a lot of pain and a little joy

Sometimes I spend my nights reading about Haiti. I read news articles and blogs from people on the ground. Sometimes I see such a small picture - I don't know what all is happening. And I need the reminders that other people see and agonize over the same things and in the same way as we do here. One of the blogs I read is written by another nurse working for a different hospital. Jessica wrote a few weeks ago about a conversation with a Haitian doctor who put the way of life here for the majority of Haitians into words so well:

"For them everything is a fight. It's a fight for food, a fight to get on the tap-tap going in the right direction. A fight to sell every piece of fruit and every soda. It's a fight to survive . . . She said they get so used to fighting everyday that their entire life a

nd attitude becomes just like that, a battle."

Put yourself in that place for a moment. You have a broken cooler full of pop bottles in a market packed with people selling the same things, but all united under the same idea - I must sell all of this so my family can eat tonight. Or maybe so I can take my child who has had a fever for 8 days to the doctor. Or maybe so I can buy purified water to drink so my family isn't forced to drink from the canals of water filled with trash and waste.

This is the way of life here. This is the way of life in the majority of the world.

Add onto that tent cities, flooding, cholera, political unrest and riots, cholera, skyrocketing food prices, cholera, lack of education, cholera.

Of course it is survival mode here. People are too busy trying to keep their heads above water to try and plan for rebuilding or moving forward.

I spent Thursday of this last week in a cholera treatment center a few minutes north of Mission of Hope. I took our medical team as it was a Haitian holiday and our clinic was closed. We pulled up to tents and the smell of bleach and human waste. The center was so well run but overrun. The staff there thanked me over and over for bringing the few people I could to help, saying for the first time in 10 days they have felt like they had almost enough people to treat all 180-200 patients they see a day.

I had eight patients I oversaw with the off and on help of a Haitian nurse. It's a delicate guessing game of "How much fluid does this person need?" How sunken are their eyes? How many times in the last hour have they sat up and vomited or had diarrhea? One little girl had an IO and an NG to try and replace fluid. I was put in that tent so I would ensure that every 10 minutes I put 20 mL of ORS into her NG. Between those ten minutes it was replacing IV bags, encouraging every patient to drink ORS every ten minutes, washing hands, documenting, and then it was time to repeat.

My small victory of the day was seeing the girl sit up. We pulled her IO and her NG, put in an IV, and got her taking ORS orally. But she was still vomiting and having diarrhea - she was not in the clear yet.

Each person in that camp was fighting. The patients were fighting to physically survive. The workers were fighting to get through another day, to keep everyone alive. The news articles that cover the story cannot accurately put that into words. You cannot understand cholera until you see its victims.

And in the midst of this, the everyday still occurs. Babies are still being born. People are still diagnosed with TB. People are still malnourished. Accidents happen. Health care is now being stretched thinner and thinner throughout Haiti. And this week I have seen it, and I can see the storm clouds growing darker and darker. With more cholera means less hospital care. With more Port-au-Prince cases comes less room for the everyday cases to go.

But beauty has not perished here. Wounds are still healing, or at least improving. A 30 minute session with a mom and newborn baby teaching breastfeeding has seen the cessation of the baby's seizures and the growth of his little belly. And perhaps the most encouraging thing of all:

CLERMOND IS WALKING!

What joy that sight brings. I only wish that joy could be infectious too.

Lespwa

Some friends of mine have formed an organization called Lespwa Means Hope - and I now blog for them as well! Be sure to follow what they are doing alongside Mission of Hope, follow them on their tour if you live in a city they are visiting, and go read the blogs!

www.lespwameanshope.org

I have blogged about cholera there - it's been an insane week and I hope to update here soon.

a song for every one of us

Growing up in church, we were taught that Jesus was the answer to all our problems. We were taught that there was a circle-shaped hole in our heart and that we had tried to fill it with the square pegs of sex, drugs, and rock and roll; but only the circle peg of Jesus could fill our hole. I became a Christian based, in part, on that promise, but the hole never really went away. To be sure, I like Jesus, and I still follow him, but the idea that Jesus will make everything better is a lie. It's basically biblical theology translated into the language of infomercials. The truth is, the apostles never really promise Jesus is going to make everything better here on earth. Can you imagine an infomercial with Paul, testifying to the amazing product of Jesus, saying that he once had power and authority, and since he tried Jesus he's been moved from prison to prison, beaten, and routinely bitten by snakes? I don't think many people would be buying that product. Peter couldn't do any better. He was crucified upside down, by some reports. Stephen was stoned outside the city gates. John, supposedly, was boiled in oil. It's hard to imagine how a religion steeped in so much pain and sacrifice turned into a promise for earthly euphoria. I think Jesus can make things better, but I don't think he is going to make things perfect. Not here, and not now.

