Infection

This lady was wearing sandles on a motorcycle and got her heel in the spokes while driving through the mud. The wound is infected. Here it is being cleaned. This happens a lot here in Haiti.
Sent from my BlackBerry® device from Digicel

A Post from Annelies!

Dutch Version
English further down


Hoog tijd voor een update, hier vanuit noord west Haïti.
Om ook even over het weer te hebben. We hebben nu 1 week bijna elke dag een flinke regenbui.
Wat is dat heerlijk. En je ziet de natuur veranderen van geel naar groen. Het voelt lekker om de regen op je neer te vallen.
Ik sta er vaak niet bij stil, hoe belangrijk regen is. Maar sinds deze week zit her weer fris in mij geheugen. Regen… wat een Zegen!
Tussen de regendruppels door, zijn Dustin en ik, druk bezig met het werken in en rond het ziekenhuis en de kliniek. Dustin maakt vorderingen met het monteren van de zonnepanelen. Maar regelmatig helpt hij ook mee rondom de zorg van patiënten.
Afgelopen week, kwam er een jongen van 14 in de kliniek, zijn familie gaf ons wat medische gegevens, diarree, overgeven en koorts sinds 1.5 dag. Maar er moest meer aan de hand zijn, want van 1,5 dag kan je niet zo slecht zijn. Hij overleed al snel, na een uur. Wat we later hoorde was, dat iemand hem had vergiftigd. 
en.. ja hoe nu verder, het lichaam van de jongen, moet naar huis worden gebracht, maar er is geen vervoer en geen geld. 
Dustin heeft hem later met zijn familie naar huis gebracht.
En ja, dan is de auto weg en moeten wij ( dokter en verpleegkundige) verder met de dag. Want er staan meer patiënten te wachten. Omschakelen, weer terug naar de orde van de dag. 
Pff niet leuk om zo de dag te beginnen. 
Gelukkig zijn er ook geweldige momenten. Afgelopen week bijvoorbeeld, midden in de nacht, heb ik bij mijzelf , een bevalling gedaan. Een 19 jarige vrouw/meisje was voor de tweede keer zwanger. Tijdens haar eerste bevalling, is het kindje overleden. God zij dank, heeft zij en haar man, nu een gezonde zoon! Prachtig, een mooi geniet moment.
En zo, zijn we allemaal druk bezig rondom de zorg van patiënten.
De mensen die mijn weblog hebben gevolgd van 2008, weten misschien nog wel, dat little John in het ziekenhuis was voor een tijd met ondervoeding. 
Dustin en ik hebben nog steeds contact met hem en zijn familie. En hebben hem sinds april dit jaar al een paar keer gezien. John komt namelijk elke maand nog naar de kliniek voor controle. Maar we hadden zijn familie nog niet bezocht. Dat hebben we van de week gedaan, twee keer zelfs. 
Het was erg leuk en fijn om zo samen met hem en zijn familie te zijn. John is echt flinke kerel geworden. Hij is nu ongeveer 3,5 jaar. Zijn oma die het meest voor hem zorgt., is druk bezig om een nieuw huis te bouwen. Het huizenproject van Rob helpt hun daarmee. En zo is ook deze familie druk bezig.
We hebben ons plekje hier in Haïti ondertussen wel weer gevonden. Met leuke momenten mindere leuke momenten. We kunnen zeggen: God is goed, Hij zorgt voor ons!




English Version

Just a warning, this email has been translated from Dutch to English using google translate!

