Friday, 22 December 2017

The grip of Satan

One thing that has struck me recently is the grip that Satan has over Haiti.  Yes people go to witch doctors here and yes they have voodoo parties where they invite spirits to enter into them but the grip I see is one of fear.  It seems to me that Satan doesn't even really need to do very much in Haiti, people automatically give him the victory for many things that happen.  Let me tell you about 3 patients of mine.

My first patient is a  young guy, let's call him John.  In May John had an accident at work and hurt his knee.  He went to various doctors who told them there was nothing that could be done, in fact one doctor even suggested he get his leg amputated because it was useless.  Since May, John has been getting around on a pair of crutches and not putting his foot on the ground at all.

Since I started treating John his leg has become stronger and stronger but progress is slow as all the muscles on his leg are completely wasted away.  Two weeks ago John came for his physio and as soon as I start treating him he started wailing, rolling about the bed and crying.  I stopped what I was doing, explained that I cannot treat him if he is like that and asked what was wrong.  He responded, 'Julie there are some things that happen in Haiti which you just can't understand.'

So I asked him to explain. We talked for well over an hour and to summarize, John believes that someone has prayed to Satan to put a spell on his knee.  He told me that no matter how hard we work it is never going to get better.

We continued to talk, I talked to John about the gospel and explained if he truly believed in God and has the Holy Spirit living inside of him then Satan can't put any spell on him.  John said he believes in God, he goes to church but I am not sure how much of what he said was him telling me what he thinks I wanted to hear.  We talked about the freedom which we find in Jesus and how we are no longer slaves to sin.  And how if John believes Satan is putting a spell on him, then he has given Satan the victory and he will continue to live in fear and hopelessness.

I prayed with him, told him to go home and think about what we talked about. I said if he firmly believes the problem in his knee is a result of Satan then there is no point in coming back to physio because it won't help.

John came back to physio a week later with a completely different attitude, during the week he had had a dream that an old man came and removed a lot of cockroaches from his knee and since that night the pain has decreased.  He told me, 'last week when you were talking to me, that wasn't you talking, it was God speaking through you.'  I really think God is doing something in John's life, please continue to pray for him.  On a physical note, he walked on Monday with no crutches for the first time!

Now let me tell you about the second patient.  My sister in law, Melissa, was here just a couple of weeks ago, she treated a lady who brings her daughter for PT every month.  This lady has told me she gets ill every month or so, and during that time period she has a 'bad spirit', she doesn't know what she is doing, where she is going and she talks a lot even to the point where people don't understand what she is saying.  Every time this happens, her family keep her at home and people from the church come to pray with her and ask the spirit to leave.  This has been going on for 20 years. 

It turns out instead of this lady having a 'bad spirit' she is bipolar, and can easily be treated with medication.  Another 20 year victory for Satan where he didn't have to do anything. 

My third patient came just yesterday with his brother, a young guy who was shot in the head in April and now has two bullet fragments in his head.  After he was first shot his family took him to Port au Prince and they were told if they operate and remove the bullets he would die, but if they don't do anything he will probably die.  So he was sent home to die.  At this stage he couldn't move or talk, he could only open and close his eyes. Over the next few months he began to start moving, talking, eating and drinking.  By November he was walking on his own but he still had issues with his right leg and left arm so he came to Bethesda for physio.  After he told me the story I remarked that it really was a miracle that he was alive and that God must have a plan for his life.

This started a new discussion, his family have been taking him to a witch doctor to get better.  He doesn't believe he has two bullet fragments in his head, he thinks the bullet skimmed by his head and now he hasn't fully healed because of a spell someone put on him.  Yet again, Satan is getting the credit and victory for something he didn't do.  As we talked I could tell that God was really doing something in his life and he told me that he wants to become a Christian but he can't while he is going to a witch doctor.  After a long discussion (and no physio), I sent him to talk with Pastor Daniel.  Pastor Daniel later told me that during their discussion the young man stopped him and said you don't need to talk anymore, I am ready to accept Christ into my life.

And that's how I want to finish this post,  knowing there is HOPE in the despair, knowing there is LIGHT in the darkness and knowing that there is FREEDOM in Christ where people no longer have to live in fear.

Praise the Lord that he is working in Haiti and even though it feels like Satan has a grip on Haiti, little by little, one life at a time God is working to change Haiti for Him. 

