Saturday Morning: Up the Mountain to Two Trees
The prosthetic and physical therapy teams decided we would hike up the mountain to watch the sun rise today. This task involves waking up quite early so we can be on the road by 5:00 am. We met up at the prosthetists’ house and began climbing the mountain. We kept climbing and climbing! It was dark so flashlights were a must. It also appeared to be rush hour as many people were heading up to the well to get their daily supply of water and a bath in. The well had a pump and was the center of community life as folks gathered to visit, bathe, or collect water. Children and adults alike were everywhere. We had not even completed a third of the trek yet! As we continued onward, more and more barefoot kids joined our group.
The footing is extremely rocky, steep, and slippery. Nevertheless we forged ahead. As we reached higher spots, we would pause momentarily to catch our breath and let our screaming thighs calm down. Although there are many paths up the mountain, it was comforting to know that we were in a group and would not let each other get lost. The local children seemed to know the routine quite well and happily guided us up the mountain. When we reached the top, we could see the entire Artibonite Valley in front of us. There were mountains surrounding it on all sides with a muddy looking river meandering its way through the green valley. Far below was the water tower of HAS. We stood in awe of the raw beauty before us. The full moon in the western sky was still hanging around, a bit sheepish to give way to the sun. A mist on the valley becoming visible below made it clear the sun would soon be banishing the moon from the heavens. The two would both be present together for only a moment in the sky before the moon would have to leave its place in the sky and tuck behind the western mountains.
We learned that this place called Two Trees is sacred ground. People come here each morning to pray and sing praises to God. (There has also been much similar singing at night which we can hear as we lie in our beds since the cholera outbreak.) The singing of a couple of ladies added to the ambiance of the moment. Haiti - beautifully difficult.
Suddenly, at 6:00 am on the dot, the sun began to peek through the distant mountains. Shades of purple, browns, and greens of the mountains gave way to the bright orange fire ball of the sun. Slowly the sun began to show it face with exquisite glory. The views were spectacular. We continued to remain in this sacred spot enjoying the view, the time, and each other. The children from the villages below continued to entertain us and wanted many pictures to be taken. Then reality hit us and we had to come down from the steep mountain. Two of the young teenage girls each took one of my hands and walked me down the steep rugged mountain paths. It was nice to have the company of these girls for balance but it turned out they were using me for balance as well! They removed their fancy sandals for the decent and preferred traversing the rugged slopes barefoot. For me, Keens rock!
Sunday, November 7, 2010
Cholera Outbrreak Confirmed
A Cholera Outbreak for Sure: Dye Mon, Gen Mon
Yesterday afternoon we learned that the US State Department is now on the ground in Port Au Prince. Anytime there is a possibility of an epidemic anywhere near the US – the State Department sends troops in to help control the flow of traffic and restrict movement back to the US. There are rumors that the main road to the Artibonite Valley will be shut off. We will not have access to Port Au Prince. We are unclear if new teams will be allowed in or if we will be allowed out. More news will follow later today (Friday, Oct. 22nd).
Apparently, the center of the trouble is near St. Marc which is on the road to the beach as the road makes a hairpin turn back toward Port Au Prince. We hear rumors that up to 2000 people are now infected. Unfortunately, too many wait too long to come to the hospital. Many are severely dehydrated and have sunken eyes. They appear to be a shell of a human, yet they are brought in to the hospital for care. All the nurses can do is hang IVs and encourage drinking oral rehydration fluids. There is the familiar blend of body odor, diarrhea, and vomit that pervades the air. It is not unlike the scent of sweat and body odor that hung in the air after the earth quake at the tent hospital in Jimaní last February. Back then the smell which might otherwise be considered offensive became a sign of survival. Now, the mixture of sweat, body odor, vomit, and feces represented a fight against death as these weary souls clung to life.
After our shift in the prosthetics center, Claire and I headed back to the hospital to see how we might best serve the weary staff and patients. People were coming from near and far. It was quite crowded in front of the hospital with family members peering into the sick wards where 20-30 dehydrated people lay on gurneys hooked up to IV fluids. One family member was allowed in to care for each patient. If there were no family members, the patient would be at the mercy of a busy staff to receive the badly needed tasks of personal cares.
Clair and I helped MJ and Debbie – an NP from New York. We assisted with the rehydration of the patients. Each patient is given a quart-sized Styrofoam container which we fill with filtered water that has been mixed with rehydration salts. We then go and encourage our patients to drink. “Bezwen bre dzlo.” “You need to drink water,” we tell them. We have plenty of gloves so we are safe. Many of the Haitian are quite fearful of getting the disease and are wearing masks even though cholera is not spread by airborne pathways – just contact oral fecal transmission. We love the gloves and hand sanitizer!
We occasionally hear the commotion of screaming and yelling once someone outside hears of the passing of a family member as they mourn. Quite luckily it is not very often that this occurs. Nevertheless, there are patients everywhere on the portal between life and death. It is truly miraculous what one bag of IV fluids can do. Many patients’ family members seek me out as the IV bag hanging by their family member runs low. I am able to get the nurses to replace the old bags with new ones. We move from bed to bed encouraging our patients to drink, assisting them to a sitting position if they are able. Otherwise, we simply raise their heads and shoulders in our arms and assist in getting the cup to their thirsty lips.
Occasionally, some vomit. Others defecate. Housekeeping moves in with a mixture of bleach and ammonia to clean the floors and we clean the patients and their beds. We often do not know if we are walking in vomit or feces as our patients are so ill. Although it may sound terrible, it is sacred work we do. Cura Personalis. The looks of gratitude we get from patients are amazing. They know they must drink but it is so difficult. With the care we are giving, it seems many of these souls are called back from death into life. They become reborn. Again, Haiti is beautifully difficult. How much suffering there is here and yet how the people cling to life!
