Last Wednesday afternoon, the prenatal nurse, Lori and I sat down with a 15 yo girl who was in for a visit. She had been seen several months ago for her pregnancy and for several reasons, including her age was identified as high risk and encouraged to come back with a family member so the nurse could work with them during pregnancy. The area we are in is very rural and the closest hospital is about an hour away. They wanted this young mama to be to establish care with the hospital so when it came time to deliver she would be accepted and have a chance at a safe and healthy delivery.

The young girl disappeared for awhile and had not been coming for care. The staff here spent quite some time trying to find a neighbor or family member who might know how to find her. They finally got ahold of an aunt and the young girl came back last week for a visit, by herself. When we sat and talked with her, we stressed the importance of coming for care and wanted to know who was responsible for her and who would be supporting her during the birth and after the baby came. We told her we loved her and wanted to do what we could to help her, but that every woman needs a support system. In her immaturity, she was unable to give us much helpful information but ensured that she would come back the next week with an adult.

This Tuesday afternoon, clinic was running normally when the gatekeeper yelled to Lori that there was a pregnant woman coming in who was not good. I ran out in the yard to find a several people carrying a pregnant woman who was not responsive. The laid her on the ground and I took a quick glance between her legs to make sure there was not a baby coming. I could tell she was not well and they were yelling that they brought her in because she kept passing out. We all went into emergency mode and got her into the dressing room. I checked her and established that she was definitely in labor but not close to having a baby. As we were attempting to get a blood pressure, she started seizing. After stopping and taking a closer look, I realized that this girl looked very young. At that point the prenatal nurse came in and we realized that the patient was in fact the young girl we had seen last week. Thankfully we were able to get and IV and some oxygen while drawing up some magnesium sulfate to treat the eclampsia. Her blood pressure was severely elevated and thankfully we had some IV medication we could give for that.

After she was stabilized, we started to come up with a plan. We would need to transfer her to a hospital that is about an hour away to be delivered urgently. Everyone started mobilizing but no one could find a car in the village who could take her in. Lori called the governmental ambulance service but they informed us that the one ambulance for this area was taking someone into Port au Prince and would likely not be available for a couple hours. They asked if we could wait until then. Ha. Thankfully someone was able to take a motorcycle to the next town in and find a car to come out and get her. It was about 30 minutes before a car was able to come for her. Thankfully in that time she did not have any more seizures and I was able to get good heart tones on her baby. We worried about the car trip in, but did what we could and made an IV bag of medication that could be given while they were riding. We wrote a referral letter with her chart information hoping that the hospital would receive her and urgently get her delivered. We saw them off in the back of a truck and hoped and prayed God would protect this baby and mama until they could get care, but honestly we would be surprised if either one of them would come home alive.

What most of you don't understand is that eclampsia is a sever life threatening emergency of pregnancy for both mom and baby. If this incident took place in the US, we would have been back in an operating room and the baby would have been delivered by c-section in 5 minutes.

Yesterday, we did not hear anything from the family about what happened, and we assumed the worst.

This morning, the prenatal nurse had heard through the grapevine that mother was indeed alive and the baby was alive but in an incubator. We were shocked and thoroughly surprised. I had gone upstairs for lunch and when I came down to the office this afternoon everyone was quiet and said we have a surprise for you. I looked in Licia's arms and realized she had a baby in her arms. A big, healthy baby boy.

Here is what we know about what happened between Tuesday afternoon and today. Mom and baby made it to the hospital one hour away where they were told that she was too sick and they needed to go into the government maternity hospital in Port to be delivered. The extended family member who brought the baby said that mom had a vaginal delivery, and by the baby's bracelet we realized it's time of birth was 7:10 on Wednesday morning. Mom is still in the hospital but the "machines" for the baby broke today so he was discharged and told to go back to the clinic that helped them before.

Y'ALL. This is nothing short of a miracle that both mom and baby are alive today. The chart said the baby had meconium aspiration and antibiotics had been ordered. He looks great for us and we will keep him here until mom is discharged and we can make sure they are both safe to go home. I don't pretend to understand the broken healthcare system here in Haiti and why the delivery was so delayed. This is why maternal health matters so much in this country. It's overwhelming to think that this is just one story of thousands of mamas who will deliver in Haiti this year.

For the moment we are rejoicing in His goodness and soaking up all the snuggles with precious Samuel.

Last Sunday afternoon Lori, Licia and I were sitting in the office chatting when the gatekeeper told us there was a sick child outside the gate. Sunday is not a normal clinic day, but the doors at Real Hope for Haiti are always open for urgent care. When Lori and Licia went to the gate, they found a small group of people on their knees praying for a very fragile baby. They took one look at the baby who was pale and breathless and ran back with it to the dressing room and yelled to me to come, "the baby is almost dead." We immediately starting working to get an IV, raise his glucose and put him on oxygen. He had to be stimulated just to breathe every 5 seconds. The baby's mother sat outside the door praying and terrified that her baby was dead. None of us would have believed that 11 days later he is still with us.

