NURSING BOOKS

We ordered nursing books and wall diagrams last night with donations from various people.  Many were from Federated Church which has it's 100th year celebration this year.  One goal of the church is to do 100 of something every month.  March is 100 donations to Haiti!  Thanks everyone! NN

FEBRUARY MEETING FOR HAITI 2014

We're having meetings about the Haiti trip once a month in order to keep organized.  We've had lots of supplies come in.  Since we opened the "Wish List" on Amazon we've had 7 items delivered.  So far all posters for the nursing school.  They will be a huge help since they are diagrams of anatomy.  On the trip to Columbus this morning, one of the nurses from Fremont called to ask if we could use C batteries.  I said we always take batteries so she should bring them  She had a whole box full donated to her for the trip.  We weren't sure how we'd use them, but it seems there is always a use for batteries.  Laci came over early since she was on call and couldn't stay for the whole meeting.  We went through the mastoid drill  equipment to make sure it works and it looks like a "go".  This would be used for chronic ear disease.  John has also taken 3 used microscopes he found on eBay and patched them together to make 2 good working microscopes that could be used for ear surgery. It looks like we are set to go. We will only take one to Haiti and save the other for future missions.

John also has been surfing the web looking for equipment and found otoscopes, not the high end we use which cost $400 for the bare bones, but really good ones.  There was a mission donation site where I could get one for $125 a couple years ago, but didn't think we could afford it, so have never bought one.  He found one for $25 on eBay so ordered three of them.  He brought them in the house this morning to show me the first two that came.  It turns out the batteries we currently use don't fit in these, as they are foreign made.  I'm sure you already know how this turns out.  The batteries that Mary brought fit them exactly and it looks like we have enough batteries for the army!!!  God provides!

This is one of the otoscopes in the red case sitting on the box full of batteries. 

Our kitchen table.  In the back right corner are rigid rhinoscopes and headlights that we've had donated.  We will give some of these things to the ENT physician from Haiti that I've been e-mailing.

Broader view of the kitchen.  We've been packing all along.  John has put A LOT of time into organizing all this and double checking that everything works and fits. The little round white lid on the left on the floor is a container full of diagrams for the nursing school.

The box full of hospital gowns and pillowcases made by the women's needlework ministry from Federated Church.  Thank you ladies.  

I've received an e-mail for and ENT PA who recently traveled to Haiti and found some surgery for us.  She's identified a thyroid, parotid, cleft lip and perforated draining ears.  The goal is more to teach than anything else so these will be good cases to work with.  I've been listening to Creole language on CD in my car.  I'm on lesson 4 and it's amazing how much language you can learn in a short time.  I'll never be conversant, but I can say "Excuse me, please, thank you, hello, goodbye" and a few others.  Those few words go a long way. There is a lot of French in it, which would be great if I only knew some French!  NN

BOOKS FOR HAITI

The nursing school in St. Marc, Haiti was demolished in the earthquake of 2010.  The nurses are now using a school with children during the day and nurses after the regular school day.  Many work during the day and some have to take time off to save up money to go to school. Our team wants to take books to the school.  They need to be books in French.  I have set up a wish list on Amazon.  You have to have your own Amazon account, then search 'wish list', then Nila Novotny.  You can buy whatever you want and have them shipped to Federated Church, 2704 15th St., Columbus, NE, 68601, or you can send monetary donations to the same address and designate "Nursing book donations" and we will purchase them.  We'd like to get them by the middle of March, so we can get them packed and organized before we leave.  This will be a lasting donation to help students for today and the future.

The destroyed school in 2010 that killed students and instructors.

Current nursing students

Goofing around at the teachers desk.

The current school 2013. No running water.

TEAM ASSEMBLED HAITI 2014

We've got quite a good team ready to go to Haiti.  I tried to make a slideshow, but keep getting stuck so won't do that now.  I'll post our pictures so you know who is on board.  In addition to our own Columbus Medical Mission Team, we also have about 20 folks from Grace 4 Haiti which has their own blog and FB page.