That evening we were invited to the Mellon house for dinner with Ian and his wife Lucy. Ian is the son of the couple who started the Hopital Albert Schweitzer (HAS) here in Dechapelles. His parents greatly admired Albert Schweitzer and his work in Africa. Larry Mellon went to medical school in his mid forties and his wife Gwen completed a medical technology degree. They opened Hopital Albert Schweitzer in 1956and their home was spectacular. It seemed odd to be going to a dinner when there was so much going on in the hospital. Yet, it was important to take care of ourselves, too. We hiked under a full moon on narrow paths through the woods, across a bridge over a small stream, and through a fenced in pathway to the Mellon home. It was spectacular with textured stone walls, wooden floors, and cedar framed windows which open onto the Artibonite Valley. We had time to visit and learn what might next happen.
The Health System of Haiti was proposing that the hospitals at two neighboring towns of Verrette and Petite Riviere become the headquarters for the cholera patients. It was proposed that by noon on Saturday all patients with cholera should be moved to these two hospitals. Unfortunately, these hospitals are very small. The problem of containing the situation in this way was that patients who are not stable cannot be moved by noon the next day! If new patients arrive at our gaits, we cannot turn them away. Again, it is good to have plan A, B, C, and D here in Haiti. Dye mon, gen mon: Beyond the mountains, more mountains. And so it goes here in Haiti.
Yesterday afternoon we learned that the US State Department is now on the ground in Port Au Prince. Anytime there is a possibility of an epidemic anywhere near the US – the State Department sends troops in to help control the flow of traffic and restrict movement back to the US. There are rumors that the main road to the Artibonite Valley will be shut off. We will not have access to Port Au Prince. We are unclear if new teams will be allowed in or if we will be allowed out. More news will follow later today (Friday, Oct. 22nd).
Apparently, the center of the trouble is near St. Marc which is on the road to the beach as the road makes a hairpin turn back toward Port Au Prince. We hear rumors that up to 2000 people are now infected. Unfortunately, too many wait too long to come to the hospital. Many are severely dehydrated and have sunken eyes. They appear to be a shell of a human, yet they are brought in to the hospital for care. All the nurses can do is hang IVs and encourage drinking oral rehydration fluids. There is the familiar blend of body odor, diarrhea, and vomit that pervades the air. It is not unlike the scent of sweat and body odor that hung in the air after the earth quake at the tent hospital in Jimaní last February. Back then the smell which might otherwise be considered offensive became a sign of survival. Now, the mixture of sweat, body odor, vomit, and feces represented a fight against death as these weary souls clung to life.
After our shift in the prosthetics center, Claire and I headed back to the hospital to see how we might best serve the weary staff and patients. People were coming from near and far. It was quite crowded in front of the hospital with family members peering into the sick wards where 20-30 dehydrated people lay on gurneys hooked up to IV fluids. One family member was allowed in to care for each patient. If there were no family members, the patient would be at the mercy of a busy staff to receive the badly needed tasks of personal cares.
Clair and I helped MJ and Debbie – an NP from New York. We assisted with the rehydration of the patients. Each patient is given a quart-sized Styrofoam container which we fill with filtered water that has been mixed with rehydration salts. We then go and encourage our patients to drink. “Bezwen bre dzlo.” “You need to drink water,” we tell them. We have plenty of gloves so we are safe. Many of the Haitian are quite fearful of getting the disease and are wearing masks even though cholera is not spread by airborne pathways – just contact oral fecal transmission. We love the gloves and hand sanitizer!
We occasionally hear the commotion of screaming and yelling once someone outside hears of the passing of a family member as they mourn. Quite luckily it is not very often that this occurs. Nevertheless, there are patients everywhere on the portal between life and death. It is truly miraculous what one bag of IV fluids can do. Many patients’ family members seek me out as the IV bag hanging by their family member runs low. I am able to get the nurses to replace the old bags with new ones. We move from bed to bed encouraging our patients to drink, assisting them to a sitting position if they are able. Otherwise, we simply raise their heads and shoulders in our arms and assist in getting the cup to their thirsty lips.
Occasionally, some vomit. Others defecate. Housekeeping moves in with a mixture of bleach and ammonia to clean the floors and we clean the patients and their beds. We often do not know if we are walking in vomit or feces as our patients are so ill. Although it may sound terrible, it is sacred work we do. Cura Personalis. The looks of gratitude we get from patients are amazing. They know they must drink but it is so difficult. With the care we are giving, it seems many of these souls are called back from death into life. They become reborn. Again, Haiti is beautifully difficult. How much suffering there is here and yet how the people cling to life!
That evening we were invited to the Mellon house for dinner with Ian and his wife Lucy. Ian is the son of the couple who started the Hopital Albert Schweitzer (HAS) here in Dechapelles. His parents greatly admired Albert Schweitzer and his work in Africa. Larry Mellon went to medical school in his mid forties and his wife Gwen completed a medical technology degree. They opened Hopital Albert Schweitzer in 1956and their home was spectacular. It seemed odd to be going to a dinner when there was so much going on in the hospital. Yet, it was important to take care of ourselves, too. We hiked under a full moon on narrow paths through the woods, across a bridge over a small stream, and through a fenced in pathway to the Mellon home. It was spectacular with textured stone walls, wooden floors, and cedar framed windows which open onto the Artibonite Valley. We had time to visit and learn what might next happen.
The Health System of Haiti was proposing that the hospitals at two neighboring towns of Verrette and Petite Riviere become the headquarters for the cholera patients. It was proposed that by noon on Saturday all patients with cholera should be moved to these two hospitals. Unfortunately, these hospitals are very small. The problem of containing the situation in this way was that patients who are not stable cannot be moved by noon the next day! If new patients arrive at our gaits, we cannot turn them away. Again, it is good to have plan A, B, C, and D here in Haiti. Dye mon, gen mon: Beyond the mountains, more mountains. And so it goes here in Haiti.
