Torches and other things

This is going to sound like a piece of unmitigated advertising, but one of the best purchases I made for coming to Haiti was a Maglight pen torch!

We had been warned about the inevitability of power-cuts, but I wasn’t really sure what that would mean in practice. Robyn and some of the Haitians spoke darkly about periods of power-cuts lasting 4 weeks, but for my first 3 or 4 days there were none...

Then one morning I woke at 4.00am and realised that it was because of someone moving about outside and talking. And it took a moment to realise that I could hear them talking because the fan wasn’t working. The fan noise had become for me a bit like the background drone of a engine, or a “white-noise” masker that you can get to detract from the irritation of tinnitus. And so consequently I was spared from a lot of the normal noise that accompanies a house and street life. But with a power cut that distraction had gone, and I was aware of a lot more going on around me, and also a lot more aware of the heat! That time the power cut was for about an hour, and the relief was great when the motor re-started. But until the sun rises at about 5.05am – (yes, I have seen it rise) unless you are well aware of the surroundings a torch is a very handy device.

One evening I was using the torch to project patterns onto the wall – as the focus changes so do the patterns - and I was subjected to some good-natured teasing. I think the phrase “boys and their toys” was mentioned. The next day and the torch started to come into it’s own – in theatre one of the power-cuts happened while a patient in the lithotomy position, (the operation was for haemorrhoids) and the surgeon was literally working in the dark... Until that is the Maglight pen torch came into its own. (Not sure if it the sort of use likely to find its way into an advertising schedule) – but one added factor was that this patient was HIV positive, and it does not take much imagination to see how working in the dark with needles and scalpels puts the surgeon at significantly increased risk...

Also that night we were eating at a friend’s house – on the lower floor, and there was a power-cut – and the only torch was the same one (it had been at a long way away from the operation site) and verily it was a lamp unto our spoons, and a light upon our food....

And please try to remember the state of the streets, and the size of the manholes, and then you too can give thanks for a Maglight pen torch!

(The teasing about men and their toys was more than mitigated by the gift of some batteries for when the current ones expire.)

The Power cuts have got worse the longer we have been here: there seems to be a pattern developing: occasional loss during the day, but a fairly consistent stopping (all over Cap Haitien) at about 4.00am, for about 5 hours. This is the coolest part of the day, and so missing the fan is not such a problem. Many of the hotels – there are a few – have their own generators, and listening to them start up is sickening as we move as slowly and gently as we can to avoid over-heating.

The hospital clearly also has a generator – but it is not as reliable as it might be. Frequently during cases the lights are flickering on and off with the intensity of a fair-ground, and would be a risk factor for anyone with stroboscopic induced epilepsy. But it’s not only the lights: I am sure that the constant power surges are what damages the air-conditioning, and so after the first two or three cuts of the day the air-con functions only as a fan, circulating increasingly hot air. Ross was operating during one particularly florid bout of cuts and discovered that the diathermy machine had to be re-configured after every power drop – time consuming and irritating to say the least.

I am surprised how good-natured most people remain despite the conditions and equipment. There are very few raised voices in temper, and generally everything gets done.

As a post-script to previous postings: I was surprised to be told how few people drink the tap water when they have, and made a few more detailed enquiries, and in fact many Haitians do drink the tap water... Is there a surprise that during my first week here I was involved in the staged closure of an abdomen in a 10 year old boy: his original diagnosis was peritonitis secondary to typhoid causing a perforation of the large bowel?

Also on the Consent Form front: some patients, (so far only urology patients) do have a consent form in their notes, where the patient has consented to “Le procedure”....

Finally a couple of pictures to lighten the literary load: Ross involved in closing the originally typhoid-induced perforation (It was the first case of typhoid-induced perforation he had seen as well).

And the second – taken from a distance at the back of the surgical ward: a cleaner is filling her bucket from a well, and the container that she threw down into the well to collect the water is tied to pieces of suction tubing and IV giving sets!

PS As I am waiting for the pictures to upload the water in the tank has run out, and the electric pump has finally failed. It makes the Old Testament account of Abraham's servant being given water by Rebeccah (Genesis 24) and Moses giving water to Zipporah (Exodus 2) and Jesus by Jacob's Well (John 4) all the more credible...