Dr. N - ENT Surgeon

John - MacGyver

Linda - Nursing

Kate - Nursing

Mary - Nursing

Molly - Nursing

Dr. C - Family Medicine

Kevin - Nurse Practitioner

Dr. M - Team Leader, Family Medicine

John - MacGyver

Kim - Nurse Practitioner

Laci - Nursing

Vanessa - Nursing

Wendie - Nursing

FIRST HAITI MEETING, DECEMBER, 2013

We've had one team meeting so far and have a good team lined up.  All told there will be around 40 people going over the 2 week span period.  The Columbus Medical Mission Team component includes Me, John, Dr. Mark and Linda Carlson from David City, Kevin and Kim Harm, both nurse practitioner, Molly O'Tool, a nurse from Omaha, Mary Hilgenkamp, Amanda Mesloh and Kate Pullen nurses from Fremont, John Diedrichsen, my nephew, Wendie Nash, Kelsey Berlin, a medical student and Cole Boyle, a student of public health. Here's a picture of our first team meeting.  Only a few of us were there along with a couple others who were trying to decide about going.

 This is a picture with the Carlson's, Novotny's and Harm's.  Dr. Kip Anderson and Dr. Art Liebentritt were both considering going, but decided to wait for another trip as we have a lot of physicians. Dr. Carlson is the one who seems to be hiding his face.  He was actually looking at the handout. Ruth Diedrichsen is there to represent her son, John who wants to go as a MacGyver to help John Novotny.

 Maps of Haiti.  It shares an island with the Dominican Republic just south and east of Cuba.

There is a good video of Mountain Top Missions including a girl from my home town of Lyons, Nebraska that I will attach as a link.  It's nicely done. NN

http://www.youtube.com/watch?v=mJoH7aUrgV0&feature=youtu.be

LETTER REGARDING HAITI FROM DR. MILLER

Haiti both energizes me and makes me tired. I think the team this time would agree. The first Monday we saw 160 people in clinic.  We saw over 1050 patients in clinic and did 100 procedures (98 on patients and the last 2 on team members removing sea urchin spines from their feet after swimming in the ocean the second to the last night).  The teams were great with 38 first week and 30 the second week.  We had brought over two tons of supplies that were donated from team members and many sources across the country.

Highlights include a 19 year old with a ~15% total body burn early first week.  We debrided him daily initially.  One of our nurses who works in the burn OR at St. E's in Lincoln called the St. E's burn unit for supplies. They generously sent what we needed. Her son (past team member), picked them up and drove them to Omaha in a snow storm so the second week team could bring them the next morning.  The special dressings were amazing. By the time we left, it appeared he would need minimal to no grafting. The Haitian nursing and physician staff had been instructed by team members on how to use these dressings. Dr. Toussaint will be available if/or when grafting will be necessary. WOW - team work coordinated both in Haiti and back home. There were enough dressings for probably 3 more patients and now the Haitian staff has been educated on how to use them.

We were asked by a Haitian physician to see a new patient he had admitted with respiratory distress, a 9 year old who was lethargic and severe respiratory distress. We took him to the OR and set up for an emergency tracheostomy. Once everything and everyone was in place, anesthesia, ENT and family medicine saw our first epiglotitis. With significant difficulty they got a 4.5 ET tube in place instead of a tracheostomy.  He remained intubated in the big OR overnight (with nursing at his side and physician close by) and in the small OR the next day till extubated about 6:00pm. With IV antibiotics, IV steroids and the grace of God he was able to leave the hospital 6 days later.  Though we had many years of experience, we saw our first case of epiglotitis, a disease we used to fear in the US. This disease is almost non existent in the US now due to vaccines.

A major jaw tumor removed in a 50 year old man, multiple hysterectomies, radical prostatectomy for prostate cancer, breast lumps, lipomas and other masses removed, nasally surgeries, urethral strictures and many more surgeries were done.  Medically we saw 100's of cases.  Three excellent family medicine residents, a family medicine PA and a PA student covered the clinic which was a great gift to me. The surgeons and I were available as needed.

We had many successes but unfortunately there were all too many times we could not change the course of things in Haiti such as a 17 year old boy with end stage hepatocellular carcinoma. We were unable to resuscitate a 34 year old woman stab wound victim.  Unfortunately we see where culture, poverty and lack of availability of technology and limited resources limit our ability to help.  What I did see was a team that always cared even to the point of tears at times.  Having two team members to lead devotions most mornings helped remind us why we were there, to serve.

