Wednesday, November 30, 2011


Big Red 1 broke down. That was the first hang up. We thought we were going to get an early start this morning, but while waiting at the mission gate, the Honda 2 seater ATV, the one that Dr. Sorg, Abby, Johnny, Wilner and Hebron were in just decided to stop running.

We actually didn't find out until we were about a mile up the road following Rob Baker with Chelsea and Darla and he pulled over to let us know that he needed to turn back to sign a check for something. We waited up the road a little ways, but when Dr. Sorg never met us in Big Red AND we never saw Rob again, we grew concerned and turned back at the suggestion of Tee, my co-pilot.

Dr. Sorg was standing at the gate smiling with Abby and our translators when we arrived. They just resolved to pile into the pickup and leave Big Red 1 behind. We followed in Big Red 2 while wearing surgical masks and glasses to protect us from the increasingly unbearable exhaust fumes and dust.

I saw something on the way up that I've never seen in Haiti before. Road construction crews paving the single lane winding mountain highway.

Well, that's not exactly accurate, there are no official lanes in this part of Haiti and apparently only one speed limit sign (which said 50 km/hr, an impossibly dangerous speed on these roads). The road construction is a very good sign, it means that there might be an improvement in infrastructure coming to the heavily populated and developed areas of Haiti.

That's not where we were headed though. We were on our way to the previously unreached section of the Southwestern mountains called Boudon. What the area lacked in infrastructure, it made up in beauty. Beautiful scenery, beautiful weather and beautiful personalities.

We saw 80 patients today, with many of the same complaints and lots of hypertension, even with one particularly sweet 19 year old mother. Darla, an NP with several years of experience in remote medicine from the North Pole to Eastern Europe and the 10-40 window, had a small dilemma at one point involving this 19 y/o mom and whether to give her captopril or HCTZ or both for her hypertension, which was extreme for her age.

Due to tridiculously high sodium intake of the rural Haitians, hypertension is an epidemic affecting nearly everyone, it seems. I dropped a message on Twitter and Facebook hoping for a quick answer as to the efficacy and possible adverse reactions of Captopril. I got a lot of responses (Thanks for those of you who cared so much that you took the time to ask people and do the research on that! I love you guys). The most surprising was an anonymous email from a physician from the American Academy of Paediatric Physicians who sent me a link to cited research findings (after the fact, but no less helpful). Captopril has not only been shown to not be harmful to breast fed babies, but intact showed that we probably UNDER-dosed the mom while trying to error on the side of caution. If we see her tomorrow we might remedy that.

If you are interested, I would be happy to send you the research on it.

So Darla and I discussed it for a minute and decided that we were primarily concerned with long term renal function and that captopril would fit the be in our risk v. benefit analysis. Luckily. As it turns out we were correct, if not overly cautious.

That little village with no road, no electricity, no plumbing, running water, sewage or any other modern convenience was filled with the 150 most wonderful people I've ever met. They were primarily agragarian growing onions and cabbage on the steep mountain sides over-looking the cloudy bay of Haiti and Port-au-Prince.

The homes were little more than corrugated metal nailed to shaved tree trunks embedded in the ground. On the roofs, like a patch work quilt, clothes were laid out to dry and doors remained opened, if there was a door at all, while chickens roamed freely. Giant pigs basked in the equatorial sun and mother cats nursed their kittens in the middle of busy walkways, entirely un-intimidated by all the people walking around them.

I took pictures of everyone, because everyone wanted to know what they looked like on a digital camera. The video camera was a big hit too, if not too overwhelming for some of the other older folks who knew no more of technology that the single battery operated transistor radio situated like a shrine next to a woman who appeared to be the gentle and revered matriarch of the village.
They were so blissfully impoverished. They seemed to really want for nothing, except for the two things we came to offer them. Medicine and the good news about what Christ did for us on the cross.

Not long after we arrived, we were sort of ambushed by a loud, carismatic and sweaty group of a couple men with anachronistic bullhorns and a single file line of women in all white chanting and singing at the top of their lungs. They marched all over the tiny village stopping each time they saw a "blanc" person congregating with a Haitian and would scream/sing something in Creole as if we were 100 yards away. After they finished they'd shout "Hallelujah" about 4 or 5 times then break up and shake our hands the return to formation and go accost someone else.