High time for an update here from north west Haiti.
Also a weather update. We now have 1 week almost every day a big rain. 
 What is that delicious. And see the natural change from yellow to green. It feels nice to the rain fall down on you. 
 I am often not realize how important rain. But since this week is fresh in my memory again re. Rain ... what a blessing!
Between the rain drops by, Dustin and I are, busy working in and around the hospital and clinic. Dustin is making progress in assembling the panels. But he also regularly helps with the care of patients.
Last week, there was a boy of 14 in the clinic, his family gave us some medical information, diarrhea, vomiting and fever since 1.5 days. But there was more to it, because of 1.5 days can not be so bad. He died soon after one hour. What we later heard was that someone had poisoned him.
 and .. so what now, the body of the boy should be brought home, but there is no transportation and no money. Dustin brought him later with his family home.
And yes, the car away and we (doctor and nurse) go by the day. Because there are more patients waiting. Switch, back to the order of the day. Phew 
 not so nice to start the day.
 Fortunately there are great moments. Last week for example, in the middle of the night, I did my first completely solo delivery. A 19 year old woman / girl was pregnant for the second time. During her first birth, the child is deceased. Thank God, she and her husband, now a healthy boy! Wonderful, enjoy a nice moment.
And so, we are all busy about the care of patients. 
 Those who have followed my blog in 2008, knowing perhaps that little John was in the hospital for a period of malnutrition. Dustin and I still have contact with him and his family. And have him since April this year a few times. John is because each month to the clinic for a checkup. But we had not visited his family. We have done of the week, even twice. It was fun and so good to be with him and his family. John has become really big guy. He is now about 3.5 years. His grandmother who most care of him., Is working hard to build a new house. The housing project of Rob helps them with that. And so is this family busy.
We have our place here in Haiti now be found again. With less fun moments funny moments. We can say God is good, He gives us! 


Levius

This guys name is Levius, he is a candidate for on of the houses of the housing project that Rob is running. Right now he lives in his Mother in laws house with his wife and their two kids. When her brothers and sisters come back from the Dominican Republic Levius and his wife and two kids have to live in this hut that is used as the kitchen.
The kitchens dimensions are about 10 feet wide by 15 feet long.


Deze jongens naam is Levius, hij is een kandidaat voor op een van de huizen van de woningbouw project dat wordt uitgevoerd Rob. Op dit moment woont hij bij zijn moeder in de wet-huis met zijn vrouw en hun twee kinderen. Toen haar broers en zusters komen terug uit de Dominicaanse Republiek Levius en zijn vrouw en twee kinderen hebben om te leven in dit huisje, dat wordt gebruikt als de keuken.
De keukens afmetingen zijn ongeveer 3 meter breed en 5 meter lang.

Malaria and Diarrhea

So it has been a rough week. Monday started of with stomach cramps and a slight headache... By nightfall I had the chills so bad that I couldn't stop shaking. So I woke up Dr. Micheal and he found some chloroquine for me which took care of the headache and chills. But the diarrhea it seems is here to stay. So Josh, I can sympathize with you now ;] But I am feeling much better. A few days ago I made it out to the hospital and took some footage. Here it is below. Sorry the editing is pretty bad... I just did it in a couple seconds. Annelies is well and is taking good care of me while I am sick. We have a small baby who's mom has HIV. The baby is having a hard time of it so we are taking care of it some of the time. We lost a little girl last week to a strange set of symptoms that we have seen before but we have no lab to test for certain things.
We are going to try to stay longer, we are working it out with our insurance company.


Het is een zwarre week. Maandag begon Dustin met krampen in de maag en een lichte hoofdpijn ... Tegen de avond had hij koude rillingen, zo erg dat hij niet kon stoppen met schudden. dr. Michael en hij vonden chloroquine- medicijnen voor hem, die zorg heeft genomen van de hoofdpijn en koude rillingen. Maar de diarree heeft hij nog steeds.
Dus Josh, hij kan meevoelen met jou nu;]
Een paar dagen geleden maakte Dustin wat filmpjes vanuit het ziekenhuis. zie hieronder.

We hebben een kleine baby, de moeder heeft hiv en heeft op het ogenblik genoeg aan zichzelf. Wij verloren een klein meisje vorige week in een vreemde verzameling van symptomen die we eerder gezien, maar we hebben geen lab om te testen op bepaalde dingen.
We gaan proberen om langer te blijven, we werken het uit met onze verzekeringsmaatschappij.

We are here!

