God Speaks Creole

Written By: Sharon Steen

Guest Blogger Sharon here. Okay, so maybe I missed a post or two, but I did not realize until I was here for 24 hours that there is no electricity that comes into this house from the outside. They don’t even want electricity from the outside if it were available, because it only works for three hours each day (those being the convenient hours between 3 & 6 am). So the lights, internet, fans, fridge, washer, water pump all plug into the wall like at our apartment in Iowa, but the power comes from huge car batteries, and those batteries are charged 6 hours/day with the generator. Blows my mind.

Sunday at the Haitian Lifeline church was amazing. The whole service was in a language I don’t understand, and they never once broke down and started speaking English. I could tell when they were praying, though. And I could see their love for Jesus. Who saved them from their sins just like he saved me from mine. I saw that God speaks Creole every bit as well as he speaks English. I realized that God loves these people who can’t afford to make their clothes match every bit as much as he loves me. We serve a very big God, who became a lot bigger to me this past Sunday. After the service, I had the privilege of shaking hands with almost every one of my Haitian brothers and sisters in Christ in the room. Brothers and sisters I didn’t know I had a week ago.

Tuesday Tidbits

Bebo Norman -Nothing Without You



Take these hands
And lift them up
For I have not the strength to praise You near enough
See, I have nothing
I have nothing without You
And take my voice and pour it out
Let it sing the songs of mercy I have found
For I have nothing
I have nothing without You
And all my soul needs is all Your love
To cover me, so all the world will see
That I have nothing without You
Take my body and build it up
May it be broken as an offering of love
For I have nothing
I have nothing without You
And all my soul needs is all Your love
To cover me so all the world will see
That I have nothing
That I love You, yeah
With all my heart
With all my soul
With all my mind
And all the strength I can find
Take my time here on this earth
And let it glorify all that You are worth
For I am nothing
I am nothing without You

~~~~~~~~~~~~~~~~

Tonight, guest bloggers, Jamie and Sharon Steen will check in.

Peace.
Tara for all

More Fun Things about Monday (without gross photos)

So, you might be asking yourself, 'What do the rest of these people who are not stitching, running around listening to needs or amputating fingers do all afternoon?'

It's simple really. We just sit at the top of the stairs and watch Troy, Britt, Paige, Jamie and Sharon work. It's exhausting. ;-) The server comes by for our drink & hors d' oeuvres orders at the top of each hour. Good thing - or we might not be able to be sooo supportive. ;-)

We had a busy day, everytime I looked down three hours had passed, we accomplished much, so much that I don't even feel bad for missing my run today. If every day was as busy as today, we'd all be dead by now. (Thankfully Britt has no classes this week.)

I think they saw 15 patients, four of whom had stitches done and two who had pieces of bones cut out of their hands. We turned a few away because after ten hours of standing up the medical gurus were ready to call it a day. Lazy butts. All of this took place in the cool breeze of another 98 degree day. Ack.

~~~~~~~

I promised our church, especially one opinionated and scrappy guy named Dave Foy, that it would not be too hot in December ... I am hoping not to become a liar --- but right now it's not looking good. Who knew October would be hotter than July?

We cannot express what an encouragement it is to have J and S here ... to know that they could have spent their $1200 in airfare to go anyplace else in the Caribbean and beyond, but instead they chose US, that is just way too cool. So, knowing that our church, my parents, and other friends are also headed south in the coming months ... we're just slaphappy.

Who else wants to come?

~~~~~~~~~

We have spent the last many months training our children not to leave lights or fans on if they are not in the room. (Electricity here equals expensive diesel fuel to run a generator. The generator charges batteries. The less electricity you use, the longer the batteries last.) I believe tonight I have proof of successful training.

Jack-Jack walks into the bathroom and flushes the toilet, for no reason at all.

Hope says: "Noah!!! You are wasting the batteries on that toilet!" "Don't do that!!!"

Have a great Tuesday!

