Seeing Patients

Opening the clinic

Rather then going on and on about the perils of travelling to and fro from the clinic, I thought that I would spend a moment discussing the real reason that I came to Haiti-- to provide health care for the Haitians.

A lot of people (myself included) assumed that I came to Haiti to provide earthquake relief, but in truth most of the most effective programs have been working in Haiti for years before the earthquake hit, Mountain Top Ministries included. The village that I work in, Granmothe, was actually not directly affected by the earthquake. There was an influx of people coming out of Port-au-Prince after the majority of the city was devastated which has overwhelmed what little resources that there are here.

This little one had a burn on her lip

Most of my time was spent in the lab area, which is a tiny little space, separated by a cubicle wall that houses the scabies treatment area and a shelf that blocks view into one of the treatment rooms where patients are seen by one of the providers. This assembly-line setup has meant that I don't really come into contact with the individual stories or illnesses. But I got pulled from the lab for a few hours and was able to help one of the nurse practitioners, Kristen, as she helped patients.

My job with Kristin was to keep track of the patients she saw, write out prescriptions on a pad, mark the diagnosis on a list, and gather the supplies that she needed. This was the first time that I was actually being a nurse, and I loved it!

The first patient that we saw had complaints of stomach problems and gas. Kristen laid the patient down and felt her tummy, then asked me to do the same. In the books, a patient with worms had what was described as “a doughy stomach” and I had been worried that I would not be able to recognise this. I shouldn't have worried, the woman's stomach felt exactly like a huge bowl of bread dough. This was incredibly common in Haiti. Fortunately, it was easily treated with a dose of Albendazole. Worms would also cause gas, as they would bloat the host. We have nearly every patient Albendazole, as nearly every patient.

Glaucoma (right eye)

The next patient that we saw was a little 10 year old with a terrible looking eye. We called for a consult with Mary Kay, the pediatrician. We quickly diagnosed him as having glaucoma. This exciting moment of seeing this rare ocular disease was quickly tempered when we realized that we had no treatment. Without the correct eyedrops, the young boy would one day go blind.

Cataracts, conjunctitis

The next two people that we saw also had eye issues. One lady had nasty cataracts and conjunctivitis (pink eye). She was easily treated with amoxicilian eye drops. In looking for these eyedrops, we also found some eardrops for another patient that we had seen with a nasty ear infection. Antibiotics are really a wonderful thing, and they are perfect for our purposes, as we would not see the patient again. However, I was worried about compliance. The people who worked in the pharmacy hardly had time to count off the pills and tell them how to take them, much less provide teaching on the importance of taking all the pills and not sharing them. Paul Farmer has done a lot of work with TB (which requires 6-12 months of treatment with a nasty antibiotic) to prevent resistance. With every pill that we handed out, I worried about what would happen if that particular bug became resistant, but other then not handing out the pill there was no other solution.

I helped Kristen to a pap smear (to pictures of that!) She needed me to hold up an otoscope so that she had a little light to see what she was doing. She and I had to lean over between the woman's legs, as I shined the pathetic flashlight into the speculum so that she could visualize the cervix.

elephantiasis

Near lunch we saw a woman whose leg was swollen with elephantiasis. I was back in the lab by the time that I met her, and didn't even notice that her right leg was double the size of her left until I got her on the table. She was also hypertensive. The clinic was closing, but I snuck her in to see Norma, the other nurse practitioner after getting her labs. In addition to the massive swelling of her legs, she also had a pulsing right carotid artery that could be felt easily on palpitation. Her right leg was swollen as well with pitting edema, but that was easy to miss with has massive other leg. Her right leg was probably edemous as well, but the elephantiasis hid that. She saddest bit, like the boy, was that the condition with treatable and preventable, but because she hadn't sought medical attention prior, her leg will always be terribly deformed.

Scabies

In addition to these, we saw a few people and kids with scabies. For the adults, we treated with a pill, ivermectin, which is not approved in the US but works well nonetheless. For very young kids, We had to use the scabies cream. This involved taking them to the “scabies treatment area”, taking off their clothes, rubbing them with permethrin cream, then redressing them with new clothes. I worry about the effectiveness of this treatment, as they should really be re-treated a week later when the scabies eggs that are under their skin hatch, but we have no way of seeing them again. This makes the babies scream

Kristen and JM with the glaucoma eyedrops

The Glaucoma boy had a happy story. While sitting on the floor to breastfeed, our trip leader, Linda, noticed a bunch of eye drops that were under a shelf. She got them out and saw that they were glaucoma drops. We asked around and managed to find out the address of the boy that had Glaucoma and were able to send a 4x4 with the drops to him. We passed along several bottles. Although this will probably only postpone the inevitable (blindness) it was still good that we could get him some treatment. Even if blindness is only postponed for a week, I tried to think of all the things that he would see during that week that he would have otherwise missed. As Kristen said, we can only do what we can do.

