Deliveries

Eleanor Nancy Price came to join my family on July 12, 2009 at 2:33am. It turns out being a mother is a lot more wonderful than I thought it could ever be. It was quite a process, though, and throughout the whole affair I couldn't help comparing my experiences to those of the haitian women that I helped with labor and delivery in the mountains. Specifically, I kept comparing what was happening to me with what happened to my best haitian friend. Here is a point by point summary of the differences in our labor and delivery experiences.

-I had my baby one week late and was induced. She had hers five weeks early.

-I took a tour of the hospital where I was going to deliver about three weeks beforehand. She travelled to three different hospitals while she was in active labor before she found one that offered incubators and oxygen for premature infants.

-My husband and sister and I had to weave around a few orange cones in construction zones on our way to the hospital. My haitian friend had to pause on her journey to the hospital to wait for another woman to give birth in the bed of the truck she was travelling in.

-I was allowed to have my husband, my sister, and my mother present with me during my labor. My haitian friend was not allowed to have anyone in the room with her, and labored alone.

-The nursing staff at the hospital where I delivered checked on me every few hours and continually monitored my progress on their computers. My haitian friend didn't receive any nursing care. I found her at one in the morning, screaming, alone, with her IV materials lying beside the bed, still unopened. I had to wake the nurse up to tell her the patient was ready to deliver.

-I received an epidural and only felt intense labor pains for about four hours. My friend didn't even receive tylenol and labored in extreme pain for more than twelve hours.

-I received an episiotomy that was performed under anesthesia and was repaired immediately. My friend received an episiotomy without anesthesia and was repaired 14 hours later, when a doctor finally saw her.

-My baby was greeted by a team of pediatric specialists and taken to a special care nursery to help her breath better. Much later, she was given her first bath. My friend's baby was taken to her bedside and expected to sleep and survive the night, even though he was struggling for every breath he took. When I insisted that the nurse send him to the nursery for oxygen, she told me "if you think he needs it, you take him." I did, and the nurses in the pediatric ward spent precious time washing him off before they gave him the oxygen and medicine he needed to live.

In the end, we both survived, and so did our babies. Mine was labeled a "traumatic birth" by the medical personnel at the hospital. My friends' experience was considered normal to above average by the medical community in haiti. I guess "traumatic" and "normal" are relative terms. I don't know if I deserved all the specialized care and medicine that I got, but I know that my haitian friend and her son deserved more than what they received. The whole experience has just solidified my resolve to provide truly good medical care for as many people in Haiti as I can. They deserve the best.

Sharing the Good News, Breaking the Bad News

Medicine on the mission field is an interesting profession. The frustrations of practicing good medicine in the third world can be overwhelming, and the day to day struggles of working with a staff that is culturally very different can bog anyone down. However, the hardest thing about medicine, on the mission field or at home, is telling a patient that their illness is terminal. This is especially hard in Haiti, where doctors usually don’t tell their patients any bad news, but always hold out to them a little hope. Haitians are hope-filled people, and cling to any chance that they might get better. So, when I tell a patient, “you have cancer that is incurable” or “you have end-stage heart failure”, I often get a blank stare in response, or words of denial. Some patients cry, others ask ‘what else can we do?’ Sometimes there are a few more things that can be done, but many times we have exhausted the medical possibilities by the time we give them the bad news. Breaking bad news like this can be very draining, especially if it happens on a regular basis. However, thank the Lord, breaking the bad news isn’t the end of the story at a mission clinic like ours.

Sick people tend to think about the future. Very sick people tend to think about death and life afterwards. That’s what is so great about working in medicine as a missionary. The people we come into contact with are ripe for hearing good news. They want to hear that there is hope- in this life and in the next. When I worked in Seguin, we had a local preacher come and share the gospel with our patients three days each week. Here at Christianville, the staff of the clinic takes turns sharing the gospel each morning. So I get to share the good news every Tuesday morning. Two weeks ago, I talked about my river experience, and explained how I called on the Lord in my time of need, and He was there to rescue me. I explained to my patients that He heard my voice because He knows me… because I walk with him daily. I urged them not to wait until they were in the middle of the river to cry out to God, but to call on Him today, and start their relationship with Him. Two people responded to the message that day. Sandy was able to pray with them to receive Christ. Another day, several weeks ago, Marie (our pharmacy tech) was preaching to the patients. A young man responded to the gospel message. Sandy prayed with him to receive Christ. Later on, I saw him in my exam room and gave him an HIV test, because of a suspicious rash he had. The test came back positive, so I counseled him. I found out he had accepted Christ that morning, because he was worried about his future after death, and wanted to get his heart right with God. Even though I had to break the bad news about HIV to him, I was able to share with him in the joy of finding life eternal. We see people coming to Christ each week at the clinic, and that is what medical missions is all about.