-Tara

Monday Night Medical Update

By Britt:

This is the part of the show where Britt comes out and sings, a warning song. So everyone who has no interest in finger ampuation, a machete cut .... please do not torture yourself by scrolling down. Do you remember last night how I wrote that it would be really sweet to get a picture of the bone to actually show? Well ya, we succeeded today. This is the part of the post when Britt ends the warning and posts a non-gory picture just so the bad ones don't show up at the top. :)





Paige was a great helper today. She was the runner, going and grabbing stuff, and the chaplain, praying before everything we did and sometimes during the tough parts when the patients were hurting/crying a lot. Since I posted the photos in backwards order, I will just have to write from the end of the day back. In the above photo, we used a blood pressure cuff as a tourniquet. This wound is posted below, so I will explain about it in the below post where the before and after photos are. Sorry, I wasn't really thinking when I loaded the photos in this random order.

Because I am tired and I used poor planning .... the 'before' picture that goes with the photo below, is three pictures down. It is the first photo on the continued post. Once again, sorry, my bad.

This (below) is Miguelson, he is 8 and he lives in Barbancourt. His mom isn't really around, it sounds like she has a different husband than his father and lives somewhere else. So, he lives with his aunt. Today, he was playing (unsupervised). He was, for whatever reason, playing with a machete. Seems kind of fun, right? Ya, right up until the point where you cut off the tip of your thumb. Then it becomes a little less fun.

So, we did another digital block (with Paige, Sharon, his aunt, and Jamie all holding him down for that part). Next we opened up all the tissue around the bone to get it to the point where the bone was in access to be clipped, sticking out like this:




If you haven't fainted yet, I will continue. So next I removed the little remaining portion of the nail bed. Which wasn't as gross as I thought it was going to be, but I don't think I want to pull off a complete nail anytime soon. After that, I clipped the bone so that it was short enough for the remaining flap of skin to be stitched up over it. The final product turned out kind of weird, the angle is odd. But it took 9 sutures, and the flap of skin was trimmed a little bit so that the edges matched well.

Britt's Post Continued....

This is the before picture of the above thumb. After we all had to hold him down for the needle-numbing part, he must have used a lot of his energy because at one point he was asleep. Sleeping through amputations ... wow. But then when he woke up at the end, he was watching us sew it up and kept moving his thumb around to test if he still even could.

This is the ankle of the above post. Edmon is 12 and he was cutting down branches with his machete when he got some thorns on his shirt and dropped his machete to brush the thorns off. So this is the result of that:



I learned how to do a new type of stitch today. It is called a vertical mattress stitch, in which you first do a shallow suture and then go back and do a deeper one, in the same spot. This was done first thing, in the middle and brought the cut together so that it was easier to close up the rest. Paige really had to comfort Edmon, he was crying a lot and pretty scared, but he was happy when it was all over.





First thing in the morning we saw a weird-out-of-whack knee, but I don't have the photos. Tomorrow, we are all going to Cazale, and are going to bring him along to see if Lori has the skills and tools to figure things out.

After that, Viejeyli came. She is from last Saturday, the thumb-nail machete cut. She has still had a ton of pain, so Jamie said that was probably because the bone was exposed. I did a digital block so that we could examine it better. The bone was exposed, so we cleaned it out really well and then sutured up the spot where the bone was exposed. That was interesting, I sutured through the nail bed that was still remaining. Here is what it looked like with one of the stitches:




I better get to bed, tomorrow morning we (Troy, Britt, Paige, Jamie, Sharon + three patients) are off to Cazale. We want to show J&S a different area and they are excited to meet the Zachary's and see the awesome clinic work. The three patients are Pastor Silanse (the abscess from yesterday), the out-of-whack knee, and a different elderly man who has seizures.

Lots of people have been asking about the Zachary's. They are all doing well, but they have had problems with the internet. It is fixed now, so they should be blogging again soon. We are so excited to see them tomorrow!

Another Trip to Port Au Prince

By Troy-

I've always thought that one of my favorite parts about living in Haiti is the constant excitement. Seriously, I have never been bored.

Apparently, when I am the chauffer, my passengers cannot say the same.

Every time I drive to Port with any of our Haitian employees/friends, I invariably end up with this scene in the truck:


What gives? You'd think that the existing damage to the vehicle alone would be enough to keep them on their toes. But, no...my passengers always fall asleep. I must be really boring.