Hello everyone, we are here in Haiti and getting adjusted. People have some corn to eat and we just got a rain last night. Annelies is busy in the clinic and hospital. I am working on a solar power system for the operating rooms. Sorry this is short but no time :]

Mensen hebben wat maïs te eten en we kregen eenIk ben bezig met een zonne-energie systeem voor de operatie kamers. Sorry, dit is kort, maar geen tijd:]

Going Back to Haiti

Dear Friends,

Tomorrow we will be headed back to Haiti. We may not have internet set up for a while so do not worry if you don't hear from us.

In the mean time here is a video of the area we live in.

Dustin and Annelies



Show romanization

Beste Allemaal,

Morgen is de dag van vertek naar Haiti, waar we donderdag hopen te arriveren. We hebben een goede tijd gehad in Californie.
Het was bijzonder om bij de bruiloft van Leitha (Dustin's zus) te zijn en de rest van de twee weken, met de familie op te trekken.
Zoals gezegd hopen we donderdag de 15e van april aan te komen.
Wij zullen daar tot eind juni zijn wat eventueel verlengd kan worden.
Spannend is het wat we daar weer mee gaan maken.
De eerste twee weken, zullen jullie niet veel van ons te horen krijgen, dit in veband met het installeren van de computers en internet.
We hebben er zin in om de bekenden weer te gaan ontmoeten.


Vriendelijke groetjes van Dustin en Annelies

Dental and Medical teams

Here are some of the doctors and some of the crowd waiting this morning to see the doctors and dentists.

Foizon Visit

So yesterday I went and visited Foizon, the area Annelies and I would eventually like to go and work. We visited John who many of you know just to see how he was doing. Foizon is really dry right now, drier than I have ever seen it. Please keep them in your prayers many are hungry. Johns family seems to be doing well. They where playing dominoes when we got there. There field is ready to plant as soon as the rain falls. You can see how dry it is in the first picture. I am down in PC today and we have two large teams of dentists and Doctors. We are waiting on delivery of the dental tools today so that the dentists can begin seeing patients. I would estimate we have about 200 patients waiting at this point down at the hospital. We probably have a team of 24 doctors and dentists at this point.

Back in Haiti

So I am back in Haiti, it has been a while since I have updated this blog. I came back to Haiti to finish installing a sattelite antenna that I did not have the part for earlier. I will try to do short daily updates since time is limited. Yester day I went with Rob to the house of Pastor Mike to deliver supplies for the housing project, boards and 2oo sheets of roofing tin. On the way we were going up a steep hill and all the roofing tin fell out along with selifor, (the guy on the trailer) so he was bruised up and we had to reload the tin as well. We also brought a trailer load of water to Pastor Mike becuase they have no water yet after the hurricane. Hope to go to the church in Foizon today if I can find a motorcycle to rent. Please pray for the people here, especially Foizon, they have not had much rain since November and many people have lost crops. The hills look really dry. There is hunger in Foizon.

Here is some of the corn I was talking about, this lady will get a harvest out of it but not much. I looked around and could spot the occasional ear of corn.

F-100

Hello Everyone, It has been a while, and for that I apologize. Things have been very busy here. We have received a large shipment of F-100 and F-75 from UNICEF and that has been a big help here. F-75 and F-100 are therapeutic milks for children with malnutrition. The F-75 has 75 calories per 100ml. When a child gets to a certain point with malnutrition that child no longer wants to eat which is where F-75 comes in. F-75 gets a child from the point of not wanting to eat to having an appetite again. Once the child has regained the desire to eat they get switched over to F-100 which will help them to rebuild the weight they have lost. I go with Annelies on her rounds in the Hospital occasionally and have seen this stuff work. It is amazing, kids that almost had to be force fed are now happily drinking down their portion of F-100. They change drastically from being sad and having no energy to running up and down the hall of the hospital playing and laughing. One child in particular named Regiles has had a great turn around. Some of the other patients tease him by pretending they are going to take his milk away, well… he is only about two years old but I think you would have a big problem on your hands if you did manage to take his milk away from him :] A sincere thanks to UNICEF for their generous response and sincerity!

