Cap Haitien

For the entire 4 years that I have lived in Haiti, people have constantly asked me whether I'd been to Cap Haitien, the old city on the north side of the island that was the hub of culture and government during colonial days. The answer has been a regretful "No". So when we closed our clinic for Nurse Spring Break, Grace and I decided that Cap Haitien would be our destination.

A sickening 4 hour taptap ride over the mountains and a terrifying moto-taxi run through the city dropped us at our adorable hotel. We spent the first afternoon exploring the city and marveling at the traditional style buildings and the cleanliness!

I woke up at 3:30am the following morning with a lovely case of vomiting and diarrhea. It's been going around our community, though everyone has gotten varying degrees of illness. Some, like Grace, have been chronically pooping for 4 or 5 days while others, like me, were more violently sick for about 36 hours. I spent 6 hours on the floor of the bathroom wishing that I was dead. Needless to say, we didn't leave the hotel that day, although we did gain the strength to manage some pool time in
the afternoon.

We had only one full day left, so we got up determined to make the trek to the famous Citadelle. It didn't matter that both us had some toilet time that morning and couldn't hold our breakfast down; we were going. A taptap to Milot, a town outside Cap, and then the climb. Most people take a moto 3/4 of the way up and then hike or donkey that last stretch. We were stubborn (I have no idea why) and hiked the whole thing...that is, until we both realized that we were so weak from our sickness and from not eating, that we might pass out on the way.

Halfway up, we accepted a moto ride, only to have the moto break down before he reached the stopping point! So we were back to climbing, slowly and painfully, stopping frequently to rest and encouraging one another with thoughts of how amazing the Citadelle would be.

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Everyone has told me that the main reason to go to the Citadelle is the incredible view. This is what we saw when we got to the top.

We were completely fogged in. We could barely see 10 feet in front of us so we had to satisfy ourselves with just exploring the inside of the fortress.

We left the Citadelle when it started to rain. Because of the rain, it wouldn't have been safe to take a moto, so we hiked the entire way down, still food-less and feeling like death. We taptapped to the hotel in the rain and arrived soaking wet to the great amusement of the hotel staff. A classic ending to a ridiculously catastophic day.
 

I love the Lovena ups and downs

It is my goal to not lose my heart to the kids I work with here in Haiti. I fail miserably.

I have fallen head over heels, helplessly and hopelessly, in love with Lovena, the abandoned baby that I helped rescue from the hospital who has been living with her grandma and following our MedikaMamba program.

What kills me about Lovena is that she isn't gaining enough weight. She's been sick, yes, several more cases of diarrhea since we brought her home, but she has also had week of inexplicable weight loss. I was elated 3 weeks ago when she appeared with fat cheeks weighing 4.5kg!

But the next week, she was back down to 4.4kg. I was frustrated. And confused. Until I caught her aunt (grandma's 8 year old daughter Shelda) eating a MedikaMamba packet for breakfast.

I was angry. We make it very clear to the families that if another child eats the MedikaMamba, that baby will be immediately removed from the program. But the grandma obviously knows that she has my hands tied; as much as I want to enforce honesty and accountability, I simply can't send Lovena home with no nutritional help knowing that she will waste away and possibly die.

So we stretched the rules a little. We met with the family and gave them a last chance - if Lovena doesn't gain the appropriate amount of weight by her next appointment, we will know that they have been cheating and she will be out.

I hope I hope I hope that she gains weight. What in the world will I do if she doesn't?

A loooooong day

Two weeks ago I loaded up the truck with 8 kids and 8 parents. We drove the 3 hours to Port-au-Prince, the first time that the children and even some of the parents had been to the big city, to see a team of visiting surgeons. Most of the kids had chronic ear infection issues, including Johnny, the 10 year old from the Genada's orphanage who has the perforated ear drum. An ENT surgeon was coming and I was very hopeful.

Our first day lasted from 6am when I left my house until 11pm when the docs stopped seeing patients. Most of my kids, including Johnny, were dismissed with strong ear drops because the hospital lacks the microscope the ENT needed to fix their perforations. But three children were scheduled for surgery.

Chedline, a little firecracker of a girl, had an inguinal hernia that caused her significant pain. She was scheduled for a 9am operation but she didn't go into the OR until 4:30. We entertained ourselves in the meantime (on no food and water because you have to have an empty stomach for surgery) with crayons, cards, and self-portaits with my camera.



Dayana is a 13 year old with ambiguous genitalia. I gave one of my most convincing speeches ever to convince the docs to do her more complicated plastic surgery and at the last minute, her mom got nervous and decided against it. She let the doctors examine Dayana under anesthesia but nothing more. I have been searching for care of Dayana for 2 years and it was terribly disappointing to lose that opportunity. Her mother is my friend and I see her regularly, so hopefully once Dayana starts having periods and developing more decidedly as a female, she will agree to it.

