbow and sutured hand). Madelene's wound still seemed to be healing well. Last time she was here, we put some steristrips across the wound to bring the skin closer and make the wound narrower. The wound was a bit narrower, but there were a couple blisters under the steristrips. It may have been caused by friction from steristrips, or she could be allergic to them, so this time we just bandaged the wound. We'll see if the blisters are any better next time.

Then we saw Augusma, whose hand also seemed to be healing well. So Gavin took out the stitches while I held Augusma's arm so his elbow won't move. After 10 minutes or so I started to feel lightheaded, so I got Laura to cover for me and sat down. Earlier this morning I had some loose stool (probably a side effect from erythromycin). I hadn't had much water since then, and I could feel my heart palpitating (fast and hard), so I was probably dehydrated. Then my stomach started to feel queasy just before I felt lightheaded. Good thing I saw that coming and was able to hold Augusma's arm until someone took over. I sat and put my head between my knees for a while, went to the bathroom, and then I felt much better.

All the missionaries took a half day today and went out to lunch as a farewell for three long-term missionaries: John, Dorothy, and Scott. We went to La Kay restaurant, and most of us got cheeseburgers with fries. We don't get to eat much burgers in Haiti, so it was a treat.

In the afternoon I took a long nap to recuperate from my illness this morning. I feel all better now. After dinner we hung out at Amy's as usual.