Last week, an old man was carried into my exam room by his crying family members. He had had a stroke, and was very weak on his right side. He could not say more than a couple words, and they were very slurred. I gave him some medicine to help prevent another stroke, and gave him the bad news that usually the damage done during a stroke is permanent, with very little that medicine can do to improve it. I gave him physical therapy tips along with medicine, and sent him on his way. Today at church, an old man got up to give a testimony of God’s goodness. He looked remarkably familiar to me. He said that he had been carried into the clinic this past week. I didn’t think it could have been the same man, though, because this old man in church was holding the microphone with his right hand, was walking without a limp, and was speaking clearly and without difficulty. But as he told his story, it became clear that it was indeed the same man. God had healed him. And he gave his testimony to the church, not to give glory to the clinic or the doctors, but to God alone, the great Physician, who healed his body. I’m glad that in this instance, the ‘bad news’ I gave him and his family was turned into a testimony to the whole church congregation of the good news that God is alive and powerful, and heals our infirmities.

Several years ago, when I was first entering college and debating what type of missionary I wanted to be, my choices were Bible translation, business administration, or medicine. While I’m sure God could have used me in any of those areas, I’m glad He led me into medicine.

My Community

Eight years ago, when I announced to my church in Florida that I would be leaving for full-time service overseas, I never imagined what I was getting myself into. I knew I would have to face lonely times, disease, danger, a foreign language and culture, and fund-raising, but I wasn’t sure to what extent God would test me in each of these areas. And of everything on that list, fundraising was the thing that really made me tremble. I dreaded it. So it came as a total surprise and complete relief when the ministry team at my church (Community Christian Church in Ft. Lauderdale, FL, called me in for a “talk” just a few short weeks after my announcement. They expressed to me their desire to support me fully, as a living link missionary of their congregation. I was overwhelmed with a feeling of relief (no begging!), with a feeling of unworthiness (how could God or any church love me that much?), and with a feeling of responsibility (I’ve got to make them proud!)

Over the years, Community has come to my aid again and again. Not just with their faithful financial support, but with advice, wise counsel, encouragement, rides to the airport and places to stay while stateside, and even a new truck when I destroyed the one they bought me in the river. Each summer, the kids in VBS raise funds for the kids here in Haiti who need formula or money for the hospital. Many of the kids at Community still greet me with a hug and a “hello miss Teresa” each time I come home to visit. The kids even showered my exam room with valentines this year. I couldn’t ask for a better sending church. There was one thing that was lacking, though. A team to come visit me. I wanted the church to see the work here in Haiti. It seemed that each year they would plan something, a coup d’etat or a food riot or some other civil unrest would upset the plans and cause a cancellation. But finally, this year, the time was right. The teams were planned, the flights were purchased, and two teams from my sending church arrived! Each team spent one week here, and it was wonderful to have them. Both teams jumped right into helping out wherever needed. Christianville has had some pretty finicky teams come and visit over the years, but Community Christian Church was not one of them. They were voted “Most Easy-Going Team” of the year by our guest house coordinators, in fact. They worked on construction, evangelism, teaching, upkeep (painting and cleaning and organizing and counting meds) and they even washed my dog. Some of my favorite memories of their visit are of Carla Behrenberg, perched on luggage, enjoying the sights of Port au Prince from the bed of the truck, and Terry Harding signing with a hearing-impaired girl here who hadn’t had a real conversation with anyone in years. I also thoroughly enjoyed the storytimes we shared each night. It was great to get to know everyone so much better.

I thank God every day for His provision for me. Only He knew what a blessing He was leading me to 12 years ago when I chose Community Christian Church out of the phone book and spent my first Sunday there. I couldn't have guessed that it would lead to such a faithful and meaningful relationship. Thank You, Lord, for Community!

