Sitting on the airplane, flying over the ocean right now. Love the view from up here. Islands scattered below surrounded by a sea of blue that stretches as far as I can see, and clouds like pillows floating above. We were thrown into the exit row so we could all sit together, and the extra foot of leg room is just about perfect (first class would have been nice....). It was really a great trip and I'm kind of sad to return, especially not knowing when I can return. There is a urology trip coming up in June, and potentially if I can work it out with my schedule I will try to come with on that trip. I have a radiology rotation in January and a maternal fetal medicine rotation in February. March is a lot of prep with the school for graduation and match week (find out where I'm going for residency), and then I leave end of March through April for the Congo in Africa to work in a hospital there with Jason Zimmermann (board member with Make a Change International). Come back from there and graduate from medical school in May. Residency starts in July. It's hard to know that in general, my global health trips will need to be limited for a while yet, but the most important thing right now is for me to continue to gain medical experience and become a better doctor. As mentioned in my last post, every doctor from Rush I've worked with in the DR has been an really top notch doctor, and it's been wonderful to provide the highest quality care to these people. I want to know that when I provide care in the future, that it's the same high quality. The best way to do that is to focus on my studies and throughout residency to really learn to practice medicine and increase my clinical skills. Not to say that I cannot use my vacation times to continue to go on trips and all, but as I'm flying in this airplane, I wish I could just turn around and stay in another country forever. A lot of what we talked about last night was what the future holds for me in global health....and I have no clue. Many of you know the vision I have, and through Make a Change International, my vision is starting to become a reality......but it's an exciting unknown really. Residency is going to prove a difficult time but also amazing in the preparation for the great unknown ahead. We are getting close to the point that the org will have some scholarship/grants set up for global health trips, and I am working with some others on developing a database of opportunities. This will allow the org to keep running and being effective in supporting global health in a variety of ways. We also have a great fundraiser coming up in February that I hope and pray will be successful and raise a lot of money to support all that is happening. As unknown as the future all is, I have faith that things will work out in a way that is better than I could have planned. Every step of my journey thus far has been different than I thought it would be, and I know that he continues to guide my steps. Thank you to each of you for the support that you provide to the work we are doing, and all the different ways you support us and me especially. As always, we really continue to need great financial support, as that is often a limiting factor. But I cannot place a value on how necessary your prayers are, as well as just knowing that you support what we are doing.....it means a lot to me. I know that great things are going to happen around the world because of all the small things I am taking part in now. In the words of Mother Teresa, "I alone cannot change the world, but I can cast a stone across the waters to create many ripples." It's my hope that everything I am doing now will start a domino effect and inspire others to do similar things. I know that my vision is too big for just me, and I hope that I can just be a small pebble that ripples along. Each of you, with all your support, adds to that ripple. May he richly bless you. Until next time.....
Tuesday, December 16, 2014
Dominican Republic December 13, 2014
Our final day in Peralta working in the hospital. Sad to see it go by so fast. It was a quick trip, yet at the same time, it feels like it's been months since we first arrived. It's easy to lose yourself here. The people are amazing, the area is beautiful, and the work that we do is fulfilling. It's the little things too, like the coffee. I wish I could explain how much I love the coffee. They grow it here in the mountains, and the place we get it from (a guy named Chino) is an all organic farm that is some of the most expensive in the area. When they ship it out to the rest of the country and the world they import the coffee from all over the area and mix it together. So by the time we get coffee, even if you were to go buy organic Dominican coffee in the states, you would be getting a mixture of all different qualities. Here, it's pure, one of a kind, perfection. It's the smoothest most delicious coffee you've ever tasted. They also bring us this "hot chocolate" every morning, which is not like hot chocolate you are thinking of at the moment. It's basically liquified chocolate mixed with milk -- best way I can describe it. It's pretty much just amazing, and really hard to describe without tasting it. So we get that every morning too, and if you mix it with the coffee you kind of can get like a mocha. All throughout the day then they bring us coffee, so we were able to keep caffeinated and plow through all the surgeries. Since I'm on the topic, I'll describe the food a bit. Breakfast is usually some bread, peanut butter, processed meat and cheese. Simple. And coffee! Ok, moving on from coffee (I think you get the point). Lunch is usually rice and beans, some type of chicken, and some yucca, okra, mashed plantain, or some other banana creation that is fried or something. Dinner is pretty similar as well. They do quite a bit with banana, plantains, and yucca. The meals are all prepared by the pastor's family that the group that runs our logistics is partnered with. The logistics connection is called Del Camino Connection, or DCC, and that's where Henry and Alfredo work. So they handle all the lodging, travel (gas is like $5 a gallon here, was $7 a few months ago), food, water, etc. Anyway, so on our last day we had 5 surgeries. We did 3 adenoidectomies, 1 cleft lip revision (looks great now), and 1 bilateral ear keloid removal. We were supposed to have these two kids come in with bilateral cleft lip and palate disease, but we never found out what happened to them. I guess they talked to Wendy (one of our people in the DR) who had set it up and they were traveling from afar, but we lost contact. Hopefully in the future we can connect and help them. The day went really well though, again with no complications. Peter is an absolutely amazing surgeon, and really really humble about it. He continues to be a great teacher too, always looking for little tips to give me for my future as an ER doctor as well. I'll definitely be posting some pictures of the lip revisions that we did and you'll be able to see his artistic surgical skills as well. It's great to not only be able to provide surgical care that is helpful to these people, but also to provide top notch surgical repair. Like, he's the guy you would want to go to if you needed a facial plastic surgeon to repair something. That's what I love about working with Dr. Wang and the other's from Rush. We aren't providing sub-par care that is free, we are providing the best, most high quality health care available -- and otherwise, as mentioned before, these people would never receive any of it. It's really crazy how the system works because you can get a lot of health care here....if you have money. In the evening we drove back to Santo Domingo, which is a couple hours away, to spend the night and make the drive to the airport in the morning a little bit easier. We stopped at a local grocery store in Peralta first to buy some coffee, then once we hit Santo Domingo, Henry, Oscar, Peter, Stephanie and I all grabbed dinner at this chicken place. Chicken here is really quite amazing. Probably because it was clucking a few minutes before. Afterwards Henry dropped the three of us off at this little hotel, and we sat on the rooftop relaxing and talking about the trip. It was nice to relax and get to know each other a little more as well, talking about our travels and our future goals in global health and medicine. It's really awesome to work with like minded people who have great experience in this field, and both Stephanie and Peter have traveled extensively and have a lot of helpful input. I look forward to a future that involves working with both of them.
Dominican Republic December 12, 2014
Third day in the DR was a busy one. We had 7 surgeries scheduled, and with only one ENT surgeon, with myself to assist and Dr. Wang doing everything else, we knew it would be a little crazy. Today was Tonsil and Adenoid day, and one nasal polyp biopsy/removal. Most of these kids have huge chronically infected tonsils and adenoids, and many of them were symptomatic (trouble breathing/eating/fevers/etc). Taking them out may seem like a minor thing, and maybe even routine in some regard, but here it is difficult to get surgery. One of the moms was explaining how she had placed her child on a waiting list for six months to have the tonsils removed. When the day of surgery came, they drove a few hours to the hospital and waited....and the surgeon did not show up to do the surgery. The next available slot was a year later. You hear stories like that and it makes our small trips feel much larger. Sure there are 60ish kids waiting for these surgeries in this region, and we will do a total of of 15ish this week, abd again with one surgeon and a total of 3 people from Rush here working.....enough said. The most amazing thing is that this really isn't a "short term service trip" by any means. Because Dr. Wang and the Rush group travel here so frequently, we can tell people that we will be back and we can schedule them for another trip. Many of the surgeries we would like to do, we simply do not have the supplies needed. But now knowing what we need, we can try to acquire those supplies before the next trip and maybe we can do some more of those complicated cases. Either way, this short trip is going to have some amazing results. This evening after we finished all the surgical cases, we drove back down to Azua (the main region that we are staying in). There is a hospital there owned by the Taiwanese (long story) and a general surgeon and his wife, who is an anesthesiologist, invited us to join them for dinner. They are both truly incredible people. He works in the area and does some cases at the hospital that we work in. When we do trips here, he comes and volunteers his time to do some surgical cases as well. I guess he says that if we can come from America to do free surgeries, he can come help his own community alongside us. His wife works in anesthesia in the Taiwan hospital and was a big asset when the orthopedic surgeons were here with us a few weeks ago (they worked in that hospital as they have more ORs and more ortho equipment). Anyway, we met them at a building they work in, which had a rooftop party thing going on. They ordered pizza (which was quite delicious really, and had the most meat I've ever seen on a pizza) and we got to relax and chat with them and a few of the other Dominicans we have been working with. When we got back I decided to take a hike up the mountain to the dam/waterfall I had gone to a few weeks ago. I like night time hikes, and with it being11pm and pitch black, the stars are absolutely amazing. It's about an hour walk there and back, so it was a nice quiet hike and a chance to reflect on things that happened the last few days. I'm looking forward to tomorrow and finishing the rest of our cases. We were supposed to have two more cleft lip/palate kids come in, but we haven't heard.....maybe they'll just show up. But we have 4 cases otherwise scheduled for tomorrow. Thankfully we haven't had any surgical complications or post-op infections. Actually, Dr. Wang said that over the years they've done over 800 surgeries and never had a really severe post-op infection. Considering the conditions in which we do surgery, and the limited resources.....it's amazing. I can describe in detail to you in person sometime kind of how different things are, but it would be difficult in a short post to really give you a good picture of it. Maybe if you see some pictures from the trip on the website you'll get an idea for how different things are. I think that God has his hand on this place though and he is watching out for everyone that comes on these trips, whether they believe in him or not. He definitely has not forgotten about these people. Continue to pray for our success here, and pray for the people of the DR, especially the community here in Peralta.
