Jul 31, 2010

pain and beauty

This morning I made coffee for the first time this week. This is monumental. I have avoided our coffee pot in our apartment here because the last time I used it there was nearly a disaster.

I had just woken up and shuffled my way to the kitchen. Bleary eyed and hair in a very awkward messy bun, I grabbed the coffee pot to fill it with water. As I pulled, something was underneath the pot on the burner (which was off) and it flew with the pot.

It was...a COCKROACH.

I don't think I hate anything more than cockroaches. I am determined to get over my fear of them while I am here, but so far no luck.

Anyways, the cockroach flew into my sink and disappeared from there, making me not touch the counters in the apartment for about 4 days. When I finally decided the dishes were too many and too dirty and soon they would attract more cockroaches, I made my way to the sink.

There, in a coffee cup, was the cockroach. Drowned. Sucker.

But really, I guess it loved coffee.

So needless to say I scrubbed my coffee pot well this morning, and there is a delicious cup of coffee that I didn't have to wait a long time to enjoy alongside every team member here.

On Tuesday we had a car accident come in to the clinic. Our patients didn't come all at once like we usually see. Instead they came at least 30 minutes apart. We normally don't hear about big accidents until the patients start showing up. The story was: the driver of a tap-tap, for some unknown reason, ran over 12 people. 12 pedestrians hit, 2 died instantly, and the other 10 were being brought to hospitals around the area.

Our first patient was 13. She had two large open wounds on her thighs, and as I jumped into the truck to put her on a board, it was very obvious that she had broken both of her legs. They were pointed in very wrong directions, and her knees were facing out rather than straight on.

Our other two patients had head injuries and both had to be intubated. We have no ventilation systems which required us to bag them all the way to the next hospital. The hospital we took our head injury patients to was in Port-au-Prince and is well known for emergencies and critical care.

When I arrived with our last patient, they looked at me and said "We have no open vents". I continued to bag him while the checked him out in their two bed trauma area, then we wheeled him to the ICU. The four bed ICU, probably the size of your bedroom, stuffed with patients and nurses and doctors and oxygen tanks and supplies.

It isn't easy to do anything here. To go buy milk takes at least 3 hours of your time after you get a vehicle and a driver to take you. To take care of patients with head injuries is nearly impossible. And somedays I would rather just scream and refuse to deal with any of it, because it's too hard.

Thankfully, I am surrounded by people who remind me of why I am here. I have a great cloud of witnesses to point me away from my own works to grace. And then I get to share moments like these with them.

Haiti has REAL cappuccinos!

Haiti has practically perfect sunsets!

There is the ocean.

Out of Zion, the perfection of beauty, God shines forth.
Our God comes; he does not keep silence...
Psalm 50: 2-3

In this world there is pain and there is beauty. Thank goodness for the beauty, because it reminds me that this isn't the whole story and this isn't the end of the story.

Jul 17, 2010

ear to the earth

This week was surgery week. A team of 41 medical people that I worked with all week. Hundreds of patients seen in the clinic, wound and orthopedic consultation area, and ER. 54 surgeries completed. Several car and motorcycle accidents. Early morning and late night radio calls for blood expanders and extra hands. Meals ferried back and forth. Water, water, water, IVs, broken down cars and ATVs, ambulance runs, laughs, candy, hugs, tears, frustration.

This week was one of the most beautiful things I have ever taken part in.

I just waved goodbye to our medical team. Our 41 friends just left to go back to the States. Some of them have a look in their eyes that tells me something: change has occurred. In some way, everyone is leaving changed, more beautiful, emptied and filled.

I don't know how I will get off this couch. I could sit here all day to process. But our next team comes in this evening. We have 6 patients on our ward through the weekend. And we hurtle onwards.

Yet this week has torn me apart too. To be so endlessly served by this team, to watch them love and care and agonize alongside us with our patients, and then to leave, it tears me up. They have become a little family with me this week - and I am sad to see them go.

I am agonizing over the stories of some of our patients.

Crushed by buildings on January 12.

Ulcerations on legs for 8 years, desperately wanting to not have dressings done each day.

Beaten with sugar cane as a child slave.

Abused with battery acid that has disfigured her face.

Dear brothers and sisters, what a wretched world we are in. What a wretched world to be treated so poorly. What injustice. How much my heart aches. How much I desire to cry out for them, yet how beautiful this week to begin to see transformation. Perhaps we can help heal these scars, both physical and emotional. Perhaps we can learn how to walk alongside instead of walk away. Perhaps I can begin to pull myself away from my quiet world where I am safe and comfortable. Perhaps, just perhaps, God can redeem this wicked heart of mine.

May the Gospel grip me today and not let me go. Sweet Jesus, come quickly and sand away the exterior. Allow Truth to seep in and around. May the strength of Jesus manifest in us as we walk along.

Jul 10, 2010

a long road

This week we had a great medical team working with us. They were from all over the country, and half of them were students. Our week in the clinic was smooth and busy. Thursday was a quieter afternoon, so I offered that the medical students, the EMT, and our one visiting nurse could go out into the mountains with our ministry team going out. The ER doctor who is an anesthesiologist and myself stayed and closed up the clinic with our Haitian staff, then we joined the cardiologist and his kids at the guest house for the afternoon.

It was shortly after 5:00, and I had spent the previous hour alone, feeling rather confused about the state of my heart. I was feeling sad about something, but I couldn’t put my finger on it. I was tired and ready for my day off on Saturday. I sat down next to Diana, our prosthetics lab coordinator, and some of the interns and chatted when a grey truck pulled up with some other visitors at the Mission in the back.

“Sarah, there’s been a terrible tap-tap accident in Source Matelas. At least 25 people.”

