Friday January 27th Post #5

Dispatch Friday January 29,2010

I’ve been remiss in my journaling but why will become apparent.

Wednesday AM, I’m talking to the pilot who is flying my docs out to Nassau and he mentions he may stop by Cap Haitian. I run back to the house, pack last clean shirt, a bit of food, and my passport and the next thing I know, I’m flying a huge beautiful jet from Cayes airport that brought in food and meds and supplies for the hospital. The flight that takes Tortug 60 minutes was over in 25.

Now I’m on the ground outside the airport with no translator, no one knows I’m coming except Jan called from the States and told Pastor Noel. My phone won’t work and I’ve painted myself into a bit of a corner.

I’m drawing a little bit of a crowd and one of the airport employees who is off duty takes me under his wing and sits down with me on the curb, running off the gawkers and panhandlers. I’ve never spent a better $20.

Two hours later, Pastor Noel and Woodley have arrived by taking a bus! 60 miles from Ouanaminthe. Now we’re all trapped together but I have a translator.

We hire a car and drive to Ouanaminthe. Cap Haitien is a beautiful seaside town covered in more squalor and trash than anyplace I’ve been in Haiti. Very hectic. If there were tracks down the middle of the street, you’d consider Ouanaminthe at 100,000 people, a railroad town. Very wild west. No electricity for 25 years. No internet. No business center. But VERY friendly.

I got to see our other container that we shipped, did training on how to install the Lister Generator and the Bakery Oven, talked about many things about the new orphanage and collapsed back in my hotel room. After the best baked chicken and Brown rice I’ve ever had in Haiti. I left for church.

With the new building, attendance has quadrupled and Pastor Noel made me preach with Woodley translating. We had much fun and I talked about the community opening their doors to refugees to wild applause. What wonderful people.

Pastor Noel has already taken in 10 orphans to our new orphanage since the quake. He’s hoping to make room for up to forty more.

After Church, I followed Pastor Noel on his motorbike with the new BUV. No lights, Pitch black and I get stopped by the Haitian Police. They detain me for 30 minutes (I’m assuming since I don’t speak Creole but they didn’t seem happy) and then with THREE bikes, we slowly went home directly and I kept my virginal criminal record for another day.

The next AM, John Vrooman calls and says he has a flight out to Cayes from Cap and get right back. No such luck, I spend all day trying to hitch any ride out of town, with Woodley and Noel sitting beside me as faithful friends. No luck and at 6PM, the airport closes, no rides, two false alarms, made lots of nice friends with the Haitian Police (the nicest I’ve ever seen or met). 

Back to the hotel (the only one safe enough for a Blan is $120), with no electricity, water but lots of mosquitoes due to no screens. Little sleep and Jan calls at Midnight and says flight out at 7AM. 

I’ll skip the details but in one hour, four different solutions that all fell through, a chopper with two orthopedic surgeons, a small plane, a really big plane then a wonderful man by the name of Wayne George sent ANOTHER jet to pick me up, and fly me back to Cayes. They were at max weight so they took out 170 lbs of Margarine and spaghetti and sardines and gave it to Pastor Noel for the orphans and we left. Another fast flight and wonderful people. He was a sheriff from Colorado and his wife was co-pilot. They’d been flying humanitarian aid since day one of the quake.

They dropped me in Cayes, gave 1300 lbs more of the same to John Vrooman for the distribution center and left. I’m home.

Today was a day of amazing people. Dave Kroeger came home to announce that the solar panels are pumping water in the Savanette and the drought for all those people is OVER. What a wonderful day to make that happen.

At the airport, a multi-millionaire heard the story and talked me out of 20 panels for his orphanage. I hope what comes around goes around. He’s been flying aid since the day after our team.

I finally got to actually talk to Jan, rather than text or do that 16 second verizon call until they figure out they have no service (we’re getting quite good at it).

Another neat story: A very rich Haitian owns a resort on the Isle south of Cayes. She owns a big sailboat for taking tourists out on the gulf. She is loading a ship in Miami with food and supplies and it will leave for Les Cayes Monday with 20,000 lbs. !!!. Her turn around is going to be about a week and her max capacity may push 40,000 lbs. That’s what I’ve been saying! Don’t fly, Pull up illegally to a doc and off load real volume.  This contact came from one of Jan’s students who is working hard to help us.