Dominican Republic December 11, 2014
Today was the day we began the adventure of ear nose and throat surgery in the Dominican Republic. We started our day at the hospital in Perralta about 8:30am, and thankfully having Oscar as our anesthesiologist, who knows the lay of the land, we started pretty quickly. We kicked things off with a full palate repair. You've heard of kids with cleft lips and palate? This little guy had already had the first procedure, which was initial repair of the lip, and we were the first ones to start fixing his palate. It's a fairly complex procedure, separating the muscle and mucosal layers, and crossing them over in a z-like pattern to close the gap and create the palate that you and I are so very accustomed to, that allows us to do things like swallow, talk, and eat without food coming out of our nose. It took a couple hours, but the result was definitely a successful one, and we can only hope that all the post-op instructions are followed and no fistulas form. Fistulas, or small holes, can happen in the palate between the hard and soft palate, and apparently studies have shown that it is more common in countries like this than in America. Maybe because of some misunderstanding for how to care for the kids after surgery....but we aren't sure. In addition to the palatal reconstruction, we had two palate revisions today, which was fixing these fistulas that had formed over time.....again, not sure why, but it happens. Peter is a great surgeon, and a wonderful teacher. He has walked me through every step of the surgery, and it has been amazing to see how this works. Even more amazing to see the final outcome with these kids. We also repaired another cleft lip, which had already had an initial repair, but over the years as the child grew, he needed another surgery. I can't wait to post the before and after picture for you, because it is tremendous. We also did a revision on a lip for one of the palate kids too. So, overall we did 4 surgeries today, 1 palate reconstruction, 1 stand alone lip revision, 1 stand alone lip revision, and 1 lip revision and palate revision. The kids afterwards were doing great, and we will keep them at least overnight to make sure everything goes well. It's a cool surgery to take part in because there is definitely immediate gratification. Seeing these kids with gaping holes in the top of their mouth, affecting their daily ability to communicate and eat, and the deformed lips, which I'm sure affects how others treat them in some way.....it's just cool to be part of fixing that and giving them a new way of living. Overall we did surgery from about 8:30am until 7ish-pm, so it was a good long day. Tomorrow we have several tonsillectomies and adenoidectomies, which is going to be a little bit quicker each surgery but a long day nonetheless. I'm really glad I came on the trip, especially as there is only one ENT surgeon and no one else to assist.....Dr. Wang has her hands full with everything else going on, and though I'm sure she could handle it with pre-op and assisting in the surgeries, I think it's helping to take a load off and make things flow more smoothly. Peter has had me assist on some of the operations as well, and I've been doing a lot of just the nuts and bolts of getting things set up, moving along, and "scrub nursing" for the operations (making sure he has everything, passing the instruments and all that, etc.). It's nice to get to play all the roles in medicine, especially when you have to set things up from scratch that are normally just "done" in the hospital setting. It teaches you quite a bit outside the normal. Anyway, time to turn in for bed as we have a long day ahead of us tomorrow. I'm trying to take some more pictures on this trip and have some to show you when I return. It's hard to get some with me in them, but I have some of the patients and the surgeries we are doing, which is more important I think. Thanks for reading.
Dominican Republic December 10, 2014
Today we flew back to the Dominican Republic. Small group this time, just Dr. Wang, an ENT/plastics doc named Peter, and myself. We will meet up with Alfredo and Henry in Santo Domingo, and Oscar will again be joining us to do anesthesia. Our journey down had a few mishaps, as I suppose I expect on any trip now. We arrived at O'hare at 3am for our flight, only to have that flight cancelled, resulting in us missing our connecting flight in Miami. Thankfully, we were rebooked on the next flight and still made it down to Santo Domingo. The only downside being that we arrived 3-4 hours later, and there were patients waiting to be screened for their surgeries the next day. Alfredo picked us up and we drove the few hour trip from Santo Domingo to Perralta in Azua, south west of the city. I've only been here once before, on my trip a few weeks ago, but it strangely feels like I'm driving back home. I see familiar sights of landscape and the houses and mini-stores set up along the way. It's nice to be back. When we arrived at the clinic, I started seeing patients with Peter, setting up surgeries for the next couple days. Thursday will be several cleft lips and palates, Friday looks like Tonsillectomy and Adenoidectomy day, and Saturday we got a mix of things. Sadly, we again have to turn away a lot of the people that have traveled and waited all day for us. But, we'll see how many we can get through, and with just the one surgeon, it'll be an impressive amount regardless. As we learn very little ear nose and throat type stuff in medical school, save my dissections of cadavers, it's already been a fascinating and educational experience. I'm looking forward to the surgeries and continuing to enhance my hands on skills. Even the "basics" like placing IVs and all that pre-operation stuff, that very few med students and even doctors do, I'm looking forward to doing and increasing my experience. The next few days are going to be very busy.....like I'm sure next to the insane level. Even today we didn't finish with our patient screenings until 11pm, which considering I didn't sleep the night prior and only napped on the plane for a few hours, it's a little tiring. But knowing that you're providing a service for these people that they could not otherwise obtain, is as always, just the most incredible feeling. Surgical trips are always more instantly rewarding as I'll be able to see the effects of our work immediately -- and will be able to share that with you in some regard through some pictures. Anyway, I'm just going to jot down some thoughts each night and a little recap of the day, and I'll upload all of these to the blog when I return, so you'll be able to read the whole trip at once. I didn't get to do this much on the last trip given some time constraints, but I'll make sure it happens each night, even if it's just for a short while. I know you all are praying for us back home, and I thank you for the support you offered in that way during this time.
November 8-16 Dominican Republic Trip
Finally, I get a chance to sit down and reflect on the trip that took place and share our experiences with you all. We flew out of O'Hare on Saturday morning, and the trip started out with great success as I was able to talk to the manager at the JetBlue check in counter and get all of our second bags packed with medical supplies checked onto the airport for free -- saved us about $600-700. We connected in San Juan and arrived in the DR that evening. The medical team from the prior week was on their last day, and we were able to meet up with them for lunch and discuss a bit about what they did and the patients they saw. Sunday morning we left Santo Domingo and drove about 3 hours to Peralta, where we spent a bit of time sorting through our supplies and started pre-screening patients for the surgeries in the coming week. The general surgeons will be doing things like hernia repairs, mass removals, hysterectomies, tubal ligations, etc. and the orthopedic guys will be working in a hospital in Azua. Sadly, we didn't have a great deal of supplies as far as orthopedic stuff goes, so we had to turn away some people that could easily be fixed in the states. Things like plates and screws are not cheap, and they are hard to come by in the DR. Motor vehicle accidents are common around here, especially motor bikes vs cars/vans/trucks, so lots of broken bones. We saw one guy right off the bat Sunday morning who had previously shattered his femur and had some plates put in, but reinjured somehow and came to us with metal hardware sticking out of his knee -- basically have to amputate here because otherwise we would need 5-6 surgeries with a total process of about a year -- impossible here. He never showed up for surgery, I guess he was keen on the idea of keeping his leg, though the infection that he has will kill him at some point.
That afternoon we worked in a clinic in the main part of Peralta, and I lost count on how many patients we saw, but I think we scheduled about 40 surgeries, and declined quite a few cases or deemed them non-surgical candidates for one reason or another. The masses were gathered outside and we sadly had to turn away another 50+ people that we just could not possibly see. At some point you realize that we can't fix everyone....though that doesn't make it any easier. Having to walk through the crowds and apologize that we had no more space....words don't quite describe it. Some of these people travelled several hours, and waited all day long to see us....and we couldn't help them. Again, you have to realize that there is no way that we could see everyone, and there will always be more to patients to treat. But, that's the benefit of working with a group like this that returns to the same area over and over, year after year.
We scheduled about 6-7 general surgery cases a day, and a gen surgeon who does OB/GYN stuff who is from the DR came in to volunteer and do hysterectomies and tubal ligations, and he has a good number of those scheduled each day.
Monday morning we started our surgical cases. I started out helping in the pre-op area, getting IVs placed and all that. Then I started to circulate the OR with our two gen surgeons, scrubbing in on a few cases throughout the day to help assist or close the patients. Surprisingly, things ran fairly smoothly for being the first day. We did 6-7 gen surg cases, 2 hysterectomies, and 6-7 tubal ligations. Every surgery went well. We had one patient several hours later who spontaneously went into respiratory distress and was found cyanotic and not breathing. She ended up doing ok - though we monitored her throughout the night and made sure she continued to breathe. She ended up having some strange narcolepsy disease, but it had been going on a long time. So, as soon as she was ok to go home, we discharged her.