Over the next couple hours we sat close, helping him to breathe and learned more about their story. Mom had been to church Sunday morning and some people at her church saw how ill her child was and had heard of a clinic in Cazale that helps sick children. Jolicoeur was born in late January at full term, but has always been small. Mom breastfed religiously but says he has never grown and began to have swelling just a few weeks after he was born. In the week before they came to us, the baby became very sick and stopped taking breastmilk and Mom knew it was time to get help. She spent several days going around to different pediatric hospitals in Haiti, only to be turned away because there were no beds. On his first day with us he weighed 4.1 pounds at almost 4 months old. He was severely dehydrated but his hands and feet were shiny due to serious swelling from malnutrition. He was obviously extremely anemic and has a severe heart murmor. Since that day, he has been stable with oxygen on and continues to breastfeed with supplements through an NG tube. His glucose and fluid balance is constantly monitored and he is up to 4.8 lbs with a decrease in swelling. We are hoping we can continue to get him well so we can send him in for a referral in the coming weeks. 

His mama has stayed very close by his side since the moment they came. She is steadfast and loyal and loves this baby boy so well. We have enjoyed getting to know her and hear more of her story. She is a single mother to 4 other children, her oldest is 16 and the youngest is 2 1/2. They live in a small house in a part of Port au Prince called Canaan. This area was originally a tent city after the Earthquake in 2010 but more permanent houses have been built there now. Since she has been here with Jolicoeur, her 16 year old has been taking care of the other children. On Monday afternoon she called her family and heard that the wind from the storms had blown the tin off the roof of their house and her kids were having to stay with neighbors. She was very upset by this and had to leave Tuesday for the day to go in and check on them. They are all in school at this time so it is important for them to stay there, but she obviously feels the pull of needing to be here with Jolicoeur, as the breastfeeding is crucial if he is going to have any chance of surviving. We have no idea how long they will need to be with us.

I am so amazed by this mother's sacrifice and her fight to do what she can to care for her kids. I would love to be able to bless her with the funds to repair her roof and make sure her other children have a safe place to stay in while she is away. We are in need of $300 for the materials, labor and transportation to cover this for her. I'd love for you to pray for this family and if you are in a position to give money, I know this mama will be overjoyed. 

You can click this link below and give via Paypal to Real Hope for Haiti and your donation will automatically go toward this need specifically.

Little ones to Him Belong

It's late and a rainy breeze is blowing through the open air windows and I can't fall asleep.

There is a line of people sleeping outside the gate who are waiting to be seen in clinic tomorrow, hopeful for healing.

And there is the body of sweet baby girl, bathed and dressed in a white dress who took her last struggling breaths in my arms tonight as I rocked her and sang to her about the hope I have in Jesus.

I get to share in lots of joys when I am in Haiti. I love this country, the vibrant people, the colors and the smells.  There are births and beautiful babies and recovering children and wounds healing and I get to use skills that are long lost at home. I love the adventure, the challenges, and my dear friends who live here full time and the wisdom and grace that just oozes out of their lives into mine. I love how being in this country makes me brave. The joys are some of the highest I have ever experienced on earth. But these joys come with unbearable loads of heartache. Life in this country is complicated. It is twisted and backwards and unfair and maddening and it begs me down to a place that I don't often go where a deep groaning in cries for His redemption.

Baby girl came to us late Thursday afternoon with her young mother after being referred by someone who recognized the gravity of her condition. She was 7 months old and wasting away, severely dehydrated and struggling to breathe. We immediately got to working on her, and Licia with years of wisdom took one look at this child with her mouth full of thrush (a fungal infection) and said "We need to get an HIV test." Two solid lines, clear as day. Our hearts sank and we immediately started thinking about her mother, who was 20 years young, bright and healthy, and hopeful for her only child to be rescued. The staff gently pulled her aside and counseled her, she was unaware of any existing infection and stated she had been breastfeeding her baby since she was born last fall. Two solid lines, clear as day. I would like to say "as you can imagine" but I'm not sure you or I actually can imagine. She was devastated and hysterical and confused and frightened and alone in a strange place with her dying child. She wanted to leave with her baby immediately, she just could not begin to process all that was going on and she certainly could not be dying herself of HIV. The staff was kind and gentle and respected her privacy but explained to her that her baby would likely not make the trip home and if she wanted, we would do what we could to save her. She could stay or she could go and come back at any point, but we wanted to give her baby girl a chance. She agreed to leave her baby and got a phone number where she could reach us. We stabilized baby girl but it was very clear to us all that she was still dying. We prayed for minimal suffering, but also hoped for some peace and reconciliation for mom. She would go home that night and talk with Dad. The next day called several times throughout the day to check on baby. We reported that she was stable and hoped they would come to visit. She and the young father came on Saturday morning and spent a few minutes with the baby, but did not touch her or talk to her, they just watched. I imagine they were and still are grieving how their lives' took a most devastating turn in a matter of seconds on that Thursday afternoon. We have not heard from them since they left. Baby girl struggled over the weekend and it was clear this morning when she started having seizures that the end was close. We did our best to keep her comfortable today and as it neared tonight, I held her and rocked her just hoping she sensed that someone was near. She was fighting hard for air for what seemed like eternity and then finally she was still. No more struggle, no more pain. Her little body that has only known disease in her short time here is finally whole.

Last week I caught a baby who was born severely premature and had a difficult entry into this world. We worked to resuscitate him and got him stabilized without the luxuries of NICU full of equipment and staff. It was exhilarating and miraculous and we were so grateful for this little life God gave us. Baby was doing okay and for many complicated reasons we decided the best thing for baby was to go home with mom and dad who were equipped with all the tools we could give them to care for him. A few days later, baby Wesley died at home with his family in the rural mountains of Haiti.

Complicated, twisted, backwards, unfair and maddening.

