Thursday, February 11, 1999
The airline pilots with American are beginning to be “sick” in greater numbers but a Federal judge has ordered them back to work. Flights should be better by Sat. when we leave. The day was crazy as usual when trying to leave town. But I have a day off tomorrow to get caught up and ahead.
Friday, February 12, 1999
I took today off since I worked last weekend and it gave us a good chance to be prepared before leaving tomorrow. Lots of last minute details. Sheri & I went by the office at noon and a Channel 10 - KAKE TV news reporter called and wanted to interview us because of the continuing work action taken by the pilots slowing down flights. We arranged for him to come by the house at 3:00 p.m.
We had done some packing of personal bags but not the tubs we used to transport medicine & Surgery stuff. So, Sheri & I ran home to make the house & basement presentable for TV. That also prevented us from actually packing.
When C., the newsman came by to film us, he was very professional. And as it turned out, he is also a Christian who had been on a mission trip to Haiti. The interview went well and Sheri was even able to interject our faith in Him who provides and has the plan. They even left that on the film for 6:00 pm news.
Then we began to pack in earnest. Fortunately, B., an attorney from our church, came over Thurs. & Fri. to help pack because we received boxes & boxes of medicine on Wed. night from Heart to Heart (an organization that serves as an intermediary to process medicines that are about to expire). Unfortunately, most were samples with 6-8 pills in each bottle, so we opened 2000 little bottles & took the cotton, etc. out and consolidated in better containers. By doing that, we got all our medical & surgical supplies along with the many dolls, crayons, medicine bags, toothbrushes (1500) and soap into 6 tubs. Two tubs will be coming the second week with M. (a Certified Registered Nurse Anesthetist).
Even with all our efforts, we still didn’t finish until 11:30 p.m. Our last check on the Internet showed that one of our flight segments was canceled but we were still optimistic.
Saturday, February 13, 1999
Up at 4:30 am & a quick check of the Internet showed two of the three segments of our trip are canceled. But we had to go to the airport to be able to rebook since the telephone number at the airline was perpetually busy.
We were really making good time until I went out to put the tubs in the van only to find the door open & the dome light no longer shinning. The battery was so dead that when I called a friend to jump start us in the garage (at 5:30 am), it wouldn’t even turn over. Mandie had taken my car so she could leave hers in the shop for maintenance. My friend let us take him home & use his van to get to the airport.
We made it to the airport & met Mandie, B., K. and Dr. A. After unloading our tubs and bags, we stood in line a short time and at our turn, we were formally told our flights were canceled. Then over the next 45 minutes to an hour we found out there was no way to get there today --- or tomorrow. Monday looked good but we would have to fly through San Juan instead of Miami.
We were able to contact Dr. A.’s son, A. who was meeting us in Dallas from Denver to go on the project and reschedule him. We left the airport without losing our temper or our witness.
Sheri & I went home and crashed for a 3-hour nap. After getting up, we were able to accomplish many things we had to put on hold to get ready for the trip. It feels really good to get the Christmas decoration down off the roof before April Fools day.
We went out for a nice Valentine’s Day dinner with friends (a day early).
Sunday, February 14, 1999
Needless to say, no one expected to see us at church today but we were there for Sunday School and Church and Evening Vespers since we had not much to do except wait. We were able to get the two extra tubs to M., an anesthetist who will be joining us next Saturday for the second week. We were told at the airport that positively no extra baggage or over weight luggage. Getting the extra luggage to M. allowed us to get more there. Peoples generosity this year was overwhelming with gifts, meds, medical bags, cards, toothbrushes and much much more!
Monday, February 15, 1999
Getting through customs was a breeze. They just looked at our tubs & the Medical clinics address & we were waved past all the lines of people opening their suitcases. The only problem was that there was no one there to meet us. We waited for an eternity (or maybe 15 min.) with our bags stacked & all kinds of people staring at us & speaking in unknown tongues. Finally, D. (project director) arrived after many traffic jams to take us to the “Chicken Hilton” (a church camp in Santo Domingo). The hour-long ride was scary. Traffic in the DR uses different rules and laws. The only mandatory part on any vehicle is a horn.