We were stopped dead in our tracks as Benjamin and I were sitting with this very old woman who didn't know what year she was born, trying to discern her medical history. When conversation became impossible, I pulled out my video camera and recorded the spectacle laughing at the silliness of it all. To be honest. I just thought that they were voodoo practitioners but Rob Baker told me that they were Catholics (probably Catholic mystics, a common combination of Catholicism and voodoo) that had come from another village and that they were probably visiting because they had heard that we were here. I'm not sure what their intention was but throughout the day, we saw at least 3 other similar groups traverse the switch backs of the mountains coming toward us (probably from other remote villages in the area), but we had no more visits.

A Haitian Baptist Pastor came to hang out with us while we moved the patients through the clinic and seeing their medical needs, grinning from ear to ear. Recently this village and a few surrounding villages have been getting visits from the native Haitian Pastors who walk for miles up the steep muddy mountain sides with nothing but a Bible to tell them about Jesus. Today 11 people chose to follow Christ and several more showed an intense interest in hearing the gospel. What a moving experience to see so many break from the years of tradition of voodoo-catholicism and seek a relationship with Christ!

The clinic day ended unlike any other. With the expert talents of Chelsea, a young full-time missionary new to BHM, a rousing game of Canar, Canar, Swa (Duck, duck, goose) was intiated and played for the very first time by some 20+ kids followed by sing-a-longs, Simon Says (which is really hard to play if you don't speak the language) and some soccer.

One of the most impressive things I saw was kids playing soccer in a dirt field with golf ball chunks of rock through BAREFOOT! Haitian kids are way tough!

The drive down through the mud and rock was a blast until about 15 minutes from Fermathe when we hit pavement again and, again, sucked exhaust fumes from a large taptap (taxi/bus/pick-up truck).

All was well after we got back and hung out with Patty Baker, Rob's wife, who walked around the campus with us for a bit and informed us of much of the history of this marvellous mission.

Our night ended like any other with dinner, fellowship and prayer and... Of course, counting pills and preparing the formulary for another day in the field.
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Tuesday, November 29, 2011

Dust and Smoke

The smell of smoke envelops me while I lay in bed tapping this out on my Blackberry. I don't get it either, I took a shower, changes my clothes and everything. Maybe its just stuck in my nostrils like all that dust from the "road". Maybe its my backpack or my hat next to the bed.

The smoke is from the process of making charcoal that the locals sell in the markets. Some of them make their entire living by burning wood to charcoal the carrying it miles on their heads up and down these crappy mountain roads.

My patients routinely complain of headaches, back aches, stomach aches (mostly worm infestations and Giardia) and hypertension. Draw your own conclusions of the living conditions of Haitians... and we've been working in some of the most developed parts of southern "Ouest" Haiti.

These locals cook over these little charcoal fires. Choking the smoke in their cramped poorly ventilated one bed room homes. My eyes stung the entire time I was in the little cement church. There were no fans and ventilation was screen-less and glass-less windows, the same windows through which the smoke from the charcoal fires was entering the building. My nose is rejecting the smoke by creating a thick crust around my nostrils that feels like a stalactite hanging precariously from those hairs that I now grasp the purpose of.

And the dust. Dust is everywhere. Its part of life in Haiti. The road are dust, our ATVs kick up dust. The wind blows dust. Guys sits on giant piles of rocks on the side of the road with hammers breaking big rocks into smaller rocks and those smaller rocks into pebbles, and those pebbles into dust.

It cakes onto your hair giving it a texture similar to that of a horse. The dust is so incredibly intertwined into the lives of Haitians that I had two patients todays tell me that they were eating is because they were anemic.

I asked them why they didn't just eat some lettuce or cabbage (which is literally in every single family garden and market stand) and they just looked at me incredulously as if to say "hey idiot, don't you think that, if I could afford it, I'd rather eat a green salad than a friggin dirt biscuit!" That wasn't supposed to be funny.

Crap it all makes my head hurt. I hate thinking about this stuff. It pisses me off to such an extent that I almost want the trip to just end. Almost. We smile and laugh and joke around a lot. It helps. Even our translators have to decompress from this stuff. They laugh so easily!

One woman today hadn't eaten in over a week and neither had anyone in her family of 5. That was her medical complaint: "My stomach hurts because I have no food." Yes, we did what we could, but we don't have the ability to provide any long term solutions. In case you're wondering what that feels like, its like getting kicked in the stomach.