Cholera Prevention & Holistic Care
Cholera Prevention Plan & Holistic Care
I am back at work today and thankfully am much better. We have only three patients left at L’Escale and are trying to figure out how to get our patients on the bus back to Port Au Prince tomorrow so they can avoid the epidemic. There will be a big meeting today at 11:30 am to determine what will happen. Our greatest challenge is the fact that many patients are streaming into the hospital after waiting a bit too long after having symptoms of vomiting and diarrhea. Nevertheless, patients receive IV fluids and encouragement to drink. Unfortunately, it is difficult to know what body fluids are sweet and which feces as the diarrhea produced is so clear. (So sorry about the graphic details.)
Holistic treatment is important. We are doing a great deal of education with our patients that the well at L’Escale is not fed by the river and that it is good water. We teach about the river water having the cholera bug in it which makes the water unsafe. We also teach that if family members are caring for someone who is ill, they must wash their hands or they could also catch cholera if they touch their face or mouth after touching contaminated materials. Wearing gloves is crucial. We are also encouraging the patients to use the filters in the houses in L’Escale. We teach about boiling, filtering, or treating the water. This morning as Clair and I walked to the clinic, our gardeners asked us how we like the Artibonite Valley. We told them we liked it very much. They then immediately warned us not to drink the water from the river. They are very sweet to take care of us!
It was great to be back at work today even though we have only 3 patients. There is some talk of a possible quarantine of this region of the country with no one getting in or out for a while. I will find out more information later today. Could be that my trip to Haiti could be extended . . . maybe until Nov. 14th.
Our patients finished their gait tasks which included obstacle courses at the tennis courts. One young man who had a hip disarticulation even walked the 2 foot high rock wall around the courts and then proceeded to navigate behind the backboard on a small 2 inch ledge! Talk about function and it is incredible to think of the energy cost of walking! He is brilliant! Our goal today was to get as many patients send home to Port Au Prince as possible. We also connected they up with the Israeli team at General Hospital for follow up in a month. Virtuous Reciprocity in action! One last patient remains here and we will finish things up with him on Monday. We will then have a limited supply of patients due to a possible quarantine so we plan to run a week long education program for the prosthetic/PT technicians and translators.
No more bon bons as well. We don’t know what water is being used to cook with so our Bon Bon Lady is finding very little business prospects today.
Vern (our head prosthetist) thinks going to the beach may not happen this weekend as we must go through St. Marc which is apparently the epicenter of the cholera outbreak. He says that it would be quite possible that people may commandeer the tap tap we will be riding. The beach itself is fine. The problem is that we must go through St. Marc to reach the beach. One never knows what can happen if people feel trapped and become desperate. Haiti is beautifully difficult.
I am back at work today and thankfully am much better. We have only three patients left at L’Escale and are trying to figure out how to get our patients on the bus back to Port Au Prince tomorrow so they can avoid the epidemic. There will be a big meeting today at 11:30 am to determine what will happen. Our greatest challenge is the fact that many patients are streaming into the hospital after waiting a bit too long after having symptoms of vomiting and diarrhea. Nevertheless, patients receive IV fluids and encouragement to drink. Unfortunately, it is difficult to know what body fluids are sweet and which feces as the diarrhea produced is so clear. (So sorry about the graphic details.)
Holistic treatment is important. We are doing a great deal of education with our patients that the well at L’Escale is not fed by the river and that it is good water. We teach about the river water having the cholera bug in it which makes the water unsafe. We also teach that if family members are caring for someone who is ill, they must wash their hands or they could also catch cholera if they touch their face or mouth after touching contaminated materials. Wearing gloves is crucial. We are also encouraging the patients to use the filters in the houses in L’Escale. We teach about boiling, filtering, or treating the water. This morning as Clair and I walked to the clinic, our gardeners asked us how we like the Artibonite Valley. We told them we liked it very much. They then immediately warned us not to drink the water from the river. They are very sweet to take care of us!
It was great to be back at work today even though we have only 3 patients. There is some talk of a possible quarantine of this region of the country with no one getting in or out for a while. I will find out more information later today. Could be that my trip to Haiti could be extended . . . maybe until Nov. 14th.
Our patients finished their gait tasks which included obstacle courses at the tennis courts. One young man who had a hip disarticulation even walked the 2 foot high rock wall around the courts and then proceeded to navigate behind the backboard on a small 2 inch ledge! Talk about function and it is incredible to think of the energy cost of walking! He is brilliant! Our goal today was to get as many patients send home to Port Au Prince as possible. We also connected they up with the Israeli team at General Hospital for follow up in a month. Virtuous Reciprocity in action! One last patient remains here and we will finish things up with him on Monday. We will then have a limited supply of patients due to a possible quarantine so we plan to run a week long education program for the prosthetic/PT technicians and translators.
No more bon bons as well. We don’t know what water is being used to cook with so our Bon Bon Lady is finding very little business prospects today.
Vern (our head prosthetist) thinks going to the beach may not happen this weekend as we must go through St. Marc which is apparently the epicenter of the cholera outbreak. He says that it would be quite possible that people may commandeer the tap tap we will be riding. The beach itself is fine. The problem is that we must go through St. Marc to reach the beach. One never knows what can happen if people feel trapped and become desperate. Haiti is beautifully difficult.
Getting Sick in Haiti - Not Fun!
Getting Sick in Haiti - Not Fun!