Every time we go to Port (Mr. Haitian and I), it goes the same...

We speak about the events of the previous day at the mission, discuss the business at hand for the current day, and sooner or later my Creole runs out and we're just tired of struggling to communicate. Eventually, I start whistling, and then remember that whistling is very offensive to Haitian people. (If you whistle in their presence it apparently means that you don't respect them.) I try to avoid that. So then I try to sing. Here's the problem with this idea - I'm not really sure how to sing to oneself and not feel weird in the presence of others. Usually, when singing, I've always thought the idea was for others to hear you. So since I don't think my passengers signed up for a concert during the ride...I feel weird singing loud enough for them to hear. Plus, would they enjoy hearing "The Boxer" by Simon & Garfunkel? And not even all of the lyrics since I can't remember them? OK fine, I admit it - I do remember them all.

(Sidenote - way too much of my brain is taken up by lyrics to songs that I no longer need to know. I wish I could find a delete program in my psyche to free up space in there.)

We usually end up listening to Haitian radio stations, which are about the worst thing ever. I always tell myself that subconsciously it will help my language skills. That doesn't help. I almost always end up staying with the news station - Haitian talk radio, I guess - and then understand about one fourth of what's being said. Meanwhile - my passengers are fast asleep.

Here are some sights along the way - (if you're still awake):


Haiti's Immigration Office. I'd like to know why the sign says "Immigration and Emigration." I think the words are similar enough in both languages to figure it out.

This is a neighborhood between downtown Port and the bourgeois area of Petionville.

While my friends snored away, I stopped in at Agape mail - our missionary mail service. I thought I'd show you all what it looks like, and ask if anyone else thinks it looks like a scene from a 1950's dectective movie? Pictured are Mr. Davis Zachary ("Zach" from the famed medical clinic in Cazale) and Mr. Bill Manassero, the worship leader from our church in Port. It was nice to see and visit with friends for a while, and also nice that they managed to stay awake in my presence.

Mission Monday

Monday mornings are typically very busy here, and today is no different. Monday mornings are a free for all and anyone who wants to talk to Troy can come without an appointment.

Paige got up at the crack of dawn and got busy with her school day, so she is basically done with today's lessons and feeling pretty darn good about herself! Britt, Jamie and Sharon saw a scary looking swollen knee this morning but did not have the right tools to open it up. We are hoping we might be able to visit Lori in Cazale and try and help him over at her clinic. There are a few more serious wounds coming today so the day will be full for the medical personnel around these parts.

We have much to do to prepare for our team, Sharon is cleaning down at the other missionary house, I am cleaning up here and the massive grocery list is being complied. We have 12 coming next week.

Britt in her oddness, will likely be on an adrenaline high after today's procedures, so I am sure she will blog again tonight. It is so fun to see her excited ... weird too... the way she writes about this stuff, with such excitement, is exactly as pumped as she is in reality. The rest of us don't really get it, but we are entertained. Using "awesome abscess-amputation" to describe what we saw yesterday ... well, awesome might not be our word. We are here to cheer these medical dorks on though ... more power to them. I don't really want to stick a hose inside of a guy's gut, so it's good someone finds that fun.

No baby news. Every time the phone rings we jump, but no news of anything happening yet.

Thanks for checking in on us. We appreciate your support and care for our tribe. MUCH LOVE and many thanks,
Tara

An Awesome Abscess-Amputation Filled Day

By Britt:

Woah, what a crazy, fun, awesome day I had! This morning we went to the Lifeline Haitian church, here in La Digue. I had a major Creole feat because I actually understood the entire sermon. Woot-woot. Later on we toured Jamie & Sharon around the village and went up to the dam. The water was calm enough, that we actually walked/climbed up and down the actual dam ... which was way fun. We have plans to go back later this week with mats so we can slide down it. Heck yes.

I had scheduled patients to start coming at 5. Our first one was Pastor Silanse. Lifeline supports his school and has a feeding station there; it is down the road a little ways. I need to ask his exact age, but I would guess he is in his late 60s or early 70s, which is a really long life by Haitian standards.