Haitian Rollercoaster

A few little munchkins we met on the way

After the harrowing experience of riding home in the pickup during a thunderstorm, I decided to join the walkers and trek back.  Unfortunately, it was not raining this afternoon, and the sun was doing all it could to try and convince me that a walk was a bad idea.  the only positive thing about walking was that Haiti is on "island time" and walking in the sun seemed a better idea that waiting around in the van for Willem.  (There is a third option, which would be waiting in the shade in view of the truck, but that option seems only to have come to native Haitians.  

My little 12.5 megapixal camera can NOT do justice to the landscape of this place, and I doupt that I have the poetry that would also be needed to describe it.  Mountain Top Ministries is located in a section of massive hill-like mountains.  I say "hill like" because they are rounded and covered with vegetation, but have the height and slope that is normally associated with a mountain.  The villagers will plant their crops on the side, with the plants growing at acute angles to the land.  Sadly, this is one of the reasons that the county has such a poor growth rate per acre, as this method of planting causes massive erosion.  In addition, much of the trees were cleared for plantations and for charcoal, so thier supportive roots also are not present to help keep the soil in place.

The road heading out of the clinic. 

So my commute to work is three parts.  First, we travel almost at a 45 degree angle downhill with the riders in teh back holding white-knuckled to the truck.  Then, there is a light respite as we travel over a massive dray river bed covered in large white rocks.  Finally, we travel uphill again at a hear 45 degree angle (the Haitians are not one for switchbacks.)  It's not a trip for the lighthearted or the weak-stomached.  In addition, the "road" is actually mostly mud and rocks.  Oh yes, and there is often a massive drop to one side.  And the road is one lane with tons of blind spots.   Good times.  Some of the people in my group cross themselves before they leave, and trust me, they are not just being cute.

The little bracelet girl

So I walked.  We met up with a few kids who joined our group. One was a little school girl who enjoyed tossing her bracelet down the path.  It would  bound, bound, bounce until it hit a curb and she would run and grab it and start again.  she listed to our chattering in English with great interest, saying "oui" and "no" when she felt it was appropriate.  This part of the road was fairly well maintained, with the middle pretty much cracked out but the sides still more or less intact.  There were huge ruts in the side so that there was something to grab onto, the road is that steep!

We came across a few other travelers
Unlike myself, most people are not able
to choose if they walk or not!

Chicken wire "bricks" with rocks inside make up a wall

Eventually, the road gave way to a rocky path near the bottom near the dry river bed.  The "road" was washed away when the waters came, and no one was been able to rebuilt them.  One of the groups that came with MTM actually rebuilt the road, which was hard to believe since the rock path was barely transverseable-- made me wonder what it looked like before!!  In addition, the group build a wall by making boxes of chicken wire, then loading them full of rocks and making large "bricks" that they would use to keep the waters back.  These were still intact.

Other volunteers chose to ride instead

A pathetic Haitian excuse for a road

The dry river bed

After making it down the mountain that the clinic is on, we trek along a wide dry river bed.  I guess during the rainy season, the river will fill up.  The rainy season is from May and goes on through the summer.  It's good that the season is in the summer, because if the river bed is transformed into an actual river, the children that go to school at the ministry can not cross it to get to school and back.  There is no bridge.  When the water comes in, people are stuck.  As an American, it is nearly impossible for me to understand how life can be so ruled by the weather, when of course in most of the world the weather is a way of life!

She loves shoes, boys and chocolate

All in all, the trip is about three miles although it feels like more, especially the last mile heading up hill in those slippery paths.  There are not many houses on the ministry side of the "river", but on the guesthouse side we start to see a lot more houses.  Some of them are nice houses, others are not so nice.  A lot of them are just concrete bricks that make up a room, with no electricity or running water.  Many times, the water is brought from a public well on the heads of female children of the household, and all the laundry and bathing is done from this.