A light dinner at Santana Hospital was followed by bed. Somehow, they didn’t have enough mosquito nets so we slept without. My tossing & turning probably kept them off because I had no bites.
Tuesday, February 16, 1999:
A breakfast of fresh fruit and more. We then loaded all our bags into a horse trailer & began the journey to the camp at Dajabon. It takes about 4-5 ½ hours with one stop for snacks. We were pulling a trailer and we had two people who were joining a project in Haiti that was running concurrent with our project. Dajabon is border town with Haiti and H. met the two there and took them to meet the others.
While we parked to let them off by the hospital we worked at 2 years ago in Dajabon, I walked over and found a family practice doctor from Wichita. He was there as a part of his residency. We had a great visit. He hadn’t seen anyone who spoke English, much less from Wichita.
Then on to the camp to unpack. The Campamento De Los Pinas was just as we had left it a year ago. There was a new coat of turquoise paint in the bathrooms. We moved into our dorm rooms and found out there was no electricity or water. They fixed the electricity but not the water.
M. & her family fixed a great meal with beans rice and chicken, mashed potatoes along with salad. The medical team went out for a half day since we weren’t here yet. About half the group had come in a day ahead of our Wichita group & the others that arrived Monday morning.
Breakfast was a treat with eggs & bacon mixed, fresh bread and fresh fruit. After morning devotions, we boarded the bus for the 30-minute ride to Las Almacigas. The early group had gone to the hospital while we were traveling up to Dajabon, so the hospital was mostly set up. They didn’t bring the OR table so we just had their OR bed. We put a gurney on concrete blocks to make the second OR table beside the first.
It took the anesthesia people a couple of hours to set up their machines, so we went to the consultation rooms in the hospital and had clinics to see new patients. By about 10:30 am or 11:00 am we did the first case of the day.
The 1st case I did was a thyroidectomy with Dr. B. He became sick on Monday while in transit, was nauseated, and was unable to eat or keep anything down. Last night he had an IV started to give him fluids in the dorm room. Today he felt well enough to work, although we helped each other on a lot of cases. I then did an epigastric hernia, a hemorrhoidectomy, an excision of a bartholin cyst, an excision of multiple warts and skin lesions of the neck.
Back to the camp by 6:30 pm in time to eat… fried eggplant, seasoned fried rice, corn, salad, and fresh bread. After dinner we had games, fun and to bed before lights out by 10:00 pm.
I forgot my soap and shampoo in the other building, so I still had to walk to the other bldg. for my shower. Breakfast was oatmeal, fresh cinnamon bread. After morning devotions, I was able to join the walkers. We walked about 3-5 kilometers up and down the hills before the van caught up with us.
The hospital was very busy today. Dr. R. worked mainly in the consultation room since he can’t stand alone due to pain from his car accident 3 month ago. Most men 79 years old wouldn’t have survived a fractured pelvis, flail chest with multiple broken ribs and all the problems he has had, but God is faithful and D. is persistent.
Dr. B., an OB/GYN surgeon was very busy. F. was here last year also. I did 4 inguinal hernias (3 children, 1 adult). Also, I helped F. with a hysterectomy. One difficult case was the local pharmacist who was over weight and had a massive ventral hernia. It required mesh to repair and he had trouble waking up, because of pulmonary problems. But, he finally began to improve but needed to stay overnight. A large lypoma of the back completed the long day. By the time we got back to camp it was 7:30 pm.
Dinner was great. Rice & pinto beans with some kind of meat was served along with french fried yucca and salad. A vanilla flan completed the meal. After dinner Sheri went to the chapel to help sort and replenish the pharmacy bins. She & Mandie are working the pharmacy and it has been crazy because this is an area out of the comfort zone but today was better than yesterday.
To bed before lights out at 10:00 pm but the best part was that the blankets arrived and we didn’t have to sleep in layers of clothes.