Paco

A little announcement for everyone who's been here to haiti and met our inherited dog, Paco (A.K.A. Stanky Dangle)..... he just passed away yesterday morning. He was about 10 or 11 years old, we think. He had been struggling with a hematoma on his ear, which looked like it was getting better. Then two days ago he stopped eating, and yesterday he went over to our gate, laid in the sun, and passed on. Ryan and I were in Jacmel when it happened, so Doug and some good friends on the team (Mike and Kurt) buried Paco in our side yard. He will be remembered for his friendly nature, his morning howls with the church bell, the strange nubbin on his chest, his sneaky way of getting in the guest house just to be near people, and his fear of thunderstorms. We'll miss you, Paco.

IT'S A GIRL!

We had an ultrasound today, and the baby girl is fine and due the first week of july.

Hospitals in Haiti---and Some News

It's been five months, so I figure it's time for a new blog!  I wouldn't want to overload any of you with news of Haiti and myself by writing too often, you know?  Actually, life's just been super busy with wedding, medical and optometry mission conferences, work, new house, new marriage, and holiday visits to the stateside folks.  But now I've finally found a couple of minutes and a high speed internet connection, so I'm taking this opportunity to update my much-neglected blog.

   The topic of this blog is Haitian Hospitals, because they've been on my mind a lot lately.  For personal and professional reasons.  As you all know, health care in Haiti is a funny thing.  And I mean funny in the tragic sense of the word, of course.  I was very happy to move to Christianville and I've been overwhelmed at how much nicer it is to practice medicine in a facility with a full lab, xray capabilities, and ultrasound.  It makes diagnosis 100 times easier than it was in Seguin.  However, there remains one frustration.  Seguin was two hours from any hospital, and Christianville is only five minutes from one, and about one hour from dozens of others.  So I thought that moving here would eliminate some of my hospital frustrations, but it turns out they are only magnified by working so close to civilization.   Why?  Because whether you are five hours or five minutes from sub-par hospitals doesn't change the fact that they stink.  There are a few exceptions to this rule:  a Doctors without Borders hospital for pregnant women (but they only take the very sickest cases and turn all others away), a free Catholic hospital for children under 13 (but they are often full and have to turn patients away), and a Harvard funded episcopalian hospital (that is four hours away by bus for our patients).  Besides these hospitals, we shudder each time we have to refer a patient for hospital care.  Here are some examples from patients of mine.

In October I saw a woman who had been bleeding for more than one year straight.  It was like she stepped out of the biblical story where the woman with the "issue of blood" came and touched Jesus' robe.  Only I couldn't offer her Jesus' robe.  I did pray for her, and sent her to a hospital for treatment.  She had a hematocrit of 7 (normal is 36 and anyone with a count under 10 should probably not be alive... definitely should not be standing in my exam room having a conversation with me).  All this woman needed was several blood transfusions and a hysterectomy.  I sent her to the hospital, and the next time I saw her was two months later.  She had a hematocrit of 13 (still very dangerously low), and had a tissue sample in a cup in her hands.  She said the hospital had given her one unit of blood, made her lay in bed for weeks, and then taken a biopsy and sent her on her way to go get it analyzed and bring back the results (a process which could take weeks in Haiti).  She was still actively bleeding.  I gave her more iron, sent her on her way to go get the biopsy analyzed, and tried not to bang my head against the wall.

Another patient of mine was a young man whose wife brought him in.  He could barely stand up and was complaining of a huge headache.  I examined him and found neurologic deficits.  Jim came and looked at him and saw a cranial nerve palsy.  We sent him to Ryan to have his eyes examined and Ryan found cranial nerve problems as well.  All this led us to believe he had a mass or bleed in his head.  He needed a CT scan right away.  Sandy gave him the money to go get one done, and he came back the next day with the results.  There was a large amount of blood pooling in his brain.  He had had an aneurysm that burst, most likely.  He needed immediate surgery.  We called a neurologist, who told us to send him and his wife (they were both very pleasant people and appreciative of everything we did for them) to the hospital.  The neurologist said he would meet them there.  Perhaps he did, but if he did meet them there, he did nothing during his visit to help them.  The man died that night.  His distraught wife came to cry on Sandy's shoulder the next day.  Perhaps this man would have died in the States as well, but at least an attempt would have been made to save his life.  In Haiti, he was just left to die in his hospital bed.