Mountain Top Ministries at dusk,
as seen from the guest house
(although it should be called
"Halfway up the Mountain Ministries")

Finally, we get to the guesthouse!  Time for a soda, a cold bucket shower, and a rest.  While resting, I realized that the ministry could be seen from the back of the guest house while sipping cold Sprite on the porch.  I noticed that you could see the ministry from the porch.  I suggested that it might be easier to install a skybridge, like the one at OHSU, where we can just ump in a little carriage (preferably air-conditioned) and travel over in comfortable seats over a wire.  Beth, who runs MTM with her husband, said that this was a good idea and she would be happy to have it built as soon as I raised the funds needed.

The Haitian Experience

While driving in the back of a pickup under a metal cage going uphill along a cliff on a mud path in a thunderstorm:

Sherry: It's all part of the Haitian experience!

Me: What, dying?

Another long day in the clinic.  We saw about 500 patients today, I did blood sticks on about a quarter of them.  I have been so busy that I haven't even seen the rest of the clinic (a large room, divided by curtains, that is about the size of a very small gas station convenience store) and I didn't notice that the weather outside was turning bad.  Anyone that has been in the tropics knows that the weather can be very bipolar.  

This little guy didn't cry once

I am lucky as my station is right by the window with the breeze blowing in, but I was so busy that I couldn't spare a glance outside.   I had to do sticks on all pregnant women, kids between 6 months and 3 years, and people who have hypertension that are on meds.  A lot of people, but I would see more if it meant that I didn't have to see any babies.  These little guys are the worse because they are just too small to really give the amounts of blood that the machine needs to be able to do a proper reading.  They are also pretty dehydrated.  They also start screaming the second that the little needle pierces their skin, and that's the real problem.  I try to get the people that are standing around watching the spectacle to help out by holding them down, but they generally don't hold hard enough, and they also get bored and wander off or start to play with the baby.  Meanwhile, the baby will smear what little blood has come out all over the place with their screaming.  I have been trying to get the moms to breastfeed in order to keep them quiet, but that only helps a little.

Me and Judi drawing blood from a 87 year old

Anyway, while working on baby #5 the head of Mountaintop Ministries, Wilhem came running into the clinic and said that we had to get done and leave now.  I looked out the window as he was telling us that a thunderstorm was coming, and saw that he was right.  I finished up the draw that I was working on and started to clean up.  One of the nurse practitioners, Norma, stopped by and said that she absolutely needed am H&H and one last baby.  Wilhem was yelling that if we were going to leave, we had to leave now.  By this time, the clinic was empty except for me, my lab assistant Janet, the family and Norma.  I guess that the family had been waiting for several hours to be seen, and Norma needed an H&H to make a crucial decision in her treatment.  Fortunately, I was able to get blood on the kid (a one year old) pretty quickly and we threw it into the machine.  We cleaned up the lab, watching the storm blow in from the neighboring valley and threaten ours as the machine ran through it's agonizingly slow three minute cycle.  The test came back, negative, and we grabbed the iStat and ran out of the clinic to the waiting pickup.

My side job, treating scabies with Kim 2

We jumped in, watching as the clouds invaded our valley and everything turned to gray.  I asked Lynda, the trip leader, if maybe we shouldn't stay at the clinic and wait the storm out.  I told her that this would give us a chance to clean the place up, maybe come up with a few new protocols, but she wanted to head home.  Since her infant baby was riding in the front, I felt that she wouldn't have said that we should head out.

I had never seen anything like that fog coming in.  It was a black thunderstorm, and we were right in the middle of it.  It wasn't the rain that worried me, however.  It was the journey home.  You see, both the guesthouse where I am staying and the church are on the near tops of large hill-like mountains.  The roads go almost straight up the mountain, with few switchbacks that we are used to int he states.  As a result, it often feels like we are travelling at a 45 degree angle, and it's harder to say whether it is more terrifying to go uphill or downhill.  Plus, there is often a step drop on one side of the road.  So the reason that I was offering to sleep on the concrete floor of the clinic rather then brave the drive home was that the roads were of that really slick mud and rock that sends even the most sure-footed person on their ass.  Oh, and did I mention that the driver had to stick his head out the window just to see the outline of the road?

Obviously this story has a happy ending.  We got home okay and I was soaking wet from the rain.

Tomorrow I am going to switch stations and work with one of the NP.  This is going to be great as I will see patients and learn about their conditions and assist in their care.  I am sad to be giving up the lab, but I am also very excited to know that I am going to learn about their health problems and learn more about patient care in a developing country, as this is really what I want to learn long term.

Finally, a touching story.  When I was trying to get blood from a Haitian, I commented that "Haitians don't bleed."  My translator smiled at me and said "That's because they've bled enough."