After lunch on Wednesday, my stomach began to feel quite sour. I made it through the afternoon – but just barely. Feeling ill when in a foreign country is not fun. I tried to take a nap and hoped my stomach would settle down. After about an hour and a half I got up and decided to hike down the hill to Alumni House for more water. Not feeling well is not an excuse for not staying hydrated! The possibility of needing an IV here at the hospital is not something I wanted to consider. We seem to be having a Cholera outbreak. Cholera is spread by contact with oral fecal contact. Many patients had come in to the hospital yesterday and today with vomiting and diarrhea. I made it back to Kay Dunn and drank some water. Suddenly I did not feel so good. The bathroom was not a place to go if you feel like vomiting with our limited flushing capabilities! I went out front of the house to sit down. Suddenly the smell of burning wood for charcoal hit my nostrils increasing the eruptive feeling of my stomach. In the next instance I found myself projectile vomiting in front of the house. Luckily, no one was home I thought. Suddenly, the Haitian doctor who rooms across the hall from me came running out to check on me. He was very concerned and took a history of what was going on with me. He thought I should go right to the hospital. I laid out my reasons for resting up here in my own bed. He reluctantly agreed that I could remain here but said if things became worse, I should go to the hospital. I went to bed, missing dinner altogether. Morning came and brought with it incredible body aches. Ibuprofen could barely touch the pain. I ended up staying home and sleeping all day. I did try a bit of fruit for breakfast, missed the talk on cardiomyopathy by Dr. Bob Caraway, and slept all morning. I am feeling better and even tried a bit of lunch. Will try to head over to the library to catch up on email where it is cool.
Although the CDC will be out tomorrow, it is highly suspected that we are indeed in the midst of a cholera outbreak. The internet says there are 1500 confirmed cases and 120 deaths from it in the Artibonite region where we are located. Patients are streaming into the hospital tonight. Many are being placed in overflow areas and out onto the patio to sleep on benches. Will see what tomorrow brings.
After lunch on Wednesday, my stomach began to feel quite sour. I made it through the afternoon – but just barely. Feeling ill when in a foreign country is not fun. I tried to take a nap and hoped my stomach would settle down. After about an hour and a half I got up and decided to hike down the hill to Alumni House for more water. Not feeling well is not an excuse for not staying hydrated! The possibility of needing an IV here at the hospital is not something I wanted to consider. We seem to be having a Cholera outbreak. Cholera is spread by contact with oral fecal contact. Many patients had come in to the hospital yesterday and today with vomiting and diarrhea. I made it back to Kay Dunn and drank some water. Suddenly I did not feel so good. The bathroom was not a place to go if you feel like vomiting with our limited flushing capabilities! I went out front of the house to sit down. Suddenly the smell of burning wood for charcoal hit my nostrils increasing the eruptive feeling of my stomach. In the next instance I found myself projectile vomiting in front of the house. Luckily, no one was home I thought. Suddenly, the Haitian doctor who rooms across the hall from me came running out to check on me. He was very concerned and took a history of what was going on with me. He thought I should go right to the hospital. I laid out my reasons for resting up here in my own bed. He reluctantly agreed that I could remain here but said if things became worse, I should go to the hospital. I went to bed, missing dinner altogether. Morning came and brought with it incredible body aches. Ibuprofen could barely touch the pain. I ended up staying home and sleeping all day. I did try a bit of fruit for breakfast, missed the talk on cardiomyopathy by Dr. Bob Caraway, and slept all morning. I am feeling better and even tried a bit of lunch. Will try to head over to the library to catch up on email where it is cool.
Although the CDC will be out tomorrow, it is highly suspected that we are indeed in the midst of a cholera outbreak. The internet says there are 1500 confirmed cases and 120 deaths from it in the Artibonite region where we are located. Patients are streaming into the hospital tonight. Many are being placed in overflow areas and out onto the patio to sleep on benches. Will see what tomorrow brings.
Monday - Tuesday - Wednesday
Monday – Tuesday – Wednesday
Monday was graduation day for our patients from last week. We did the group walk, exercises, and rugged terrain ambulation. Then the bon bon lady came and we bought bon bons for everyone to celebrate being done and the graduation of many of our patients. Certificates and gold medals were issued. Photos were taken and it was a festive day. Our new group of patients arrived on Tuesday and we did evaluations and education sessions and then our therapy sessions began. After some collaborative work tweaking things to get the sockets and legs fit, we were off traversing the rugged terrain which represents the rugged terrain that Haitians must traverse in their everyday lives. I also called the materials man at Hopital Albert Schweitzer to see if I could get a few planks to build a small bridge to better simulate conditions that Haitians must navigate in their daily activities. After our trip on Sunday to Le Petite Riviere, it was clear we need to do more challenging gait training with our patients! We do challenge them by asking them to navigate obstacle courses, ramps, stairs, and the rugged terrain around the clinic. Yet we need to do much more!
On Wednesday, the Israeli team from General Hospital in Port Au Prince came with 8 – 10 patients. It was great fun to share ideas across nationalities. The Israeli team comes here with their patients when they have no prosthetists. We have been invited to bring our patients to General Hospital in Port Au Prince when we have no prosthetists at Hanger in late November and December. It is pure reciprocity. The therapist and physician have invited me to come to Israel for 3 weeks in the future to learn about their system. I wonder how I can work that into scholarly activities!? The Israeli team needed some crutches and canes which we happily provided. The Israeli physician spoke about what wonderful collaboration we have and the wonderful character of people who come to Haiti to serve the people. He said it is a true life of virtuous reciprocity where we all provide for each others’ needs. The physician also shared his story of growing up in the Holy Land. He shared how much progress has been made in Israel in the last 50 years and how lucky he was to witness that as he grew up. He shared that Mark Twain wrote about what a desolate place Israel was back about 150 years ago. Twain described the land as desolate and barren and felt nothing productive would ever come from this part of the world. The Israeli physician said that it was incredible to see Israel now with its beauty and lush plants. It is truly a Holy Land. Seeing the change in his own country gives him hope for Haiti and its possibilities. Yesterday was an amazing and fun day.
Wednesday afternoon, Clair and I learned from our patients that there was no water in L’Escale. The patients were looking for buckets to bring back water with them. Apparently, someone had come by and stolen the buckets to the water filter systems in each house. The filters (which were more valuable in some minds were left behind.) It took a long time for us to get the problem resolved. We did get it resolved! Earlier one of our patients asked to bring a broom back to L’Escale so he could sweep the shower area. He felt it was unsafe and dirty. What a productive and take-action man!
