Rice patties in the desert!

Jubile, the ghetto in Gonaives where my friends work, is located on the outskirts of town, very close to the sea. It's like a desert, a barren brown plain, all dust and concrete homes and tin shacks. The little greenery that can grow is stunted and rarely survives long enough to produce crops or fruit.





Some of the children took me and Kathy out to see the rice patties on a part of the plain 10 minutes from the school. I expected to see three or four shabby plots and a few gray, dying plants. Instead, we found acres full of rich, wet fields and rice growing strong and healthy thanks to a small stream that the local women say has water all year long, even during dry season. It was beautiful and very encouraging - now we know that if we can get a reliable water source to the little gardens near the school, we will be able to grow some greenery!

"Mwen gen gwo bibit!"

Translation: "I have big biceps!"

And yes, I did need to talk about that to illustrate a point for my hypertension talk. Thanks to my buddy Rebecca Brooks for the awesome photo!

Health seminars in Gonaives

This week, I am working in Jubile, a ghetto in Gonaives, with my friends from Much Ministries, teaching the first of six weeks of health seminars. My classes focus on health problems that are common to most Haitians, how to prevent them and how to treat them at home in the ghetto. In the following weeks, other Americans will come to teach first aid, mother-infant nutrition and health, basic care for a hospitalized relative, and to midwifery.

My first day went well. Over 35 people attended, mostly women, but a few men as well. About 7 were midwives, 4 were nurses, one was a nurses' aide, and the others were simply members of the community there in Jubile. The topic was heartburn and vaginal infections, two conditions that my adult patients constantly present with when they come to clinic or to my house.



Apparently I provided great entertainment when I demonstrated to the crowd why it’s better to pee on rocks than on dusty ground! Don’t fear – I wasn’t actually urinating, but still, the sight of a white woman, squatting in the dirt pouring water from a cup so that it fell between her legs was quite amusing.



Needless to say, there were a lot more men in the class the following day! They were probably disappointed, though, because the lesson was about hypertension, headaches, anemia, and back pain. The dramatic interpretations were more mundane; I demonstrated proper body mechanics when lifting a heavy object and then made everyone get up and practice by picking up one of the many children who were sitting on the pavilion walls to watch. The visual aid for blood pressure was a little more fun. I put 12 year old Rebecca behind the door to the school and told her to push against me with gradually augmenting force when I tried to open the door. None of us realized just how strong Rebecca is, especially me! Everyone was laughing when I had to push my whole body against the door to get it open. But they got the point and I was able to refer back to the door example many times during my talk.



I had spoken with the Haitian nurses after the first day’s session about how we could incorporate them into the seminars. We want to teach them but also empower them to be able to really use their skills to help Jubile, so when it came time to actually check blood pressures and talk about what the healthy levels are, we called the nurses up. Each one got a stethy and a cuff and did the check-ups themselves. Something that would have taken 45 minutes had I been alone took about 10 minutes and showed those nurses that we value them and want them to take ownership of this community’s health. They were simply beaming later when I thanked them and asked them to come every day to help, especially in the weeks to come when the teacher will be someone who does not speak Creole and is less familiar with Haitian culture and way of life.




All in all, a very good start!

At Sherrie's

The work at Sherrie's school and orphanage, my jumping board for the medical rounds in the ravine, continues. Recent developments that make me very happy include the building of new cupboards with lots and lots of shelves to stock my pharmacy. Sherrie has also hosted several medically trained visitors recently who have organized and re-organized the meds, removing the ones that are expired and grouping meds according to type. Although this makes it hard for me to find meds because the stocking system changes so frequently, I really appreciate it because I simply don't have the time to do it myself.



Construction has been finished on the main 2 school buildings and just this week, they broke ground on foundations for the third building that will include more classrooms, the office, and a separate clinic and pharmacy for me. No longer will my meds share space with the office and kitchen!