On a more positive note, one 15 year-old kid came in right at the end of the day, we were wrapping up and he approached Darla and her translator Hubron. Darla asked what he needed to see the Dr. for, he told her that he just came over because he needed someone to tell him about Jesus. He wanted salvation. That's it. That's what we all want for him. That is what this is all about. He prayed with Hubron and came into an unbreakable relationship
with Christ right there.

I could fill you in on all the other details of my day, but nothing could compare to this great victory of God.
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Monday, November 28, 2011


(Note: All of the entries made this week are from my Blackberry mobile phone. Please excuse typoes, mis-spellings and inarticulate recollections and descriptions. I am writing this like I journal, just thoughts and short bursts of memory regurgitated without serious contemplation or consideration for syntax and form.)

After snagging some of the world's most delicious grape fruits ever with a net I made from a broom, a hanger, a pillow case and some duct tape.

Darla, the NP from New Brunswick was very grateful for the fresh fruit for breakfast and the vitamin C gave my immune system some confidence to address the health crises of rural Haiti.

We were a little late getting off the mission campus and on the road in our two Honda ATV's. With a driver, front seat passenger and three holding on in the bed of the ATV (pictures of the ATV's, nicknamed Big Red 1 and Big Red 2, can be found on my facebook page in the album titled "Haiti Medical Mission 2010).

We squeezed the equipment, meds, medical missionaries and translators in as tightly as we could pack them. I really missed this part of the trip, yes, the driving, because even when you're on the road in Haiti, you're still off road.

Dr. Sorg wanted his ATV in front because its equipped with a horn which aids in navigating the blind corners on the narrow cliff lined roads. Two little beeps let's anyone on the other side know that you are about to collide with them. This has proved valuable as we encounter a near miss every 2 or 3 minutes on the roads. I know that that sounds bad, but we're rarely travelling more than 15 to 20 mph by my estimation, although, they don't have speedometers so I don't really know.

By the time we reached the church in Callebasse, all of our faces were thoroughly, caked in dust and we smelled like exhaust fumes. Abby road in the back with my pal and translator Fedner along with Benjamin, a translator I'd never met before (none of which stopped smiling at any point over the course of the day). Tee, my plucky retired nurse friend from Maryland, sat up in the passenger seat with me.

Dr. Sorg was driving the lead Big Red for a bit until he realised he had left his driver's license at the mission and had Johnny drive the remainder of the trip. Johnny drives just as slow as Dr. Sorg, as Tee pointed out to me while we grudgingly ate their dust on our way up the mountain.

This was a clinic I've worked at before in an old church. It was already full of people when we arrived. The translators adeptly sent the would-be patients outside so the we could set up. The church's pastor, a gracious and kind faced Haitian man, laid down the law at one point (I don't really know what he told them) and we had silence and order after a tense 15 minutes of chaos.

With all the experience on the team (including many of our veteran translators) the mobile clinic and pharmacy were assembled in a matter of about 5 minutes and we immediately set to work with Abby taking vitals, me assessing and gathering histories and Dr. Sorg and Darla (my new favourite NP) wrote up scrips. The whole thing was so fluid and well-executed with us in these roles that we had seen 100 patients before 2 pm.

The patients were mostly church goers from the local Baptist church, with more paediatric patients than I have seen in one of these clinics. For the first time we are starting to see patients with chronic health complaints that can be traced back to the earthquake last year. Some of the kids has some nasty infections and cellulitis and predictable intestinal-worm type complaints.

Johnny and I met one young lady who was not a Christian and very receptive to the Gospel which we (I say we, but mean Johnny) shared with her. Please pray for Mme. Noel.

There were 2 others that did not claim to be Christians, one was not receptive and the other seemed mildly interested. Tomorrow, now that word is out beyond the local church congregation, is expected to be much busier with more non-churchgoers than Christians.

After wrapping up, and the hot/humid/dusty/smelly drive back to the mission, we re-stocked our medication supplies, debriefed, discussed diagnoses and trends we were seeing then went down to the medical supply store room to check on the progress of our once oppressively over-stuffed, garbage-ridden donation room. It didn't even look like the same place we worked those long evenings re-organizing a year ago when we should have been sleeping. Kudos to the teams that attacked and conquered that storeroom since!

The night was finished off with some laughs and story telling with the full-time BHM staff, an excellent dinner (as usual) and a short group Bible devotion and prayer. Abby Darla and I sat down after dinner and did some record keeping and diagnosis tracking then watched part of a movie (Amazing Grace) on Dr. Sorg's lap top.