Clinic Day One

The clinic

Just got back from my first day at the clinic. We saw about more then 100 people, which I am told is actually not that many. Julie, the pathologist told me that it was because word travelled and people were scared of us. And by “us” she really meant me due to the screaming coming from the clinic.

The day started when we were woke up around 7AM. I found a set of scrubs and got them on, and went downstairs to run the controls on the iStat and eat breakfast. We loaded the massive amount of medications and supplies into the back of a truck and then headed up down the hill. Mountain top Ministries is located on a hill, and the clinic is on an other hill. The “roads” (very much deserving of quotes) were just a little more narrow then the truck, and I swear that they ran about 45 degrees to the road. We went down the mountain, across a dry river bed, and then up the other side where we unloaded the bags and headed into the clinic.

Dry river bed

We had three stations at the clinic, plus the pharmacy and the lab. Two nurse practitioners, a pathologist, and a pediatrician saw patients and diagnosed. I drew blood and fed it into the iStat, and the pharmacy obviously handed out pills. To get the blood, I had to prick the patient's finger and draw the blood into a lancet. I think that I would have preferred doing simple venipunctures, but we don't have the equipment that we need for that. Although the finger pricks might hurt less, they took a lot longer, and the patient saw a lot more blood.

The babies were the worse, because I needed to perform heel sticks, and they just refused to bleed. The child would scream and kick, and the stress would cause vasoconstriction, which would in turn halt the bleeding. After the first three or so patients, I finally got it figured out and was able to do my job.

I didn't know why most of the patients were being seen. There were a lot of young women that were pregnant that came in for well-woman visits, and we tested them for problems with glucose and anemia. A bunch of people with hypertension. A few kids with scabies which were covered head to toe in spacial cream (the adults got a pill). Yes, a lot of screaming. We also did a lot of urinalysis and pregnancy tests.

Right now we are sitting around the table at home looking at “People Magazine”. Justin Bieber, hot or not?

Arrived in Haiti!

The first time we were all together in Miami

No pictures, because I can't quite get the internet in the guesthouse to keep it together enough to actually write and publish a post.  (But the pictures are pretty cool.)

Haiti is hot.  I had forgotten what hot really was.  After getting off the plane, I went from being happy to be someplace warm to feeling happy to actually be hot for a change to wishing that the Haiti airport was air-conditioned in the space of about a minute.  About five minutes later I was sweating like I was back in Samoa.

Haiti is one of the most densely populated places that I have ever seen, with the smallest airport that I have also ever seen.  Someone had fixed it since the earthquake (probably so that aid could get in) and made a nice little walkway.  There was a band playing for us as we moved down the  walkway into the main terminal.  Throughout our trip, we would pick up various people from various places that were in our group, and this was honestly the first time that I saw us all together.  Most of the people that were on the plane were Haitian or of Haitian decent, and all the white people that I talked to was there with an NGO.  We gathered in the main terminal (which was slightly smaller then the woman's bathroom at LAX) and tried to figure o Tut how to fill our our customs forms that had been written in French and Creole.  I think that this was one of the first places were English was not an option.  I wondered why this was, since there was such a strong (and highly dysfunctional) relationship between the US and Haiti.

From there, it was a pretty long walk from the terminal to the truck, even with our bags (50lb each x 2) on carts.  Some guys that were identically dressed swooped in to take the carts, I found out (too late) that they didn't work for the airport.  I tried to get rid of mine, and handed him a dollar.  He said "Give me five dollars" and refused to take it.  It turns out that "give me five dollars" is a common catcall for Americans here, there was a kid that called to me from the other side of the gate "Hey, sister!"  When I looked, he requested this distinct dollar amount.  Fortunately, but this point, the guy who is in charge of Mountain Top Ministries, Willhelm, told us not to pay and the haggle was over, although I was out my dollar.  I didn't feel to mad about it, I was temped to give more to the kid at the fence.  But I also know that such handouts are not helpful in the long run.

We left Port-au-Prince in a huge traffic jam.  I was in the back of a pickup truck, and I am not going to describe driving in a third world traffic jam except to say that if you've even been in a third-world traffic jam, you know exactly what I am talking about. It's not for the lighthearted, and the danger was compounded by the fact that we were climbing up mountain roads along cliff sides.  I had been nervous about my stomach-- I don't do well on windy roads, but after just a few minutes I forgot about my stomach and would have taken the chance just to get the car to move and generate some breeze.  I was wearing a hat, my face was burned just a few minutes later anyway.