He has an abscess on his abdomen. It started about 15 days ago; but details are kind of difficult to get, especially clear ones ... so we are still kind of unclear on how exactly it started. Last week, we sent him to Cazale but it was the day that Lori was sick; but they were able to give him the necessary meds that I don't have here and also sent him to get a few tests done. Jamie taught me that often abscesses will form from the outside in. For example, if he had a splinter or a bug bite that got infected and wasn't treated and just continued festering ... into this. Jamie came prepared with scalpels and brought tons of gauze and suturing material. I am so thankful, as always, it was the perfect timing since I was running low on those things.

Last week when Pastor Silanse went to Cazale, the outside of the abscess was still crusty. So I had been putting silvadene on it to try to loosen up the crusty stuff so that it would be ready to be drained. Yesterday, when he came for a bandage change, it had already opened up and had been leaking a lot of pus. Most of the original crud had leaked out since yesterday. Today, the abscess started out like this:

Then, Jamie showed me how to cut away/open up some of the pockets of pus that still remain. That process looks a little something like this: (and yes, it was very deep)

After we made sure all the pockets of pus had been opened up, we washed it out with high water pressure (a garden hose to be exact; We call it medical improv). Then we cleaned it out with betadine and packed it with a 4x4 piece of gauze soaked in betadine. So, if you will, picture a hole large enough to shove a piece of wadded up gauze into it. Are you grossed out yet?

It was much worse yesterday when he came with it all leaking out (and it smells kinda) ... but today was just way too cool of a learning experience to be grossed out. Pastor Silanse is as tough as nails, we didn't numb the area because it would have taken way too much (more than we have) lidocaine. So he endured a garden hose and us poking around in there. I told him that I was so proud and that I was amazed how strong he was. He told me that he was strong 'paske mwen gen Jezi' : because I have Jesus. How awesome is that?

Onto the next patient. This is the finger, the one that I warned you about. So don't click this link if you don't want to see it again. And for that matter, don't scroll down. :)

This is Peirre; if you want a refresher of what happened, you can click the link to read the story. Anyway, the amputation job that the Haitian clinic did was less than excellent ... the distal tip of the bone was exposed. This creates a huge risk of infection entering the bone, which is 'tre grav': very serious.

It was decided that we needed to cut the bone down further so that none of it would be exposed. Also, by opening it all up, we could do a really good job of cleaning under the surface of the wound. This is the picture of me numbing it up. Jamie taught me how to do a digital block ... which is where you inject lidocaine into the place on your hand (the palm) where the natural crease is ... this is where the nerve bundle is located. By injecting into the nerve bundle, the lidocaine flows up into the finger, numbing the finger as well. I am told this is how hand surgeons do it in the states (even though in the picture it looks like I am torturing him.)

He was super tough for that part. I had to go down until the needle tip hit the bone, and then pull up a little bit ... that is where the nerves are. This was really painful for him because it wasn't like a quick shot, it was slow and pushing/pulling. But he was super tough and we did a successful digital block because he didn't feel a thing from then on out. Which is good, once you hear what we did next.

So the task at hand was to clip the bone down lower so that we could sew the soft tissue on top, covering it so that the bone was no longer exposed. Also, usually it will not even heal entirely/correctly if the bone is exposed. First we put a tourniquet around the base of the finger. Then we opened up/loosened the tissue around the bone, so that we had gotten down to the where the bone was visible/in access. That was by far the coolest part ... seeing the bone marrow. I wish we could take a picture of that; it was sweet!

You might ask, how does one cut a bone? With a wire cutter, of course. That was crazy. The whole time we were doing that (clipping the bone, one little snip at a time), I was just shocked at what I was actually doing/seeing. So ... we got the bone down to where it was far enough so that the soft tissue could be sewn up over it.

The next post shows a few more photos, including the finished product.

Medical Sweetness Continued

This is the finished product; correctly blocked, amputated and sutured. It may not look all that great/better ... but the bone is no longer exposed and now the finger can heal without the huge risk of infection.