The group I'm here with is absolutely amazing - gen surgeons, ortho, nurses, PA student, CRNA, and our fearless leader Dr. Stephanie Wang, who started this whole process at Rush and makes all this possible. She's an incredible inspiration to me, and proves to anyone and everyone that it's possible to do global health in a way that really partners with communities and empowers them. I'm privileged to learn from her and honored that I get to be part of this experience. it will be invaluable for my training as a doctor and in global health. The entire group is just a joy to be around though and in the evenings, after the work is done, we have a good time. The bonds that form between people while doing medical service work is like none other -- and maybe it's the "I haven't showered in a while and I'm standing in surgical gear super close to you sweating like crazy and changing people's lives".....but everyone pretty instantly connected and the celebrations at night make all the hard work of the day that much easier.
In the past I've sent these posts out to you nightly and asked for prayer requests and such at the end, sadly as I am posting these all at once at the end of the trip I cannot do that. However, for all of you who had been praying for our success during the whole trip, thank you so so much. Knowing that you all are back home in support of this is wonderful, and helps me to keep going. I ended up not getting to write down each night as much as I had hoped during this trip, but now that I am sitting back home I will recap a little more for you.
The entire week was an amazing success. We ended up doing 92 cases in total, with about 80 of those being major surgeries. This included the general surgeries, orthopedic surgeries in Azua, and the assistance of the Dominican surgeon. It was really amazing how much we got done in just 5 days. Every day we worked hard, long hours. But everyone kept such an amazing attitude and worked so hard, it was inspiring. I spent one of the days in Azua with the ortho guys, and I have to say, I saw some of the most bizarre things in my life. People that had been in accidents years before, with horrible fractures healed wrong, walking on legs that looked they had two knees.....just crazy. We were fortunate in that the hospital there ended up having some hardware that the ortho guys were able to use, and we were able to do some tibial and fibular nails to repair broken bones. Normally you would do these with constant x-ray, but not in the DR as they just don't have it. So we did a lot of it blind, and I prayed. It was amazing that every surgery went smoothly and there were no complications. I just returned from my second trip as well (read the later blog postings) and everyone is doing just amazing. No post-op complications, even in the conditions we were in. There was one point where this fly was buzzing around the OR, and even during the surgery landed in the open surgical site......one of the nurses squirted some antibiotics in there and we moved on. It reminded me of that episode of breaking bad where the guy is hunting down the fly for the whole 45 minutes.....yeah, that was us. I think I scrubbed out at one point and tried to find that fly. No such luck. But, he didn't infect our patient, so thank God for that.
I will be posting some pictures on the website, so please check them out. Also, on the next trip I went on I was able to blog each night, and all those are now posted as well, so please read. I was able to type more about the area and such too. Thanks for reading, and thanks as always, for your support!
Wednesday, August 6, 2014
.....well I obviously made it home
For anyone who was interested and read through the stories from my trip to Haiti, I could not find the email that ever said that I actually made it back to America. Sooooo I figured I would recap just slightly on how things worked out in the end.
I did finally get a flight, which cost about $2500 because the only option was first class. So the next day I went back to the airport, and was supposed to check in with delta airlines to get my flight for air-france. When I went up to the counter they told me that "the flight didn't exist." By this point I almost wanted to just start laughing because it was so ridiculous, but I remembered what I was told about how Haitians don't like to wait in line and if I wanted answers I should march right up to the counter. So that's what I did, I skipped the lines and went right to the counter.....and they found my flight. Mislabeled it or something, couldn't totally understand. I was luckily able to land that flight back to Miami, and from there spent a night in the airport waiting for my next flight to Atlanta, and then from there finally back to Chicago. It was a long flight, especially having not showered in quite some time, but being first class for part of it, and convincing them to give me business class for the rest, it made it endurable for sure.
When I finally made it back to Chicago, I was lucky to find out that the surgeons I was scheduled to work with for my rotation actually canceled surgeries that day, so I was safe.
I commenced a long discussion with JetBlue, trying to get them to refund the costs of me getting home. At first they claimed they weren't responsible for "acts of God," however, when I explained to them that they told us at the airport it was a scheduling error.....well I got the same response lol. Ultimately I started tweeting them (first use of twitter ever btw) and they responded pretty quick. Guess they don't like people posting horror stories in the twitterverse that they cannot control.....so they ended up refunding the original flight, giving me some compensation to pay for the other flights, and a flight credit to use in the future. So, pretty much all worked out in the end.
It was a great trip and I learned a lot. Writing this so far away from it (8 months) it seems like forever ago. But, if any of you are reading this now, just know that things are going well and I hope to go back to Haiti in the not so distant future. Thanks for all your support.
-Aaron Tabor
I did finally get a flight, which cost about $2500 because the only option was first class. So the next day I went back to the airport, and was supposed to check in with delta airlines to get my flight for air-france. When I went up to the counter they told me that "the flight didn't exist." By this point I almost wanted to just start laughing because it was so ridiculous, but I remembered what I was told about how Haitians don't like to wait in line and if I wanted answers I should march right up to the counter. So that's what I did, I skipped the lines and went right to the counter.....and they found my flight. Mislabeled it or something, couldn't totally understand. I was luckily able to land that flight back to Miami, and from there spent a night in the airport waiting for my next flight to Atlanta, and then from there finally back to Chicago. It was a long flight, especially having not showered in quite some time, but being first class for part of it, and convincing them to give me business class for the rest, it made it endurable for sure.
When I finally made it back to Chicago, I was lucky to find out that the surgeons I was scheduled to work with for my rotation actually canceled surgeries that day, so I was safe.
I commenced a long discussion with JetBlue, trying to get them to refund the costs of me getting home. At first they claimed they weren't responsible for "acts of God," however, when I explained to them that they told us at the airport it was a scheduling error.....well I got the same response lol. Ultimately I started tweeting them (first use of twitter ever btw) and they responded pretty quick. Guess they don't like people posting horror stories in the twitterverse that they cannot control.....so they ended up refunding the original flight, giving me some compensation to pay for the other flights, and a flight credit to use in the future. So, pretty much all worked out in the end.
It was a great trip and I learned a lot. Writing this so far away from it (8 months) it seems like forever ago. But, if any of you are reading this now, just know that things are going well and I hope to go back to Haiti in the not so distant future. Thanks for all your support.
-Aaron Tabor
Stuck in Haiti, January 4, 2014
Hello again everyone,
Well, sadly I did not make it out. Had a pretty terrible day here in Haiti. My flight was initially delayed due to weather in New York, but my connecting flight was 6 hours later so Jet Blue assured us that even with the delay we would be ok. Thus I didn't pursue any other flights out of Haiti. The plane landed from New York in Haiti at 2:30 pm.......at 3:30 one of the flight attendants walked by and asked if we were taking the plane to JFK, and when we said yes, he was like oh it's about to leave you better hurry ---- mass panic. Literally everyone rushed the gate. After an hour of standing now surrounded by angry screaming Haitians, Jet blue informs us that they cancelled the flight. Why? Not because of the weather but because the flight crew worked too many hours and they could no longer continue -- they couldn't have told us that like 6 hours before? Or when the flight left New York? Clearly they knew how long the flight crew had been working. So, asked for a flight to Miami -- all flights are actually cancelled. Jet blue shut down. No other flight until.....wait for it........Thursday! Where should I sleep you ask? They said the airport. For 5 days. No food vouchers, no hotel, nothing. Their area is awful too cause you go through a separate extra security so once you're in, there's no bathroom no food nothing. You have to leave and redo all the security. So we were already a little cranky. Now you're telling me to sleep in the airport until Thursday???? And at this point the other airlines had nothing available either. Completely booked with no options. Jet blue remained adamant and said that if we wanted a flight, it was Thursday - take it or leave it.
Now Bob and Rae had apparently put an alert on their phone for my flight, and when they found out it cancelled they emailed me. At this point, out of the jet blue area I was able to pick up so,e free wifi and saw their email. They were incredibly gracious and came back to the airport and waited a couple hours as I tried to get a new flight. Eventually we just left and went back to their place. My parents were working back home to try to find anything sooner than Thursday (especially cause I start surgery on Monday, and they wouldn't take kindly to being late), and as soon as I got back to Bobs I started searching too. After a couple hours we were able to get a crazy expensive flight to Miami and a couple hours after that found another crazy expensive flight to Chicago on Monday morning, arriving at midway at 9:30am (hopefully anyway). I just emailed my rotation coordinators and pleaded my case, and am really hoping that they realize I, doing the best I can -- even just paid $2,000 to get home. Ugh and so far Jet blue has said they won't do anything about it. So far def the worst customer service I've ever dealt with. They told us at the airport that it had nothing to do with weather, just that they didn't schedule properly. But then later said they're not responsible for acts of God and that's why no vouchers or anything. I'll be discussing with their customer service department for a while to come I'm sure.
I was hoping to have a day to rest, unpack, shower (water is still out so been about 5 days), and prep for my new rotation.....which won't happen haha. I'll get back and immediately drive to Skokie to start surgery. Hopefully they still let me start the rotation and don't kill my evaluations too bad for being "unprofessional" based on their standards. Anyway, hopefully I actually make it back lol. Gonna be a long couple days here. I'd ask for prayer that I make it back on time.....but that's already passed lol, so we'll just see what happens. Thanks for reading. I'll let you know if I'm ever back in America.