We again spent time in the pool with the new team members to debrief. Then it was dinner and off to do an interview for the Physicians for Peace photographer. Finally, I made it to the library in time for a storm to blow in knocking out our internet. I then ran out of minutes on my new Haitian cell phone – as calling the US is quite expensive! It is much better to get calls from the US! Life in Haiti is beautifully hard with nothing easily done.
Shaun, our director is always so busy coordinating many things. I hope we can relieve some of his worries. He jokingly asked me when St. Kate’s will open their Haitian campus here! My mind is racing with possibilities! He has planted the seeds so we will see what happens!
Monday was graduation day for our patients from last week. We did the group walk, exercises, and rugged terrain ambulation. Then the bon bon lady came and we bought bon bons for everyone to celebrate being done and the graduation of many of our patients. Certificates and gold medals were issued. Photos were taken and it was a festive day. Our new group of patients arrived on Tuesday and we did evaluations and education sessions and then our therapy sessions began. After some collaborative work tweaking things to get the sockets and legs fit, we were off traversing the rugged terrain which represents the rugged terrain that Haitians must traverse in their everyday lives. I also called the materials man at Hopital Albert Schweitzer to see if I could get a few planks to build a small bridge to better simulate conditions that Haitians must navigate in their daily activities. After our trip on Sunday to Le Petite Riviere, it was clear we need to do more challenging gait training with our patients! We do challenge them by asking them to navigate obstacle courses, ramps, stairs, and the rugged terrain around the clinic. Yet we need to do much more!
On Wednesday, the Israeli team from General Hospital in Port Au Prince came with 8 – 10 patients. It was great fun to share ideas across nationalities. The Israeli team comes here with their patients when they have no prosthetists. We have been invited to bring our patients to General Hospital in Port Au Prince when we have no prosthetists at Hanger in late November and December. It is pure reciprocity. The therapist and physician have invited me to come to Israel for 3 weeks in the future to learn about their system. I wonder how I can work that into scholarly activities!? The Israeli team needed some crutches and canes which we happily provided. The Israeli physician spoke about what wonderful collaboration we have and the wonderful character of people who come to Haiti to serve the people. He said it is a true life of virtuous reciprocity where we all provide for each others’ needs. The physician also shared his story of growing up in the Holy Land. He shared how much progress has been made in Israel in the last 50 years and how lucky he was to witness that as he grew up. He shared that Mark Twain wrote about what a desolate place Israel was back about 150 years ago. Twain described the land as desolate and barren and felt nothing productive would ever come from this part of the world. The Israeli physician said that it was incredible to see Israel now with its beauty and lush plants. It is truly a Holy Land. Seeing the change in his own country gives him hope for Haiti and its possibilities. Yesterday was an amazing and fun day.
Wednesday afternoon, Clair and I learned from our patients that there was no water in L’Escale. The patients were looking for buckets to bring back water with them. Apparently, someone had come by and stolen the buckets to the water filter systems in each house. The filters (which were more valuable in some minds were left behind.) It took a long time for us to get the problem resolved. We did get it resolved! Earlier one of our patients asked to bring a broom back to L’Escale so he could sweep the shower area. He felt it was unsafe and dirty. What a productive and take-action man!
We again spent time in the pool with the new team members to debrief. Then it was dinner and off to do an interview for the Physicians for Peace photographer. Finally, I made it to the library in time for a storm to blow in knocking out our internet. I then ran out of minutes on my new Haitian cell phone – as calling the US is quite expensive! It is much better to get calls from the US! Life in Haiti is beautifully hard with nothing easily done.
Shaun, our director is always so busy coordinating many things. I hope we can relieve some of his worries. He jokingly asked me when St. Kate’s will open their Haitian campus here! My mind is racing with possibilities! He has planted the seeds so we will see what happens!
A Leisurely Sunday - NOT!
A Leisurely Sunday – NOT!
Last night (Saturday) we spent some time with the prosthetists on their last night watching a movie and visiting. Then it was to bed around 10:00 pm. On Sunday I woke up bright and early as the heat prevents us from sleeping in. Our showers run from 6:00 – 7:00 am and pm only. Time for a shower and to wash out some clothes before breakfast! Clair and I were hoping to go to the beach but our plans for a ride fell through. Instead we were able to accompany Dr. Bob and his wife MJ (short for Mary Jane) to Le Petite Riviere where they wanted to visit Marco, a dear friend. They have lived in Haiti for 5 years and Dr. Bob has been involved in Haiti for over 30 years. We felt safe to be with Dr. Bob & MJ Callaway. We were excited at the prospect of getting off campus and seeing a bit of the real Haiti. Indeed we did!
Our adventure began just after breakfast of spicy eggs, bread, and coffee. We then walked through Dechapelles through the open market to the tap tap stop. In the market there was everything one could imagine for sale – even pig entrails hanging out to dry! Nevertheless there were spices, fruit, meat, clothing, and many other things. We hiked to L’ Escale where our patients stay when not in the Hanger clinic as they await their legs, receive therapy, and become competent with their new limbs. Our patients were excited to see us. Clair and I are thinking about coming here in the afternoons to do more rehab if the patients get sent home early.
We then wove our way through the country side hopping over rocks in streams and through fields to the main road where our tap tap stop was located. Soon a tap tap arrived and we were on our way to the crossroads to Le Petite Riviere. We had wall to wall people loaded onto the tap tap and we were off. MJ told us to be sure to hang on! It was one of our first moments in Haiti were we were not sweating buckets! We enjoyed beautiful scenery, the wind blowing through our hair, and then it happened! We heard an ugly clunk and suddenly the tap tap began to waver a bit. MJ commanded us to hang on and get down. Luckily the driver was able to control the tap tap to a stop. What we did not notice that Dr. Bob did notice was that the right back wheel came off and went rolling down the road ahead of the tap tap. We all dismounted from the tap tap to inspect the situation only to find that the wheel that left us all behind originally did not have lug nuts holding it on! Or, perhaps they had come loose! Fortunately, there were no injuries. Lesson learnt is to inspect the tires for lug nuts on all wheels before mounting the tap tap. We only had about a quarter mile to walk to the cross roads.