By the time we were done with the amputation, the sun had gone down. So I changed the bandages of the two other finger patients. And tomorrow they are both returning so that we can take a better look at them. Jamie thinks that both of these might have the same problem Pierre had ... where the bone is exposed. I am going to bed now; I might have another fun-filled amputating day again tomorrow. So look forward to plenty more excellently graphic medical photos in the coming week. ;)

~Britt

P.S. - I got this (Jesus Heals) shirt at Okoboji, IA in August. The verse is 1 Peter 2:24.

*Really Being Posted on May 22nd, 2007**

This post is being back-linked from May 22nd's post: Tuesday's Toe Trauma. It was written/posted by Britt.

Congratulations if you were bold enough to click over to this post. I promise you won't be disappointed. ;) I am excited to show you the morning's excitement. Here it is, first glimpse: (notice the little gnats, a special Haiti-esque feature)


The cut went all the way from the back of his foot to the top and right through the third toe. Back and front, post-cleaning and partially sutured:


`

About 30 minutes into cleaning/suturing .... a special delivery was made. I wish that I could say the "package" was as useful as it was entertaining, but ... no. The delivery-man gets an "A" for presentation though. I love how the green of the leaf contrasts the chunk of toe, don't you?


After I had come as far as the above pictures, I stopped. Right when Tiroy showed up, I had my mom email a few of our doctor friends to get their input on treatment. I knew that the toe needed to be amputated, but I just wanted to get some outside, more knowledgeable, & experienced advice. I also should note that I've never amputated a toe before. I learned how to amputate fingers in October when Jamie & Sharon visited (pictured in 10/23/06's post), but I only did a couple and haven't done any since then. I really was just trying to determine if I could actually do the procedure, and in doing so, that I wouldn't be causing him any more harm than good.

This is probably the coolest part of the story. I had a pre-op conference call with our above-mentioned good friends, Dr.(s) Steen. But because our internet phone has been working so poorly lately, Jamie couldn't hear me at all. So I had my mom type my response to what he was saying on the phone on IM. So it went like this: Jamie talks, Britt listens and dictates her responses/questions to Tara who sends them via IM to Iowa, and Sharon does the same on their end of the IM. It was really weird but cool at the same time; I just kept laughing and shaking my head. Thank goodness for multiple forms of technology, huh?

Needless to say, I got the go-ahead from Jamie & Sharon and Lori via email; they all agreed the toe had to go. Jamie did an awesome job of reassuring me that I could do it and gave me a quick refresher on digit-amputating "how-to. " If it's not apparent, I kind of dig that I can post this picture and make you cringe. But it's SO cool, from an anatomy point-of-view. You can't knock that. So here it is, my friends, the bone:

I clipped the bone all the way to the base of the toe. I had skin left to flap from the middle joint. I cut-away some of the skin to get it to match up better and flapped the skin back, sewing to the bottom of the foot. Here is the finished product: (front, back, and top view)


`

`


The top view is definitely my favorite. 24 stitches total. I'm really glad that I was able to do this; it was definitely a challenge, but in the end - well worth it. Please be praying for Tiroy, that he is spared from infection and will heal quickly and without too much pain.

Here's something that I thought was cool and worth telling about:
`

This was caused by a insect. (Ya, I know, now you really want to come visit us) The wound is on the back of the leg of a good friend of mine, Ameslin. She came a week ago, saying that she had been bitten in her sleep by a bug, an 'anni-pye.' I tried to look up the bug's identity in my Creole dictionary, but I couldn't find it. To me it was just this nasty, unidentified bug that must have been pretty big to bite and wound a rather large surface-area.

I used to think that I am kind of good at conclusive reasoning, but maybe not. 'Pye' means foot/feet in Creole .... bug + feet ...... what did you come up with? Centipede! A centipede did this ... sick, huh? So she came back today and the wound has progressed from just a surface irritation into a pretty deep hole. I'm treating it like an abscess and plan to pack it daily w/ betadine packing. If you think I should be doing otherwise, please tell me. And let me know if you ever see a centipede big enough to cause this so I can catch it to show my bug-loving little brothers (who unintentionally kill everything they catch.)