Friday, February 19, 1999:
I woke 15 minutes before the generator and was first in the shower in our bldg. Most folks shower in the afternoon but not me. I must be crazy.
Breakfast today was pancakes and watermelon – very good. There were 8-9 of us to walk this morning and it was a little warmer today. (Almost didn’t need the newly arrived blankets last night).
Surgery was pretty busy today with a total of about 23 cases. I did 3 umbilical hernias, an inguinal hernia (21 month old), an epigastric hernia and scrubbed a thyroid and open gall bladder. We don’t see many of either at home so Dr. B. and I worked together. The saddest case was one Dr. B. asked me to help on. I involved a 38 year old lady who had pain in the lower abdomin and went to Santiago (3 hours away) to have an ultrasound. It showed a cyst on her ovary. When he did the surgery he found an unsuspected ovarian cancer that was metastatic already making her prognosis poor – less than 6 months usually. Far from what she and her family expected from the surgery. We did a complete hysterectomy which should help slow the growth some.
We arrived back at camp about 7 pm to dinner already being served. Spigot, meat sauce, corn, tomatoes, fresh bread. After dinner we said good bye to 5 from Kalamazoo, Michigan (Dr. S. – anesthesia, Dr. B. –surgery and their 2 sons (14 years old) and R. – general helper). They left to return to Santo Domingo to fly out to the states in the morning.
In the morning about 10 more will leave, including the dental students from West Virginia Dental College and a dentist and helper that brought them and a family practice doctor from Georgia (who graduated from the Univ. of New England and had been there for one of the classes I taught). Small world. They will be missed. We don’t usually have so many only stay for one week, then again with the delay in getting here it even compounds the problem for us but not for God.
Tomorrow will be different since we are planning to work a half day and the medical team is going to do their clinic in the same hospital where we are in Los Almacigas. It’s awfully small and should be interesting.
Both teams used the hospital today and work a “half” (till about 3:00 pm) day to make up for the cancelled day earlier in the week. I did an inguinal hernia on a 7 year old, then an epigastric hernia. We also did a dressing change on a child with an abscess. I then did a breast biopsy and the patient wanted the specimen to take to Santiago for pathologic analysis. It is about 120 miles away and that is where the closest pathologist is. It will take 1-2 weeks to get the results. I then did a rectal surgery and ended the day by taking a small mole off the lower eyelid of a Dominican Doctor.
I got to see Mandie & Sheri in the Pharmacy at work as the medical team used the front half of the hospital while surgery used the back half.
We finished and all went by bus into Dajabon for Ice Cream and a phone call back home to M. It was hot and dusty and by the time we got back to camp a cool shower and short nap felt good.
Dinner tonight had a roast beef and potato mixture with rice and fresh bread. Bread pudding completed the meal. Afterwards we played cards and laughed and had great fun.
All but 9 or 10 of us went to the beach at Monti Christi. Sheri & I stayed in camp and had a leisurely day of reading and resting. Lunch was chicken noodle soup with chicken salad sandwiches and chips. That was a nice change from the peanut butter and jelly sandwiches we usually have at the hospital.
M. & his daughter from Wichita arrived at camp this evening to join our group for the last week. Also 3 new interpreters to replace those who had to return to school. Several of us who remained (not going to beach) drove into to Dajabon (25 min.) to use the phone to call home. A 10 min. call costs about 40 pecos ($3.00). It was good to talk to M. and my folks.
The evening meal was a shepherds pie kind of meal with rice on top and bottom and salad. D. and J. celebrated their 28th Anniversary with a beautiful (wedding type) cake that M. made for them.
The local Dominican Evangelical Church that owns the camp invited us into Dajabon to their evening worship service and pushed it back to 7:00 pm so we could join them. Pastor A. and his wife have been there every time I have returned. They have recognized and welcomed me to the service along with all of us. It was a 2 hour praise and worship service similar to our 9:15 am service in Wichita. The message was interpreted for us by one of the new interpreters and was very powerful.