Dayana and Chedline were done by 6pm. But little Tchivenchina aka "Bebe" was still waiting. In Creole, bebe means "deaf/mute"; the 6 year old is not, in fact, deaf or mute, but she had ear blockage that seriously affected her hearing and therefore her speech. We waited and waited until finally at midnight, the doctors took her into the OR. At 1am, we carried a whoozy Tchivenchina into my apartment on Delmas 91 and we all spent a short night before heading back to Gonaives in the morning.

It was a terribly long day but I would have waited hours more to get Bebe the operation that would make her no longer bebe. She hears correctly now and little by little, she is learning how to speak correctly too.

Thank you so much, doctors, nurses and support staff from the LEAP Foundation!

No more shots!

Happy happy happy Yonelson on the day that we gave him his last shot - he'd received 42 shots from us, one daily for 6 weeks. Now that is a lot of shot for 2 very skinny butt cheeks! He was a very happy boy when we declared his bone infection healed and the shots finished.

The "M" word

I was never a big milk drinker. Then I moved to Haiti where they don't sell real milk. In the markets of Port-au-Prince, you can buy UHT milk or powdered milk or canned milk, none of which taste quite right. Suddenly, milk became a precious commodity on my short visits to the US and something all my friends here in Gonaives crave. We get jealous when visitors talk about it and we joke that the mere mention of the "M" word is painful to the ears.

One day as we sat, dreaming about "G's of M" (gallons of milk, in case you were wondering), we realized that here in Gonavies, we are much closer to the countryside and all sorts of livestock, including cows. Where there are cows, there should be "M". So Lewis, Clark, and Sacajawea (aka Josh, Isaac, and Keziah) set out on their faithful steeds (bicycles) through the uncharted wilderness (farmlands 3 miles outside the city). We rode for about an hour along dirt roads and little paths until we were pointed to the house of James and Gilbert.


James and Gilbert are brothers and they own 8 milking cows. Right there, that Sunday morning, James led us half a mile through the fields to his favorite cows and milked them in front of us. We came home with beautiful, fresh frothy milk.



We have an arrangement with James and Gilbert now, 4 gallons of milk every Sunday. Josh, Isaac and I ride out there and fetch it on our bikes, bring it home and boil it for about an hour on the stove.



And then we all enjoy bowls of cereal and glasses of chocolate milk and servings of real homemade ice cream and cookies and milk and peanut butter sandwiches and milk and brownies and milk and ... MILK.

MedikaMamba

JohnLove spent over a month on my peanut butter diet and didn't gain any weight. In fact, he lost weight. I got suspicious.

There are diseases that can make a child fail to gain weight; I sent him to the hospital but HIV and tuberculosis, our biggest culprits, were negative. The other factors that would make the peanut butter be insufficient are all related to the staff at the orphanage: inconsistency in giving it, maybe witholding other food, giving too little or sharing it with other children or staff...There are lots of places, such as Dorothy's or HFC, where I have complete confidence in the staff and know that my instructions will be followed to the letter, but I don't have the relationship with the Genada's orphanage yet.


Fortunately, an American we call JTP has started volunteering at the orphanage and he has become our point of contact for all things medical. With him there, I trust that supplements will go to the right child at the right times and so we've been able to start JohnLove on MedikaMamba. MedikaMamba is a calorie-packed, vitamin-infused, protein-whopping peanut butter paste that we use for severe malnutrition and protein deficiency in Jubilee. It's wildly expensive but wildly effective - if it's given correctly.


On Tuesday, JohnLove had his first appointment. We start him out at 30.1 lbs (only 0.3 lbs more than what he weighed on January 19th when we first met) and we'll see how much he gains by next Tuesday. Fingers crossed!

Machete-fights

When I was a kid, my older brother and I were part of a gang of kids. We'd run around the woods behind the playground and ride our bikes and play baseball. Sometimes, we'd have "Free-for-All's" where we would all beat each other up. From my 7-year old memory, it was pairs of kids wrestling on the ground, throwing punches and elbows and body slams. I loved it, probably because I was the only girl so nobody hit me hard but I could hit them as hard I wanted.

We were just packing up clinic for the day when we saw a teenage boy with a bloody shirt wrapped around his hand and a throng of people marching behind him. Apparently there had been an argument, a fight and eventually, a machete. This kid, who said he was 17 but who looked 12, was the loser. His hand was split deeply open from the middle of his palm through his wrist, about 4 inches long. In between two fingers was another slice, about an inch long. I used 12mL of lidocaine to numb it up (that's 4 times the amount I usually have to use) and I put in a total of 22 stitches, the most I've ever put into one injury.



When we were done, I suggested that he stick to fistfights next time.