The paradox of the joys and heartaches I experience in Haiti is where life is born for me. I love God and sense his unmatched graces in the most real way. I know Him deeper and want to taste every bit of beauty and joy this earth has to offer because He is so good and He is so near to us. And yet, I long for heaven and His ultimate and eternal healing because this world is broken. His beautiful creation and the people He made in His image are groaning for new life, a whole life, apart from this brokenness. He promises us that and all those promises are made true in His son Jesus.

Little ones to Him belong, this is my only hope.

A sack of eggs

To understand the gravity of this story you must go back and read the story of this birth that took place a year and half ago. At the time of the birth, I knew that I had no idea what I was doing. Then I went to Midwifery school and realized that I HAD NO IDEA WHAT I WAS DOING. But God was merciful to us on that day and brought that precious life into our hands. Not a day has passed that I don't think of sweet Jesula and I love my Jesus more.

Licia surprised me this week by giving Jesula and her mom an appointment to come to clinic while I was here. Jesula was dressed in her best white dress and frilly socks for this special occasion. I can't explain the joy in seeing this precious and healthy baby today. Then mom whipped out her boob and started breastfeeding her and it was like total Midwife ecstasy. Not that I am responsible for her continuing breastfeeding for 18 months, but I'd like to think that getting her started those first two days helped. We got to spend some time together and Jesula played and laughed and walked, things I never ever thought this child would do. They passed through the clinic and then we went to snap this picture, but Jesula had fallen asleep so she doesn't look too happy. I promise there were many smiles.





While this was such a joyous reunion, it was also one of the most humbling moments of my life. One of the times I walked past them while they were waiting today, Jesula's mom grabbed my arm. I turned to her and she reached in her bag and handed me this sack of eggs. You see, this is her incredible gesture to say thank you. To me and to Real Hope for Haiti and to God. I froze. How could I take eggs from a poor Haitian woman who lives way up in the mountains when she could feed her family for days on this precious resource? I can't even quantify what this gift would translate to in the world you and I live in. I don't think twice about getting in my SUV and driving to the store to purchase a dozen eggs at home. I couldn't help but think of the woman who poured out her expensive perfume on the head of Jesus. To those watching it seemed silly to waste it when she could have sold it and made more money, but Jesus saw her humility. I told Lori and Licia how uncomfortable I was accepting the gift, and they quickly reminded me to humble myself, for I am no better than this woman with the eggs. We both need Jesus the same.



Lord, I pray for less of me and more of you.

Being with woman in Rural Haiti

Being a Midwife means a lot of things to me. It literally translates to mean "with woman" and being with woman looks different everyday. Sure it means getting to attend births and sharing in the joy that is new life, but sometimes it means screening for cancer, helping women make choices to plan their family, or prescribing blood pressure medication. Other days it means listening to a women who carries many burdens, educating women on protecting themselves in relationships, or walking with a family through the loss of a baby. It means championing efforts to promote healthy lifestyles, healthy families and healthy communities, because women are worth it.  Here's a glimpse of what being a Midwife in rural Haiti has looked like this week.

Each month a new education topic is chosen for the bulletin boards in the patient waiting area in the clinic. Roughly 800 patients come through the clinic each week and as they pass through the line to be seen, a staff person gives a 15-20 minute talk on something relevant to public health education. This weekend I wrote some material and gathered information to create a presentation on "Danger Signs for Pregnant Women." I gave the first few presentations with a translator yesterday so that the staff person could learn the material and now she will give the talk for the rest of the month. We covered topics like eclampsia, hemorrhage, labor dystocia and signs of infections. The majority of women here give birth at home, and most births are not attended by anyone with skilled training. The challenge for me was looking at prevention of  obstetric emergencies and how you deal with them in a place with very limited resources and access to a higher level of care. We work with a very rural population and the closest hospital is 1-1.5 hours away, which makes dealing with potential emergencies very difficult. The best treatment in these situations is recognizing the danger signs early enough to get to a place where they can be taken care of.

One of the patients asked me in front of the group what to do if a woman who lives in the mountains is having a baby come with the feet first? Being from the mountain means you are anywhere from a 1 hr-10 hr walk from the clinic here and even further from a hospital. This is a small glimpse of the dangers women face in Haiti. Praying that this teaching will fall on ears who will share what they have learned and it help save lives of women and babies in Haiti.

Let's catch up

***Don't scroll down if you can't do blood and guts

I have sat down to write an update several times since Friday and each time something more important came up. The weekend was good. I got to work with the community group in their nursery on Saturday cleaning up and filling sacks where seeds will be planted to grow trees that will eventually be planted in the community. That afternoon we went up to the new land to see the progress of the new Cholera Treatment Center which will open very soon. It was overcast that day, but from the back of the CTC you can see this beautiful landscape and the Caribbean Ocean on the horizon. I love the peace and quiet in that place and look forward to many more evenings watching the sunset from this spot.





We have a kiddo who was burned over the weekend after he pulled a pot of hot cereal on him. Sweet thing is the stinking cutest kid and he is already healing nicely but would you continue to pray for his pain that it would be minimized and that he his wounds would continue to heal.



Saturday night we lost sweet Pearalson who was admitted last week. He had severe kwashiorkor and even though all of his fluid came down, his little body had just been through so much that he was unable to recover.

Sunday was spent taking care of the ICU kiddos and a few cuts that came in, and working on an education project I will share later.

Monday was the day of nasty cuts to be sewn up. First thing was a bad machete cut to the hand that a visiting doctor worked on. This little lady fell down and it her face on some kind of branch or stump. That long skinny piece on the left side of the cut is a vein. She busted through all the way to her gums and it took quite some time to clean out all of the pieces of wood inside the cut.