I really wasn't in the mood to tap out this long blog because every cell in my body is telling me to sleep, but, I know from experience, if I don't write it out, I'll forget it.

And I would be remiss if I didn't tale the opportunity to thank my dear wife, Elizabeth, for making it possible for her husband to fly way over to Haiti to help some sick people neither of us know. You're the best babe! I love you!
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Sunday, November 27, 2011


I've been seeing a lot of familiar faces, smelling familiar smells, hearing familiar sounds, feeling familiar feelings. Its been an nostalgic circus for me today. Its hard to believe that I was here only a year ago.

I was awakened by all sorts of animal sounds this morning. First it was pig, then a rooster, then a cow, then more rooster, then a goat (lots of goat noise, I think it was being tortured by the rooster), more rooster, some kind of really obnoxious tropical bird, and (you guessed it) more rooster.

I felt remarkably refreshed when I woke up and made some instant coffee and studied my Bible in the cool tropical morning mist for about an hour. By 7:30 I was ready to really get the day started. After having breakfast with Dr. Sorg, the next person I ran into was Johnny, a Haitian national, translator from our last trip, and a spiritual dynamo. We smiled and shook hands and it was clear simultaneously to both of us that the hand shake wasn't enough and had a good (very manly) hug with 3 hard slaps on the back and everything.

The church service started at probably somewhere around sunrise, but I joined our Haitian hosts in the chapel for some amazing chorals and "chants" lead by none-other than another one of our translators and friend, Fedner. Seeing that guy felt really good. We spent a lot of time together when I was here a year ago and hardly a week has gone by when I didn't think of something funny that guy said (often unintentionally) and his admirable sense of humour and candid honesty.

The service was loud and long. No church in my town would have more than just the half dozen most devout attendees if the service ran that long in Modesto. It was glorious though and I'll post some videos of the singing as soon as I return home.

The sermon was on 1 Cor 5:19-23 and was in Creole. Between Dr. Sorg, Darla and myself, we were able to collectively piece together the sermon message afterwards and chuckled at our inadequacies for a bit.

I tried to sing along with the Hymns (also in Creole) but got lost easily while reading them from my little program (which now has the blood of two or more dead mosquitos on it).

After a lunch of left over casserole, Tee took Abby and Darla for a tour of the mission hospital and came back for me shortly after. We hiked around the campus and explored some of it with Dr. Sorg who has obviously paid attention on his previous tours of the mission.

Afterwards we hiked down the ravine, took the wrong trail and ended up taking a longer but much more treacherous route through the jungle to a village previously un encountered by any of us. We stopped just short of the first home and took some photos then, realising that we were out longer than the amount of time allotted to us by our busy schedule, had to turn around as access to our destination seemed to either be over grown by the jungle or we just chose the wrong trail.

Getting back was even more of an adventure because, being the one who lead on the way down, I should have lead the way back, but I was so enthralled by the wildlife that I got distracted and let us get on the wrong trail again. Eventually I had our intrepid team sit in one place while I scrambled up the terraces long reclaimed by the jungle to get our bearings.

I couldn't believe my eyes but we had managed to find our way back to an area right below our dorms (down a series of 6 foot tall terraces). Not too bad for not being able to see more than 20 feet in any direction, right?

Sweaty, covered in seeds, dirt, leaves and bug bites, the ladies went for a shower and we started what will be our nightly ritual of sitting around a tiny table counting out Rx medications and discussions on medical and cultural issues we are likely to encounter in the field tomorrow morning.

I lost track of how many Rx's the 5 of us prepared, but I'm sure its more than we need for our 100+ patients we'll be seeing tomorrow.

We took a short break for a Bible study taught by Pastor Rob Baker who runs the mission with all of the other Baptist Haiti Mission (BHM) full-time missionaries. We went over Luke 15 and talked a lot about the lost and the found and the key to salvation and why "the heavens rejoice" when a lost un-saved person is "born-again," the joys of the prodigal returning home and the dreadfulness of the self-righteous.

Afterwards, we returned to our dorm and continued in our assembling of tomorrow's formulary, discussed each members' duties and responsibilities tomorrow and more tropical medicine orientation.

I said a couple of days ago that I no longer wanted but instead needed to go to Haiti. I know this was true because I feel like I've received the prescription I've needed for the last few months. If only the people I'm about to go help could know how much they help me. I really love this place, but I especially love Whose service I am in.

