scrapheap challenge

With the introductions complete I started to go back to the key staff and begin to find out what it was they wanted and expected of me over the next 12 months.  At the same time, I am ploughing through the Management Accounts to try and understand better the financial challenges ahead.  And there is firefighting.  My long term colleague here is gently and tactfully helping me understand the culture of work; which is very different to what we are probably all used to.

The week saw the closing of our Covid-19 ward.  All other hospitals we know of here have already closed their wards and since we only had 1 patient last month, it is time (theories on why Covid-19 seems less problematic here next time).  As a thank you to the team for their bravery (we had none of the tools, techniques, process or resources that a developed country has) and commitment (we have a strong Voodoo culture) we took them to the beach to celebrate.  This was a rare treat for even a working-class Haitian, so was very much enjoyed.  I tried to introduce them to rugby; but had to settle for throwing the ball around in the surf.

This week also saw me finish (I hope) my acclimatisation to Haiti, when I was laid low for 36hrs with a gastro thing, which on the plus helped with my weight loss agenda…

Before I came I read a great history book; Haiti: The Tumultuous History – From Pearl of the Caribbean to Broken Nation by Philippe Girard in case you are interested.  It explains a number of the cultural challenges.  Take X-Ray.  There is only one X-Ray machine, it has two computers to store the images but only one film reader, though that has two cartridges.  On installation, a couple of years ago.  They only had one cartridge which arrived broken so another was ordered.  Over time one of the PCs became defective.  This week the other PC stopped working.  As nobody other than the department lead knew the first PC was broken (and they didn’t report it or request a replacement) there was now no X-Ray.  Anyway the PC was fixed, but then when it was restarted the cartridge stopped working too.  But the original cartridge which had been replaced had not been repaired.  So still no X-Ray; not just bad for patients but as all revenue comes from patients (or donations), bad for the hospital’s future too.  The cultural lessons.  It’s always the boss’s fault when something goes wrong (or gets broken) even if they don’t know and are not told.  There is no place for initiative (well to be fair very few people show any).  So the boss should have bought a new one/had it repaired.  Contingency planning and spares, no.  Most vehicles don’t have a spare wheel – it seems it will have been used and the defective one somehow discarded.  You regularly see vehicles having their wheels repaired at the roadside.  Anyway the good news is that the part is on order. 

Oh and the lesson.  A nation with such a sad history of violence and rebellion seems always to look to the boss (the all knowing and all powerful master of slaves) for responsibility and direction; or live for the moment (to overthrow the brutal master and live free, without sadly the ability to then plan and organise).

There is always the exception to the rule however, thankfully.  I went over to the Neonatal Intensive Care Unit (NICU) to catch up with a good news story this week too.  On Sunday 9 November two twins born prematurely in the hospital at just 30 weeks, arrived at NICU.  They were very poorly and needed an incubator and CPAP to help with their breathing.   Unfortunately, the NICU has only one incubator and one CPAP machine.  The Nurse in Charge reviewed all of the babies on the ward and decided that the infant currently in the incubator was well enough to be moved to another bed and so one of the twins was put in the incubator with the CPAP.  The other twin was placed in a cot with a heated mat and the staff fabricated a second CPAP machine using an oxygen cylinder, some spare items and a make-shift filter using a sterilised water bottle.  The twins were routinely rotated through the two systems and both twins fight on; though it has to be said the makeshift CPAP and heated pad is not as effective as an incubator and CPAP machine; we pray for the babies continuing recovery, their parents and the dedicated staff of HCBH.  The Nurse in Charge that night was also clear; it was due to God’s Blessing that the baby in the incubator was well enough to move and let the more poorly twins receive the benefit of improved care.

You can just make out the water bottle in the first picture, it has a blue top.  The second is of the pair of them, close by.  Inspiring and resourceful barely does justice to what they achieved that night, and continue to do.  The NICU has 14 ‘beds’ though some of them are literally an open topped perspex box mounted on a chest of drawers with wheels not feet.  And there are never enough, often the NICU has upto 20 children; ironically they are small enough to share…  I am not, repeat not, asking for anything except your prayers and emotional support, however this short video has footage from the NICU to bring my words alive.