The day was crazy busy and as we finally sat down to do some work last night, an old lady came in who had fallen at her home. She knocked her head pretty bad and kind of made us worried she was having a stroke. She follows here in the clinic for high blood pressure so we kept her overnight and she was well enough to go home this morning.




And the best news of all is that while I was doing some teaching this morning, Licia came and told me that one of her ladies who works in the RC was in labor and she was going to come over. A few minutes later I saw an uncomfortable pregnant lady heading for the toilet. Let's just say I have learned enough to know that means grab your gloves and follow her. She was already pushing and by the time we got her up on a bed the head was on the perineum and we had a beautiful baby girl just a few minutes later! In true Haitian style she recovered and got up and walked home an hour later. This was baby #51 for me and my first baby as an official Nurse-Midwife.

I walked back up to the house to eat lunch after the baby was born and when I walked past the ICU I saw a woman sitting in a chair with empty arms sobbing. She came to visit her baby and found that her Pearalson had died over the weekend. Such as life is in Haiti, the land of contrasts, that in a moment you are celebrating life and the next you ache for the starving child and his mother who simply couldn't feed him. This doesn't ever get easier. Pray for his sweet Mama who goes to sleep tonight without her baby.

In other news, Trey found a baby chick and adopted it for a day until the owner came looking for it.

Wensky

Nadia had a good day and is eating really well. I even got a few smiles out of her after sneaking her some ice chips.

Meet Wensky. He has had a really hard life. Both of his parents are dead and he has two siblings that he has not seen in years. His mother was sick for a long time and was told her illness was not one for doctors but for a Voodoo priest. She died from HIV under their care and Wensky was living with cousins when he became sick a few months ago. He was told to go to the same place his mom did, but he did not want to so 12 year old Wensky snuck on a boat from the island of LaGonave with only $2 in his pocket and found some of his mom friends to help him. He was brought here to Real Hope for Haiti a few weeks ago where they discovered that he too is HIV positive. He weighed 36 lbs and was very near death, unable to walk. He began to eat more and get better little by little, but last week he came down with one of the worst case of shingles I have ever seen. His poor little body is so immunocompromised that he has had a horrible time with it. He is in an incredible amount of pain and has spent almost all of the last few days in bed. We have tried to keep him comfortable with medication so that his body can rest and try to heal.





Pray for sweet Wensky that his pain level will come down. Pray that he will be well enough to go in for further testing and begin ARV treatment this next week. Pray for his appetite, and mostly pray for his little heart. In his 12 short years he has been through more than most of us will experience in a lifetime and we are praying that He will come to know how much God cares for him and how precious his life is.

the same Haiti

I am here in Haiti and I want to spend the next week or so telling you some stories, but I need you to know something first.

I need you to know why I have kept this gut-wrenchingly personal but deliberately public journal through the years.

I have written for myself as a means to process all that I have experienced. I have tapped out my joys and sorrows on a keyboard just to put them somewhere outside of my heart. I also write for you too, because I think it is important that you know about this place. I write to connect you to the amazing people I get to serve with, to tell you about the atrocious things that happen to the people here in Haiti and to tell you about how I experience God in ways I never have in America. I write to advocate for the Haitian people, because to keep the injustices of everyday life here a secret would be wrong. I hope to be a voice for those whose stories should be heard and I hope you’ll ask questions like why are things like this happening in the world and what can I do about?

But more than anything, I write and share all of this to make most of our God. If all this blog does is make you think “oh those poor people, what a good person she is to go help them” then I will have failed. I invite you to read and engage and be so moved that you must take another look at Jesus. You may know nothing of this person Christians call God, but I hope to show you a glimpse of Him through these beautiful people. That’s really what I need you to know.

So, I’d like to tell you some stories…

It’s been a year and a half since I was last here and some things have changed but most are still the same. The same feelings of excitement I have felt each time I have flown over that crystal blue ocean and landed on this island came flooding back. The sites and the smells and the faces brought so much joy as we drove the same drive out to Cazale I have made dozens of times. There are a few new landmarks, but I still remember each curve of the road to get here. After saying hello and hugging my favorite people I went to get some water upstairs which of course means I have to walk past the ICU kids. And as quick as the excitement had come so it left, and my heart sunk into that deep place I don’t even know exists most days. Twenty or so precious little ones whose bodies fight severe malnutrition, TB and HIV suddenly before me. My eyes are immediately drawn to a small one standing next to the bed of a critically ill teenager here recovering from TB. The teen girl is writhing in pain and wrapped under three blankets in this ninety degree weather. The small one stood and stretched out a small limb and small fingers wrapped around the hand of this teenage girl, as if dying for any human connection. You see the small one is called Nadia and she was brought to the clinic on Tuesday and admitted for severe malnutrition.



    

Her eyes are sad and her solemn face doesn’t begin to tell the story of what is going on in her body. Her thin, fragile hair reveals how long she has been hungry. She is small but her molars give away her age. She is 2 years and 11 months old and weighs 16 lbs. She has 2 sisters and one brother that has died from diarrhea. The day before she was admitted she only had cheese puffs to eat. Her parents brought her to Real Hope for Haiti in faith that she could be healed.

 

I would love for you to pray with us for Nadia, that God would restore her health and she would know how much she is loved. I am so grateful for the nannies in the Rescue Center who love these little ones like their own and I pray for sweet Nadia’s heart while she is here away from her parents. I can’t imagine the sad and scary place she is in right now, nor can I imagine what her parents have experienced leaving their child near death in the hands of other caretakers. She has an awesome appetite and I quickly discovered that she is a sassy little thing, praying that it will help her to fight.