Monday, 11 December 2017

Five things I've learned

My sister in law, Melissa was just visiting for a week from Canada.  Melissa works as a psychiatric nurse with children and adolescents, she spent the mornings educating our clinic staff and treating patients.  In the afternoons she was teaching nursing students in Dr Rodney's medical school. Here are her reflections on her time in Haiti...

After a week of working at Bethesda Medical Center, teaching staff, seeing patients, and lecturing in the nursing school, I want to share 5 things that I learned:

It is wrong to assume that healthcare professionals in Haiti know nothing of mental health.

In my teaching at the nursing school, I came with the assumption that they would know very little. I was surprised to hear that they had a psychiatry component in their curriculum and the national registration exam includes psychiatry. They covered schizophrenia, Alzheimer’s, depression, and anxiety. I had the general impression that their psychiatric practice was not current, and this might be because of a lack of current teaching materials and textbooks.  Because so few professionals are doing psychiatric practice, the students would have limited exposure to adequate clinical placements.

As always, it is better to understand what people know, and partner with them to fill in the gaps. I talked with the academic director and adjusted some of my presentations to match with information she thought relevant. I provided the newest version of the DSM 5 (the diagnostic manual of mental illnesses) in French for use at the nursing school and the clinic. I hope that access to diagnostic information will help the assessment of many patients. I also gave my slides and talks to Julie to find someone to translate. I would love to be able to provide more resources in French that would be helpful for the students and staff.

Where mental health treatment is not available, people suffer.

Because of the limited psychiatric care in the north of Haiti and wide-spread poverty, most people with mental illness do not have access to treatment.

We saw a young man who had struggled with symptoms of bipolar disorder for about 10 years. He became aggressive at home when experiencing mania. The family’s way of dealing with his behavior was to tie him up. He came to our office with his hands tied together behind his back. We were able to prescribe a medication that should help regulate his mood and treat his psychotic symptoms. We told the family that they should not be tying him up (especially when he was not experiencing mania), and that with effective treatment the manic episodes should be reduced if not eliminated.

People are resilient.

Dr. Rodney Baptiste and I saw a woman who had been struggling with symptoms of bipolar disorder. She would have days of not sleeping, as well as psychotic symptoms, such as feeling like Satan coming after her and hearing voices. Many people had prayed with her with no change in her symptoms. She had seven children and was managing to bring one of her daughters on a regular basis to see Julie for Physiotherapy. I cannot imagine how difficult it would be for someone to be as consistent in caring for her children as this woman. Dr. Rodney will be talking to his medication provider to see if he can get some Quetiapine (a mood stabilizing drug that is also an antipsychotic) at the clinic, as this woman would not be able to afford the medication otherwise. This woman was functioning much better than I would have expected.

Another patient we saw was a man suffering from HIV. He had lost some of his family because of his diagnosis and he also lost his job. His life was very difficult. As I was assessing symptoms of depression, I was surprised at how well he was coping and how much fight he had to continue to battle poverty and hunger.  He was very resilient man.  He continues to be supported at Bethesda for HIV treatment and social work.

Having someone understand your symptoms is validating.

Dr. Rodney and I saw a young woman suffering from panic attacks. As I was asking some diagnostic questions about this experience, I could tell that she knew that we understood her experience.  She started to cry.  I was able to give her some relaxation and breathing strategies to help her cope with her panic attacks.

At Bill and Julie’s home, I met with one of Julie’s friends. Her husband was murdered 2 years ago, and she has 4 kids. She has been working to support her family.  She has periods of time where she feels really heavy and sad.  These feelings are totally normal for someone that has gone through such a traumatic experience! The grief feelings have become less over time and were not getting in the way of working or caring for her family. In my opinion, was processing the grief and trauma well. Her strength has allowed her to be a good example for her children and for the rest of the family. I think sometimes it is helpful just to have someone tell you that what you are experiencing is normal.

Hope comes from the people.

There is no psychiatric hospital in northern Haiti. The psychiatrists that I learned about were ones that lived in Port au Prince, and traveled to see some patients in the north. There is a real lack of psychiatric services in the Cap Haitian area. 

I was really impressed by the curiosity and desire to learn of the nursing students and staff, including Dr. Rodney. I really think that they want to do the best they can for the patients that they see. I believe that with more knowledge and resources, that they could be a leading resource in northern Haiti.

Finally, I want to thank Julie Edler (my lovely sister-in-law) for asking me to come to Haiti, and Dr. Rodney Baptiste for translating for me, putting things into cultural context and for seeing patients with me. It was a great (and exhausting) week.


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