At the cross roads we took a moto taxi to the river crossing. Clair and I were on one moto and Dr. Bob and MJ on another. We told the driver “duesma” which means drive slowly! “Slowly” it seems has different meanings depending on the age of the moto driver! After a few minutes, we had to portage a small foot bridge that was about 15 feet above a ravine with a river flowing beneath it. It was quite rickety! Pictures will follow when posting my blog! Not knowing the way back meant there was no chickening out - we had to continue forward! On the other side we hiked down to the river where we had a choice of the barge cabled to an overhead wire or a boat where the crew had to bail water out as the boat crossed the river. We chose the safe route on the barge! When the barge reached the other side of the river, it was about four feet from shore in knee deep water. Several local men demanded that they give us a piggy back ride to shore! Clair, MJ, and I were then carried to shore. Dr. Bob decided this would not be the manly thing to do so he removed his running shoes and waded in! We then hiked up the hill to the town of Le Petite Riviere. Dr. Bob and MJ met their friend Marco. Clair and I were given directions to the fort and the cathedral. The cathedral was easy to spot and then we began our hike up the mountain. After a 25 minute hike we reached the top of the mountain where the old fort was sitting. We were provided with a glorious view of the Artibonite Valley. It is easy to see why the slaves chose this spot to place their fort to defeat the French! One could see for miles in all directions!
Clair and I hiked down the mountain in search of a coke! No cokes were to be found until we reached the bottom of the hill in town by the cathedral. We were so excited to find 2 cokes at one of the shops. Next, all we needed was a bit of shade. We were told we must drink our cokes at the stand. We eventually were allowed to cross the street and sit in the shade to finish them if we returned our bottles. Never has a coke tasted so good! When I returned my bottle & cap – there was much laughter! We did not want to disappoint and we returned everything!
We then met up with Dr. Bob & MJ, visited a short while with Marco. Dr. Bob saved one of Marco’s daughters many years ago so he and his friends are treated like royalty. Dr. Bob then led us off to the river via a more sane bridge and we hiked to the river barge crossing. This time however, we took the leaky boat back! I guess we felt lucky and the barge was otherwise occupied. We reconnected with our moto drivers and headed to the crossroads to catch another tap tap back to Hopital Albert Schweitzer. A very full tap tap wanted us to join them which we declined! When the next empty tap tap arrived we mounted and even had seats! We made sure to check that all wheels had lug nuts before hopping on! We forgot to tap at our stop and then got off at the main Hopital Albert Schweitzer entrance. This return route was different than our original departure route. The road is at a high incline and is full of rocks. Walking in Haiti requires that one look down at the ground so as not to fall. Looking at the ground does not necessarily mean you will not fall! The story behind the rugged roads is that the original folks who built the hospital wanted to keep tourists away and keep the hospital for the local people who needed it most. The roads were never graded or paved. Yet, it is a challenge to gain access to the hospital!
After our four hour adventure, we made it home for lunch and had time for a dip in the pool! Next was time for reading and relaxation in preparation for the upcoming week. Next week we hope to go to the beach with a group of folks where we can rent a private tap tap which is much safer than the public one! Even though we did not make it to the beach for swimming and lobsters cooked at Club Indigo (the popular beach), we had a most interesting adventure – one that we would not want to have missed. In Haiti it is always good to have plan A, B, C, and D!!!
Last night (Saturday) we spent some time with the prosthetists on their last night watching a movie and visiting. Then it was to bed around 10:00 pm. On Sunday I woke up bright and early as the heat prevents us from sleeping in. Our showers run from 6:00 – 7:00 am and pm only. Time for a shower and to wash out some clothes before breakfast! Clair and I were hoping to go to the beach but our plans for a ride fell through. Instead we were able to accompany Dr. Bob and his wife MJ (short for Mary Jane) to Le Petite Riviere where they wanted to visit Marco, a dear friend. They have lived in Haiti for 5 years and Dr. Bob has been involved in Haiti for over 30 years. We felt safe to be with Dr. Bob & MJ Callaway. We were excited at the prospect of getting off campus and seeing a bit of the real Haiti. Indeed we did!
Our adventure began just after breakfast of spicy eggs, bread, and coffee. We then walked through Dechapelles through the open market to the tap tap stop. In the market there was everything one could imagine for sale – even pig entrails hanging out to dry! Nevertheless there were spices, fruit, meat, clothing, and many other things. We hiked to L’ Escale where our patients stay when not in the Hanger clinic as they await their legs, receive therapy, and become competent with their new limbs. Our patients were excited to see us. Clair and I are thinking about coming here in the afternoons to do more rehab if the patients get sent home early.
We then wove our way through the country side hopping over rocks in streams and through fields to the main road where our tap tap stop was located. Soon a tap tap arrived and we were on our way to the crossroads to Le Petite Riviere. We had wall to wall people loaded onto the tap tap and we were off. MJ told us to be sure to hang on! It was one of our first moments in Haiti were we were not sweating buckets! We enjoyed beautiful scenery, the wind blowing through our hair, and then it happened! We heard an ugly clunk and suddenly the tap tap began to waver a bit. MJ commanded us to hang on and get down. Luckily the driver was able to control the tap tap to a stop. What we did not notice that Dr. Bob did notice was that the right back wheel came off and went rolling down the road ahead of the tap tap. We all dismounted from the tap tap to inspect the situation only to find that the wheel that left us all behind originally did not have lug nuts holding it on! Or, perhaps they had come loose! Fortunately, there were no injuries. Lesson learnt is to inspect the tires for lug nuts on all wheels before mounting the tap tap. We only had about a quarter mile to walk to the cross roads.