I’m not sure what else they yelled, but the two doctors quickly mobilized and jumped in the truck. I grabbed my radio and told Dr. Cheryl, who was in her house, and I ran to change out of my skirt into scrubs. The grey truck with the doctors, followed by me on my ATV with three of the interns, and Dr. Cheryl behind went to the clinic. We grabbed our mass trauma bins from the pharmacy extension, equipped to treat 30 trauma patients at once. Brianna used my phone to try and get a hold of Lindsay, our team coordinator who is a nurse, and the rest of our medical team. They were only 10 minutes away, praise the Lord.

The first tap-tap backed up to our clinic with about 6 patients just as the team pulled in. Lindsay and Kari, our two other nurses in addition to me, jumped out with our EMT, medical students, and other team members. Dr. Cheryl began to triage with the doctors, and I started to ask people for additional supplies. We had an incredible team assembled.

Somewhere in the process Brad, Mission of Hope’s director and president, drove our small ambulance to the scene to pick up patients. He returned and called us over, saying he had some severely injured people.

When we opened the back door I walked up to the first patient I saw and realized his feet were at odd angles. As I got right next to them I realized that they were barely hanging on by some skin and tissue. I could see all of the bones of his feet, and his flesh around the bones looked to be ground. I held on to his feet as we moved him out of ambulance, and they took him over to be triaged. I then realized that we had no morphine out, and we were going to need it. One of the medical students ran and got it for me, and I started to teach people how to draw up morphine. I did a few vital signs, during that time the man with the feet was transferred out to General Hospital. The head orthopedic surgeon that I called and Diana spoke with told us to send him the worst cases, so we immediately sent our first patient in the little ambulance.

Soon after that we needed to transfer three more in our big ambulance. Cheryl wanted to send a nurse along. Knowing we needed Kari on site as she was the most experienced and Lindsay was working with Cheryl on triaging, I found myself climbing in with three patients, a medical student, and our Haitian ambulance driver Jocelyn.

We rushed to General Hospital with a man with a femur fracture and intense chest pain and shortness of breath and a man with a potential cervical spine injury. The ride was so bumpy that I squatted between the two patients to try and make sure they didn’t get thrown anywhere. I prayed out loud and I prayed in my head. I knew if one of them started to take a turn for the worse I would be ill-equipped to help them. When we made it to General Hospital I was so relieved to get our patients into more capable hands.

General Hospital is the main Haitian hospital in Port-au-Prince, what would be the county hospital in a city. It is Truman Medical Center to Kansas City. Jocelyn and I wheeled in our femur fracture and chest pain patient, and it wasn’t long before I saw the trail of blood. We followed it into the center of the ER, where I found the man with his feet dangling, surrounded by doctors who seemed to just stare at him. I was greeted by a Brazilian UN member who quickly realized I was trying to bring in THREE patients, and he left. I met a first year general surgery resident who began to explain to me that they could not accept not only our three, but also the man with the feet and another man brought in by a different clinic from the same accident. I was suddenly being handed 5 patients, 4 of whom were critical, and told I had to deal with them.

Thank goodness for Jocelyn. He was by my side the entire time. He did not push me, but he took everything in and would advise me along the way. He informed me that General Hospital has TWO ambulances, and if they refused to accept our patients, they would have the capability to transfer them. The doctors told me it was too difficult to find ambulance drivers at this time of night, and they did not call. Short of dialing the number for them, I hounded them until they did call. Within 10 minutes, the two ambulances arrived with drivers. We agreed those two ambulances would transfer the 4 critical patients and General would keep our other one. It took another 30 to 40 minutes to get the patients in the ambulances. We followed them off, knowing we had 7 more patients to transfer that night.

Our next two transfers were to Carrefour, on the other side of Port-au-Prince, the epicenter of the earthquake. Those transfers were much smoother and less time-consuming, but we made it back to the mission after our final transfer at 3:30 in the morning. The next day I found out the man with the feet died between transfers to a third hospital after a second refused him. He was our only patient that we know of who died, though we only got 14 of the 30+ people involved.

The MAIN hospital in Port-au-Prince has had nearly all aid groups pull out. They have no sterile OR. They have NO sterile operating room at the MAIN Haitian hospital in Port-au-Prince after having suffered arguably the worst natural disaster. They did not have enough staff or beds. The tent and field hospitals are downsizing or closing altogether. But the need has not passed. The work is still here, and the workers are leaving.

At some point in the evening I looked around and realized that more people had come, and they were familiar faces. The interpreters for our groups, both medical and non-medical, had heard that there was an accident and came immediately. The same was to be said for some of our drivers. Everyone knew what a mass trauma accident meant, and they came. I cannot begin to tell you what that moment of clarity gave me. Following our first transfer I had some time to sit and breath in and out, and it dawned on me that the people I had come to serve already serve each other so endlessly. And they serve me and Mission of Hope endlessly. What I have taken away from them last night reaches far beyond what I could ever do in my entire time in Haiti.

The need is so great; it is dire. May we all find ways to fill and pour into the needs around us. May I wrestle with how that looks in my own life.

Jul 3, 2010


It's nighttime in Haiti. I am sitting on the concrete outside my front door and listening to the hum of the generator down the hill, the quiet voices from the group on the opposite side of the wall, and Bon Iver.

I have no pressing news to report. I am here, and I am living life each day, and I am trying to piece together the blocks of a new little life. Diana Cherry chopped off a good chunk of my hair today. I have spent more time in the last two days laughing and smiling and listening than I have feeling lonely and afraid. God has been pressing on me the importance of silence and solitude. I am trying very hard to seek that out in this time, to listen carefully for His voice.

Thanks for the thoughts, notes, and love over the past two and a half weeks.