PT and OT and a new twist, chiropractic, were invaluable from the ambulation of patients to back pain to hypo and hypertonic infants to burns and more.  Students and non-medical personnel filled in everywhere from the gate and crowd control to inventory to washing instruments to working in each of the areas.

An added duty this time was running the pharmacy. The residents, PA and an ICU nurse with a student and other assistants gave out over thousand (maybe 2000) prescriptions.  We inventoried medical supplies in all the areas and will set up a way for groups to access the inventory. The new meds were added and we kept track of the meds given out for the pharmacy inventory. With all the scripts it was greatly depleted in many areas.

One of the greatest successes was working side by side with the Haitian nurses and physicians. The family medicine residents put on an afternoon of education for the younger Haitian physicians and the Hatian nursing staff that was excellent and well received. 6 days we sent at least 2 people to the nursing school in St. Marc to teach and answer questions.  The second week Dr. Sterman Toussaint was the general surgeon all week and Dr. Optaint (OB/GYN) did Ultrasound Monday and surgery Wednesday.  Dr. Lavouwe is the director of the HIV program and worked with us on several cases. Every patient seen in the clinic was screened for HIV.   Dr. Lavouwe will also follow up with the burn patient.  In the pre-op/post-op area the nursing staffs worked well together.

A veteran team member and master electrician arrived a week before we did and he rewired the OR and central supply from 2 wire to 3 wire. We are now grounded. He remained the first week and was joined by a mechanical engineer, civil engineer and a 6 trip veteran. The four of them in conjunction with Steve Mossburg, director of Project Help Haiti for Church of God, started planning for structural improvements including a second story on the hospital, second story and new kitchen on the guest house, solar energy and other electrical and mechanical needs on the compound.  They also did many fix it jobs, cleaned out old junk, built shelves and benches and more over the two weeks.  A faculty member from Wichita State University volunteered to write an energy grant for the solar energy.

Every trip offers new successes, opportunities and challenges. God has blessed us with a way to serve our brothers and sisters in Haiti. To the team, hopefully it was a fulfilling experience.  Hopefully you will come again or tell your friends so the network continues to expand.  To those of you that contributed in so many ways, thanks and we would appreciate your continued support.  The goal is to make Pierre Payen Hospital and Clinic self-sustainable and completely staffed and operated by Haitians. Each trip by each team should work toward this goal. Since earthquake, many positive changes have happened both structurally, operationally and with equipment.  Many times this week I thought of Dr. Victor Binkley who started this over 35 years ago.  I think he would be smiling.

The picture below is Giana with some Haitian nursing students. 

HAITI SUMMARY NOVEMBER 2013

I just received and e-mail from the team leader of Grace 4 Haiti.  The just finished a 2 week mission.  My daughter was part of the team the first week so we've also had a first hand account.  I'll share the summary letter below and a couple of my daughter's pictures. It shows food, pharmacy supplies, sleeping quarters and the new birthing bed.  Find their site on FB to see more pictures. NN

Dear team, past and future team members and other supporters,

Haiti both energizes me and makes me tired. I think the team this time would agree. The first Monday we saw 160 people in clinic.  We saw over 1050 patients in clinic and did 100 procedures (98 on patients and the last 2 on team members removing sea urchin spines from their feet after swimming in the ocean the second to the last night).  The teams were great with 38 first week and 30 the second week.  We had brought over two tons of supplies that were donated from team members and many sources across the country.

Highlights include a 19 year old with a ~15% total body burn early first week.  We debrided him daily initially.  One of our nurses who works in the burn OR at St. E's in Lincoln called the St. E's burn unit for supplies. They generously sent what we needed. Her son (past team member), picked them up and drove them to Omaha in a snow storm so the second week team could bring them the next morning.  The special dressings were amazing. By the time we left, it appeared he would need minimal to no grafting. The Haitian nursing and physician staff had been instructed by team members on how to use these dressings. Dr. Toussaint will be available if/or when grafting will be necessary. WOW - team work coordinated both in Haiti and back home. There were enough dressings for probably 3 more patients and now the Haitian staff has been educated on how to use them.