At the cross roads we took a moto taxi to the river crossing. Clair and I were on one moto and Dr. Bob and MJ on another. We told the driver “duesma” which means drive slowly! “Slowly” it seems has different meanings depending on the age of the moto driver! After a few minutes, we had to portage a small foot bridge that was about 15 feet above a ravine with a river flowing beneath it. It was quite rickety! Pictures will follow when posting my blog! Not knowing the way back meant there was no chickening out - we had to continue forward! On the other side we hiked down to the river where we had a choice of the barge cabled to an overhead wire or a boat where the crew had to bail water out as the boat crossed the river. We chose the safe route on the barge! When the barge reached the other side of the river, it was about four feet from shore in knee deep water. Several local men demanded that they give us a piggy back ride to shore! Clair, MJ, and I were then carried to shore. Dr. Bob decided this would not be the manly thing to do so he removed his running shoes and waded in! We then hiked up the hill to the town of Le Petite Riviere. Dr. Bob and MJ met their friend Marco. Clair and I were given directions to the fort and the cathedral. The cathedral was easy to spot and then we began our hike up the mountain. After a 25 minute hike we reached the top of the mountain where the old fort was sitting. We were provided with a glorious view of the Artibonite Valley. It is easy to see why the slaves chose this spot to place their fort to defeat the French! One could see for miles in all directions!
Clair and I hiked down the mountain in search of a coke! No cokes were to be found until we reached the bottom of the hill in town by the cathedral. We were so excited to find 2 cokes at one of the shops. Next, all we needed was a bit of shade. We were told we must drink our cokes at the stand. We eventually were allowed to cross the street and sit in the shade to finish them if we returned our bottles. Never has a coke tasted so good! When I returned my bottle & cap – there was much laughter! We did not want to disappoint and we returned everything!
We then met up with Dr. Bob & MJ, visited a short while with Marco. Dr. Bob saved one of Marco’s daughters many years ago so he and his friends are treated like royalty. Dr. Bob then led us off to the river via a more sane bridge and we hiked to the river barge crossing. This time however, we took the leaky boat back! I guess we felt lucky and the barge was otherwise occupied. We reconnected with our moto drivers and headed to the crossroads to catch another tap tap back to Hopital Albert Schweitzer. A very full tap tap wanted us to join them which we declined! When the next empty tap tap arrived we mounted and even had seats! We made sure to check that all wheels had lug nuts before hopping on! We forgot to tap at our stop and then got off at the main Hopital Albert Schweitzer entrance. This return route was different than our original departure route. The road is at a high incline and is full of rocks. Walking in Haiti requires that one look down at the ground so as not to fall. Looking at the ground does not necessarily mean you will not fall! The story behind the rugged roads is that the original folks who built the hospital wanted to keep tourists away and keep the hospital for the local people who needed it most. The roads were never graded or paved. Yet, it is a challenge to gain access to the hospital!
After our four hour adventure, we made it home for lunch and had time for a dip in the pool! Next was time for reading and relaxation in preparation for the upcoming week. Next week we hope to go to the beach with a group of folks where we can rent a private tap tap which is much safer than the public one! Even though we did not make it to the beach for swimming and lobsters cooked at Club Indigo (the popular beach), we had a most interesting adventure – one that we would not want to have missed. In Haiti it is always good to have plan A, B, C, and D!!!
The Bon Bon Lady
The Bon Bon Lady
Each morning we have quite a substantial breakfast. Yet around 10:30 we start to hear the grumbling of our stomachs! Luckily, the Bon Bon Lady arrives. She sells bon bons or what resemble banana bread cookies she has just baked. They are wonderful and cost only 10 gourdes. They are safe to eat and we tend to take turns buying bon bons for each other! We really missed the Bon Bon Lady today on Saturday as she has a day off.
Each morning we have quite a substantial breakfast. Yet around 10:30 we start to hear the grumbling of our stomachs! Luckily, the Bon Bon Lady arrives. She sells bon bons or what resemble banana bread cookies she has just baked. They are wonderful and cost only 10 gourdes. They are safe to eat and we tend to take turns buying bon bons for each other! We really missed the Bon Bon Lady today on Saturday as she has a day off.
Changing Money
Changing Money
Yesterday I had an opportunity to change $20. Clair led me to the mysterious window in the hospital where it is possible to exchange USD for Haitian Gourdes. We enter a small room and wait. There are 2 chairs to sit upon if you are lucky enough to have a small or no line. There are 2 windows with shutters and bars that are too high for any type of public negotiation. A name is called, the shutters open, and a hand passes money through the bars to a person on the other side of the corner. Apparently there is a wall separating the two rooms.
There are the two other windows – one square and one round tinted black with a small door on the other side of the glass. There is also a small slot for money and other items to be passed back and forth. The windows are likely not really tinted black. It appears there has been a black garbage bag taped to the inside of these windows. We don’t really know when someone is back behind the window.
To exchange money you approach the round window and knock. Then you wait. And wait. Eventually the shutter door behind the window opens and you slide your USD through the slot at the bottom of the window. Then you wait and wait some more. A paper eventually is sent back to you to sign. Eventually money is slid back to you as you wonder what will happen and if you will ever see any money ever again. Both Claire and I received our money. It was so dirty it was difficult to see the denominations! I now had money to add to our Prestige collection. For 210 Gourdes one can purchase 6 Prestige beers! That is about 50 Cents per beer! I also now have money for the beach!
Yesterday I had an opportunity to change $20. Clair led me to the mysterious window in the hospital where it is possible to exchange USD for Haitian Gourdes. We enter a small room and wait. There are 2 chairs to sit upon if you are lucky enough to have a small or no line. There are 2 windows with shutters and bars that are too high for any type of public negotiation. A name is called, the shutters open, and a hand passes money through the bars to a person on the other side of the corner. Apparently there is a wall separating the two rooms.
There are the two other windows – one square and one round tinted black with a small door on the other side of the glass. There is also a small slot for money and other items to be passed back and forth. The windows are likely not really tinted black. It appears there has been a black garbage bag taped to the inside of these windows. We don’t really know when someone is back behind the window.