The area that we are staying was not directly affected by the earthquake, but a lot of people fled Port-au-Prince and came back to these villiages, so they are going to be the people that we are helping as this area isn't well set up for medical help.  Our first job, after lunch, was to sort the bags.  We had a ton of bags to sort, and Linda had packed them in a way where the necessary supplies we spread out rather then in one bag.  As the bags were lost or pilfered, this made for a extensive re-sorting process.  We scattered all our pills on the table and made then into little 30-day packets.  We bundled them into baggies and slipped in a little piece of paper saying what the pills were and how they were to be taken.  We are thinking that we sorted 30,000 pills as we went through about 1000 bags.  It wasn't a bad job, very zen.

Tomarrow, we will go to the clinic.  I will be drawing blood for the iStat.  Tonight, I took my first bucket bath since leaving Thailand and loved every bloody second of it.  The ambian is start to really kick in, and as much as I would like to write in my soon-to-be-forgotten ambien high, I think that I will turn in.  Talk to y'all tomorrow!

Forest Park Hike

Took a break from Haiti preperations for a hike in Forest Park.  Forest Park is known for being the largest forest reserve within city limits in the country.  (Not be be outdone,  they also have the smallest park in the country as well, but this one isn't a very good hiking spot.


Hailstone!



Can you see the harp in the window?



In typical Portland style, the day was clear and sunny when I left, started to rain while I was on the road, overcast when I got to the parking lot, and started to hail about fifteen minutes into the hike.  The hailstones were a good few centemeters in diameter, unfortunatly we were not able to get a good picture of one before it melted.

Pitcock Mansion

 I was hiking with a new friend, Casey, who is also studying wildlife and has most of his labs in places like this.  He was able to point out most of the different plants that we saw, let me know which ones are edible and which ones will sting (and demonstrated thier stinging properties over my protests).  He also pointed out the types of birds that we saw, although having only seen a robin, his skills in that areas were not quite as impressive. 

A mysterious stone structure

A doorway becons..

Me in the mysterious stone structure

Casey investigating the moss

The view of Portland from the top

Jeremy Cowart's "Voices of Haiti"

One of my teamembers posted a link to our list that featured the photography of Jeremy Cowart, who is truly very talented and has captured the Haitian people in a truly unique and touching way.  I highly recommend that you check out his photography work in Haiti.

Haiti Preview

T minus 7 days until Haiti!!  If you (like me) can't wait to see my blog from Haiti, check out this link.  It's from a guy that went to Haiti and worked with Mountain Top Ministries in the Gramothe Villiage.  He seemed to have a pretty good time.

http://hiking-cyclingchristian.net/vacations/2008-Haiti/2008-Haiti.htm

Also, I learned that the villiage I am going to be is someplace between Petionville and Kenscoff, but Google Maps does not have it.  So, the best that I can reckon is that I am going to be someplace in the little red circle that I made:

Or, someplace on the little squiggly blue line that can be seen here.

iStat-tastic

Connie, Mary Kay, and Julie

On Thursday I went to the office of the pediatrician who is going to be going with me to Haiti.  She wanted to make sure that I knew how to use the "iStat".  Not developed by Apple, this nifty little device is going to enable us to check the blood of our Haitian patients.

It comes with cartridges that you put a little blood on.  Slide the cartridge into the device, and it will tell you the blood chemistry, Hbg and Hct.  This is normally a test that you would have to send down to the lab.  I learned that the clinic in Haiti will not electricity.  That means, in addition to not having power to run devices, we also don't have any refrigerator in the clinic.

Me showing off my awesome blood collection technique

 This means that we can't spin down blood and store it, so this device is pretty handy.  So why isn't it used in all labs, or at doctor's offices?  Because the device is very expensive, and the little cartridges cost more per pop then I fork over for a co-pay.

We really wouldn't have the funds to have anything like this in Haiti, but the company that developed them decided to donate the device and 300 cartridges.  This comes to several thousand dollars (they have to give back the machine, but still.)  The amount of generosity that I have seen while preparing for this tip has been pretty incredible.

Figuring out the iStat
(Note: it needs you to configure it to require a barcode.)

And hard to use!  To get the blood, I had to use a little glass tube (similar to a swizzle stick) to get the blood without any bubbles.  Fortunatatly, Julie, the pathologist was more then willing to be a guinea pig as I demonstrated my ability to suck blood.  (She proved to be in good health, according to our iStat.)  There was another person who worked in the lab, Connie, who knew all about getting blood, and she helped us out. She said that she would like to go, hopefully she will be on the next trip.  (So might I!)