Thanks friends.

Carrying on.

I'm back in the States.

I HATE leaving Haiti. There is never a good time to leave and I am never ready. There are still so many needs and so much to be done. Mackens is fighting hard for his life today and I'm not there.

Thankfully, there are some who have committed their life to this. Licia will fight alongside Mackens today. The rest of the staff will continue to fight everyday for their community in the clinic, the Rescue Center, the Cholera House, the Community Group, School Sponsorhips and more. From here we can join them in prayer and spirit. We can advocate for the poor and we can give our time and our resources so they may carry on. Let's carry on.

I'll leave you with this video I was unable to upload while in Haiti. This is about an hour after Jesula was born. Such a sweet sweet memory!

Untitled from Caroline Tigner on Vimeo.

And now back to my regularly scheduled un-blogworthy life. Until the next trip, y'all....

Sunday Sewing

Yanick has the education of a 4th grader. And she can suture like a boss.


*heel caught in the chain of a motor cycle

critical kids, critical prayers.

WARNING: I don't have password protection capability on this blog, so I am telling you right now if you don't want to see a severe burn, please stop reading, move your mouse to the X box in the corner of this page and resume your normal web surfing activities....

Last week Licia and I were talking about how God has been so good to us because things have generally calmed down since Lori and all of the other volunteers left. We have had fewer patients and more help in the cholera house and virtually no critical kids. It was a blessing to have so many extra hands when we had lots and lots of sick kids a few weeks ago. Now don't get me wrong, God is still just as good to us as He was last week but we now have several very sick kids who require lots and lots of care. I am writing about them today to ask you to get on your knees on their behalf.

We have had several bad days with Macken, he won't eat anything and wouldn't drink anything at all so I (painstakingly) decided to put an NG tube in. He HATED it and he hated me for putting it in. I wanted to try and get some calories in and get his Kwash down and not let his sugar drop. Instead, he puked violently and could not get used to having the tube in. He got super dehydrated and I had to put an IV in his scalp because his limbs are so swollen from the Kwash. I took the tube out yesterday morning and he has done a little bit better, keeping down some liquids. He has also had high fevers off and on. Please pray specifically that Macken will start to eat.

He's kinda cute, huh?



This is Rose Marie. She is a 7 month old who was in the Rescue Center and then got cholera 3 weeks ago. She recovered from the cholera and was back down in the RC, but got really sick on Thursday. We are really not sure what is going on with her except for high fevers and severe respiratory distress. She is on oxygen and is not doing well at all, I was really shocked she made it through the night last night. Please pray for that her fevers would stay down and her lungs wouldn't have to work so hard. Also, those are frozen water bottles next to her, to keep her temp down.



Ludes was being treated at the cholera house and came down with something last weekend and is very very sick. He has had severe seizures and has basically been in a coma for the last week. His Mama and Papa have been close by his side all week. We are working with Dr. Jen on a plan for his care so will you pray for wisdom for us and pray that he would respond quickly to treatment.



This little girl came to us on Thursday night. She lives very very far away and traveled 17 hours by foot, tap tap and moto with her mom and aunt to come see us. 6 Days before she was in her house and her older brother was playing with matches. He burned his finger on a match and threw it out of his hand. She was laying on the ground with her little sister on her stomach and the match landed on top of them. She threw her sister off and her dress caught on fire, she jumped up and tried to put it out with her hands. Her mom came running in and threw water on her but not until a large portion of her trunk had been burned. They tried to treat it with some homemade medication up in the mountains but heard about a place in Cazale that helps children who have been burned and decided to head our way. Praise God they did! This burn is very severe and is showing some signs of infection so we are getting her covered and will be glad to have Dr. Jen here next week to get us going on a long term plan for her. She is really doing fantastic considering and has the sweetest spirit. When she told us the story of what happened, she said "I saved my sister, you see she is so little she would have died. God chose me to burn and that is okay." Please pray for her recovery, pray for her pain to stay minimal and pray for no complications in her treatment.

The first night she came in.



After her second dressing change. You can bet I wouldn't have a smile on my face.

one day last week when things had calmed down we went for a walk.















I love being out here in the mountains where the people live such beautiful, organic lives.

Macken

I hate Kwashiorkor. I hate malnutrition and I hate the poverty that causes it.

Macken and his Papa came to the clinic today. Macken lives with his Papa, his parents are no longer together and Mamma has moved on. He was seen back in March in the clinic and had mild Kwash in his feet so as procedure goes, his Papa was given all the education about what to feed him and how to care for him. He was told to feed him foods high in protein, eggs, beans, peanut butter etc. He went home and he did what the nurse asked and Macken got better for a little while. In the last few weeks his Kwash got really bad and Papa tried some herbal medicines and then took him to see the voodoo doctor. The doctor gave him no answers so he carried Macken down from the mountains to his Mama, who declared that she didn't care what happened to Macken, she is now pregnant with another man's baby and doesn't want anything to do with him. Papa told us he brought him to Real Hope for Haiti today to "see what God could do."







Macken is adorable and my heart aches for all of the pain he is going through. His arms and legs are so incredibly swollen and have open sores in many places. He was totally distraught when his Papa left today and kept walking around the clinic looking for him. I had to stop letting him walk in real fear that his feet were going to bust open.