In my last blog I told about the discouraging 2 weeks we had with loosing so many children. I am happy to say that we have not lost any little children to malnutrition since then. But, we are still looking to ways we can help prevent some of those types of cases. Annelies and I have been talking about the possibility of starting a little extension clinic up in the mountains near where many of these patients come from that would be able to refer patients down to the clinic here where Dr. Anne-Marie works. Last Sunday we went up into those mountains to visit the church and some patients in the region. While we were on our way to see John Little, the kid two posts below, a man stopped us and asked if we would stop by his house and take a look at his wife who had an infection. There is a real need for some simple medical help up in those mountains and it pulls heavily on both mine and Annelies’ hearts. Annelies and I are getting married next year and have a lot of changes happening in our life at the moment so it is not even certain when we will be able to return to Haiti. But I see a clear need up in that region that Annelies and I could be of great help in.
In other news we made a request to FAO for seeds for the farmers here, we asked for seeds for about 9,000 farmers and received a commitment for about 500 farmers. We received the first shipment of seed from FAO about 2 and a half weeks after planting season. Of the committed 200 bags of seed we have received 40. It has been a bit difficult working with them and a large amount of our time and resources have been spent holding their hand coaxing them to do what they should be doing without our help. We are still waiting for the remaining 160 sacks of seed and where told that they would be here a week and a half ago. But the farmers here where happy to get what they could at the distribution, we are loaning the seed from them and expect them to return it with an increase if they get a good harvest. We would like to start some sort of seed bank here so the farmers have somewhere to go when they need seed. Storing seed is complicated and risky however. But all in all we are thankfull for the help FAO has been giving the farmers.
Annelies and I visited John little, you can see his house here. It has since been replastered. His family situation is complicated and while we would like to build him a new house with a tin roof and a water storage tank we are not sure that he would benefit in the end. His house is about a half hour uphill hike from the nearest water fountain. We may be able to help them out with a new house once we get back and get to know them better. Please be praying for John Little and his family. Also pray that we would have wisdom how to help and how not to help them.
Annelies and I have only two weeks left here in Haiti. December 31st we will be flying to the States for two weeks in California with family and friends. Then we head out to the Netherlands to be with our family and friends there. I may come back to do some work in March in California and Annelies has a job lined up in the Netherlands. We look forward to seeing all of you soon, but we already know that we will be missing the people here in Haiti a lot. Please pray that we would be open to where God leads us in the future.

The Children are dying.

This morning we lost our seventh child in the last two weeks. Betty's son Wolbinski died this morning of hunger. Hunger you say, can't we just feed them? By the time they make it to the hospital it is often too late. Which leaves me with the question, how can we prevent these deaths? Relief food is obviously not making its way to those who need it most because those people are the weak ones the ones without friends in high places of local government that will put their name on the list for food distribution. Meanwhile I see those who have the connections selling a sack of the relief food from a local USAID food distribution. The way the people here see it free food has no rules, how can you steal free food? My question is how do we help kids like Wolbinski? How do we find Wolbinski before his mother brings him to the hospital beyond the point of recovery? How do we help Betty the mother of Wolbinski without making her permanently dependent upon charity? Mortality should never be accepted for the sake of sustainability though. So what can we do about this situation as a whole? The people here need to be able to make their own food. In order to do this they need to have education. In order to have education they need to have a stable economy. In order to have a stable economy they need to have a stable government. In order to have a stable government the people need to be honest and trustworthy. In order to be honest and trustworthy the people need to have a relationship with Jesus. I know this may sound like cheesy pop Christianity but we in the developed world too often take the values and principles that Jesus teaches and that our societies are built upon for granted.

