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.

Problem Case, Sick Baby, HTN, Diabetes, and Counting Pills

Friday, June 20, 2008

This morning Gavin showed Laura and me what he calls a problem case. There is a man who has hydrocele testis (accumulation of serous fluid around the testis), and he used to come to the clinic get the fluids drained. One day he fell from a tree and broke just below the superior head of right humerus. He went to a local hospital where they put a cast on him. One problem is that they fixed his right arm against his chest so he could not move his arm and only barely move his wrist, which is stuck just below his neck. The cast goes around his chest and is so tight that his hand is getting stiff and numb. Another problem is that he has been using his situation to get money from the clinic, often by lying. Consultation here at BMC costs 5 Haitian dollars (about $0.66US), which includes about half of the medicine given out, but somehow it's well known that this patient can't pay anything at all. So he's been getting free consultations here. In the past he has come to the clinic with a receipt saying that he needs to buy this and that for his arm, and BMC has given him some money to get what he needs. He has also said that he needs some things but he had lost his receipt for various reasons. What really needs to be done is a surgery to put his humerus together, but the original doctor is supposedly already treating him (by putting a cast around his chest and arm), so there is an issue of stopping another doctor's treatment. Also, since the patient has been living off his situation, we're not certain that he wants a treatment that will really heal him. Very soon he will be permanently crippled.

Gavin put Laura and I with Ms. Ketlye today. Ms. Ketlye is a Haitian nurse, but like many nurses here she consults patients, especially on specialty clinics. Two Fridays a month we have hypertension and diabetes clinic, so most patients we saw today were hypertensive, diabetic, or both. The first patient we saw was neither, and it was a 6-month old baby boy. He had been sick for 8 days, and he was hyperventilating and hypertachycardic. He was breathing so hard and fast that his ribs were sunken in and his nostrils flared. We had other doctors including Gavin look at him, but there was nothing we could do. I'm not sure what we ended up doing for him, but I think we referred him to a hospital so he could get some oxygen. Before we let them go, Ms. Ketlye asked Laura to pray for him. It was a very difficult and emotional situation for all of us.

Throughout the morning, Ms. Ketlye let Laura and me take turns to auscultate, take blood pressure, and check ears and throat. It was a good practice for me to take some blood pressures since I will be doing a survey of BP during the mobile clinic next week. Interestingly, I measured one patient's blood pressure to be something like 204/110, so Ms. Ketlye rechecked and got around 187/80. Laura said the patient must have some sort of White Coat Syndrome (fear of doctors causing nervousness and rise in BP)... It could have been because I'm a blan ("white," I'm white here even though I'm Asian).

In the afternoon, Laura, Carly, Anna, Emily, Jen, and I prepared small bags of drugs for the mobile clinic next week. Counting pills reminded me of my time in Sierra Leone when I went there with a medical team. I'm really excited for this mobile clinic.

After dinner a few of us watched Wimbledon (movie) at Amy and Julie's place. It was mostly girls (well, most of us here at OMS are girls), but Tyler came so I wasn't the only guy... not that I'd have a problem if I were. I'm usually not a big fan of romantic comedy or sports movie, but I've learned to enjoy movies despite their unrealistic/predictable story lines. Although, Christina made it a little hard because she kept criticizing how silly the movie was. She was right, but I'd rather fool myself and enjoy the movie rather than regret watching a movie I didn't enjoy. Julie slept through pretty much the entire movie in her chair. She must have been so tired.