Please, please pray with me tonight for little Macken. Pray for his little organs to recover from this severe disease. Please pray for his little heart, that he would know how much his Papa and all of us who are caring for him love him. Pray for his Papa, that his heart would be moved to know God more through this. And I'm going to pray to our big God who can do big things that his Mama would have a heart change.

Fabienne

Baby Jesula

Yesterday morning we said goodbye to baby Jesula and her Momma. I selfishly wanted them to stay another week just so I could hold her longer, but it was time for them to get settled back at home with their new family. We were able to print out all the photos of the birth and after for Mom who will always have them to remember God's goodness to us on that day.They made an appointment to come back to the clinic on Sept 1 for a check-up. As they were leaving mom said, "i'll come back next week if you want to, just so you can see the baby." She could tell we were a little obsessed...

I love this picture because Jesula is screaming her head off and let me tell you a scream from a baby never sounded so sweet to my ears.



Grandma, Mom, Baby Jesula, and Momma's sister. Beautiful, beautiful women!



Baby Jesula,

We love you and will always stand in awe of the way God miraculously brought you into our hands. I pray you come to know your Heavenly Father and grow into your namesake telling all the world, Jesus is here.

Jesus is here.

Caution: this is graphic. If you were uncomfortable in your 9th grade Biology screening of "the Miracle of Life" let this be your warning….

At 3:00 yesterday afternoon I had a few problems. We were trying to prepare for Emily, stalking all the weather news, preparing the houses to hold all the extra people, storing enough clean water etc. Hannah (another volunteer) and I were having the hardest time covering a table in contact paper. Too many stinking air bubbles.

At 3:30 I heard Licia's yelling voice from the clinic yard, "CAROLINEEE" (a little panicky) and then I had a few more problems. Two specifically…

A mother in labor was being consulted by the momma and baby nurse, Bernita. She told Bernita that she had been having labor pains since 4 a.m. and started pushing without any progression. Her previous 3 children had come really fast so she was alarmed and had a midwife come who told her to go to a hospital. Mom and Grandma get on a moto and ride 3 hours (YES, I SAID 3 HOURS) down from the mountains. In labor. On a moto. They didn't get a hospital when they came to us, but they had nowhere else to go. It was clear by the time that she got here that her contractions are one on top of the other so Bernita puts her on the table to check her and when she does something doesn't feel right and the fluid mom was leaking was green. This is what Licia tells me as I'm running across the yard. Okay, hmm so that sounds interesting.

I like labor and delivery so I yell at Hannah to come down and help because we get to deliver another baby, yay! Let's get mom up on the table and see what's going on. I check her and sure enough baby has passed meconium (baby's first poop for all you 9th graders). And sure enough something didn't feel right. Babys pass meconium in utero most often when they are in distress. I am not a midwife yet. I am not an L&D nurse or an OB. I know enough to know that what I am feeling is not a head or a foot, but I can't tell you much more than that. Okay, so what are we going to do here? I have never delivered a breech baby. Lori is somewhere between Texas and California. Licia knows accounting really really well and has helped Lori birth some babies in the past. Yanick is the best non-nurse suterer and IV starter I know. Hannah is a very eager, very helpful college student. Bernita and I are technically the only trained medical professionals.

Momma's contractions are getting closer and stronger and she is looking like she is going to push. Our hearts beat a little harder and we breathe a little faster and Licia looks at me and says "we're in trouble here." Great, got that. Now what? The closest hospital is a two hour drive away. We both start to talk out loud, racking our brains for what to do. We finally get a glimpse as mom starts pushing and all we see is blue blue skin. And more meconium. The out loud rambling between me and Licia goes on, something like "okay calm your breathing, let's not freak out, what can we do?" Mom is pushing and hollering, grandma is crying waving her arms in the air. The name of Jesus is then envoked thousands of times over the next 2 hours. It is all sort of a blur but I will try to piece the next few minutes together.

Basically as mom is pushing out pops baby's blue butt. More meconium. None of us can get a finger around any other part of baby. We are stretching mom and yelling PUSH! PUSH! Out pops little girl part. She pees. PUSH! PUSH! Stuck, not budging. More stretching. More hands trying to get around any part of baby to help pull her out. Shoot, this is already taking way too long. PUSH! PUSH! Out pop's a very blue, very floppy leg. More stretching, more yelling, more Jesus. Licia screams out the door of the dressing room "everybody come pray!!!!" The entire staff crowds around the room, peeking through the window singing praise songs. PUSH! PUSH! Baby girl's abdomen comes out and we see her take a breath. PRAISE GOD! Now Jesus, get that baby out. More stretching, more pushing, and nothing. I try to reach in and grab an arm but can't get ahold of anything. Baby girl's shoulders were stuck with her arms above her head. JESUS! Mom has to rest between contractions and we are just losing time. JESUS! At one point, there were multiple hands inside momma trying to get a hold of her shoulders to pull her out. One very blue, very floppy arm is delivered. Another very blue, very floppy arm is delivered. I will never in my life forget the next few moments that seem to last for eternity. Baby girl's entire body was delivered except for her head, momma was exhausted and could hardly push anymore. We stood and watched baby girl's ribs rise and fall with every breath she tried to take. It has been minutes and we cannot get the head out. We try to turn baby around. We open mom's hips wider. Nothing. Licia looks at me and says "I can't do this." We were watching that baby die before our eyes and now have a mom who is at very high risk of losing her life. There would be no way to send mom in town if we were unable to deliver. JESUS. No signs of baby breathing anymore. Mom is starting to bleed. We have to get baby out. Let's get her up, let's get her squatting. It takes 4 people to get mom squatting on the bed. And with a few really good pushes the head comes out.