We are also taking a bunch of urine sticks, that technology has been power-free for quite some time. I was the guinea pig for that test (no pictures of that, I am afraid!)  I am happy to say that from a urinary standpoint, my health is quite good.
T minus 10 days!

Peanut Butter

I think that we are good for peanut butter donations for Haiti.

On getting the Flintstones Vitamins, I started singing the Flintstones vitamin song ("We' re the Flintstones Kids/Ten million strong, and gr-o-owing") and none of my coworkers knew what the hell I was talking about.  I'm old.

Brandenburg Concerto No. 4 in G major

Well, here it is.  Andante from Brandenburg Concerto No. 4 in G major, performed on 4/6/2011 at Classical Revolution PDX.  It's good that I can record this as I am able to hear that I really need to work on pitch, although the other flute isn't much better, which tells me that a) I am coming along well when copared to a more professional student and b) we didn't tune well and c) the recording equiptment didn't have the best sound.  (This ws a cell phone video that Kazu took, which is why it is so bloody dark!)

We actually performed this without a rehersal (which would have been very helpful) and down a flute.  That violinist stepped in at the last minute.  Finally, Kristin (the player on the right of me) pointed out that the peice was actually more difficult due to the numerous long tones, and suggested that a piece with shorter tones would be easier, as we don't have to sync up the pitch so much.

My flute teacher tells me that I need to keep my fingers down, and this picture illistrates her point well...

Still, it was a lot of fun and I can't wait to perform again!

Special Things Happen

A few weeks ago, I sent out an email asking people for supplies for Haiti.  I put out a box and a bit of hope.  When I came into work today, I was pleased to see that someone had added a few items.  There was a big thing of paper towels, wipes, band-aids and Tylenol.  (I felt like a moron when I was asked why we could donate Tylenol and not aspirin.  When I told this to the meeting, half the group yelled out that it was because of Reye's Syndrome.  Duh.)

Honestly, I wasn't really expecting much of anything.  I wanted people to just bring junk from home.  So I was pretty surprised when Kevin (my hiring manager) and Barbara Crow, the CEO of the Lions Eye Bank (where I work) told me that they wanted me to speak at the monthly staff meeting about my upcoming trip.  (This is where I made the Reye's snafu.)

I got up and talked at the meeting about my upcoming trip.  I told the group about how I was going to be travelling down to provide medical aide as a nurse, and that any donations -- either money or goods -- would be very welcome.  I explained that due to the disasters that followed Haiti (namely New Zealand and Japan) donations for Haiti have dropped while the need in Haiti is still very great.

At this same meeting, we had had a lady who represented our benefits provider walk us though a few things, and she had sat politely sat through our meeting.  When I told the group how Haiti still needed lots of help (perhaps more help then Japan and New Zealand needed, as they are first-world counties) she stood up, identified herself as Hatian, and asked to speak.  With tears in her eyes and her voice cracking, she spoke passionatly about her family who were living in tents.  She told us about how she didn't know if her family was even alive for three weeks.  She provided rememberances of an elder member of her family who had died from lack of medical care.  She told us how the entire country was still covered in rubble.  And she thanked me for remembering Haiti, and asked the group to do the same.  It was a very powerful moment.

I found out later that one of the people in the office (Janet) wrote the following:

I’d like to suggest that coincidence is more a matter of the good work we do and the good energy we all put out, rather than a random occurrence.  I don’t think that anyone else had the good fortune of seeing all of the pieces that went into the phenomenal occurrence at our staff meeting last night... Kevin... suggesting that the Eye Bank get behind Kim in her assistance of the Haitian people.  Barbara forwarding Kevin’s suggestion.  Kim giving us an opportunity to help others through her mission.

Is it a coincidence our first benefits rep wasn’t a ‘fit’ and that our new benefits person happens to be Haitian?  Is it a coincidence that  we happened to have our benefits person speak with us the evening that Kim shared about her trip to Haiti?  I don’t know.  What will happen as a result of all of these ‘coincidences’?  I don’t know.  I do know that  I have experienced special things happen when thoughtful people put strong thought and energy into producing something good, whether they are directing that energy together consciously or not.   For me, this is definitely one of those experiences and I thought it was worth mentioning; as we all contribute in our own way.  It’s something to think about.”

And when I walked into the office today, I found that someone had placed a box-- with a ton of goods in it, in the front room where we greet visitors.  As you can see, someone put a great deal of work into the box, and I was nearly moved to tears.



Be the Change...

“Be the change you want to see in the world.”
 -Mahatma Gandi

Haiti Jobs

I got an email from one of the doctors who is part of the medical team a few days ago:

Hi Kim, 

I am a pediatrician and the medical director of our Haiti mission team.