I find myself caught in the idea of our stories. We all tell stories with our lives, and along the way we intersect with other stories that will forever stick with us. Most recently, in living in Haiti, I am intersecting with entirely different sorts of stories. They are wrenching and beautiful and painful and altogether astounding. They have faces: a dying 17 year old boy, the man with the feet, the baby with seizures. They have names: Clermond, Pierre, Alexandre, and now - Alix.

About 15 minutes from Mission of Hope you can find a boy named Alix. He is 14 years old, and six months ago he fell on his chin and fractured his jaw upward. Since that day he has been unable to open his mouth. Living in extreme pain, he has eaten through a straw every day for six months and speaks words through clenched teeth.

Once again, the same problems. Not enough resources, not enough access, not enough education. And once again, I find myself asking the same question: "Why God do these things keep happening?"

And that is essentially all God says to Job. God doesn't explain pain philosophically or even list its benefits. God says to Job, Job, I know what I am doing, and this whole thing isn't about you.

Alix saw a dentist in our clinic who was so broken over his case that he went home, asked an oral surgeon friend to help, and set up a surgical team to return to Haiti in order to take care of Alix's case, as well as other maxillofacial surgeries. The dentist and his dentist wife (power couple!) covered all of the costs and after many weeks, I sent Alix and his mother with the money to buy bus tickets for the 5 hours journey to the hospital. I could not help but celebrate - Alix was finally getting proper care.

I received an e-mail from my contact at the other hospital tonight - Alix's surgery is too risky. They will be unable to preform the operation. He needs to go to the States in order to have the appropriate treatment done.

I found myself surprisingly more upset than I would have expected. I think of Alix and his mother, so thankful for the idea that the end of this trauma was in sight. I think of the delays, of getting passports, of the letters that need to be written, of the longer wait. I think of the disappointment.

What I love about the true gospel of Jesus, though, is that it offers hope. Paul has hope our souls will be made complete. It will happen in heaven, when there will be a wedding and a feast. I wonder if that's why so many happy stories end in weddings and feasts. Paul says Jesus is the hope that will not disappoint. I find that comforting. That helps me get through the day, to be honest. It even makes me content somehow. Maybe that's what Paul meant when he said he'd learned the secret of contentment.

I say it often, but I have to remember that the story does not end here. The mouth of injustice may be gaping, but it will not remain that way. This too shall pass, and this too shall be made right.

The pain made the city more beautiful. The story made us different characters than if we'd showed up at the ending an easier way. It made me think about the hard lives so many people have had, the sacrifices they've endured, and how those people will see heaven differently from those of us who have had easier lives.

Amen.

All above italicized excerpts were taken from Donald Miller's A Million Miles in a Thousand Years.

show me a place where hope is young

There are some days here where I find myself wondering how on earth I got myself into this position. Don't get me wrong, I wouldn't have me anywhere else. I love what I get to be a part of here. I love the cast of characters I work with and live among.

Today I had a knock on my door and there was a Red Cross representative. She has come often to get supplies the hospital she works for needs. We chatted pleasantries as I walked her up to our supply tent. She informed me she would be leaving next week for good, moving on to a Red Cross hospital in Pakistan.

I asked what supplies she needed.

Gloves. Syringes. Needles. Sheets. Basics.

My mind went back to Price Chopper in Kansas City. Every check out line with Donate to Red Cross opportunities - money being given by people left and right. Millions and millions donated to them. Like everyone else is asking now, where did all the money go?

They have supplies. In containers. In port. In customs. Unreleased. Why? Who knows? The reason could change every day. Now they are hoping to bring supplies through the DR but that will take weeks.

A multitude of problems.