Monday, February 22, 1999:
It started as a normal day with the generator at 5:30 am. After a brisk shower we had a breakfast with fresh bread, boiled egg and fresh fruit.
We then re-loaded the yellow school bus with the pharmacy stuff for the medical clinic then the surgery team was on the way. Some walked but I drove one of the two 15 passenger vans. Some didn’t like my driving through the winding up and down hill roads. There are no sidewalks and kids, donkeys and cows made the driving more of a challenge than some thought I was up to. But we made it to the hospital in spite of their doubts.
It was nice to have M. and J. join us at the hospital. I began the day with 2 children’s hernias then I removed an enormous thyroid that took about two 2 hours. The generator kept going on and off then the air conditioner and cautery wouldn’t work so it was hot and difficult. Then I did an open cholecystectomy and then removed a spermatocoel. The last case of the day was a man with a needle in his arm. Dr. R., who I had met and corresponded with over last year came and helped me since he had already tried two times to remove it. The patient brought an xray with him, but it only showed part of his forearm.
We began with an incision where it looked like it was. In the States these are difficult cases, here it seemed impossible. After 45 minutes Dr. R. said (through an interpreter) lets get another xray. I didn’t know it was possible but after they went to town and found the man who runs the machine (notice – I didn’t say xray technologist). We loaded the man on a cart and wheeled him to the xray room and shot a new picture. When the man came out of the room with the film dripping wet, we saw the original was backwards and the needle was on the opposite side of the arm from where he was complaining. Back to the OR and you guessed it – new incision & no lunch. After another 30-45 minutes, we quit to try again tomorrow with more xrays.
I was exhausted and the drive home (with different people in the van) was slow but complicated only by a gentle rain.
When we got to the camp around 7:00 pm the rain really became a downpour. It seems even worse with tin roofs. We couldn’t even hear each other talk. It finally eased up about 8:00 pm.
Dinner was good with beans and rice and some meat with fresh tomatoes, fresh bread, friend sweet potatoes wedges and cole slaw.
I was in bed asleep by 8:30 or 9:00 pm and slept like a rock.
Breakfast by candlelight was french toast with syrup and fresh oranges. After devotions. I drove to the hospital with fewer passengers. There appears to be some question as to my competence in driving the van.
When we arrived we found out there was still no water. The pump broke…in any event no running water.
B., from Wichita – a bank attorney, was working the central supply this trip. His first time in anything medical, much less in surgery. He had a bad day with no running water to clean instruments. Someone went down to the creek and brought them a bucket of water. Also, he was overrun with ants in the Central Supply room, then found a dead lizard on the autoclave. Needless to say, our environment with open windows, etc. leaves much to be desired with sterility, but they have very few infections.
I came up with the idea to pull the radiopaque marking string out of 6 guaze sponges and taped them to his arm to create grid markers. Then, when it was xrayed again today, the grid allowed me to better localize the needle. When the picture came back the needle appeared right under the incision I made yesterday. So I re-anesthetized the incision and opened it up and 1 millimeter to the inside of the incision we found and removed the needle. The patient was glad since he hadn’t eaten since Sunday night and wanted to take the xray home.
We were back to the camp by 5:30 pm and had time to rest before a dinner of potatoes, chicken, eggplant, carrots & tomatoes with fresh bread. After dinner the “annual” talent show showcased the limited talents of most of us.
I drove uneventfully to the hospital to pack today. We didn’t have any gynecological cases today so Dr. B. did some circumcisions and local cases. I started the day with a recurrent right inguinal hernia then did a lypona of the neck. It’s a difficult area to operate for me because I don’t do much in the neck back home. I thought the worst was over. Next an 18 year old came in with keloids in both earlobes. When she got to the OR she had string in both earing holes. When I explained she couldn’t war earrings for 2 to 3 weeks. Se said okay, but when I removed the strings both had pus coming out so we had to cancel surgery because I couldn’t do surgery on her ears with infection. We gave her antibiotics and sent her home.