-Aaron
Well, sadly I did not make it out. Had a pretty terrible day here in Haiti. My flight was initially delayed due to weather in New York, but my connecting flight was 6 hours later so Jet Blue assured us that even with the delay we would be ok. Thus I didn't pursue any other flights out of Haiti. The plane landed from New York in Haiti at 2:30 pm.......at 3:30 one of the flight attendants walked by and asked if we were taking the plane to JFK, and when we said yes, he was like oh it's about to leave you better hurry ---- mass panic. Literally everyone rushed the gate. After an hour of standing now surrounded by angry screaming Haitians, Jet blue informs us that they cancelled the flight. Why? Not because of the weather but because the flight crew worked too many hours and they could no longer continue -- they couldn't have told us that like 6 hours before? Or when the flight left New York? Clearly they knew how long the flight crew had been working. So, asked for a flight to Miami -- all flights are actually cancelled. Jet blue shut down. No other flight until.....wait for it........Thursday! Where should I sleep you ask? They said the airport. For 5 days. No food vouchers, no hotel, nothing. Their area is awful too cause you go through a separate extra security so once you're in, there's no bathroom no food nothing. You have to leave and redo all the security. So we were already a little cranky. Now you're telling me to sleep in the airport until Thursday???? And at this point the other airlines had nothing available either. Completely booked with no options. Jet blue remained adamant and said that if we wanted a flight, it was Thursday - take it or leave it.
Now Bob and Rae had apparently put an alert on their phone for my flight, and when they found out it cancelled they emailed me. At this point, out of the jet blue area I was able to pick up so,e free wifi and saw their email. They were incredibly gracious and came back to the airport and waited a couple hours as I tried to get a new flight. Eventually we just left and went back to their place. My parents were working back home to try to find anything sooner than Thursday (especially cause I start surgery on Monday, and they wouldn't take kindly to being late), and as soon as I got back to Bobs I started searching too. After a couple hours we were able to get a crazy expensive flight to Miami and a couple hours after that found another crazy expensive flight to Chicago on Monday morning, arriving at midway at 9:30am (hopefully anyway). I just emailed my rotation coordinators and pleaded my case, and am really hoping that they realize I, doing the best I can -- even just paid $2,000 to get home. Ugh and so far Jet blue has said they won't do anything about it. So far def the worst customer service I've ever dealt with. They told us at the airport that it had nothing to do with weather, just that they didn't schedule properly. But then later said they're not responsible for acts of God and that's why no vouchers or anything. I'll be discussing with their customer service department for a while to come I'm sure.
I was hoping to have a day to rest, unpack, shower (water is still out so been about 5 days), and prep for my new rotation.....which won't happen haha. I'll get back and immediately drive to Skokie to start surgery. Hopefully they still let me start the rotation and don't kill my evaluations too bad for being "unprofessional" based on their standards. Anyway, hopefully I actually make it back lol. Gonna be a long couple days here. I'd ask for prayer that I make it back on time.....but that's already passed lol, so we'll just see what happens. Thanks for reading. I'll let you know if I'm ever back in America.
-Aaron
Haiti Day 6, January 1, 2014
Happy New Year!
Today started off pretty slow. It's Tuesday, and I guess that means it's their big free market day, so most people were there. Also, tomorrow (New Years Day) also happens to be Haitian Independence Day, which is a big deal. There is lots of pumpkin soup in store for me tomorrow from what I hear. Apparently that's a big thing here in Haiti for Independence Day....so we shall see. They aren't the big orange pumpkins we are used to, but these small greenish ones -- I've never had pumpkin soup....but I like pumpkin pie.....I'm excited to try it. Anywho, between the big free market and the preparations for tomorrow (today at this point), people don't come to the hospital. Sure, we have the ones who have been here receiving treatment, but the nurses pretty much had everything under control and everyone was stable. So, I just kinda chilled out for a while....which was nice given the busy last few days I've had. I decided to go for a run, as I haven't had a chance to really explore yet, and I'm feeling out of shape given that I don't exactly get to go to a gym every day here. I guess Haiti means "the land of many mountains," and it's definitely the case. You can tell you aren't in Illinois flat lands anymore haha, everywhere you look there's a mountain. So I took off outside the complex down the rocky road, passing the concrete structures that are their homes and the truck trailer storage container things that they have converted into small shops. Pretty much every building here is made of concrete....one cause it's stable but also cause it keeps everything at least a little bit cooler. By a little bit, I mean it's still hot and muggy and you pretty much are just in a constant state of sweating.....considering all of you are reading this from Chicago that probably sounds good right about now compared to the probably like 0 degrees and snowing.....but after a few days, cooling off would be nice....after their whole lives they probably don't notice. Anyway, I'm running down the road, with buses, trucks, pick-ups with 20 people in the back, and those crazy motor bikes with like 3 people on the back are flying down the road and zig-zagging around each other. They say in America we drive on the right, in England they drive on the left, and in Haiti they drive wherever is the quickest -- literally, they just don't have any concept of a traffic laws....it's a sight to see. So, I'm braving the dangers of getting run over and running down the street listening to the new Daughtry album (great to listen to English words haha), and it's definitely just absolutely beautiful. I got to one point where there was a path going up the mountain, almost like a goat trail or something (and yes there are goats everywhere, along with dogs, donkeys, roosters, and chickens) and started to trek up that. Got some pretty sweet pics that I'll send you when I'm back. Just beautiful. I wanted to keep going higher but at this point I realized that I was sweating a lot, had no water, and was starting to get tired....it had been about a 35 minute run at this point, and I still gotta run that distance back lol. Tomorrow if I have time I'll try to run down the other way towards where they have the market set up.....I think it's still going on tomorrow or something.
At dinner time (7ish) I was pretty much planning on just eating and then going to the 9:00 to midnight church service to ring in the new year. I ran down to the hospital just to make sure all was quiet, and of course it wasn't. There had just been a huge motor cycle accident and several pretty badly injured people. The medical director saw me and was like "oh thank God, you're just in time." He was planning on going home at this point as he had been there all day, so he was grateful to pass the baton to me. He wrote the prescriptions for the patient's families to go and get the supplies I needed, and the nurses started prepping for me. He was pretty much like, "you got this," and he left. It's funny how at this point they pretty much trust me with whatever. The nurses all were getting ready to stitch up this lady's leg and I walked over, looked at it, and told them that no, suturing wasn't necessary, we could just bandage it up as it wasn't deep enough for stitches (it was more like just chunks of the skin were out). They were all like, oh ok, you're the doctor. When the other doctor came in later and saw, she was relieved that I didn't stitch it.....so I guess I'm getting the hang of some of this. That same lady had a nice laceration along side the inside of her bottom lip. Now, I've worked with an oral surgeon before.....but I just suctioned blood as he did all the hard work.....but I realized as I started to clean this lady's lip that working inside of mouths is tough work....for one she kept yanking her head away every time I touched it. Then the other doc recommended soaking the gauze I was cleaning with in Lidocaine first to get some topical numbing going on....that helped quite a bit. I'll remember to do that next time. The doc kept saying, "Aaron, you are a criminal, you're so mean!" As she laughed cause all the patients in the room were in so much pain and there I was making everything momentarily worse by squirting betadine into their wounds. I offered to let her take over, but she said she preferred that the patient's kept liking her for the moment. Anyway, stitching up her lip proved to be just as difficult, and not until I was done, doing individual stitches as we do on most wounds, did the doc say that for mouth wounds a running stitch is just fine. No biggie, just woulda made it about 5 minutes quicker for me. Good to know as well for the future. Another guy had a broken left arm with lots of surface wounds, so we pretty much just cleaned it, wrapped it with a ton of gauze, then some ace bandages, and put it in a splint.....pumped him with some fluids. I'm still not sure what we are gonna do for him beyond that. Can't exactly x-ray it to see how bad it is.....but it's clearly broken.....I think they may send him to the bigger hospital once he's more stabilized. Right as we were finishing up all this, two more guys came in that had some sort of head on collision on their motor bikes. The one guy was wearing a helmet and only had some cuts and abrasions on his hands and back. The other guy had this huge spidering slice in the back of his head, along with multiple other wounds. I looked at them both, pointed to the helmet, and gave the guy who had it a thumbs up. He smiled, and the other guy just shook his head. Sounded it like it was the helmet dudes fault that the accident happened, and he felt pretty bad....I think he paid for the other guy's supplies too. I helped as Dr. Josef stitched up his head as it took quite a bit to hold him down and keep the wound closed as she was stitching. He was howling and screaming the whole time.....and I felt bad for him cause he did have like a 4 inch slice in the back of his head. I laughed then when I started cleaning his ankle and back (minor abrasions) and he screamed just as much. I was like, "dude, I just fixed a hole in your head, seriously this can't be that bad!" All the nurses were laughing at this point cause it def seemed out of proportion to his prior injury. By the time we finished fixing up all the injured people from the accidents, I looked at my watch and it was 12:03 -- gotta say, what a great way to bring in the New Year though....fixing up people, arms deep into the blood and guts (slight exaggeration haha)....I was sad that I missed the service, but this was obviously more important.