Thanks for reading about my day ... it was pretty fun. I'm excited about being back into the swing of things. If the rest of the summer is anything like the last two weeks (I've had 9 stitches patients), I will enjoy a busy & exciting summer. :D

~Britt

Testing the PEBCAK Theory

Are you having trouble with the blog? Do you have to scroll down to see the most recent post or is it showing up on top of the screen as usual? We are learning that sometimes the video YouTube entries force the whole blog down. Let us know what you see.

T & T

Loot and Love

Jamie and Sharon got here safe and sound. It surprised us how giddy we were to be getting them, picking them up, and bringing them here. I think we kind of "buck up" and tell ourselves we don't miss our friends and family too much ... but really we do. A lot.

They came loaded down with a few hundred pounds of loot for the kids and us. The trick now is to pace ourselves so that when they leave next Saturday we might still have candy, fruit snacks, granola bars, gatorade, coffee mate, and chocolate chips. It's not likely though. One bag of twizzlers was devoured in 21 seconds. They also brought a bunch of diapers for Noah (still wearing them at night) and the new baby too.

Britt got a bunch of medical supplies, including some tools to do new things that Jamie and Sharon hope to teach her this week. Jamie came prepared to amputate fingers (the right way) so it should be a fun few days for Britt. She gave her first shots this week and was all freaked to do it, which made no sense to us because that would seem less scary then doing stitches ... but it might have just been weird looking at some Haitian guys butt cheek. She gave the guy two shots and says the second time was a little less scary then the first. All week long she has been instructing her patients that Sunday was a day to come for answers, they may not sit down today. There are three really bad fingers she's been working on and there was a HUGE abscess that burst yesterday so she will learn how to "pack" an abscess today too. It sounds horrific to me but she is skipping around here excited.

I am up early, unable to sleep. I think I ate too many Hot Tamales or something. In my email box was a note from friends at our home church. I had all but forgotten that they went to our house in Zimmerman to do our leaves today. Thank you so much New Joy Church for everything you do to make it easy to be here. Thank you Bev for coordinating this project. Thanks you for raking the 59 tree yard and for loving us. We are blessed. I bet our renter was pumped too.

Thank Yous, High Fives, Hugs and Props to-
Brad Lien - Cal Sayler -Scott, Isabelle, Loren Farkas - Pete Bogle -
Garth and Jared Booms - Steve and Michael Kohnen -
Andy, Kathy, Adrianne, Mitchell Lamers
Woot Woot guys!

PEBCAK

E-MAIL RCV'D from a friend from church in MN-

Date: Thu, 19 Oct 2006 09:04:49 -0500
From: Marcy
To: Troy/Tara Livesay
Subject: Re: from Marcy 10/18/06
Hi!
Just a note to see if all is well in LaDigue. I've been missing your daily blog entries and wondering if there is something to be concerned about other than a non-functioning computer or no power.Will be praying that all is well.
Marcy

Tara- Troy, Marcy is worried about us. Have the blog entries been *that* odd/different/lacking in substance?

Troy- What? Let me see. Huh. Weird. Oooooh, I bet she needs to hit refresh.

Tara- Ok, well I will write her and let her know we're fine and to try that.


PEBCAK- In the business, the official tech-support diagnosis:
Problem Exists Between Chair and Keyboard

Marcy, we might be poking fun at you, but really, it touched us that you were missing us and took the time to check on our situation. It is good to be loved.

Love to all from LaDigue-

T & T

Excitement Building

These photos are all from Thursday evening. There are lots of beautiful spots to walk and play in the river. Our idea was to stay dry and just walk in the shallow parts in our sandals. Isaac and Noah had their own ideas.





Two (free) tickets to the gun show. With this sort of muscle power it is no wonder we have chosen to forego armed guards at the mission compound. ;)



Our friends get in late this afternoon and we're all very excited. In March we had our last family/friend visitor --- so the seven months of waiting for J & S to come seemed long at times. We're very anxious to be with them!

Charity

From 'Light For My Path':

Jesus, remind me that when I give to others, I am really giving to You. Help me to share all that you have given me - my money, my possessions, my time, my talents, my love - with those who are in need. Amen.