That also doesn't stop me from asking where all the corruption is - is the Red Cross money being put to good use? Is it being used to finance salaries of US side jobs? And if so - is that taking away from basic supplies for medical care?

So I found myself helping her load boxes of gloves into the back of her truck. We dug through to find needles and syringes and sterile gloves size 7&1/2. We talked about how everyone needs supplies and the need in Pakistan and in Haiti. I bid her farewell, wished her luck as she left.

For the problems being as large as they are, this place is a very personal one. Anytime I meet another medical worker in Haiti, we swap numbers and e-mails, say what resources we have, and try and connect people with each other. Survival here is in many ways all about who you know.

So today I put in a call to ask a favor. It involves a helicopter. Flying hours north of us. To get a 14 year old who has been unable to eat for 6 months surgery. I promise to keep you posted on what happens.

And these past few days I am being constantly reminded of this:

Whatever your hand finds to do,

do it with your might.

Ecclesiastes 9:10

Whether it's digging literal needles out of a metaphorical haystack or flying a young man to a once-in-a-lifetime surgery, do it with your might.

Fievel in Haiti

When I was growing up my parents kindly allowed my sister and I to raise all sorts of animals. We tried gerbils, hamsters, bunnies, puppies, kittehs!!1!, and Becca even had a guinea pig. Annie had some fish once. I always wanted a horse, but we settled with letting my have horseback riding time every Saturday with Nikki Steidl. That is, until the horse died. And then all my dreams were shattered.

Moving on.

Needless to say, I like animals. In general I don't like to kill things, unless they are spiders or cockroaches. All other animals may live. Especially the cat-sized rats from the depot. Those I don't even attempt to kill.

So a few weeks ago when I stumbled upon the little mouse who had taken up residence in our house, I didn't mind. He kept to his corner and scuttled away if he came anywhere close to me. When Diana came home and moved back in, we started to notice him more. Then we started to notice his...problems.

He moved sluggishly. His fur stood out at odd angles. He looked rather malnourished. I am guessing Mother Mouse never really loved him. We keep our food locked up tightly, so he probably starved much of the time he was here.

One week he made appearances more often and was getting bolder. It was probably the hunger that sent him to madness. He would run under our feet like a crazed lunatic. He would hide under our couch and chair. He would not move when we tried to shoo him away - he stood mighty as an oak...a mangy, matted oak.

Diana wanted to pound him with a flip flop. I told her no, that we just needed to get him to run out the door and close him out. So one night I grabbed a broom and Diana grabbed a tiny tupperware bowl and we set out to capture him. He would run one way and I would try to corral him out of the corners into the bowl. We got him right to the front door, and in a moment of attempting "DO YOU BELIEVE IN MIRACLES?!", I hockey pucked him into the door.

I have horrid aim, he flew into the doorframe, and scuttled back underneath the fridge. He escaped for that night.

A few nights later, the show down began again. This time we were much more prepared, and I was much calmer, much more focused. I got the mouse to the door and gently guided him out the front door. Success! We helped him down the stairs away from our apartment, where we were promptly greeted by two young boys who live on the mission.

They were very interested in our mouse and set about trying to capture it. I was thankful the mouse was gone, instructed the boys to leave the poor guy alone as he has surely been traumatized, and went back inside. I felt proud of the fact that I had saved the mouse's life and that he may be able to make it in the wild.

That was promptly ruined by the entrance of one of the boys.

"Diana, you don't need to worry. The mouse is far away."

"Oh that's good, where is it?"

"It's up in the sky."

"What?!"

"It's dead?"

"You KILLED it?"

"NO. We were trying to save it, but I accidentally kicked it."

I gathered it had a seizure at that point and died. So much for trying to save it's little life. Probably for the best though, the cats would likely have found him.

That or the depot rats. Those things are monsters.

every breath brings a chance for redemption

The sight that exposes our sin is the exact same sight that reveals God's grace.

Taken from Kevin Cawley's words from Martin Luther in June 2010, heard today in Haiti.

The last week has been full of reminders of grace. Thank you all for your messages and e-mails and notes about Clermond and Pierre. The amount of response to the last post was overwhelming.

Clermond is doing as well as one could hope. His surgery went very well, and his leg looks wonderful. The people at Adventist did an excellent job. We will continue to follow him for wound care and therapy and explore the possibility of getting him to the States for continuing oncology care.