Still here

Hey we are still here. WFP has been delivering food to our village and that has been a blessing. We have a lot of TB and malnutrition patients in the hospital and are borrowing beds. This is John, we take him home once in a while to give him some extra care. He is not too happy with what is being done to his hair during bath time. His mom died and here in Haiti that is often fatal for her children. During the first month that we where here we lost 3 kids in one week to malnutrition. They just come to the hospital too late... The Doctor and Nurses are now scouting the villages in the surrounding area to try and locate some of these cases before they are so far gone but it is difficult to get away from the hospital. They are trying to take a look at all the kids in the area by having them come in to be weighed. We now have lights in the hospital hallway thanks to some dilligent work by several electricians (you know who you are) and some borrowed solar panels. This is very important because it reduces our use of oil lamps which are dangerous flame wise and breathing wise and are expensive. We still need to get some low wattage led bulbs for the individual rooms and hope to have them by December so that we can completely eliminate the oil lamps from the hospital.

Also of note, Annelies and I got engaged the 4th of September in the Netherlands. I had meant to make an announcement on the blog but things have been busy here. We plan to get married June 10th 2008!

Food!

Food has arrived! We had five loads of food delivered by the World Food Program today. We have one more that is supposed to be delivered but there seems to be some weather or mechanical problems. We still need food in two other areas that are more desparat than us because their roads are still impassable. We hear the WFP for Haiti is running out of food. I think the word will spread monday for the distribution and it will start to go out to the people who need it tuesday. Thank you for your prayers.

Water

Hi Everyone,
We have water! The guys here were able to repair the water temporarily the day before I got here. It broke again 2 days later but we were able to fix it more permanently. We are now working on re routing the water through a more secure pipeline. There is much work to be done. Today I will head up to the source with my engineer friend sadrack that I have told many of you about. We will see what is needed immediately to fix the water system now and what is needed for a long term solution so that it can survive the next hurricane.



In the photo above you can see where the water line is in danger of being washed out. This is our more secure waterline that will need to be moved before the next huricane. Things are bad here, many people in the clinic from hunger and malnutrition related illnesses. I will try to get photos up soon.

Whole gardens have been washed away. The problem here is most of the gardens that people get reliable food to eat from are in the valley next to the river since they can be irrigated and do not depend on rain. During the huricane whole gardens several acres in size have been wiped out. (see photo with palm tree) We are asking for assistance from the world food program, hopefully they will be able to send some food via helicopter. I spent my first days here surveying potential landing sites. The roads are bad but we have one that is now passable into our village. When I ask people what they need up in the mountains it is usually: food, roads, gardens, houses in that order. The people here need food now to survive until they can get the next havest, 2 months from now for beans.


Some have told me they need seeds to plant beans, and sweet potatoe slips to plant as well. Please pray for us, and please pray that relief food gets here. Much of it is going to gonaives but it is more difficult to delivere it here in the mountains where the roads are gone.

(the water is about 5 or 6 feet deep and 8 feet wide through the main road to Foizon.)

Many people have lost homes as well. Most stay with family.




These kids where helping me find Sadrack and check the temporary water line.

This kid told me he is not using this water for drinking, but he probably is using it for washing. But it kind of shows you how precious water is here.

Going back

We are on our way back to Haiti. Please pray for the people there. We still have no drinking water. Pray for those working on the water lines.

Please Pray!

Here is an email from Rob and Anne-Marie:


Ike is here and he really is a hurricane.
Trees are pulled out of the ground, water every where, animals are dying, it
is a huge storm.
We try to stay in the house but have to see the patients at the hospital. It
is dangerous to go there but we have to.
I had to put your e-mail addressess (cc instead of bcc) like this so my
parents have them too.
If internet is not working anymore than I can try to call my mother and she
can keep you posted by e-mail.

Please pray for safety!

Blessings, Rob & Anne-Marie

A lot of Rain

There was quite a bit of rain in Haiti from the storm Hannah. It has washed out the pipeline for drinking water in two places. This river is normally small enough to walk across without getting your knees wet. Please be praying for everyone there and that they will be able to get the pipes back in soon.

here is an email I received from Rob and Anne-Marie. It was in dutch originally so please excuse the google translation. Annelies and I are in Netherlands so please do not worry about us.

Dear all,

We are in a disaster area alone we notice the impact is not well.

Both waterleidingensystemenare at different places riped out.
We have no water, no electricity and 2 storms still to go.