The little blue baby girl flops on the bed, nose and mouth full of fluid. My first breech and my first stillborn, I thought. We flip her upside down and I get underneath with a bulb syringe sucking as much out as possible. With the other hand we are slapping baby on the back trying any stimulation. Nothing. Thank God for the other women in the room because I completely forgot about mom. Nothing from baby. I probably said "come on little girl" 100 times. After a minute or so, we started CPR and had a good heartbeat but still no breathing. After 5 minute I was this close to saying "we're done" and then a tiny little gasp from baby girl. We stop and look at each other. Was that a breath? Licia yells "everybody pray for the baby." The voices singing praise rose and the rain came down hard. We could hardly hear each other's voice. We continued to give 2 breaths for a few minutes and she began to breathe every 20 seconds or so. We continued stimulation, warmed her up and got a the suction machine on. The gasps got closer together and before I knew it she had a steady respiratory rate. We put her on a little oxygen and though her limbs were still very blue and she had no tone, a little glimpse of hope stirred in our hearts.

Meanwhile, mom was bleeding pretty heavily. The other nurses gave her pitocin and started IV fluids and she began to regain her strength, eyes fixed on the baby between her legs God was saving. Licia had to run out the gate to give some medicine to someone and she came back with tears filled in her eyes. There were 75 people outside the clinic gate with their arms in the air praying for baby girl. They all wanted to know if she was alive. YES, JESUS she was alive. Over the next two hours we slowly watched her come into this world. With every faint cry there was a celebration. After an hour she opened her eyes and we all cried Jesus.

After a couple hours she was starting to pink up and gain a little more strength. Her cries became louder we decided to call our favorite and very available pedi guru, Dr. Jen. I had not been able to think past getting her to breathe so we wanted her help in knowing what to do next. She suggested an IV with some fluids with a little dextrose, since you know, little girl had been under a little bit of stress today. By 8 pm last night you would have never known what little girl had been through, she looked amazing and was even smacking her lips to get her momma's breast. I woke up every two hours last night to check on them and was continually amazed at how well she was doing. Mom was gently holding her and feeding her as she cried. A scene only hours before I thought was impossible.











This is the beautiful, perfect, non-bruised face of a baby who did not come down the birth canal head first :) Instead she has tons of bruising on her butt and shoulders.



All day I had been occupied by the impending storm and though the sky looked like this outside, inside the dressing room Jesus sweetly whispered to me "Child, I've got this."



In all the madness yesterday, Yanick suggested that we name this little girl Jesula, which means Jesus is here. Because He is.

You can read Licia's version here.

more calm, less storm please

I was thinking gosh, the last few days have really been calm, what should I write about? And then I remembered all the things I haven't told you yet.

On Sunday night, just after the sun went down, the heavens opened up and a big storm blew through. The thunder and lightning kind of storm. The only nurse who was working up at the cholera house called and yelled into the phone come quick, a 7.5 month pregnant lady is having pains and pushing already. Lori and I ran around like idiots trying to grab the necessities like shoes, a light and all the birthing stuff. The truck got stuck going up the road the night before because of rain so we knew we would have to hike. We threw on ponchos (which turned out to be kind of a joke) and set out across the river and up to the house. Before we got out the gate, the nurse called again and said the baby had come but to hurry because mom was bleeding a lot. We were hurrying as fast as we could but again with the jokes as it is raining so hard I can't see my hand in front of my face. Mudslides everywhere and guided by the light of a little headlamp. I laughed out loud several times thinking how can I actually be living this right now? I got up to the house first and found a crowd on the porch hovered over mom and baby. I was shocked because this woman had been in the cholera house for several days and was very very sick (on her 47th bag of IV fluids) and we had no idea she was even pregnant. I grabbed the clamp, cut the cord and started working on baby, who for only 7.5 months gestation looked to be decent sized, but had a very poor cry. Lori worked on mom to get her bleeding under control. We moved them into a small private hallway and got settled but the baby was not looking great. It was clear that his lungs were underdeveloped as he struggled to breathe. We made the very hard decision to not bring the baby down in the storm knowing his best chance was to be snuggled up close to mom. He would be freezing cold and wet and the most we could do would be to give oxygen that his little lungs wouldn't even be able to circulate. We left them peacefully resting and the baby died not long after in the arms of his mamma and pappa. It's pretty crappy that the severe dehydration brought on by cholera is causing all these moms to go into labor.

Monday was spent getting lots of work done in the office and caring for the little 4 pounder that was born up at the cholera house last week. He was not looking good and clearly have some GI problems, he died early Tuesday morning.

Erline, who I posted about here, had been released from the cholera house but was in 2 week quarantine before going back to the Rescue Center and she died suddenly this morning. We thought she was looking better, and although dehydrated, she was up drinking from a bottle this morning and then just died. The combination of the sever Kwashiorkor and cholera was too much for her little body.

I'm pretty much over you, cholera.

Anna and Lori left yesterday for California (where Lori is going to skydive!) Licia, Hannah and I are left to hold down the fort and so far, so good. Other than that whole Emily thing...