Dr. Josef asked if I had decided to just stay in Haiti, and I told her that no I have to leave on Friday back to Port-au-Prince -- to which she said she was very sad....I have become their friend and they like having me there to help. She wanted to know if I would ever return, and I told her yes, I hope and plan to, potentially with others as well. She was very happy about that. It is pretty cool to see how everyone reacts to me now when I'm down in the hospital. A few times some patients have needed stuff and she told me to just write the prescriptions....when the nurses looked at them they were like, who is this? She told them, oh it's Dr. Aaron....and they all smile and go fill the prescription. Now when there's emergencies and I'm there, like tonight, they almost defer to having me fix things up and they start prepping to assist me. They are usually pretty quick to start the IVs, so I haven't gotten a lot of practice with that....but that's okay, I can't do it all. Today, one of the guys that mans the front door (almost like a security guard) asked what my cell phone number was so he could call me if there was an emergency. I told him that my phone only worked in America, so it wouldn't work.....just come upstairs and find me if he needed me. I'm definitely still learning a ton, and each time I've fixed someone up I realize a way that I could have done it better, made that stitch a little straighter, a way to do it quicker, make it less painful, etc. But then I think about how I've watched some of the nurses stitch people up, and they don't think too much about scars haha, they just want to get em stitched up and on their way quick so they can help the next bleeding person. Today, when I was stitching the lady's lip, she kept pulling away and screaming how much it hurt. I pointed to my lip, where there resides a scar from when I split it open. I was only 2 years old at the time, and I ran into the corner of a dresser.....tore that thing to as many shredded pieces as you could imagine. They say you remember the most traumatic things in life....and I definitely can account for everything that happened that evening as the ER people said they couldn't help me, and then called in a plastic surgeon who strapped me to a table and started his work. Now, luckily this cut was on the inside of her mouth, and it wasn't as ugly to where a plastic surgeon was needed as far as rebuilding the muscles as well.....but it got the point across to her that I understood that it hurt, and that I would do my best to fix her up quick and as painless as possible. After I showed her, it def calmed her down a bit.
We'll see what tomorrow holds. In general, should be another quiet day in the hospital as most people will be celebrating the new year and Haitian independence....eating all of their pumpkin soup -- I hear people sometimes get sick from eating too much, so maybe I'll be treating some stomach aches haha. But, I'm sure there will be some motor bike accidents and the need to fix some more people up. Usually they come in towards the end of the night, cause as I've said they drive absolutely crazy here....and in the dark, with no helmets, it's just a disaster for their heads. I did a quick neuro check on the one guy and it didn't seem like he had any crazy symptoms, but who knows if he had a concussion....I can't imagine how he wouldn't given how hard he must have flown off that bike. Maybe I'll get a chance to check out the market, we'll see. I probably will sleep a bit after breakfast (they seriously don't eat without me, so I have to make sure I'm on time for meals....I felt bad when I didn't show up for dinner the other day and they waited the 2 hours until I got there to eat with me....sure I was fixing people in the ER, but I was like, oh please just eat without me...) and try to rest up for the likely long night ahead of me again. Not sure how long I'll be at the children's home on Thursday, but I'm guessing if there are accidents in the ER I'll be there again Thursday night. Oh, btw, the pregnant woman from yesterday....not entirely sure what happened with her....when I got down there this morning she was gone.....I think that they transferred her to the bigger hospital because they thought it was going to be a complicated birth, so still no Haitian babies at this point. We'll see if one comes in the next two days, otherwise I'll have to wait to get my experience with that part of medicine in the third world until another time (which I'm okay with, I think I could def use some more experience first).
In thinking about the potential to come back here and help out again in the hospital, I'm trying to think of ways that I could serve needs specifically, so that leads into my prayer requests.
Prayer:
- That God would lead me to more specific ways that I could be of service to the people in this area in regards to medical needs that are not currently being met. I think I mentioned but like a doctor is coming in next few months to run an ear clinic for them.....so something that they don't get everyday that would be of use. I'm definitely a big help in their ER, mostly at nights, so maybe something a little more specific that I could do for them during the day so that I'm not just running around trying to see if I can help, sometimes having nothing to do for a few hours. Maybe part of it is that I'm used to never sitting still, so when I have even 2 hours of down time, I'm like itching to go do something -- they are all like, oh good you get to relax for a bit -- I'm like AHHHHHH!!!!!! So, yeah, anyway, I think it would be good for future trips to have more of a set schedule anyway.....maybe something along the lines of traveling out to the areas where people may not be able to come down and get help at the hospital. I tried to ask Minel a bit about it this morning....about villages maybe that don't have their medical needs reached, I'm not sure he entirely got my question, but I know that Bob and Rae had mentioned some villages that are only visited every once in a while, so that may be something to look into.
- Today, just about as soon as I got down to help in the ER, I had the nastiest migraine strike me. I took some Excedrin, but that has done next to nothing and I'm still in a decent amount of pain and pretty nauseous....but hey, God is good and he helped me push through, so thanks for your prayers -- they're helping me have the strength to keep going through it.
- Pray for all of the people that I'm treating. I'm doing the best that I can with the situations presented to me, and we are so very limited with what we can do for them. I trust that we are doing the best possible and without our help, they would have no one, so that is at least a little comforting. Either way, pray for their recovery. Everyone here is pretty dirty with the conditions they live in, so I can only imagine the infections they are likely to get, even with how aggressively I clean their wounds.
Thanks again for reading and for your continued prayers and support. I hope you had a great time celebrating into the New Year! Can't wait to see what God does in 2014 with my medical mission work.....but kick starting it still working in Haiti is a great way to do it!
-Aaron Tabor
Haiti Day 9, January 3, 2014
Hey everyone,
I just sent you yesterday's email......semi incomplete, but the internet ran out of money at the Hospital so I couldnt finish it. The update portion was mostly done though.
Anyway here I am in Port-au-Prince now staying with Bob and Rae until my flight departs tomorrow at 11. They have wifi too.....man that's nice haha. No sooner had I finished that email yesterday and lost internet then someone dropped off a cards the kids made me that they all signed. It was pretty awesome, so I guess they answered the question of whether or not I affected them :)
After finishing up at the children's home, I pretty much packed, relaxed, and slept to be on the early road to the Capitol. If I thought the road was crazy going there.....try driving in an "ambulance" driven by a crazy, very brave (stupid? Insane?) Haitian guy. I know I said they drive wherever.....but throw an ambulance siren on a car and you just hope for the best. Few times we were just cruising right at oncoming traffic in their lane, and waited till they swerved last second -- the ultimate, ongoing game of chicken. Thankfully we did win and I'm alive lol. We were also crammed, the three of us, in the front seat (basically like a small pick up).
Bob and Rae gave me a tour of the Salvation Army base in the Capitol and then a tour of the area in Port-au-Prince. We then drove up the mountain to get a great view of the area, and I'll send you a bunch of photos later -- actually might just start like a blog or something like that to post pics on....we shall see. I hate blogging, but it's basically what I'm doing with y'all lol. Anyway, just amazing views and really cool to see the whole city from above. Bout 3 million people crammed into the city and "suburbs," and Port-au-Prince was built for 40,000 with 1 million residing -- so it's crammed, very dirty, and pretty much like Chicago lol. Really is as far as any city goes (minus the sky scrapers I guess).....it's hard to describe, but go to lower wacker and you'll get an idea maybe slightly. We went to a couple other places in the area, including their "zoo" -- basically a goat, rabbits, snakes, cages where the monkeys were (they died), the dead alligators cage too, and a mangy looking peacock. This was all on the mountain btw. Also a little museum with Haitian history that was cool to see. We grabbed a bite at a restaurant, stopped at the market (looks like a super walmart), and headed back where I'm chilling out at their home. Really nice place. Salvation Army pays for their house and car, and then gives them like a $140 food allowance per week. Not bad for missionaries I guess. It's nice and big so they can house guests (like me).
Anyway, shorter update today -- just sight seeing and relaxing before I head back....and I'm typing on iPad, which is much slower and limiting lol. Don't all applaud at once. Thanks so much for reading my updates and supporting me during this trip. Without you all, none of this happened. I can't wait to come back and continue to gain the experiences in other cultures I need to serve the people around the world. I head back to Chicago to start my 8 week surgery rotation, which will be busy. My last few prayer requests:
- that God will continue to bless my efforts in growing support for medical missions. Including financial, supplies, partners, etc
- that God would bless all those in Haiti that I touched and that he would continue to heal them
- that I stay healthy!
- that I muster up the strength and determination to keep pushing through medical school so I can even more effectively help others. Med school is tough and I don't like it, but trips like these remind me of why I have to keep going and learning.
- especially on surgery, pray for me and my 3 partners on rotation (Mike, Christina, and Kainat) as we push through the next brutal 8 weeks. Surgery is one of the tougher ones with long hours (at hospital by 4:30am and out late, sometimes 7-8pm) and the docs aren't as forgiving. Pray that we learn fast, function as a team, and perform well.
- PRAY I RETURN ON TIME TOMORROW EVENING!!!!!!