I hope at the end of all this unlawful use of non –PAP airstrips and docks, they realize they're crippling their country with the rules to control bribes and greed.

I also met a real nice man, about my age who has a mission much like MIA. Two schools, two orphanages, both in Cayes and he’s running out of food so I sent him to John who provisioned him. He’s already ‘adopted’ two orphanages in PAP and packed them into his schools to get them out from under tarps. Just what I wanted to do with Joel’s Leogaine kids.

Ran into two execs from the Coast Guard. They are frustrated they are not being allowed to land at any ports and learned from me that we have two nice docs. They were told there were none. They’re getting to work on that next. I told them my story about almost declaring an emergency the third day I was here and they said I should have done it.

I guess the best story of the day is the prison. I was wrong on my last note. We fed 550 prisoners in a total of 18 cells, measuring maybe a quarter acre. I stopped by briefly, trying to be obscure (the only white face in a black prison) and it was heart breaking. Then I got home and one of the workers showed me incredible pictures. He’s a pro, great moments with a dozen arms reaching through peeling bars for food from Benot and his team. Most of these prisoners are not felons but stole a loaf of bread etc. to feed their famillies!!!!

Jan and I have been communicating with a reporter from national CBS thanks to an eloquent letter to them from David Meier. He  has been in PAP for two weeks and is coming to visit what we are doing in Cayes this weekend. Finally, maybe I get the message out; we have real problems out here with all this crowding.

I hope it helps bring attention to our isolation and food pressure and crowding.

The 1800 meals did not begin to cover the refugees from PAP today.

Fonkoze is limiting the withdrawals from the bank wires so tomorrow I have to ask the Bank president if he wants me to tell CBS, the reason no one is being fed at the refugee center, cargo trucks or prison is because he won’t give me my own money! I’m betting I get it.

What I’d give for one working phone! I’m getting carpal thumbs from texting. Rick figured out how to attach a recording of his voice to the text which while kludgey is better than 16 seconds or driving 45 minutes up to Johns to talk on the only working phone. I’ve still got Digicel at 5AM when no one is using the bandwidth. I hate that since Jan is getting to bed at 1:30 AM.

Well, after two days in airports and finally airplanes, I’ll say ‘over and out’

I am simply overwhelmed by both the Haitian response to their own people and the wonderful things Americans are doing during this massive crisis. I’ve been remiss in thanking everyone.

Addendum much later at night:

Tonight is the first night I’ve had no travel, meetings, training, visitors and I sat down on the porch with my ipod to listen to some music and pray.

It’s easy to go pretty feral here. Showers are to cool down, not get clean. But on the other hand, it’s hard to find a place more interesting to sit and look over than Haiti. With the dogs barking, the roosters, the kids crying and the church songs rolling over the roofs, its somehow much more real. 

It must be time to come home as I’ve spent the evening designing my perfect desert home and it’s pretty Spartan. I could easily move here, and do what John does every day, just making peoples lives easier.

Although this two weeks has had it’s tense moments, all in all, I’d never think of an earthquake as being this relaxing.

Ive been doing a lot of reading in the late evening and marvel at how the world has managed to mess Haiti up so much. The final formula is simple. The USAID is a branch of the USDA that buys crops from farmers as subsidies to prop up farmers (it doesn’t work, it’s like giving everyone in the class one grade higher). Then they give that food to USAID and those bureaucrats donate it to massive aid organizations like CARE, CRS, WorldVision, etc who are required to sell 1/3 of it on the open market to produce their operating expenses.

That dump onto local markets destroys local economies  making the world dependent on high priced American food. We’ve been doing it since 1953. If you’d like to see the references, read Travesty in Haiti, by Tim Schwartz.

That comes to mind as I listened, not to praise music but instead was struck by the words of John Lennon.

Imagine:

Imagine there’s no heaven, It’s easy if you try.

No hell below us, Above us only sky.

Imagine all the people, living for today.

Imagine there’s no country

It isn’t hard to do

Nothing to kill or die for

No religion too

Imagine all the people Living life in peace

You may say that I’m the dreamer but I’m not the only one

I hope that some day, you may join us and the world will be as one.

Imagine no possessions. I wonder if you can. No need for grief or hunger.

A brotherhood of man.

Imagine all the people, Sharing all the world.