I am so glad you are coming along. My last team only had one nurse and it was really tough. This time we have 4 maybe even 5, so much better.

Margie and Lynn have told me that they would like to work in the pharmacy. Margie said you like hands on jobs best. I would like to find out what you want to do as we are going to try to prepare a little to make things a little smoother. You can trade off later in the week but initally getting set up it's nice to have one person in charge of a station.

I will need a nurse to do the check in. It means taking a lot of weights and blood pressures, and other vitals as you see fit, like temps.  You would have 2 helpers.

The other station is the lab. We are going to have a little machine to check hgb/hcts and lytes/glucose with. Also lots of urine dips and preg tests. This person would also likely oversee the scabies treatments. Again 2 helpers along side.

Let me know what you think. I still need to ask Betty also what she wants to do.
Looking forward to a wonderful experience.

I wrote back with:

Actually, the lab station sounds the most interesting, but honestly I really want to be where ever I am most helpful!  I don't think that I would have any problem with either of these jobs, although I do not know French.

She answered with:

Thanks for getting back to me so quick. I talked with Bettie today and she is very happy to do the BP check in station, so you are set to be the lab RN. She lives up in Shelton so it would be hard to do the training on the i-stat machine anyways. I should be getting the machine in the mail on April 12th, and so sometime after that you and our pathologist, Julie Kingery will need to get together and figure out how to use it. I want to make sure we have all the right supplies and controls and all that. It's good to practice reading Urine dipstixs too before you go. No worries on the language. We will have Creole translators and they are very versed on telling people to pee in cups!! :) You can read about the i-stat on line at Abbot.com.

Item Donations for Haiti?

(This post is more for local people, although you non-locals are welcome to help out.)  I am in the process of gathering supplies to take to Haiti.  As I mentioned, my team leader is going to commandeer my checked luggage and most of my carry on for supplies that the Haitian people need.  All of my trip fees are for buying supplies, but it doesn't cover everything that is needed.  Therefore, if you are able to help out with supplies, let me know.

If you do want to donation, things can be either used or new.  If you have these lying around the house, great, if you want to pick up a generic bottle of acetaminophen (generic Tylenol) the next time you are at the store, even better!  All items will go directly to the Haitian people that we work with in the clinic, as well as an orphanage that is also associated with my group.

Here is a list of supplies that we still need:

nr Clinic:

washclothes (for hygiene packs)

bags of all sizes (large trash, small trash, baggie, snack, etc)

clorox wipes

non-latex gloves

peanut butter

batteries- all sizes

adult multi vitamins with and w/o iron (UNOPENED)

children's multi vitamins with and w/o iron (no gummy, they melt, also UNOPENED)

Tylenol (generic or regular, UNOPENED)

paper towels

For MTM orphanage:

combs & brushes for black hair

skin lotion

hair cream-with a tar or sulfur base if possible, these tend to repel scabbies

deodorant/antiperspirant

bath towels

kitchen towels/bar rags work best & are less expensive, can be bleached

underclothes & socks

pj type clothing

misc. clothing in good condition, modest (boys sizes 7-12, girls sizes 7-16)

accessories are always welcome-belts, purses, ties, hair foo foos, etc.

As I said, you can just give these things to me (either at work or at home) or if you are feeling really ambitious you could mail me the things if you live far away (although it would probably just be either to send me a check and a list of what you want me to buy.)

Three Things....

OK, the first thing is an earthquake update.  I was listening to this guy on the radio who was talking about earthquakes and tsunamis on the west coast.  His interviewer asked him about tsunami warning systems, and how people would know if there is a wave coming after an earthquake.

His answer: if the ground shakes, that IS your warning.  If an earthquake stikes the west coast, a tsunami WILL follow.  South coast has about 10 minutes until the wave hits, north coast has a little more time, about 20 minutes.  He suggested that you get about 80 feet up, more if possible.  If you don't know what 80 feet looks like, then right after a earthquake is not the time to find out.

The second is an update on my trip to Haiti.  This lady that I am going with is insanely organized.  She is bringing food.  She brings supplies.  Scrubs are already there.  There are books and a computer there.  She even has toothbrushes.  "What should I bring?" I asked her.  "Nothing, really", she admitted.  Of course, she is claiming my entire checked bag quota (and part of my carry-on bag) for medical supplies going there, and I will have to stuff my nothing into whatever is left.  I have my ticket and so this is looking like a go.