Sorry if there are typos, autocorrect is crazy sometimes. Thanks again. May The Lord bless and keep you all, restoring unto each of you many fold the blessings and support you have give to me. I will let you know the progress of tomorrow's return.
Humbled and blessed,
Aaron
I just sent you yesterday's email......semi incomplete, but the internet ran out of money at the Hospital so I couldnt finish it. The update portion was mostly done though.
Anyway here I am in Port-au-Prince now staying with Bob and Rae until my flight departs tomorrow at 11. They have wifi too.....man that's nice haha. No sooner had I finished that email yesterday and lost internet then someone dropped off a cards the kids made me that they all signed. It was pretty awesome, so I guess they answered the question of whether or not I affected them :)
After finishing up at the children's home, I pretty much packed, relaxed, and slept to be on the early road to the Capitol. If I thought the road was crazy going there.....try driving in an "ambulance" driven by a crazy, very brave (stupid? Insane?) Haitian guy. I know I said they drive wherever.....but throw an ambulance siren on a car and you just hope for the best. Few times we were just cruising right at oncoming traffic in their lane, and waited till they swerved last second -- the ultimate, ongoing game of chicken. Thankfully we did win and I'm alive lol. We were also crammed, the three of us, in the front seat (basically like a small pick up).
Bob and Rae gave me a tour of the Salvation Army base in the Capitol and then a tour of the area in Port-au-Prince. We then drove up the mountain to get a great view of the area, and I'll send you a bunch of photos later -- actually might just start like a blog or something like that to post pics on....we shall see. I hate blogging, but it's basically what I'm doing with y'all lol. Anyway, just amazing views and really cool to see the whole city from above. Bout 3 million people crammed into the city and "suburbs," and Port-au-Prince was built for 40,000 with 1 million residing -- so it's crammed, very dirty, and pretty much like Chicago lol. Really is as far as any city goes (minus the sky scrapers I guess).....it's hard to describe, but go to lower wacker and you'll get an idea maybe slightly. We went to a couple other places in the area, including their "zoo" -- basically a goat, rabbits, snakes, cages where the monkeys were (they died), the dead alligators cage too, and a mangy looking peacock. This was all on the mountain btw. Also a little museum with Haitian history that was cool to see. We grabbed a bite at a restaurant, stopped at the market (looks like a super walmart), and headed back where I'm chilling out at their home. Really nice place. Salvation Army pays for their house and car, and then gives them like a $140 food allowance per week. Not bad for missionaries I guess. It's nice and big so they can house guests (like me).
Anyway, shorter update today -- just sight seeing and relaxing before I head back....and I'm typing on iPad, which is much slower and limiting lol. Don't all applaud at once. Thanks so much for reading my updates and supporting me during this trip. Without you all, none of this happened. I can't wait to come back and continue to gain the experiences in other cultures I need to serve the people around the world. I head back to Chicago to start my 8 week surgery rotation, which will be busy. My last few prayer requests:
- that God will continue to bless my efforts in growing support for medical missions. Including financial, supplies, partners, etc
- that God would bless all those in Haiti that I touched and that he would continue to heal them
- that I stay healthy!
- that I muster up the strength and determination to keep pushing through medical school so I can even more effectively help others. Med school is tough and I don't like it, but trips like these remind me of why I have to keep going and learning.
- especially on surgery, pray for me and my 3 partners on rotation (Mike, Christina, and Kainat) as we push through the next brutal 8 weeks. Surgery is one of the tougher ones with long hours (at hospital by 4:30am and out late, sometimes 7-8pm) and the docs aren't as forgiving. Pray that we learn fast, function as a team, and perform well.
- PRAY I RETURN ON TIME TOMORROW EVENING!!!!!!
Sorry if there are typos, autocorrect is crazy sometimes. Thanks again. May The Lord bless and keep you all, restoring unto each of you many fold the blessings and support you have give to me. I will let you know the progress of tomorrow's return.
Humbled and blessed,
Aaron
Haiti Day 8, January 2, 2014
Greetings again!
This may be the last chance I have to write you as tomorrow morning I head back to the capitol at 6am and will be staying with the Americans, Bob and Rae, for the day until Saturday when they take me to the airport for my flight at 11am. I fly from Port-au-Prince into JFK airport in New York, and from there to O'hare in Chicago. Hopefully all the snow has already come and between flying to New York and Chicago I make it on time! I may have access to internet at Bob's house, and if so I'll update on what happens tomorrow, but just in case, wanted to let you know the flight info. I return back in Chicago (all things going as planned of course) at 11pm Chicago time.
Today I went to the Salvation Army Bethany Children's home to do wellness checks for the kids. There are 36 kids that reside there with the Major who takes care of them, ranging in age from 6 years to I think 17-18 if I remember the birth days correctly. Before I saw each kid I was given the folder that contained all of the information that the Salvation Army has on them. Talk about heart breaking.....some of the kids did have a packet full, with their birth certificates, information about parents and family, where they're from, IDs, etc. Others.....nothing, other than a note that said "found after earthquake, parents assumed dead." No clue what their date of birth is, where they are from, who their parents are....nothing. Just their name. So for each child I read through the extent that anyone really knows about their lives....most of them orphaned, a few of them having parents but the families being too poor to care for them brought them here. I wanted to take pictures of all of them to show you, but I was extremely pressed for time with 36 exams to do in one day, so I was only able to snap a photo of one 6 yr old girl.....I thought about putting her in my suit case and bringing her home....but I feel that would not be allowed. Her name escapes me as it was a spelling and name I didn't recognize, but her middle name I believe was Rose, and her first name started with a C if I remember right (with 36 new names to learn they got jumbled...) -- so we will call her Rose for now. Anyway, I did not sneak her back, but if I was allowed to adopt one (or gotten one for my sis) she would have been the one. She was very shy and simply smiled the whole time. Most of the wellness checks were very simple....I took their blood pressures (providing they weren't too small....I only had an adult cuff....good to know I need a child one now), listened to heart/lungs/stomach, checked their ears, nose, throat, examined their skin for cuts/abrasions/bug bites/etc (and if they had any, I cleaned and bandaged them, put cortisone on the bites)....basically a typical physical exam. And of course....reflexes. Not because checking their reflexes really would mean anything as I couldn't follow up if it was something serious neurologically, but because I remember laughing when I was a kid every time the doc hit me with that hammer thing....and sure enough, they all just laughed and looked entirely surprised when I hit their knees/ankles/elbows and their limb went flying. The Major asked why I was doing it....I said "oh, it helps me check that they are neurologically intact...." Kind of true, but more just cause it was fun lol. Most of the kids are remarkably healthy, but that's probably because the Salvation Army orphanage does take remarkable care of them. Many of the files noted how underweight and malnutritioned they were when they were found, but now they were up to a good weight (from what I could eye out) and they all looked rather healthy. The Major asked if I would please document everything I found, so I wrote just a basic little note with whatever their complaint was, my basic findings (listed their BPs, that the ear/nose/throat was non-erythematous, tympanic membranes clear, if the ears were compacted with wax and weather or not I could clean it depending on how small the canals were, if I cleaned and bandaged any wounds, etc -- just the basics). For some of them, it was the only other thing in their file other than the admission note to the home. I guess that felt good, giving them some documentation that someone in the world spent time to write down something about them. Really, I didn't contribute a whole lot to their health.....one girl was tested and found anemic back in 2007, and she still has pretty severe fatigue....she didn't look anemic necessarily at the moment, but I recommended if it worsened to take her to the hospital. Another boy had BP of 140s/90s, so I recommended that they keep an eye on it. Many of the kids complained of having headaches, so I advised that they drink lots of water and if they have access to Tylenol to take that (I should have brought some down to leave with them....). But I think it was worth it just from the angle of giving these kids the 10-15 minutes that I spent with each of them, letting them know that someone thought they were worth the time. I know they were initially very scared cause when they heard the "American Doctor" was coming they all thought I was coming to give them shots haha. They were quite relieved to find out differently. So, I dunno, I know the Major was very thankful, and she expressed it, I'm not sure if it made much of a difference in the kids' lives at this point, but who knows.....I guess it impacted me, and that's something. Pray for them for sure.
I spent about 8 hours there, with most of it pretty much seeing the kids. They did make me lunch, and brought out some chicken legs, cooked carrots, and french fries -- and kept bringing me sprite and water all during the day. I almost felt bad eating it cause I was like, um do the kids need food? But I know they are well taken care of there, and they will definitely not starve in the Salvation Army's hands. The Major was able to translate for me btw, in case you're wondering how I talked to them. A couple of the kids spoke a few words of English, and they were happy to say "hello," "I am fine," "Thank you," and so one. Otherwise I pretty much just asked if they had any pain, any cuts/rashes/bites, any thing they wanted help with -- aside from headaches, some cuts, some bites, and a few other minor things, they all reported they felt fine.....so I just did the basic check-up, wrote a note on them, and sent them on their way. I was able to leave a couple hundred band-aids with a thing of neosporin and cortisone, along with some applicators and some cleansing wipes to clean wounds. I instructed the major to clean any cuts, use the neosporin and place a band-aid, and use the cortisone for any bug bites that aren't healing. She was grateful, though I wish I had more.