You may say I’m a dreamer. But then I’m not the only one.

I hope that some day, you join us. And the world will live as one.

And with that, I leave you. Haiti is a mean place and rarely fair. I only hope as the graphic pictures leave the TV sets that the world does not forget this wonderful place and it’s people. They need our prayers and help forever.

Jay Post #4 1/25

Dispatch #5


Only two things happened today:

The Cavalry came. We were standing in the Refugee Center talking to the men who work night and day when three army guys and the regional director of the UN came up to us and asked our status and work.

They never greeted the Haitians at all, never asked them a question!

They invited us to a conflab on future planning for Cayes, congrats on the work we’ve done, warned us not to send more people to Jeromie (they are overloaded) and informed us, I’m not kidding, that “the 600 lb gorilla had arrived” and would be working with us. (not the Haitians standing with us).

We did what we could to connect the two and they kept at it until they left.

If that’s how the military treats Haitians in the past, no surprise, they are tired of these bloodless coups.

They say food is paramount, they have tons, and don’t expect it soon because the special forces types are afraid of riots. We pointed out we’ve been delivering bags of rice in an open BUV with no problem but I’m sure tons is another issue. Maybe. As Pogo once said. I’ve met the enemy and they are us.

We have consulted Dr Rudolph at Bonnfine, the Admin of Bonnfine, Dr. Tenhaaf, The Army, the U.N., Jean Beaucejour, John Vrooman, and all of our team and all say ‘go’ for the trip tomorrow.

We’re taking every precaution.

We load at 5AM, drive at 5:30, arrive maybe 9AM at Leogaine where our truck supplier says we’ll find ‘lots of problems and injured people’

We asked around and the opinion of the pundits is that even though two days ago, we couldn’t take off limbs fast enough, they’re all healed suddenly today. Which the driver thought was amazing as he was there this AM. He said we don’t have to go to PAP to find badly injured people.

We are doing much planning.

We are taking the cot tops, 12 total to put across the bus seats to fill the gap in the seats for limb support, then tying up the second side to hold the injured in their bumpy seats.

We are lining each seat with a cut tarp for blood control.

Dave went to the coffin maker in town and bought wood for splints though Paul pointed out we can buy sugar cane on every corner cheaply and later eat the splints if we don’t use them.

Dave built steps to get up into the back of the bus.

A taptap is following us to carry extra family. We are taking a bike to avoid entering hospitals in the bus until we’re needed.

We are carrying water, oral electrolyte solution made from Tang, brown sugar and salt, bread, bananas for feeding.

We have coffee cans for urinals.

Everyone gets a phonetic name tag and a card for a chart to put down meds, food, and water plus known problems.

We found 3 duragesic patches, 12 toradol injections (we’ll give half and hope it’s enough), methadone, reglan, rocephin. Our 7 liters of IV solution, betadine, dressings, ace wraps, tape, rope, knives,

Most important is we’re taking the guy who goes every day to PAP, and the Police.

I am SO glad we brought a fireman now. Wayne has had great ideas on transport. Paul is assisting as EMT-B.

We have three doctor, Ann is Inventory control and knows all the gear inside and out. Matt is doing assessment and I’m starting IV’s and watching triage. Jan is trip leader. Two translators. Each extra body knocks out one patient.

I hope we’re headed home by 2PM, can unload the 10-15 most unstable patients at Tenhaff’s place then drive 2 hours up to Bonnfine with the other 20-35 to the two orthopedists.

Dave got the power saw working, went to the Savannette and made stretchers, found rope, made splints, and also got the first work done on the well and solar panels.

I’m making Tuesday our first rest day UNLESS this really works and is important. THEN we’re going back until we overload our system with patients, which may be one trip.

I hear great things about Doctors without Borders. They have pop up surgical labs, neat tools, lots of meds, anesthesia, and are getting lots done.

Today, Jan diverted a flight to Gouanave with aid. Also a plane crashed on landing with aid at Jacmel. No injuries, the plane died.


Dispatch #6

I guess the good news is the bad news. There were NO patients to move. We found Doctors without Borders from Paris also looking for cases. The big surgeries are all done or the patient could not last 13 days.

We visited three medical facilities areas and found no need. Doctors are pouring into Haiti

We started poorly. The bus arrived not at 5AM but at 7AM but we still made it to Leogaine by 10:30.