We were asked by a Haitian physician to see a new patient he had admitted with respiratory distress, a 9 year old who was lethargic and severe respiratory distress. We took him to the OR and set up for an emergency tracheostomy. Once everything and everyone was in place, anesthesia, ENT and family medicine saw our first epiglotitis. With significant difficulty they got a 4.5 ET tube in place instead of a tracheostomy.  He remained intubated in the big OR overnight (with nursing at his side and physician close by) and in the small OR the next day till extubated about 6:00pm. With IV antibiotics, IV steroids and the grace of God he was able to leave the hospital 6 days later.  Though we had many years of experience, we saw our first case of epiglotitis, a disease we used to fear in the US. This disease is almost non existent in the US now due to vaccines.

A major jaw tumor removed in a 50 year old man, multiple hysterectomies, radical prostatectomy for prostate cancer, breast lumps, lipomas and other masses removed, nasally surgeries, urethral strictures and many more surgeries were done. Medically we saw 100's of cases.  Three excellent family medicine residents, a family medicine PA and a PA student covered the clinic which was a great gift to me. The surgeons and I were available as needed.

We had many successes but unfortunately there were all too many times we could not change the course of things in Haiti such as a 17 year old boy with end stage hepatocellular carcinoma. We were unable to resuscitate a 34 year old woman stab wound victim.  Unfortunately we see where culture, poverty and lack of availability of technology and limited resources limit our ability to help.  What I did see was a team that always cared even to the point of tears at times.  Having two team members to lead devotions most mornings helped remind us why we were there, to serve.

PT and OT and a new twist, chiropractic, were invaluable from the ambulation of patients to back pain to hypo and hypertonic infants to burns and more.  Students and non-medical personnel filled in everywhere from the gate and crowd control to inventory to washing instruments to working in each of the areas.

An added duty this time was running the pharmacy. The residents, PA and an ICU nurse with a student and other assistants gave out over thousand (maybe 2000) prescriptions.  We inventoried medical supplies in all the areas and will set up a way for groups to access the inventory. The new meds were added and we kept track of the meds given out for the pharmacy inventory. With all the scripts it was greatly depleted in many areas.

One of the greatest successes was working side by side with the Haitian nurses and physicians. The family medicine residents put on an afternoon of education for the younger Haitian physicians and the Hatian nursing staff that was excellent and well received. 6 days we sent at least 2 people to the nursing school in St. Marc to teach and answer questions.  The second week Dr. Sterman Toussaint was the general surgeon all week and Dr. Optaint (OB/GYN) did Ultrasound Monday and surgery Wednesday.  Dr. Lavouwe is the director of the HIV program and worked with us on several cases. Every patient seen in the clinic was screened for HIV.   Dr. Lavouwe will also follow up with the burn patient.  In the pre-op/post-op area the nursing staffs worked well together.

A veteran team member and master electrician arrived a week before we did and he rewired the OR and central supply from 2 wire to 3 wire. We are now grounded. He remained the first week and was joined by a mechanical engineer, civil engineer and a 6 trip veteran. The four of them in conjunction with Steve Mossburg, director of Project Help Haiti for Church of God, started planning for structural improvements including a second story on the hospital, second story and new kitchen on the guest house, solar energy and other electrical and mechanical needs on the compound.  They also did many fix it jobs, cleaned out old junk, built shelves and benches and more over the two weeks.  A faculty member from Wichita State University volunteered to write an energy grant for the solar energy.

Every trip offers new successes, opportunities and challenges. God has blessed us with a way to serve our brothers and sisters in Haiti. To the team, hopefully it was a fulfilling experience.  Hopefully you will come again or tell your friends so the network continues to expand.  To those of you that contributed in so many ways, thanks and we would appreciate your continued support.  The goal is to make Pierre Payen Hospital and Clinic self-sustainable and completely staffed and operated by Haitians. Each trip by each team should work toward this goal. Since earthquake, many positive changes have happened both structurally, operationally and with equipment.  Many times this week I thought of Dr. Victor Binkley who started this over 35 years ago.  I think he would be smiling.

God's servant,

Joe Miller

KENYA VIDEO 2013

I've made a Kenya Slideshow that covers the trip from beginning to end.  When I look at it I see the really nice accommodations that we had and feel a little guilty that we didn't suffer more, but then knowing we got the Kenyan rate because we were missionaries and it helps out the local economy I guess it's OK.  NN

HAITI

I just received a link to an interesting article about Dr. Gardy, our Haitian contact physician.  It starts out:

Raised fatherless and poor in a Haitian coastal town, Dr. Jean-Gardy Marius studied medicine abroad thanks to the financial assistance of an American missionary. Now he is leading an innovative, grassroots effort to root out cholera and bring communities in Haiti’s rural north to health and self-sufficiency.