I am glad I brought the supplies down that I did. Thanks to those of you who donated, everything was very much needed....especially all the gauze/wound care stuff I had -- gloves especially cause theirs didn't fit me lol. I am going to leave the remaining gauze (lots of it), gloves, sterile gloves, tape, stethoscopes, band-aids, masks, alcohol swabs, ace bandages, IV tubing, etc down here for the hospital staff to use as they need it. But really glad I had it all here with me cause there were many times in the ER that as we were waiting for people to go buy their supplies I was able to at least stop some bleeding and clean wounds with the gauze and supplies that I had.
There were only a couple of patients here with Cholera....seems like they have a much better handle on that now. The government has some programs to help them with clean water from wells, and most people are pretty good about buying bottled or 5 gallon Culligan filtered water. Some people still get Cholera though, so they have a separate part of the hospital where they keep them. Basically, it's a cot where the patient lies, with a small hole cut around their butt with a bucket underneath to collect the pretty much constant flow out of them. So they lie there, draining fluids and we pump them full of fluids via IV and force them to drink water/gatorade type drinks constantly. Aaaaaaand they wait it out. We wash our hands with bleach -- only thing that really kills it I guess, hand sanitizer does nothing) -- and yeah, that's about it. But I only saw two people with it. As far as TB, I didn't really see anyone in the TB ward this time around....they have a couple nurses who administer the drugs to the TB ward patients, who live there for about 6 months -- but most of them were already there and receiving their treatment. We did have the one patient with peritoneal TB that we drained, but that was in the main hospital and she didn't have any respiratory problems.
Haiti Day 7, January 1, 2014
Hello again from Haiti!
Today makes 7 days that I've been here now and I'm looking forward to a little bit of cold weather to cool me down when I return. I hear we got lots of snow....so, I'm glad that it's all pouring in now and hopefully Saturday I will have easy travels.
Today, being the first day of the year and Haitian Independence Day = a very slow day in the hospital. This morning Dr. Josef called me down to see two patients, one who had fluid overloading her lungs and another guy who had a heart attack. The woman's lungs sounded awful and we started treatment with some diuretics and heart medications for her as we assumed she had some level of heart failure (not like we could do an echo to confirm, so we make the best guest and treat). The guy I guess came in grabbing the left side of his chest screaming in pain, sweating, and his extremities were cool to the touch. They were able to initiate treatment pretty much the same way we do in the US, and they did get an ECG that was back by the time I got down there....which confirmed an MI. The Salvation Army Hospital does have some pretty high tech stuff all things considered, like being able to do an ECG, run some basic blood labs (CBC and all....think I mentioned this in the past maybe), they can do a CD4 count check for the HIV patients.....no X-ray machine that I'm aware of, but that would be handy. Either way, we can only do what people can pay for, so that's always limiting. But, we got the ECG, confirmed an MI, and started treatment for him. Other than that, the hospital was pretty empty throughout the day.
We did eat pumpkin soup for breakfast.....and maybe I would have enjoyed it more if it wasn't eaten in the morning. It was ok, not my new favorite dish or anything. Partially because there was lots of stuff in it that I couldn't tell what it was......some sort of skin and lots of fat -- they pretty much eat everything, half the time I'm afraid they are going to break their teeth as they crunch through the ends of the chicken bones trying to get the last bit off it. Anyway, I ate it and tried my best to seem like I really enjoyed it....but again, I think it probably was partially cause it was like 9am lol. That's one thing I haven't gotten used to is that they eat some meals for breakfast I wouldn't expect. One day, Deniese asked if I liked spaghetti, to which I said of course.....I wasn't entirely prepared for spaghetti the next morning for breakfast haha. Once you start chowing down you kinda forget how early it is. They eat a lot of porridge for dinner too.....so, flipped a bit for me lol. We've had spaghetti a few times for breakfast now, and though I probably won't make it for my breakfast when I'm home, I am no longer surprised when I see it :)
In the afternoon, since we had a good amount of time, Minel asked if I'd like a tour of Fond-des-Negres beyond what I see off the main road. The place is lot bigger than I thought it was, but given that he told me the town has about 30,000 people I guess I should have expected lots of hidden homes. Once we started trekking through the trees it was pretty cool to see where everyone lives. Some of the homes more luxurious than others, and the really nice ones are typically owned by people who travel back and forth -- lots of people from France have homes here I guess, or people have family members who live in America and build nicer homes for the family still in Haiti. Deniese's family all lives within walking distance, as she grew up here. So Minel took me over there and I met Deniese's mother. His father is 102 years old, but lives a couple hours away. Minel also was telling me how he bought a bunch of land back in the day and now it's 9x the price as back then, but from what he was telling me it's still not very expensive in our terms (like thousands only in American dollars for some plots). Anyway, he bought a bunch of land back in the day and built a really really nice home with a private well and indoor plumbing. The whole house is solid cement with tile flooring, nice wood doors. There's a Filipino nurse who is living there now who is doing a 3 year mission term with the hospital (since Minel and his family live at the Hospital in the apartment where I'm staying). There was another large home that was in the process of being built, some French doctor who started to build it when he came down to help after the earthquake, but I guess he moved back to France and just the massive foundation is left. But nice to know that if we ever wanted to establish like a base in Haiti, it wouldn't be terribly expensive to build something down there -- could be a way to help support the area too, you know build like a complex and staff locals to take care of it, grow food and all. Who knows, just thinking aloud here.
So, not a lot of clinical awesomeness today.....I checked in the ER a little while back and there were no accidents, but that's a good thing I reminded myself. They have been asking if I plan to come back, which I told them that it is my long term goal to regularly do trips to Haiti and around the world, and I would love to come back and work and learn in their hospital again. I said there are others that want to come to, and they said I am always welcome, and they'd love to have friends. Minel said, "if you came here every two months, that would be okay with us." Nice to know I always have a place in Haiti if I need it now. I think that for future trips this would be a great place to come back and work, especially with the ER situations and helping with all of the accidents. For the day-time stuff I would need to think of a service that we could offer them that is beyond what they already have. It's been nice to help the docs and learn, but with a group of people that wouldn't work so well. I know there is an ENT doc who is coming to set up a clinic to do ear checks and such, as that's not a normal service for them, so if we could think of something along those lines, that might be a great way to help them in a better way. I need to think on it more, and if anyone has any suggestions, I'd love to hear them. I think if I learned some Creole I could operate a little more within their structure, but at this moment in time I just don't know enough to converse with people and discuss their medical needs. Either way, I'd like to help them in a way that is not currently being offered......and the ER experiences are always great for us and very helpful for them as they get easily overwhelmed sometimes with the number of accidents.
Well, there you go, I've managed to turn this into a long e-mail again :)
Prayer:
- I'm feeling better today, less of a migraine, so thanks for the prayers on that.
- Heading to the children's home tomorrow to do some basic well checks on the kids. I don't know exactly what they're hoping I'll do for the kids, but check em, make sure everything is as good as it can be, maybe bandage some minor wounds, clean some ears, stuff like that. Walk em to the hospital need be, though I bet they'd be here already if it was anything serious. But, pray I'm some sort of a blessing to those kids and the staff that runs the home
- Pray that God gives me some ideas to how I can better serve the people of Haiti in the future. For now I'm content knowing that I am getting experience working in a foreign country, as that's most important. Minel was telling me how he's been to many different countries and that getting the experience of traveling and working in different places is crucial. He said even just basic things like getting used to the food and the customs, it's important to know how to quickly adapt. He thanked me for being so great about everything and eating things that he knows I probably didn't enjoy, which made me chuckle a bit. He said they've had some people come in that complain a lot about things and don't eat the food, so he said he appreciated it....which I'm like sheesh thanks for feeding me free food and giving me a free place to stay lol.
- So, continue to pray a special blessing on Minel and his family here, and the hospital staff -- they're all truly amazing people who have been very accepting of me and wonderful teachers
Thanks again for reading and as always, thanks for all your prayers and support. Tomorrow is last day of doing medicine here in Haiti, so hoping that I can be effective and make some sort of change in their lives. Until tomorrow....