Pierre - oh Pierre. How I love this little boy. If there is a lesson of grace and hope in this world, I see it so clearly in him. He has been moved into the Hope House for the time being. We do not know where he will be taken or if he will stay with us for good. All we know is that each day he grows healthier and stronger. He has begun to hold his head on his own for short stints and is smiling and laughing more and more.

To think that out of such a broken moment, left under a bench with pneumonia, in one week we would see such a turn around. It is a testament of grace. In those moments of pain and suffering and despair, we can see God's grace in the possibility for something other.

In the last week I have laughed and smiled and felt more joy than I can remember. I know part of it was our incredible medical team this last week. Now none of you go getting a big head - I know you are reading this to see if I actually would blog about you. There you go - you guys are awesome and now the whole blog-dom of Sarah knows it. Peace an' Blessings.

And while those five people would be enough to make a week great, when you have encounters with Hope, when you have an invitation into those moments to DO something, and then you do it, and then you see the glory of the Lord - those are the moments that provide such a sheer amount of joy.

For the first time in three months, I have seen and heard the invitation. We are invited to step into the brokenness and the muck and the pain. We are invited to mourn alongside and to help move forward. We are invited to experience God's grace in our own lives and then speak it out.

We are never meant to pretend that pain isn't there. We should never ignore the hard questions because their answers scare us. We never have to fear what happens if we don't have all the answers, because we never will.

I think as I have begun to realize this, I have found freedom.

The moment of Despair is the moment of Hope.

- Tim Chester

Clermond & Pierre

What does the face of injustice look like? What does it look like when injustice manifests itself in the flesh, in your face?

Meet 21 year old Clermond.

HaitiMedTeam29: Joseph's Leg from Kurt Neale on Vimeo.

Clermond came to the clinic 3 weeks ago with what was thought to be an abscess. The first set of doctors to see him said they thought he had a sarcoma. The second set of doctors said it definitely wasn't cancer, just a cyst. The third doctor performed a biopsy - and the news came back yesterday.

Clermond indeed has cancer - a stage II osteosarcoma. Today I sat with him for an hour, told him the news, and told him that his only real option for treatment was an above-knee amputation. I was also the one to inform him that there was a hospital willing to do the surgery for him on Sunday. After a long conversation about what cancer is and what treatment looks like, we took a trip to see his father and told him the news.

How wretched for your only feasible option to be an amputation. Clermond said he would consent to the surgery but that his life as he knew it was over. I did my best to speak hope into his world. But in that instant I saw injustice in the flesh, in the tumor that protruded out from below his knee.

Later on that day I transferred a patient to a hospital in Port-au-Prince and got a call on my way back to the mission that there had been a baby abandoned at the clinic. The young mother had gotten news that her 2 year old baby boy likely had muscular dystrophy and would not make much of a recovery. She agreed to return with him on Monday, left him under a bench, and walked away. He became the responsibility of the government today. After trying to transfer him to three different hospitals in Port-au-Prince, the officials left him at the mayor's home tonight.

Injustice in the flesh: a boy in a country with no resources to help his teenage mother care for him. An environment that can be so unforgiving. Muscles that are not developed. A prognosis that is grim for a boy even well-nourished.

With no medical care at the mayor's home and a very malnourished, dehydrated, underdeveloped baby with a possible lung infection, several nurses and myself decided to try and get him back to the mission. With the approval of our Haitian director, I made my way to the mayor's house in the little ambulance and asked to take care of the baby's medical needs. Permission granted.

So, where do we go from here? When injustice is so in your face, what do you do?

As for me, I would seek God,

and to God would I commit my cause,

who does great things and unsearchable,

marvelous things without number:

he gives rain to the earth

and sends water to the fields;

he sets on high those who are lowly,

and those who mourn are lifted to safety.

But he saves the needy from the sword of their mouth

and from the hand of the mighty.

So the poor have hope,

and injustice shuts her mouth.

Behold, this we have searched out; it is true.

-From Job 5

As for tonight little Pierre sleeps on our living room floor on our mattress. I will accompany Clermond to and from the hospital this week. And I will join in the groanings of this world and wait in anticipation for the day when He makes all things new.

Until then, may God show us ways to shut the mouth of injustice.