There are good pictures and a good story at this link: 

http://inthefray.org/2013/08/a-country-doctor/

NN

HAITI IS NEXT

I've been invited to join Grace4Haiti so am going to hear Dr. Gardy speak today in Lincoln.  He's a physician in Haiti who, I believe, more or less grew up at the mission and was helped and encouraged to go to medical school by the missionaries.  In the mean time, John has been collecting things for our upcoming trips.  He can fix about anything, but it didn't work out to fix up an old cautery unit so I guess we'll trash it.  He got a fairly decent, if old, autoclave and the Kiwanis donated a very nice carrying case for it.  He has also patched together 2 (not 1) operating microscopes that can travel and clamp to a table or the OR bed. It also fits in a case for travel.  Right now all our various extra mission supplies are stored in our garage with the plan to inventory and organize so we know what we have.  I'll post a picture of John with the autoclave in it's new case.  NN

Nicaragua team

Nicaragua '13 team members

As of now, the team members who have traveled to Nicaragua will now have a new name, Global Passion Ministries-Nebraska.  You may follow us at www.globalpassionministries1.blogspot.com.  Thank you for your prayers & support!

KENYA - End of the Trip

We had fun on the trip as well as hard and sometimes frustrating work.  We got to visit a giraffe conservation center on the way to the airport in Nairobi and visited Carnivores Restaurant.  I highly recommend both.  We were so happy to get home to our own homes and families. 

Diana and Erin feeding the giraffe.

Molly getting a slice of ostrich.

The team leaving Naivasha Panorama Park Hotel.

We were gone 16 days.  It took 2 days to get there and 2 days traveling home.  We're all expecting some jet lag for the next few days.  It's by far the most exotic place I've ever been and for all the missions I've been on, it's the first one I felt like we had done more than just help the patients we worked on.  The new Women's Hospital in Naivasha will improve the health care of people there in so many ways.  The current hospital has wards with 32 patients in each ward, women's, men's, pediatric and maternity. The chaos and lack of privacy you'd have to see to believe.  I've not put in too many pictures because of patient privacy, so the only ones posted are with the consent of the patients or their families.  Many photos are too gruesome to post.
This was my first opportunity to work with the local ENT physician and I went away with a really good feeling that she will be able to do a T&A with much less bleeding and be able to see what  she's doing with some simple retractors and instruments.  I'll see what I can do about getting her a proper tray.  She also now is able to do a needle biopsy that she had never done before as well as nasal surgery she hasn't done.  Some of my instruments she had never seen and didn't know how to use, but she had good clinical judgement and was a quick learner.

22 year old with lumps in the neck. Probably TB.

Dr. Novotny demonstrating Fine Needle Biopsy for Dr. Maina

Dr. Maina, ENT, Margaret, clinic nurse, Dr. Novotny

I believe the others on the trip had the same feeling.  The L&D group got the maternity ward to start using the fetal monitor, oxygen and suctioning on distressed newborns.  They also got the infant CPAP working.  The babies die so easily there that they don't name them or consider them a person until they are 3 days old.  They say that babies become angels when they die so it give the families some sense of relief to know their babies are angels. There's no real count of the infant mortality because so many are born and die at home without ever being counted. The Maasai place their dead out in the bush to be eaten by animals.
Dr. Stice brought a dermatome (instrument for skin grafting) and worked extensively with the local general surgeon to help him be able to care for the many burn victims.  Her daughter, Caitlin worked on the stove project which we hope will eventually cut down on so many terrible burns.

Dr. Shulte, John Novotny, Cindy Berkland, APRN

Dr. Hawthorn, Dr. Norton, John Novotny, Laura W., Kenyan nurses, Dr. Novotny

We were so happy to get home to our own homes and families.  It was a challenging and rewarding trip that will leave a real and permanent improvement in their healthcare system, especially when the new hospital is up and running through the help of several Nebraska hospitals, medical teams and many generous donations. 

Nicaragua

                                   This little girl almost drowned last year when we were there.

These are some of the beautiful children we saw during our time at the hospital.  You can only wonder what their lives will be like as they grow up.