-Aaron Tabor
Haiti Day 5, December 30, 2013
Hello again everyone,Made it to day 5! Time is moving right along down here....and it's still hot if you're wondering. I'm probably going to freeze entirely when I return to Chicago as it's going to be like a 90 degree drop....though it might feel nice too, never really a chance to cool down here (though the showers are ice cold.....). The beginning of the day was pretty slow for me. I went down to the hospital and as they said, it was jam-packed. All the people who didn't come over the weekend for various reasons all showed up Monday morning. It was literally overflowing with people. In this case I wasn't able to do much as the doctor who I normally work with was off visiting her family for the day and the remainder of the doctors don't speak much English. In general, when the patients come in for their well checks, follow up visits, etc. the system is very tightly run and I can't exactly just go all cowboy on them (in the ER a little....). They document everything and really only provide the level of care that the patients can afford to pay, so it's limiting and doesn't allow me to do much in these cases. Considering I was feeling pretty sick anyway, I returned to my room and slept for a good portion of the morning. I would periodically go down to check if there was anything going on in the ER, and if there wasn't, I would return back upstairs and rest a bit more. My cough has turned into this lingering nagging cough that just is always there and is super annoying, but not really doing anything....other than annoying me and everyone else. I really miss those cough drops about now haha. But this morning as well I was a little light headed and just felt like crap overall, so the nap did me some good. When I checked in downstairs around 4ish I saw a couple of patients with the medical director. One 27 yr old woman post-partum day 5 who had some pretty severe swelling in her legs....her bp was elevated and we gave her a prescription to get an ECG done and decided we would go from there tomorrow. We discussed all the possible things that could be going wrong, but are limited again to providing the tests that she can pay for. I guess it's not like in America where if someone can't pay you just do it and the costs get eaten up by something else (really expensive orange juice for instance).....here, there's no one and nothing to eat up those costs, so if they can't pay for it they simply don't get it done. So, we'll see what the ECG shows tomorrow and if she can afford more lab tests we can order them. If not, I guess we send her on her way and hope for the best. Couple other patients had come into the ER....a small child with burn wounds over the lower back, buttocks, and upper thighs -- they said something about the weather burning him, but it looked more like hot liquid was spilled....so not sure. I let the nurses take care of him as I attended to a guy with a nice 3-4 inch laceration on the bottom of his foot. After yesterday I'm confident in repairing these wounds and the medical director was thrilled that he could leave me to it. The nurse prepped the "sterile" field for me and I started to try and numb this guy up. Now sure, I'm jabbing a nice inch long needle into your open wound, but after yesterday and fixing up all those motor bike accidents, I guess I got used to the tough guy patients. Maybe cause yesterday they were all in the room together and no one wanted to show any pain to their friends, but they all just sat there quietly as I jabbed them with lidocaine and then stitched them up. This guy was howling and screaming like crazy and I could barely numb him up. I guess the bottom of the foot is sensitive.....either way, it made it rather difficult. At one point I injected into the wound to give him some more lidocaine and he jerked his foot away right as I started to push -- resulting in a nice face-full of lidocaine and whatever else squirting out of his wound. Luckily I closed my eyes pretty quick and didn't get any into them, but needless to say as soon as I was finished stitching the guy up I went upstairs, wiped my face down with anti-bacterial wipes, and flushed my eyes out with saline. Now, stitching the bottom of a foot is a lot tougher than a knee, arm, face, or even head. Especially around here where everyone is barefoot most of the time, the bottoms of their feet are like leather. I had a nice big needle but the thing was nearly bending in half as I was trying to push it through each side of the laceration. I'm sure this contributed to his pain, as I was extremely forceful.....and after the first stitch he was yelling at me so loudly the medical director came back into the room. He smiled and told the guy "it's okay to cry," smiled at me and walked out. I proceeded with the next two stitches, and yeah, he was crying by this point. The nurses were all saying something to him, I think making jokes about he was over-reacting. I had one more stitch to put in and he was insisting that I just stop and he would leave as is. I tried to put more lidocaine in but again, he kept pulling away. So, I handed the stuff to the nurse, latched onto his leg, and held him down as she injected and did the final stitch for me. In the end it looked pretty nice and I think it will heal well anyway. The lady that I wrote about yesterday, with the really low blood sugar, she came back in today and I guess the doctors think she might have appendicitis....and I have no clue what they are thinking about doing. From what I saw they gave her IV fluids and were just waiting -- not like we really can do much here at this hospital, so she may be transferred out if she can afford it.At this point Dr. Josef returned and we went and admitted a pregnant lady at 39 or so weeks...she looked ready to give birth at that moment. But she hasn't yet, she's still down there screaming a lot, so we'll see if sometime tonight she delivers. Hopefully they remember to let me know if she does cause that would be interesting to see how they do it here. Obviously no epidural or any other kind of pain med. I took a picture of the OB/GYN room to send to you later....it literally looks like a dungeon torture chamber. I tried to listen to the fetal heart tones, and the doc swore she could hear them with the metal cone thingy....but I couldn't hear anything. It's also very noisy in there in general, but even if it wasn't, I think I would need superman's hearing.....she said with practice I would learn to hear it. We'll see. We also went and saw a guy who had tetanus and we discussed what the treatment should be. I guess her and the medical director were having a disagreement on it. Luckily, some of the medical apps still work on my phone even without internet or service, so I was able to pull up some data that had clinical studies cited with the best treatment options. We'll see if it helps. I think they were trying to get the anti-tetanus immunoglobulin to give him but they don't have it here or something....it was a little confusing. Either way, the guy is writhing in pain in an isolation room (basically a very small room, enough for just the bed) as his body is twisted and contorted by the toxin. I read that tetanus causes hyper-reflexia, and I kinda wanted to go in and check, but since they already knew he had it (I guess it was immediately obvious), it didn't seem like a great idea to go and torture the guy more, so I resisted my temptation.So, at this point I'm just waiting to see if a baby comes out at any point tonight and if anyone comes into the ER for any other reason I'll help em out. But otherwise, should be a rather quiet, very muggy hot night.Prayer:- My health still....it would be nice if this cough would clear up for sure, but at this point just that I can push through it and make it to the end of the week without coughing up my lung....or my spleen for that matter. I think with the little rest I had today that overall I'm feeling better....I'm no longer light headed or anything. Excedrin is helping the headaches along with the Amlodipine I take daily now to knock them out. Haven't needed to use the Imitrex injections yet, so that's been nice cause that really incapacitates you.- Amazingly I haven't gotten sick in any other way. No diarrhea or nausea or vomiting -- I attribute this largely to the fact that they cook the food here so well and make sure that it's extra safe for me to eat. Also, the water is all bottled so no risk there. Even if I use the faucet water to wash my hands, I still usually use hand sanitizer afterwards just to be safe.- 2 more days of working in the hospital, so just pray that I continue to be effective in that matter and that I'm a blessing to the staff and doctors here. The nurses and staff all keep trying to talk to me and laugh a lot about my responses -- I still know very few words as their accents are hard to hear so even when they try to tell me a word it's hard to really grasp what it is. I keep wishing that my iphone worked so I could google it, read it, and connect it better. If I had just a basic understanding of the language it would help a lot -- something to put on my list to work on in the future. I know I suck at languages, and that hasn't changed yet. When talking with Dr. Josef it's helped that she speaks Spanish too, cause sometimes if we can't communicate it in English we just speak Spanish. Now my Spanish is pretty terrible as well, but I realize how much I actually do know, especially in comparison to Creole, so Spanglish is really working with her anyway. Some of the staff think they know a little English, so they'll try to talk to me, but they are still speaking Creole and not realizing they aren't actually speaking English....then they laugh as they realize it and throw me a word or two in English. Everyone wants to know how many brothers and sisters I have, if my parents are alive, if I'm married, where I'm from in the US, stuff like that. So one or two words in English and we can usually get some stuff across. Anyway, I'm not going to magically learn Creole, but I've been effective enough as is and we've had some fun at my expense, so pray that the last two days here at the hospital are just as good.- As I mentioned, Thursday I will plan to go to the children's home, so just be praying for the kids and that I'll be able to help them- Prayer that everything works out with me getting home on time wouldn't hurt.....my return is going to be tight as I'm traveling back leaving here Saturday 11am and returning to Chicago 11pm -- gives me one day to rest up and start my surgery rotation at 4:30am on Monday. So, not much room for error like a missed flight or anything. Coming here, everything was great -- arrived on time, all my bags came (what!?), so going back it'd be great if it was the same.- I'm hoping that this experience really helps kick start global health at Rush and my future organization and everything. In the immediate future, sometime in January, I'm going to meeting with the community service director at Rush and the Salvation Army contact I initially spoke to about what possibilities will exist for other students to travel to various countries and have a similar experience as I have had. Now that I've spent some time here I'm kind of making a list of what will need to be known in advance and how things would need to be set up and scheduled so that other students learn and don't feel as lost as I initially did. But I really think that this opportunity is at least one of the keys to solving the global health problem at Rush as far as lack of opportunity for interested students and it will really open up the door for me and others to return here in Haiti and to other countries in the future. I've had such a great welcome from everyone here and I realize a little bit more of how their system works that I think it will help launch other mission trips, some with maybe more of a focus than this one where I just hopped a plane and flew down here.....but it's the start to something much grander for sure. I've always figured that if I just jumped in with both feet and hoped for the best that things might line up in a good way....so far so good haha, granted it makes for some crazy experiences and bizarre adventures for me (and lengthy e-mails), but in the end I trust that the ideas in my head will be put into action.....hopefully, if nothing else, that my these small things I'm doing others will be inspired and they can be the ones to really make the impact. I'll update you all much more in the future with all that is happening back in America as far as the non-profit stuff, funding, participants, etc. as there is a lot starting to unfold and once it does, I anticipate amazing things. But I'll save that for another lengthy e-mail. In short, please just continue to pray that God uses this adventure to be the spark that really ignites the passions of others to join with in making what I believe to be His dreams, a reality.For the moment, that's all I have for you. Thanks again for reading. I am terrible at journaling, and every time I attempt it, I usually fail to do so the next time. However, writing these e-mails to you all is a sort of way for me to journal out the day and will help me to remember what is happening here in the future. I hope that the experiences I am having here are at least some sort of inspiration for you, as without your support I would not be here doing what I am. So thank you again, and I know the people of Haiti are thankful as well.Orevwa (good bye) for now,Aaron Tabor
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