  Perhaps you all remember me telling the story of the pregnant woman in Seguin who gave birth to twins and then started to hemorrhage.  It was 10 at night.  I had no pitocin.  I needed to get her to a hospital.  She bled all night long in my truck as I went from one hospital to the next looking for help.  Four hospitals and 8 hours later, I finally found help for her.  That is the state of hospitals in Haiti.  Why am I telling these depressing stories, and why do we have a Hospital Fund, if this is what the patients get?  Well, many times patients do get the help they need... it's just not as fast or as neat as we are used to in America.  Patients do need CT scans and surgeries to remove cancer or repair ruptured bowels or broken bones, and the Hospital Fund helps make that happen.  It's just frustrating for us to send our patients out, knowing that they won't get timely care, but praying that they will get the care they need before it's too late.  Please pray with us for our very sick patients.  Pray that they will receive mercy at the hospitals that they are sent to, and prompt treatment.  Pray that we will have wisdom to choose the right hospital for each different case.

Now for the personal side to these stories.  I've been thinking a lot about hospitals in haiti, because I may need to use one this year.  It turns out that the honeymoon that Ryan and I took in the Dominican was not only relaxing and wonderful, but also reproductive.  We got pregnant!  I'm due in early July.  It would be easiest for us to stay in Haiti to have the baby, but knowing all that I know about hospitals in Haiti, we have decided to try to come stateside for the birth.  We won't be moving permanently back to the States.  We'll still live and work in Haiti after the baby is born, but we are currently planning on coming to Minneapolis in June (or May) to prepare for the birth of the wee-one.  Please pray for us as we decide when the best time for our trip home would be.  Timing is everything, and only God knows when this little one is coming.

   Happy New Year!

CHRISTIANVILLE

I've been waiting for awhile to do a blog on Christianville because I was hoping to have some pictures to include with the write-up. But my camera broke and so I decided to write this anyway. I'm sure you all know that I've been working in a place called Christianville full-time since June. There is a clinic on the Christianville property that is run by Haiti Health Ministries. The staff includes two haitian doctors, two haitian nurses, a haitian pharmacy worker, two haitian laboratory techs, and three other haitians on support staff. There are also two american nurses, an american administrator, an american doctor, and me! If it sounds like more people than I used to work with, IT IS, and I'm excited about it. It is so great to not have to do every job myself, but instead to stick to what I'm good at. Which is seeing patients. Together we see about 120 people every day. We are capable of providing many services to our patients which other clinics can't offer, including x-ray, ultrasound, and lab tests. Dr. Jim and his wife Sandy have worked hard to equip the clinic with every item necessary to provide the highest quality medical care possible for our haitian patients.
One thing that I love about the work in Christianville is that we all work together to share the gospel with our patients. Leading people to the Lord and plugging them in to the local churches for growth is our goal. Each morning one of the staff, whether haitian or american, preaches the gospel to our patients who wait in a covered porch in the courtyard to be seen. Our patients are presented with an invitation to accept the gift of Christ's saving grace each morning. We all take turns preaching the daily devotion. If there are patients who are interested in receiving the Lord as Savior, Sandy prays individually with them while we begin to see patients. Then they are provided with discipleship materials and encouraged to attend a Bible-believing church near their home. While in the exam rooms, Jim and I pray with patients as the opportunity arises.
My favorite part of working at Christianville is the team aspect. I missed that and longed for it while I was in Seguin. Here is a patient story that demonstrates the way we like to work as a team in the clinic, while keeping our main focus to share the love of the Lord: A man walked into my office with a very large belly and yellow eyes. He was only in his early fifties, and he did not know the Lord. After I gave him a physical exam and Stacey gave him a chest x-ray and Jim gave him an abdominal ultrasound, we diagnosed him with liver cancer that had spread to his lungs. I talked to him about his spiritual condition and I gave him the bad news about his physical condition. He admitted that he did not know the Lord and was not ready to meet his Maker. I laid him on an exam table to remove some fluid from his abdomen to make him more comfortable. While the fluid was being drained, I called Sandy into the room to continue talking to him about the gospel while I went next door to see more patients. He accepted the Lord while Sandy prayed for him. He came into the clinic a few more times for follow up visits, and I encouraged him to read the Bible and go to church if he physically could. Then we didn't see him anymore. I'm sure he passed away, and I'm hopeful that we will see him one day in heaven, whole and healthy and joyful.
Thank you for all your prayers and all your support. Haiti is currently being hit by a category 1 hurricane. I'm in the States to prepare for my upcoming wedding, so I'm not sure how much damage is being done by the hurricane. Please pray for those who have dwellings that are less than adequate to hold up during this storm.