In addition to the 27 Gonaives orphans who live at Sherrie's, there is now a number of local children and school children at the orphanage. Some were malnourished, a few came from abusive situations, and several were abandonned. It's odd to see toddlers and babies like Magdala (Nadege), Vidlon, and Kervenson playing happily all over a construction site. But the nannies and older children keep careful watch of them. And honestly, there's no harm in learning how to drive a wheelbarrow at a very young age!





The older children, especially the boys, help with all of the day-to-day operations at the orphanage and school. They are learning carpentry skills under Wisnal, my community health worker, and making the benches and tables for the school. They help mix concrete and move supplies, clean the yard and care for the dogs, translate for medical teams and help the cooks make meals for visitors.





It never ceases to amaze me to see how those kids are growing up. I first met them one day after they got rescued from the 2008 floods in Gonaives; they had spent 2 days on a tiny tool shed roof while the floodwaters raged around them and then a week in a hotel room living on flour and water. But here they are, nearly fluent in English, muscling their way through 2 grades of school a year, becoming young men and women who can handle responsability. It's beautiful!

Just taptapping along!

For the past year, I've been using taptap several times a week to get around the city. I still walk on average 4 miles a day, but when I need to get to the ravine or to Delmas 24, taptaps take me there and back.

A taptap is the Haitian version of a public bus, though they are all privately owned. There are standard routes that they run, such as Petionville-Carrefour Aeroport or Delmas 65-Portail Leogane and you have to know where each taptap is going before you jump on. They are made out of a small pick-up truck with a covered back and 2 benches that could comfortably hold 4 Americans, but actually hold 6 Haitians. In addition, a passenger or two can sit in the cab with the driver and a few people often hang off the back or balance inside, bent almost double, leaning on the window that overlooks the roof of the cab. Fares are supposed to be specific to each route, but since each taptap is private, you never know when you may end up paying an extra few gouds.


On the one hand, I detest taptapping. It's hot, smelly, full of car exhaust fumes, and I always seem to have a screw or a broken piece of metal frame poking into my back. Traffic is horrendous, especially after 1pm when school starts getting out. And you always run the risk of getting into a taptap whose brakes don't work and causing a rather spectacular show on one of Port-au-Prince's many steep hills.


On the other hand, I love taptapping. Though I get called "Blan" and have people beg from me constantly when I walk on the streets, none of that happens on the taptap. It's almost like passing a test or entering a strange brotherhood - the white lady is suffering through the same commuter conditions as us so we can't treat her differently. Sure, I do occasionally get a shocked look when I jump onto a moving taptap and everyone always gawks when I start speaking Creole, but the gawks and the looks seem to come with a degree of respect.


I tell people that a reason why I love Haiti is the openness of the people, and on taptaps, I frequently see examples of this: people who grab a man's arms and pull him up as he leaps onto a rolling taptap or strangers who offer their lap to someone when there aren't enough seats. I have seen men offer their inside spot to women and children so they can get out of the sun and away from dangerous traffic. I have seen people pick up kids to help them on and off, and I've seen people lift large sacks for someone who is climbing off and can't carry everything.

One day, I was sitting in the very front of a bench when a woman got on. There were no more seats, so she moved to the front and balanced by holding onto the window ledge facing the road ahead. In one of her hands, she held her cell phone and it kept her from gripping the ledge tightly, so I reached out and, without saying a word, took it from her. Five minutes later, a seat cleared and she sat down. I handed her the phone and she nodded thank you. It was nothing and felt completely natural to me, but when I thought about it later, I realized that if I'd done that in my home town of Boston, I probably would have been arrested for theft!


Today, I waited nearly 10 minutes before a taptap swung to the curb and the driver peered through the crowd of hopeful passengers and looked right at me. "Miss!" he called. "C'mon," and gestured to the only open seat on the taptap, the one in the cab beside him. When I got in, he explained why. Not my skin color as I'd assumed, but because, "When the earthquake happened, I kept bringing victims to you on the field at Delmas 91 and you treated every single one of them." I do not remember him at all, but he remembered me and gave me a free taptap ride home.