The road to the Catholic church is gone. The gabions (nets with stones)
have been moved and there can be no more car door.
At the cemetery (direction lesson Fund) is also on the road and there can be no car
more. We are therefore in an isolated area.

The whole area has no water. People are advised to rainwater to
catch.

I hear now the church of the cath. church. I think they have a meeting
have.

The consequences are worse than with Hurricane Jeanne!

Attached photographs of the river, the men in a kokosnootboom (were
surprised by the water and fled into the tree) and the radio antenna in
our house has been moved by the wind.

We keep you up to date.

Rob & Anne-Marie

Today I decided to take some photographs of the
patients in the hospital to give you an idea what we see here on a regular basis.
On the left is Loren with her little girl Wedgina. Rob and Dr.
Anne-Marie picked up Loren on the road in Bassin Blue and brought her back to the
clinic. Loren has a heart condition which is causing her to
retain water. Her heart got stressed during the delivery of Wedgina
and she has had failing health ever since. When wegina first came to
us she weighed 1.65 kilograms 2 weeks later she now ways 2.6 kilograms.
We started her off with a feeding tube because she did not have enough strength to eat on her own.

This is Flanez and her parents. Flanez came
to us at 2 kilograms. She is underweight has problems with
her lungs and also appears to be handicapt physically and possibly
mentally. Her parents are very nice and hopefully the problem
with her feet can be corrected surgically. Her husband is
pumping breast milk for Flanez since she is too week to drink.
Special thanks to those who purchased the breast pumps for
us. Flanez drinks through a feeding tube as well.
Right now her biggest problem is breathing. She is
often congested.

This is Castrol, he has TB and is being treated.
He seems to be getting better complains about pain in his
legs a lot. He is also trying to steal my girlfriends heart!
He is quite the smooth opperator so I've got my eye on him.
On a sadder note his family left him at the hospital with no
food and no one to care for him. Fortunately the mother of a
TB patient across the hall has taken him under her wing and keeps him
fed. Someone recently donated money to the Hospital to help
feed the patients who can not afford to bring food. Because
we do not have the resources and because we do not charge a lot the
patients must bring their own food and family to cook for them when
they come to the hospital. There are a few exceptions like
Castrol and some others who can not afford food. Castrol has
a great attitude and is always good for a late night conversation.

This is the mother of Mama Anne-Rose. She is
the one who took it upon herself to feed Castrol when his family
abandoned him. Her daughter (Mama Anne-Rose) is being treated
for TB in the room on the left.

Here is Mama Anne-Rose she has TB and is being treated.
Annelies is on the left and Ryna a nurse from America is on
the right. She lost her child who was born premature.
She is doing much better now.

This is a daughter and mother. The daughter
had TB first and then her mother caught it. The duaghter is
in the 4th month of TB treatments and is able to stay at home now but
came back to the hospital to help take care of her mother.

This is the daughter of Belizer. Belizer had
a motorcycle accident and so his whole family is staying here.
She and her sisters are very cute and allways chase me down
to say hi or wave at me as I drive by on the tractor.

This is Belizer. His leg was not cleaned
properly by a hospital that will remain unnamed. The cut was
not a serious one but he fell in a canal filled with sewage and the
wound was not properly cleaned before it was stiched up. A
few days later the skin started to buble and rot. Dr.
Anne-Marie cleaned the wound and cut away the infected skin and
Annelies and Ryna have been cleaning and bandaging the wound ever
since. It is starting to heal rapidly but he is still without
skin over a large part of his leg.

Hope this gives you a better idea of what we are up to
over here. We both realy enjoy being over here in Haiti.
Sometimes it is overwhelming with the climate and the poverty
but there is a lot of joy to be found here in the people.
Please pray that we would have patience and strength for the
work over here and that our endurance holds up. We are headed
to Netherlands for a month which will give us a nice break but since
both of us plan to be here long term, years... we will need a new level
of endurance and patience than when we knew we where going home in a
year or less. Thank you for your prayers and support.

Uncle Dustin

Tasha gave birth yesterday to my niece Yaelle 7.5 lbs!!!!! that is 3,4 kilos!!! nice :]