At Mirogaine, half way to PAP, we started to see major road cracks and one river blocked and occasional collapsed houses. But at 10 miles from Leogaine, it changed suddenly. Sometimes three or four houses in a row were gone, all the houses had major damage and having been inside some, we know that any visible damage from the road means the house is unsafe and ruined.

The roads are lined now with tents and tarps of those living outside.

So here we are with a bus that holds 65 people (100 Haitians since they don’t have personal space) and I called Pastor Joel in Leogaine. He met us at the orphanage where I began my work in Haiti.

I offered to transport the 59 orphans to Brad Reddick School, set up a feeding program, put them on our classes, and quickly finish the computer lab and workshop but instead use them for an orphanage until he can find a place. While he was moved. He felt it would be hard to move the children twice and also with so little notice so he is thinking about it.

We went and looked at the 17 machine woodshop tools that he was storing. They were mostly collapsed under concrete and destroyed minus the big wood saw. Pastor Neto, his brother begged me to let him have it to try to start a business during the rebuild so I left it.

We came away with two ideas. We think this idea of Medical, non-surgical people arriving early on the scene and transporting the injured to empty hospitals on the first days, not the 12th day, is a good model and this team is ready to try again if the demand requires it.

The second was that we we’re glad for a dry run. Practicing medicine in a lurching bus took practice.

This was a great group and very, very flexible. Blessed be the flexible as they don’t get bent out of shape.

Dave had a hard day at the school working on solar panels as we’re having problems with refugees to the desert. Many have moved back to the Savannette from PAP and they are hanging around knowing we do that kind of work and it’s hurting Dave’s efforts.

Benot and Pezzo had a great day again. 1200 people again got fed climbing off the buses from PAP and I am getting people who ask me about the program and thank me. It is very visible as it happens right in the square of town. Pezzo found another person, Wayne the fireman, who can do American Sign Language so we had another interesting evening with him.

I think today, Haiti turned a corner. It was a bit more like business as usual. The banks opened, stores opened, people were in the fields, and shops and buying and selling.

Jay Blog #3 Sunday 1/24

Jay’s blog #3


Don’t remember what I wrote, or where I ended. I’ll leave Jan to fix that. The days are blurring. Today is Sunday.

Late Friday, Ann and Matt, husband and wife Internist and Pediatrician, Wayne, the Firefighter, and Paul Davis (Jan’s husband and Team leader) arrived via Nassau. Many delays,

They got to the house by 4PM and MEBSH was SUPPOSED to pick us up at 5PM to drive a hard hour (More like 100 minutes) to Bonnefin (Good ending), the finest mission hospital in Haiti.

BF has fallen on hard times. 30 years ago, all the senators and rich went there for care. It’s own hydroelectric up in the mountains at, I’m guessing 3500 feet, it was steep, beautiful and a huge campus. The last coat of paint was maybe 1950. Every door and counter worn to nubbins. Ten years of bad economy and other factors drove off the docs and now it’s Dr. Belding, a brilliant dedicated Surgeon from the U.S. who comes in frequently and Dr. Rudolph, the finest Haitian physician, I’ve ever met.

They were joined two days after the quake by a pediatric orthopedist, a paramedic, a nurse and the five of them admitted and discharged 190 of 250 critical patients in 8 days doing 60 amputations and losing FOUR patients. Dr.Belding was flying out and I was being brought in to mop up post op and complications care with my team of three docs plus the rest of the team.

We arrived at 10PM, did rounds, went back and talked, slept, and in the AM, I awoke to a house empty of the old team.

We got up early, went to the hospital and NO STAFF. It was Saturday, they were tired, they have not been paid in 11 months and we had NO ONE. By 9AM a couple nurses trickled in and ignored us.

At 9:30, after 3 hours of unpacking and organinzing our supplies, we we’re called by MEBSH and told, we have a team of 21, with two orthopedic surgeons plus anesthesia (good luck, we’re out of oxygen and anesthesias supplies) and they’d be here by 10:30.

We sat and waited and at noon, decided to eat lunch, and if they no showed. Get to work. Ann and Matt went up to make rounds with Wayne, Paul ran supplies and Jan and I went off to do Admin.

