Early Sunday morning

Bon Jour-Good Morning! Today will be a day of rest for this writer. Many team members will go to Bassin Blu, the waterfall, later this morning. After the waterfall, the next trip is to the beach at T Moulage. As for me, I plan to relax, read, and enjoy a day off with very little to do. It will serve as recovery time as the clinic winds down.
Saturday morning started with a heavy rain storm just about 7:30 AM. The rain lasted about 45 minutes and it made the day even more humid. It also made for more mud, dirt, rocks, and other landscape materials to be tracked into the clinic. One of the ironies is that the Haitians often take off their shoes outside the door and soon there is several pair outside that everyone must maneuver past to enter or exit. Haitians are, by culture, afraid of the rain. We had some canopies outside the compound and a tarp over the triage area for shelter. The providers are located on a portico with a new cement floor so they were relatively dry.
After the rain, with the limited amount of soil, there was very little mud. This area has very little top soil. I was remarking to Chip Moodie, who farms near Bradford, Illinois, about soil quality. We both agreed that the soil near Bassin Blu seemed very rich and we observed a planting of beans as we walked to the waterfall. There is an area on the way to Jacmel from Cyvadier that we pass that appears to be a crop raising area. Ooops, I’ve let my mind wander to another area instead of finishing my description of Saturday. We ended the day having seen160 patients. That brings our total to 2607 for the mission. Garron Lukas, our surgeon, performed 17 surgeries during this mission. He was only able to perform one on Saturday as the lady who was supposed to have a breast removed did not show up for the surgery. There is always a last minute demand by our Haitian helpers to have some family member seen on the last day, or to come up with some medical problem that day so that they can get some Motrin, or vitamins, or Tylenol, or some other medication. It takes me a long time, on the last day, to exit the pharmacy. The last day is also a hard day in the pharmacy as we do not want to package more that we need for the day as we will have to take it out of the packages for storage between clinics. So it is packaging in small lots for the pill packer which is hurry up and wait situation. I am so grateful for the work of Carol Steiner in the pharmacy again this year. She is a hard worker, never complains, works with a smile on her face, is very careful with her filling of orders, and a great blessing to me. I found out on Saturday that she will return with me on the July mission. HOORAY! I also want to acknowledge James Bender. He came in from triage, after it calmed down, and helped fill orders so we could keep our pharmacy bench cleared. He could also administer the injections as they came through pharmacy so that I did not have to chase down a nurse to give the injection. I was also assisted by Leah Barr. She took a heavy load of stress off my shoulders by keeping the pill packers at work. She shouldered the stress well and we were never completely out of stock of any medications in packages. Out of stock meds, packaged in a hurry, is a bad situation and we avoided it. We did have some advancement this year in the pharmacy that I want to brag about. I purchased plastic dropper bottles for the Lugol’s solution. In the past we have used empty bulk pill containers. They had poor seals and no dropper to use to dispense the medication properly. The plastic dropper bottles worked out very well for that and some other situations where a dropper bottle as needed. Speaking of Lugol’s solution, I had one of my translators, Edzer, write out the directions for the use of Lugol’s in Kreole. I then took that and put it on a Microsoft Word file and now we can preprint the labels for the Lugol’s. We have some the same for the baby vitamin formula and, my favorite item, BB Sirop. BB Sirop is a Haitian cough and cold liquid preparation. It comes in gallon bottles. It smells funny and is take with coffee by the patients, kids and adults alike. This year I purchased 2 oz and4 oz amber graduated Rx bottles to dispense liquids in a tight sealed container. In years past, the medication would leak out of the bottles if they were not held upright and I hated that. How could the bottle remain upright as the Haitians walked home from the clinic? It was most likely to spill. So I am pleased with the purchase. Also, I am happy to report that we JUST made it with the Ivermectin medication for scabies. We have less that 2 oz left of the 3 pints we started with. At 10 AM on Saturday, I began to ration it so that we could treat the worst cases. That meant that we would be painting adults with Lindane. We wanted to avoid, if at all possible, painting the small children with the Lindane and we did not have to paint them.
