The Senate President

We started with Mass at 0700. Many of us are not religious, but that’s not why you attend Mass here. Father Rick Frechete, one of the founders of St. Luke’s, holds Mass each morning to honor the dead appropriately. The Mass, unfortunately, is a daily funeral. The bodies from the previous day are brought into the center of the small chapel, and the attendees sit on benches that line the walls in a circle. The Mass is said mostly in Creole, but at certain points it is translated into English for the benefit of the guests. I was looking around for a woman named Estelle. When she sings, everything is ok. Her voice is so wonderful, it doesn’t matter what she says or the language she uses; it’s peaceful and makes it okay to look at the dead bodies.

In the past, when we have been to Mass here, there would be as many as 12 or 15 deceased bodies in the middle of the circle. Sometimes it only looked like a few, until they removed the decorated, hand-sewn burial shrouds, and then it’s possible to see the many small kids who didn’t make it through the night.

Father Rick leads the group in song and prayer and we stand there, getting up when they stand and sitting when they sit. We kneel at one point and hold hands surrounding the dead. Sometimes, there are family members attending. Today there was no one who knew the two deceased people in front of us. One of them was a man who was shot on Tuesday. Gang activity has been reported in the area and the peacekeeping is now underway again. We now know one of the leaders of a local gang was called into the hospital to get things back under control. The victim was in front of us, in the middle of the circle.

We didn’t know about the second body until after the service. We were invited to follow the truck that brings the bodies to a trailer in the back of the property. Our group had never been back there before. When there are not a lot of bodies, they use some papier-mâché coffins. The truck arrived at the site and the coffin was placed back into storage. It was at that point we saw a 3-pound wrapped bundle lifted and placed into the trailer. This was the other body, a baby, whose name was Stephanie.

Father Rick showed us around the new tilapia farm next to the trailers. They were growing and farming over 8000 tilapia. The tilapia are used to feed the workers, and to be sold for profit to put back into the programs here. The fish are sold for about 40% of the retail price, allowing those less fortunate to afford some good protein. This is one of the micro-economies that St. Luke’s helped establish; another micro-economy nearby makes and bottles oxygen (O2), and a third makes pasta and bread.

We headed over to St. Luke’s to start our day. We had rounds and vital sign classes, as well as three EKG classes for the nurses scheduled. We had done ACLS for the doctors and nurses the past few trips, but the goal this time was to help the nurses be more comfortable recognizing malignant rhythms on the monitor, so they could alert the doctors more quickly and intervene.

We have been working on early intervention for Septic patients. METI introduced a Sepsis Protocol that the nurses and doctors could follow. Based on patient presentation and vital signs like heart rate, BP and temperature, the Sepsis protocol could be implemented. If a patient showed signs of Sepsis, they could have fluid, early antibiotics and interventions, possibly saving their life. Two of our Pro EMS paramedics and METI team leaders had implemented the Sepsis protocol at St. Luke’s last August. We donated Lactate meters as another early diagnostic test. A 25 year old patient presented to the ED last night, could barely walk, very weak. She was sick for 4 days and was having some difficulty breathing. Heart rate was 142, BP was 80/48. Temp was 102.4 and her Lactate was 5.2.  The triage nurse quickly recognized the signs and let the doctor know. IV fluid and antibiotics were ordered as well as a chest x-ray showing pneumonia. Twelve hours later, the patient was afebrile and doing really well. Six months ago, that patient may have died. Huge win for the St. Luke’s team.

The team usually goes out to dinner one night during the week. Luckily we have made some great connections in Haiti – family members of teammates and locals with whom we have bonded. The team was picked up at 4:30 for a trip up the mountain to Petchonville. A ten-mile trip that takes two hours because of traffic, it allowed us to see more of the country, the poverty, the devastation, the roadside markets, the collapsed houses. It was hard to tell where one street ended and a new one began. Most roads were incredibly bumpy and not paved. It was a tight fit in the car. We were underdressed for the restaurant but it was nice to sit and relax for a minute. The company was great! We had conversations in a mix of English, French, Creole and Spanish, as we debriefed and told stories from our trip. The team was able to eat some native Haitian food while they listened to Compas, the traditional Haitian jazz.

The Senate President of Haiti arrived at the restaurant, accompanied by his delegation. We felt a little too casual in jeans and T-shirts, but we were introduced to the Senate President and took a photo with him. He spoke English very well and we chatted about our stay.

Wait. What just happened?

Yet another interesting paradox.

We left the restaurant, thanking our hosts and the owner, who delivered a complimentary amuse bouche, a small tasting of Haiti, to us. We made our way back through the restaurant, which looked like a rain forest, and passed the Senate President’s security, with their AR’s and shotguns. We were eerily silent getting back in the car. The drive back to our villa was about 15-20 minutes, shorter than our trip up. Only in Haiti.

Posted in 2014 February, Culture, Haiti, Patient Stories, St. Luke's Hospital, Training

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