To exchange money you approach the round window and knock. Then you wait. And wait. Eventually the shutter door behind the window opens and you slide your USD through the slot at the bottom of the window. Then you wait and wait some more. A paper eventually is sent back to you to sign. Eventually money is slid back to you as you wonder what will happen and if you will ever see any money ever again. Both Claire and I received our money. It was so dirty it was difficult to see the denominations! I now had money to add to our Prestige collection. For 210 Gourdes one can purchase 6 Prestige beers! That is about 50 Cents per beer! I also now have money for the beach!
Saturday's Physical Therapy Session
Saturday’s PT Session
Today we were able to sleep in as we did not have to be at the clinic until 9:00 am. It is funny how the heat and the daylight make it easier to wake up early. In our house, we have water for a cold shower between the hours of 6:00 – 7:00 am and 6:00 – 7:00 pm. The rest of the time we take a bucket shower which is completely adequate and refreshing. (It is amazing how much water we waste back home!) Today there was not rush for a shower and I still made it down to breakfast by 6:30. Pancakes and fruit made for a delightful breakfast, in fact, my favorite all time breakfast here. We have no syrup but the guava preserves add a wonderful taste sensation. The coffee with crème and sugar is also an incredible staple despite the heat.
We walked over to the clinic and waited for our 6 patients to arrive from L’Escale which is the community down the road where the patients are housed while awaiting their limbs. Clair and I decided to have the women walk around the block out in the community to practice their community reintegration. We paused at the half way point to sit down momentarily on the low wall in the shade. Pictures and a bit of dancing also occurred! One patient was just finishing 9th grade. The other 3 were older women. We proclaimed it to be the parade of the femn valiant or the valiant women. The walk took about a half hour and we made sure that everyone rehydrated when all were safely back at the clinic. It was great for the women to be out in mass and for others in the community to see these women walking. Two of the men remained behind to work with Luke. We then broke into small one-on-one sessions with each patient working on functional activities like balance, gait training, and strengthening exercises. Although we have the normal PT equipment such as parallel bars, balls, theraband, stairs, ramps, and a plyos ladder, we also have our patients do function activities such as carrying things like a jug of water or boxes of things on their heads as they navigate the clinic. Anywhere in Haiti it is clear that balancing items on one’s head as people navigate from one point to another over rustic terrain is the norm. No ice or snow to deal with – just rugged terrain.
We were playing catch with one of our older women and she decided to get tricky. She passed the ball between her legs, around her back, and then she tossed me the ball. Eventually, she became even trickier and as she passed the ball between her legs, her face took on a mischievous appearance. Suddenly, she passed the ball up under her shirt and began to walk around like a young pregnant woman! It was hilarious! She then feigned that it was time to have her baby. She very functionally dropped down to the ground and gave birth to our soccer ball. We were then told to cut the cord! Everyone howled with laughter! We then practiced falls recovery with everyone in the padded cubical that Clair and I put together the other day after washing down the mats. All in all it was a fun and functional morning. We said goodbye to our patients and went back to the Alumni House for lunch. The rest of the afternoon we were off so we spent time in the pool.
Tonight will be very low key and I am looking forward to a good night of sleep. I thought I was coming down with a cold, but the fresh juice we have with every meal seems to have killed any bugs attacking my system. I hope to get on the internet tonight!
Today we were able to sleep in as we did not have to be at the clinic until 9:00 am. It is funny how the heat and the daylight make it easier to wake up early. In our house, we have water for a cold shower between the hours of 6:00 – 7:00 am and 6:00 – 7:00 pm. The rest of the time we take a bucket shower which is completely adequate and refreshing. (It is amazing how much water we waste back home!) Today there was not rush for a shower and I still made it down to breakfast by 6:30. Pancakes and fruit made for a delightful breakfast, in fact, my favorite all time breakfast here. We have no syrup but the guava preserves add a wonderful taste sensation. The coffee with crème and sugar is also an incredible staple despite the heat.
We walked over to the clinic and waited for our 6 patients to arrive from L’Escale which is the community down the road where the patients are housed while awaiting their limbs. Clair and I decided to have the women walk around the block out in the community to practice their community reintegration. We paused at the half way point to sit down momentarily on the low wall in the shade. Pictures and a bit of dancing also occurred! One patient was just finishing 9th grade. The other 3 were older women. We proclaimed it to be the parade of the femn valiant or the valiant women. The walk took about a half hour and we made sure that everyone rehydrated when all were safely back at the clinic. It was great for the women to be out in mass and for others in the community to see these women walking. Two of the men remained behind to work with Luke. We then broke into small one-on-one sessions with each patient working on functional activities like balance, gait training, and strengthening exercises. Although we have the normal PT equipment such as parallel bars, balls, theraband, stairs, ramps, and a plyos ladder, we also have our patients do function activities such as carrying things like a jug of water or boxes of things on their heads as they navigate the clinic. Anywhere in Haiti it is clear that balancing items on one’s head as people navigate from one point to another over rustic terrain is the norm. No ice or snow to deal with – just rugged terrain.
We were playing catch with one of our older women and she decided to get tricky. She passed the ball between her legs, around her back, and then she tossed me the ball. Eventually, she became even trickier and as she passed the ball between her legs, her face took on a mischievous appearance. Suddenly, she passed the ball up under her shirt and began to walk around like a young pregnant woman! It was hilarious! She then feigned that it was time to have her baby. She very functionally dropped down to the ground and gave birth to our soccer ball. We were then told to cut the cord! Everyone howled with laughter! We then practiced falls recovery with everyone in the padded cubical that Clair and I put together the other day after washing down the mats. All in all it was a fun and functional morning. We said goodbye to our patients and went back to the Alumni House for lunch. The rest of the afternoon we were off so we spent time in the pool.
Tonight will be very low key and I am looking forward to a good night of sleep. I thought I was coming down with a cold, but the fresh juice we have with every meal seems to have killed any bugs attacking my system. I hope to get on the internet tonight!
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