Clearly, we need your prayers in the next 48 hours. We are far enough in from the coast so we have to worry more about flash flooding. Most of the mission's buildings are down in the valley, but only about 50 feet from the river. We have plans to have everyone moved upstairs tonight and we will move the Rescue Center kids, who are next door upstairs as needed. I am most worried about the cholera house that is across the river and higher up on the mountain. They are not protected from the wind, especially the 30 or so people who are out in the tent. We are trying to send as many people home today as possible and will put people on the floors in the house if we have to.

Licia has been trying to talk to the staff about the storm coming and they keep saying "oh, you silly white people, don't you know that God is going to send the storm away. Something else that bad cannot happen to us." Let's pray they are right.

Seriously, let's pray.

And this is why we press on.

Longing for the day

this is ugly and honest.

3:23 am and I popped up in bed, something wasn't right. It was a cooler night because of storms so the fans were off and it was silent. Silence...and the sound of rain drops on tin. The hum of the oxygen concentrator I have heard for two weeks was gone and so was she.

Friday night Marilice began vomiting and it was clear that she was bleeding internally, maybe an ulcer. It was a steady downhill fight from there with a seizure yesterday afternoon and her sugar dropping to 42. We spent a good hour trying to get an IV in but her breathing became more and more labored. We fought to put her ng tube back in but she was vomiting profusely. I went to sleep knowing deep down where the night was going. Anna woke me up around 12:30 because she was bleeding from the only IV site we had and couldn't keep anything down. She had that same longing look in her eyes and begged for more water from a syringe. The palms of her hands blanched white, a sign of severe anemia. I offered no help to Anna as there was absolutely nothing more we could do, just love her in those last hours. I kissed her forehead for the last time and went back to bed. Anna held her as she struggled for air for more than 3 hours. It is an unexplainably painful honor to give love and dignity to a child in their last moments. When I awoke at 3:23 I ran down to the clinic and found Anna taking care of her body. We both marveled at how long she really was and how tall she would have stood. She was placed back in the crib where she has spent the last two weeks until she could be buried today. Her body was put in a small white box and laid in the ground this afternoon.

I have never wanted death and life in the same moment like I did for this child. I don't know how to explain the frustration of not knowing what is really wrong with a kid. She was so very sick and I don't know if the extensive care we gave her prolonged her suffering or not. I don't know why she didn't die two weeks ago. The alternative is to do nothing and that I can't imagine either. Yet, I wanted her fight to end. She will never have to know the betrayal of a friend, the heartbreak when a boy doesn't treat her right and the misery I see in so many lives in Haiti. What were we saving her for? In that same breath I wanted this precious little girl to live forever. I don't know how to understand these things but the beauty is that I don't have to because tonight, she is perfect and her arms cling tight around the neck of her heavenly father.

I can't understand His timing or why she suffered so long, yet I turn to Jesus and I understand what he did on that cross thousands of years ago. God loved us so much that Jesus had to give His life to make this right. All of our burdens and our pains and every way that our sin has messed this world up were justified and made right. Because you see if that's not true, then all of this stuff, it's meaningless. If this is it, this life is all we have, then what's the point?

The point is in Christ we hope. We hope for His kingdom to come. We hope for the day when we live with God in beautiful harmony, the way He made us to. He promises to make us all whole and because of that we press on. We press on to save the other 79 kids in our care tonight. You and I press on to love one another in spite of failures, to speak truth when it's hard, to care for our neighbor and forgive our debtors because it was all justified that day on the cross. And we joyfully hope for that day we are all whole.

I love you little girl and I'm thankful, for your life has made me love my Jesus more. This heart longs to see you in heaven.

I will love Thee in life, I will love Thee in death,
And praise Thee as long as Thou lendest me breath;
And say, when the death-dew lies cold on my brow;
If ever I loved Thee, my Jesus, 'tis now.

In mansions of glory and endless delight,
I'll ever adore Thee in heaven so bright;
I'll sing with a glittering crown on my brow;
If ever I loved Thee, my Jesus, 'tis now.

Friday, Friday

I wish you could just be here. I wish I could remember everything that happened so I could tell you.

Marilice had a really good night last night. All of the below things we prayed for came to fruition and the fight goes on. Her bum is really really raw and so she is in a lot of pain from that. At one point today, one of the ladies yelled for us to go into the dressing room and there was a pool of blood under her diaper with a few clots and I was terrified for half a second until I realized that she had just scratched her bottom until it bled. Her vitals are stable so please continue to pray for those things, as well as for her pain level to go down.

Lori and I finished up the Healthcare worker training yesterday with some role playing. We were the cholera patients, it was hilarious...

My baby just died and they were breaking the news.



Another time I passed out...



And then Lori passed out.



They will be starting the 12 oral rehydration posts all around in the next few weeks. Hoping to see big changes in the communities with this program.

This baby passed through the clinic this week with a very very rare genetic disorder called epidermolysis bullosa. Their skin is so fragile and peels off any place something or someone touches it. This is the second family that Lori has seen in Haiti with this disease. The baby is not expecting to live very long. It's crazy to me that I get to see stuff here that I probably wouldn't ever in a lifetime in the States.






Fabienne is doing really well. Look at those eyes! Can you believe the change in her face that a little protein and some TLC has made in just two days??? She is freaking cute...






Numbers are down to 58 in the cholera house tonight, Praise God! An older man died on arrival at the house this morning. I went up to cover for one of the nurses for a couple hours today and it was amazing how much easier it is to care for 50 less patients :)


We are closely watching Marilice tonight and also have a tiny newborn that was born up the cholera a few nights ago with us. Mom is having trouble feeding and the baby got very dehydrated.





And lastly, go check out the big news over at the RHFH blog...