Proverbs 28:27 -
He who gives to the poor will never want,
But he who shuts his eyes will have many curses.

"The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted, uncared for and deserted by everybody. The greatest evil is the lack of love and charity."

-Mother Teresa

Movie Magic

Here we go again...

The marvelous movie making magic of Troy Livesay is not so proud to present:
A Morning At the Mission Lifeline School - La Digue, Haiti.

Shout Out to Mom and Dad Livesay

33- the number of years Troy’s Mom and Dad have been married

6- the number of minutes we discussed what year they would have gotten married, thus leading to difficult subtraction problems and disagreement, finally ending in just going with Troy's number even though it is probably wrong

10- the number of minutes I spent trying to dig up the email that said how many years they have been married

7- The number of people in Haiti wishing them a very Happy Anniversary

0- The capacity Troy has for remembering anything of this sort

39- The number of googled images I looked at before I found this, our internet gift offering, the Happy Anniversary dragon.

Se Yon Semen Move Pou Dwet

(It's a Bad Week for Fingers)

By Britt:

Today I sent a really badly infected finger to Lori in Cazale. I don't have any pictures that are worth showing ... the story is that he got a splinter under his fingernail while making charcoal about a week ago. He told me he removed it himself. Shortly after, the finger started swelling up and eventually two little points on his fingertip broke open, leaking out pus and blood. From talking with my doctor friends/connections, it sounds like there is probably still a fragment(s) of the splinter left and that is what causing the inflammation and pain. One probable idea was that he has flexor tenosynovitis which was described to me as 'basically an infection of the flexor tendon sheath of the finger.' Whatever it is, it is causing Simeon a lot of pain and I don't have the skills or the tools to help. Lori, my nurse friend in Cazale was sick yesterday, so please pray for her. I hope together we can get this particular finger problem figured out.

Onto the next issue .... WARNING: What I am about to tell you may be overly graphic. It may paint a picture in your mind that you do not want to be painted. But if you are not getting a visual and care to view it for yourself ... then scroll down. Seriously, it's bad. So I will not tolerate any complaints about the goriness because you've been warned! But I've heard that some people have a piece of paper ready to cover up the photo and then are still able to read the story. That may be a good idea tonight.

Alright, now that we've got that cleared up, for those of you who are not wimps ... this is the story. For any of you who have traveled to Haiti, most likely you have visited a market. You understand that in going to the market, you are signing yourself up for issues ... the smells, the overcrowded-ness, the variety of animal parts, the dirt, the bugs ... you know. Keeping this in mind, I'd like to tell you a story about Msr. Pierre Philipe. Yesterday was market day in Archaie, the closest 'big' town to us. He was walking in between two tap-taps. From my understanding, they were very close and started to pull forward and in doing so, crushed poor Misye Pierre's finger. But not only did they crush it, they mangled his ring finger. It was bleeding very badly, and was crushed at the last knuckle. He went to a clinic in Archaie that amputated the finger after the last knuckle. He said that they numbed it, so that is good. But ... otherwise I don't really have anything to say nice about it. Maybe it was so mangled that nothing better could be done, but I (wrongly) expected better. They gave him a piece of paper with prescriptions to take to a pharmacy to buy ibuprofen and amoxicillin. Also, it is common in Haiti (actually I think this is almost always the case) for a clinic to give the patient the list of supplies they will need to buy in order to get their bandages changed. So also on the piece of paper was betadine, tape, and gauze.

Pierre lives right here in La Digue. He explained to me that he heard of someone 'ki fe pansman' (who does bandages) in this area. That someone happens to be me. So here I am with this horrid finger. I am so thankful that our friends James & Sharon are coming on Saturday, because they both happen to be doctors. They help me a lot. But woot woot to this perfect timing. It concerns me because of the closeness the bone has to the surface ... basically it's just that scab separating the tip of the bone and the open air. Not good. So today, I gave him amoxicillin, ibuprofen, and some benadryl to help him sleep (someone coming down soon, tylenol PM is an idea.) I was wincing the whole time I was cleaning it ... because this has to hurt SO bad. I'm praying that nothing happens and that the antibiotics work, especially until my smarty-pants friends come to the rescue.