The third thing is that I MAY be playing flute at the Waypost on 4/6 at 7:30pm.  I will probably be playing as a part of Classical Revolution PDX.  I am hoping that I will be playing  Bach's Andante from Brandenburg Concerto No. 4 in G major with three other flutes, which will sound near but not quite like this:

(Yes, there is a lot of uncertainty in this announcement.  But if you get there and I don't play, then you are probably better off.)

Only [NOT] in the US

Could you imagine the president of a major company in America personally apologising to those that were affected by his company? 

 This picture is from http://www.msnbc.msn.com/id/42144324.  The caption reads:

Norio Tsuzumi, vice president of Tokyo Electric Power Co. (Tepco), left, apologizes to evacuees at an evacuation center in Tamura, Fukushima prefecture, March 22. Public sentiment is such that Fukushima's governor Yuhei Sato rejected a meeting offered by the president of Tepco, the utility that runs the Fukushima nuclear plant. "Considering the anxiety, anger and exasperation being felt by people in Fukushima, there is just no way for me to accept their apology," said Gov. Sato on national broadcaster NHK.

If this were America, not only would the mayor take the companies apology (and probably his campaign finance contributions), the company and the mayor would probably band together to place all the blame on the opposite political party.

Please consider Donating to Japan.  They are doing all they can to try to help themselves, but this disaster is too big for anyone to handle alone.

Earthquake readiness

So, my housemate found a video of some geologist that is claiming that due to a perfect storms of tides and full moons and equinoxes (equini?) the "big one" is going to hit this Saturday.  As the picture shows, I ran right out to the store, and I feel pretty prepared:



In all seriousness, if there is a big one, check here: Safe And Well.  I will put myself on the site, if anyone cares.

Here is the video.  Imminent earthquake?  Decide for yourself.  Before you panic, keep in mind that this is Fox News that we are talking about:

   

Music for All?

I attened a "Brown Bag" at the Old Church in Portland.  As the name implies, the Old Church is the oldest church building in Portland.  However, the name is misleading as it is actually no longer a church.  It is not a nonprofit that houses weddings, concerts, and other gatherings.  It is a beautiful place, and they will hold free noontime Wenesday concerts that I love to attend.  This week, we heard David Rothman, who presented us with many lovely Chopin pieces.  A list of their concerts can be found here.

They announced that the concert was going to be taped, and requested that we remain silent between movements, only clapping when the piece was completely finished.  I wondered why live concerts were taped like this, rather then just taping in a controlled environment.  I guessed that it probably had something to do with the energy of the player or something like that.

A few minutes into the concert, a few people came in.  The newcomers were obviously a group of people who were developmentally disabled, with two escorts.  They had to come in through the handicapped door due to the fact that one of them was in a wheelchair, and that door was at the front of the room, so everyone was staring at them.  I glanced at the microphones, and thought to myself that this wasn't going to go well.

About five minuets after they showed up, one of the members gave a long, loud moan.  Everyone's head spun around at the sound, mine included.  The person who had made the noise was smiling and clapping his hands siliently in joy at the music, and the room glowered at him.  I smiled, but I saw that a lot of people were troubled and a few were angry.

The pianist was one of them.  After the song, he asked if there was a noise.  One of the audience members pointed out the group and said that it was them.  There was an uncomfortable silence, then one of the escorts led the noisemaker away.

I felt so terrible for him.  Although I understood that the tape of the concert was probably ruined (at least for that song) I wondered if the audience and the pianist realized just how vital it was for the young man who was kicked out to attend a concert like this.  If it was so important to get a good tape, then they should have made this clear prior to the concert to make sure that people who were not able to listen silently would not show up.    Maybe the man who left didn't understood why he was leaving, or maybe he did and was sad, hurt, or even humiliated.  I wouldn't be surprised if the small part of the concert gave him just as much joy as the rest of the people listening, perhaps even more.  The disabled are marginalized, removed from societal, and rarely able to attend an event like that.  It was wrong for him to leave.

Anything helps

I was driving to work the other day when I saw a guy holding a sign asking for money standing by the road.

Now that isn't a strange thing in Portland.  At almost every busy corner, stoplight and stop sign, there are homeless people holding signs.

What was odd about this guy is that he was standing at the end of a freeway on-ramp.  You know, the part where you have just accelerated to the speed of the expressway and you are getting ready to merge.  He was standing right where the expressway meets the ramp.

He was holding a sign that stated "VETERAN, ANYTHING HELPS, GOD BLESS".

And as I zoomed by him at 50 mph I couldn't help but think, "Well, that explains why we haven't left Iraq yet."