I Found Dr. Rudolph asleep at home and asked if he could open some doors and he informed me that he had not been paid in 11 months. I knew this in advance as DR Tenhaaf, from DeSante Lumiere Mission Hospital who loves this man dearly had said he pay $500 US for him to stay for two weeks. The money did not arrive.

I handed him $500 in $20’s and he went to work. I want to be careful. This man is not a mercenary. He’s wonderful. But he’s exhausted, he can’t feed his family , he has a job offer, and can go anywhere that DOES pay and he had arrived at a natural time to make the decision.

Matt and Ann changed dressings, adjusted traction, accessed wounds, blood clots, lungs, fluid volume, IV’s, antibioitics and we worked until 4PM when two things happened at once. A clot let go and a women started bleeding out and the new team arrived.

I went to debrief them, tell them that they might want to fundraise payroll for the hospital staff and send the orthopod up to help Matt and Ann.

They we’re 21, they were 12, and the driver informed he was NOT going back down the mountain, wasting another precious day. I was NOT happy. Called all over MEBSH and an hour later, we’re on the road back to Cayes.

I showered (there was no water at BF so we we’re a bit ripe). Dave Kroeger, my engineer had arrived with the well head to get water to 5,000 people in the drought in the desert. He’s here to install the first of our solar panels. He brought in 100 doses of Tetanus toxoid (all the dead tissue is ahuge risk) and Ketamine for anesthesias, Versed for anesthesia and valium.

I left for Dr. Tenhaaf immediately as it was on ice.

My own team had discussed with Dr. Rudolph and the administator that all over Haiti, the teams are running out of patients. At 10 days, all Americans would be long dead but we’re still pulling out Haitians. But the ones with Gangrene or crushed extreminities are dying by day 10 so they either saw or surgeon or they didn’t.

Lot’s of missions teams are arriving just a bit late. PAP was a trainwreck and it was just too slow.

I Asked Dr. Tenhaaf and he also said he could do more amputations if we can find them quckly.

We decided last night, we’re renting a big bus, 60 seats (That holds 100 Haitians) and drive to PAP, Monday AM at the break of light, with out team, two translators, two Haitian Police, and a Taptap to follow to carry a family member.

We’re putting out house cots without legs across the seats (we have 12), and hand IV’s from the windows, give food, replcement liquieds like home made Gatorade, water, Injectable antibiotics, all the pain relief we own and make a run back to Tenhaff to give him the ten worst, then up to Bonnefin with the rest.

Amoce is working with Joel Beaucejour and a friend of Jan D’s from Christianville to talk to hospital administrators and we hope we can take the last lagging care back here.

Today is church and David and I are going to the little church that Elmore Church started last year. We’ll have maybe 50 people.Not sure where Jan’s team is going.

Then Wayne, Dave and I are going to the Savanette to get supplies for the bus and work on water while Paul and Matt and Ann and Jan pack for the bus trip.

Every once in a while, you hear someone call it a “roadtrip”

The refugee center is full to overflow and While gone, We paid to put 150 more people in a bus to Jeromie where they have family.

Jan N. flew in 2500 lbs of rice and beans and oil the day we ran out of food and that BUV arrived to cheers from staff and visitors. We got 50 more tents,

today, we are supposed to get 1900 lbs of meds and supplies I ‘ordered’ from the US. That Jan N. somehow got over night and put in our plane.

I got a txt message last night that we have plane load of rice and beans coming daily for the next five days, Sounds like Jan is getting really good at this.

Benot continues to feed about 1500 people getting off buses at the police station.

Tomorrow will be interesting to say the least. We will be stuck again in BF, and all day we’ll be walking on top of the seats to get from one patient to another. Reaching down to hand out urinals (coffee cans), change IV’s, give out pain pills, nausea shots, food and reassureance in a lurching bus.

We are rested and ready as we can get.

Six year old amputee

At Bonne Fin hospital this morning we gave toys to the kids in the pediatrics unit. 8 kids, 2 amputees. Others scraped up badly and broken limbs.

Now a change in plans. Moving back down to Cayes to Centre de Sante Lumiere because a team of 21 surgeons, anesthesiologists, etc are arriving in a couple hours. Haiti is operating on an hour by hour schedule. Read blog later for more info.

Toledo Blade 1/24/2010

Article in Today's Blade about relief efforts of local groups in Haiti:

http://toledoblade.com/apps/pbcs.dll/article?AID=/20100124/NEWS16/1240306