The above photo is us trying to figure out how to fashion a sling. He had one when he came, but it was just a necklace with his hand slung in it - it looked uncomfortable. But I don't know that we did much better, Where There Is No Doctor gives an example but I think we are kind of sling-makingly challenged.

And I said that I was experiencing a lack of interesting medical cases ... It never takes too long:

The good news about fingers is that one from Saturday, the thumb, is healing very quickly. I am really surprised. I think she may have pulled a tendon or something, because she can't move her thumb very easily. But the cut is healing really well. I was able to share with her today about the reason the word on the street is that 'fi nan Lifeline, li gen bon men.' They say this: 'that girl at Lifeline has good hands' ... which I think is kind of weird, but I was able to share with Viejeli that I try to pray every night before I go to bed for each of my patients. And seriously you guys, the only reason I have had such success is because of this factor. And, by sharing the stories with you, you guys can pray too.

This is such a difficult place for healing to take place, in more ways than one. The cuts/burns that heal are nothing short of a miracle because of all the factors (dirt, sweat, dirty water, ect) going against them here. I may have 'bon men' but it is only because God is doing the work for/through me. Seriously, I know nothing, but somehow it almost always works out. Mwen se rekonesan pou fos de laprieye. I am thankful for the power of prayer.

All Hat No Cattle - Part Deux

pos·tur·ing - v.
1. To assume an exaggerated or unnatural pose or mental attitude; attitudinize.
2. To assume a pose.

Better explained as, All hat, no cattle. (When someone talks big, but cannot back it up.)

The longer we live here, the more we learn about posturing. It is the key to getting things done here. As long as you act in charge, well then ... you are in charge. Troy need only keep his head high and act informed, and voila he is in fact informed and in command. Even though he is not a Canadian Ambassador, he can fool most of those around him into believing he knows what he is doing.

This is a borrowed trick. It's the Haitian way. Whoever seems the maddest, gets their way. Whoever drives the most aggressive gets where they're going fastest. Whoever best intimidates other people, gets to be the boss of the village. It is all about posturing. We cannot get away with it nearly as well as they can. But, at least we have figured out the system. That is helpful.

Our friends, Jamie and Sharon are coming Saturday. They are well-traveled individulas. Sharon grew up an M.K. in Africa and Guatemala. They are both Doctors. They were just in India working a few months ago. The point is, they're smart, worldly-wise kind of people. Knowing that about them, this is the airport advice Troy sent them. Save this for when you visit. (You ARE visiting, right????)

Hi guys-
You’ll exit the airplane down the stairs, proceed to your left along with the crowd through a doorway into the polebarn/airport. The flock will be going down a hall and then turning left into a room with lines forming at four or five wooden booths for passport checks. Hop in line, defend your position, and forget about respecting “personal space bubbles”. Lines in Haiti are a proving ground. It’s a very Darwinian test of survival.

Anyway, when it’s your turn, just hand the agent (who is underpaid and doesn’t give a darn) your passport and form from the airplane. They’ll look at you disapprovingly and stamp a few papers and your passport. They will give you your customs claim form and a green card inside of your passport and send you on your merry way. Keep the green card – you’ll need it to exit the country.

Head for the baggage claim area – it is on your left after the booth stamp experience.
Enter the area and act like you own the place to avoid being accosted by desperate guys trying to make money by finding your bags. (It’s really not that bad.) At this point one of my peeps (Alexis, or myself) should accost you instead, and help you get your bags. There is a guy who checks your baggage tickets against your claim stickers on the folder from the airlines as you enter the line to get out. Then after you fight for your life in that line ;) someone will look at your customs declarations form before they let you exit and pass the tables on the left side with customs officials. Just sail on by them and don’t make eye contact. Remember, you own this place. There will be an immediate turn to your right after the customs tables…down a short hallway, and then to the left out the doors to the waiting area where we will give you a shout out from the crowd. Alexis or myself will get your bags past all the other guys fighting to help with your bags and to our truck. I’ll take care of the necessary bribing/fighting after that. Just go with the flow. It’s ridiculous, but totally harmless. ~Troy