We all noticed that the rain and humidity caused a great increase in body odors from the Haitians on Saturday. It was, for me at least, the first time this clinic that the odor was present as I worked with the Haitians. We did run out of soap to pass out to the Haitians. I do not know how much we brought along but it is all gone. We had more orders for selenium sulfide (Selsun or Head and Shoulders) shampoos. We will have to restock more heavily in future clinics. The only medications we completely ran out of were Methyldopa (Aldomet) for blood pressure control, Phenytoin (Dilantin) for seizure control, and Diphenhydramine (Benadryl) for allergies. That is not too bad for all the patients we see but I hate it none the less. We will pick up a small amount of Methyldopa and Phenytoin from a supplier in Port-Au-Prince who may or may not have some in stock. You can bet that I will lobby for more for the April and July upcoming clinic.
After the clinic on Saturday, we trucked to Cap Lamando. It seemed to take forever to get on the trucks for the trip. Then, as we started down the main road in the second truck, the first truck stopped and turned around for no apparent reason. We stopped and moved the truck to the limited shade at the wrong side of the road. Using the Haitian cell phones, we found out that someone (best left unnamed) had lost cigars off the back of the truck and needed to attempt recovery of same cigars. I hear we, in the second truck, had only crushed one of them as we passed over them on the rough rocky road. At Cap Lamando hotel, we had the pool to ourselves for the most part. There was one family from Appleton Wisconsin there. The husband was Haitian from Jacmel, who had gone to school in the USA and continued to live in Wisconsin. The wife had met him when he was stationed in Wisconsin. They were in Jacmel for Karnaval with their two children and were enjoying a day at the pool. The hotel is much busier again this year as the presence of the UN has caused an increase in room nights. Donna and I ordered a bottle of Chardonnay wine. It cost, with taxes-new to me this year- $12.00 American. It was served by my “old” friend Jean Chadony. On my first visit to Haiti, Jean Chadony was a bus boy. He and I worked together at the hotel setting up tables, table cloths, plates, silverware, and drink glasses so we could have our meal. We had a good time, that night, laughing and working together. He is now the head barman and I got to catch up on him and his growing family. I used to hear from him by email but he has been too busy lately to write. The wine was Australian and a dark yellow color but a nice taste. When Jane Gray went to order another bottle, we found out that I had purchased the only one. She selected a French Sauvignon Blanc and it was also tasty. Many, many Rum Punches, Prestige beers, and ???? Later, the team sat down for our meal. It was the usual Haitian confusion central getting the correct meal to the correct person. Donna and I got ours early on. I think the goat was the last to be served. After we finished the meal, they served pomme fries (French fries) which are tasty, then they brought out a serving of white rice. By that time, many were too full to enjoy the rice. After the meal, there was a swimming pool challenge among the team members. For the sake of confidentiality, I will not name names, at this point. I am, however, open to bribes.
All had a good time and we waited-and waited-and waited for the check. Again, this is very Haitian. When it came, the hotel staff could not agreed on the total. We paid one amount shown on the bill, and one hotel employee, the front desk clerk, argued and argued with the rest of the hotel staff about something or other. We were loaded in the trucks, ready to go, but our driver would not proceed until was give the word from Boyer, our interpreter. This driver is Boyer’s friend and has driven us around the entire mission. I went in to get Boyer. He was in the middle of the argument. The catering manager, with whom I had spoken to earlier, came out with an arm full of Cap Lamando tee shirts for the team. Finally we left and returned to the clinic. It was sometime around 9 PM and the streets were still full of people coming and going. The vehicles all dive with their bright lights on and will only go to low beam about 10 yards from the oncoming vehicle. Traveling on the roads in Haiti is always an adventure. There are people walking along side the road day and night. There are vehicles, parked along the sides and stripped of any and all useful parts, there are motorbikes that either fly around you or slowly put-put along. If you are in a slower moving vehicle, you are passed by a speedier vehicle, no matter what may be on the road ahead. The Haitians use their vehicle horns, so you do have some idea what is happening, but near miss opportunities abound. So far, we have been safe and sound..
The sun is now up, most of the team awake, and soon we will have our prayer service. No one looks the worse for wear from last night and I’ve written more that you may care to read so I’ll TRY to correct some of the many grammar and typographical errors and get this published. Oh, I almost forgot, we are aware of the additional 4 inches of snow that Peoria received on Saturday. We are still watching the forecast for our Tuesday travels. The 45 degrees that is forecast sounds cold to us but better than below zero. Again, it is Sunday, so relax and enjoy the day. Our thoughts and prayers are for you and with you.