I don't have rewarding interactions like those every single day, but I do have them often enough to put up with the obnoxious parts of taptapping and even enjoy myself.

Ravine babies

Izaola (below) was badly malnourished as an infant and spent nearly a year at Dorothy's house. She had been home in the ravine over a year when the earthquake hit and her family was displaced. I finally saw her in person last week and she hasn't changed a bit. OK, she's a little taller but she still refuses to smile at me!




Angeline (below) and her little siblings, Roseberline and Robinho, appeared in the ravine early this fall. They were malnourished, on the edge of severe, with large swollen bellies and red hair, very lethargic and weak. I dewormed them, treated their chronic diarrhea, got them a water filtration system, signed all three kids up for Sherrie's feeding program that gets them a meal and a vitamin every morning, and started them on Medikamamba twice a day. Medikamamba is a special peaunt butter ball that we make for children who are protein deficient. It works miracles and it tastes really good! Months later, the three of them still have big bellies and red hair, but they are developing muscles and most importantly, they are strong and energetic. They play with me now, talk and smile, something they never did during the first few months of treatment.




Emmanuel and Emmanuealla are twins, born in early January. At 2 weeks of age, Emmanuella was being neglected (unintentionally by a mom who was overwhelmed and exhausted from the stress of twin newborns) so she was sent to Dorothy's for a brief stint. Another 2 weeks later, she was doing OK but her brother was nearly dead from dehydration and diarrhea - someone had convinced the mother that it was better to express her breastmilk into a bottle rather than breastfeed directly thereby exponentially increasing his risk of being ill. He ended up spending a week at the Doctors Beyond Borders field hospital while Emmanuella went back to Dorothy's. Now, both babies are home with their mother, taking milk directly from the breast, and looking very healthy.


And yes, I do know that the cat is not technically a baby anymore, but he had such beautiful eyes, I just had to capture them. The orphans at HFC used to say that I have cat eyes, so I am always on the look-out for a cat with blue eyes like mine and this green-eyed one was the closest I've found thus far.

A taste of honesty

The official results of the presidential election recount were due to be announced on February 2nd. Most businesses closed early in anticipation, shopowners boarded up their windows, and parents picked their kids up early from school. The UN and the Haitian police were on the streets in full force. But when I went to bed at 10pm, the announcement still had not been made.



On Thursday morning, I had an early appointment at the Embassy with a medical visa patient named Bethsarida. I was pretty nervous that the announcement would be made while we were out, that the streets would explode in violent rioting, and I would never make it home to the Shoebox. Fortunately, I walked out of the Embassy at 10am to utter normalcy and commented to my hired driver, Eres, that it was a shame that they didn't just get it over with and tell us who the final 2 candidates were. "Oh," he shrugged. "They just did."

They made the election announcement and no one is rioting??! Impossible.

When round one of the elections was publicized, the winners were supposedly Madame Manigat and Jude Celestin. But leaks from the inside told the real story: Sweet Mickie Tet Kale Martelly had actually beat Celestin, and the current government, who is responsible to choose the election committee, was cheating to keep Celestin, their preferred candidate, in the running. Hence the angry riots of December when the people discovered that their votes had mysteriously been counted towards Celestin. A recount was demanded by Martelly and others and was backed by the international community, to the displeasure of the government. This billboard has popped up here and there in the city, depicting puppeteers from the US, France, Canada and the European Union directing the election.


So with the populace hating Celestin and rooting for Martelly, there was only way that the city could be riot-free after the announcement: Jude Celestin must have done the honest thing and stepped out.


Amazingly, incredibly, remarkably, miraculously, that is exactly what happened. Celestin is out of the race and we now move towards a second round of elections in March that will be between the true winners, Madame Manigat and Michel Martelly.

I live in Haiti

I live in Haiti. Every day I see things that make me cringe a little - rivers of trash or never-ending tent cities, for example. Every day I see things that make me smile a lot - kids running for hugs, horses on the main road, and nurses still wearing uniforms complete with little white hats!