I want to leave you with a hymn we sang at Bible study this evening (along with about a half dozen Christmas Carols):

At Calvary
1. Years I spent in vanity and pride,Caring not my Lord was crucified,Knowing not it was for me He die dOn Calvary. ◦

Refrain:Mercy there was great, and grace was free;Pardon there was multiplied to me;There my burdened soul found liberty At Calvary.

2. By God's Word at last my sin I learned;Then I trembled at the law I'd spurned,Till my guilty soul imploring turned To Calvary.

3. Now I've giv'n to Jesus everything,Now I gladly own Him as my King,Now my raptured soul can only sing Of Calvary!

4. Oh, the love that drew salvation's plan!Oh, the grace that brought it down to man!Oh, the mighty gulf that God did span At Caaaal-vaaaaryyyy!

Pastor Stuart, at my church, loves this hymns and I could hear him voice singing the "AT CAAAAALVAAAARYYYYY" part at the top of hos lungs. The whole time.
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Saturday, November 26, 2011

Day One of Trip Two

I'm writing this from my Blackberry, as I will all of the posts from here in Haiti.

The day was long and actually started sometime yesterday at home as I packed up the rest of my things (and mostly donated things). I checked an additional bag and found out that my flight from LAX to MIA had been rescheduled, instead of leaving LAX around 7 pm, we'd now be leaving at midnight. Our flight, that meant wouldn't be arriving in Port-au-Prince until around noon today.

That complicated things for everyone but Abby and me. Poor Darla, a nurse practitioner from New Brunswick, expected to find Abby and me waiting for her in the baggage claim. We were supposed to be there an hour before her, but instead we ended up arriving an hour after her. Darla still managed to find the driver and waited for us after contacting the mission and expertly navigated the chaotic and intimidating airport international arrival gate.

I met a Haitian born New Yorker on my flight from MIA to PAP who was travelling with his wife to visit his family. He asked me why I was going to Haiti, I told him, then, as if screening those who were about to serve his country, he asked "you have Jesus Christ as your Lord and Savior?"

I told him I did, we acknowledged our brotherhood and just chatted like we'd grown up in the same neighborhood for the rest of the flight.

The airport was chaotic as usual. Tee, Abby and I couldn't find our luggage for the longest time. As I was shouting to tell Abby over the cavenous cement block terminal echoing with the voices of hundreds of fellow passengers also baffled by the disappearance of their luggage, I heard some yell, "are you Zach?" I spun around and didnkt see anyone at first but definitely didn't recognize the voice.

Then suddenly in front of me was the visibly relieved NP, Darla. I introduced the three of us to her and went on the hunt for our bags. We finally found them and fought through the crowd of much too assertive "helpers" who thought the deserved 20 dollar tips for trying to rip my bags from my hands repeatedly as I walked a half mile to the awaiting SUV.

Abby held her own, although visibly intimidated by the experience. I did my best to laugh about it as they harrassed us all the way to the truck and rolled my eyes at the "helpers". They were, in fact, just trying to help, kind of...

The long drive (less then 30 miles that takes about 2 hours) to Fermathe revealed some progress in clean-up of the rubble from the earthquake but not as much construction as I hoped.

We stopped to get some cereal on the way to the mission at a Grocery store, then our driver, Wilson, stopped to give some bread to a woman walking down the road with about 20 kids in tow. Maybe a teacher?

Arriving at the BHM, Dr. Sorg was somewhat suprised to see me and Abby. Our introductions were short and we went straight to work sorting and classing meds taking only a short break to walk around the mission and have some Tuna caserole provided by one of the full-time missionaries here.

We talked about our plans for the week and Abby set out to completely re-organize and re-label the formulary (we were all pretty impressed) as the rest of us counted out children's vitamins.

We're all pretty much exhausted and excited to start the day tomorrow with more work on the pharmacy, a chapel service and a Bible study with the full-time staff here.

At this point, I'm just beat and I don't have the strength or energy to nail out the week's worth of encounters we had in the last 9 hours. Its tough to have to pick and choose which experiences to write about because, I know that the one's that I don't will fade from memory. Its like when you meet someone while waiting in line for a booth at a restaraunt or are seated next to someone at a wedding reception and you hit it off. You think, "man, we could really be friends with this couple!" Then their name gets called for their booth or they have to leave early to pick kids up from the sitters and you never see them again. Yeah, these memories are like that. Ah well, se la vie.

Well, its pouring down rain outside and I need a shower, BAD! More updates tomorrow, so check back.

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