The AC in our bedroom was broken. The fan was on, but no cooling. With the windows and door closed, the room was as hot as an oven. The electric fan just stirred up hot air and made a loud noise, but it did nothing to cool the temperature down. I was sweating profusely. I got up to take a cold shower. We had no hot water for the shower anyway. The last time I took a cold shower was back in my college days, almost 40 years ago! The cold water did cool me down temporarily, but soon I was sweating again. My roommate Dr. Yu had no problem sleeping in such a hot room. I tossed and turned, and slept about 3 hours altogether. I got up and went to the balcony.
The eastern sky began to change colors. A big white rooster raised its head proudly to announce the coming of dawn. Soon Dr. Yu and Dr. Shu joined me on the balcony with morning prayer. Our new day just began.
The breakfast was relatively simple. We had some green bananas. I thought they were not ripened yet, but I was wrong. Once I peeled off the skin, and tasted it, it was sweet. I drank a cup of juice and ate two slices of pancakes. Dr. Shu wanted to make rounds before the patients got discharged, so we went to the surgical center soon after breakfast.
In the courtyard near the surgical center, some sheets and linens hanging on ropes were waving by the winds. Sunlight shined on them and made them almost transparent. I guessed this was a cost-effective way to dry the linens. This brought back my memories in 70’s. My mom used to work in a county hospital. They dried the linens under the sun too.
Most of the patients had already gone home. But my first patient was still there, ready to leave. I hugged him and took a photo with him.
The first patient was a seventeen-year-old man, who looked like a nine-year-old. There was basically no pre-op documenting the heart rate, blood pressure, height, weight, or the patient’s medical history. There was no scale to be found! I had to roughly estimate the young man’s height and weight in order to calculate the correct dosage of medication. This patient had congenital hydrocele. The operation was not complicated and took less than an hour to finish. However, the patient was very anxious and not cooperative during the operation. His blood pressure was high and he started vomiting. He was having an anxiety attack. The only sedative I had was diazepam. I injected a small dose incrementally through an IV route. The medication did not help him much. He finally calmed down once he was transferred to a stretcher. It seems that the stretcher had a calming effect.
The second patient was a 59-year-old man with a large right inguinal hernia and hydrocele. Hydrocelectomy was relatively easy, but repairing the inguinal hernia was challenging. The patient must have had the hernia for a long time. His intestines already adhered to the abdominal wall. Dr. Shu and Dr. Joliu operated together. Anesthesia was provided by the local anesthesiologists. After almost 3 hours into the operation, the spinal anesthesia started to wear off and the patient had quite a bit of pain. The anesthesiologists used ketamine and fentanyl to relieve the pain, trying to avoid converting to general anesthesia. Providing general anesthesia would be challenging, since the ventilator was manually operated. Fortunately, the operation finished soon.
Our third patient was a 58-year-old man with a large hydrocele. His symptoms were mainly difficulty in urination.
Our patients were relatively slim, I had not met an obese patient yet. Their heart rates were relatively slow, between 40-50 beats per minute, perhaps due to the fact that most of them were farmers. I had not seen patients abusing drugs yet.
Most of my patients’ spines were scoliotic, a sideway curvature of the spinal column. I guess this was due to carrying heavy weight on their heads since they were young kids. The third patient’s spine intervertebral space was very narrow. But God had mercy on me, I succeed in placing spinal anesthesia in one attempt.
I had no idea that the medication and medical supplies were in such shortage in Haiti. They didn’t even have enough alcohol pads for IV puncture! I asked the nurse for some alcohol pads, and they gave me a container of a roll of cotton soaked with alcohol!
Next time I come to Haiti for medical mission, I will bring everything that I may use including medications, spinal needles, IV needles, gloves, alcohol pads, etc.
In the United States, we waste so many supplies! We use only a portion of a vial of medication and discard the remaining. But in Haiti, medication supplies were not abundant. They save the remaining medication for later use.
Under spinal anesthesia, some patients shiver. My third patient shivered badly. We did not have a blanket in OR. We covered a surgical gown on him. I wished I had demorol IV for the shivering.
Haitians speak Creole. We had two translators for pre-op, intra-op and post-op services. Wouldn’t it be great if I could speak Creole?
The patients were very tolerant. After spinal anesthesia was placed, no other sedatives were given. The patients were fully awake for the whole operation. This was in contrast with the patients in the States who usually request to be sedated during operation.
We did 11 cases today and worked from 8 am to 8:30 pm, with half an hour for lunch break. We operated in 2 ORs at the same time.
Many patients came from villages near the surgical center, and some patients came from far away. Transportation was not that convenient for them.
One thing I learned from our medical mission was this: It is more of a blessing to give than to receive. It seems that we are the ones who bless others with the medical mission, but we are really the beneficiaries. The more I got to know our patients’ lives and their stories, the more I was impressed with their grateful and positive attitudes. They lived in poverty! Most people’s daily income was about $2, yet their smiles were genuine and contagious. No one complained! We have far more wealth than what they have, yet many of us complain and complain. Complaining is like an infectious disease, spreading from one person to another until the whole group starts complaining. Why would we let such negative attitudes ruin our day? We should be like the Haitian patients: appreciate more and complain less.
I was blessed to meet other volunteer doctors who were like-minded in serving the Haitian patients. Though we came from different places and had different background and experience, we worked together as one. We all shared one goal: to provide safe and successful operations for the patients.
This was our third day in Haiti.