My next case was scheduled as a removal of cervical lymph node. She was young, about 25 and I tried to do it under local, but after I got down to it, it was too deep to anesthetize well. So we placed gauze in the incision and she got up and walked over to the other table where we could give a general anesthetic. Then I worked another hour removing what turned out to be a salivary gland tumor. Once again, we had to give it to her to take to Santiago (2 hours away) for the pathologist to examine.
F., at the same time was to do an incision and drainage of a face abscess. I looked like a dental abscess, but when he incised it there was no infection, but a necrotic tumor. Once again – no pathologist. Very frustrating.
The last case of the project was a 5 year old with a large mole on the bridge of her nose. She was the sister of a young boy who had a circumcision today because her mother was originally scheduled of an axillary mass removal but she gave up her slot for her kids to have surgery. As it turns out, they are the children of the pharmacist that had the large ventral hernia repaired last week.
We ate lunch quickly and then began the 2 – 3 hour process of tearing down and packing the 24 foot truck. We had completely finished and loaded into the vans when a man in a tie carrying a guitar on a mo-ped ran over to the interpreter and she told us he was the local pastor. They were planning on a celebration for us with singing and a regional health minister was coming to present something to us at 4:00 pm. So we got out of the vans and waited for an hour until 4:30 pm when they arrived. In the meantime the pastor played his guitar and the people sang and entertained us with Christian songs. He preached and thanked us, as did the hospital administrator and district hospital administrator. Ultimately the politician arrived with his wife and a newspaper photographer. The camera was old, but the sentiment was genuine. It was a very moving time for everyone.
Dinner back at the camp was special with rice and raisins, hotdogs, bean burritos and vegetables (tomatoes, carrots & pickles). The meal was completed with bananas. After dinner, it was time for the skits. Each dorm did a skit. Afterwards, we each had to pack our bags. Tomorrow, when we leave camp, we won’t return to the camp but go on to Santo Domingo. So, I took an evening shower tonight (still cold).
Sheri & I rode in the tan van for the 4 hour ride back. Part of the trip was bumper to bumper with crazy drivers. Santiago is a city of 1 million and took us a long time to get through because of terrible traffic. We finally arrived in town to find out that there was no running water in the cabins. The ultimate disappointment. We had to clean up to leave camp for a fancy dinner down by the Caribbean Sea at a 4 star Italian Restaurant. It was almost another hour by bus to the restaurant. The food was good and the restaurant was cold. We had gotten used to not having air conditioners.
After dinner, the hour bus ride through the city was tiring. So we set up our nets and fell asleep except for some who walked into town.
We also had the pleasure of eating last night and visiting with those who had gone to Haiti. Several were people whom I had met on previous projects to the DR. The Haiti project was more depressing than the DR and in some ways more rewarding also.
After our evening meal of rice, soy sauce, meat and salad, we had our time or reflecting and sharing with the whole group. It was great to hear how everyone had reacted and responded to the trip.
I made the observation that I had been concerned about this project because so many key people from previous projects were no longer here. Also, with B. and C.’s accident, we didn’t know what Dr. R. could do. C. made the observation that often God equips those who He calls instead of calling those who are equipped. The project was a success but not because of our plans but HIS. It rained a bit which made it hard to hear but finally quit.
Sheri and I looked forward to time together. It also allowed time to repack to leave tomorrow. We turned in about 11:00 pm and at 12:15 am we awoke to rain outside and inside. It dropped right on Sheri’s forehead. Pretty well woke us up. It was also stuffy so we left the ceiling mounted fan on but the electricity went off at 1:30 pm and that startled us. The guard’s dog went nuts about 2:30 am and they had some king of drag races at 3:30 am outside our window. At 4:30 am some of our group had to get up to get to the airport. At 5:00 am the electricity abruptly came back on so we just watched our alarm go off at 5:30 a.m.
My stomach didn’t feel good at all so I didn’t eat much before the bus ride to the airport to be there at 8:30 am. Our flights seemed very long but uncomplicated. Customs and immigration was fast and before we knew it we were speed walking through the airport just like I had never been in a 3rd world country.
